The Preparation of Frozen Red Blood Cells and a Procedure for Deglycerolizing Frozen RBCs using COBE 2991 Blood Cell Processor / 대한수혈학회지

BACKGROUND: The cryopreservation of red blood cells (RBCs) has not ever been applied to the clinical services in Korea. The aim of this study was designed to supply the frozen-thawed RBCs as a routine service through estimation of efficiency and safety after freezing, thawing and washing. METHODS: Fifteen fresh packed RBCs were frozen with 40 percent(wt/vol) glycerol. After frozen storage at -70degrees for at least one month, the RBCs were thawed and washed in the COBE 2991 blood cell processor. We measured the blood cell count, RBC recovery rate, K+, LDH, specific gravity, osmolarity, and the percentage of hemolysis in the supernatant after deglycerolization. Autologous transfusions were done to the four voluntary donors with deglycerolized autologous blood for clinical assessment. RESULTS: The freeze-thaw-wash recovery rate of RBC was 76.8+/-10.0%, which is not enough to pass the AABB standard. But the recovery rate was increased up to 87.0+/-2.1% with the 4 stepwise predilution technique. The supernatant plasma specific gravity, osmolarity, and K+ were 1.006+/-0.001, 292+/-3 mOsm/KgH20, and 1.1+/-0.2mEq/L, respectively. The Hb ATP and 2,3-DPG were 3.6+/-0.8nmol/g and 13.4+/-4.5nmol/g. In simulated study, the free hemoglobin was 2.8+/-1.1mg/dL and 0.4+/-0.2% of total hemoglobin. In four autologous transfusion cases, plasma haptoglobin level was 96.0+/-40.8 mg/dL (reference range 30~200 mg/dL) and urine hemoglobin was not observed after 2~6 hours later after transfusion. CONCLUSION: The results of this study indicated that technical experiences for freezing, thawing and washing were established for clinical use of frozen RBCs in Korea.

A Survey of Blood Collection and Transfusion in Korea, 1998 / 대한수혈학회지

BACKGROUND: The Korean Red Cross (KRC) supplies above 98% of blood components used in Korea. The KRC reports the blood collection data annually, but the transfusion data at hospital were not included in this report. The blood supply and utilization data in 1988 were surveyed to produce basic statistics of blood collection at the blood centers and transfusion at hospitals. METHODS: Transfusion data were collected from two hundred and nine hospitals, which belong to the Korean Hospital Association. We received the answers of completed survey questionnaires about blood bank activities in hospital transfusion services. The blood collection data were cited from the KRC annual report. RESULTS: Among 93,486 beds in total hospital, 32%, 10% and 7% of the beds are located in Seoul, Pusan and Taegu, respectively. The usage of red blood cells showed a good correlation with the hospital bed numbers. However, most of the FFP and platelet concentrates were used in Seoul, Pusan, and Kyunggido. The average number of RBCs transfused per bed was 13.1 units, FFP 6.4 units, and platelet concentrate 8.5 units. The average usage of blood components increased in proportion with the bed number increases. The numbers of RBCs transfused showed a good correlation with those of FFP and platelet, respectively (RBC vs. FFP r=0.68, RBC vs. platelet concentrate r=0.72). The upper top ten ranked hospitals in usage of blood components were mostly university hospitals. Forty five percent of total whole bloods, 22% of packed RBC, 37% of FFP, and 43% of platelet concentrates were used in these top ten ranked hospitals. CONCLUSION: The averages of blood component transfusion units and the loss of blood from collection to transfusion for the patients were higher than those of other developed countries. Finally, for further effective blood usage, we should analyze the blood component transfused in hospital annually, and the supply of blood components by KRC should be controlled according to the demands of transfusion in hospitals.

Red Cell Depletion from the Bone Marrow Aspirates for the ABO Incompatible Transplantation by Apheresis Separations / 대한혈액학회지

BACKGROUND: Allogeneic bone marrow transplantation across ABO incompatibility barriers may result in immune mediated hemolysis. Hemolysis may be avoided by RBC depletion from the graft. In vitro graft manipulations carry the risk of hematopoietic stem cell loss, a factor that may be most important in graft failure. We report 16 major ABO blood group incompatible allogeneic bone marrow transplants using erythrocyte depletion of marrow prior to infusion. METHODS: From March 1997 to July 2001 in Yonsei University College of Medicine, 16 patients underwent ABO blood group incompatible allogeneic BMT: 5 for acute myelocytic leukemia, 5 for severe aplastic anemia, 3 for acute lymphocytic leukemia, 2 for chronic myelocytic leukemia, and 1 for myelodysplastic syndrome. RBC depletions were done with automatic cell separator, COBE Spectra (COBEBCT Inc., Lakewood, USA). RBC removal rates and mononuclear cell recovery rates were calculated. And the evidence of successful engraftment and intravascular hemolysis were also evaluated. RESULTS: The RBC removal rate was 99.1+/-0.0% and a mean of 1% of the original red cell volume was contained in the final infusate. The mononuclear cell recovery rate was 70.0+/-16.3% from the original MNCs. Fourteen patients tolerated the infusion of the marrow concentrates without any adverse effects. Two patients experienced hemoglobinuria, but disappeared within 2 days by continued observation. After transplantation, absolute neutrophil counts exceeded 500/nL by 10.8+/-1.9 days, platelet counts exceeded 50,000/nL by 30.5+/-8.5 days, and reticulocytosis sustained at >1% was by 25.8+/-13.9 days. CONCLUSION: RBC depletion from ABO major mismatched bone marrow aspirates by the automatic cell separator is a safe and effective technique.

Establishment of an HLA-matched Platelet Donor Registry for the Management of Patients with Platelet Refractoriness / 대한수혈학회지

BACKGROUND: Heavily transfused patients commonly become refractory to platelet transfusion. Patients with platelet refractoriness due to HLA alloimmunization need HLA-matched platelet transfusion. We have established an hospital-based donor registry of HLA-typed platelet donors for the first time in Korea and evaluated the possibility of HLA-matched platelet supplies. METHODS: A total of 450 donors were registered and typed for HLA class I (A, B, C) antigens. A computer program was developed and used for the donor registry and HLA-matched donor search. A simulation study was performed on the availability of HLA-matched platelets for 100 patients from a pool of 450 donors. The availability of HLA-matched and cross reactive epitope group (CREG)-matched donors were analysed for HLA-A, B antigens. The CREGs defined by Fuller, Rodey, and UCLA criteria were used. RESLUTS: Among 100 patients, 63% had HLA-identical or HLA-matched (match grade: A, B1U, B2U) donors with only a low number of donors (mean 1.4) available per patient. Including CREG-matches (match grade: B1X, B2UX, B2X), majority (98%) of the patients had HLA- or CREG-matched (match grade: A~B2X) platelet donors with a higher number of donors (mean 26.6~40.5 by different CREG criteria) available per patient. Majority (86-98%) of the patients had 20 or more A~B4X matched donors, and about two thirds (61-74%) of the patients had 20 or more A~B2X matched donors. However, the number of ABO-identical matched donors was less than 30% of the total HLA- or CREG-matched donors. CONCLUSION: We established an HLA-matched platelet donor registry and using a donor pool size of < 500 donors, attainable in an hospital-based donor registry, the possibility of HLA-matched platelet supplies was confirmed in this study. However, for more satisfactory and ABO-matched platelet supplies a larger pool size is needed.

Development of decision support system for antibody identification / 대한수혈학회지

BACKGROUND: Determination of antibody specificity using antigram spread sheet requires experience and knowledge on in vitro characteristics of red cell antibodies, time-consuming, and still subjective to human error. A computer-based antibody identification system was developed to overcome these disadvantages. METHODS: Decision support system program for antibody identification was designed using Visual Basic 5.0 for Dade Data-cyte Plus. This system integrates the reaction patterns of saline, 37degrees C albumin, antiglobulin, 4degrees C saline enzyme treated and user-defined phases and lists the antibodies according to the probability. 115 irregular antibodies previously confirmed by standard manual method reanalyzed with this program. RESULTS: In 111 of 115 cases (96.5%), this system produced the same results with the manual identification. In two cases, of not matched 4 cases the computer program suggested additional antibodies and in one case, the computer program detected previous human error. In the other case, antibody identification was possible only after further tests including selective adsorption of multiple antibodies. CONCLUSION: The decision support system was rapid and easy and showed good concordance rate when compared with manual antibody identificaion results. In addition, human error could be reduced. Decision support system for antibody identification could be used in small blood banks by less experienced staffs.

A surgical review of gastroduodenal ulcer

No abstract available.

Autophor ceramic total hip arthroplasty: thirteen hips followed-up more than five years / 대한정형외과학회잡지

No abstract available.

Treatment of Fracture of Tibial Shaft with Rush Nails or Ender Nails: Comparative Study / 대한정형외과학회잡지

In the orthopaedic literatures of the past thirty years, many methods of treating fractures of the tibial shaft have been reported, and there have been many analyses of the end results of such treatments. Recently, closed flexible intramedullary nailing have been widely used to treat fractures, and results were also presented. These nails were inserted using a relatively simple procedure without reaming. The fracture site was disrupted minimally, thereby lessening the risk of infection. Dynamic controlled motion at the fracture site led to early callus formation. However, there were only few reports of comparative study of the results of intramedullary nailing such as Rush and Ender nsilings. Authors csrried out retrospective study of the 51 tibial shaft fractures that were internally fixed with Rush or Ender nails, who were trested at the Orthopaedic Depsrtment, Kang-Nam St. Mary's Hospital, from May 1981 to May 1987. The results were as follows :1. The radiological union was obtained at 12.8 weeks in Ender nailing group, and 13.7 weeks in Rush nailing group. The median healing time was shorter in the Ender nailing group than the Rush nailing group. 2. Ratio of the external callus formation did not show the difference between Ender and Rush nailing groups. 3. Rush nailing group had more complications than Ender nailing group. Especially, among 4 cases not associated with fibular fracture in Ender nailing group, 2 cases had varus malunion of the fractured tibia. 4. Even in the distal 1/3 tibial fracture, Ender and Rush nailings were well indicated.

Fatigue Failure of Wire in Orthopaedic Use / 대한정형외과학회잡지

Orthopaedic wire has been used widely as a good internal fixator in cases of fracture, the ligament reconstruction, and for the stabilization of cervical spine. But if it is used inappropriately, a wire can be easy to fail by elongation, untwisting, or breakage. Among them, the most common failure of wire is breakage. To clarify the mechanism and the causes of wire failure, the authors analysed serial roentgenograms and scanning electronmicroscopic findings of broken wire in total 13 cases, which were experienced at the department of orthopaedic surgery, St. Mary's Hospital, Catholic University Medical College From January 1981 to December 1987. The results obtained were as follows :1. The mechanism of wire failure were classified into the 4 types ; minor continual flexing motion in 6 cases, repeated minor back and forth torsion in 1 case, tension failure in 2 cases and combined type in 4 cass. 2. The causes of wire failure were in appropriate use and inadequte application, a lack of s ufficient mechanical strength, micromotion due to inadequate postoperative imm obilization, early mobilization before tissue healing as well as certain injuries to the wire during handling in operation.