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1.
Article in English | WPRIM | ID: wpr-903727

ABSTRACT

Background/Aims@#Febrile neutropenia (FN) interferes with the proper chemotherapy dose density or intensity in non-Hodgkin’s lymphoma (NHL) patients. Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) ± rituximab has an intermediate FN risk. Prophylactic granulocyte colony-stimulating factor (G-CSF) support is recommended for patients with other host-related risk factors. @*Methods@#We evaluated the risk factors for FN-related admission in NHL patients who have received primary G-CSF (lenograstim) prophylaxis. @*Results@#Data from 148 patients were analyzed. The incidence of neutropenic fever was 96 events (12.2%), and the median period was 3.85 days (range, 0 to 5.9); the median duration of neutropenia was 4.21 days (range, 3.3 to 5.07). Eighty-three FN-related admissions were reported. Advanced age (> 60 years), female sex, a low albumin level, and prednisone use were associated with FN-related admission in multivariable analysis (p = 0.010, p < 0.001, and p = 0.010, respectively). A comparison between diffuse large B-cell lymphoma patients treated with R-CHOP and pegylated G-CSF and those treated with R-CHOP and lenograstim did not reveal significant differences in the FN-related admission rate between the two groups, although the lenograstim-treated group had a higher incidence of severe neutropenia. @*Conclusions@#Elderly patients, female patients, and patients with low albumin levels need to be actively followed-up for FN even when primary prophylaxis with G-CSF has been used.

2.
Korean Circulation Journal ; : 866-874, 2021.
Article in English | WPRIM | ID: wpr-901665

ABSTRACT

Background and Objectives@#It is crucial to understand the exact public health burden of out-of-hospital cardiac arrest (OHCA) cases; this is presently unknown since sufficient episodes are not reported in registry studies. We aimed to evaluate the epidemiologic features and outcomes of non-traumatic OHCA. @*Methods@#During January 2008 to December 2017, we enrolled 387,665 patients who had been assigned a code for sudden cardiac arrest or had undergone cardiopulmonary resuscitation in the emergency room using the Korean National Health Insurance Service database. Those whose arrest was of non-cardiac origin were excluded. @*Results@#The incidence of OHCA per 100,000 patients increased steadily from 48.2 in 2008 to, 53.8 in 2011, 60.1 in 2014, and 66.7 in 2017, with a 1-year survival rate of 8.2%. Age and sex-adjusted mortality rates showed a decreasing trend. The hazard ratio was 1.0015 in 2009, 0.9865 in 2012, 0.9769 in 2015, and 0.9629 in 2017 (p for trend <0.0001), with coronary artery disease-related OHCA accounting for 59.8% of the total. Subgroups with coronary artery disease-related OHCA were more likely to be older and have a higher prevalence of all related comorbidities, excluding malignancy, than those with non-coronary artery disease-related OHCA. @*Conclusions@#This nationwide population-based study showed that the incidence of OHCA in Korea had increased during the last decade. The post OHCA 1-year mortality rate showed a poor outcome but improved gradually.

3.
Article in English | WPRIM | ID: wpr-896023

ABSTRACT

Background/Aims@#Febrile neutropenia (FN) interferes with the proper chemotherapy dose density or intensity in non-Hodgkin’s lymphoma (NHL) patients. Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) ± rituximab has an intermediate FN risk. Prophylactic granulocyte colony-stimulating factor (G-CSF) support is recommended for patients with other host-related risk factors. @*Methods@#We evaluated the risk factors for FN-related admission in NHL patients who have received primary G-CSF (lenograstim) prophylaxis. @*Results@#Data from 148 patients were analyzed. The incidence of neutropenic fever was 96 events (12.2%), and the median period was 3.85 days (range, 0 to 5.9); the median duration of neutropenia was 4.21 days (range, 3.3 to 5.07). Eighty-three FN-related admissions were reported. Advanced age (> 60 years), female sex, a low albumin level, and prednisone use were associated with FN-related admission in multivariable analysis (p = 0.010, p < 0.001, and p = 0.010, respectively). A comparison between diffuse large B-cell lymphoma patients treated with R-CHOP and pegylated G-CSF and those treated with R-CHOP and lenograstim did not reveal significant differences in the FN-related admission rate between the two groups, although the lenograstim-treated group had a higher incidence of severe neutropenia. @*Conclusions@#Elderly patients, female patients, and patients with low albumin levels need to be actively followed-up for FN even when primary prophylaxis with G-CSF has been used.

4.
Korean Circulation Journal ; : 866-874, 2021.
Article in English | WPRIM | ID: wpr-893961

ABSTRACT

Background and Objectives@#It is crucial to understand the exact public health burden of out-of-hospital cardiac arrest (OHCA) cases; this is presently unknown since sufficient episodes are not reported in registry studies. We aimed to evaluate the epidemiologic features and outcomes of non-traumatic OHCA. @*Methods@#During January 2008 to December 2017, we enrolled 387,665 patients who had been assigned a code for sudden cardiac arrest or had undergone cardiopulmonary resuscitation in the emergency room using the Korean National Health Insurance Service database. Those whose arrest was of non-cardiac origin were excluded. @*Results@#The incidence of OHCA per 100,000 patients increased steadily from 48.2 in 2008 to, 53.8 in 2011, 60.1 in 2014, and 66.7 in 2017, with a 1-year survival rate of 8.2%. Age and sex-adjusted mortality rates showed a decreasing trend. The hazard ratio was 1.0015 in 2009, 0.9865 in 2012, 0.9769 in 2015, and 0.9629 in 2017 (p for trend <0.0001), with coronary artery disease-related OHCA accounting for 59.8% of the total. Subgroups with coronary artery disease-related OHCA were more likely to be older and have a higher prevalence of all related comorbidities, excluding malignancy, than those with non-coronary artery disease-related OHCA. @*Conclusions@#This nationwide population-based study showed that the incidence of OHCA in Korea had increased during the last decade. The post OHCA 1-year mortality rate showed a poor outcome but improved gradually.

5.
Blood Research ; : 243-251, 2021.
Article in English | WPRIM | ID: wpr-913728

ABSTRACT

Background@#Chronic lymphocytic leukemia (CLL) is the most common type of adult leukemia in Western countries but is rare in the East Asian countries. Due to its rarity and the lack of feasible novel agents and laboratory prognostic tools, there are limited data on the clinical outcomes of this disease in Asia. To clarify the current treatment status, we performed a multicenter retrospective analysis of patients with CLL in Korea. @*Methods@#The medical records of 192 eligible patients between 2008 and 2019 were reviewed for clinical characteristics, treatment courses, and outcomes. The first-line treatment regimens of the patients included in this analysis were as follows: fludarabine/cyclophosphamide/rituximab (FCR) (N=117, 52.7%), obinutuzumab plus chlorambucil (GC) (N=30, 13.5%), and chlorambucil monotherapy (N=24, 10.8%). @*Results@#The median progression-free survival (PFS) was 55.6 months, and the average 2-year PFS rate was 80.3%. PFS was not significantly different between the patients receiving FCR and those receiving GC; however, chlorambucil treatment was associated with significantly inferior PFS (P <0.001). The median overall survival was 136.3 months, and the average 5- and 10-year OS rates were 82.0% and 57.4%, respectively. @*Conclusion@#This is one of the largest studies involving Korean patients with CLL. Although the patients had been treated with less favored treatment regimens, the outcomes were not different from those reported in Western studies.

6.
Article in English | WPRIM | ID: wpr-875504

ABSTRACT

Background/Aims@#Although the use of surveillance 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is discouraged in patients with diffuse large B-cell lymphoma, its usefulness in different subtypes has not been thoroughly investigated. @*Methods@#We retrospectively evaluated 157 patients who showed positive results on surveillance FDG-PET/CT every 6 months following complete response for up to 5 years. All of the patients also underwent biopsies. @*Results@#Seventy-eight (49.6%) of 157 patients had true positive results; the remaining 79 (50.3%), including eight (5.1%) with secondary malignancies, were confirmed to yield false positive results. Among the 78 patients with true positive results, the disease in seven (8.9%) had transformed to a different subtype. The positive predictive value (PPV) of FDG-PET/CT for aggressive B-cell non-Hodgkin’s lymphoma (NHL) was lower than that for indolent B-cell or aggressive T-cell NHL (p = 0.003 and p = 0.018, respectively), especially in patients with a low/low-intermediate international prognostic index (IPI) upon a positive PET/CT finding. On the other hand, indolent B-cell and aggressive T-cell NHL patients showed PPVs of > 60%, including those with low/low-intermediate secondary IPIs. @*Conclusions@#The role of FDG-PET/CT surveillance is limited, and differs according to the lymphoma subtype. FDG-PET/CT may be useful in detecting early relapse in patients with aggressive T-cell NHL, including those with low/low-intermediate risk secondary IPI; as already known, FDG-PET/CT has no role in aggressive B-cell NHL. Repeat biopsy should be performed to discriminate relapse or transformation from false positive findings in patients with positive surveillance FDG-PET/CT results.

7.
Article in English | WPRIM | ID: wpr-875491

ABSTRACT

Background/Aims@#We investigated the impact of obesity on the clinical outcomes following percutaneous coronary intervention (PCI). @*Methods@#We included South Koreans aged > 20 years who underwent the Korean National Health Screening assessment between 2009 and 2012. Obesity was defined using the body mass index (BMI), according to the World Health Organization’s recommendations. Abdominal obesity was defined using the waist circumference (WC), as defined by the Korean Society for Obesity. The odds and hazard ratios in all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed up to the end of 2017. @*Results@#Among 130,490 subjects who underwent PCI, the mean age negatively correlated with BMI. WC, hypertension, diabetes, dyslipidemia, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels correlated with the increased BMI. The mortality rates were higher in the lower BMI and WC groups than the higher BMI and WC groups. The non-obese with abdominal obesity group showed a mortality rate of 2.11 per 1,000 person-years. Obese with no abdominal obesity group had the lowest mortality rate (0.88 per 1,000 person-years). The mortality showed U-shaped curve with a cut-off value of 29 in case of BMI and 78 cm of WC. @*Conclusions@#The mortality showed U-shaped curve and the cut-off value of lowest mortality was 29 in case of BMI and 78 cm of WC. The abdominal obesity may be associated with poor prognosis in Korean patients who underwent PCI.

8.
Article in English | WPRIM | ID: wpr-875447

ABSTRACT

Background/Aims@#Compared with Western countries, chronic lymphocytic leukemia (CLL) rarely occurs in Asia and has different clinical characteristics. Thus, we aimed to evaluate the clinical characteristics, treatment outcomes, and prognostic significance of Korean patients with CLL. @*Methods@#We retrospectively analyzed 90 patients with CLL who had received chemotherapy at 6 centers in Korea between 2000 and 2012. @*Results@#Compared with Western patients with CLL, Korean patients with CLL express lambda (42.0%) and atypical markers such as CD22 and FMC7 (76.7% and 40.0%, respectively) more frequently. First-line chemotherapy regimens included chlorambucil (n = 43), fludarabine and cyclophosphamide (FC) (n = 20), fludarabine (n = 13), rituximab-FC (n = 4). The remaining patients were treated with other various regimens (n = 10). The 5-year overall survival (OS) and progression-free survival (PFS) rates were 79.3% and 28.1%, respectively. Multivariate analyses showed that hyperleukocytosis (≥ 100 × 103/μL), extranodal involvement, and the Binet C stage were significant negative prognostic factors for OS (hazard ratio [HR] 4.75, p = 0.039; HR 21.6, p = 0.002; and HR 4.35, p = 0.034, respectively). Cytogenetic abnormalities including complex karyotypes (≥ 3), del(11q), and del(17) had a significantly adverse impact on both OS and PFS (p < 0.001 and p = 0.010, respectively). @*Conclusions@#Initial hyperleukocytosis, extranodal involvement, complex karyotype, del(17) and del(11q) need to be considered in the risk stratification system for CLL.

9.
Blood Research ; : 6-16, 2021.
Article in English | WPRIM | ID: wpr-874333

ABSTRACT

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, is a condition characterized by abnormal blood clot formation in the pulmonary arteries and the deep venous vasculature. It is often serious and sometimes even fatal if not promptly and appropriately treated. Moreover, the later consequences of VTE may result in reduced quality of life. The treatment of VTE depends on various factors, including the type, cause, and patient comorbidities. Furthermore, bleeding may occur as a side effect of VTE treatment. Thus, it is necessary to carefully weigh the benefits versus the risks of VTE treatment and to actively monitor patients undergoing treatment. Asian populations are known to have lower VTE incidences than Western populations, but recent studies have shown an increase in the incidence of VTE in Asia. A variety of treatment options are currently available owing to the introduction of direct oral anticoagulants.The current VTE treatment recommendation is based on evidence from previous studies, but it should be applied with careful consideration of the racial, genetic, and social characteristics in the Korean population.

10.
Laboratory Medicine Online ; : 330-333, 2020.
Article in English | WPRIM | ID: wpr-902673

ABSTRACT

Hu5F9-G4, an immunoglobulin 4 (IgG4) monoclonal humanized antibody targeting CD47, is under active clinical trials as a novel immunotherapeutic for hematologic and solid malignancies and can cause pretransfusion testing interference. In this study, we demonstrate our first experience of Hu5F9-G4 interference with serologic testing and mitigate this interference through multiple platelet alloadsorption. A 69-year-old woman with a history of ureter cancer presented with anemia. On routine blood group typing, the patient showed strong agglutination (4+) with anti-A, A, and B cells. Unexpectedly, antibody screening and identification showed panreactivity to all panel cells, although the autocontrol result was negative. Medical records revealed that she was enrolled in an anti-CD47 clinical trial. To eliminate interference by the drug, we attempted alloadsorption using pooled platelets that were prepared from segments of random single donor platelets. After seven alloadsorption sessions using pooled allogeneic platelets, the ABO discrepancy and panreactivity was resolved. To our knowledge, this is the first demonstration of anti-CD47 interference elimination in Korea.

11.
Laboratory Medicine Online ; : 330-333, 2020.
Article in English | WPRIM | ID: wpr-894969

ABSTRACT

Hu5F9-G4, an immunoglobulin 4 (IgG4) monoclonal humanized antibody targeting CD47, is under active clinical trials as a novel immunotherapeutic for hematologic and solid malignancies and can cause pretransfusion testing interference. In this study, we demonstrate our first experience of Hu5F9-G4 interference with serologic testing and mitigate this interference through multiple platelet alloadsorption. A 69-year-old woman with a history of ureter cancer presented with anemia. On routine blood group typing, the patient showed strong agglutination (4+) with anti-A, A, and B cells. Unexpectedly, antibody screening and identification showed panreactivity to all panel cells, although the autocontrol result was negative. Medical records revealed that she was enrolled in an anti-CD47 clinical trial. To eliminate interference by the drug, we attempted alloadsorption using pooled platelets that were prepared from segments of random single donor platelets. After seven alloadsorption sessions using pooled allogeneic platelets, the ABO discrepancy and panreactivity was resolved. To our knowledge, this is the first demonstration of anti-CD47 interference elimination in Korea.

12.
Article | WPRIM | ID: wpr-836066

ABSTRACT

This report summarizes the 2019 survey results of the external quality assessment (EQA) scheme for the Transfusion Medicine Program (TMP) in Korea. Proficiency testing materials were prepared at the Asan Medical Center for the biannual distribution to participating laboratories. The average accuracy rates and number of participants (in parenthesis) for ten survey items were as follows: ABO typing, 99.4%–99.9% (N=875); RhD typing, 99.8%–100% (N=864); crossmatching, 90.8%–99.6% (N=760); ABO subtyping, 98.2% and 100% (N=58); Rh CcEe antigen testing, both 100% (N=55); weak D test, 97.9%–100% (N=232); antibody screening, 99.7%– 100% (N=316); direct antiglobulin test (DAT) using a polyspecific reagent, 99.6%–100% (N=273); DAT using an immunoglobulin-G monospecific reagent, both 100.0% (N=67); DAT using a C3d monospecific reagent, 95.6%–98.5% (N=67); antibody identification, 87.9%–99.2% (N=132); and ABO Ab titration, 85.7%–100% (N=134). The number of participants showed an average increase of 14% across the ten survey items, with the ABO antibody titration showing the highest increase at 83.6%. While results were generally excellent, antibody identification and ABO antibody titration results showed room for improvement. The 2019 EQA scheme for TMP has contributed to the improvement and maintenance of the participating laboratories to the program.

13.
Article | WPRIM | ID: wpr-835578

ABSTRACT

The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is increasing globally. However, a few studies have addressed their epidemiology in Seoul, Korea. In this study, we conducted one-year surveillance of CRE among 1,468 clinical isolates of Enterobacteriaceae at the hospital in Seoul with molecular characterization of carbapenemase genes. About 85% of CRE-positive samples were isolated from the elderly age group (above 60 years). The most common isolated organisms were Klebsiella pneumoniae (K. pneumoniae) (56.5%) and Escherichia coli (E.coli) (17.0%). We detected six different Carbapenemase-producing Enterobacteriaceae (CPE) of blaKPC, blaNDM, blaOXA, blaVIM, blaIMP, and blaGES alone or in combination with other bla genes. Typically, 853 (58.1%) isolates were tested positive for at least one CPE. KPC (K. pneumoniae carbapenemase)-2 was the most common CPE type (46.0%) followed by NDM (New Delhi metallo-β-lactamase)-1 (5.9%). KPC-2 was most commonly found in K. pneumoniae (494/676 isolates [73.1%]) and E.coli (107/676 isolates [15.8%]), whereas NDM-1 was commonly found in Enterobacter cloacae complex (20/86 isolates [23.3%]). Detailed information and molecular characteristics of CPE is essential to prevent the spread of these pathogens.

14.
Article | WPRIM | ID: wpr-831772

ABSTRACT

The objective of this study was to compare changes in the simplified disease activity index (SDAI) between biologic (b) and conventional (c) disease-modifying antirheumatic drugs (DMARD) users with seropositive rheumatoid arthritis (RA) in daily clinical practice. Methods: This was a nationwide multicenter observational study. Patients who had three or more active joint counts and abnormal inf lammatory marker in blood test were enrolled. The selection of DMARDs was determined by the attending rheumatologist. Clinical parameters, laboratory findings, and Health Assessment Questionnaire (HAQ) scores were obtained at baseline and at 6 and 12 months. Serial SDAI changes and clinical remission rate at 6 and 12 months were assessed. Results: A total of 850 patients participated in this study. The mean baseline SDAI score in bDMARD group was higher than that in cDMARD group (32.08 ± 12.98 vs 25.69 ± 10.97, p < 0.0001). Mean change of SDAI at 12 months was –19.0 in the bDMARD group and –12.6 in the cDMARD group (p < 0.0001). Clinical remission rates at 12 months in bDMARD and cDMARD groups were 15.4% and 14.6%, respectively. Patient global assessment and HAQ at 12 months were also significantly improved in both groups. Multivariate logistic regression showed that baseline HAQ score was the most notable factor associated with remission. Conclusions: There was a significant reduction in SDAI within 12 months after receiving DMARDs in Korean seropositive RA patients irrespective of bDMARD or cDMARD use in real-world practice. Clinical remission was achieved in those with lower baseline HAQ scores.

15.
Article | WPRIM | ID: wpr-831755

ABSTRACT

Thrombotic microangiopathy (TMA) is defined by specific clinical characteristics, including microangiopathic hemolytic anemia, thrombocytopenia, and pathologic evidence of endothelial cell damage, as well as the resulting ischemic end-organ injuries. A variety of clinical scenarios have features of TMA, including infection, pregnancy, malignancy, autoimmune disease, and medications. These overlapping manifestations hamper differential diagnosis of the underlying pathogenesis, despite recent advances in understanding the mechanisms of several types of TMA syndrome. Atypical hemolytic uremic syndrome (aHUS) is caused by a genetic or acquired defect in regulation of the alternative complement pathway. It is important to consider the possibility of aHUS in all patients who exhibit TMA with triggering conditions because of the incomplete genetic penetrance of aHUS. Therapeutic strategies for aHUS are based on functional restoration of the complement system. Eculizumab, a monoclonal antibody against the terminal complement component 5 inhibitor, yields good outcomes that include prevention of organ damage and premature death. However, there remain unresolved challenges in terms of treatment duration, cost, and infectious complications. A consensus regarding diagnosis and management of TMA syndrome would enhance understanding of the disease and enable treatment decision-making.

16.
Cancer Research and Treatment ; : 1262-1272, 2020.
Article | WPRIM | ID: wpr-831146

ABSTRACT

Purpose@#The epidemiology of B-cell non-Hodgkin lymphoma (BNHL) in Asia is not well described, and rates of second primary malignancies (SPM) in these patients are not known. We aimed to describe temporal changes in BNHL epidemiology and SPM incidence in Korea. @*Materials and Methods@#A retrospective cohort study used claims data from the National Health Insurance Service that provides universal healthcare coverage in Korea. Newly diagnosed patients aged at least 19 years with a confirmed diagnosis of one of six BNHL subtypes (diffuse large cell B-cell lymphoma [DLBCL], small lymphocytic and chronic lymphocytic [CLL/SLL], follicular lymphoma [FL], mantle cell lymphoma [MCL], marginal zone lymphoma [MZL], and lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia [WM]) during the period 2006-2015 were enrolled and followed up until death, dis-enrolment, or study end, whichever occurred first. Patients with pre-existing primary cancers prior to the diagnosis of BNHL were excluded. @*Results@#A total of 19,500 patients with newly diagnosed BNHL were identified out of 27,866 with non-Hodgkin lymphoma (NHL). DLBCL was the most frequently diagnosed subtype (41.9%-48.4% of NHL patients annually, 2011-2015). Standardized incidence of the six subtypes studied per 100,000 population increased from 5.74 in 2011 to 6.96 in 2015, with most increases in DLBCL, FL, and MZL. The incidence (95% confidence interval) of SPM per 100 person-years was 2.74 (2.26-3.29) for CLL/SLL, 2.43 (1.57-3.58) for MCL, 2.41 (2.10-2.76) for MZL, 2.23 (2.07-2.40) for DLBCL, 1.97 (1.61-2.38) for FL, and 1.41 (0.69-2.59) for WM. @*Conclusion@#BNHL has been increasingly diagnosed in Korea. High rates of SPM highlight the need for continued close monitoring to ensure early diagnosis and treatment.

17.
Article | WPRIM | ID: wpr-831060

ABSTRACT

Purpose@#The treatment outcome of brentuximab vedotin (BV) has not been related with CD30 expressionin previous studies enrolling patients with a wide range of CD30 expression level.Thus, this study explored the efficacy of BV in high-CD30–expressing non-Hodgkin lymphoma(NHL) patients most likely to benefit. @*Materials and Methods@#This phase II study (Clinicaltrials.gov: NCT02280785) enrolled relapsed or refractory high-CD30–expressing NHL, with BV administered intravenously at 1.8 mg/kg every 3 weeks.The primary endpoint was > 40% disease control rate, consisting of complete response(CR), partial response (PR), or stable disease. We defined high CD30 expression as ! 30%tumor cells positive for CD30 by immunohistochemistry. @*Results@#High-CD30-expressing NHL patients (n=33) were enrolled except anaplastic large cell lymphoma.The disease control rate was 48.5% (16/33) including six CR and six PR; six patients(4CR, 2PR) maintained their response over 16 completed cycles. Response to BV and survivalwere not associated with CD30 expression levels. Over a median of 29.2 months offollow-up, the median progression-free and overall survival rates were 1.9 months and 6.1months, respectively. The most common adverse events were fever (39%), neutropenia(30%), fatigue (24%), and peripheral sensory neuropathy (27%). In a post-hoc analysis forthe association of multiple myeloma oncogene 1 (MUM1) on treatment outcome, MUM1-negative patients showed a higher response (55.6%, 5/9) than MUM1-positive patients(13.3%, 2/15). @*Conclusion@#BV performance as a single agent was acceptable in terms of disease control rates and toxicityprofiles, especially MUM1-negative patients.

18.
Article in Korean | WPRIM | ID: wpr-765647

ABSTRACT

BACKGROUND: Transfusion in neonates and infants can be performed using an electromechanical infusion system that has appropriate accuracy in terms of flow rate, volume, and bolus. However, there are no infusion systems approved for transfusion in Korea. In this study, we evaluate the performance of two electromechanical infusion systems for transfusion in pediatric patients. METHODS: We tested two systems, Baxter and Terumo, using 9 units of leukocyte-filtered red blood cells. The blood samples were delivered through the systems at constant speeds of 10, 30, and 100 mL/hr, and the accuracy in terms of the delivered volume was estimated. Before and after infusion, hemoglobin, hematocrit, plasma hemoglobin, potassium, and lactate dehydrogenase levels were measured in each sample. The percentage of hemolysis (%Hemolysis) was calculated to evaluate the safety of the infusion systems. RESULTS: For Terumo, the mean error rate of the infused volume was less than 5%. We expect that Terumo can transfuse blood at a volume close to the set volume. Further, both infusion systems showed acceptable %Hemolysis levels (mean±standard deviation: Terumo, 0.14±0.04; Baxter, 0.17±0.06). CONCLUSIONS: Both infusion systems can be used safely for transfusion in pediatric patients.


Subject(s)
Erythrocyte Transfusion , Erythrocytes , Hematocrit , Hemolysis , Humans , Infant , Infant, Newborn , Korea , L-Lactate Dehydrogenase , Plasma , Potassium
19.
Article in English | WPRIM | ID: wpr-765088

ABSTRACT

Para-Bombay phenotypes are rare blood groups that have inherent defects in producing H antigens associated with FUT1 and/or FUT2. We report the first case of para-Bombay blood type in a Southeast Asian patient admitted at a tertiary hospital in Korea. A 23-year-old Indonesian man presented to the hospital with fever and was diagnosed with a disseminated nontuberculous mycobacterium infection and anemia. During blood group typing for blood transfusion, cell typing showed no agglutination with both anti-A and anti-B reagents. Serum typing showed strong reactivity against B cells and trace agglutination pattern with A1 cells. His red blood cells failed to react with anti-H reagents. Direct sequencing of FUT1 and FUT2 revealed a missense variation, c.328G>A (p.Ala110Thr, rs56342683, FUT1*01W.02), and a synonymous variant, c.390C>T (p.Asn130=, rs281377, Se³⁵⁷), respectively. This highlights the need for both forward and reverse grouping.


Subject(s)
ABO Blood-Group System , Agglutination , Anemia , Asian Continental Ancestry Group , B-Lymphocytes , Blood Group Antigens , Blood Transfusion , Erythrocytes , Fever , Humans , Indicators and Reagents , Korea , Mycobacterium Infections, Nontuberculous , Phenotype , Tertiary Care Centers , Young Adult
20.
Article in English | WPRIM | ID: wpr-764234

ABSTRACT

Legionella species are abundant in the built environment and are increasingly recognized as a cause of Legionnaires' disease (LD). As the number of cases of Legionnaires' disease acquired by local communities in the Seoul metropolitan area in Korea has been increased, there was concern that changes in environmental factors could affect disease outbreaks. We described the association between climatic variables and occurrence of legionellosis in Korea and Legionella detection rate in Seoul area. A total of 418 cases of legionellosis were reported between 2014 and 2017. There was a seasonal peak in summer. LD continuously occurred from early spring to winter every year and rapidly increased in summer. In the regression analysis, the primary variables of interest- PM2.5 (µg/m³), NO₂ (ppb), and a number of the date of issue O₃ warning were not significant except for average temperature (R²=0.8075). The Legionella detection rate in Seoul, Korea showed a trend similar to precipitation (P=0.708, ANOVA). A relatively high proportion of Legionella detection rate was shown, especially cooling tower (17.7%) and public bath (19.3%). This finding is in line with current understanding of the ecological profile of this pathogen and supports the assertion that legionellosis occurs through contamination of water sources.


Subject(s)
Baths , Disease Outbreaks , Epidemiology , Korea , Legionella , Legionellosis , Legionnaires' Disease , Regression Analysis , Seasons , Seoul , Water
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