Blood Transfusion Status Based on the Literature of the 1920s in Korea / 대한수혈학회지

The ABO blood type was discovered by Karl Landsteiner in 1901. The frequency of occurrence of the ABO blood type in Korea was reported in the journal of the Joseon Medical Association in 1922. The status of 54 transfusions at one medical clinic in 1924 was reported at a medical congress in 1925. Many direct transfusion cases in Korea were identified by a literature search for articles published during the 1920s.

Analysis of Results of Donor Blood Screening Tests of Hanmaeum Blood Center (2011~2020) / 대한수혈학회지

Background@#According to blood management law, serology and nucleic acid testing (NAT) are performed for HIV, HBV, HCV, and others as blood screening tests in Korea. The blood screening tests for HIV, HBV, and HCV have substantially improved transfusion safety. The blood screening results of one blood center were investigated because there is little domestic data available on screening tests. @*Methods@#The blood donation records and screening tests results of a supplying blood center were analyzed retrospectively from January 2011 to December 2020 in Korea. Annual first-time donation numbers, sex, and age distribution of donors were investigated during 10 years. The positivity of ALT, HBsAg, anti-HCV, and anti-HIV antibody testing and the positive cases of HIV, HCV, and HBV NAT were inquired. @*Results@#For 10 years, the blood center has collected 1,896,392 units of blood, and male donation was 1,239,873 units, which was 65.38% of total blood donation. ALT abnormal blood units were 2.06% in 2011, 2.14% in 2013, and 0.81% in 2019. The donor screening test showed HBsAg 0.03%, anti-HCV 0.02%, and anti-HIV 0.06% positivity at 2020. NAT yield cases were three with HIV, two with HCV, and 260 with HBV for 10 years. @*Conclusion@#The positivity of serology screening tests of the Hanmaeum blood center showed a decreasing trend, and the transfusion of nucleic acid positive but serologically negative blood could be prevented by performing NAT.

The Effect and Development of a Simulation Learning Module based on Schizophrenic Patients Care of Nursing Students / 정신간호학회지

Purpose@#The purpose of this study was to develop and examine the effects of a simulation learning module based on schizophrenic patients care on the knowledge of schizophrenic patients care, learning self-efficacy, and nursing skill performance of nursing students. @*Methods@#Junior nursing students with no mental health nursing experience from two different colleges in G city participated. A total of 64 participants were classified into the experimental group (31) and the control group (33). This study was conducted based on the Jeffries simulation model, and the simulation learning module based on schizophrenic patient care was developed based on the Instructional System Design simulation learning module based on schizophrenic patients care comprising the module I lecture, the module II case-based team learning, and the module III standardized patient-based simulation learning. @*Results@#There were significant increases in the knowledge of schizophrenic patients care (t=2.85, p=.006), learning self-efficacy (t=3.42, p=.001) and nursing skill performance (t=16.69, p<.001) in the experimental group compared to the control group @*Conclusion@#The simulation learning module based on schizophrenic patients care can be useful in the educational and clinical environment as effective strategies in contributing to nursing education and clinical changes.

Suggestions for Specialization and Enhancing Capacity in National Blood Services / 대한수혈학회지

Blood is an essential medical resource for treating diseases and trauma of people, but a limited biological resource for which no artificial production is possible. Therefore, systematic and rational management of its supply and use must be carried out under the national responsibility. On the other hand, the low birthrate and aging population have raised the problem of blood shortages in Korea. To help solve this problem, this study examined proposals for the development of a blood management system in Korea. In addition, the works of blood management bodies were analyzed based on the operation subjects and types of blood projects in the United States, the United Kingdom, France, Germany, the Netherlands, Canada, Australia, Singapore, and Japan. Based on these data, this paper proposes a new organization that can best enhance the specialization of national blood services and strengthen its capacity under the current blood supply system in Korea.

How Does COVID19 Affect Blood Transfusion and Blood Management? / 대한수혈학회지

The scientific interest in transfusion medicine as related to COVID19 can be summarized in three important points. 1) How can we identify asymptomatic COVID19 infected potential blood donors from healthy donors, and if the asymptomatic COVID19 infected person has donated blood and it has been transfused, how will it affect the transfused patient? 2) What affect will COVID19 have on blood establishments and medical institutions that use blood? 3) How will convalescent plasma from recovered COVID-19 patients be collected and then be used for patients in need of it? Since COVID19 has a negative effect on blood transfusion and blood management, well developed lines of communication and cooperation from blood establishments, medical institutions, government agencies, and people are urgently needed to overcome the impact of this negative effect.

Estimation of the Residual Risk of Transfusion-Transmissible Infectious Agents in Korea / 대한수혈학회지

BACKGROUND: The risk of transfusion-transmissible infections (TTIs) of HBV, HCV, and HIV in Korea has been reduced significantly by strengthening the blood safety policies. On the other hand, the risk of TTI still exists due to the diagnostic window period or viral variants. METHODS: The residual risks of TTI of HBV, HCV, and HIV were calculated from July 1, 2012 to June 30, 2018 by dividing the data into two year sets. The residual risk was conducted by separating the donors who donated only once and those who donated more than once during each period. RESULTS: In the first two years, the residual risks of HBV, HCV, and HIV were calculated to be 17.54/106, 0.42/106, and 0.30/106 respectively. The residual risk of HBV and HCV over the last two years was calculated to be 9.41/106 and 0.27/106, showing a tendency to decrease with time. On the other hand, the residual risk of HIV over the last two years was calculated to be 0.29/106, showing no significant difference. The residual risk in the donors who donated only once was higher than that in the donors who donated more than once during each period. CONCLUSION: The real transfusion-transmitted infection can be different from the estimated residual risk in this study because this study was based on the thesis that all NAT-reactive blood components cause infection. Because the residual risk of HBV is higher than HCV and HIV, it was considered that the safety measures for the HBV need to be improved continuously.

Development of External Quality Controls for Human Immunodeficiency Virus Antigen/Antibody Tests in Korea

BACKGROUND: Quality control is important for accurate diagnosis of human immunodeficiency virus (HIV) infection, and proficiency testing with external quality controls is an important part of quality control. This study intended to develop and supply customized external quality controls for HIV antigen/antibody testing fitted with currently used reagents for standardization of HIV infection diagnosis and evaluation of HIV testing competency of laboratories in Korea. METHODS: Serological tests and inactivation were performed on the obtained HIV antibody positive plasma. To manufacture quality controls having the required antibody titers, dilution ratio was searched using VIDAS (bioMérieux, France), Architect (Abbott Laboratories, USA), and Cobas 8000 (Roche Diagnostics, Germany) analyzers. Diluted source plasma was divided into aliquots after filtering. Homogeneity and stability of the produced external quality controls were evaluated. RESULTS: The collected HIV antibody positive plasma was confirmed by Western blot. Dilution ratios for source plasma were produced for each analyzer showing signal-to-cut-off 2–3, 5–7, and 15–16 reactivity. Diluted plasma was made to 1 mL aliquots and total set of 1,500 external quality controls for HIV antigen/antibody were manufactured. Produced controls satisfied the required criteria of homogeneity and showed less than 10% coefficient of variation for stability except negative controls. CONCLUSIONS: Customized external quality controls were developed and qualified for HIV testing reagents used in Korea. Continuous external quality control assessment for HIV tests with controls would be required.

Development of HLA-A, -B and -DR Typing Method Using Next-Generation Sequencing / 대한수혈학회지

BACKGROUND: Research on next-generation sequencing (NGS)-based HLA typing is active. To resolve the phase ambiguity and long turn-around-time of conventional high resolution HLA typing, this study developed a NGS-based high resolution HLA typing method that can handle large-scale samples within an efficient testing time. METHODS: For HLA NGS, the condition of nucleic acid extraction, library construction, PCR mechanism, and HLA typing with bioinformatics were developed. To confirm the accuracy of the NGS-based HLA typing method, the results of 192 samples HLA typed by SSOP and 28 samples typed by SBT compared to NGS-based HLA-A, -B and -DR typing. RESULTS: DNA library construction through two-step PCR, NGS sequencing with MiSeq (Illumina Inc., San Diego, USA), and the data analysis platform were established. NGS-based HLA typing results were compatible with known HLA types from 220 blood samples. CONCLUSION: The NSG-based HLA typing method could handle large volume samples with high-throughput. Therefore, it would be useful for HLA typing of bone marrow donation volunteers.

Performance Evaluation of the DxH 800 Hematology Analyzer

In this study, the performance of a hematology analyzer, DxH 800 (Beckman Coulter, USA) was evaluated. The precision, carry-over, linearity, and comparison studies were performed according to the Clinical Laboratory Standards Institute guidelines. The test items were white blood cell, red blood cell, hemoglobin, red blood cell index, platelet, and reticulocyte counts. The 6C control and Retic-X cell control (Beckman Coulter) were used for precision evaluation. For the correlation study, the test results were compared with those obtained from the ADVIA 2120i (Siemens, USA) using 120 blood samples. The results of precision and carry-over evaluations were within acceptable range. The coefficient of determination (R 2) for linearity was good, being more than 0.99. The correlation coefficient (R) ranged from 0.945 to 0.996. DxH 800 was evaluated as an acceptable hematology analyzer for the automation of large volume of laboratory samples.

Analysis of Recent Four Years' Cross-Matching Tests of One Commercial Laboratory

The cross-matching test, an essential pre-transfusion test, is usually performed using only a segment of a blood bag and a recipient's blood sample at a commercial laboratory. We analyzed cross-matching test results obtained at LabGenomics laboratory, client of which were mainly small- and medium-sized medical clinics. Data for a total of 12,902 cross-matching tests referred from January 2012 to December 2015 were analyzed for incompatibility in the results and trends based on the distribution of medical clinics. Medical clinics were categorized as nursing home, obstetrics and gynecology, plastic surgery, dental clinic, orthopedic surgery, and others. Incompatible results were observed for 35 cases (1.09%) in 2012, 22 cases (0.68%) in 2013, 31 cases (1.02%) in 2014, and 41 cases (1.20%) in 2015. Overall, 55.4% of referrals came from a nursing home, 6.4% from obstetrics and gynecology, 4.4% from plastic surgery, 20.0% from dental clinic, 5.9 % from orthopedic surgery, and 7.9% from others. Further studies are required to evaluate the efficacy of cross-matching test results and its relationship with transfusion requirements.