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원저(原著) : Pooling 검체에 대한 Antiglobulin Gel Test의 불규칙항체 선별능에 관한 연구
이정신 ( Jung Sin Lee ),한금희 ( Keum Hee Han ),최민자 ( Min Ja Choi ),김현옥 ( Hyun Ok Kim ) 대한임상병리사협회 1997 임상수혈검사학회 발표자료집 Vol.4 No.1
The recently introduced gel technique offers significant advances with respect to standardization of test and provides clear and stable reactions that improve the interpretation of results. The purpose of the present study was to design an antibody screening test based on the gel technique using the pooled cells and pooled sera. Four hundred patients` sera were screened for irregular antibodies by the gel technique in parallel with conventional tube indirect antiglobulin test(IAT). Irregular antibodies were detected in 2 sample(anti-Le(a) and anti-Fy(a)) in both IAT and gel technique. Twenty four frozen sera, which the specificity of irregular antibodies was identified at our blood bank, were test for irregular antibodies by antiglobulin gel test using pooled panel cells or pooled serum two sample. The gel technique proved equal to the tube test in the detection of all antibodies except "enzyme-only" anti-E and anti-Le(a). Our main reason for pooling test is financial. We conclude from this study that screening for irregular antibodies using the gel test with pooled panel cells is a sufficiently reliable and sensitive procedure, and saves handling time.
일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동
박은숙,장경희,윤영옥,이정신,김태곤,여한승,김선호,신정원,이경원,김준명,Park, Eun Suk,Chang, Kyung Hee,Youn, Young Ok,Lee, Jung Sin,Kim, Tae Gon,Yea, Han Seung,Kim, Sun Ho,Shin, Jeong Won,Lee, Kyungwon,Kim, June Myung 한국의료질향상학회 2001 한국의료질향상학회지 Vol.8 No.2
Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.
원저(原著) : 소아 수혈용 소단위 적혈구 농축액 제조 및 사용경험
엄용빈 ( Yong Bin Eom ),배인철 ( In Cheol Bse ),안효준 ( Hyo Jun Ahn ),이정신 ( Jung Sin Lee ),김현옥 ( Hyun Ok Kim ) 대한임상병리사협회 1996 임상수혈검사학회 발표자료집 Vol.3 No.1
For pediatric and neonatal transfusions, it is important to supply the volume needed. Newborns, compared to adult, require transfusion more frequently, which increases donor exposure and donor-related risks such as hepatitis. The unique small-volume requirements of transfusion to neonates may give rise to a large amount of wastage. Thus, a single donor unit for adult transfusion is not adequate for the pediatric and neonatal transfusion. Our technical approaches for pediatric units are available to supply the small volume needed and decrease blood wastage associated with requests for small volume transfusion and reduce donor exposure for those infants who are maintained with transfusion from the same unit for several days (14 days). Small-volume bags is attached to tubing from the outlet port of the main bag using the Sterile Connective Device. The repeated manipulation needed to make small-volume aliquots of packed RBCs did not result in contamination. This method for pediatric transfusion was simple for preparation and easy to adjust the volume. The outcome of the transfused patients was successful. In Korea, transfusion services providing blood for pediatrics and neonates need to develop the methods of preparing 70~120 ml pediatric units of whole blood or red blood cells to realize above advantages and to minimize wastage.
일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동
박은숙,장경희,윤영옥,이정신,김태곤,여한승,김선호,신정원,이경원,김준명 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.1
Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea(CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C.difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C.difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program(8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C.difficlie from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C.difficile may have affected the incidence of vancomycin resistant enterococci(VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C.difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients’ risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.