일개 삼차의료기관 혈액원에서 헌혈자 선별검사로서의 Anti-HBc와 Anti-HBs 검사의 시행 경험

임영애,윤석호 대한진단검사의학회 2009 Annals of Laboratory Medicine Vol.29 No.1

Background : The aim of this study was to report the first experience of using tests of antibody to hepatitis B core antigen (anti-HBc) and antibody to hepatitis B surface antigen (anti-HBs) for the selection of blood donors in a tertiary hospital blood center in Korea. Methods : From January 2005 to December 2007, the data of all eligible donors according to the Korean Blood Regulation Law were analyzed. Anti-HBc testing was performed in all donors, but anti-HBs was tested only in anti-HBc seropositive donors. Anti-HBs negative but anti-HBc positive donors were regarded as ineligible for blood donation. Cost for donor testing was calculated based on Korean health insurance payment schedule from 2005 to 2007. Results : The seroprevalence of anti-HBc in blood donors was 23.2% (162/699) and increased with increasing age. The proportion of ineligible donors for blood collection was 2.7% (19/699) of total donors and 11.6% (19/162) of anti-HBc seropositive donors. The cost of testing for anti-HBc and anti-HBs was estimated to be about 40% of the total screening cost. Conclusions : Although additional donor screening tests for anti-HBc and anti-HBs requires increased cost and relatively small number of donors are additionally excluded by these tests, they are considered to be helpful for the safety of blood products, because our blood center has characteristics with small number of donors and relatively high percentage of donors in the age group of thirties and older. 배경 : 본 의료기관 혈액원은 국내 혈액원으로서는 유일하게 anti-HBc와 anti-HBs 검사를 헌혈자 선별검사에 추가로 실 시하였기에 이에 대한 경험을 보고하고자 하였다. 64 임영애∙윤석호 방법 : 2005년 1월부터 2007년 12월까지 혈액관리법에 명시 된 헌혈자 선별검사에 적합한 헌혈자만을 대상으로 anti-HBc 검사를 실시하였다. Anti-HBc 검사가 양성인 경우에는 anti- HBs 검사를 실시하여 음성이면 부적합 헌혈자로 간주하였다. 검사비 산출은 2005년부터 2007년까지 건강보험 요양급여비 용에 제시된 금액으로 연도별로 산정하였다. 결과 : Anti-HBc 양성률은 23.2% (162/699)였으나 연령이 증가함에 따라 증가하였다. 부적합 헌혈자는 전체 헌혈자의 2.7% (19/699), anti-HBc 양성자 중에서는 11.6% (19/162)를 차지하였다. Anti-HBc와 anti-HBs 검사를 위한 비용은 나머 지 헌혈자 선별검사 비용의 약 40%에 해당하였다. 결론 : Anti-HBc와 anti-HBs 추가 실시로 의료기관 혈액 원의 비용 부담이 있었으며 소수의 헌혈자가 추가로 배제되었 으나, 헌혈자가 많지 않으며 30대 이상의 헌혈자가 상대적으로 많았기 때문에 수혈 혈액의 안전성을 확보하기 위한 보조적인 검사로서는 의미가 있었던 것으로 사료된다.

COVID19는 수혈과 혈액관리에 어떠한 영향을 미치는가?

임영애,서동희,황유성,임영애 대한수혈학회 2020 大韓輸血學會誌 Vol.31 No.1

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. (Korean J Blood Transfus 2020;31:1-4)

지역수혈관리 네트워크 사업 만족도 조사

임영애,김경희,정영준,최새롬,송치은,김준년,임영애 대한수혈학회 2020 大韓輸血學會誌 Vol.31 No.1

Background: The Korean Blood Safety Commission established the Regional Networks for Blood Transfusion Management (RNBTM) Project which has operated in 14 regions across the country since 2017 to help blood transfusion management in small and medium-sized medical institutions. Since implementation of the RNBTM, participant’s satisfaction has not been evaluated, therefore in order to evaluate participant’s satisfaction and assist in future planning a survey was conducted. Methods: Fourteen facilitators participated in an anonymous on-line survey (5 questions). Laboratory Medicine (LM) doctors from small and medium-sized medical institutions from 14 regions also participated in a separate anonymous on-line survey (15 questions). Results: 14/14 (100%) facilitators responded to the survey. In addition to the RNBTM they were also in favor of establishing a Network of University Hospitals. 135 LM doctors responded to the survey. Of the RNBTM participants, 94.1% (111/118) replied that RNBTM was helpful in providing and exchanging blood transfusion information. Respondents indicated that they wished to remain part of RNBTM into the future because they felt that RNBTM not only helped improve quality of blood transfusions but also other aspects in the laboratory. In 70.4% (95/135) of participating medical institutions, LM doctors have been the Chairperson of the Hospital Transfusion Committee. Conclusion: Extremely positive survey results were received from LM doctors. These survey results from LM doctors and facilitators will be helpful in developing and planning future projects related to RNBTM. (Korean J Blood Transfus 2020;31:34-42)

성분수혈요법과 수혈관리

임영애 주식회사 녹십자 2001 녹십자의보 Vol.29 No.3

단회 Widal 검사의 임상적 가치

임영애,전희선,곽연식,송정엽 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

Introduction: To evaluate the usefulness of Widal test requested only once during the clinical episode(single Widal test) in diagnosing typhoid fever, results of culture for Salmonella typhi were compared to the results of single Widal test. Materials and Methods: Widal tests were performed by rapid slide melhod(stained Salmonella suspensions, Murex, England) and the cutoff values of Widal test liter were ≤ 1:160 for 0 antigen, ≤ 1:320 for H antigen. After reviewing culture results of S.typhi the sensitivity, specificity and efficiency of the single Widal test were computed. Results: Culture results of S.typhi in positive Widal test were 7.1%(9/126) for 0 antigen, 7.6% (11/134) for H antigen, 10.9%(6/55) for 0 & H, therefore false positive results were 92.9% for 0, 92.4% for H, 89.1% for 0 & H combined and false negative results were 0.7%(7/1022) for 0, 0.5% (5/1003) for H, 0.2%(2/1093) for 0 & H. The sensitivity, specificity and efficiency of single Widal test were 56.3% (9/16), 89.7%(1015/1132) and 89.3%(1026/1148) for 0; 68.8%(l 1/16), 88.2% (998/1132) and 87.8%(1009/1148) for H; 37.5%(6/16), 95.7%(1083/1132) and 94.9%(1089/1148) for O & H, respectively. Also, Widal test results were positive on many occasions when group D Salmonella was isolated even if isolates were not S.typhi and some group B Salmonella isolates, Conclusion: The outcome of single Widal test showed more than a 90% false positive rate for both 0 and H antigens. Furthermore, Widal tests were positive when patients were infected with Salmonella groups other than S.typhi. Therefore, it is concluded that single Widal test is not a good diagnostic test for typhoid fever.

일개 3차 의료기관의 대량수혈 혈액 사용 분석

임영애,정경원,이국종 대한수혈학회 2018 大韓輸血學會誌 Vol.29 No.3

Background: A massive blood transfusion (MT) requires significant efforts by the Blood Bank. This study examined blood product use in MT and emergency O Rh Positive red cells (O RBCs) available directly for emergency patients from the Trauma Center in Ajou University Hospital. Methods: MT was defined as a transfusion of 10 or more RBCs within 24 hours. The extracted data for the total RBCs, fresh frozen plasma (FFP), platelets (PLTs, single donor platelets (SDP) and random platelet concentrates (PC)) issued from Blood Bank between March 2016 and November 2017 from Hospital Information System were reviewed. SDP was considered equivalent to 6 units of PC. Results: A total of 345 MTs, and 6233/53268 (11.7%) RBCs, 4717/19376 (24.3%) FFP, and 4473/94166 (4.8%) PLTs were used in MT (P<0.001). For the RBC products in MT and non-MT transfusions, 28.0% and 34.1% were group A; 27.1% and 26.0% were group B; 37.3% and 29.7% were group O, and 7.5% and 10.2% were group AB (P<0.001). The ratios of RBC:FFP:PLT use were 1:0.76:0.72 in MT and 1:0.31:1.91 in non-MT (P<0.001). A total of 461 O RBCs were used in 36.2% (125/345) of MT cases and the number of O RBCs transfused per patient ranged from 1 to 18. Conclusion: RBCs with the O blood group are most used for MT. Ongoing education of clinicians to minimize the overuse of emergency O RBCs in MT is required. A procedure to have thawed plasma readily available in MT appears to be of importance because FFP was used frequently in MT.

May-Hegglin Anomaly 가족 1예 보고

임영애,전희선,강원형,곽정식,곽연식 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

The May-Hegglin anomaly is characterized by thrombocytopeiua, giant platelets and inclusion bodies in granulocytes. This disorder is inherited as autosomal dominant traits and has been reported in only 2 families in Korea. We experienced May-Hegglin anomaly in a 46-year-old woman who visited the Dermatology outpatient Clinic for care of brown pigmentation around the bilateral periorbital area. This pigmentation occurred after trauma several years ago. The patient had a history of hematuria one year prior to visit and was diagnosed as having idiopathic thrombocytopenic purpura. One of her sisters also had a history of severe bleeding during the surgery in an other hospital about one year ago, and had been diagnosed as having myelodysplastic syndrome by bone marrow biopsy. In peripheral blood smear both patient and her sister were noted to have thrombocytopenia, giant platelets and basophilic inclusion bodies present in the granula-free zone of cytoplasm in the periphery of neutrophils and eosinophils. Transmission electronmicroscopy revealed abnormal cytoplasmic inclusions in granulocytes. The inclusions were characterized by parallel collection of rough endoplasmic reticulum. The findings of bone marrow aspiration and biopsy were normal, except for the presence of basophilic inclusions in myelocytes. The results of PT, aPTT, bleeding time and platelet aggregation test were normal except for decreased aggregation to epinephrine.

蔡萬植의 歷史意識

林英愛 우석대학교 국어국문학연구회 1983 又石語文 Vol.1 No.-

혈소판제제의 저장기간에 따른 cytokine 변화와 수혈자 호중구 respiratory burst에 미치는 영향

임영애,박애자 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.4

Interleukin(IL)-8 generated from the stored platelets are known to be a cytokine to activate the neutrophils by priming effects, especially in patients with the primed neutrophils and to have a synergistic effect with other cytokines such as IL-6, IL-1β and tumor necrosis factor(TNF)-α. This study was conducted to evaluate the cytokine release from the stored platelets and their effects on neutrophil activation. Ten units of fresh platelet concentrates and ten units of platelet-pheresis products were obtained from healthy donors and kept on agitator at room temperature. Samples were collected from the above preparations on day 0, 1, 3, 5 and 7 of storage for counts of leukocyte and platelet and assays of IL-8, IL-6, IL-1β and TNF-α using enzyme immunoassay. Platelet poor plasmas obtained from on day 0, 1, 3, 5 and 7 of storage or recombinant human(고) IL-8 were incubated with neutrophils from healthy donors and patients to measure the neutrophil respiratory burst using 2',7'-dichlorofluoroscein diacetate by flowcytometry. The results were expressed as by Mean Channel Fluorescence(MCF) Ratio (MCF value of stored platelets/MCF value of negative control) and were summarized as below: 1. Mean leukocyte count of random platelet concentrates(1.23±0.32x10^9/L) was significantly higher than that of platelet-pheresis products(0.45±0.28 x10^9/L, P<0.05). 2. The concentrations of IL-8 and IL-6 were significantly higher in random platelet concentrates than in platelet-pheresis products. Especially, the concentration of IL-8 was progressively increased after 3 days of storage, depending on the storage time. 3. All of the MCF ratio of stored platelet preparations on day 1, 3, 5 and 7 with patient's or healthy donor's neutrophils were not significantly different from those of day 0(P>0.05). However mean MCF ratio in the patient group(1.125±0.363) was signifivantly higher than that of healthy donor group(1.024±0.274, P<0.05). 4. Priming effects of whole blood neutrophils were found with rhIL-8 when stimulated 10 ng/ml for 5 minutes incubation, however, 1 ng/ml, 5 ng/ml, 10 ng/ml, 100 ng/ml for 30 miniutes incubation(P<0.05). In conclusion, stored random platelet concentrates contained high leukocyte count may relate to non-hemolytic transfusion reactions by increment of concentrations of cytokines, which have synergistic effects to neutrophil activation in primed recipients. Therefore, especially massive transfusion of stored random platelet concentrates should be avoided in already primed patients to prevent nonhemolytic transfusion reactions due to activated neutrophils.

‘서역인’인가, ‘서역인 이미지’인가 -통일신라미술 속의 서역인식-

임영애 한국미술사학회 2002 美術史學硏究 Vol.- No.236