ABO 혈액형 기록 불일치로 적발된 신분 도용 사례

최수인,신희봉,조덕,최수인 대한수혈학회 2019 大韓輸血學會誌 Vol.30 No.1

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최수인 덕성여자대학교 일어일문학회 1986 語り合い Vol.3 No.-

Planned Transfusion of D-Positive Blood Components in an Asia Type DEL Patient: Proposed Modification of the Korean National Guidelines for Blood Transfusion

최수인,천세종,서지영,양지혁,조덕 대한진단검사의학회 2019 Annals of Laboratory Medicine Vol.39 No.1

DEL type red blood cells (RBCs) are characterized by the expression of extremely low levels of D-antigen, and thus, they cannot be detected by routine serologic D typing or a weak D test but are revealed by RHD genotyping or adsorption-elution studies [1]. The most common DEL phenotype is RHD (NM_016124.4: c.1227G>A), which is also referred to as Asia type DEL [2] and accounts for 94.7% of all Korean DEL cases [1]. Although DEL is a rare phenotype in individuals of European ethnicity [3], it is found in approximately 10–33% of serologically D-negative East Asian individuals of serologically D-negative East Asian individuals [1].

RhD 음성 산모에서의 항-G 항체 동정: 국내 첫 보고

최수인,윤선주,서지영,천세종,오수영,조덕 대한수혈학회 2017 大韓輸血學會誌 Vol.28 No.3

Anti-G positivity can be misinterpreted as the presence of anti-D or -C antigen in an antibody identification test, as this antibody is known to show agglutination to D or C antigen-positive red cells. Correct identification of anti-G is important in pregnant women, as prenatal care or the need for RhIG administration can vary between anti-D and -C versus anti-G cases. We recently encountered a D-negative case with suspected anti-D and -C, which was ruled out by adsorption and elution tests, and ultimately confirmed the presence of anti-G. The pregnant woman was a 33-year-old patient with cde Rh phenotype with a previous history of spontaneous abortion, followed by administration of RhIG. The spouse’s Rh phenotype was CDe. Initial antibody identification test showed 2+ positivity to C (homozygotes and heterozygotes) and trace to 1+ positivity to D. Upon additional adsorption and elution with R0r (cDe/cde) and r’r (Cde/ cde) red cells, we identified the antibody present in the patient’s serum as anti-G. The patient is currently under close follow-up monitoring for anti-G titer using antibody titer testing with both CDe and CcDEe red cells. Periodic fetal cerebral Doppler examination is being carried out without evidence of fetal distress.

위 신경내분비종양의 진단과 치료

최수인,Soo In Choi 대한소화기암연구학회 2022 Journal of digestive cancer reports Vol.10 No.1

The incidence of gastric neuroendocrine tumors (NET) has been increased with the improvement of endoscopy accessibility. The World Health Organization classified NET of low (G1), intermediate (G2), high (G3) grade and neuroendocrine carcinoma with poor differentiation by mitotic count and Ki-67 labeling index. Gastric NET are divided into three subtypes based on the pathophysiology, and treatment is determined according to the subtype and prognostic factors of tumor. For diagnosis, endoscopy with biopsy, endoscopic ultrasonography, abdominal pelvis computed tomography, and serum gastrin level measure are required. In general, type 3, size > 2 cm, deep submucosal infiltration, high histological grade, lymphovascular invasion and metastasis are poor prognostic factors. Type 1 or 2 without these factors are treated by endoscopic resection, and other tumors needs surgery. Endoscopic resection of early type 3 or type 1 and 2 tumors with poor prognostic factors still remains a challenge.

컴퓨터 시스템 설치를 위한 위치-할본-규모결정 모형

최수인,Choe, Su-In 한국전자통신연구원 1983 전자통신 Vol.5 No.3

복수 설비입지 문제의 한 유형인 컴퓨터 시스템 설치문제는 설치위치의 결정, 서비스 지역의 할본, 각 시스템의 규모 결정 등 복합적인 의사결정 과제를 안고 있다. 이 세가지 의사결정 문제는 상호 밀접하게 연결되어 있으므로 세 문제를 동시에 고려하여 전체적으로 최적화할 수 있는 해를 구하도록 해야하는 데 이는 매우 어려운 일이다. 그러므로 지금까지는 각각의 최적해를 독립적으로 구한 후 이를 적당히 결합한다거나 또는 아예 최적해를 구하기 보다는 만족할 만한 적정해를 구함으로써 만족할 수 밖에 없었다. 본 연구에서는 이러한 한계를 극복하기 위해 컴퓨터 시스템 설치에 있어서의 location-Size결정모형을 구축함으로써 이러한 의사결정 문제의 수리적 최적해를 구하고자 했다. 이 모형은 선형 및 비선형의 제약조건을 갖는 non-linear programming 문제로 수식화 되었으며, penalty function method, feasible conjugate, direction methods, branch & bound technique등의 algorithm들을 단계적으로 사용함으로써 최적해의 도출이 가능하게 되었다. 실제 문제에 적용한 결과 유용성은 충분한 것으로 보여졌으나 해법상의 개선을 통해 계산노력을 줄이도록 함이 요구 되었다. In the area of computer network planning, a location-allocation-size problem is involved. Since multi-facility location-allocation-size problems are very complex in formulating a mathematical model, it is a usual practise to adopt alternative approaches, which give no optimal results, instead of the optimal solution by mathematical approach. In this article, however, an attempt is made to formulate a mathematical model for the decision making problem of computer network design.

단일 상급종합병원에서 여러 수혈전검사 프로토콜 운영 경험

최수인,조덕,신성환,서지영,유홍비,천세종 대한수혈학회 2018 大韓輸血學會誌 Vol.29 No.2

Background: Pretransfusion tests are essential for safe transfusions, but occasionally, part or all can be omitted when a transfusion is needed urgently in an emergency. The purpose of this study was to share the authors’ experience of various pretransfusion test protocols in a tertiary referral hospital in Korea. Methods: From July 2016 to June 2017, all transfusion cases at Samsung Medical Center were analyzed retrospectively. For each pretransfusion test protocol, the parameters regarding issue, return and disposal rate of blood products, occurrence of hemolytic transfusion adverse effect, and prescription frequency of each respective department and ordering site were analyzed. Results: A total of 90,539 units of red blood cells, 24,814 units of fresh frozen plasmas, 24,758 units of single donor platelets, and 23,303 units of platelet concentrates were issued during the study period. Among them, 3.6%, 1.8%, 0.3%, and 0.4% of red blood cells, fresh frozen plasmas, single donor platelets, and platelet concentrates were issued according to the emergency transfusion protocols. When various pretransfusion test protocols were applied to issue blood products, there was no case in which an adverse hemolytic transfusion reaction was suspected. When compared with usual pretransfusion test protocol, all emergency transfusion protocols showed significantly higher return and wastage rates in red blood cells and fresh frozen plasmas. Platelets also had a higher return and wastage rate, but the difference was not significant. Conclusion: These results suggests that there is no different risk of adverse hemolytic transfusion reaction regardless the pre-transfusion protocols, but management about of the increased rate of return and wastage of blood products in emergency transfusions should be considered.

Population pharmacokinetic analysis of metformin administered as fixed-dose combination in Korean healthy adults

최수인,Sangil Jeon,한승훈 대한임상약리학회 2018 Translational and Clinical Pharmacology Vol.26 No.1

Metformin, an oral antihyperglycemic agent, is widely used as the first-line pharmacotherapyfor type 2 diabetes mellitus (T2DM). It has been in use for several decades as numerous differentformulations. However, despite its use, population pharmacokinetic (PK) modeling of metforminis not well developed. The aim of the present study was to evaluate the effect of formulation on PKparameters by developing a population PK model of metformin in Koreans and using this model toassess bioequivalence. We used a comparative PK study of a single agent and a fixed-dose combinationof metformin in 36 healthy volunteers. The population PK model of metformin was developedusing NONMEM (version 7.3). Visual predictive checks and bootstrap methods were performed todetermine the adequacy of the model. The plasma concentration.time profile was best describedby a two-compartment, first-order elimination model with first-order absorption followed by zeroorderabsorption with lag time. From the covariate analysis, formulation had significant effect (p <0.01) on relative bioavailability (F = 0.94) and first-order absorption constant (Ka = 0.83), but thedifference was within the range of bioequivalence criteria. No other covariate was shown to havesignificant effect on PK parameters. The PK profile of the disposition phase was consistent with thepublished literature. However, in the present study, the multiple peaks found during the absorptionphase implied the possible diversity of absorption PK profile depending on formulation or population. Unlike traditional bioequivalence analysis, the population PK model reflects formulation differenceson specific parameters and reflected simulation can be performed.

Weak D Testing is not Required for D- Patients With C-E- Phenotype

최수인,천세종,이환태,유홍비,서지영,조덕 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.6

Background: Although testing to detect weak D antigens using the antihuman globulin reagent is not required for D- patients in many countries, it is routinely performed in Korea. However, weak D testing can be omitted in D- patients with a C-E- phenotype as this indicates complete deletion of the RHD gene, except in rare cases. We designed a new algorithm for weak D testing, which consisted of RhCE phenotyping followed by weak D testing in C+ or E+ samples, and compared it with the current algorithm with respect to time and cost-effectiveness. Methods: In this retrospective study, 74,889 test results from January to July 2017 in a tertiary hospital in Korea were analyzed. Agreement between the current and proposed algorithms was evaluated, and total number of tests, time required for testing, and test costs were compared. With both algorithms, RHD genotyping was conducted for samples that were C+ or E+ and negative for weak D testing. Results: The algorithms showed perfect agreement (agreement=100%; κ=1.00). By applying the proposed algorithm, 29.56% (115/389 tests/yr) of tests could be omitted, time required for testing could be reduced by 36% (8,672/24,084 min/yr), and the test cost could be reduced by 16.53% (536.11/3,241.08 USD/yr). Conclusions: Our algorithm omitting weak D testing in D- patients with C-E- phenotype may be a cost-effective testing strategy in Korea.

The characteristics of pulmonary disease in North Korean articles published between 2006 and 2018

최수인,김병근,정원재,이상엽,인광호,이은주 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

Background: We supposed that past decades of division between South and North Korea made differences in medical environments. However, there are few studies about North Korea’s medical status and research field. In this study, we reviewed the status and characteristics of North Korea’s articles regarding pulmonary diseases. Methods: Among the eleven medical journals, articles published in Internal Medicine between 2006 and 2018 were reviewed. A total of 267 articles were associated with pulmonology. We analyzed these articles according to their features, disease categories and publishing year. Results: Experimental studies accounted for 45% (n=121), observational studies for 24% (n=63), reviews for 18% (n=49) and case reports for 13% (n=34). Experimental studies were all comparison studies but diagnostic criteria and randomization were not mentioned. Articles related to respiratory infection accounted for 36% (n=96). those to chronic obstructive pulmonary disease for 14% (n=36), those to asthma for 11% (n=29), those to CO poisoning for 9% (n=24), those to tumor for 13% (n=35) those to critical care medicine for 2% (n=6) and the others for 15% (n=41). Conclusion: Compared with South Korea, studies for infection and CO poisoning were actively conducted. There were many studies for pleural effusion and most of them were related to tuberculosis. Persistent studies have been carried out in North Korea with dedication despite the poor medical environment. We hope that this study will be the beginning of comprehension of North Korea’s medical status and research field.