Clinical Use of Procalcitonin in the Diagnosis of Sepsis: Evaluation of PCT–qSOFA

김반석,임현선,김영아 대한진단검사의학회 2021 Laboratory Medicine Online Vol.11 No.1

Background: Sepsis is a life-threatening medical condition, and the diagnosis of sepsis should be conducted rapidly and accurately. The purpose of this study was to evaluate the diagnostic performance of a combination of procalcitonin (PCT) levels and quick sequential organ failure assessment (qSOFA), namely PCT–qSOFA, for the diagnosis of sepsis. Methods: A total of 204 patients were grouped according to the results of blood culture and systemic inflammatory response syndrome criteria (≥ 2/4) into the bacterial sepsis group (N = 67), the blood culture-negative sepsis group (N = 37), the blood culture-positive group without corresponding clinical symptoms or signs of sepsis (N = 35), and the control group without evidence of sepsis (N = 65). The diagnostic performance of PCT–qSOFA was assessed using the post-test probability analysis. Results: Compared with qSOFA, PCT–qSOFA demonstrated improved post-test probability (from 0.772 to 0.884) and a positive likelihood ratio (from 1.59 to 3.55) when it was applied to all subjects, including those in the intensive care unit (ICU). However, this improvement in diagnostic performance was not observed when PCT–qSOFA was applied to patients outside the ICU. Conclusions: The combined use of PCT and qSOFA can help clinicians identify patients with sepsis, including those in an ICU setting

혈액은행 자동화 검사장비 ORTHO VISION를 이용한 ABO 항체역가검사의 평가

김반석,박유진,김진주,이은경,김신영,김현옥 대한수혈학회 2015 大韓輸血學會誌 Vol.26 No.3

Background: ABO antibody titration is important in cases such as ABO incompatible hemolytic disease of the fetus and newborn (HDFN), ABO incompatible bone marrow, or solid organ transplantation. This study was conducted in order to evaluate usability of ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) designed automated ABO antibody titration equipment. Methods: The isoagglutination titers were determined in 80 subjects (20 A, 20 B, 40 O (anti-A 20, anti-B 20)) using a conventional tube technique, including a 30 minute room temperature phase (CTT), Dithiothreitol treated manual column agglutination technique (MCAT), and automated column agglutination technique (ACAT) by ORTHO VISION. The concordance of titer was compared within one dilution step between the two methods. Results: The isoagglutinin titers measured by the ACAT with anti-human globulin poly cassette (ACAT_Poly) and anti-human globulin IgG cassette (ACAT_IgG) were the highest and the isoagglutinin titer measured by the MCAT was also higher than that by the CTT. The isoagglutinin titer measured by the ACAT with reverse diluents cassette (ACAT_Reverse) was similar to that measured by the CTT. The concordance of anti-A and anti-B titers between CTT and ACAT_Reverse was 83% and 68%. The concordance of anti-A and anti-B titers between MCAT and ACAT_Poly was 100% and 83%. The concordance of anti-A and anti-B titers between MCAT and ACAT_IgG was 98% and 88%. Conclusion: Automated isoagglutinin titration using ACAT_Poly or ACAT_IgG without DTT showed reliable concordance with DTT treated MCAT, and it appears to be a possible replacement for the conventional MCAT method. 배경: ABO 항체 역가의 측정은 ABO 부적합태아신생아용혈성질환, ABO 부적합 골수 이식및 ABO 부적합 고형장기이식에서 중요한 지표이다. 이에 본 연구에서는 ABO 항체역가 자동화검사가 가능한 ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) 장비의 유용성을 평가하였다. 방법: A형 20명, B형 20명, O형 40명(anti-A 20 명, anti-B 20명) 총 80명을 대상으로 30분 실온배양 수기 시험관법 및 dithiothreitol을 처리한 수기 원주응집법과 ORTHO VISION 장비를 사용한자동화 원주응집법을 시행하였다. 역가는 두 방법 간의 희석배수 1단계 이내의 일치율로 비교하였다. 결과: AHG (Anti-human globulin) poly cassette, AHG (Anti-human globulin) IgG cassette를 사용한자동화 원주응집법으로 측정한 동종응집소 역가가 가장 높았으며, 수기 원주응집법 역시 시험관법에 비해 높게 측정되었다. Reverse diluents cassette를사용한 자동화 원주응집법은 시험관법과거의 동일하게 측정되었다. 시험관법과 reverse diluent cassette를 사용한 자동화 원주응집법에 의한 anti-A, anti-B의 일치율은 83%, 68%이었다. 수기 원주응집법과 AHG poly cassette를 사용한 자동화 원주응집법의 anti-A, anti-B의 일치율은 100, 83%이었다. 수기 원주응집법과 AHG IgG Cassette를사용한 자동화 원주응집법의 anti-A, anti-B 의 일치율은 98% 88%이었다. 결론: DTT를 처리하지 않은 AHG poly cassette 또는 IgG cassette를 사용한 자동화 항체역가 측정은 DTT 처리한 수기 원주응집법과 비교적 좋은일치율을 보여주어 기존의 수기 원주응집법을 대체할 수 있을 것으로 사료된다.

지자체의 청년정책 실험과 청년의 (재)발견: 경상남도 남해군의 ‘청년친화도시사업’을 사례로

김반석 한국사회학회 2023 한국사회학회 사회학대회 논문집 Vol.2023 No.12

Application of Multiplex Ligation-Dependent Probe Amplification Assay for Genotyping Major Blood Group Systems Including DEL Variants in the D-Negative Korean Population

김반석,이승태,김신영,최종락,김현옥 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.1

Background: The DEL blood type, a very weak D variant, is a major concern in the field of transfusion medicine because of its potential to cause anti-D alloimmunization. We investigated the molecular basis of serologically D-negative phenotypes, including the DEL type, and the distribution of other blood group systems in the Korean population using the recently developed multiplex ligation-dependent probe amplification (MLPA) assay. Methods: Blood group genotyping using the MLPA assay and RhCE phenotyping were performed on randomly selected 95 D-negative red blood cell products. The MLPA results were verified by multiplex PCR for the RHD promoter, exons 4, 7, and 10 and by direct sequencing of RHD exon 9. Results: Out of 95 cases, total deletion of the RHD was observed in 74 cases (77.9%) and four cases (4.2%) had an RHD-CE-D hybrid allele. The other 17 cases (17.9%) had an RHD(1227G>A) allele, which was further confirmed by sequencing analysis. The RhCE phenotypes of RHD(1227G>A) alleles were composed of 14 Cce and 3 CcEe, and all 60 cases of the ce phenotype were revealed to have a total deletion of the RHD. Genotyping results and allele distribution of the other 17 blood group systems were consistent with previous reports on the East Asian population. Conclusions: MLPA assay correctly determined RHD genotype, including RHD-CE-D hybrid alleles or RHD(1227G>A) allele, and other clinically relevant blood group genotypes in D-negative Koreans. The use of MLPA assay on serologically D-negative individuals may help improve transfusion safety by preventing anti-D alloimmunization.

공공서비스 로봇의 의인화에 관한 사용자 선호

김반석,김승인 한국디지털정책학회 2020 디지털융복합연구 Vol.18 No.2

본 연구는 사람들의 선호를 조사하여 공공서비스 로봇에 의인화가 어떻게 적용돼야 할지 알아보는 연구이다. 공공장소에서 서비스를 제공하는 공공서비스 로봇이 도입되고 있으며 이는 앞으로도 증가할 전망이다. 적절하게 의인화된 로봇은 사용자 경험을 증진하는 효과가 있지만 지나치게 인간과 흡사한 로봇은 불쾌감을 느끼게 한다. 이에 따라 공공서비스 로봇에 요구되는 의인화 적용 기준을 마련하는 것이 필요하다. 이를 위해 설문조사와 심층 인터뷰를 진행하였다. 분석 결과 사람들은 로봇에 언어적 상호작용을 선호하며 음성의 적절한 나이는 20~30대이다. 로봇에 생체 신호는 나타나지 않는 것이 바람직하며 개인에 맞춤화된 서비스에 대한 요구가 있다는 것을 알게 되었다. 본 연구를 통해 사용자 경험을 높이는 공공서비스 로봇 디자인에 기여할 것으로 기대한다. The purpose of this study is to find out user preference on personification of the public service robot. Public service robot services in public places is increasing, which is expected to continue to increase. Proper anthropomorphism of robots has positive effect on user experience. On the other hand, when the level of likeness exceeds a certain point, it provokes strangeness and a sense of unease. Therefore, it is necessary to prepare standards for anthropomorphism required for public service robots. In order to find it, a survey and an in-depth interview were conducted. According to the analysis, people prefer verbal interaction with the robot, and the proper age for the voice is in their 20s and 30s. It is recommended that no biological signals appear on the robot and there is a need for personalized services. Through this research, it is expected that it will contribute to design of public service robots that enhance user experience.

tu백혈구증가증치료에서의 백혈구성분채집술 - 단일 상급 종합병원의 10년간 경험

김반석,이경애,김신영,김현옥 대한진단검사의학회 2016 Laboratory Medicine Online Vol.6 No.3

Background: Hyperleukocytosis is a medical emergency that is characterized by increased blood viscosity and predisposition to various neurological, pulmonary, and gastrointestinal complications. In addition, patients are at risk of the tumor lysis syndrome because of the increased tumor burden. Therapeutic leukapheresis is an important treatment for these emergent states. In this study, we retrospectively analyzed therapeutic leukapheresis procedures that were performed in our institution during the last 10 yr. Methods: We retrospectively analyzed therapeutic leukapheresis procedures conducted from July 2005 to March 2015 at a tertiary care hospital. We present our observations, especially the procedural characteristics and hematological parameters before and after the aforementioned procedures. Results: Seventy-two patients underwent a total of 146 therapeutic leukapheresis procedures. The average presenting white blood cell (WBC) count was 268×103/μL, and ranged from 54×103/μL to 673×103/μL. After an average of two sessions, a statistically significant drop in the WBC counts was observed. The average WBC removal rates during the initial and entire therapeutic leukapheresis procedures of each patient were 33% and 46%, respectively. The platelet count and hemoglobin concentration were significantly reduced. Conclusions: Therapeutic leukapheresis significantly reduces peripheral WBC counts and is a safe and effective procedure for the treatment of hyperleukocytosis. 배경: 백혈구증가증은 혈액의 점도를 증가시켜 다양한 신경, 폐, 위장관계의 합병증을 유발할 수 있는 내과적 응급상황이다. 또한,종양 부담의 증가로 인해 종양용해증후군이 발생할 위험이 있다. 치료적 백혈구성분채집술은 이러한 응급 상황에서 치료 방법의 하나로 고려될 수 있다. 이번 연구에서는 본 기관에서 10년간 시행된 치료적 백혈구성분채집술을 후향적으로 분석하였다. 방법: 2005년 7월부터 2015년 3월까지 일개 3차 의료기관에서 시행된 치료적 백혈구성분채집술에 대하여 술식과 관련된 특성 및 시술 전후의 혈액학적 지표의 변화를 분석하였다. 결과: 72명의 환자에서 총 146회의 치료적 백혈구성분채집술이 시행되었다. 대상 환자의 최초 내원 당시의 백혈구 수는 평균 268×103/L로, 54×103/L에서 673×103/L까지 분포하였다. 평균 2회의 시술을 시행 후 백혈구 수는 통계학적으로 유의하게 감소하였다. 대상 환자의 최초 1회의 치료적 백혈구성분채집술과 전체의 치료적 백혈구성분채집술에 의하여 백혈구 수는 각각 33%, 46%가 감소하였다. 혈소판 수와 혈색소 수치 역시 유의하게 감소하였다. 결론: 치료적 백혈구성분채집술은 말초혈액의 백혈구 수를 유의하게 감소시키며, 시술 중 특별한 부작용은 관찰되지 않아 백혈구증가증 치료의 안전하고 효과적인 술식으로 판단된다.

시선패턴 기반 독해보조 시스템

김반석(Ban Suk Kim),옥광진(Kwang Jin Ock),박성진(Seong Jin Park),유준(Joon Yoo) 한국통신학회 2019 한국통신학회 학술대회논문집 Vol.2019 No.1

SOC 민자사업에서 편익비용과 관련한 최소운영수입보장제도(MRG)의 타당성 분석 필요성에 대한 연구

김반석(Kim, Ban-Seok),이석원(Lee, Suk Won),김주형(Kim, Joo Hyung),김재준(Kim, Jae Jun) 대한건축학회 2012 대한건축학회 학술발표대회 논문집 Vol.32 No.2

New high-energy-density Ga₂Te₃-based composite anode for Li-ion batteries

이영한,김반석,박철민 한국공업화학회 2022 한국공업화학회 연구논문 초록집 Vol.2022 No.1

COVID-19 PCR 신속 검사가 응급실 체류시간에 미치는 영향

김영아,김반석,노경호 대한의료관련감염관리학회 2024 의료관련감염관리 Vol.29 No.1

The rapid COVID-19 polymerase chain reaction (PCR) test using Xpert Xpress SARS-CoV-2 and the conventional COVID-19 PCR test using Standard M nCoV Detection were compared after matching for sex, age, and hospitalization period. The rapid COVID-19 PCR test group exhibited shorter turnaround time and emergency department stay.