Objectives In our hospital’s hemovigilance system, a Wi-Fi–based vital signs monitor that automatically transmits data to ensure patient safety has been implemented. We derived the potential clinical characteristics for subsequent association of acute transfusion reactions (ATRs) using the hospital information system database. Methods We retrospectively analyzed multiple factors to identify the possible associations between clinical factors and developing ATRs. The following data were collected: recipient’s pretransfusion and posttransfusion vital signs, clinical and laboratory characteristics, and presence of ATRs. Results In all, 44,691 events were analyzed. Of these, ATR events occurred in 1586 (3.5%). Logistic regression analysis revealed that leukopenia (<5×10 3 /μL) before transfusion was shown a statistically associated with developing mild ATRs (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.68–3.35, P < 0.001). The association between elevated body temperature (forehead temperature > 37.5°C) and moderate ATRs was significant (OR = 1.55, 95% CI = 1.22–1.98, P < 0.001). In addition, the association between high diastolic pressure (>90 mm Hg) and severe ATRs was significant (OR = 1.78, 95% CI = 1.06–2.99, P = 0.03). Therefore, evaluated patient’s status such as vital signs before transfusion is very important. In addition, every hospital should established a complete hemovigilance program focus on effectively reporting and real-time monitoring ATRs to improve transfusion patient safety. Conclusions Vital signs monitoring and leukocyte counts before transfusion were significantly associated with the subsequent risk of ATRs. When patients with elevated body temperature, leukopenia, and high diastolic pressure who are scheduled to receive transfusion, clinicians should be aware of increasing the risk of ATRs in these patients.

The experiences of percutaneous transhepatic catheterization of the portal vein and immunoassay for insulin of blood samples taken from the splenic and portal veins for localization of isulinoma are reported. This method was carried out in 17 patients, including 11 cases of clinically diagnosed insulinoma (with pathological proof in 9), 2 patients with residual symptoms following previous excision of an insulinoma, and 4 cases eventually proven not to be insulinomas. The results showed that a high value of insulin was present at or near the site of the tumor in 8 single benign insulinomas, while a sustained elevation of plasma insulin throughout the course of the veins was seen in a patient with malignant insulinoma and widespread metastases. The insulin values were not elevated in the 4 patients without insulinomas. Although this method is useful in preoperative localization of insulinomas, it cannot replace thorough and careful palpation of the pancreas at the time of operation.

Malignant triton tumor is a rare malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. Most of these tumors are located in the head, neck, and extremities, and about half of cases are associated with neurofibromatosis type 1 featuring cafe-au-lait spots or cutaneous neurofibromas. We present a 76-year-old man with an insidious chest wall tumor with late progressive painful enlargement and pleural and pulmonary involvement. Complete resection of the affected thoracic wall as well as single separate lesions in the parietal pleura and left upper lung was carried out. The pathological examination confirmed that it was a malignant triton tumor. The patient received adjuvant chemo-radiotherapy but eventually succumbed to disease relapse and distant metastases 6 months after the surgery.