Objective: This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. Materials and Methods: This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. Results: The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. Conclusion: 2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.
Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.
In this paper, we propose a real-time method of detecting hand motions and extracting the signal frame induced by EF(Electric Field) sensors. The signal induced by hand motion includes not only noises caused by various environmental sources as well as sensor's physical placement, but also different initial off-set conditions. Thus, it has been considered as a challenging problem to detect the motion signal and extract the motion frame automatically in real-time. In this study, we remove the PLN(Power Line Noise) using LPF with 10Hz cut-off and successively apply MA(Moving Average) filter to obtain clean and smooth input motion signals. To sense a hand motion, we use two thresholds(positive and negative thresholds) with offset value to detect a starting as well as an ending moment of the motion. Using this approach, we can achieve the correct motion detection rate over 98%. Once the final motion frame is determined, the motion signals are normalized to be used in next process of classification or recognition stage such as LSTN deep neural networks. Our experiment and analysis show that our proposed methods produce better than 98% performance in correct motion detection rate as well as in frame-matching rate.
This study aims to introduce and economical review on the possibilities of rare earth elements(REEs) recovery from coal ashes and the analysis of economical evaluation factors based on the data for securing domestic rare earth elements. The cut-off grade of REEs on recovering from coal ash was confirmed to be 1,000 ppm on total rare earth oxides(TREO) basis, and while the economic value of coal ash changed with contents and specific elements of rare earth elements. This shall be resulted in the price differences of rare earth elements required by the current industry, and it probably varies depending on the future demand of rare earth components. For developing of commercial recovery technology on REEs in coal ashes, many researches have been carried out by various analyzing methods, such as evaluation of holding value of REEs in ashes, assessment between supply and demand of industry, comparison of investment and its profitability for the REEs's production from coal ashes, and so on. Although these methods have been suggested, its recovery system with economical feasibility could not been confirmed up to present. In this reason, the process design of recovering REEs from coal ash shall be researched continuously to solve the problems of the global rare earth market. And also these researches shall be conducted actively in Korea for the purpose of securing the REEs resources and their recovering technologies.
Yoo, Dae Han;Lee, Jung Won;Choi, Jae Hyung;Jeong, Dong Kil;Lee, Dong Wook;Lee, Young Joo;Cho, Young Shin;Park, Joon Bum;Chung, Hae Jin;Moon, Hyung Jun
Journal of The Korean Society of Clinical Toxicology
/
v.14
no.2
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pp.107-114
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2016
Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic x2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.
Background: Sperm-associated antigen 9 (SPAG9) has been recently proposed as a novel biomarker for early diagnosis of several human tumors, including ovarian, cervical and breast cancers. Its clinical value remains to be clarified for endometrial cancer (EC). In this study, we investigated the utility of serum SPAG9 levels in diagnosis of EC and its association with important clinicopathological parameters. Materials and Methods: This cross-sectional study was performed at a tertiary women's referral center in Ankara, Turkey. Preoperative serum samples were collected from patients surgically treated for endometrial cancer between June 2012-April 2013. Similar aged women with a biopsy proven benign endometrium were used as controls. Serum SPAG9 levels were measured with an enzyme-linked immunosorbent assay (ELISA) method and assessed for links with clinicopathological factors. Receiver operating characteristic (ROC) curve analysis was performed to assess power of SPAG9 levels for EC prediction. P values less than 0.05 were considered statistically significant. Results: A total of 63 women with EC and 27 with benign endometrium were included in the study. Mean age in the EC group was $58.7{\pm}1.1$. Median SPAG9 levels in the EC and control groups were 18.3 (range, 12.7-53.8) and 14.1 (range, 4.3-65.3), respectively (p<0.001). A cut-off value of 17 ng/ml for SPAG9 predicted presence of malignant endometrium with 74% sensitivity and 83% specificity [Area under curve (AUC)=0.82, p<0.001]. SPAG9 levels did not demonstrate any significant association with histological type, FIGO stage, tumor grade, size, myometrial invasion, lymphovascular space invasion, cervical involvement, adnexal involvement, peritoneal cytology or lymph node status (all p>0.05). Conclusions: Testing for SPAG9 may be useful for early detection of EC in asymptomatic high-risk women. Its role in post-treatment follow-up and early detection of recurrence should be assessed in future trials.
Objectives : Fatigue is a common symptom in primary medical care and has nonspecific and highly subjective features. So it has been difficult to define and measure fatigue, especially those present without any organic diseases. This study was conducted to evaluate the validity of the Fatigue severity scale(FSS) in patients with persistent fatigue who were free of any organic diseases or psychiatric disorders of depression or anxiety. Methods : Subjects consisted of 45 controls, 44 fatigued patients and 43 psychiatric patients with depression or anxiety. They all completed the fatigue severity, modified Bepsi stress, and Hospital anxiety and depression scales. Chalder fatigue scale was administrated randomly in 30 of them. Data were analyzed for reliability and validity of the FSS. Results: Cronbach's a coeffient of FSS was 0.929, and the Pearson correlation coefficient for test-retest was 0.916(p<0.01). ANCOVA for discriminant validity revealed that there were significant differences in mean FSS values among the three groups. The fatigue group had significantly higher FSS value than the other two groups. The psychiatric group also had significantly higher FSS value than the control group. The Pearson correlation coefficient for convergent validity by comparing FSS with Chalder fatigue scale was 0.782(p<0.01). Using FSS index 3.22 as the cut-off point, sensitivity was 84.1% and specificity was 85.7% for the fatigue and control groups, respectively. Conclusion : Results suggested the clinical application of the FSS to be a useful measurement for distinguishing fatigue between patients with physiologic fatigue and psychiatric patients with depression or anxiety.
Purpose: Mucopolysaccharidosis type II (MPS II or Hunter syndrome) is a rare lysosomal storage disorder caused by iduronate-2-sulfatase (IDS) deficiency. MPS II causes a wide phenotypic spectrum of symptoms ranging from mild to severe. IDS activity, which is measured in leukocyte pellets or fibroblasts, was reported to be related to clinical phenotype by Sukegawa-Hayasaka et al. Measurement of residual plasma IDS activity using a fluorometric assay is simpler than conventional measurements using skin fibroblasts or peripheral blood mononuclear cells. This is the first study to describe the relationship between plasma IDS activity and clinical phenotype of MPS II. Methods: We hypothesized that residual plasma IDS activity is related to clinical phenotype. We classified 43 Hunter syndrome patients as having attenuated or severe disease types based on clinical characteristics, especially intellectual and cognitive status. There were 27 patients with the severe type and 16 with the attenuated type. Plasma IDS activity was measured by a fluorometric enzyme assay using 4-methylumbelliferyl- ${\alpha}$-iduronate 2-sulphate. Results: Plasma IDS activity in patients with the severe type was significantly lower than that in patients with the attenuated type ($p$=0.006). The optimal cut-off value of plasma IDS activity for distinguishing the severe type from the attenuated type was 0.63 $nmol{\cdot}4hr^{-1}{\cdot}mL^{-1}$. This value had 88.2% sensitivity, 65.4% specificity, and an area under receiver-operator characteristics (ROC) curve of 0.768 (ROC curve analysis; $p$=0.003). Conclusion: These results show that the mild phenotype may be related to residual lysosomal enzyme activity.
This study was conducted to detect the serum antibodies in the experimentally toxoplasma infected dogs and street dogs by use the of an enzyme-linked immunosorbent assay (ELISA). And this test was performed on the polystylene microplate by coating with the tachyzoites soluble antigen of T gondii (RH strain), incubated with sera diluted then, added with HPO-conjugated rabbit anti-dog IgG and o-phenylenediamine used as a substrate. Tachyzoites of T gondii harvested from mouse peritoneal cavity were purified by 30, 40 and 50% Percoll density gradient centrifugation and used as the source of antigen. The results obtained were summarized as follows; 1. The highest ratio of positive to negative (P/N ratio) was obtained at the level of $l{\mu}g/ml$ protein concentration of antigen with the 1/4000 dilution of the conjugate measured by checker-board titration. It was regarded as the optimum concentration of the antigen and conjugate. 2. Cut-off value in this IgG ELISA was 0.375 that was determined by mean absorbance (at 492nm) of IFA negative serum added with the dauble value of the standard deviation $(mean{\pm}2S.D.)$. 3. Serum ELISA IgG antibodies to T gondii in the exyerimentally infected dogs were detected firstly at the Week 3 after inoculation and the highest titer was recognized at the Week 4, 5 and 6 after inoculation. 4. Stability of the antigen absorbed in the microplates that were preserved at $4^{\circ}C$ and $-25^{\circ}C$ separately were prolonged up to 3 weeks and 10 weeks at $4^{\circ}C$ and $-25^{\circ}C$, respectively. However the reproducibility was not reliable after the preservation of 4 weeks and longer. 5. Positive rate of the specific antibodies in 312 test sera was 28.5% and there was no significant differences between the male (27.8%) and female (29.5%), respectively. 6. The IgG ELISA was proved to be a specific procedure for the detection of antibodies to canine toxoplasma infection and also evaluated as a screening test for the large scale of test samples in laboratory.
Journal of agricultural medicine and community health
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v.16
no.1
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pp.79-89
/
1991
A systematic study was conducted to identify and isolate a serologically pertinent antigen with high specific activity and low cross reactivity from Cysticercus parenchymal antigen. Differential centrifugation of the homogenate yield three particulate and one soluble fractions ; the $480{\times}G$ pellets($CyL_2$), the $7650{\times}G$ pellet($CyL_3$), the $100000{\times}G$ pellet($CyL_4$), and $100000{\times}G$ supernatant($CyL_6$). We compared antigenicity of these antigens to that or cystic fluid antigens($CyF_1$), saline extract of cystic wall($CyL_1$), and n-butanol treated $GyL_4$ antigen ($CyL_6$) based on SDS-PAGE and immunoblot techniques. The data obtained were as follows : 1) The ratio of O.D. value of ELISA against cysticercosis positive pool sera to that of negative pool sera was highest when using $CyF_1$ as antigen. However the ratio was relatively low in case of $CyL_{3.4}$ and $CyL_5$. 2) We have noted in previous paper that most strong antigenic activities are present in 63Kd band with low cross reactivities. An effective serologic reagent must contain components that are recognized by most infected sera. 63Kd band met this criteria and could be considered as a reliable band for the diagnosis of cysticercosis. As far as 63Kd band concern, $CyL_5$ showed most strong activities without disturbance of cross reaction by EITB in spite of low applicability to microplate ELISA. 3) $CyL_5$ could detect the serum antibody of cysticercosis even in very low titers, around cut-off values of microplate ELISA, by immunoblot. It also could detect the cross reactivities of Echinococcus species, which showed high absorbance value in micro plate ELISA and some sparganosis cases. Further purification of this antigen will be able to represents a antigen that can be used in the diagnosis of cysticercosis.
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