• Parasites, Hosts and Diseases
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• v.55 no.3
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• pp.247-254
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• 2017

ELISA has been used for the diagnosis of toxoplasmosis, but it is being gradually replaced by a rapid diagnostic test (RDT). We compared and analyzed ELISA and RDT results using the sera collected during 4 consecutive years from residents of Gyodong-do (Island), Incheon-city, Korea. Sera from 921, 993, 940, and 838 adult residents were collected on a yearly basis (2010-2013). ELISA was performed by using a crude extract of T. gondii RH strain antigen and IgG/IgM RDT mounted with recombinant fragment of major surface antigen (SAG1), GST-linker-SAG1A, were applied to the sera. Comparison between groups was analyzed by the Student's t-test. The positive seroprevalence surged from 14.7% (135/921, 2010), 23.1% (231/993, 2011), 23.6% (222/940, 2012), and 32.1% (269/838, 2013) by ELISA. In contrast, RDT showed a more moderate increasing trend from 21.7% (200/921, 2010), 25.5% (253/993, 2011), 28.9% (272/940, 2012) and 33.1% (277/838, 2013). Discrepancies between ELISA and RDT were noted near the cut-off value. At the OD 0.15-0.24 range, RDT could detect 16.1% (169/1051) more positives, which suggests an early or acute toxoplasmosis, but at the OD 0.25-0.34 range, ELISA could detect 35.9% (92/256) more positives of possible chronic infections. Over the OD > 0.35 ELISA and RDT agreed in the majority of the cases. This surge in seroprevalence may be caused by the organic agriculture in addition to eating behavior or increase in pets among Koreans. These facts may be applied on a full-scale national survey using RDT to supplement ELISA to define the characteristics of the infection.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.4
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• pp.143-148
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• 2015

Objective: The aim of the current study was to determine the predictive value of anti-$M{\ddot{u}}llerian$ hormone (AMH) levels for pregnancy outcomes in patients over 40 years of age who underwent in vitro fertilization or intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods: We retrospectively analyzed the medical records of 188 women aged 40 to 44 years who underwent IVF/ICSI-fresh ET cycles due to unexplained infertility in the fertility center of CHA Gangnam Medical Center. Patients were divided into group A, with AMH levels <1.0 ng/mL (n=97), and group B, with AMH levels ${\geq}1.0ng/mL$ (n=91). We compared the clinical pregnancy rate (CPR) in the two groups and performed logistic regression analysis to identify factors that had a significant effect on the CPR. Results: The CPR was significantly lower in group A than group B (7.2% vs. 24.2%, p<0.001). In multivariate logistic regression analysis, AMH levels were the only factor that had a significant impact on the CPR (odds ratio, 1.510; 95% confidence interval, 1.172-1.947). The area under the receiver operating characteristic curve for AMH levels as a predictor of the CPR was 0.721. When the cut-off level of AMH was set at 1.90 ng/ mL, the CPR was 6.731-fold higher in the group with AMH levels ${\geq}1.90ng/mL$ than in the group with AMH levels <1.90 ng/mL (p<0.001). Conclusion: Our study showed that AMH levels were predictive of clinical pregnancy in infertility patients over 40 years of age. Further prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1861-1864
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• 2016

Although early diagnosis of thyroid nodule type is very important, the diagnostic accuracy of standard tests is a challenging issue. We here aimed to find an optimal combination of factors to improve diagnostic accuracy for distinguishing malignant from benign thyroid nodules before surgery. In a prospective study from 2008 to 2012, 345 patients referred for thyroidectomy were enrolled. The sample size was split into a training set and testing set as a ratio of 7:3. The former was used for estimation and variable selection and obtaining a linear combination of factors. We utilized smoothly clipped absolute deviation (SCAD) logistic regression to achieve the sparse optimal combination of factors. To evaluate the performance of the estimated model in the testing set, a receiver operating characteristic (ROC) curve was utilized. The mean age of the examined patients (66 male and 279 female) was $40.9{\pm}13.4years$ (range 15- 90 years). Some 54.8% of the patients (24.3% male and 75.7% female) had benign and 45.2% (14% male and 86% female) malignant thyroid nodules. In addition to maximum diameters of nodules and lobes, their volumes were considered as related factors for malignancy prediction (a total of 16 factors). However, the SCAD method estimated the coefficients of 8 factors to be zero and eliminated them from the model. Hence a sparse model which combined the effects of 8 factors to distinguish malignant from benign thyroid nodules was generated. An optimal cut off point of the ROC curve for our estimated model was obtained (p=0.44) and the area under the curve (AUC) was equal to 77% (95% CI: 68%-85%). Sensitivity, specificity, positive predictive value and negative predictive values for this model were 70%, 72%, 71% and 76%, respectively. An increase of 10 percent and a greater accuracy rate in early diagnosis of thyroid nodule type by statistical methods (SCAD and ANN methods) compared with the results of FNA testing revealed that the statistical modeling methods are helpful in disease diagnosis. In addition, the factor ranking offered by these methods is valuable in the clinical context.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1367-1370
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• 2015

Diagnosis of cholangiocarcinoma (CCA) is difficult when patients do not show jaundice. The aim of this study was to examine the feasibility of using the total serum bile acid (TSBA) level as an aid for the diagnosis of CCA in patients without jaundice. For this purpose, TSBA of the following groups were measured using a Beckman Synchron CX4 clinical chemistry analyzer: 60 cases of CCA with total serum bilirubin ${\leq}2mg/dL$ (low total bilirubin group, LTB); 32 cases of CCA with total serum bilirubin >2 mg/dL (high total bilirubin group, HTB); and 115 healthy controls. Liver function parameters such as serum cholesterol, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also examined. The results showed that the TSBA of both LTB and HTB groups of the CCA patients were significantly higher than that of the healthy controls. Also, significant correlation was observed between TSBA and total bilirubin levels in the HTB group of CCA patients. However, no such correlation was seen in the LTB group. The cut-off value of TSBA was determined for the LTB group of CCA patients using the receiver operating characteristic curve analysis, and it was $6.05{\mu}mol/L$ with the sensitivity and specificity of 46.7% and 84.4%, respectively. In addition, the ALP level was correlated well with the TSBA level and ALP in HTB group was significantly higher than that of LTB group. Moreover, the combination of high TSBA and high ALP levels gave higher specificity up to 97.4%. TSBA might be useful for the diagnosis of CCA patients without jaundice.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.104-110
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• 2013

Purpose: Bedside ultrasonography is available in most emergency departments, and detecting the intracranial pressure is elevated is critical. Our objective is to evaluate the availability of bedside optic nerve ultrasound (ONUS) as a secondary survey for patients with head injuries in the emergency department (ED). Methods: From September, 2012, to March, 2013, we performed a prospective study of patients presenting to the ED after an accident. Patients with head injuries but without obvious ocular trauma or ocular disease were included. The ONUS was performed using a 3 to 12 MHz linear probe on closed eyelids after a primary survey. We analyzed the correlation between the brain computed tomography (CT) findings that suggested elevated intracranial pressure (ICP) and the Optic nerve sheath diameter (ONSD) measured by using ONUS. Results: A total of 81 patients were enrolled. Forty-seven had CT results consistent with elevated ICP, and their mean ONSD was $5.98{\pm}0.59$ mm; the mean ONSD of patients who showed no signs of elevated ICP on CT was $4.63{\pm}0.21$ mm. The sensitivity and the specificity for the ONSD, compared with elevated ICP, were 98.87% and 100%, respectively, when the cut-off value was set to 4.96 mm. The area under curve (AUC) was 0.997 in the receiver operating characteristic curve (ROC curve). Conclusion: An evaluation using ONUS is a simple noninvasive procedure and is a potentially useful tool as a secondary survey to identify an elevated ICP.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.83-89
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• 1997

About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We peformed FDG-PET studies in patients who had radiologically indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC), Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch-ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.48-51
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• 2012

Background and Objectives : Vocal fold cyst is generally treated by surgical resection, it has a difference with vocal fold polyp, treated by conservative management first. Decrease in mucosal waves is known as main diagnostic criteria of vocal fold cyst. Sometimes there is a difficulty for diffrential diagnosis between cyst and polyp only by endoscopic examination. The purpose of the study is to identify the objective features of vocal cyst and polyp on the basis of voice analysis for the proper differential diagnosis, especially at high pitched phonation. Materials and Method : The voice analysis was done in 15 focal fold cyst patients and 42 vocal fold polyp. Parameters of perceptual assessment, acoustic and aerodynamic measure, and voice range profile were compared between two groups. Results : Vocal fold cyst patients showed significantly reduced MPT by acoustic and aerodynamic analysis, narrowed frequency-range and low maximun frequency by voice range profile analysis compared with vocal fold polyp patient. Maximun frequency 381 Hz is established for cut off value, differential diagnosis between cyst and polyp (ROC analysis, sensitivity 60%, specificity 68%). Conclusion : Voice analysis is helpful for differential diagnosis between vocal fold cyst and polyp, especially there is a difficulty for distinguish cyst from polyp at clinical situation by endoscopic examination. The result of decreased maximum frequncy at vocal fold cyst supports incomplete high-pitched phonation and falsetto regester at vocal fold cyst patients due to decreased mucosal wave, compared with vocal fold polyp patients.

• Journal of Trauma and Injury
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• v.26 no.2
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• pp.47-52
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• 2013

Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.16 no.2
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• pp.125-132
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• 1983

Dielectric properties of sardine-starch paste with moisture content of 4 to $13\%$ were investigated as functions of moisture and frequency. And the effects of the levels of fat and starch of the mixtures upon dielectric permittivity, critical moisture, were also mentioned. In addition, a theoretical prediction of frequency dependence of dielectric constant which was computed by the lumped circuit of two layer condenser model was evaluated. For the preparation of sardine-starch paste, comminuted sardine meat was washed thoroughly several times in chilled water by soaking and decanting, and finally centrifuged. This procedure was extended longer to provide a low fat sample. The centrifuged meat was mixed with adequate amounts of starch and salt, and ground for 25 minutes in a stone mortar, moulded in the form of disk with 7cm diameter and 1.2cm thickness and then freeze dried. Dried meat disks were cut off for the size of 5.5cm diameter and 1.0cm thickness and their moisture contents were controlled in humidified desiccators with saturated solutions. Dielectric constants of sardine-starch paste tended to decrease frequency was increased showing a critical charge at the moisture called critical moisture content. In case of the sample with $20\%$ starch and $2\%$ salt an average complex permittivity($\epsilon^{\ast}$) at 7 to $8\%$ morsture as the critical moisture content was presented; $\epsilon^{\ast}$=3.37+j 0.39 at 0.1 MHz, $\epsilon^{\ast}$=2.54+j 0.19 at 15 MHz, and $\epsilon^{\ast}$=2.15+j 0.08 at 1.8 GHz, respectively. The theoretically obtained complex permittivity values from the two layer condoner model were in close agreement with these actual measurements under the same conditions, that appeared as $\epsilon^{\ast}$=2.53+i 0.09 at 0.1 MHz and $\epsilon^{\ast}$=2.28+j 0.06 at 15 MHz, respectively. The fast level of the mixture also revealed an influence on dielectric property that defatted neat with $1.0\%$ fat showed a higher hc and $\epsilon^{\ast}$ value than the meat with $4.8\%$ fat. Complex permittivity being related to the moisture level remained nearly unchanged or slightly changed at the moisture range of 4 to $8\%$ but was dispersed widely at higher moisture contents.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.757-767
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• 1999

Background: Diagnosis by smear and/or cultures of the Mycobacterium tuberculosis from body fluid or biopsy specimen is "Gold standard". However the sensitivity of the direct microscopy is relatively low and culture of mycobacteria is time consuming. Despite an explosion in the techniques of rapid identification of mycobacteria by molecular genetic means, it is laborious and expensive and then rapid, inexpensive serodiagnosis is interested in diagnosis of tuberculosis. But sensitivity and specificity of known serologic antigen is not full sufficient level and then new antigen develop and combination cocktails of new developed antigens by ELISA are needed. Method: To compare the efficacy of different mycobacterial specific antigen and to assess the applicability of the combination of several different antigens in the diagnosis of tuberculosis, five ELISA tests derived 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were evaluated in 57 active pulmonary patient and 24 inactive post-therapy follow up patient and 48 normal control. Results: The optical densities of ELISA test with 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were significantly higher in active tuberculosis cases than in normal control(P<0.001, P<0.001, P<0.027, P<0.001, P<0.001) and those with 16KDa, 38KDa were significant higher in active tuberculosis cases than in inactive post-therapy follow up cases(P<0.01. P<0.001) and those of 14KDa, 16KDa, 23KDa, 38KDa were significant higher in inactive post-therapy follow up cases than in normal control(P<0.008. P<0.01. P<0.006. P<0.001). The sensitivity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 42.1%, 43.9%, 15.8%, 28.0%, 70.2%, respectively and the specificity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 95.8%, 95.8%, 91.7%, 89.6%, 93.8%, respectively. The sensitivity and specificity of combination 38KDa with 16KDa was 87% and 93.7%. Conclusion: The sensitivity and specificity of new antigens for serodiagnosis of the tuberculosis still remains limited at around 70%, which makes its a poor diagnostic tool for disease confirmation. A combination of cocktail antigens provided by cut-off value adjustment for serodiagnosis of tuberculosis some improved diagnostic yield than single antigen serologic test.