• Title/Summary/Keyword: Cut-off values

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Clinical Analysis of Rhabdomyolysis Complicated with Drug Intoxications (횡문근융해증을 유발하는 음독 약물별 임상경과 분석)

  • Lee Mi Jin;Kim Hyung Min;Kim Young Min;Lee Won Jae;So Byung Hak;Kim Se Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.27-33
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    • 2003
  • Purpose: According as the accessibility about drugs becomes various, the occurrence of drug intoxication is increasing. Since report that doxylamine causes rhabdomyolysis often, drug-induced rhabdomyolysis is one of the most important complications in patients with drug intoxication. Acute renal failure (ARF)'s availability is important to the management in rhabdomyolysis, but report about rhabdomyolysis or ARF occurrence for whole intoxicated drugs is lacking up to now. Methods: This research did to 61 patient who had rhabdomyolysis of drug intoxication. First, object patients were divided into two gruops: doxylamine-ingested (Group I) vs non-doxylamine ingested (Group II). And then we analyzed on the early patient's clinical events and laboratory data. We used ROC curve to recognize'the early clinical factors that could forecast ARF appearance among these patients in addition. Results: Almost rhabdomyolysis was happened by doxylamine in drug intoxication ($55.7\%$). However, as compared to group II, group I showed better clinical course, lesser ARF occurrence and hemodialysis requirement. In group II, time was longer in hospital reaching from intoxication, the ARF occurrence rate was higher ($52.6\%$). Analyzing the ROC curve to useful initial factors, they were creatinine, uric acid and interval time from ingestion to hospital. These cut-off values were 1.44 mg/dL, 6.8 mg/dL and 5 hrs. Sensitivity for ARF estimate was $100\%$, specificity $69-98\%$. Conclusion: Compared to group II, Doxylamine-ingested group showed good clinical course. Creatinine, uric acid, interval time from ingestion to hospital aided in ARF estimate in drug-induced rhabdomyolysis.

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Validation of the Short Form Bobath Memorial Hospital Fall Risk Assessment Scale at a Specialized Geriatric Hospital in Korea (단축형 노인 낙상위험 사정도구의 타당도)

  • Sohng, Kyeong-Yae;Park, Mi Hwa;Chaung, Seung Kyo;Park, Hye Ja
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.495-508
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    • 2014
  • Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

Microsurgical Foraminotomy via Wiltse Paraspinal Approach for Foraminal or Extraforaminal Stenosis at L5-S1 Level : Risk Factor Analysis for Poor Outcome

  • Cho, Sung-Ik;Chough, Chung-Kee;Choi, Shu-Chung;Chun, Jin-Young
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.610-614
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    • 2016
  • Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).

Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season (우리나라 농촌지역 노인들의 영양점검표(DETERMINE)를 통한 계절별 영양상태 판정의 신뢰도 분석 연구)

  • Moon, Hyun-Kyung;Kong, Jung-Eun
    • Korean Journal of Community Nutrition
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    • v.14 no.3
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    • pp.340-353
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    • 2009
  • It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

Multiple Linkage Disequilibrium Mapping Methods to Validate Additive Quantitative Trait Loci in Korean Native Cattle (Hanwoo)

  • Li, Yi;Kim, Jong-Joo
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.7
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    • pp.926-935
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    • 2015
  • The efficiency of genome-wide association analysis (GWAS) depends on power of detection for quantitative trait loci (QTL) and precision for QTL mapping. In this study, three different strategies for GWAS were applied to detect QTL for carcass quality traits in the Korean cattle, Hanwoo; a linkage disequilibrium single locus regression method (LDRM), a combined linkage and linkage disequilibrium analysis (LDLA) and a $BayesC{\pi}$ approach. The phenotypes of 486 steers were collected for weaning weight (WWT), yearling weight (YWT), carcass weight (CWT), backfat thickness (BFT), longissimus dorsi muscle area, and marbling score (Marb). Also the genotype data for the steers and their sires were scored with the Illumina bovine 50K single nucleotide polymorphism (SNP) chips. For the two former GWAS methods, threshold values were set at false discovery rate <0.01 on a chromosome-wide level, while a cut-off threshold value was set in the latter model, such that the top five windows, each of which comprised 10 adjacent SNPs, were chosen with significant variation for the phenotype. Four major additive QTL from these three methods had high concordance found in 64.1 to 64.9Mb for Bos taurus autosome (BTA) 7 for WWT, 24.3 to 25.4Mb for BTA14 for CWT, 0.5 to 1.5Mb for BTA6 for BFT and 26.3 to 33.4Mb for BTA29 for BFT. Several candidate genes (i.e. glutamate receptor, ionotropic, ampa 1 [GRIA1], family with sequence similarity 110, member B [FAM110B], and thymocyte selection-associated high mobility group box [TOX]) may be identified close to these QTL. Our result suggests that the use of different linkage disequilibrium mapping approaches can provide more reliable chromosome regions to further pinpoint DNA makers or causative genes in these regions.

Prognostic Significance of Preoperative Lymphocyte-Monocyte Ratio in Patients with Resectable Esophageal Squamous Cell Carcinoma

  • Han, Li-Hui;Jia, Yi-Bin;Song, Qing-Xu;Wang, Jian-Bo;Wang, Na-Na;Cheng, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2245-2250
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    • 2015
  • Background: The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy. Materials and Methods: Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models. Results: The median follow-up was 38.6 months (range 3-71 months). The cut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients. Conclusions: Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.

Utility of Peripheral Blood Parameters in Predicting Breast Cancer Risk

  • Okuturlar, Yildiz;Gunaldi, Meral;Tiken, Elif Eda;Oztosun, Bugra;Inan, Yesim Ozdem;Ercan, Tarik;Tuna, Savas;Kaya, Ali Osman;Harmankaya, Ozlem;Kumbasar, Abdulbaki
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2409-2412
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    • 2015
  • Purpose: We aimed to study the inflammatory parameters of complete blood count in breast cancer cases. Materials and Methods: This retrospective study covered 178 breast cancer patients and 107 age and body mass index matched healthy women. Complete blood count parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and MPV/platelet were analyzed. Results: The leukocyte, neutrophil and neutrophil/lymphocyte ratio were higher in the patient group (p values 0.001, 0.0001 and 0.0001, respectively) while haemoglobin and hematocrit were higher in the control group (p=0.0001 for both). Logistic regression analysis showed that elevated neutrophils and platelet distribution width (PDW) (OR: 0.627, 95%CI: 0.508-0.774, p=0.001 and OR: 1.191 95%CI: 1.057-1.342 p=0.003) were independent variables for predicting breast cancer. The cut-off value for the neutrophil/lymphocyte ratio was 2.56. Conclusions: According to our study results, neutrophil levels as part of complete blood count may be used as an independent predictor of breast cancer risk.

Guidelines of Body Mass Index in Korean Childhood and Adolescent Obesity and relationship with Physical Strength (한국 초.중.고등학생 비만의 BMI 기준 제시 및 체력과의 관계에 대한 연구)

  • 원혜숙;한성숙;오세영;김혜영;김우경;이현숙;장영애;조성수;김숙희
    • Journal of Nutrition and Health
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    • v.33 no.3
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    • pp.279-288
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    • 2000
  • The study examined BMIs, physical strength, activities, and the attitudes and behavior toward weight control among 7,968 Korean students{2,435 5th graders from elementary schools(ESs), 2,524 2nd graders from middle schools(MSs), 2,739 2nd graders from high schools(HSs)} nationwide. Compared to the 1987 data, there were increases of height(3-6cm) and weight(3-8kg), but decreases of physical strength and exercise. Lack of 'regular exercise' among girls from MSs and HSs and higher proportion of time spent on watching TV and using a computer for elementary schoolers were particularly noticeable. Proportions of students who were satisfied with their body weight were 49% for ESs, 35% for MSs, and 29% for HSs. There was no relationship between subjective and objective evaluations of body weight. Diet rather than exercise was more frequently chosen as a method of weight control. Compared to boys, girls showed stronger association between the amount of exercise and the subjective body weight in MSs and HSs, however this association was not found for the subjects from HSs. Values for the 50th percentile of BMI of boys and girls were 18.4 and 17.7 for ESs, 19.9 and 20.1for MSs, and 21.4 and 20.6 for HSs. In MSs and HSs, boys with BMI between 15th to 85th percentiles were physically stronger than those whose BMIs were lower than 15th kor higher than 85th percentiles. For the other groups, there was a trend of a positive relationship between BMI and physical strength. Based on the analyses of BMI and physical strength, this study suggests 22 and 21 for upper grades in ESs, 24 and 23 for MSs, and 27 and 25 for HSs as the respective cut off points of BMI for weight control n boys and girls. A need for implementing nutrition education program focused on weight control is also suggested.

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Quality of Breast Cancer Early Detection Services Conducted by Well Woman Clinics in the District of Gampaha, Sri Lanka

  • Vithana, Palatiyana Vithanage Sajeewanie Chiranthika;Ariyaratne, M.A.Y.;Jayawardana, P.L.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.75-80
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    • 2013
  • Background: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. Aim: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. Methods: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003-2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. Results: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35-90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7-20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ${\geq}70%$, the cut off set for satisfaction. Conclusions: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

Impact of Various Tumor Markers in Prognosis of Gastric Cancer -A Hospital Based Study from Tertiary Care Hospital of Kathmandu Valley

  • Mittal, Ankush;Gupta, Satrudhan Pd.;Jha, Dipendra Kumar;Sathian, Brijesh;Poudel, Bibek
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1965-1967
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    • 2013
  • Background: To obtain the maximum additional information about the prognosis of gastric cancer, we compared CA-50 with other previously defined markers. Materials and Methods: This hospital based study was carried out in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between $1^{st}$ July 2012 and $31^{st}$ December 2012. The variables collected were age, gender, AFP, CEA, CA19-9, and CA50, assayed with ELISA reader for all cases. The cut off values for serum AFP, CEA, CA19-9, and CA-50 were 10 ${\mu}g/l$, 10 ${\mu}g/l$, 37 U/ml, and 20 U/ml, respectively according to the manufacturer's instructions. Approval for the study was obtained from the institutional research ethical committee. Results: Of the 40 examined patients, 13 patients had tumors located in the upper third of the stomach, 6 patients had tumors in the middle third, 16 patients had tumors in the lower third, and 5 patients had tumors occupying two-thirds of the stomach or more. The distribution of lymph node staging of the patients was as follows: 7 patients belonged to N0, 9 patients to N1 stage, 10 patients to N2 stage, and 14 patients to N3 stage. The statistical method of Cox proportional hazards using multivariate analysis also illustrated that tumor markers including CEA (2.802), CA19-9 (2.690), CA50 (2.101), were independent prognostic factors, as tumor size (1.603), and lymph node stage (1.614). Conclusions: The tumour markers now available, like CEA, CA 19-9 and CA 50, chiefly perceive advanced gastric cancer. The preoperative rise in those tumour marker level have a prognostic significance and may be clinically helpful in choosing patients for adjuvant management.