Purpose: PTH (parathyroid hormone) level is a useful index for prediction of hypocalcemia after thyroidectomy. The fast results are required for an early diagnosis of hypocalcemia. In this study, we evaluated the PTH change according to incubation time, and investigated the usefulness of hypocalcemia diagnosis of PTH results in early incubation time. Materials and Methods: The subjects were 131 patients who had taken the PTH test from July to August in 2009. All experiments were used IRMA method. PTH value were evaluated with the correlation between precision (10 times repeat) and recovery rate and at 0.5, 3, 6 and $18{\pm}2$ (below overnight) hours following incubation time. Data analysis was investigated with relationship of the sensitivity, specificity, PPV (positive predictive value) and accuracy. Results: The correlation was time-dependent with levels reaching $R^2$=0.987 at 0.5 hours, $R^2$=0.993 at 3 hours and $R^2$=0.996 at 6 hours compare to overnight levels. The precision (%CV${\pm}$SD) were $15.92{\pm}15.54$ at 0.5 hours, $6.91{\pm}7.38$ at 3 hours, $4.30{\pm}4.69$ at 6 hours and $4.59{\pm}2.59$ at overnight. The recovery rate (%Mean${\pm}$SD) were $96.8{\pm}5.44$ at 0.5 hours, $102.6{\pm}4.35$ at 3 hours, $100.7{\pm}2.56$ at 6 hours and $102.2{\pm}5.98$ at overnight. When 15 pg/ml of overnight density was set up as criteria, we measured the sensitivity, specificity and PPV, accuracy at 0.5, 3, 6 hours. The sensitivity was shown to 97.5% at all times. The specificity was 96.0% at 0.5 hours, 100% at 3 hours and 92.3% at 6 hours for control, respectively. The PPV was 86.6% at 0.5 hours, 100% at 3 hours and 92.8% at 6 hours. The accuracy was shown to 84.7% at 0.5 hours, 97.5% at 3 hours and 90.6% at 6 hours. These data were accompanied by a corresponding PTH value of overnight incubation time, which significantly correlated with early time results. Conclusion: The values of PTH at 3 hours has favorable the rate of concordance of 94.1% and may be useful for prediction of hypocalcemia, and it responses to overnight incubation PTH values. Therefore, This method may be an attractive alternative to proper treatment to stop symptom revelation by giving a calcium agent to the patient.
Objectives: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. Methods: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) ${\geq}5$. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. Results: In 121 subjects, 73.6% were males, with a mean age of $48.8{\pm}13.0$ years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA ($AHI{\geq}5$ and <15), 26 (21.4%) had moderate ($AHI{\geq}15$ and <30), and 40 (33%) had severe OSA ($AHI{\geq}30$). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for $AHI{\geq}5$, 75.8% and 38.2% for $AHI{\geq}15$, 77.5% and 34.6% for $AHI{\geq}30$, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for $AHI{\geq}5$, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. Conclusion: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.
Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
Tuberculosis and Respiratory Diseases
/
v.61
no.1
/
pp.34-40
/
2006
Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.
This study was conducted to select the indicator species (plant) according to the topographical characteristics in the Picea jezoensis forests, endangered subalpine coniferous trees. In South Korea and China (close to Baekdusan), the southern tree line limit of Picea jezoensis has meaningful geographical and latitudinal values for analyzing the ecological characteristics of P. jezoensis forests. Latitude greatly affects the geographical values of plant ecology, and the difference in latitude and habitat affects the change in species composition in forests. With prolonged environmental change, the habitat of subalpine plants will become smaller, and the plants may become extinct. As the P. jezoensis forests of South Korea and China, in particular, are in danger of disappearing without protection, it is important to monitor the population and develop a conservation strategy. Eighty-seven circular plots were established in P. jezoensis forests in South Korea and China. Through processes such as MRPP-test and NMS ordination, indicator species were selected based on this, and basic data for biodiversity assessment were presented. As a result of the Indicator Species Analysis (ISA), 5 taxa were selected from the upperstory vegetation and 18 taxa from the understory vegetation at the altitude(p<0.05). Indicator species by aspect were analyzed as 3 taxa for upperstory vegetation and 16 taxa for understory vegetation (p<0.05). In the case of indicator species according to the slope, 6 taxa for upper vegetation and 24 taxa for understory vegetation were selected(p<0.05). As for the indicator species according to their habitat, 8 taxa in upper vegetation and 65 taxa on understory vegetation were selected. As a result of MRPP-test, it was analyzed that the species composition was heterogeneous in the group of understory vegetation than that of upperstory vegetation. As a result of NMS ordination, the correlation with environmental factors of indicator species was analyzed by rock exposure for upperstory vegetation and latitude for understory vegetation (cut off level=0.3).
Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.
Lee, Su Jin;Lee, Jae Hyung;Park, Ji Young;Jo, Woo Sung;Kim, Ji Eun;Kim, Ki Uk;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
Tuberculosis and Respiratory Diseases
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v.60
no.5
/
pp.540-547
/
2006
Background : Vital stability and right side heart failure are major prognostic factors of acute pulmonary thromboembolism. While it is important to recognize right side heart failure, it is often difficult in real practice. Recently, several studies have described early diagnostic tools for detecting right side heart failure including echocardiography and biochemical markers. This study, we evaluated the prognostic role of the B-type natriuretic peptide (BNP) in an acute pulmonary thromboembolism. Methods : Thirty-four patients with a diagnosis of acute pulmonary thromboembolism were enrolled in the study. The BNP levels were measured and echocardiography was performed at the Emergency Department. Data on the prognostic factors including ventilatory support, vital stability, pulmonary artery pressure, degree of tricuspid valve regurgitation, complications and death was collected from the patients' medical records. The patients with an acute pulmonary thromboembolism were divided into two groups based on the vital stability and the BNP level and the cutoff values and prognostic factors of the two groups were compared. Results : The predictors of the vital stability that influence the prognosis of patients with acute pulmonary thromboembolism were the BNP level, ventilatory support and death. The plasma BNP levels showed a strong correlation with the vital stability, ventilatory support, thrombolytic therapy and death. When the BNP cutoff level was set to 377.5 pg/dl in a ROC curve, the sensitivity and the specificity for differentiating between the groups with stable or unstable vital signs was 100% and 90%, respectively. Conclusion : This study indicates that a measurement of the plasma BNP levels may be a useful prognostic marker in patients with an acute pulmonary thrombo-embolism.
Journal of the Korean Society of Food Science and Nutrition
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v.32
no.4
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pp.506-512
/
2003
Peach wine was fermented at $25^{\circ}C$ for 2 weeks using Saccharomyces cerevisiae KCCM 12224, aged at 15$^{\circ}C$ for 14 weeks, and its physicochemical and microbiological changes were investigated. The viable bacterial cell numbers, 1.4$\times$10$^3$ CFU/mL at the beginning of fermentation, increased to 2.8$\times$10$^{6}$ CFU/mL after 2 weeks, but decreased to 7.0$\times$10$^3$ CFU/mL after 14 weeks. The viable yeast cell numbers were changed from 3.4$\times$10$^2$ CFU/mL to 2.4$\times$10$^{7}$ CFU/mL during fermentation, and decreased to 4.0$\times$10$^4$ CFU/mL after aging. Turbidity total sugar content, reducing sugar content, solid content and b value of peach wine decreased during fermentation but acidity, alcohol content, L and a value increased. Most physicochemical properties except alcohol content and reducing sugar content were not changed significantly during aging. When peach wine was filtered through 0.45 ${\mu}{\textrm}{m}$ nitrocellulose membrane followed by various ultrafiltration membranes with different molecular weight cut-off values, Biomax 100K membrane, with 79 liter/$m^2$/h (LMH) of initial flux, was suitable for ultrafiltration process of peach wine. These membrane filtration treatments resulted in complete removal of microorganisms and decrease in turbidity and alcohol content without changes in other chemical properties. The physicochemical properties of peach wine were not changed and any microorganisms were not found during the storage at 3$0^{\circ}C$ for 12 Weeks.
The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.
The purpose of the study was to develop an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Eating habits, food intake, and anthropometric data were collected from 142 children (80 boys and 62 girls) in the $4^{th}$ to $6^{th}$ grades of elementary schools. Percentage of Recommended Intakes (RI) and Mean Adequacy Ratio (MAR) of six micronutrients; vitamin A, riboflavin, vitamin C, calcium, iron, zinc, and the number of nutrients the children consumed below EAR among the six nutrients were used as indices to detect the risk of inadequate micronutrient intake. Pearson correlation coefficients were calculated between eating habit scores and inadequate micronutrient intake indices in order to select questions included in the checklist. Meal frequency, enough time for breakfast, regularity of dinner, appetite, eating frequencies of Kimchi, milk, fruits and beans showed significant correlations with indices of inadequate micronutrient intake. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 8-item checklist with test results from 0 to 12 points was developed, and those with equal or higher than 6 points were diagnosed as high-risk group of inadequate micronutrient intake, and those with 4 or 5 points were diagnosed as moderate-risk group. Among our subjects 14.1% was diagnosed as high-risk group, and 30.3% as moderate-risk group. The proportions of the subjects who consumed below EAR of all micronutrients but vitamin C were highest in the high-risk group, and there were significant differences in the proportions of the subjects with intake below EAR of all micronutrients except vitamin B6 among the three groups. This checklist will provide a useful screening tool to identify children at risk of inadequate micronutrient intake.
Background: Cytokeratin 19 is 40KD acidic molecule whose distribution is restricted to simple or pseudo-stratified epithelia, such as the epithelial layer of the bronchial tree. Immunohistochemical study have shown that cytokeratin 19 is overexpressed in lung carcinoma tissue. An immunoradiometric assay, CYFRA 21-1 has been developed using two monoclonal antibody, BM 19-21 and KS 19-1, reactive to different epitopes on cytokeratin 19. We studied the diagnostic value of CYFRA 21-1 in lung cancer. Method: The serum CYFRA 21-1 level using immunoradiometric kit(ELSA-CYFRA 21-1) was measured in 54 patients who admit to Yeungnam University Hospital from April, 1993 to August, 1994. Lung cancer group was 39 primary lung cancer patients(19 patients with squamous cell carcinoma, 11 patients with adenocarcinoma and 9 patients with small cell carcinoma). Control group was 15 patients with non malignant lung diseases(8 patients with pulmonary tuberculosis, 3 patients with chronic obstructive pulmonary disease, 2 patients with pneumonia and 2 patients with chronic obstructive pulmonary disease combined with pulmonary tuberculosis). Results: The mean serum value of CYFRA 21-1 was $20.2{\pm}4.7ng/ml$ in squamous cell carcinoma, $7.2{\pm}1.6ng/ml$ in adenocarcinoma and $15.5{\pm}4.7ng/ml$ in non-small cell lung cancer. The serum value of CYFRA 21-1 in control group was $1.7{\pm}0.5ng/ml$. All of the serum values of 3 histologic types were significantly higher than that of control group(p<0.01). The serum value of CYFRA 21-1 of squamous cell carcinoma was significantly higher than that of adenocarcinoma(p <0.05). Serum value of CYFRA 21-1 in small cell lung cancer was $2.9{\pm}0.9ng/ml$ and not significantly different compared with control group. Using cut off value of 3.3ng/ml, sensitivity and specificity was 11.1%, 65.2% in small cell lung cancer, 70.0%, 62.5% in non-small cell lung cancer, 73.7%, 75% in squamous cell carcinoma and 63.6%, 78.9% in adenocarcinoma, respectively. Conclusion: The serum levels of CYFRA 21-1 may be useful in diagnosis of non-small cell lung carcinoma, especially in squamous cell carcinoma with its high specificity.
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