• Title/Summary/Keyword: Level indicator

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Development and Research into Functional Foods from Hydrolyzed Whey Protein Powder with Sialic Acid as Its Index Component - I. Repeated 90-day Oral Administration Toxicity Test using Rats Administered Hydrolyzed Whey Protein Powder containing Normal Concentration of Sialic Acid (7%) with Enzyme Separation Method - (Sialic Acid를 지표성분으로 하는 유청가수분해단백분말의 기능성식품 개발연구 - I. 효소분리로 7% Siailc Acid가 표준적으로 함유된 유청가수분해단백분말(7%)의 랫드를 이용한 90일 반복경구투여 독성시험 평가 연구 -)

  • Noh, Hye-Ji;Cho, Hyang-Hyun;Kim, Hee-Kyong
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.2
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    • pp.99-116
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    • 2016
  • We herein performed animal safety assessment in accordance with Good Laboratory Practice (GLP) regulations with the aim of developing sialic acid from glycomacropeptide (hereafter referred to as "GMP") as an index ingredient and functional component in functional foods. GMP is a type of whey protein derived from milk and a safe food, with multiple functions, such as antiviral activity. A test substance was produced containing 7% (w/w) sialic acid and mostly-hydrolyzed whey protein (hereafter referred to as "7%-GNANA") by enzymatic treatment of substrate GMP. The maximum intake test dose level was selected based on 5,000 mg/kg/day dose set for male NOEL (no-observed-effect-level) and female NOAEL (no-observed-adverse-effect-level) determined by a dose-range finding (DRF) test (GLP Center of Catholic University of Daegu, Report No. 15-NREO-001) that was previously conducted with the same test substance. To evaluate the toxicity of a repeated oral dose of the test substance in connection with the previous DRF study, 1,250, 2,500, and 5,000 mg/kg of the substance were administered by a probe into the stomachs of 6-week-old SPF Sprague-Dawley male and female rats for 90 d. Each test group consisted of 10 male and 10 female rats. To determine the toxicity index, all parameters, such as observation of common signs; measurements of body weight and food consumption; ophthalmic examination; urinalysis, electrolyte, hematological, and serum biochemical examination; measurement of organ weights during autopsy; and visual and histopathological examinations were conducted according to GLP standards. After evaluating the results based on the test toxicity assessment criteria, it was determined that NOAEL of the test substance, 7%-GNANA, was 5,000 mg/kg/day, for both male and female rats. No animal death was noted in any of the test groups, including the control group, during the study period, and there was no significant difference associated with test substance, as compared with the control group, with respect to general symptoms, body weight changes, food consumption, ophthalmic examination, urinalysis, hematological and serum biochemical examination, and electrolyte and blood coagulation tests during the administration period (P<0.05). As assessed by the effects of the test substance on organ weights, food consumption, autopsy, and histopathological safety, change in kidney weight as an indicator of male NOAEL revealed up to 20% kidney weight increase in the high-dose group (5,000 mg/kg/day) compared with the change in the control group. However, it was concluded that this effect of the test substance was minor. In the case of female rats, reduction of food consumption, increase of kidney weight, and decrease of thymus weight were observed in the high-dose group. The kidney weight increased by 10.2% (left) and 8.9% (right) in the high-dose group, with a slight dose-dependency compared with that of the control group. It was observed that the thymus weight decreased by 25.3% in the high-dose group, but it was a minor test substance-associated effect. During the autopsy, botryoid tumor was detected on the ribs of one subject in the high-dose group, but we concluded that the tumor has been caused by a naturally occurring (non-test) substance. Histopathological examination revealed lesions on the kidney, liver, spleen, and other organs in the low-dose test group. Since these lesions were considered a separate phenomenon, or naturally occurring and associated with aging, it was checked whether any target organ showed clear symptoms caused by the test substance. In conclusion, different concentrations of the test substance were fed to rats and, consequently, it was verified that only a minor effect was associated with the test substance in the high-dose (5,000 mg/kg/day) group of both male and female rats, without any other significant effects associated with the test substance. Therefore, it was concluded that NOAEL of 7%-GNANA (product name: Helicobactrol) with male and female rats as test animals was 5,000 mg/kg/day, and it thus was determined that the substance is safe for the ultimate use as an ingredient of health functional foods.

The Effect of Customer Satisfaction on Corporate Credit Ratings (고객만족이 기업의 신용평가에 미치는 영향)

  • Jeon, In-soo;Chun, Myung-hoon;Yu, Jung-su
    • Asia Marketing Journal
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    • v.14 no.1
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    • pp.1-24
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    • 2012
  • Nowadays, customer satisfaction has been one of company's major objectives, and the index to measure and communicate customer satisfaction has been generally accepted among business practices. The major issues of CSI(customer satisfaction index) are three questions, as follows: (a)what level of customer satisfaction is tolerable, (b)whether customer satisfaction and company performance has positive causality, and (c)what to do to improve customer satisfaction. Among these, the second issue is recently attracting academic research in several perspectives. On this study, the second issue will be addressed. Many researchers including Anderson have regarded customer satisfaction as core competencies, such as brand equity, customer equity. They want to verify following causality "customer satisfaction → market performance(market share, sales growth rate) → financial performance(operating margin, profitability) → corporate value performance(stock price, credit ratings)" based on the process model of marketing performance. On the other hand, Insoo Jeon and Aeju Jeong(2009) verified sequential causality based on the process model by the domestic data. According to the rejection of several hypotheses, they suggested the balance model of marketing performance as an alternative. The objective of this study, based on the existing process model, is to examine the causal relationship between customer satisfaction and corporate value performance. Anderson and Mansi(2009) proved the relationship between ACSI(American Customer Satisfaction Index) and credit ratings using 2,574 samples from 1994 to 2004 on the assumption that credit rating could be an indicator of a corporate value performance. The similar study(Sangwoon Yoon, 2010) was processed in Korean data, but it didn't confirm the relationship between KCSI(Korean CSI) and credit ratings, unlike the results of Anderson and Mansi(2009). The summary of these studies is in the Table 1. Two studies analyzing the relationship between customer satisfaction and credit ratings weren't consistent results. So, in this study we are to test the conflicting results of the relationship between customer satisfaction and credit ratings based on the research model considering Korean credit ratings. To prove the hypothesis, we suggest the research model as follows. Two important features of this model are the inclusion of important variables in the existing Korean credit rating system and government support. To control their influences on credit ratings, we included three important variables of Korean credit rating system and government support, in case of financial institutions including banks. ROA, ER, TA, these three variables are chosen among various kinds of financial indicators since they are the most frequent variables in many previous studies. The results of the research model are relatively favorable : R2, F-value and p-value is .631, 233.15 and .000 respectively. Thus, the explanatory power of the research model as a whole is good and the model is statistically significant. The research model has good explanatory power, the regression coefficients of the KCSI is .096 as positive(+) and t-value and p-value is 2.220 and .0135 respectively. As a results, we can say the hypothesis is supported. Meanwhile, all other explanatory variables including ROA, ER, log(TA), GS_DV are identified as significant and each variables has a positive(+) relationship with CRS. In particular, the t-value of log(TA) is 23.557 and log(TA) as an explanatory variables of the corporate credit ratings shows very high level of statistical significance. Considering interrelationship between financial indicators such as ROA, ER which include total asset in their formula, we can expect multicollinearity problem. But indicators like VIF and tolerance limits that shows whether multicollinearity exists or not, say that there is no statistically significant multicollinearity in all the explanatory variables. KCSI, the main subject of this study, is a statistically significant level even though the standardized regression coefficients and t-value of KCSI is .055 and 2.220 respectively and a relatively low level among explanatory variables. Considering that we chose other explanatory variables based on the level of explanatory power out of many indicators in the previous studies, KCSI is validated as one of the most significant explanatory variables for credit rating score. And this result can provide new insights on the determinants of credit ratings. However, KCSI has relatively lower impact than main financial indicators like log(TA), ER. Therefore, KCSI is one of the determinants of credit ratings, but don't have an exceedingly significant influence. In addition, this study found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size, and on service companies than manufacturers. The findings of this study is consistent with Anderson and Mansi(2009), but different from Sangwoon Yoon(2010). Although research model of this study is a bit different from Anderson and Mansi(2009), we can conclude that customer satisfaction has a significant influence on company's credit ratings either Korea or the United State. In addition, this paper found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size and on service companies than manufacturers. Until now there are a few of researches about the relationship between customer satisfaction and various business performance, some of which were supported, some weren't. The contribution of this study is that credit rating is applied as a corporate value performance in addition to stock price. It is somewhat important, because credit ratings determine the cost of debt. But so far it doesn't get attention of marketing researches. Based on this study, we can say that customer satisfaction is partially related to all indicators of corporate business performances. Practical meanings for customer satisfaction department are that it needs to actively invest in the customer satisfaction, because active investment also contributes to higher credit ratings and other business performances. A suggestion for credit evaluators is that they need to design new credit rating model which reflect qualitative customer satisfaction as well as existing variables like ROA, ER, TA.

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A Study on the Determinants of Patent Citation Relationships among Companies : MR-QAP Analysis (기업 간 특허인용 관계 결정요인에 관한 연구 : MR-QAP분석)

  • Park, Jun Hyung;Kwahk, Kee-Young;Han, Heejun;Kim, Yunjeong
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.21-37
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    • 2013
  • Recently, as the advent of the knowledge-based society, there are more people getting interested in the intellectual property. Especially, the ICT companies leading the high-tech industry are working hard to strive for systematic management of intellectual property. As we know, the patent information represents the intellectual capital of the company. Also now the quantitative analysis on the continuously accumulated patent information becomes possible. The analysis at various levels becomes also possible by utilizing the patent information, ranging from the patent level to the enterprise level, industrial level and country level. Through the patent information, we can identify the technology status and analyze the impact of the performance. We are also able to find out the flow of the knowledge through the network analysis. By that, we can not only identify the changes in technology, but also predict the direction of the future research. In the field using the network analysis there are two important analyses which utilize the patent citation information; citation indicator analysis utilizing the frequency of the citation and network analysis based on the citation relationships. Furthermore, this study analyzes whether there are any impacts between the size of the company and patent citation relationships. 74 S&P 500 registered companies that provide IT and communication services are selected for this study. In order to determine the relationship of patent citation between the companies, the patent citation in 2009 and 2010 is collected and sociomatrices which show the patent citation relationship between the companies are created. In addition, the companies' total assets are collected as an index of company size. The distance between companies is defined as the absolute value of the difference between the total assets. And simple differences are considered to be described as the hierarchy of the company. The QAP Correlation analysis and MR-QAP analysis is carried out by using the distance and hierarchy between companies, and also the sociomatrices that shows the patent citation in 2009 and 2010. Through the result of QAP Correlation analysis, the patent citation relationship between companies in the 2009's company's patent citation network and the 2010's company's patent citation network shows the highest correlation. In addition, positive correlation is shown in the patent citation relationships between companies and the distance between companies. This is because the patent citation relationship is increased when there is a difference of size between companies. Not only that, negative correlation is found through the analysis using the patent citation relationship between companies and the hierarchy between companies. Relatively it is indicated that there is a high evaluation about the patent of the higher tier companies influenced toward the lower tier companies. MR-QAP analysis is carried out as follow. The sociomatrix that is generated by using the year 2010 patent citation relationship is used as the dependent variable. Additionally the 2009's company's patent citation network and the distance and hierarchy networks between the companies are used as the independent variables. This study performed MR-QAP analysis to find the main factors influencing the patent citation relationship between the companies in 2010. The analysis results show that all independent variables have positively influenced the 2010's patent citation relationship between the companies. In particular, the 2009's patent citation relationship between the companies has the most significant impact on the 2010's, which means that there is consecutiveness regarding the patent citation relationships. Through the result of QAP correlation analysis and MR-QAP analysis, the patent citation relationship between companies is affected by the size of the companies. But the most significant impact is the patent citation relationships that had been done in the past. The reason why we need to maintain the patent citation relationship between companies is it might be important in the use of strategic aspect of the companies to look into relationships to share intellectual property between each other, also seen as an important auxiliary of the partner companies to cooperate with.

Effects of Colpomenia sinuosa Extract on Serum Lipid Level and Bone Formation in Ovariectomized Rats (불레기말 추출물이 난소를 절제한 갱년기 장애 모델의 혈청 지질 변화 및 골 형성에 미치는 영향)

  • Lee, Juyeong;Kim, Bokyung;Park, Mi-Hwa;Choi, Kyung-Ha;Kong, Changsuk;Lee, Sang-Hyeon;Kim, Yuck Yong;Yu, Ki Hwan;Kim, Mihyang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.4
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    • pp.492-500
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    • 2016
  • In this study, the effects of Colpomenia sinuosa (CS) extract on serum lipid level and bone formation in an ovariectomized animal model were investigated. Twenty four nine-week old female Sprague-Dawley rats were randomly assigned to four groups: sham-operated rats (SHAM), ovariectomized control rats (OVX-CON), and ovariectomized rats supplemented with CS extract at 50 mg/kg bw (OVX-CS50) or 200 mg/kg bw (OVX-CS200). Three OVX groups were surgically ovariectomized while the SHAM group was sham-operated. CS extract was orally administrated at 1 mL per day. Analysis of serum lipid contents found that the total cholesterol, triglyceride, and low density lipoprotein cholesterol levels in the OVX-CON group were higher than those in the SHAM group. Notably, upon administration of CS extract after ovariectomy, triglyceride levels tended to significantly decrease. In addition, platelet aggregation ability decreased in groups treated with CS extract compared to the OVX-CON group. Serum alkaline phosphatase activity as an indicator of bone formation was lower in the CS extract group compared to the OVX-CON group. Collagen contents in bone and cartilage were reduced by ovariectomy, whereas the CS extract-supplemented groups exhibited higher concentrations in bone. According to these results, CS extract improved serum lipid parameters and osteogenesis in ovariectomized rats.

Effects of the Massage Therapy on Weight, Stress Hormone and Mother - Infant Interaction (마사지요법이 저체중아의 성장, 생리적 변화 및 모.영아 상호작용에 미치는 효과)

  • Kim, Mi-Ye;Kim, Sun-Hee
    • Korean Parent-Child Health Journal
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    • v.3 no.1
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    • pp.1-14
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    • 2000
  • The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

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LIM Implementation Method for Planning Biotope Area Ratio in Apartment Complex - Focused on Terrain and Pavement Modeling - (공동주택단지의 생태면적률 계획을 위한 LIM 활용방법 - 지형 및 포장재 모델링을 중심으로 -)

  • Kim, Bok-Young;Son, Yong-Hoon;Lee, Soon-Ji
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.3
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    • pp.14-26
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    • 2018
  • The Biotope Area Ratio (BAR) is a quantitative pre-planning index for sustainable development and an integrated indicator for the balanced development of buildings and outdoor spaces. However, it has been pointed out that there are problems in operations management: errors in area calculation, insufficiency in the underground soil condition and depth, reduction in biotope area after construction, and functional failure as a pre-planning index. To address these problems, this study proposes implementing LIM. Since the weights of the BAR are mainly decided by the underground soil condition and depth with land cover types, the study focused on the terrain and pavements. The model should conform to BIM guidelines and standards provided by government agencies and professional organizations. Thus, the scope and Level Of Detail (LOD) of the model were defined, and the method to build a model with BIM software was developed. An apartment complex on sloping ground was selected as a case study, a 3D terrain modeled, paving libraries created with property information on the BAR, and a LIM model completed for the site. Then the BAR was calculated and construction documents were created with the BAR table and pavement details. As results of the study, it was found that the application of the criteria on the BAR and calculation became accurate, and the efficiency of design tasks was improved by LIM. It also enabled the performance of evidence-based design on the terrain and underground structures. To adopt LIM, it is necessary to create and distribute LIM library manuals or templates, and build library content that comply with KBIMS standards. The government policy must also have practitioners submit BIM models in the certification system. Since it is expected that the criteria on planting types in the BAR will be expanded, further research is needed to build and utilize the information model for planting materials.

Serum Vascular Endothelial Growth Factor as a Predictive Risk Factor for the Occurrence of Coronary Artery Lesions in Kawasaki Disease (가와사끼병에서 관상동맥류 발생에 관한 혈청 Vascular Endothelial Growth Factor의 임상적 의의)

  • Park, Min Hyuk;Jung, Hye Lim;Yang, Ju Hee;Shim, Jung-Yeon;Kim, Deok Soo;Shim, Jae Won;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.811-816
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    • 2003
  • Purpose : Kawasaki disease is an acute systemic vasculitis of unknown etiology with a predilection for the coronary arteries. Vascular endothelial growth factor(VEGF) is a cytokine which promotes vascular permeability and angiogenesis. We investigated serum VEGF(sVEGF) levels in Kawasaki disease to determine whether sVEGF level can be used as a risk factor to predict the occurrence of coronary artery lesions(CAL) in Kawasaki disease. Methods : We measured sVEGF levels in 11 patients with Kawasaki disease in acute phase(patient group)and 11 normal children(control group) by enzyme-linked immunosorbent assay(ELISA) method. We investigated the relationship between sVEGF levels and the lumen diameters of coronary artery and other potential CAL risk factors; duration of fever, hemoglobin, WBC counts, platelet counts, ESR, CRP and LDH levels. Results : SVEGF levels of patients in the acute phase of Kawasaki disease(mean $847.9{\pm}495.7pg/mL$) were significantly higher than that of normal controls(mean $279.9{\pm}150.6pg/mL$; P<0.05). SVEGF levels showed significant positive correlation with the lumen diameters of the coronary artery(P<0.05, $r_s=0.75$) in the patient group. There was no significant correlation between sVEGF levels and duration of fever or other laboratory measurements. Conclusion : Our results support the notion that sVEGF level may be considered as a predictive indicator for the occurrence of coronary artery lesions in Kawasaki disease.

Dietary effect of green tea extract on epidermal levels of skin pH related factors, lactate dehydrogenase protein expression and activity in UV-irradiated hairless mice (자외선 조사와 병행된 녹차 식이 공급이 무모생쥐의 표피 산도 관련 인자 함량 및 젖산 탈수소 효소의 단백질 발현과 활성에 미치는 영향)

  • Lee, Bomin;Kim, Jongyei;Hwang, Jaesung;Cho, Yunhi
    • Journal of Nutrition and Health
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    • v.49 no.2
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    • pp.63-71
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    • 2016
  • Purpose: Skin pH, an indicator of skin health, is maintained by various organic factors, which include lactate, free amino acid (FAA), and free fatty acid (FFA). As skin ages or with illness, skin pH becomes less acidic, and functional food has been developed to maintain the acidic pH of skin. In this study, we determined the dietary effect of green tea extract (GTE) on skin pH of photo-aged mice, as measured by epidermal levels of lactate, FAA, and FFA. The protein expression and activity of lactate dehydrogenase (LDH), an enzyme of pyruvate reduction for lactate generation, was further determined. Methods: Albino hairless mice were fed a control diet (group UV+) or a diet with 1% GTE (group GTE) in parallel with UV irradiation for 10 weeks. A normal control group was fed a control diet without UV irradiation for 10 weeks (group UV-). Results: Skin pH was higher (less acidic) in group UV+ than in group UV-. In parallel, epidermal levels of lactate and FFA, as well as of LDH protein expression and activity, were reduced in group UV+. Dietary supplementation of GTE (group GTE) reduced skin pH to similar to the level of group UV-, and inversely increased epidermal levels of lactate, LDH protein expression and activity, but not of FFA. Although epidermal levels of FAA were similar in groups UV- and UV+, it was increased in group GTE to a level higher than in group UV-. In further analysis of major FFA, epidermal levels of palmitic acid [16:0], oleic acid [18:1(n-9)], and linoleic acid [18:2(n-6), but not of stearic acid [18:0] in group GTE were similar to or lower than those in group UV+. Conclusion: Dietary GTE normalized skin pH with increased levels of lactate and FAA, as well as with increased protein expression and activity of LDH in the epidermis of UVB irradiated hairless mice.

Changes in Provenance and Transport Process of Fine Sediments in Central South Sea Mud (남해중앙니질대 세립질 퇴적물의 기원지 및 이동과정 변화)

  • Lee, Hong Geum;Park, Won Young;Koo, Hyo Jin;Choi, Jae Yeong;Jang, Jeong Kyu;Cho, Hyen Goo
    • Journal of the Mineralogical Society of Korea
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    • v.32 no.4
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    • pp.235-247
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    • 2019
  • The Central South Sea Mud (CSSM), developed in the Seomjin River estuary, is known to be supplied with sediments from Heuksan Mud Belt (HMB) and Seomjin River. However, in order to form a mud belt, more sediments must be supplied than supplied in the above areas. Therefore, research on additional sources should be conducted. In this study, clay minerals, major elements analyzes were performed on cores 16PCT-GC01 and 16PCT-GC03 in order to investigate the transition in the provenance and transport pathway of sediments in CSSM. The Huanghe sediments are characterized by higher smectite and the Changjiang sediments are characterized by higher illite. Korean river sediments contain more kaolinite and chlorite than those of chinese rivers. Korean river sediments have higher Al, Fe, K concentraion than Chinese river sediments and Chinese rivers have higher Ca, Mg, Na than those of Korean rivers. Therefore, clay minerals and major elements can be a useful indicator for provenance. Based on our results, CSSM can be divided into three sediment units. Unit 3, which corresponds to the lowstand stage, is interpreted that sediments from Huanghe were supplied to the study area by coastal or tidal currents. Unit 2, which corresponds to the transgressive stage, is interpreted to have a weaker Huanghe effect and a stronger Changjiang and Korean rivers effect. Unit 1, which corresponds to the highstand stage when the sea level is the same as present and current circulation system is formed, is interpreted that sediments from Changjiang and Korean rivers are supplied to the research area through the current.

Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.