• Title/Summary/Keyword: Nadir

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The predictive value of serum myeloma protein in solitary plasmacytoma

  • Chang, Won Ick;Koh, Hyeon Kang;Yoon, Sung-Soo;Kim, Han-Soo;Eom, Keun-Yong;Kim, Il Han
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.129-137
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    • 2020
  • Purpose: To identify the clinical usefulness of serum M protein and to establish a rationale for regular follow-up with serum protein electrophoresis in solitary plasmacytoma. Materials and Methods: Sixty-nine patients with solitary plasmacytoma and solitary plasmacytoma with minimal marrow involvement according to the International Myeloma Working Group criteria were retrospectively reviewed. Results: At a median follow-up of 6.2 years, 5-year local control (LC), 5-year multiple myeloma-free survival (MMFS), 5-year failure-free survival (FFS), and 5-year overall survival (OS) were 82.6%, 44.1%, 41.8%, and 85.1%, respectively. Among the patients whose initial serum M protein was present or not evaluated, 37.3% of patients showed disappearance of serum M protein after various treatment. MMFS of these patients were comparable to non-secretory plasmacytoma with undetectable levels of M protein, and significantly better than patients with persistent M protein. Increase of serum M protein ≥0.1 g/dL was most predictive of treatment failure with area under the curve of 0.731. Conclusion: Patients who eventually showed persistence of serum M protein after treatment showed worse MMFS and FFS compared to those whose serum M protein disappeared or who had initially non-secretory disease. The increase of serum M protein level ≥0.1 g/dL from current nadir was predictive of treatment failure. Therefore, regular follow-up with serum M protein is highly recommended especially unless the patient had initially non-secretory disease.

Report on the Guillain-Barre Syndrome with Autonomic Dysfunction(1 Case) (자율신경 기능 이상을 동반한 Guillain-Barre 증후군 1례)

  • Kim, Dong-Ung;Shin, Sun-Ho;Cho, Gwon-Il;Shin, Hak-Su;Han, Myung-A;Choi, Jin-Young;Choi, Woo-Jung;Yang, Jae-Hun;Chung, Yong-Jun;Kim, Kwan-Sick
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.453-458
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    • 2001
  • Guillain-Barre syndrome, or acute inflammatory demyelinating Polyradiculoneuropathy, is frequently accompanied by cardiac and autonomic dysfunction. We report a patient who had tachycardia, orthostatic hypotension, hypertension, pronounced blood pressure fluctuations, abnormal sweating, constipation and urinary frequency as well as qudriparesis. We thought that the GBS was incurred by Damp-Heat, used Heat-Clearing and Dampness-Transforming decoction(Chongjoo-tang) in the early stage. In the later stage, fortifying the Spleen and Boosting Qi plus Supplementing the Kidney decoction(Palmultang+chongawon) was used to remove low back pain and boost recovery. The patient reached the nadir 14 days after onset. He became bed-bound and autonomic dysfunction was very severe. From 3rd week, abnormalities of autonomic function and paresis impoved gradually and he could walk above 5m without walker or equivalent support at the 5th week after onset.

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An Artificial Intelligence Approach for Word Semantic Similarity Measure of Hindi Language

  • Younas, Farah;Nadir, Jumana;Usman, Muhammad;Khan, Muhammad Attique;Khan, Sajid Ali;Kadry, Seifedine;Nam, Yunyoung
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.15 no.6
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    • pp.2049-2068
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    • 2021
  • AI combined with NLP techniques has promoted the use of Virtual Assistants and have made people rely on them for many diverse uses. Conversational Agents are the most promising technique that assists computer users through their operation. An important challenge in developing Conversational Agents globally is transferring the groundbreaking expertise obtained in English to other languages. AI is making it possible to transfer this learning. There is a dire need to develop systems that understand secular languages. One such difficult language is Hindi, which is the fourth most spoken language in the world. Semantic similarity is an important part of Natural Language Processing, which involves applications such as ontology learning and information extraction, for developing conversational agents. Most of the research is concentrated on English and other European languages. This paper presents a Corpus-based word semantic similarity measure for Hindi. An experiment involving the translation of the English benchmark dataset to Hindi is performed, investigating the incorporation of the corpus, with human and machine similarity ratings. A significant correlation to the human intuition and the algorithm ratings has been calculated for analyzing the accuracy of the proposed similarity measures. The method can be adapted in various applications of word semantic similarity or module for any other language.

Night shift preparation, performance, and perception: are there differences between emergency medicine nurses, residents, and faculty?

  • Richards, John R.;Stayton, Taylor L.;Wells, Jason A.;Parikh, Aman K.;Laurin, Erik G.
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.240-248
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    • 2018
  • Objective Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Conclusion Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

Gloria Naylor's Linden Hills: A Tragic Saga of the Oppressive "Primal Scene" and Deformed "Family Romance" (글로리아 네일러의 『린덴 힐즈』 -억압적 '원장면'과 왜곡된 '가족 로맨스'의 비극)

  • Hwangbo, Kyeong
    • Journal of English Language & Literature
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    • v.58 no.1
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    • pp.21-42
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    • 2012
  • Gloria Naylor's second novel Linden Hills (1985) explores the issues of self-exploration, empowerment, history, and memory by delineating the communal and familial tragedies and the distortion of values prevalent in a prosperous African-American urban community called Linden Hills. Drawing upon the Freud's concept of "primal scene" and "family romance," this paper aims to focus upon the Nedeed family, the founder of Linden Hills, and investigate the compelling traumatogenic force within the family, which is inseparably intertwined with the inversion of values and moral corruption permeating the entire community. The "primal crime" committed by the Nedeed ancestors serves to preserve and perpetuate a tyrannical rule by ruthless patriarchs who reign by underhanded strategies of purposefully neglecting and abusing others, including their own wives. The imprisonment, by Luther Nedeed, of his wife Willa in the family morgue epitomizes the long legacy running in the family-the oppression and burial of the pre-Oedipal, maternal history. Willa's accidental encounter, at the nadir of the family estate and her personal despair, with the faded records of the forgotten and abused Nedeed women exposes the violence-ridden ground of the family's primal scene and the absurdity of family romance the Nedeeds pursued. As the several lines of poem composed by Willie, Willa's male double, show, the hidden, forgotten history of the Nedeed women, in a sense, is the real, which cannot be assimilated to the social symbolic governed by the inhumane patriarchy of the Nedeed family and the success-oriented Linden Hills society. By portraying a catastrophic downfall of the Nedeed family and the futile outcome of its family romance, the ending of Linden Hills conveys implicitly that the contingent symbolic order and its oppressive control, however solid and invincible they may seem, can be toppled down by the real, its nameless forgotten Other.

Damage identification in a wrought iron railway bridge using the inverse analysis of the static stress response under rail traffic loading

  • Sidali Iglouli;Nadir Boumechra;Karim Hamdaoui
    • Smart Structures and Systems
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    • v.32 no.3
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    • pp.153-166
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    • 2023
  • Health monitoring of civil infrastructures, in particular, old bridges that are still in service, has become more than necessary, given the risk that a possible degradation or failure of these infrastructures can induce on the safety of users in addition to the resulting commercial and economic impact. Bridge integrity assessment has attracted significant research efforts over the past forty years with the aim of developing new damage identification methods applicable to real structures. The bridge of Ouled Mimoun (Tlemcen, Algeria) is one of the oldest railway structure in the country. It was built in 1889. This bridge, which is too low with respect to the level of the road, has suffered multiple shocks from various machines that caused considerable damage to its central part. The present work aims to analyze the stability of this bridge by identifying damages and evaluating the damage rate in different parts of the structure on the basis of a finite element model. The applied method is based on an inverse analysis of the normal stress responses that were calculated from the corresponding recorded strains, during the passage of a real train, by means of a set of strain gauges placed on certain elements of the bridge. The results obtained from the inverse analysis made it possible to successfully locate areas that were really damaged and to estimate the damage rate. These results were also used to detect an excessive rigidity in certain elements due to the presence of plates, which were neglected in the numerical reference model. In the case of the continuous bridge monitoring, this developed method will be a very powerful tool as a smart health monitoring system, allowing engineers to take in time decisions in the event of bridge damage.

Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study

  • Jun Seop Kim;Jae Hoon Chung;Wan Song;Minyong Kang;Hyun Hwan Sung;Hwang Gyun Jeon;Byong Change Jeong;Seong Il Seo;Hyun Moo Lee;Seong Soo Jeon
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.412-418
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    • 2023
  • Background: The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP). Methods: A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis. Results: Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002-1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022-6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110-4.438; p=0.024). Conclusion: Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Alterations in Thyroid Hormone Levels After Open Heart Surgery (개심술 후 갑상선 호르몬치 변화에 대한 연구)

  • 김광휴;조삼현
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.131-136
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    • 1997
  • The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prosnosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively: The results were as follows : 1. Serum triiodothyronine(73) reached to its nadir(30.05 $\pm$ 17.5ng/dl, p(0.001) at 10 minutes after the start of CPB and remained low(p(0.05) throughout the study period. 2. Serum thyroxine(74) concentr tion slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(W4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37 $\pm$ 0.81u1U/m1, p(0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum 73 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum 73 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.

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The alteration of the positive rate of cytomegalovirus IgG antibody among preschool period children (학령 전기 소아에서 거대세포바이러스 IgG 항체 양성률의 변동)

  • Seo, Se-Young;Park, Sang-Jun;Hwang, Ja-Young;Hahn, Seong-Hoon;Kim, So-Young;Kim, Hyun-Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.51-55
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    • 2006
  • Purpose : In order to evaluate the time of disappearance of cytomegalovirus(CMV) IgG antibodies from mothers, and the alteration of the positive rate of CMV IgG antibodies among preschool period children, we investigated the positive rate of CMV antibodies among preschool children. Methods : We studied 391 children who visited the Department of Pediatrics from March, 2001 to February, 2004. We measured the serum CMV IgG of 217 children and the serum CMV IgM of 358 children. Results : The positive rate of CMV IgG antibodies is 83.9 percent(the number of positive IgG children is 182 out of 217). The alteration of the positive rate is 92.9 percent in 0-3 months, 75.0 percent in 4-6 months and the nadir was 20.0 percent in 7-9 months. Then, the positive rate increased to 83.9 percent in 22-24 months. After 22 months, the positive rate was 92.1 percent(the number of positive IgG children was 105 out of 114). The positive rate of CMV IgM antibody by age is 3.3 percent in 0-1 months, 3.6 percent in 1-2 months, 10.5 percent in 2-3 months, 14.3 percent in 3-4 months, 14.3 percent in 4-5 months, and then the results of five children among 148 children were positive. The distribution was one in 22-23 months, one in 25-26 months, one in 27-28 months, one in 28-29 months, one in 40-41 months. We discovered IgM positive children succesively from birth to 5 months, but sporadically after 5 months. Conclusion : The CMV IgG from mothers has decreased since birth and the time of nadir is 7-9 months. But it increases to a mean value of 83.9 percent at 22-24 months because of perinatal or postnatal infections.

Platelet count and mean platelet volume in low birth weight infants (≤2,000 g) with sepsis (패혈증에 이환된 저출생체중아(≤2,000 g)에서 혈소판수치와 평균혈소판용적의 변화)

  • Lee, Wan-soo;Cho, Jin-young;Yoo, Seung-taek;Lee, Chang-woo;Choi, Doo-young;Kim, Jong-duck;Oh, Yeon-kyun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.643-648
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    • 2007
  • Purpose : Sepsis is a common complication in Neonatal Intensive Care Units (NICU), seen especially in low birth weight (LBW) infants. A recent study showed that fungal or gram-negative sepsis is associated with a greater degree of thrombocytopenia than is seen with gram-positive sepsis. So, this study was undertaken to examine the platelet counts and platelet indices in LBW infants during episodes of sepsis. Methods : We analyzed 36 cases with culture-proven sepsis on chart review in LBW infants admitted to the NICU at Wonkwang University Hospital from January 2001 to June 2006. Results : Patients were grouped by organism type: gram-positive bacteria ($1,521{\pm}309g$, $31.3{\pm}2.9wk$, 15/36), gram-negative bacteria ($1,467{\pm}290g,\;30.6{\pm}3.6wk$, 17/36), and fungi ($1,287{\pm}205g,\;30.0{\pm}3.9wk$, 4/36). The most common organism was Staphylococcus epidermis and the incidence of thrombocytopenia was 88.9%. When compared with infants with gram-positive sepsis, those with gram-negative sepsis had significantly higher incidences of thrombocytopenia, lower initial platelet count, lower platelet nadir, and greater mean percentage decrease in platelet count from before the onset of sepsis. Those with fungal infections were similar to gram-negative sepsis, but they were not significant because of the small number of patients. And mean platelet volume (MPV) in sepsis was increased more significantly in time of platelet nadir than before the onset of sepsis. Conclusion : We conclude that decrease in platelet count was significantly greater in gram-negative sepsis than gram-positive sepsis, and also greater than fungal sepsis-which was insignificant because of the small number of patients-in LBW infants. And elevation in MPV will be helpful in the diagnosis and treatment of sepsis in LBW infants.