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

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

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.285-290
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• 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.139-144
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• 2012

Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

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

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

• Journal of Biomedical Engineering Research
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• v.23 no.1
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• pp.1-8
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• 2002

Atrial fibrillation(AF). chronic or paroxysmal is the most frequent arrhythmia in human subjects Duration of P wave in signal-averaged electrocardiography(SAECG) reflects intra-atrial conduction time and therefore. could be used as an electrophysiological marker for atrial conduction chance at the earthy stave. So we apply the analysis method using SAECG to diagnose Paroxysmal atrial fibrillation(PAF) . Subjects Participated for the study consisted of two groups: a control group(n=34) of normal healthy volunteers and a group of AF Patients(n=38) with a documented history of PAF but no other history of cardiac disease. We evaluated the effect of several filtering and determination methods to find the starting and ending feints of the P wavy on its duration. To increase the measurement reliability of P wave duration. the automatic detection method was proposed. Also. to increase the detection rate for PAF risk, the decision threshold value was optimized using receiver operation characteristics(ROC) curve. Results showed that the highest statistical difference (p〈0.001) of the P wane duration between controls and subjects was obtained at the Processing condition, using absolute threshold vague(8.75 $\mu N$) , a least mean square(LMS) high pass filter and 30 Hz cutoff frequency. The most outstanding difference(sensitivity 88 % specificity 64.4 %) between controls and subjects was obtained at the decision threshold value of 112 ms.

• Tuberculosis and Respiratory Diseases
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• v.68 no.4
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• pp.205-211
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• 2010

Background: Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. Methods: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. Results: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value >0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05~0.84] vs. 10.3 [0.05~22.87] ng/mL, p=0.045). Conclusion: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.11 no.2
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• pp.91-98
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• 2017

Background & Object: Basic daily activity screening tool such as the Modified Barthel Index (MBI) has been used commonly in rehabilitation clinic and community based rehabilitation setting. Previous studies have shown the significant relations between the level of daily activities and driving ability on stroke or elderly people. However, there is a lack of studies to investigate the usefulness of MBI on prediction of driving ability for stroke patient. This study was to predict driving abilities of stroke survivor using Korean version Modified Barthel Index (K-MBI). Methods: A sample of 48 patients with stroke in rehabilitation hospital was recruited. All participants were tested level of basic daily activities using K-MBI. The driving ability of participants was tested using virtual reality driving simulator. The predictive validity was calculated of the K-MBI among pass or fail group of driving simulator test using receiver operating characteristics curves. Results: The cut-off score of >86.5 on the K-MBI is proper sensitivity to predict on driving performance ability. Conclusion: This pilot result offers clinical reference to therapists and caregivers for reasoning on driving recommendation period during rehabilitation stage of stroke survivors. Further studies need to identify prediction using real on-road test in a large population group.

• The Journal of Korean Institute of Electromagnetic Engineering and Science
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• v.26 no.4
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• pp.381-388
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• 2015

In this paper, a wireless video streaming system is designed and implemented for TV white space applications. It consists of a RF transceiver module, a digital modem, a camera, and a LCD screen. A VGA resolution video is captured by a camera, modulated by modem, and transmitted by RF transceiver module, and finally displayed at a destination 2.6-inch LCD screen. The RF transceiver is based on direct-conversion architecture. Image leakage is improved by low pass filtering LO, which successfully covers the TVWS. Also, DC offset problem is solved by current steering techniques which control common mode level at DAC output node. The output power of the transmitter and the minimum sensitivity of the receiver is +10 dBm and -82 dBm, respectively. The channel bandwidth is tunable among 6, 7 and 8 MHz according to regulations and standards. Digital modem is realized in Kintex-7 FPGA. Data rate is 9 Mbps based on QPSK and 512ch OFDM. A VGA video is successfully streamed through the air by using the developed TV white-space RF communication module.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.5-13
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• 2003

The purpose of this study is to determine the value of serum concentration of C-reactive protein(CRP) in comparison with ESR and leukocyte as the tools for diagnosis and follow-up study of infection. For this study, thirty-one patients with head and neck infection and thirty-two patients performed the orthognathic surgery were selected for experimental and control groups each other. we analyzed the blood sample daily to measure CRP, ESR and leukocytosis. The results of this study are as the following : 1. Serum C-Reactive Protein levels in the experimental group were higher than control group and the pattern of CRP changes continued to decline in both groups(P<0.001). 2. ESR changes in both groups were scattered without any special pattern. 3. Correlation between CRP and Leukocyte was higher than others(r=0.664, P<0.01). 4. In the Receiver Operating Characteristic(ROC) Curve of experimental group, rapid increase of CRP curve and Area under the curve(AUC) value, 0.774, indicate the high accuracy of estimation. 5. In experimental group, sensitivity of CRP, ESR, and Leukocytosis on recovery day were 83%, 17% and 71%. Based on the results of this study, we could conclude that determination of CRP is more useful method to diagnosis and follow-up study of infection than other commonly used variables in oral and maxillofacial region.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.48 no.4
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• pp.1-9
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• 2011

Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.