The purpose of this study was to determine the zinc status of preschool children in Ulsan. The study was conducted in 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the biochemical analysis. The blood was analysed to assess serum zinc and alkaline phosphatase. And a questionnaire for dietary intakes using 24-hr recall method were performed by mothers of 95 subjects. The dietary intakes of children were analysed to determine the prevalence of inadequate and excessive intakes of zinc with Dietary Reference Intakes for Koreans (KDRIs). WHL (Weight-Length Index) and Kaup index were used to define obesity. The overall prevalence of overweight and obese subjects were 14.7% and 6.3% by WHL, were 15.8% and 13.7% by Kaup index. The mean intakes of zinc by children aged 3${\sim}$5y and 6y were 5.5 ${\pm}$ 1.4 mg/d (75.7% RDA) and 6.7 ${\pm}$ 2.0 mg/d, respectively, that was the level exceeding the estimated average requirement (EAR) and the recommended intake (RI) of Korean Dietary Reference Intakes. Less than 1.3% and 7.9% of children had usual zinc intakes below EAR and RI of KDRIs, respectively. The percentages of children with intakes exceeding the tolerable upper intake level (UL) were 2.6%. The zinc nutritional status by biological assay was found that mean serum zinc and alkaline phosphatase (ALP) of total subjects were 64.0 ${\pm}$ 8.4 ${\mu}$g/dl and 72.8 ${\pm}$ 14.9 U/L, there was not a significant difference between boys and girls. The range of serum zinc level was 45${\sim}$89 ${\mu}$g/dl and children with a low serum zinc concentration by several cut-off points were 18.9${\sim}$55.8%, especially. Serum zinc level was positively correlated to the intakes of calorie, calcium, fiber, iron, zinc, zinc/kg and height (p<0.001). Serum ALP was positively correlated height, weight and WLI. The zinc intake of children aiso showed a positive correlation with height and weight. These results indicate that there were significant correlations between the zinc status and growth of preschool children. Preschool children in Ulsan have dietary zinc intakes that exceed the new DRIs. The present level of intake does not seem to pose a health problem, but if zinc intakes with fortified foods and supplements were considered, the amount of zinc consumed by children may become excessive.
Purpose : Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis. Methods : Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays. Results : The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was $2.83{\times}10^7copies/mL$ (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis. Conclusion : Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.
Objectives: The aim of this study was to evaluate the usefulness of Anti-mullerian hormone (AMH) as a predictive marker for ovarian response and cycle outcome in IVF cycles. Methods: From Jan., to Aug., 2007, 111 patients undergoing IVF/ICSI stimulated by short or antagonist protocol were selected. On cycle day 3, basal serum AMH level and FSH level were measured. The correlation between basal serum AMH or FSH, and COH outcome was analyzed and IVF outcome was compared according to the AMH levels. To determine the threshold value of AMH for poor- and hyper-response, ROC curve was analyzed. Results: Serum AMH showed higher correlation coefficient (r=0.792, p<0.001) with the number of retrieved mature oocyte than serum FSH (r=-0.477, p<0.001). According to ovarian response, FSH and AMH leves showed significant differences among poor, normal, and hyperresponder. For predicting poor (${\leq}2$ oocytes) and hyperresponse (${\geq}17$ oocyets), AMH cut-off values were 0.5 ng/ml (the sensitivity 88.9% and the specificity 89.5%) and 2.5 ng/ml (sensitivity 85.7%, specificity 87.0%), respectively. According to the AMH level, patients were divided into 3 groups: low (${\leq}0.60\;ng/ml$), normal ($0.60{\sim}2.60\;ng/ml$), and high AMH (${\geq}2.60\;ng/ml$). The number of retrieved mature oocytes was significantly higher ($2.7{\pm}2.2$, $8.1{\pm}4.8$, $16.5{\pm}5.7$) and total gonadotropin dose was lower ($3530.5{\pm}1251.0$, $2957.1{\pm}1057.6$, and $2219.2{\pm}751.9\;IU$) in high AMH group (p<0.001). There was no significant difference in fertilization rates and pregnancy rates (23.8%, 34.0%, 37.5%) among the groups. Conclusions: Basal serum AMH level correlated better with the number of retrieved mature oocytes than FSH level, suggesting its usefulness for predicting ovarian response. However, IVF outcome was not significantly different according to the AMH levels. Serum AMH level presented good cut-off value for poor- or hyper-responders, therefore it could be useful in prediction of cycle cancellation, gonadotropin dose, and OHSS risk in IVF cycles.
Purpose: Measurement of serum ceruloplasmin level is the first step in screening for Wilson's disease (WD). Despite the rarity of WD in the general population, ceruloplasmin levels are routinely measured through hepatitis screening in both adults and children. Herein, we evaluated the diagnostic value of ceruloplasmin for the diagnosis of WD among children with hepatitis. Methods: We retrospectively reviewed data on serum ceruloplasmin levels measured as a serologic marker for patients with hepatitis at Asan Medical Center (Seoul, Korea) between from January 2004 to November 2013. The diagnosis of WD was confirmed by the identification of pathogenic variants in the ATP7B gene. To determine the diagnostic accuracy of ceruloplasmin, receiver operation characteristic (ROC) curves were constructed and the area under curve (AUC) were calculated. Results: Measurements of serum ceruloplasmin were performed in 2,834 children who had hepatitis. Among these, 181 (6.4%) children were diagnosed with WD. The sensitivity, specificity, and accuracy of a ceruloplasmin level of <20 mg/dL in the discrimination of WD were 93.4%, 84.2%, and 84.8%, respectively. In this study, 418 (14.7%) false-positive cases and 12 (0.4%) false-negative cases were noted. Using a ROC curve, a ceruloplasmin level of ${\leq}16.6mg/dL$ showed the highest AUC value (0.956) with a sensitivity of 91.2%, a specificity of 94.9%, and an accuracy of 94.7%. Conclusion: The measurement of serum ceruloplasmin was frequently used for the screening of WD in children, despite a low positive rate. The diagnostic value of ceruloplasmin may be strengthened by adopting a new lower cut-off level.
In this paper, we propose a personalized cooling management system with thermal imaging camera. The proposed equipment uses a thermal imaging camera to control the amount of cold air and the system according to the difference between the user's skin temperature before and after the procedure. When the skin temperature is abnormally low, the cold air supply is cut off to prevent the possibility of a safety accident. It is economical by replacing the skin temperature sensor with a thermal imaging camera temperature measurement, and it can be visualized because the temperature can be checked with the thermal image. In addition, the proposed equipment improves the sensitivity of the sensor that measures the distance to the skin by calculating the focal length by using a dual laser pointer for the safety of a personalized cooling management system to which a thermal imaging camera is applied. In order to evaluate the performance of the proposed equipment, it was tested in an externally accredited testing institute. The first measured temperature range was -100℃~-160℃, indicating a wider temperature range than -150~-160℃(cryo generation/USA), which is the highest level currently used in the field. In addition, the error was measured to be ±3.2%~±3.5%, which showed better results than ±5%(CRYOTOP/China), which is the highest level currently used in the field. The second measured distance accuracy was measured as below ±4.0%, which was superior to ±5%(CRYOTOP/China), which is the highest level currently used in the field. Third, the nitrogen consumption was confirmed to be less than 0.15 L/min at the maximum, which was superior to the highest level of 6 L/min(POLAR BEAR/USA) currently used in the field. Therefore, it was determined that the performance of the personalized cooling management system applied with the thermal imaging camera proposed in this paper was excellent.
Jae Beom Jeon;Cho Hee Lee;Yongwhan Lim;Min-Chul Kim;Hwa Jin Cho;Do Wan Kim;Kyo Seon Lee;In Seok Jeong
Journal of Chest Surgery
/
v.56
no.4
/
pp.244-251
/
2023
Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.
Purpose: This study was to investigate the prognostic significance of the preoperative fibrinogen and systemic inflammation response index (F-SIRI) in a Chinese cohort of resectable gastric cancer. Materials and Methods: Baseline characteristics, preoperative fibrinogen levels and peripheral neutrophil, monocyte, and lymphocyte counts were retrospectively reviewed in 240 patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and SIRI were defined as 4.0 g/L and 1.2. Then patients with hyperfibrinogenemia (≥4.0 g/L) and high SIRI (≥1.2) were assigned with an F-SIRI of 2 (both of these hematological abnormalities), 1 (one of these abnormalities), and 0 (neither abnormality), respectively. The prognostic value was examined by univariate and multivariate survival analysis. Results: Preoperative F-SIRI was significantly correlated with tumor size, fibrinogen level, and adjuvant chemotherapy. Whereas there was no significant difference in age, gender, tumor location or other characteristics between groups. In addition, high preoperative F-SIRI was significantly associated with worse disease-free survival (DFS) (hazard ratio [HR], 2.299; 95% confidence interval [CI], 1.482-3.566; P<0.001) and overall survival (OS) (HR, 2.461; 95% CI, 1.584-3.824; P<0.001) by univariate survival analysis. Moreover, it remained an independent predictor for impaired DFS (HR, 2.023; 95% CI, 1.273-3.215; P=0.003) and OS (HR, 2.341; 95% CI, 1.480-3.705; P<0.001) in multivariate Cox regression analysis. Conclusions: Preoperative F-SIRI could serve as a significantly prognostic marker for long-term survival in Chinese patients who underwent radical gastrectomy.
Background: Although nicotine dependence plays a role as a main barrier for smoking cessation, there is still a lack of solid evidence on the validity of biomarkers to determine nicotine dependence in clinical settings. This study aimed to investigate whether urinary cotinine levels could reflect the severity of nicotine dependence in active smokers. Materials and Methods: Data regarding general characteristics and smoking status was collected using a self-administered smoking questionnaire. The Fagerstr$\ddot{o}$m test for nicotine dependence (FTND) was used to determine nicotine dependence of the participants, and a total of 381 participants were classified into 3 groups of nicotine dependence: low (n=205, 53.8%), moderate (n=127, 33.3%), and high dependence groups (n=49, 12.9%). Stepwise multiple linear regression model and receiver operating characteristic (ROC) curves analyses were used to determine the validity of urinary cotinine for high nicotine dependence. Results: In correlation analysis, urinary cotinine levels increased with FTND score (r=0.567, P<0.001). ROC curves analysis showed that urinary cotinine levels predicted the high-dependence group with reasonable accuracy (optimal cut-off value=1,000 ng/mL; AUC=0.82; P<0.001; sensitivity=71.4%; specificity=74.4%). In stepwise multiple regression analysis, the total smoking period (${\beta}$=0.042, P=0.001) and urinary cotinine levels (${\beta}$=0.234, P<0.001) were positively associated with nicotine dependence, whereas an inverse association was observed between highest education levels (>16 years) and nicotine dependence (${\beta}$=-0.573, P=0.034). Conclusions: The results of this study support the validity of using urinary cotinine levels for assessment of nicotine dependence in active smokers.
Aim: The aim of this study was to investigate the frequency and correlation between auto-antibodies to survivin and MUC1 variable number tandem repeats (VNTR) in colorectal cancer (CRC), which can provide valuable information for the design of immunotherapeutic vaccines for this disease. Methods: Enzyme-linked immunosorbent assays (ELISA) were used to examine the level of auto-antibodies against survivin and MUC1 VNTR in the serum of 135 CRC patients and 95 healthy volunteers. Results: Using mean absorbance + 2 standard deviations (SD) of the healthy samples as a cut-off value, the positive rates of survivin and MUC1 VNTR auto-antibodies in CRC were 31.1% and 18.5%, respectively. Altogether, the survivin and MUC1 VNTR positive samples accounted for 36.3% of the CRC patients, and 7.4% were positive for both. Conclusion: A significant positive correlation was found between levels of specific antibodies against survivin and MUC1 VNTR in the serum of CRC patients (r = 0.3652, P < 0.0001), suggesting that vaccines against both targets would elicit immune responses more effectively.
Background: Relationships between poor prognosis of ovarian malignancies and changes in complete blood count parameters have been proposed previously. In this work, we aimed to evaluate clinicopathologic features in adolescents with adnexal masses and sought to establish any predictive value of the platelet to lymphocyte ratio (PLR) in diagnosis. Materials and Methods: This retrospective study was conducted on 196 adolescent females with adnexal masses. Three groups were constituted with respect to clinical or histopathology results: group 1, non-neoplastic patients (n:65); group 2, neoplastic patients (n:68); and group 3 expectantly managed patients (n:63). The main parameters recorded from the hospital database and patient files were age, body mass index (BMI), chief symptoms, diameter of the mass (DOM), tumor marker levels, complete blood count values including absolute neutrophil, lymphocyte, and platelet counts, mean platelet volume, platelet distribution width, and platecrit, surgical features, and postoperative histopathology results. Results: The expectantly managed patients were younger than the other groups (p=0.007). The mean body mass index (BMI) was higher in the neoplastic group (p=0.016). Preoperative DOM, CA125, mean platelet volume and PLR were statistically significantly different between the groups (p<0.05). ROC curve analysis demonstrated that increased PLR (AUC, 0.609; p=0.011) and BMI (AUC, 0.611; p=0.011) may be discriminative factors in predicting ovarian neoplasms in adolescents preoperatively. When the cut-off point for the PLR level was set to 140, the sensitivity and specificity levels were found to be 65.7% and 57.6%, respectively. Conclusions: We suggest that beside a careful preoperative evaluation including clinical characteristics, ultrasonographic features and tumor markers, PLR may predict ovarian neoplasms in adolescents.
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