• Title/Summary/Keyword: cut off level

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The Role of Plasma B-type Natriuretic Peptide Measurements in the Differential Diagnosis of Acute Dyspnea (급성호흡곤란의 감별진단에서 혈장 B-type Natriuretic Peptide의 역할)

  • Moon, Ji Yong;Bae, Joong Ho;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.656-663
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    • 2005
  • Background : The B-type natriuretic peptide (BNP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload. Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea. Methods : A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results : The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 6-47 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed, the BNP levels were also significantly higher in the patients with heart failure than in those without(p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion : BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.

Diagnostic Value of Serum CYFRA 21-1 in Lung Cancer (폐암에서 혈중 CYFRA 21-1의 진단적 가치)

  • Yoon, Hyun-Dae;Kim, Ki-Deok;Chung, Jin-Hong;Lee, Hyung-Woo;Lee, Kwan-Ho;Lee, Hyun-Woo;Cho, Ihn-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.149-155
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    • 1995
  • 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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Soluble Triggering Receptor Expressed on Myeloid cells-1: Role in the Diagnosis of Pleural Effusions (흉수의 감별 진단 시 Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1)의 유용성)

  • Kim, Jung-Hyun;Park, Eun-Young;Kim, Won-Hee;Park, Woong;Jeong, Hye-Cheol;Lee, Ji-Hyun;Kim, Eun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.290-298
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    • 2007
  • Background: The currently available diagnostic markers for pleural effusion have a limited role. The soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a molecule recently reported to play an important role in the myeloid cell mediated inflammatory response, and is up regulated in the body fluid by bacterial or fungal products. This study examined the expression of sTREM-1 in pleural effusion. Methods: Between April 2004 and December 2005, 48 patients with pleural effusions were enrolled in this study. The pleural fluids were taken and analyzed for the total protein, glucose, lactate dehydrogenase (LDH), adenosine deaminase (ADA), and sTREM-1. Bacterial cultures and cytology tests were also performed. Results: The clinical diagnoses were 17 parapneumonic, 14 tuberculous, and 13 malignant effusions. Four patients presented with transudates. The mean ages of the parapneumonic, tuberculous and malignant effusion groups were $57.1{\pm}19.7$, $49.5{\pm}18.6$, $66.9{\pm}15.5$, and $76.0{\pm}18.1$. respectively. The level of sTREM-1 expression was significantly higher in the parapneumonic effusions ($344.0{\pm}488.7$) than in the tuberculous effusions ($81.7{\pm}56.6$) and malignant effusions ($39.3{\pm}19.6$). With a cut-off value of 55.4pg/ml, the sensitivity and specificity for a parapneumonic effusion was 70.6% and 74.1%. Conclusion: sTREM-1 expression is significantly higher in parapneumonic effusions, suggesting its potential role as an additional diagnostic marker for pleural effusions.

Relationship of serum IL-13 and eotaxin level with airway hyperresponsiveness in children with asthma (소아 천식 환아에서 혈청 IL-13 및 eotaxin 농도와 기관지과민성의 관계)

  • Park, Eun Young;Shim, Jung Yeon;Yoo, Myung Hwan;Kim, Deok Soo;Shim, Jae Won;Jung, Hye Lim;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.889-894
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    • 2006
  • Purpose : Asthma is characterized by the presence of airway hyperresponsiveness(AHR) and inflammation. The extensive eosinophil infiltration into the lung is the hallmark of asthma and contributes to the damage of respiratory epithelium during late phase airway responses. Eotaxin is the major eosinophil chemoattractant found in bronchoalveolar lavage(BAL) fluid of allergic inflammation. IL-13 has been known to induce the expression of exotaxin and eosinophilia. IL-13 also induces airway inflammation, mucus production and leads to marked fibrosis, airway remodeling and AHR. We investigated whether serum IL-13 levels can reflect the presence of airway hyperresponsiveness in children with asthma, and the relationship between serum IL-13 and eotaxin levels. Methods : Using sandwich enzyme-linked immunosorbent assay, the serum IL-13 and eotaxin levels were measured in 13 atopic asthmatics, 5 atopic non-asthmatics and 12 control subjects. Metacholine challenge tests were performed in all subjects. Airway hyperresponsiveness to metacholine was expressed as provocative concentration of metacholine causing a 20% fall in FEV1[$PC_{20}mg/mL$]. $PC_{20}$ value of 25 mg/mL was used as a cut-off for defining a AHR. Results : Serum IL-13 levels showed positive correlation with eotaxin levels. Serum IL-13 and eotaxin levels showed no differences among atopic asthmatics, atopic non-asthmatics and control subjects. And there were no differences serum IL-13 and eotaxin levels in children with and without AHR and atopy. Serum IL-13 and eotaxin levels did not correlate with $logPC_{20}$ levels. Conclusion : IL-13 is closely related to the eotaxin release. But serum IL-13 and eotaxin per se can't predict the severity of airway hyperresponsiveness. IL-13 and eotaxin may have local effect on respiratory epithelium or there can be some factors to induce airway hyperresponsiveness other than serum IL-13 in asthmatic airways.

The Usefulness According to the Incubation Time of PTH as Prediction Index of Hypocalcemia (저칼슘혈증 예측지표로서 부갑상선 호르몬 검사반응시간에 따른 유용성)

  • Au, Doo-Hee;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.138-142
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    • 2010
  • 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.

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Analysis of Immunogenicity after Hepatitis B Vaccination in Korea by Literature Review (문헌 분석에 의한 B형 간염 백신의 항체 양전률의 비교)

  • Roh, Hye Ok;Lee, Woo Gill;Sohn, Young Mo
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.245-257
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    • 1998
  • Purpose : Although hepatitis B vaccine has been available to general population in Korea since 1983, it was difficult to compare various types of hepatitis B virus(HBV) vaccines primarily due to the differences in vaccination schedule, dosage, test methods and seropositive antibody level. In this study we reviewed the results of previous studies published in Korea, which include antibody positive rates and antibody titers of various vaccines, and examined the immunogenicity of these HBV vaccines. Methods : Studies published in medical journals, university journals concerning antibody positive rates following hepatitis B vaccination were reviewed. Inclusion criteria were those studies in which seroprotective antibody rate of 10mIU/mL or the sample ratio unit of 10 RU were used as the cut-off value and in which the test methods were RIA or ELISA. Exclusion criteria were; 1) unclear or inconsistent vaccine dosage, 2) no record of antibody titers or seroconversion rate, 3) no defined antibody rate or ratio for positive rating and 4) the vaccination schedule other than 0-1-2 months or 0-1-6 months. Results : 23 out of 52 studies were subjected for the review for seroconversion rates. 1) As for the immunogenicity in each age group, the seroconversion rates of Hepaccine(Cheil Jedang) were 85.1% in infants, 83.3% in children and 62.7% in adults, indicating higher rates in infants and children compared to adults(P<0.01). The seroconversion rates of Hepavax(Korea Green Cross) were 84.7%, 81.1% and 90.8%, indicating higher rates in infants and adults compared to children(P<0.01). 2) The seroconversion rate of Hepavax was 85.6% with 0-1-6 mo. schedule, 78.5% with 0-1-2 mo. schedule with a statistically significant difference(P<0.01). 4) There was no difference of seroconversion rates between the two doses of Hepavax, $5{\mu}g$ and $10{\mu}g$ in infants and children. 5) In adults the seroconversion rates were 62.7% with Hepaccine, 90.8% with Hepavax, and 94.8% with Engerix-B(SmithKline Beecham). Conclusion : In Korea, the incidence of chronic hepatitis B is high and changing the schedule in vaccination cannot contribute to the increase of the serocoversion rate. And in order to maximize immunogenicity, more effective vaccines as well as more proper vaccination methods should be used.

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A Validation Study for the Practical Use of Screening Scale for Potential Drug-use Adolescents(SPDA) (청소년 약물사용 잠재군 선별척도(SPDA) 활용을 위한 타당화 연구)

  • Lee, Ki-Young;Kim, Young-Mi;Im, Hyuk;Park, Mi-Jin;Park, Sun-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.305-335
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    • 2005
  • This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.

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Study on Plant Indicator Species of Picea jezoensis (Siebold & Zucc.) Carrière Forest by Topographic Characters - From China (Baekdu-san) to South Korea - (가문비나무림의 지형특성에 따른 식물 지표종에 관한 연구 - 중국 백두산 일대에서 남한까지 -)

  • Byeong-Joo, Park;Tae-Im, Heo;Jun-Gi, Byeon;Kwang-il, Cheon
    • Journal of Environmental Impact Assessment
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    • v.31 no.6
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    • pp.388-408
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    • 2022
  • 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).

Evaluation of anti-inflammatory efficacy of Lacticaseibacillus rhamnosus L22-FR28 (KACC 92513P) isolated from infant feces and its Oenanthe javanica ferments (영아분변 유래 Lacticaseibacillus rhamnosus L22-FR28(KACC 92513P) 균주와 미나리 발효물의 항염증 효능 평가)

  • Seoyeon Kwak;Hee-Min Gwon;Soo-Hwan Yeo;So-Young Kim
    • Food Science and Preservation
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    • v.31 no.3
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    • pp.474-485
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    • 2024
  • The purposes of this study were to isolate the potential Lacticaseibacillus spp. from the feces of infants before weaning, to investigate the safety of antibiotics resistance and beta-haemolysis, and to evaluate the anti-bacterial and anti-inflammatory effects between the selected strains and Oenanthe javanica (Oj) fermented by them. As a result of analyzing the intestinal microbial community among the stools of four infants, the genus Bifidobacterium was the most dominant, but Lacticaseibacillus (L.) rhamnosus was the most frequently isolated because of the easy culture. Nine test strains, including Lactobacillus rhamnosus LGG (ATCC 53103) as the positive control, were sensitive against 8 kinds of antibiotics without vancomycin in comparison with the cut-off values at the European Food Safety Authority (EFSA), and there was no hemolysis. In the antibacterial activity experiment, the Lacticaseibacillus rhamnosus L22-FR28 (L28, KACC 92513P) strain and Oj+L28 ferment showed significantly (p<0.05) higher activities than LGG against Bacillus cereus and Staphylococcus aureus. Additionally, these decreased the activity of the NF-kB/AP-1 transcription factor and inhibited the nitric oxide and cytokines (TNF-α and IL-6) produced in macrophage RAW cells stimulated by lipopolysaccharide (LPS). Consequently, the L. rhamnosus L28 strain and Oenanthe javanica+L. rhamnosus L28 (Oj+L28) ferment selected with the high anti-inflammatory effect will improve health functionality after more research, such as the verification of animal level and identification of mechanism on an anti-inflammatory.

Diagnostic Usefulness of Serum Level of Cyfra 21-1, SCC Antigen and CEA in Lung Cancer (폐암에서 혈중 Cyfra 21-1, SCC 항원 및 CEA의 진단적 유용성)

  • Kim, Kyoung-Ah;Lee, Me-Hwa;Koh, Youn-Suck;Kim, Seon-Hee;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Moon, Dae-Hyuk
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.846-854
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    • 1995
  • Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia such as respiratory epithelial cells and their malignant counterparts. An immunoradiometric assay is available to detect a fragment of the cytokeratin, referred to as Cyfra 21-1 in the serum. This study was conducted to evaluate the clinical utility of this new marker in the diagnosis of lung cancer compared with established markers of squamous cell carcinoma antigen (SCC Ag) and carcino-embryonic antigen(CEA). In addition, we compared the diagnostic sensitivity and specificity of Cyfra 21-1 with those of SCC Ag in squamous cell carcinoma of the lung. We also measured the level of Cyfra 21-1 in the different stages of squamous cell carcinoma of the lung. Method: We measured Cyfra 21-1(ELSA-CYFRA 21-1), SCC Ag(ABBOTT SCC RIABEAD) and CEA(ELSA2-CEA) in 79 patients with primary lung cancer and in 78 persons as a comparison group including 32 patients with pulmonary tuberculosis, 23 patients with benign lung disease and 23 cases with healthy individual. Cyfra 21-1 is measured by a solid-phase immunoradiometric assay(CIS Bio International, France) based on the two-site sandwich method. SCC Ag is measured by a radioimmunoassay(Abbott Laboratories, USA). CEA is measured by a immunoradiometric assay(CIS Bio International, France). All data were expressed as the mean$\pm$standard deviation. Results: 1) The mean value of Cyfra 21-1 was $18.38{\pm}3.65\;ng/mL$ in the lung cancer and $1.l6{\pm}0.53\;ng/mL$ in the comparison group(p<0.0001). SCC Ag was $3.53{\pm}6.06\;ng/mL$ in the lung cancer and $1.19{\pm}0.5\;ng/mL$ in the comparison group(p<0.01). CEA was $35.03{\pm}13.9\;ng/mL$ in the lung cancer and $2.89{\pm}1.01\;ng/mL$ in the comparison group(p<0.0001). 2) Cyfra 21-1 level in squamous cell carcinoma($31.52{\pm}40.13\;ng/mL$) was higher than that in adenocarcinoma($2.41{\pm}1.34\;ng/mL$)(p<0.0001) and small cell carcinoma($2.15{\pm}2.05\;ng/mL$)(p=0.007). SCC Ag level in squamous cell carcinoma($5.1{\pm}7.68\;ng/mL$) was higher than that in adenocarcinoma($1.36{\pm}0.69\;ng/mL$)(p=0.009) and small cell carcinoma($1.1{\pm}0.24\;ng/mL$) (p=0.024). 3) The level of Cyfra 21-1 was not correlated with the progression of stage in squamous cell carcinoma of the lung. 4) Using the cut-off value of 3.3ng/mL, the diagnostic sensitivity of Cyfra 21-1 was 83% in squamous cell carcinoma, 22% in adenocarcinoma and 17% in small cell carcinoma. The sensitivity of SCC Ag and CEA were 39% and 20%, respectively in squamous cell carcinoma, 11% and 39% in adenocarcinoma, and 0% and 33% in small cell carcinoma. 5) Comparison of the receiver operating characteristics curves(ROC curve) for Cyfra 21-1, SCC Ag and CEA revealed that Cyfra 21-1 showed highest diagnostic sensitivity among them in the diagnosis of lung cancer. Conclusion: Cyfra 21-1 is thought to be a better tumor marker for the diagnosis of lung cancer than SCC Ag and CEA, especially in squamous cell carcinoma of the lung.

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