• Title/Summary/Keyword: cutoff value

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Comparison of the accuracy of neutrophil CD64 and C-reactive protein as a single test for the early detection of neonatal sepsis

  • Choo, Young-Kwang;Cho, Hyun-Seok;Seo, In-Bum;Lee, Hyeon-Soo
    • Clinical and Experimental Pediatrics
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    • v.55 no.1
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    • pp.11-17
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    • 2012
  • Purpose: Early identification of neonatal sepsis is a global issue because of limitations in diagnostic procedures. The objective of this study was to compare the diagnostic accuracy of neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis. Methods: A prospective study enrolled newborns with documented sepsis (n=11), clinical sepsis (n=12) and control newborns (n=14). CRP, neutrophil CD64, complete blood counts and blood culture were taken at the time of the suspected sepsis for the documented or clinical group and at the time of venipuncture for laboratory tests in control newborns. Neutrophil CD64 was analyzed by flow cytometry. Results: CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis, CD64 and CRP had a sensitivity of 91% and 9%, a specificity of 83% and 83%, a positive predictive value of 83% and 33% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.0 mg/dL for CD64 and 1.0 mg/dL for CRP. The area under the receiver-operating characteristic curves for CD64 index and CRP were 0.955 and 0.527 ($P$ <0.01), respectively. Conclusion: These preliminary data show that diagnostic accuracy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.

Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia

  • Seo, Young Ho;Kim, Jang Su;Seo, Sung Chul;Seo, Won Hee;Yoo, Young;Song, Dae Jin;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.57 no.4
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    • pp.186-192
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    • 2014
  • Purpose: The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia. Methods: A total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared. Results: The proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L. Conclusion: The proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.

Clinical Significance of Creatine Kinase MB mass and Cardiac Troponin I as a Marker of Perioperative Myocardial Infarction After Coronary Artery Bypass Grafting (관상동맥 우회술 후 심근경색의 표지자로서 Creatine Kinase MB 농도와 Cardiac Troponon I의 임상적 의의)

  • 이재진;김응중;이원용;신윤철;지현근
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.27-35
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    • 2002
  • Background: A perioperative myocardial infarction(PMI) is one of the major complications after CABG. Among diagnostic methods of PMI, CK-MB activity assays have been increasingly replaced by CK-MB mass assays, which have more sensitive, simple measurement. Also, new cardiac-specific and -sensitive marker, cardiac troponin I(cTnl), has been shown to be a marker of myocardial infarction. We report our evaluation of clinical significance of CK-MB mass and cTnl as a marker of PMI after CABG. Material and Method: We studied 32 patients who underwent CABG at Kangdong Sacred Hospital between April 2000 and April 2001. Postoperative serum CK-MB activity level, serum CK-MB mass, cTnl, electrocardiogram, echocardiogram, and clinical data were recorded prospectively The diagnosis of PMI was defined as positive 2 among 3 or all of the following , by a new Q wave on the electrocardiogram, by serum CK-MB activity higher than 200 lU/L within 72 hours after operation, and by new regional wall motion abnormality on the echocardiogram. Result: After CABG, 3 patients had sustained a PMI according to current diagnostic criteria. As serum CK-MB activity time course, a level of CK-MB activity 12 hours after CABG had very linear correlated significance with serum CK-MB mass 24hours(R=0.946) and cTnl 48 hours(R=0.933) after CABG(p=0.000). As we used a receiver operating characteristics curve(ROC curve) for a diagnostic cutoff value in patients with PMI, serum CK-MB mass levels higher than 30.05 ug/L 24 hours after CABG detected the presence of PMI with an area under the ROC curve of 1.0, a sensitivity of 100%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 100%. Also serum cTnl levels higher than 17.15 ug/L 48 hours after CABG detected the presence of PMI with an area under the ROC curve of 0.98, a sensitivity of 100%, a specificity of 96.6%, a positive preclictive value of 75%, and a negative predictive value of 100% Conclusion: We concluded that both the measurement of CK-MB mass and cTnl are the easier, accurate methods as a diagnostic marker of PMT after CABG, also as a proposal of diagnostic cutoff value enables to an early detection of PMI. However, a 1arger number of patient will be needed because of statistic limitation that a small number of participating patients, a small number of PMI.

FDG-PET/CT as prognostic factor and surveillance tool for postoperative radiation recurrence in locally advanced head and neck cancer

  • Kim, Gi-Won;Kim, Yeon-Sil;Han, Eun-Ji;Yoo, Ie-Ryung;Song, Jin-Ho;Lee, Sang-Nam;Lee, Jong-Hoon;Choi, Byung-Oak;Jang, Hong-Seok;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.243-251
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    • 2011
  • Purpose: To evaluate the prognostic value of metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) on initial positron emission tomography-computed tomography (PET-CT) and investigate the clinical value of SUVmax for early detection of locoregional recurrent disease after postoperative radiotherapy in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Materials and Methods: A total of 100 patients with locally advanced HNSCC received primary tumor excision and neck dissection followed by adjuvant radiotherapy with or without chemotherapy. The MTV and SUVmax were measured from primary sites and neck nodes. The prognostic value of MTV and SUVmax were assessed using initial staging PET/CT (study A). Follow-up PET/CT scan available after postoperative concurrent chemoradiotherapy or radiotherapy were evaluated for the SUVmax value and correlated with locoregional recurrence (study B). A receiver operating characteristic (ROC) curve analysis was used to define a threshold value of SUVmax with the highest accuracy for recurrent disease assessment. Results: High MTV (>41 mL) is negative prognostic factor for disease free survival (p = 0.041). Postradiation SUVmax was significantly correlated with locoregional recurrence (hazard ratio, 1.812; 95% confidence interval, 1.361 to 2.413; P < 0.001). A cutoff value of 5.38 from follow-up PET/CT was identified as having maximal accuracy for detecting locoregional recurrence by ROC analysis. Conclusion: MTV at staging work-up was significantly associated with disease free survival. The SUVmax value from follow-up PET/CT showed high diagnostic accuracy for the detection of locoregional recurrence in postoperatively irradiated HNSCC.

Clinical Availability of Serum Procalcitonin in Children with Bacterical Infection (소아 세균감염증에서 혈청 procalcitonin의 임상적 유용성)

  • Noe, Eun-Jung;Lee, So-Yeon;Lee, Kyu-Man;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.108-113
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    • 2010
  • Purpose : The aim of this study was to identify clinical availability of serum procalcitonin (PCT) compared with C-reactive protein (CRP) in prediction of bacterial infection in children. Methods : A retrospective study was conducted with children who had been admitted to the Department of Pediatrics with bacterial and viral infection between April 2008 and March 2009 and children who were admitted with Juvenile rheumatoid arthritis (JRA) between August 2007 and July 2009. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : The study population included 10 patients with bacterial infection (group I), 69 with viral infection (group II), and 35 with JRA (group III). Mean PCT levels were significantly higher in group I than in group II or group III (P<0.05). Mean CRP levels were significantly higher in group I than in group II (P<0.05); however, mean CRP levels were not significantly higher in group I than in group III (P>0.05). Using a cutoff of 0.5 ng/mL for PCT and 8 mg/L for CRP, sensitivity and specificity in distinguishing between group I and the other groups were 60.0% and 92.3% for PCT and 60.0% and 40.1% for CRP, respectively. Positive and negative predictive values were 42.9% and 96.0% for PCT and 10.0% and 92.6% for CRP, respectively. Conclusion : Measurement of PCT concentrations appears to be more useful than CRP for distinguishing between bacterial infection and non-bacterial diseases in children.

Differentiation of Benign from Malignant Adnexal Masses by Functional 3 Tesla MRI Techniques: Diffusion-Weighted Imaging and Time-Intensity Curves of Dynamic Contrast-Enhanced MRI

  • Malek, Mahrooz;Pourashraf, Maryam;Mousavi, Azam Sadat;Rahmani, Maryam;Ahmadinejad, Nasrin;Alipour, Azam;Hashemi, Firoozeh Sadat;Shakiba, Madjid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3407-3412
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    • 2015
  • Background: The aim of this study was to evaluate and compare the accuracy of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) value, and time-intensity curve (TIC) type analysis derived from dynamic contrast-enhanced MR imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Materials and Methods: 47 patients with 56 adnexal masses (27 malignant and 29 benign) underwent DWI and DCE-MRI examinations, prior to surgery. DWI signal intensity, mean ADC value, and TIC type were determined for all the masses. Results: High signal intensity on DWI and type 3 TIC were helpful in differentiating benign from malignant adnexal masses (p<0.001). The mean ADC value was significantly lower in malignant adnexal masses (p<0.001). An ADC value< $1.20{\times}10^{-3}mm^2/s$ may be the optimal cutoff for differentiating between benign and malignant tumors. The negative predictive value for low signal intensity on DWI, and type 1 TIC were 100%. The pairwise comparison among the receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of TIC was significantly larger than the AUCs of DWI and ADC (p<0.001 for comparison of TIC and DWI, p<0.02 for comparison of TIC and ADC value). Conclusions: DWI, ADC value and TIC type derived from DCE-MRI are all sensitive and relatively specific methods for differentiating benign from malignant adnexal masses. By comparing these functional MR techniques, TIC was found to be more accurate than DWI and ADC.

Bandgap Alteration of Transparent Zinc Oxide Thin Film with Mg Dopant

  • Salina, M.;Ahmad, R.;Suriani, A.B.;Rusop, M.
    • Transactions on Electrical and Electronic Materials
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    • v.13 no.2
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    • pp.64-68
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    • 2012
  • We have successfully demonstrated a bandgap alteration of transparent zinc oxide (ZnO) thin film with Mg dopant by using sol-gel spin coating technique. By increasing the dopant from 0 to 30 atomic percent (at.%), a decrement value in the cutoff is observed, where the absorption edge shifts continuously to the shorter wavelength side, towards 300 nm. This resulted in a significant bandgap increment from 3.28 to 3.57 eV. However, the transmittance of the thin film at 350-800 nm gradually downgraded, from 93 to 80 % which is most probably due to the grain size that becomes bigger, and it also affected the electrical properties. The decrement from 45 to 0.05 mA at +10 V was observed in the I-V characteristics, concluding the significant relationship; where higher optical bandgap materials will exhibit lower conductivity. These findings may be useful in optoelectronics devices.

A Study on the Final Probabilistic Safety Assessment for the Jordan Research and Training Reactor (JRTR 연구용원자로에 대한 최종 확률론적 안전성평가)

  • Lee, Yoon-Hwan
    • Journal of the Korean Society of Safety
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    • v.35 no.3
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    • pp.86-95
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    • 2020
  • This paper describes the work and the results of the final Probabilistic Safety Assessment (PSA) for the Jordan Research and Training Reactor (JRTR). This final PSA was undertaken to assess the level of safety for the design of a research reactor and to evaluate whether it is probabilistically safe to operate and reliable to use. The scope of the PSA described here is a Level 1 PSA, which addresses the risks associated with core damage. After reviewing the documents and its conceptual design, nine typical initiating events were selected regarding internal events during the normal operation of the reactor. AIMS-PSA (Version 1.2c) was used for the accident quantification, and FTREX was used as the quantification engine. 1.0E-15/yr of the cutoff value was used to deliminate the non-effective Minimal Cut Sets (MCSs) when quantifying the JRTR PSA model. As a result, the final result indicates a point estimate of 2.02E-07/yr for the overall Core Damage Frequency (CDF) attributable to internal initiating events in the core damage state for the JRTR. A Loss of Primary Cooling System Flow (LOPCS) is the dominant contributor to the total CDF by a single initiating event (9.96E-08/yr), and provides 49.4% of the CDF. General Transients (GTRNs) are the second largest contributor, and provide 32.9% (6.65E-08/yr) of the CDF.

A Study on High Precision and High Stability Digital Magnet Power Supply Using Second Order Delta-Sigma modulation (2차 델타 시그마 변조기법을 이용한 고 정밀 및 고 안정 디지털 전자석 전원 장치에 관한 연구)

  • Kim, Kum-Su;Jang, Kil-Jin;Kim, Dong-Hee
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.29 no.3
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    • pp.69-80
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    • 2015
  • This paper is writing about developing magnet power supply. It is very important for power supply to obtain output current in high precision and high stability. As a switching noise and a power noise are the cause of disrupting the stability of output current, to remove these at the front end, low pass filter with 300Hz cutoff frequency is designed and placed. And also to minimize switching noise of the current into magnet and to stop abrupt fluctuations, output filter should be designed, when doing this, we design it by considering load has high value inductance. As power supply demands the stability of less than 5ppm, high precision 24bit(300nV/bit) analog digital converter is needed. As resolving power of 24bit(300nV/bit) analog digital converter is high, it is also very important to design the input stage of analog digital converter. To remove input noise, 4th order low pass filter is composed. Due to the limitation of clock, to minimize quantization error between 15bit DPWM and output of ADC having 24bit resolving power, ${\Sigma}-{\Delta}$ modulation is used and bit contracted DPWM is constituted. And before implementing, to maximize efficiency, simulink is used.

Microarray analysis of gene expression profile by treatment of Nelumbinis Semen in LPS activated BV-2 microglial cells (LPS로 자극한 BV-2 microglial cell에서 Microarray를 통한 련자육(蓮子肉)의 유전자 발현 분석)

  • Kim, Soo-Oh;Lim, Byung-Mook;Bae, Hyun-Su
    • Korean Journal of Oriental Medicine
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    • v.14 no.1
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    • pp.145-160
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    • 2008
  • Nelumbinis Semen(NS) has been used in traditional medicine to treat diseases such as depression and diarrhea. In inflammatory responses, microglia produces molecules which are known to play roles in the central nervous system. And we previously studied NS inhibited nitric oxide synthase and secretion of tumor necrosis factor alpha. To explore the global gene expression profiles in BV-2 microglial cell line treated with NS, microarray analysis was performed. The cells were treated with LPS or NS plus LPS for 30min, Ih, 3h, and 6h, respectively. Of 45,101 known genes, with cutoff value of 3-fold change in the expression, 340, 644, 280 and 219 genes were upregulated and 503, 570, 694 and 484 were downregulated in NS treated cells at each time point. The results of the present study shows that treatment of NS reversed the LPS-induced upregulation of such genes as Ecoxsackievirus and adenovirus receptor(CAR), pellino 1, and S100P binding protein. It is thought that microarrays will play an ever-growing role in the advance of our understanding of the pharmacologic actions NS.

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