• Tuberculosis and Respiratory Diseases
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• v.62 no.5
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• pp.389-397
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• 2007

Background B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. Method Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. Result Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, $219.5{\pm}57.7pg/mL$ vs $492.3{\pm}88.8pg/mL$; p=0.013, APACHE II score, $17.4{\pm}1.6$ vs $23.1{\pm}1.3$, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + $11{\times}logBNP$' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. Conclusion BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.201-208
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• 2007

Purpose: We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). Materials and methods: We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors). The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Results: Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve = 0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve =0.860), but there was no statistical differerence in sensitivity, specificity and accuracy between the combined method and a single modality. Conclusion: It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer.

• The Korean Journal of Nuclear Medicine
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• v.37 no.5
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• pp.278-287
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• 2003

Purpose: The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/24-hour redistribution Tl-201 SPECT Materials and Methods: In 22 patients with coronary artery disease, rest Tl-20l/ dipyridamole stress Tc-99m-MIBI gated/24-hour redistribution Tl-201 SPECT were peformed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution Tl-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.50-56
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• 1999

Background : Pleural effusion is a common clinical problem and many clinical and laboratory evaluations, such as tumor marks, have been studied to discriminate malignant pleural fluid from benign pleural fluid. However their usefulness in the diagnosis of pleural effusion is still not established fully. We studied the diagnostic value of cyfra 21-1 in diagnosis of malignant pleural effusion. Methods: Pleural fluid was obtained from 45 patients with malignant diseases(32 lung cancer patients, 13 metastatic malignant diseases) and 47 patients with benign diseases. The level of cyfra 21-1 in the pleural fluid and serum were determined using a CYFRA 21-1 enzyme immunoassay kit(Cis-Bio International Co.). The t-test was used for comparison between two diseases groups and receiver operating characteristic(ROC) curves were constructed by calculating the sensitivities and specificities of the cyfra 21-1 at several points to determine the diagnostic accuracy of the cyfra 21-1. Results: In patients with primary lung cancer, the level of cyfra 21-1 in the pleural fluid was significantly higher than those of patients with benign diseases and had positive correlations between the level of cyfra 21-1 in the pleural fluid and serum levels. In the ROC curve analysis of the pleural fluid, the curve for primary lung cancer group was located closer to the left upper comer and the cut off value, sensitivity and specificity of the cyfra 21-1 of the primary lung cancer group was determined as 22.25ng/ml, 81.8% and 78.7% respectively. Conclusions: Our data indicates that the measurement of cyfra 21-1 level in pleural effusion has useful diagnostic value to discriminate malignant pleural effusion in primary lung cancer from benign pleural effusion.

• Journal of the Korean Institute of Landscape Architecture
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• v.48 no.2
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• pp.10-19
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• 2020

The park program can adeptly cope with the diversification of leisure needs in accordance with the changing times. The program also makes the relationship between the users and the park itself closer. For this reason, the Seoul Metropolitan Government has operated a variety of programs, beginning with the Botanical Class Program at the Namsan Outdoor Botanical Garden in 1997. The government additionally began to organize park programs by establishing the Park and Leisure Department and three Park Greenery Offices. However, research on park programs is mainly focused on park users. Therefore, this study intends to reveal the structure of the programs by studying the program operation. The specific purposes of this study are '1. Review the institutional characteristics that underlie the operation of the Park Program in Seoul by examining the relevant laws, the operation organizations, and the personnel composition, 2. Analyze the operation methods, such as procurement and the execution of the program, operation costs, and public-private cooperation methods, etc. 3. Analyze the composition and contents of the program from 2015 to 2017, and process and identify the relationship between the structure of the program operation and the program itself.' Summarizing the results obtained from the study, as far as the structure of the first program operation, the support laws were not systematic, but the operating organization was working to establish a system. The second characteristic of the operation is that most of the budget was funded by local governments, but the level of citizen involvement was low. Third, when we looked at the characteristics of the program, the number of programs increased, but they were focused on a specific theme and few programs actively used the park facilities. Based on the results, three tasks can be proposed. The first is that the 'Act on Parks and Green Spaces' should include the concepts and support for park programs. Second, there is a need to change from the ideas of the quantitative increase of programs to qualitative improvements. Lastly, it is necessary to reorganize the Green Seoul Bureau of the Seoul Metropolitan Government into a citizen-led and leisure-oriented organization to promote the park leisure culture. This study has significance, as it was conducted with a service provider, not a program user, unlike many previous park program-related studies. The results of this study will be able to contribute not only to the Seoul Metropolitan Government, but also to other local governments to suggest the direction of the management and the operation of the park for the consumer, and consequently, it will help prepare the long-term vision of parks as the closest leisure location for most citizens.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.180-192
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• 2010

Purpose: To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents. Methods: Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program. Results: The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC${\geq}$90th percentiles. Conclusion: The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.153-163
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• 2001

This study was attempted to investigate the discriminant validity of Korean version of Eating Attitude Test-26(KEAT-26) and to provide the sensitivity, specificity and efficiency according to cutting score, which may be useful to determine the optimal cutoff point on various purposes. The KEAT-26 was administered to 108 female patients with eating disorders, 179 female participants in body slimming center, 120 female athletic college students, 227 female college students, and 183 healthy normal women. Validity was tested by ANOVA and ROC curve analysis. The results revealed that the total score of the KEAT-26 showed a statistically significance between groups and that the score of the KEAT-26 of eating disorders group was significantly higher than that of the other groups in post hoc test. In comparison of the 4 subfactor score of the KEAT-26 between groups, significant differences in main effect within groups were found in all subfactors except factor IV. ROC curve analysis showed 80% of efficiency to discriminate eating disorders group from normal control group using cutoff score on maximum discriminant efficiency and 69% of efficiency to discriminate eating disorders group from high risk groups for eating disorders. Each cutoff score on maximum in efficiency was as follows ; 25 between eating disorders group and participants in body slimming center, 19 between eating disorders group and healthy normal woman, 23 between eating disorders group and athletic college students, 21 between eating disorders group and college students. Using 22(T score 65) of the KEAT-26 as the cutoff score, sensitivity was 54%, specificity was 84%, and overall efficiency was 80%. These results indicate that the KEAT-26 has a good discriminant validity in Korean population and also suggest that the KEAT-26 may be useful assessment tool to screen the disordered eating problems on clinical and epidemiological purposes.

• The Journal of Industrial Distribution & Business
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• v.1 no.1
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• pp.33-41
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• 2010

In the age of globalization, effective and efficient corporate management is becoming more important as domestic and international business circumstances changes. In the middle of endless changes in business circumstances, fast reaction to customers and market, and offering customized goods and service became essential. In this respect, CRM designed to utilize customer information scientifically and systematically, has become an essential system and marketing strategy to enhance corporate competitiveness. CRM has placed the importance of customers in the front of marketing and has focused every process and business minds on customers. Recent change in the market and the trend of establishing and introducing CRM system has lead us to concentrate on the introduction of CRM in the financial institutions. This study searched for several views about CRM in academic and industrial papers. Through theoretical approach on CRM, the background of the introduction of CRM, the purpose of CRM, the characteristic and application of CRM, and the expected effect of CRM will be discussed. This study is focused on financial institutions where CRM is widely used. And through documents about examples of the introduction of CRM, the status of the establishment of domestic CRM and the necessity and trend of CRM will be discussed. Also the problem of CRM in the financial institutions and the improvement of CRM in domestic banks will be analyzed. When discussing CRM in the financial area, customers are the main source of corporate profit and through relationship management with the customers enhancing loyalty and maximizing profit can be obtained. Especially in CRM in financial institutions, maintaining existing customers makes higher profit ratio, so repurchasing and cross selling becomes important for obtaining lifetime value of existing customers who contribute to most of the profit of corporations. As a result, CRM should be completely customer oriented. CRM in financial institutions is not merely marketing work, but organizational competence which is made up of standardized work process through total process integration inside the corporation. Corporations which plan to introduce CRM should analyze the characteristics and conditions of corporations and establish purpose and strategy of CRM. And they need long term view to find out the factors which best fit for the introduction of CRM. To enable this, strategy composed of daily marketing activity and CRM concept is necessary. Also continued improvement through drill and training for operating organization should be followed to maintain CRM well. And corporate culture must settle customer as the center of corporate value. The race for introducing and improving CRM has already begun. CRM should not be regarded as a choice. It should be accepted as something essential. In this reality financial institutions should solve subdivision problem of customers and necessity of customers with the mind of 'customer's profit is my profit'. Customer focused management should not be emphasized only by words. Efforts like viewing from the customer's point must be nurtured to provide methods to help customers. That is, we should not just follow what is done in foreign countries. We should solve the problem of our customers according to the situation of our country, our industry, our corporation. Then we can gain the trust of customers, and the value derived from the customers will become the background of CRM which will lead the corporation to success.

• Journal of Korean Society of Environmental Engineers
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• v.22 no.10
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• pp.1905-1919
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• 2000

The main motivation of this research is to develop an intelligent control strategy for Activated Sludge Process (ASP). ASP is a complex and nonlinear dynamic system because of the characteristic of wastewater, the change in influent flow rate, weather conditions, and etc. The mathematical model of ASP also includes uncertainties which are ignored or not considered by process engineer or controller designer. The ASP is generally controlled by a PID controller that consists of fixed proportional, integral, and derivative gain values. The PID gains are adjusted by the expert who has much experience in the ASP. The ASP model based on $Matlab^{(R)}5.3/Simulink^{(R)}3.0$ is developed in this paper. The performance of the model is tested by IWA(International Water Association) and COST(European Cooperation in the field of Scientific and Technical Research) data that include steady-state results during 14 days. The advantage of the developed model is that the user can easily modify or change the controller by the help of the graphical user interface. The ASP model as a typical nonlinear system can be used to simulate and test the proposed controller for an educational purpose. Various control methods are applied to the ASP model and the control results are compared to apply the proposed intelligent control strategy to a real ASP. Three control methods are designed and tested: conventional PID controller, fuzzy logic control approach to modify setpoints, and fuzzy-PID control method. The proposed setpoints changer based on the fuzzy logic shows a better performance and robustness under disturbances. The objective function can be defined and included in the proposed control strategy to improve the effluent water quality and to reduce the operating cost in a real ASP.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4603-4608
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• 2015

Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.