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N-terminal Pro-B-type Natriuretic Peptide as a Predictive Risk Factor in Fontan Operation (Fontan 수술시 위험 예측인자로서의 N-Terminal Pro-B-type Natriuretic Peptide의 유용성)

  • Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Shim, Woo Sup
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1362-1369
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    • 2005
  • Purpose : This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide(pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations. Methods : Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure(PAP), and ventricular end-diastolic pressure(EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method. Results : Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP(r=0.70, P<0.001), pulmonary vascular resistance(r=0.57, P<0.001), RVEDP(r=0.63, P<0.001), LVEDP(r=0.74, P<0.001), and cardiothoracic ratio(r=0.71, P<0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high : 0.868(95 percent CI, 0.712-1.023, P<0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL(sensitivity 83.3 percent, specificity 82.7 percent). Conclusion : These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations.

Usefulness and Comparison of $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA Single Photon Emission Computed Tomography in Distinguishing Lung Cancer from Benign Lesion (폐암과 양성질환의 감별에 $^{201}TI$-chloride, $^{99}mTc$-MIBI, $^{99}mTc(V)$-DMSA 단일광자전산화단층촬영술의 비교 및 가치)

  • Kim, Chang Ho;Chae, Sang Cheol;Park, Jae Yong;Jung, Tae Hoon;Ahn, Byeong Cheol;Lee, Jae Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.720-727
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    • 1996
  • Objectives: $^{201}TI$ - chloride, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA SPECT has been used in distinguishing lung cancer from benign lesion. To compare the diagnostic efficacy of SPECT with these tumor - seeking agents, we perfonned three consecutive SPECT using $^{201}TI$, $^{99m}Tc$ - MIBI, $^{99m}Tc$(V) - DMSA in same subjects with a solitary pulmonary lesion. Methods: SPECT was carried out at 10min and 3hr for $^{201}TI$ after injection of 20mCi, and 2hr for $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA after injection of 20mCi, respectively, in 37 patients with a solitary pulmonary lesion(27 lung cancer and 10 benign diseases). In patients showing visual uptake on lesion site, we obtained the lesion - to - background(target lesion/contralateral normal lung) uptake ratio from transverse slice for each radionuclide and also calculated the retention index for $^{201}TI$. Results: The diagnostic sensitivity of $^{201}TI$, $^{99m}Tc$ - MIBI and $^{99m}Tc$(V) - DMSA SPECT to lung cancer was 100%, 96% and 73%, and the specificity was 40%, 70% and 70%, respectively. The low specificities for these agents were mainly due to high positive uptake in patients with active pulmonary tuberculosis. There were no significant differences in uptake ratios and retention index between malignant and benign lesions, and among the histologic types of lung cancer. Conclusion : $^{201}TI$ and $^{99m}Tc$ - MIBI showed higher sensitivity than $^{99m}Tc$(V) - DMSA for detecting lung cancer, but was of limited usefulness in distinguishing lung cancer from benign lesion due to low specificity, especially in area with a high prevalence of active pulmonary tuberculosis.

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An Epidemiologic Investigation of Enteropathogenic Escherichia Coli (EPEC) Outbreak in Seongju-gun, Gyeongbuk, 2004 (2004년 경상북도 성주군에서 발생한 장병원성대장균의 유행에 관한 역학조사)

  • Baik, Dalh-Yeon;Yeom, Seok-Hyeon;Lee, Kwan;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.39-50
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    • 2005
  • Objectives: This investigation was carried out to explore the source and the mode of transmission of the diarrhea outbreak in Seongju-gun, Gyeongbuk, 2004 Methods: The authors conducted a questionnaire survey among the 275 persons (students, staff members and cooks) who ingested the possibly contaminated foods. We also investigated the drinking water and the dining facility, and we reviewed the process of cooking the salad, which was the presumed cause of the Enteropathogenic Escherichia coli(EPEC) diarrhea. The confirmed EPEC diarrheal case was defined as culture positive for EPEC, and the suspicious case was defined as diarrheal case with symptoms more than one of fever, vomiting and tenesmus. Results: The attack rate of EPEC diarrhea was 36.7%, and there were 8 confirmed cases. The possibility of the drinking being a source of the infection was very low, for chlorine was detected in all the drinking water via reviewing the past records and using a portable detector. The foods that were significantly associated with diarrhea were found. The relative risk (RR) for the lunch served Jul 7 was 4.12 (95% CI: 1.39-12.20). Among the non-boiled foods that were finally served, the RR for the salad was 1.66 (95% CI: 1.07-2.57). The cause of this outbreak was presumed to be the contaminated foods that were prepared by cooks using rubber glove with holes, and especially the salad and foods that were served sans boiling on Jul 7. Conclusions: Though this EPEC infection was not so clinically important, if a larger outbreak occurred, it might severely affect the public health. It is recommended to develop the more safe methods for cooking foods, and to strengthen the sanitary processing foods.

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Oral Cleft Risk Factors in Rural Area of Indonesia(Sintang) (인도네시아 농촌지역의 구순구개열 위험요인 사례조사)

  • Park, Dae-jin;Lim, Young-soo;Oh, Jee-young;Koh, Kwang-Wook;Song, Sung-Eun;Jo, Eun-Joo
    • Journal of agricultural medicine and community health
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    • v.31 no.2
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    • pp.187-208
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    • 2006
  • Objectives: This study was carried out to evaluate the risk factors of Oral cleft and to inspect the living environments of the rural areas of Sintang, Indonesia Methods: During 3 to 9 August 2004, A questionnaire survey was done for the risk factors of oral cleft. Case group was composed of 11 oral cleft patients who admitted Missionary Hospital whose mother's bloods were analyzed for anemia and hyperlipidemia. Control group was composed of 56 reproductive rural women recruited from near rural villages. Also we surveyed 4 rural areas of Indonesia with simple water test kits. $x^2-test$ for significant difference was analysed. Results: Drinking water was statistically significant risk factor(p<0.05) of oral cleft. Other factors had no statistical significancy. The kind of drinking water was river-originated water. In rural villages, water sanitation state, even boiled water, was very poor. Although $NO_2-N$, $NO_3-N$ was negative, E. coli-form microorganisms were strongly positive in most samples. Total food intake amount was not enough, and vitamin supplements were also under the need. Conclusions: Drinking the contaminated river-water around pregnancy was supposed to be one of the risk factors of oral cleft in Indonesia. Further study is needed for nitrate and mercury.

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Meteorological Factors Associated with the Number of Emergency Room Patients with Wrist-Cutting Behavior (손목자해로 응급실에 내원한 환자수와 기후인자와의 관련성)

  • Han, Jae Hyun;Suh, Seung Wan;Cho, Gyu Chong;Kim, Jung Mi;Seo, Hong Taek;Jung, Yu Jin;Seong, Su Jeong;Hwang, Jae Yeon;Lee, Won Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.161-167
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    • 2020
  • Objectives : Although the seasonality of suicide is a well-known phenomenon, little is reported about the seasonality of non-suicidal self-injury. The purpose of this study was to identify the seasonality of wristcutting behavior and to examine its relationship with meteorological factors. Methods : To identify the presence of seasonality, we investigated whether there was a difference in the average number of visits per month to an emergency room (ER) of an urban hospital for 226 patients with wrist-cutting behavior enrolled between December 2014 and May 2019. To ascertain significant meteorological factors, we used the multiple Poisson regression using generalized additive model with time, monthly temperature, monthly sunshine hour, and atmospheric pressure in the prior month as explanatory variables. Results : In males, the average number of monthly visits to the ER for wrist cutting behavior differed by month and was the highest in September (male : p=0.048, female : p=0.21, total : p=0.28). As a result of multiple regression analysis, the average number of patients admitted to the ER for wrist cutting behavior was related to the interaction between atmospheric pressure in the prior month and temperature in males (p=0.010), and showed a positive correlation with sunlight in females [p=0.044, β=4.70×10-3, 95% CI=(1.19×10-4, 9.27×10-3)]. Conclusions : Wrist cutting behavior shows seasonality in male, which is associated with changes in meteorological variables.

The Association Between Neurodegenerative Diseases and Development of Type 2 Diabetes (신경퇴행성 질환과 제2형 당뇨병 발생의 연관성)

  • Sang-Woo, Koo;Hojun, Lee;Yang-Tae, Kim;Hee-Cheol, Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.155-164
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    • 2022
  • Objectives : A growing body of evidence links type 2 diabetes (T2D) with a neurodegenerative disease (ND) such as Alzheimer's disease and Parkinson's disease. The purpose of this study is to investigate the relationship between NDs and the development of T2D by comparing the incidence of T2D in a group of various NDs (ND group) and control group. Methods : A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002-2015. We used a retrospective cohort study design to investigate the association of ND with T2D occurrence. The study population included ND (n=8,814) and control (n=37,970) groups, all aged 60 years or over. The Kaplan-Meier method was used to estimate the risk of developing T2D as a function of time. Cox proportional hazards regression models were used to evaluate the relationship between ND and T2D. Results : T2D was developed in a significantly higher percentage of patients in the ND group (53.6%) than in the control group (44.7%). The ND group increased the risk of T2D (HR, 1.43; 95% CI, 1.38-1.47). About one-third of patients in both groups were additionally diagnosed with another ND before the occurrence of T2D during a 10-year follow-up period. When compared to those who did not have another ND during the follow-up period, the incidence of T2D in those who were additionally diagnosed with another ND was higher in both the ND and control groups. Conclusions : The ND group had about 1.4 times higher risk of developing T2D than the control group. Our results showed a positive association between ND and T2D.

Automatic Extraction of Eye and Mouth Fields from Face Images using MultiLayer Perceptrons and Eigenfeatures (고유특징과 다층 신경망을 이용한 얼굴 영상에서의 눈과 입 영역 자동 추출)

  • Ryu, Yeon-Sik;O, Se-Yeong
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.37 no.2
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    • pp.31-43
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    • 2000
  • This paper presents a novel algorithm lot extraction of the eye and mouth fields (facial features) from 2D gray level face images. First of all, it has been found that Eigenfeatures, derived from the eigenvalues and the eigenvectors of the binary edge data set constructed from the eye and mouth fields are very good features to locate these fields. The Eigenfeatures, extracted from the positive and negative training samples for the facial features, ate used to train a MultiLayer Perceptron(MLP) whose output indicates the degree to which a particular image window contains the eye or the mouth within itself. Second, to ensure robustness, the ensemble network consisting of multiple MLPs is used instead of a single MLP. The output of the ensemble network becomes the average of the multiple locations of the field each found by the constituent MLPs. Finally, in order to reduce the computation time, we extracted the coarse search region lot eyes and mouth by using prior information on face images. The advantages of the proposed approach includes that only a small number of frontal faces are sufficient to train the nets and furthermore, lends themselves to good generalization to non-frontal poses and even to other people's faces. It was also experimentally verified that the proposed algorithm is robust against slight variations of facial size and pose due to the generalization characteristics of neural networks.

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Pulmonary Vessel Extraction and Nodule Reclassification Method Using Chest CT Images (흉부 CT 영상을 이용한 폐 혈관 추출 및 폐 결절 재분류 기법)

  • Kim, Hyun-Soo;Peng, Shao-Hu;Muzzammil, Khairul;Kim, Deok-Hwan
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.46 no.6
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    • pp.35-43
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    • 2009
  • In the Computer Aided Diagnosis(CAD) System, the efficient way of classifying nodules from chest CT images of a patient is to perform the classification of the remaining part after the pulmonary vessel extraction. During the pulmonary vessel extraction, due to the small difference between the vessel and nodule features in imaging studies such as CT scans after having an injection of contrast, nodule maybe extracted along with the pulmonary vessel. Therefore, the pulmonary vessel extraction method plays an important role in the nodule classification process. In this paper, we propose a nodule reclassification method based on vessel thickness analysis. The proposed method consist of four steps, lung region searching step, vessel extraction and thinning step, vessel topology formation and correction step and the reclassification of nodule in the vessel candidate step. The radiologists helped us to compare the accuracy of the CAD system using the proposed method and the accuracy of general one. Experimental results show that the proposed method can extract pulmonary vessels and reclassify false-positive nodules accurately.

Ontology-based Context-aware Framework for Battlefield Surveillance Sensor Network System (전장감시 센서네트워크시스템을 위한 온톨로지 기반 상황인식 프레임워크)

  • Shon, Ho-Sun;Park, Seong-Seung;Jeon, Seo-In;Ryu, Keun-Ho
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.4
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    • pp.9-20
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    • 2011
  • Future warfare paradigm is changing to network-centric warfare and effects-based operations. In order to find first and strike the enemy in the battlefield, friendly unit requires real-time target acquisition, intelligence collection, accurate situation assessment, and timely decision. The rapid development in advanced sensor technology and wireless networks requires a significant change in operational concepts of the battlefield surveillance. In particular, the introduction of a battlefield surveillance sensor network system is a big challenge to the ground forces which have lack of automated information collection assets. Therefore this paper proposes an ontology-based context-aware framework for the battlefield surveillance sensor network system which is needed for early finding the enemy and visualizing the battlefield in the ground force operations. Compared with the performance of existing systems, the one of the proposed framework has shown highly positive results by applying the context systems evaluation method. The framework has also proven to be satisfactory by the structured evaluation method using device collaboration. Since the proposed ontology-based context-aware framework has a lot of advantages in terms of scalability and reusability, the ground force's reconnaissance and surveillance system can be widely applied to expand in the future. And, ontology-based model has some weak points such as ontology data size, processing time, and limitation of network bandwidth. However, these problems can be resolved by customizing properly to fit the mission and characteristics of the unit. Moreover, development of the next-generation communication infrastructure can expedite the intelligent surveillance and reconnaissance service and may be expected to contribute greatly to expanding the information capacity.

Comparison Study of Nitrogen Dioxide and Asthma Doctor's Diagnosis in Seoul - Base on Community Health Survey 2012~2013 - (서울시 대기 중 이산화질소 농도와 천식증상의 비교 연구 - 2012~2013년 지역사회건강조사 자료를 중심으로 -)

  • Lee, Sang-Gyu;Lee, Yong-Jin;Lim, Young-Wook;Kim, Jung-Su;Shin, Dong-Chun
    • Journal of Korean Society for Atmospheric Environment
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    • v.32 no.6
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    • pp.575-582
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    • 2016
  • Seoul city has high population density as well as high traffic congestion, which are vulnerable to exposure of environmental pollutions caused by car traffic. However, recent studies are only on local regions about road traffic and air pollution or health effect of road traffic on residents. Thus, comprehensive study data are needed in terms of overall Seoul regions. In this study utilized the nitrogen dioxide concentration through the national air pollution monitoring network data, 2012 to 2013. It also divided regions into high and low exposure districts via the Origin destination data developed by the Korea transport institute to quantify and evaluate the effect of transport policies and analyzed a correlation of asthma symptoms with high and low exposure districts through raw data of community health survey from the Korea centers for disease control and prevention. Based on the collected data, the pearson's correlation analysis was conducted between air pollution substance concentration and high exposure district and multiple logistic regression analysis was conducted to determine the effect of traffic environment and factors on asthma symptoms of residents. Accordingly, the following results were derived. First, the high exposure district was higher concentrations of nitrogen dioxide ($NO_2$) as per time compared to those of the low exposure district (p<0.01). Second, analysis on correlation between average daily environmental concentration in the air pollution monitoring network and road traffic showed that nitrogen dioxide had a significant positive correlation (p<0.01) with car traffic and total traffic as well as with truck traffic (p<0.05) statistically. Third, an adjusted odds ratio about asthma doctor's diagnosis in the high and low exposure districts was analyzed through the logistic regression analysis. With regard to an adjusted model 2 (adjusted gender, age, health behavior characteristics, and demographic characteristics) odds ratio of asthma doctor's diagnosis in the high exposure district was 1.624 (95% CI: 1.269~2.077) compared to that of the low exposure district, which was significant statistically (p<0.001).