• Title/Summary/Keyword: sensitivity Analysis

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Development and Evaluation of a Nutritional Risk Screening Tool (NRST) for Hospitalized Patients (입원환자의 영양불량위험 검색도구의 개발 및 평가)

  • Han, Jin-Soon;Lee, Song-Mi;Chung, Hye-Kyung;Ahn, Hong-Seok;Lee, Seung-Min
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.119-127
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    • 2009
  • Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

An Analysis Method on Injury Symptoms Utilizing Infrared Thermal Imaging under the Freezing Stress of Hedera helix L. (헤데라 헬릭스 식물의 적외선 열영상에 의한 저온 및 한풍피해에 관한 연구)

  • Seong, Bu-Geun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.6
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    • pp.173-179
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    • 2012
  • The experiments, which analyze the injury symptoms and diagnose growth conditions utilizing IRVT and analyzing each parts of H. helix L., had been held under a low temperature. Greenhouse and outdoor growing Genus hedera had been prepared and compared with each Genus hedera's peak and bottom leaves' surface temperature under the experimental categories $-6^{\circ}C$ and $-12^{\circ}C$. As results, analyzing the surface thermal property of peak part leaves' of outdoor growing Genus hedera, at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged from $-2^{\circ}C{\sim}-7^{\circ}C$ and $-2^{\circ}C{\sim}-15^{\circ}C$. On the other hand, the surface thermal property of bottom part leaves at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged $-2^{\circ}C{\sim}-11^{\circ}C$ and $-1^{\circ}C{\sim}-12^{\circ}C$. It appears that the thermal properties of leaves' surface on $-6^{\circ}C$ peaks and $-12^{\circ}C$ bottoms were more broadband than bottoms and peaks. It means that the peaks were more sensitive than bottoms, as like $-2^{\circ}C{\sim}-15^{\circ}C$, $-1{\sim}-12^{\circ}C$. Moreover, as similar results had seen to leaves surface temperature added to cold wind conditions. How the cold wind damaged the outdoor growing Genus hedera, analyzed the surface thermal property by IRVT data under $0^{\circ}C$, $-2^{\circ}C$, $-4^{\circ}C$ condition, it resulted to $-6.2^{\circ}C$, $-6.8^{\circ}C$, $-7.5^{\circ}C$. It appeared more $3.5{\sim}6.2^{\circ}C$ low temperature than experimental setting point. In addition, each parts thurmal property of peaks and bottoms was not similar, it referred to each parts' sensitivities of low temperature were different on the peak and bottom leaves surface temperature.

Study on the diagnostic utility of serum levels of insulin-like growth Factor-I and insulin-like growth factor binding protein-3 in growth hormone deficiency (성장호르몬 결핍증 진단에 있어서 혈중 insulin-like growth factor-I 및 insulin-like growth factor binding protein-3 농도의 진단적 유용성에 대한 연구)

  • Ji, Geun Ha;Lee, Jeong Nyeo;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1329-1335
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    • 2008
  • Purpose : This study aimed to determine the best cutoff line for insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-3 to discriminate between growth hormone deficiency (GHD) patients and the control group. Methods : Two hundred thirty subjects with normal controls (129 boys and 101 girls, aged 7-15 years), 14 patients with complete GHD (12 boys and 2 girls), and 17 patients with partial GHD (9 boys and 8 girls) were studied. IGF-I serum concentrations were measured by radioimmunoassay (RI), and IGFBP-3 concentrations were measured by immunoradiometric assay (IRMA). Results : The receiver operating characteristic (ROC) plot analysis showed that the best IGF-I and IGFBP-3 cutoff line was at -1 standard deviation (SD). By comparing IGF-I serum levels of GHD children within 1 SD of normal control, we determined the sensitivity (S) (87.5-100%) and specificity (Sp) (80-84.6%) according to the age group. For IGFBP-3, we determined the following values: S (58.7-85.7%) and Sp (79.2-85.5%). Eleven of 14 patients with complete GHD (78.5%) and 16 of 17 patients with partial GHD (94.1%) had IGF-I concentrations equal to or below -1 SD of the control group mean. Ten of 12 complete GHD children (83.3%) and 13 of 17 partial GHD children (76.5%) had IGFBP-3 concentrations equal or below -1 SD of the control group mean. Conclusion : We conclude that the measurement of IGF-I and IGFBP-3 concentrations might provide essential supplementary data in the diagnostic evaluation of patients with GHD. Our results support the need to use cutoff lines based on below -1 SD of the control.

The Differentiation of Benign from Maligant Soft Tissue Lesions using FDG-PET: Comparison between Semi-quantitative Indices (FDG-PET을 이용한 악성과 양성 연부조직 병변의 감별: 반정량적 지표간의 비교)

  • Choi, Joon-Young;Lee, Kyung-Han;Choe, Yearn-Seong;Choi, Yong;Kim, Sang-Eun;Seo, Jai-Gon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.90-101
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    • 1997
  • The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [$^{18}F$]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained. the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. ($TBR_{51}$), tumor-to-background ratio of areas under time-activity curves ($TBR_{area}$) and the ratio between the activities of tumor ROI at 51 min p. i. and at the time which background ROI reaches maximum activity on the time-activity curves ($T_{51}/T_{max}$). The pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, $TBR_{51},\;TBR_{area}$ and $T_{51}/T_{max}$ for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by $TBR_{51}$, 83.3%, 100%, 93.8% by $TBR_{area}$ and 66.7%, 70.0%, 68.8% by $T_{51}/T_{max}$. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual, analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy In conclusion, all pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.

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Comparison of Clinical Usefulness between N-13 Ammonia PET/CT and Tc-99m Sestamibi SPET in Coronary Artery Disease (관상동맥질환에서 N-13 암모니아 PET/CT와 Tc-99m 세스타미비 SPECT의 임상 유용성 비교)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Park, Jeong-Sun;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.354-361
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    • 2008
  • Purpose: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. Materials and Methods: Seventeen patients (male 13 : $63{\pm}11$ years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). Results: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/89% vs MPS: 65%/82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p < 0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. Conclusion: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.

Development of Multiplex PCR Assay for Identification of Eight Species from Meats in Korea (국내에서 유통되는 8종의 식육감별을 위한 multiplex PCR법 개발)

  • Heo, Eun-Jeong;Ko, Eun-Kyung;Yoon, Hyang-Jin;Kim, Yeon-Hwa;Kim, Young-Jo;Park, Hyun-Jung;Wee, Sung-Hwan;Moon, Jin-San
    • Journal of Food Hygiene and Safety
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    • v.31 no.1
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    • pp.28-35
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    • 2016
  • Species identification of animal tissues in meat products is an important issue to protect the consumer from illegal and/or undesirable adulteration; for economic, religious and health reasons. In this reason, accurate analytical methods are needed for the labeling of meat products with requiring simple and fast procedure. Recently, applications of PCR in food analysis have been increased because of their simplicity, specificity and sensitivity. Therefore, in this study, a multiplex PCR assay was developed for the simultaneous identification of eight species of cow, pig, chicken, duck, goat, sheep, horse and turkey from raw meats. The primers were designed in different regions of mitochondrial 16S RNA after alignment of the available sequences in the GenBank database. Two multiplex primer sets were designed as Set 1 (cow, pig, chicken, duck) and Set 2 (goat, sheep, horse, turkey), respectively. Total 274 samples from cow (n = 55), pig (n = 30), chicken (n=30), and duck (n = 30), goat (n = 40), sheep (n = 33), horse (n = 41), and turkey (n = 15) were tested. The primers generated specific fragments of 94, 192, 279, 477 bp (pig, chicken, cow, duck), 670, 271, 152, 469 bp (goat, sheep, horse, turkey) lengths for eight species, respectively. The animal species specificity was 100% in all eight samples in the multiplex PCR assay. The detection limit of the multiplex PCR assay showed from 100 fg to 1 pg of template DNA from extracted from raw meats. When applying multiplex PCR assays to sample from pork/beef and pork/chicken, beef/chicken tested raw mixed meats and heat-treated ($83^{\circ}C$ for 30min, $100^{\circ}C$ for 20min, and $121^{\circ}C$ for 10min) mixtures, detection limit was 0.1% level beef, pork and pork in beef and chicken in pork and 1.0% level pork in chicken. This study suggest that the developed multiplex PCR assay can be used for rapid and simultaneous species identification of cow, pig, chicken, duck, goat, sheep, horse and turkey from meats.

Studies on the Improvement of the Fishing Efficiency of Purse Seine in the Sea Area of Cheju Island -The Changes of Seine Volume and Tension in the Purseline During Pursing- (제주도 주변해역 선망의 어획성능 향상에 관한 연구 -짐줄 체결 중 선망의 용적과 짐줄의 장력 변화 -)

  • 김석종
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.35 no.2
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    • pp.93-101
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    • 1999
  • A simple experimental method was used in an attempt to realize the elevation of the fishing ability of purse seine in the sea area of Cheju Island, the changes of seine volume and tension in the purseline during pursing. Experiments carried out on the six types simplified reduced model seines which were made of knotless nettings. The nettings were woven in different leg length 4.3, 5.0, 5.5, 6.0, 6.6 and 7.7mm of polyester 28 tex two threads two-ply twine, and each of the seines were named I, II, III, IV, V and Ⅵ seine. Dimension of seine models were 450cm for corkline and 85cmfor seine depth, each seines rigged up 160g of float for a floatline and 50g (underwater weight) of lead for a leadline. These model purse seines were made of the scale of 1/200 of its full scale, a 120 ton in the near sea of Cheju Island. Designing and testing for the model purse seines were based on the Tauti's law. Experiments were measured in the observation channel of a flume tank at the static conditions set up shooting and pursing equipments. Motion of purse seine during purse line was recorded by the two sets video camera for VTR which were placed in top and front of the model seine. The reading coordinate of seine volume carried out by the video digitization system, disk data for the purseline tension. An analysis were performed on the changes seine volume and tension in the purseline during pursing. The results obtained were as follows: 1. The seine volume during pursing was largest for Ⅵ seine with smallest d/l followed by V, IV, III, II and I seines, and tension in the purseline was small. 2. Seine volume during pursing can be expressed by the following equation; CVt=l-EXP[{2.79 (d/l)+0.35}t-33.37 (d/l) + 0.57] Where CVt is volume ratio, d is twine diameter, l is leg length and t is pursing time (sec). 3. Tension in the purse line during pursing can be expressed by the following equation; T= 1- EXP {0.57t + 13.36 (d/l)+2.97} Where T is tension (kg) in the purseline during pursing.

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Competitive ELISA for the Measurement of Glycoprotein Purified from Acanthopanx senticosus (가시오가피로부터 분리한 단백 다당물질의 경쟁적 ELISA법에 의한 분석)

  • Ha, Eun-Suk;Hwang, Soo-Hyun;Shin, Kwang-Soon;Yu, Kwang-Won;Lee, Keyung-Ho;Choi, Joo-Sun;Park, Woo-Mun;Yoon, Taek-Joon
    • Korean Journal of Food Science and Technology
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    • v.35 no.6
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    • pp.1209-1215
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    • 2003
  • This study was carried out to establish a quantitative analysis method of separating immuno-activating substance (EN-SP) from Acanthopanax senticosus (A. senticosus) by competitive direct ELISA. Mouse antiserum (anti-EN-SP) against EN-SP was generated by immunization (s.c.) of EN-SP purified from A. senticosus as an immunogen. The titer of anti-EN-SP was about 1 : 400, and the optimal dilution of EN-SP-HRP conjugate was 1 : 1,000. When the standard curve was constructed by ELISA, its sensitivity was about $0.2{\mu}g/mL$. The coefficient variation of intra- and inter-assay were $6.13{\sim}8.81%$ and $6.73{\sim}8.60%$, respectively. According to the standard curve, the concentration of EN-SP in various senticosus extracts was found to be only $59.85\;{\mu}g$ in 10mg of extract from the bark of A. senticosus. Similarly, the immunostimulating activity to produce $TNF-{\alpha}$ or IL-12 among the various extracts of Acanthopanax was shown to be correlated with the content of EN-SP. These results demonstrated that competitive ELISA was a convenient, fast, reproducible, and accurate method for the determination of EN-SP as an immunologically active standard substance in extract of A. senticosus.

The Usefulness of F-18 FDG PET to Discriminate between Malignant and benign Nodule in Idiopathic Pulmonary Fibrosis (특발성 폐섬유증에서 발견된 폐결절의 악성여부 감별에서 F-18 FDG PET의 유용성)

  • Kim, Bom-Sahn;Kang, Won-Jun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.163-168
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    • 2006
  • Purpose: Incidence of lung canter in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; $67.53{\pm}9.53$, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: from 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules ($7.68{\pm}3.96\;vs.\;1.22{\pm}0.65$, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules ($1.80{\pm}0.43$, p<0.001). The size of malignant and benign nodule were $23.95{\pm}10.15mm\;and\;10.83{\pm}5.23mm$ (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF.

Comparison of Emergency Tc-99m Sestamibi Myocardial Perfusion SPECT and ECG in the Diagnosis of Acute Myocardial Infarction (급성심근경색증 환자에서 응급으로 시행한 Tc-99m Sestamibi 심근관류 SPECT와 심전도의 비교)

  • Cho, Ihn-Ho;Lee, Hyoung-Woo;Park, Jong-Sun;Won, Kyu-Chang;Do, Jun-Young;Sin, Dong-Gu;Yoon, Kyung-Woo;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.104-111
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    • 1996
  • We did Tc-99m sestamibi myocardial perfusion SPECT in 36 patients with acute myocardial infarction when they arrived at the emergency room. And we compared myocardial perfusion images with ECG findings. Then we obtained the follows. The myocardial infarction by the obstruction of left coronary descending artery and right coronary artery showed a good concordance in the diagnosis and infarction site between myocardial perfusion images and ECG findings. The 7 patients with myocardial infarction by a left circumflex coronary artery showed a perfusion defect in the lateral wall in myocardial perfusion SPECT images. But 4 patients of them showed ST segment elevation, 2 patients showed ST depression and 1 patient showed normal ECG findings. The diagnostic sensitivity of Tc-99m sestamibi myocardial perfusion SPECT was 100% by a qualified analysis. The perfusion defect site in the myocardial perfusion SPECT were corresponded with the infarct related coronary artery in 31 patients which was diagnosed by coronary angiograpy. The size of perfusion defect in the po1ar map was $31{\pm}18%(M{\pm}SD)$, in the myocardial infarction with left anterior descending coronary arery obstruction, $31{\pm}13% (M{\pm}SD)$ in the myocardial infarction with right coronary artery obstruction and $25{\pm}5.9%(M{\pm}SD)$ in the myocardial infarction with left circumflex coronary artery obstruction. We concluded that emergency myocardial perfusion SPECT images are useful in the diagnose of myocardial infarction and it's very useful when we are difficult to diagnose with ECG like as lateral wall infarction or left bundle branch block.

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