• Title/Summary/Keyword: Area under curve

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Detection of Hepatic Lesion: Comparison of Free-Breathing and Respiratory-Triggered Diffusion-Weighted MR imaging on 1.5-T MR system (국소 간 병변의 발견: 1.5-T 자기공명영상에서의 자유호흡과 호흡유발 확산강조 영상의 비교)

  • Park, Hye-Young;Cho, Hyeon-Je;Kim, Eun-Mi;Hur, Gham;Kim, Yong-Hoon;Lee, Byung-Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.22-31
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    • 2011
  • Purpose : To compare free-breathing and respiratory-triggered diffusion-weighted imaging on 1.5-T MR system in the detection of hepatic lesions. Materials and Methods: This single-institution study was approved by our institutional review board. Forty-seven patients (mean 57.9 year; M:F = 25:22) underwent hepatic MR imaging on 1.5-T MR system using both free-breathing and respiratory-triggered diffusion-weighted imaging (DWI) at a single examination. Two radiologists retrospectively reviewed respiratory-triggered and free-breathing sets (B50, B400, B800 diffusion weighted images and ADC map) in random order with a time interval of 2 weeks. Liver SNR and lesion-to-liver CNR of DWI were calculated measuring ROI. Results : Total of 62 lesions (53 benign, 9 malignant) that included 32 cysts, 13 hemangiomas, 7 hepatocellular carcinomas (HCCs), 5 eosinophilic infiltration, 2 metastases, 1 eosinophilic abscess, focal nodular hyperplasia, and pseudolipoma of Glisson's capsule were reviewed by two reviewers. Though not reaching statistical significance, the overall lesion sensitivities were increased in respiratory-triggered DWI [reviewer1: reviewer2, 47/62(75.81%):45/62(72.58%)] than free-breathing DWI [44/62(70.97%):41/62(66.13%)]. Especially for smaller than 1 cm hepatic lesions, sensitivity of respiratory-triggered DWI [24/30(80%):21/30(70%)] was superior to free-breathing DWI [17/30(56.7%):15/30(50%)]. The diagnostic accuracy measuring the area under the ROC curve (Az value) of free-breathing and respiratory-triggered DWI was not statistically different. Liver SNR and lesion-to-liver CNR of respiratory-triggered DWI ($87.6{\pm}41.4$, $41.2{\pm}62.5$) were higher than free-breathing DWI ($38.8:{\pm}13.6$, $24.8{\pm}36.8$) (p value < 0.001, respectively). Conclusion: Respiratory-triggered diffusion-weighted MR imaging seemed to be better than free-breathing diffusion-weighted MR imaging on 1.5-T MR system for the detection of smaller than 1 cm lesions by providing high SNR and CNR.

Pathogenicity of Two Species of Sclerotium to Nine Cultivars of Garlic Cultivated Widely in Korea (마늘의 흑색썩음균핵병에 대한 품종저항성의 역학적 평가)

  • Kim, Yong-Ki;Kwon, Mi-Kyung;Cho, Weon-Dae;Kim, Tack-Soo;Shim, Hong-Sik;Lee, Yong-Hwon;Lee, Chan-Jung;Lee, Seong-Chan
    • Research in Plant Disease
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    • v.10 no.2
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    • pp.105-111
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    • 2004
  • Mycelial growth and days required for sclerotial formation(DRSF) in vitro, and disease incidence of infected plants in the field were investigated to evaluate disease resistance of nine garlic cultivars against two species of Sclerotium causing garlic white rot. There were differences among mycelial growth and sclerotial formation of two white rot pathogens on different garlic cultivars in vitro. Mycelial growth showed the highest level on the clove of 'Daeseo'. Sclerotia of two white rot pathogen were formed the earliest on the clove of 'Kodang' and the latest on the clove of 'Namdo'. In field trial all of nine garlic cultivars were highly susceptible to Sclerotium cepivorum and cold-type garlics were less susceptible than warm-type garlics. Meanwhile garlic cultivars used showed differences among resistant responses to Sclerotium sp., forming large sclerotia. All of warm-type garlics showed highly susceptible response, but three cold-type garlics, 'Seosan', 'Danyang' and 'Yechon' showed moderate resistant response and 'Euisung' showed resistant response. To evaluate cultivar resistance of garlics quantitatively disease progress curve was transformed as linear regression equation. Among the intercept (early disease incidence) and the slope (disease infection rate) obtained from the transformed equation, final disease incidence, and area under disease progress curve(AUDPC), AUDPC was the most effective to evaluate disease resistance of garlics to both of white rot pathogens. There was little correlation between mycelial growth and sclerotial formation on garlic cloves in vitro, and epidemiological parameters (early disease incidence, final disease incidence, disease infection rate, AUDPC) obtained from the field trial. Mycelial growth of S. cepivorum was positively correlated with final disease incidence and disease infection rate obtained from the field trial, meanwhile DRSF was negatively correlated with the epidemiological parameters.

A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU (중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구)

  • Ko, Chanyoung;Kim, Jae-Jin;Cho, Dongrae;Oh, Jooyoung;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.101-110
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    • 2019
  • Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

Consideration of Normal Variation of Perfusion Measurements in the Quantitative Analysis of Myocardial Perfusion SPECT: Usefulness in Assessment of Viable Myocardium (심근관류 SPECT의 정량적 분석에서 관류정량값 정상변이의 고려: 생존심근 평가에서의 유용성)

  • Paeng, Jin-Chul;Lim, Il-Han;Kim, Ki-Bong;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.285-291
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    • 2008
  • Purpose: Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. Materials and Methods: In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F = 28:27) of low-likelihood for coronary artery disease were enrolled and $^{201}TI$ rest/$^{99m}Tc$-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. $^{201}TI$ rest/$^{99m}Tc$-MIBI stress / $^{201}TI$ 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, $Q_{delay}$ (perfusion measurement), ${\Delta}_{delay}$ ($Q_{delay}$ - m) and $Z_{delay}$ (($Q_{delay}$ - m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Results: Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was $51.8{\pm}6.5$ and the highest segmental perfusion was $87.0{\pm}5.9$, and they are $58.7{\pm}8.1$ and $87.3{\pm}6.0$, respectively in women. In the viability assessment $Q_{delay}$ showed AUC of 0.633, while those for ${\Delta}_{delay}$ and $Z_{delay}$ were 0.735 and 0.716, respectively. The AUCs of ${\Delta}_{delay}$ and $Z_{delay}$ were significantly higher than that of $Q_{delay}$ (p = 0.001 and 0.018, respectively). The diagnostic performance of ${\Delta}_{delay}$, which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. Conclusion: On automatic quantification of myocardial perfusion SPECT, the normal variation of perfusion measurements were considerable among segments. In the viability assessment, the parameters considering normal variation showed better diagnostic performance than the direct perfusion measurement. This study suggests that consideration of normal variation is important in the analysis of measurements on quantitative myocardial perfusion SPECT.

Comparison of the Imaging Features of Lobular Carcinoma In Situ and Invasive Lobular Carcinoma of the Breast (유방의 소엽상피내암과 침윤성 소엽암의 영상의학적 소견 비교)

  • Ga Young Yoon;Joo Hee Cha;Hak Hee Kim;Min Seo Bang;Hee Jin Lee;Gyungyub Gong
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1231-1245
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    • 2021
  • Purpose To investigate the usefulness of imaging features for differentiating between small lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). Materials and Methods It included 52 female with LCISs (median 45 years, range 32-67 years) and 180 female with ILCs (median 49 years, range 36-75 years), with the longest diameter of ≤ 2 cm, who were evaluated between January 2012 and December 2016. All the female underwent mammography and ultrasonography. Twenty female with LCIS and 150 female with ILC underwent MRI. The clinical and imaging features were compared, and multivariate analysis was performed to identify the independent predictors of LCIS. Female with LCIS were also sub-grouped by lesion size and compared with the female with ILC. Results Multivariate analysis showed that younger age (odds ratio [OR] = 1.100), smaller lesion size (OR = 1.103), oval or round shape (OR = 4.098), parallel orientation (OR = 5.464), and isoechotexture (OR = 3.360) were significant independent factors predictive of LCIS. The area under the receiver operating characteristic curve for distinguishing LCIS from ILC was 0.904 (95% confidence interval, 0.857-0.951). Subgroup analysis showed that benign features were more prevalent in female with smaller LCISs (≤ 1 cm) than in those with ILC. Conclusion Small LCISs tend to demonstrate more benign features than small ILCs. Several imaging features are independently predictive of LCIS.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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Effects of Sea Tangle-added Patty on Postprandial Serum Lipid Profiles and Glucose in Borderline Hypercholesterolemic Adults (다시마 첨가 패티가 경계역 고콜레스테롤혈증 성인의 식후 혈청 지질 및 혈당 농도에 미치는 영향)

  • Kim, Hwa Hyun;Lim, Hyeon-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.4
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    • pp.522-529
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    • 2014
  • Sea tangle (Laminaria japonica) is well known as having anti-diabetic and hypolipidemic effects in animals as well as in humans. In this study, we evaluated the effects of sea tangle-added patty on postprandial blood glucose and lipid profiles in borderline-hypercholesterolemic (cholesterol ${\geq}200$ mg/dL) adults. Eleven subjects voluntarily participated in the experiment, and each subject provided written consent. Experimental patty (E) was made by adding 2.25 g of sea tangle powder as a substitution to 1.125 g each of pork and chicken. In the first week, 200 g of Control patty (C) was provided to each subject, who had fasted more than 12 hours. In the second week, the same amount of E patty was supplied under the same conditions. Serum glucose levels increased significantly less at 30, 60, and 120 min after consumption of E patty compared to the levels at all time points after eating C patty. Thus, the change in the area under curve (${\Delta}AUC$) of serum glucose levels through 120 minutes was lower when consuming E patty compared to C patty. Although serum C-peptide concentrations were not significantly different at all time points between the two patties, the ${\Delta}AUC$ of serum C-peptide concentrations through 120 minutes was lower when consuming E patty compared to C patty. However, there were no differences in serum levels of triglyceride, total cholesterol, LDL-C, and HDL-C at 30, 60, 120, 180, and 240 min between the two patties. Further, each ${\Delta}AUC$ of these lipid levels through 240 minutes was not significantly different between the two patties. The results indicate that sea tangle-added patty may decrease postprandial plasma glucose concentrations and reduce insulin secretion, although it might not ameliorate serum lipid profiles in adults with borderline-hypercholesterolemia.

Implant Isolation Characteristics for 1.25 Gbps Monolithic Integrated Bi-Directional Optoelectronic SoC (1.25 Gbps 단일집적 양방향 광전 SoC를 위한 임플란트 절연 특성 분석)

  • Kim, Sung-Il;Kang, Kwang-Yong;Lee, Hai-Young
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.44 no.8
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    • pp.52-59
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    • 2007
  • In this paper, we analyzed and measured implant isolation characteristics for a 1.25 Gbps monolithic integrated hi-directional (M-BiDi) optoelectronic system-on-a-chip, which is a key component to constitute gigabit passive optical networks (PONs) for a fiber-to-the-home (FTTH). Also, we derived an equivalent circuit of the implant structure under various DC bias conditions. The 1.25 Gbps M-BiDi transmit-receive SoC consists of a laser diode with a monitor photodiode as a transmitter and a digital photodiode as a digital data receiver on the same InP wafer According to IEEE 802.3ah and ITU-T G.983.3 standards, a receiver sensitivity of the digital receiver has to satisfy under -24 dBm @ BER=10-12. Therefore, the electrical crosstalk levels have to maintain less than -86 dB from DC to 3 GHz. From analysed and measured results of the implant structure, the M-BiDi SoC with the implant area of 20 mm width and more than 200 mm distance between the laser diode and monitor photodiode, and between the monitor photodiode and digital photodiode, satisfies the electrical crosstalk level. These implant characteristics can be used for the design and fabrication of an optoelectronic SoC design, and expended to a mixed-mode SoC field.

Diagnostic Value of Serum Procalcitonin in Febrile Infants Under 6 Months of Age for the Detection of Bacterial Infections (발열이 있는 6개월 미만의 영아에서 세균성 감염에 대한 procalcitonin의 진단적 가치)

  • Kim, Nam Hyo;Kim, Ji Hee;Lee, Taek Jin
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.142-149
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    • 2009
  • Purpose : The aim of this study was to determine the diagnostic value of serum procalcitonin (PCT) compared with that of C-reactive protein (CRP) and the total white blood cell count (WBC) in predicting bacterial infections in febrile infants<6 months of age. Methods : A prospective study was performed with infants <6 months of age who were admitted to the Department of Pediatrics with a fever of uncertain source between July and September 2008. Spinal taps were performed according to clinical symptoms and physical examination. Serum PCT levels were measured using an enzyme-linked fluorescent assay. Results : Seventy-one infants (mean age, 2.62 months) were studied. Twenty-six infants (36.6%) had urinary tract infections (UTIs), and 22 infants (31.0%) had viral meningitis. The remaining infants had acute pharyngitis (n=1), herpangina (n=1), upper respiratory tract infections (n=7), acute bronchiolitis (n=8), acute gastroenteritis (n=4), and bacteremia (n=2). The median WBC and CRP levels were significantly higher in infants with UTIs than in infants with viral meningitis. However, there were no differences in the median PCT levels between the groups (0.14 ng/mL vs. 0.11 ng/mL, P=0.419). The area under the receiver operating characteristic curve was 0.792 (95% CI, 0.65-0.896) for WBC, 0.77 (95% CI, 0.626-0.879) for CRP, and 0.568 (95% CI, 0.417-0.710) for PCT. An elevated WBC count (>11,920/${\mu}L$) and an increased CRP level (>1.06mg/dL) were significant predictors of UTIs based on multiple logistic regression analysis. Conclusion : Serum PCT concentrations should be interpreted with caution in infants <6 months of age with a fever of uncertain source.

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