• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.256-265
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• 2020

Objectives: We compared the associations of 3 computed tomography (CT)-based abdominal adiposity indexes with non-alcoholic fatty liver disease (NAFLD) among middle-aged Korean men and women. Methods: The participants were 1366 men and 2480 women community-dwellers aged 30-64 years. Three abdominal adiposity indexes-visceral fat area (VFA), subcutaneous fat area (SFA), and visceral-to-subcutaneous fat ratio (VSR)-were calculated from abdominal CT scans. NAFLD was determined by calculating the Liver Fat Score from comorbidities and blood tests. An NAFLD prediction model that included waist circumference (WC) as a measure of abdominal adiposity was designated as the base model, to which VFA, SFA, and VSR were added in turn. The area under the receiver operating characteristic curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI) were calculated to quantify the additional predictive value of VFA, SFA, and VSR relative to WC. Results: VFA and VSR were positively associated with NAFLD in both genders. SFA was not significantly associated with NAFLD in men, but it was negatively associated in women. When VFA, SFA, and VSR were added to the WC-based NAFLD prediction model, the AUC improved by 0.013 (p<0.001), 0.001 (p=0.434), and 0.009 (p=0.007) in men and by 0.044 (p<0.001), 0.017 (p<0.001), and 0.046 (p<0.001) in women, respectively. The IDI and NRI were increased the most by VFA in men and VSR in women. Conclusions: Using CT-based abdominal adiposity indexes in addition to WC may improve the detection of NAFLD. The best predictive indicators were VFA in men and VSR in women.

• Journal of the Korean Society of Radiology
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• v.85 no.2
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• pp.394-408
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• 2024

Purpose To develop models to predict programmed death ligand 1 (PD-L1) expression in pulmonary squamous cell carcinoma (SCC) using CT. Materials and Methods A total of 97 patients diagnosed with SCC who underwent PD-L1 expression assay were included in this study. We performed a CT analysis of the tumors using pretreatment CT images. Multiple logistic regression models were constructed to predict PD-L1 positivity in the total patient group and in the 40 advanced-stage (≥ stage IIIB) patients. The area under the receiver operating characteristic curve (AUC) was calculated for each model. Results For the total patient group, the AUC of the 'total significant features model' (tumor stage, tumor size, pleural nodularity, and lung metastasis) was 0.652, and that of the 'selected feature model' (pleural nodularity) was 0.556. For advanced-stage patients, the AUC of the 'selected feature model' (tumor size, pleural nodularity, pulmonary oligometastases, and absence of interstitial lung disease) was 0.897. Among these factors, pleural nodularity and pulmonary oligometastases had the highest odds ratios (8.78 and 16.35, respectively). Conclusion Our model could predict PD-L1 expression in patients with lung SCC, and pleural nodularity and pulmonary oligometastases were notable predictive CT features of PD-L1.

• Journal of Pharmaceutical Investigation
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• v.23 no.1
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• pp.41-49
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• 1993

The bioequivalence of two omeprazole enteric-coated products was evaluated in 16 normal male volunteers (age 26-32 yr, body weight 57-75 kg) following single oral administration. Test product was enteric-coated KD-182 tablet (Chong Kun Dang Corp., Korea) and reference product was $Rosec^{\circledR}$ capsule containing enteric-coated pellets of omeprazole (Yuhan Corp., Korea). Both products contain 20 mg of omeprazole. One tablet or capsule of the test or the reference product was administered to the volunteers, respectively, by randomized two period cross-over study ($2\;{\times}\;2$ Latin square method). Average drug concetrations at each sampling time and pharmacokinetic parameters calculated were not significantly different between two products(p>0.05); the area under the concentrationtime curve to last sampling time (8 hr) $(AUC_{0-8hr})$ $(1946.5{\pm}675.3\;vs\;2018.3{\pm}761.6\;ng{\cdot}hr/ml)$, AUC from time zero to infinite $(AUC_{o-\infty})$ $(2288.6{\pm}1212.8\;vs\;2264.9{\pm}1001.3\;ng{\cdot}hr/ml)$, maximum plasma concentration $(C_{max})$ $(772.5{\pm}283.3\;vs\;925.8{\pm}187.7\;ng/ml)$, time to maximum plasma concentration $(T_{max})$ $(2.38{\pm}1.06\;vs\;2.34{\pm}1.09\;hr)$, apparent elimination rate constant $(k_{\ell})$ $(0.5339{\pm}0.2687\;vs\;0.5769 {\pm}0.2184\;hr^{-I})$, apparent absorption rate constant $(k_a)$ $(1.1536{\pm}0.5278\;vs\;0.9739{\pm}0.9507 hr^{-1})$ and mean residence time (MRT) $(3.13{\pm}0.73\;vs \;3.41{\pm}1.04\;hr)$. The differences of mean $(AUC_{0-8hr})$, $C_{max}$, $T_{max}$ and MRT between the two products (3.69, 19.83, 1.32 and 8.99%, respectively) were less than 20%. The power $(1-{\beta})$ and treatment difference $(\triangle)$ for $AUC_{o-8hr}$ $C_{max}$ and MRT were more than 0.8 and less than 0.2, respectively. Although the power for $T_{max}$ was under 0.8, $T_{max}$ of the two products was not significantly different each other(p>0.05). These results suggest that the bioavailability of KD-182 tablet is not significantly different from that of $Rosec^{\circledR}$ capsule. Therefore, two products are bioequivalent based on the current results.

• Imaging Science in Dentistry
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• v.54 no.2
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• pp.139-145
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• 2024

Purpose: This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT). Materials and Methods: Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test. Results: Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (P>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (P=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41). Conclusion: MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.

• Korean Journal of Radiology
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• v.21 no.6
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• pp.670-683
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• 2020

Objective: The presence of coagulative necrosis (CN) in clear cell renal cell carcinoma (ccRCC) indicates a poor prognosis, while the absence of CN indicates a good prognosis. The purpose of this study was to build and validate a radiomics signature based on preoperative CT imaging data to estimate CN status in ccRCC. Materials and Methods: Altogether, 105 patients with pathologically confirmed ccRCC were retrospectively enrolled in this study and then divided into training (n = 72) and validation (n = 33) sets. Thereafter, 385 radiomics features were extracted from the three-dimensional volumes of interest of each tumor, and 10 traditional features were assessed by two experienced radiologists using triple-phase CT-enhanced images. A multivariate logistic regression algorithm was used to build the radiomics score and traditional predictors in the training set, and their performance was assessed and then tested in the validation set. The radiomics signature to distinguish CN status was then developed by incorporating the radiomics score and the selected traditional predictors. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performance. Results: The area under the ROC curve (AUC) of the radiomics score, which consisted of 7 radiomics features, was 0.855 in the training set and 0.885 in the validation set. The AUC of the traditional predictor, which consisted of 2 traditional features, was 0.843 in the training set and 0.858 in the validation set. The radiomics signature showed the best performance with an AUC of 0.942 in the training set, which was then confirmed with an AUC of 0.969 in the validation set. Conclusion: The CT-based radiomics signature that incorporated radiomics and traditional features has the potential to be used as a non-invasive tool for preoperative prediction of CN in ccRCC.

• Clinical and Experimental Reproductive Medicine
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• v.47 no.2
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• pp.140-146
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• 2020

Objective: To investigate whether the degree of post-warming embryo or blastocyst development is associated with clinical pregnancy in vitrified embryo or blastocyst transfer cycles. Methods: Ninety-six vitrified cleavage-stage embryos and 58 vitrified blastocyst transfer cycles were selected. All transfer cycles were performed from February 2011 to March 2019, and all vitrified embryos or blastocysts were warmed from 4 PM to 6 PM and then transferred the next morning from 9 AM to 10 AM. The scores of the cleavage-stage embryos and blastocysts were assessed at warming and at transfer using the modified Steer method and the Gardner method, respectively. The mean embryo or blastocyst score, score of the single top-quality embryo or blastocyst, and the difference in the score between warming and transfer were compared between nonpregnant and pregnant women. Results: In the cleavage-stage embryo transfer cycles, both the top-quality embryo score at transfer and the difference in the score between warming and transfer were significantly associated with clinical pregnancy. A top-quality embryo score at transfer of ≥ 60.0 (area under the curve [AUC], 0.673; 95% confidence interval [CI], 0.531-0.815) and a difference in the score between warming and transfer of ≥ 23.0 (AUC, 0.675; 95% CI, 0.514-0.835) were significant predictors of clinical pregnancy. In blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor associated with clinical pregnancy. A top-quality blastocyst score at transfer of ≥ 38.3 was a significant predictor of clinical pregnancy (AUC, 0.666; 95% CI, 0.525-0.807). Conclusion: The top-quality embryo score at transfer and the degree of post-warming embryo development were associated with clinical pregnancy in vitrified cleavage-stage embryo transfer cycles. In vitrified blastocyst transfer cycles, the top-quality blastocyst score at transfer was the only significant factor affecting clinical pregnancy.

• Korean Journal of Clinical Pharmacy
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• v.31 no.2
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• pp.125-135
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• 2021

Background: Generally, pharmacokinetics (PK) models could be stratified into two models. The compartment PK model uses the concept of simple compartmentalization to describe complex bodies, and the physiologically based pharmacokinetic (PBPK) model describes the body using multi-compartment networking. Notwithstanding sharing a theoretical background in both models, there was still a lack of knowledge to enhance compatibility in both models. Objective: This study aimed to evaluate the compatibility among PBPK, lumping model and compartment PK model with voriconazole PK case study. Methods: The number of compartments and blood flow on each tissue in the PBPK model were modified using the lumping method, considering physiological similarities. The concentration-time profiles and area under the concentration-time curve (AUC) parameters were simulated at each model, assuming taken voriconazole oral 400 mg single dose. After that, those mentioned PK parameters were compared. Results: The PK profiles and parameters of voriconazole in the three models were similar that proves their compatibility. The AUC of central compartment in the PBPK and lumping model was within a 2-fold range compared to those in the 2- compartment model. The AUC of non-eliminating tissues compartment in the PBPK model was similar to those in the lumping model. Conclusion: Regarding the compatibility of the three PK models, the utilization of the lumping method was confirmed by suggesting its reliable PK parameters with PBPK and compartment PK models. Further case studies are recommended to confirm our findings.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.470-476
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• 2020

Objective : The objective of this study was to develop a score to predict patients with acute ischemic stroke (AIS) who will not benefit from endovascular treatment (EVT) using computed tomographic angiography (CTA) parameters. Methods : The CTA-ABC score was developed from 3 scales previously described in the literature: the Alberta Stroke Program Early CT Score (0-5 points, 3; 6-10 points, 0), the clot burden score (0-3 points, 1; 4-10 points, 0), and the leptomeningeal Collateral score (0-1 points, 2; 2-3 points, 0). We evaluated the predictive value of CTA parameters associated with symptomatic intracranial hemorrhage (sICH) or malignant middle cerebral artery infarction (MMCAI) after EVT and developed the score using logistic regression coefficients. The score was then validated. Performance of the score was tested with an area under the receiver operating characteristic curve (AUC-ROC). Results : The derivation cohort consisted of 115 and the validation cohort consisted of 40 AIS patients. The AUC-ROC was 0.97 (95% confidence interval [CI], 0.94-0.99; p<0.001) in the derivation cohort. The proportions of patients with sICH and/or MMCAI in the derivation cohort were 96%, 73%, 6%, and 0% for scores of 6, 5, 1, and 0 points, respectively. In the validation group, the proportions were similar (90%, 100%, 0%, and 0%, respectively) with an AUC-ROC of 0.96 (95% CI, 0.90-1.00; p<0.001). Conclusion : Our CTA-ABC score reliably assessed risk for sICH and/or MMCAI in patients with AIS who underwent EVT. It can support clinical decision-making, especially when the need for EVT is uncertain.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.24-32
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• 2013

Purpose: The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting. Methods: This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7. Conclusion: These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

• Biomolecules & Therapeutics
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• v.15 no.3
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• pp.187-191
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• 2007

This study was conducted to compare the bioavailability of two brands of atenolol (50 mg) tablets, which are a generic product of $Ditent^{\circledR}$ (Daewon Pharmaceutical Co., Ltd., Korea) and an innovator product $Tenormin^{\circledR}$ (Hyundai Pharm. Ind. Co., Ltd., Korea), in 20 healthy Korean male volunteers. The volunteers received a single 50 mg dose of each atenolol formulation according to a randomized, two-way cross-over design. The washout period between treatments was 1 week. Plasma samples were obtained over a 24-hour interval, and atenolol concentrations were determined by HPLC with a fluorescence detector. From the plasma atenolol concentration vs. time curves, the following parameters were compared: area under the plasma concentration-time curve ($AUC_{0-24}$), peak plasma concentration ($C_{max}$), time to reach peak plasma concentration ($T_{max}$), and terminal first order elimination half-life ($t_{1/2}$). No statistically significant difference was obtained between the $T_{max}$ values, and the logarithmic transformed $AUC_{0-24}$ and $C_{max}$ values of the two products. The 90% confidence interval for the ratio of the logarithmically transformed AUC and $C_{max}$ values of $Ditent^{\circledR}$ over those of $Tenormin^{\circledR}$ were calculated to be between 0.85 and 1.04, and 0.89 and 1.07, respectively; both were within the bioequivalence limit of 0.80-1.25. The mean of $T_{max}$ in $Tenormin^{\circledR}$ group was 3.1 hour, and that in Ditent$^{\circledR}$ group was 3.2 hour. The values of $t_{1/2}$ between the two products were found comparable, and the mean values were 5.2 hour in the both products. Based on these results, it was concluded that $Ditent^{\circledR}$ was comparable to $Tenormin^{\circledR}$ in both the rate and extent of absorption, indicating that $Ditent^{\circledR}$ was bioequivalent to the reference product, $Tenormin^{\circledR}$.