• Title/Summary/Keyword: Cut off values

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Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

  • Ahn, Ja-Hye;Jung, Young Hwa;Shin, Seung Han;Kim, Hyun-Young;Kim, Ee-Kyung;Kim, Han-Suk
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.102-108
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    • 2018
  • Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

Antimicrobial Activity of a Bacteriocin Produced by Enterococcus faecalis KT11 against Some Pathogens and Antibiotic-Resistant Bacteria

  • Abanoz, Hilal Seval;Kunduhoglu, Buket
    • Food Science of Animal Resources
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    • v.38 no.5
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    • pp.1064-1079
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    • 2018
  • In this study, the antimicrobial activity of a bacteriocin produced by Enterococcus faecalis KT11, isolated from traditional Kargı Tulum cheese, was determined, and bacteriocin KT11 was partially characterized. The results showed that bacteriocin KT11 was antagonistically effective against various Gram-positive and Gram-negative test bacteria, including vancomycin- and/or methicillin-resistant bacteria. The activity of bacteriocin KT11 was completely abolished after treatment with proteolytic enzymes (proteinase K, ${\alpha}$-chymotrypsin, protease and trypsin), which demonstrates the proteinaceous nature of this bacteriocin. Additionally, bacteriocin KT11 remained stable at pH values ranging from 2 to 11 and after autoclaving at $121^{\circ}C$ for 30 min. In addition, the activity of bacteriocin KT11 was stable after treatment with several surfactants (EDTA, SDS, Triton X-100, Tween 80 and urea) and organic solvents (chloroform, propanol, methanol, ethyl alcohol, acetone, hexane and ethyl ether). Cell-free supernatant of E. faecalis KT11 was subjected to ammonium sulfate precipitation and then desalted by using a 3.5-kDa cut-off dialysis membrane. The bacteriocin activity was determined to be 711 AU/mL in the dialysate. After tricine-SDS-PAGE analysis, one peptide band, which had a molecular weight of ~3.5 kDa, exhibited antimicrobial activity. Because the bacteriocin KT11, isolated from E. faecalis KT11, exhibits a broad antimicrobial spectrum, heat stability and stability over a wide pH range, this bacteriocin can be used as a potential bio-preservative in foods. Additionally, bacteriocin KT11 alone or in combination with conventional antibiotics may provide a therapeutic option for the treatment of multidrug-resistant clinical pathogens after further in vivo studies.

Phase Angle Using Bioelectrical Impedance Analysis for Predicting Survival in Patients with Metastatic Cancer (전이암 환자의 예후 판단 인자로서 생체전기 임피던스 분석을 이용한 위상각의 역할)

  • Yoon, Sung-soo;Yoon, Seong-woo;Ryu, Han-sung;Kim, Eun-hye;Lee, Jee-young
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.463-470
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    • 2018
  • Objectives: The aim of this study was to identify the validity of phase angle as a prognostic factor for survival in patients with metastatic cancer. Methods: Data of patients with metastatic cancer who visited the Korean medicine cancer center at Kyung Hee University Hospital in Gangdong from April 2016 to February 2018 were collected for this study. The values of phase angle (PhA) and blood hemoglobin (Hb), C-reactive protein (CRP), and serum albumin levels were also investigated by bioelectrical impedance analysis (BIA). Results: In total, 86 patients were analyzed. The cut-off value of the phase angle was determined as 5.0. Univariate and multivariate analysis revealed that phase angle (HR 3.15, 95% CI 1.79-5.54) and CRP (HR 2.15, 95% CI 1.24-3.73) predicted survival with statistical significance. The median overall survival of the low PhA group ($PhA{\leq}5.0$) was 1.8 months (95% CI 0.6-2.9 months) and 7.2 months (95% CI 5.2-9.2 months) in the high PhA group (PhA>5.0)(p<0.001). Conclusions: The phase angle could be an independent prognostic factor for patients with metastatic cancer. Further research is required to confirm these findings and their correlation with other indexes.

Experimentally Evaluating Fatigue Behavior of Corroded Steels Exposed in Atmospheric Environments (대기환경하에서 장기간 사용된 부식강재의 실험적 피로거동평가)

  • Mun, Jae Min;Jeong, Young Soo;Jeon, Je Hyeong;Ahn, Jin Hee;Kim, In Tae
    • Journal of Korean Society of Steel Construction
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    • v.29 no.3
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    • pp.193-204
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    • 2017
  • Fatigue strength of temporary steels and painted structural steels corroded under outdoor atmospheric environments is not clear. In this study, fatigue tests were carried out on steel plates which were cut off from 7-year-old temporary structural member under subway construction environment and from 75-year-old Yeongdo bridge member under marine atmospheric environment. After removing corrosion production on the steel surface, 3-dimensional surface geometry of the corroded steel was measured at intervals of $1.0{\times}1.0mm$, and corrosion characteristics such as minimum, maximum and mean values of residual thicknesses were calculated. From the fatigue test and FEM analysis results, the relationship between corrosion characteristics and fatigue behavior was presented, and change in fatigue strength of the unpainted and painted steels corroded in outdoor environments was also presented.

Clinical Analysis of Rhabdomyolysis Complicated with Drug Intoxications (횡문근융해증을 유발하는 음독 약물별 임상경과 분석)

  • Lee Mi Jin;Kim Hyung Min;Kim Young Min;Lee Won Jae;So Byung Hak;Kim Se Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.1 no.1
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    • pp.27-33
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    • 2003
  • Purpose: According as the accessibility about drugs becomes various, the occurrence of drug intoxication is increasing. Since report that doxylamine causes rhabdomyolysis often, drug-induced rhabdomyolysis is one of the most important complications in patients with drug intoxication. Acute renal failure (ARF)'s availability is important to the management in rhabdomyolysis, but report about rhabdomyolysis or ARF occurrence for whole intoxicated drugs is lacking up to now. Methods: This research did to 61 patient who had rhabdomyolysis of drug intoxication. First, object patients were divided into two gruops: doxylamine-ingested (Group I) vs non-doxylamine ingested (Group II). And then we analyzed on the early patient's clinical events and laboratory data. We used ROC curve to recognize'the early clinical factors that could forecast ARF appearance among these patients in addition. Results: Almost rhabdomyolysis was happened by doxylamine in drug intoxication ($55.7\%$). However, as compared to group II, group I showed better clinical course, lesser ARF occurrence and hemodialysis requirement. In group II, time was longer in hospital reaching from intoxication, the ARF occurrence rate was higher ($52.6\%$). Analyzing the ROC curve to useful initial factors, they were creatinine, uric acid and interval time from ingestion to hospital. These cut-off values were 1.44 mg/dL, 6.8 mg/dL and 5 hrs. Sensitivity for ARF estimate was $100\%$, specificity $69-98\%$. Conclusion: Compared to group II, Doxylamine-ingested group showed good clinical course. Creatinine, uric acid, interval time from ingestion to hospital aided in ARF estimate in drug-induced rhabdomyolysis.

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Validation of the Short Form Bobath Memorial Hospital Fall Risk Assessment Scale at a Specialized Geriatric Hospital in Korea (단축형 노인 낙상위험 사정도구의 타당도)

  • Sohng, Kyeong-Yae;Park, Mi Hwa;Chaung, Seung Kyo;Park, Hye Ja
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.495-508
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    • 2014
  • Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

Microsurgical Foraminotomy via Wiltse Paraspinal Approach for Foraminal or Extraforaminal Stenosis at L5-S1 Level : Risk Factor Analysis for Poor Outcome

  • Cho, Sung-Ik;Chough, Chung-Kee;Choi, Shu-Chung;Chun, Jin-Young
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.610-614
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    • 2016
  • Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).

Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season (우리나라 농촌지역 노인들의 영양점검표(DETERMINE)를 통한 계절별 영양상태 판정의 신뢰도 분석 연구)

  • Moon, Hyun-Kyung;Kong, Jung-Eun
    • Korean Journal of Community Nutrition
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    • v.14 no.3
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    • pp.340-353
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    • 2009
  • It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

Multiple Linkage Disequilibrium Mapping Methods to Validate Additive Quantitative Trait Loci in Korean Native Cattle (Hanwoo)

  • Li, Yi;Kim, Jong-Joo
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.7
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    • pp.926-935
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    • 2015
  • The efficiency of genome-wide association analysis (GWAS) depends on power of detection for quantitative trait loci (QTL) and precision for QTL mapping. In this study, three different strategies for GWAS were applied to detect QTL for carcass quality traits in the Korean cattle, Hanwoo; a linkage disequilibrium single locus regression method (LDRM), a combined linkage and linkage disequilibrium analysis (LDLA) and a $BayesC{\pi}$ approach. The phenotypes of 486 steers were collected for weaning weight (WWT), yearling weight (YWT), carcass weight (CWT), backfat thickness (BFT), longissimus dorsi muscle area, and marbling score (Marb). Also the genotype data for the steers and their sires were scored with the Illumina bovine 50K single nucleotide polymorphism (SNP) chips. For the two former GWAS methods, threshold values were set at false discovery rate <0.01 on a chromosome-wide level, while a cut-off threshold value was set in the latter model, such that the top five windows, each of which comprised 10 adjacent SNPs, were chosen with significant variation for the phenotype. Four major additive QTL from these three methods had high concordance found in 64.1 to 64.9Mb for Bos taurus autosome (BTA) 7 for WWT, 24.3 to 25.4Mb for BTA14 for CWT, 0.5 to 1.5Mb for BTA6 for BFT and 26.3 to 33.4Mb for BTA29 for BFT. Several candidate genes (i.e. glutamate receptor, ionotropic, ampa 1 [GRIA1], family with sequence similarity 110, member B [FAM110B], and thymocyte selection-associated high mobility group box [TOX]) may be identified close to these QTL. Our result suggests that the use of different linkage disequilibrium mapping approaches can provide more reliable chromosome regions to further pinpoint DNA makers or causative genes in these regions.

Prognostic Significance of Preoperative Lymphocyte-Monocyte Ratio in Patients with Resectable Esophageal Squamous Cell Carcinoma

  • Han, Li-Hui;Jia, Yi-Bin;Song, Qing-Xu;Wang, Jian-Bo;Wang, Na-Na;Cheng, Yu-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2245-2250
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    • 2015
  • Background: The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy. Materials and Methods: Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models. Results: The median follow-up was 38.6 months (range 3-71 months). The cut-off values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients. Conclusions: Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.