Purpose : Our examination was designed to determine the diagnostic properties of the cutoff point for the prediction of bacteremia in febrile children less than 3 years of age. Cutoff point is the value that simultaneously maximizes both sensitivity and specificity. Methods : We conducted a retrospective study of febrile children, less than 3 years of age, who clinically have no identifiable source of fever. Peripheral blood leukocyte count(WBC), absolute neutrophil count(ANC), erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were measured at the same time. All patients received blood culture, urine culture and/or CSF culture. Bacterial infection was defined as single pathogen isolated from the CSF or blood or a urinary tract infection (UTI). Patients were dichotomized into two groups : those with bacterial infection and no bacterial infection. We analyzed the characteristics of the children in the two groups. Results : Seventy-one patients(44 males; 27 females) were enrolled in the study. Twenty patients (28%) had a serious bacterial infection(twelve urinary tract infection, five bacteremia, three meningitis) and fifty-one(72%) had no serious bacterial infection. WBC, ESR and CRP were significantly different between the two groups(P<0.05). The cutoff point of WBC, ESR and CRP were $20,000/mm^3$, 30 mm/hr and 3.0 mg/dL, respectively. The sensitivity and specificity of each cutoff point were WBC(75%, 75%), ESR(79%, 68%) and CRP(83%, 77%), respectively. Conclusion : These data show the ability of predictors to identify febrile children less than 3 years of age with bacterial infection. Febrile children who reach the cutoff point must be treated intensively and those who do not reach the cutoff point can be carefully managed without administering antimicrobial agents.
The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.
Journal of Korean Society of Environmental Engineers
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v.31
no.11
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pp.1041-1050
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2009
The ambient temperature and concentration of carbon dioxide in Gwangju and the reducing method of temperature, air pollutants were investigated using the atmospheric data in Gwangju. Average ambient temperature ($T_{a-ave}$ was $13.5^{\circ}C$ during 1961 to 2008. The temperature was predicted as increasing of about $2.7^{\circ}C$ in 2108 after 100 years using the trend line of regression equation. Carbon dioxide was 370.7 and 391.4 ppm at Anmyundo, in 1999 and 2008, respectively, showing proportionally increased as ambient temperature. The temperature at Gwangju, $14.2^{\circ}C$ during 1997 to 2008, was a little higher than at neighboring counties as Naju, Damyang, Hwasoon, and Jangsung. In Gwangju, Spring will start in mid-January of 2108, Summer in mid-May, Autumn in mid-October, and Winter in last-December. The average relative humidity in the air ($RH_{a-ave}$) was gradually decreased as the temperature inversely increased. The average $CO_2$ was 457 ppm, which is 65.6 ppm higher than that in Anmyundo, korean background area of $CO_2$ in 2008. Carbon dioxide showed positive correlation, both of them, with carbon monoxide (0.87) and relative humidity (0.48).
The purpose of the study was to develop an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Eating habits, food intake, and anthropometric data were collected from 142 children (80 boys and 62 girls) in the $4^{th}$ to $6^{th}$ grades of elementary schools. Percentage of Recommended Intakes (RI) and Mean Adequacy Ratio (MAR) of six micronutrients; vitamin A, riboflavin, vitamin C, calcium, iron, zinc, and the number of nutrients the children consumed below EAR among the six nutrients were used as indices to detect the risk of inadequate micronutrient intake. Pearson correlation coefficients were calculated between eating habit scores and inadequate micronutrient intake indices in order to select questions included in the checklist. Meal frequency, enough time for breakfast, regularity of dinner, appetite, eating frequencies of Kimchi, milk, fruits and beans showed significant correlations with indices of inadequate micronutrient intake. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 8-item checklist with test results from 0 to 12 points was developed, and those with equal or higher than 6 points were diagnosed as high-risk group of inadequate micronutrient intake, and those with 4 or 5 points were diagnosed as moderate-risk group. Among our subjects 14.1% was diagnosed as high-risk group, and 30.3% as moderate-risk group. The proportions of the subjects who consumed below EAR of all micronutrients but vitamin C were highest in the high-risk group, and there were significant differences in the proportions of the subjects with intake below EAR of all micronutrients except vitamin B6 among the three groups. This checklist will provide a useful screening tool to identify children at risk of inadequate micronutrient intake.
Background: To examine the expression of cysteine-rich 61 (Cyr61/CCN1) protein in laryngeal squamouscell carcinoma (LSCC) tissues, and its relationship with the tumor epithelial-mesenchymal transition (EMT), invasion, metastasis, and prognosis. Materials and Methods: Immunohistochemistry was used to detect the expressions of Cyr61, Vimentin (Vim), and E-cadherin (E-cad) in 88 cases of LSCC tissues and 30 cases of tumor-adjacent normal tissues. Vim and E-cad were used as mesenchymal and epithelial markers, respectively, to determine the relationship between Cyr61 expression and the EMT of LSCC cells. In addition, clinical and histopathological data were combined to analyze the relationship between the positive-expression rates of Cyr61, Vim and E-cad and LSCC invasion, metastasis and prognosis. Results: In LSCC tissues, Vim expression rate was significantly higher than that of the tumor-adjacent tissues, whereas E-cad expression rate was significantly lower than that of the tumor-adjacent tissues. The Vim expression rate was significantly higher in stages T3 and T4 than in stages T1 and T2 LSCC tissues, whereas E-cad expression rate was significantly lower in stages T3 and T4 than in stages T1 and T2 LSCC tissues. Compared to the group without lymph node metastasis, the Vim expression rate was significantly higher and the E-cad expression rate was significantly lower in the group with lymph node metastasis. The expression rate of Cyr61 was significantly higher in LSCC tissues than in the tumor-adjacent normal tissues. In addition, the Cyr61 expression rate was higher in stages T3 and T4 than in stages T1 and T2 LSCC, and higher in the group with lymph node metastasis than in the group without lymph node metastasis. The Vim expression rate was significantly higher in the Cyr61 positive group than in the Cyr61 negative group, whereas the E-cad expression rate was significantly higher in the Cyr61 negative group than in the Cyr61 positive group. Survival analysis indicated that survival rates of Cyr61 positive, Vim positive and E-cad negative groups were significantly lower than that of Cyr61 negative, Vim negative and E-cad positive groups, respectively. Conclusions: Cyr61 expression is closely associated with LSCC invasion and lymph node metastasis. Overexpression of Cyr61 may induce EMT and therefore leads to LSCC invasion and metastasis and poor prognosis. Cyr61 may become a new maker for clinical prediction of LSCC invasion and metastasis and a new target for LSCC treatment.
Background: Craniofacial anatomic abnormalities related to structural narrowing of the upper airway have been reported in patients with obstructive sleep apnea syndrome. In this study, we evaluated the craniofacial anatomic characteristics of Korean patients with obstructive sleep apnea syndrome, and the role of cephalometric analysis in the prediction of abnormal breathing during sleep. Methods: Thirty-nine patients with obstructive sleep apnea syndrome(OSAS), 39 simple snorers(simple snorers) and 20 controls(control) had cephalometric analysis using the technique of Riley et al, and underwent standardized polysomnographic recordings. Different variables, including sex, body mass index, cephalometric and polysomnographic data, were statistically analyzed. Results: Pm-UPW and V-LPW distances were significantly shorter in OSAS when compared with simple snorers or control. PAS in simple snorers was shorter than in control. ANS-Gn distance in OSAS was significantly longer than in control. PNS-P distance in OSAS or simple snorers was significantly longer than in control. MP-H distance in OSAS was significantly longer than in simple snorers or control and MP-H distance in simple snorers was also longer than in control. NL/Pm-P angle in OSAS was lesser than in control. MP-H distance in OSAS or in the combined groups of OSAS and simple snorers was significantly correlated with apneahypopnea index(AHI). PNS-P distance in the combined groups of OSAS and simple snorers was correlated with AHI. In male of all subjects, body mass index was significantly correlated with PNS-P or MP-H distance. Conclusion: Cephalometric analysis can be useful tool in determining the craniofacial anatomic abnormalities in patients with obstructive sleep apnea syndrome. Cephalometric parameters, especially MP-H distance, can be useful for predicting frequency of narrowing or obstruction of upper airway during sleep.
The WRF-Chem model was applied to simulate the Asian dust event affecting the Korean Peninsula from 11 to 13 November 2010. GOCART dust emission schemes, RADM2 chemical mechanism, and MADE/SORGAM aerosol scheme were adopted within the WRF-Chem model to predict dust aerosol concentrations. The results in the model simulations were identified by comparing with the weather maps, satellite images, monitoring data of $PM_{10}$ concentration, and LIDAR images. The model results showed a good agreement with the long-range transport from the dust source area such as Northeastern China and Mongolia to the Korean Peninsula. Comparison of the time series of $PM_{10}$ concentration measured at Backnungdo showed that the correlation coefficient was 0.736, and the root mean square error was $192.73{\mu}g/m^3$. The spatial distribution of $PM_{10}$ concentration using the WRF-Chem model was similar to that of the $PM_{2.5}$ which were about a half of $PM_{10}$. Also, they were much alike in those of the UM-ADAM model simulated by the Korean Meteorological Administration. Meanwhile, the spatial distributions of $PM_{10}$ concentrations during the Asian dust events had relevance to those of both the wind speed of u component ($ms^{-1}$) and the PBL height (m). We performed a regressive analysis between $PM_{10}$ concentrations and two meteorological variables (u component and PBL) in the strong dust event in autumn (CASE 1, on 11 to 23 March 2010) and the weak dust event in spring (CASE 2, on 19 to 20 March 2011), respectively.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.1
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pp.16-24
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2001
The purpose of this study was to evaluate the specificity, sensitivity, and diagnostic power of caries activity test using laser fluorescence. The subjects of this study were 50 children of $7\sim9$ years old. Fluorescence from initial carious lesion of teeth illuminated by an argon laser(480nm) was observed and photographed with barrier filter. Visual examination for the dDfFtT rate and Streptococcus mutans colony counting was done to evaluate correlation with caries activity test using laser fluorescence. Data analysis was accomplished by Axelsson's method. The results from the present study can be summarized as follows: 1. There was positive correlation $(\gamma=0.48)$ between laser fluorescence test and Streptococcus mutans count. And also positive correlation $(\gamma=0.39)$ exists between laser fluorescence test and dDfFtT rate (P<0.01). 2. Positive correlation $(\gamma=0.27)$ between Streptococcus mutans colony count and dDfFtT rate was found(P<0.05). 3. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of laser fluorescence test were 44.4%, 85.7%, and 87.8%. 4. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of S. mutans colony counting were 77.8%, 92.9%, 84.8%. 5. When S. mutans colony counting was defined to standard testing method, sensitivity, specificity and diagnostic power of laser fluorescence test were 40.0%, 84.8%, 95.1%. In regard to above results, laser fluorescence test considered to be accurate and reliable method for determining caries activity because of it's close relationship with caries susceptibility test and caries experience measurements. And it was also considered to be practical because it would be simple, inexpensive, and time saving method.
Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
Clinical and Experimental Reproductive Medicine
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v.26
no.2
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pp.163-170
/
1999
Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.
Journal of the Korean Society of Marine Environment & Safety
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v.14
no.1
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pp.29-37
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2008
This study examined principles and techniques of efficient water quality management as well as total coastal pollutant loads and the relevant examples in the advanced countries from the viewpoints of water quality improvement and pollution control in coastal areas. The problems and improvements in an estimation of the current total pollutant loads were also pointed out. In addition, discussion was made on the relationship between total pollutant loads and environmental capacity as well as particulars requiring extensive examination on access to and study on water quality model used as prediction tool for marine environment. Furthermore, this study proposed details of and improvement plans for water quality control to be reflected and absorbed into systems and policies related to coastal water quality. In coastal areas, which are subject to total coastal pollutant loads, it is necessary to calculate pollutant loads reduction and allocation, to propose them in detail in statement in relations to new pollution sources for the corresponding projects or plans in environmental impact assessment and prior environmental review system. Also, in relations to regional plans for coastal management, the local government concerned must focus more on environmental management plan to implement data on pollution sources and pollutant loads flown into sea areas under basic jurisdiction, therefore it is required to actively respond to expansion and introduction of total coastal pollutant loads system in the future. Total coastal pollutant loads system must be expanded and executed by considering characteristics of sea area and changes in the environment of land. For pollution sources in land, the competent authorities in charge of coastal environment will need to initiatively administer supervision, monitoring activities and achieve integration and operation of the related laws by preparing legal bases for management system or adjusting the related laws.
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