• 제목/요약/키워드: Discordance

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Changes in Forced Expiratory Volume in 1 Second after Anatomical Lung Resection according to the Number of Segments

  • Lee, Sun-Geun;Lee, Seung Hyong;Cho, Sang-Ho;Song, Jae Won;Oh, Chang-Mo;Kim, Dae Hyun
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.480-486
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    • 2021
  • Background: Although various methods are already used to calculate predicted postoperative forced expiratory volume in 1 second (FEV1) based on preoperative FEV1 in lung surgery, the predicted postoperative FEV1 is not always the same as the actual postoperative FEV1. Observed postoperative FEV1 values are usually the same or higher than the predicted postoperative FEV1. To overcome this issue, we investigated the relationship between the number of resected lung segments and the discordance of preoperative and postoperative FEV1 values. Methods: From September 2014 to May 2020, the data of all patients who underwent anatomical lung resection by video-assisted thoracoscopic surgery (VATS) were gathered and analyzed retrospectively. We investigated the association between the number of resected segments and the differential FEV1 (a measure of the discrepancy between the predicted and observed postoperative FEV1) using the t-test and linear regression. Results: Information on 238 patients who underwent VATS anatomical lung resection at Kyung Hee University Hospital at Gangdong and by DH. Kim for benign and malignant disease was collected. After applying the exclusion criteria, 114 patients were included in the final analysis. In the multiple linear regression model, the number of resected segments showed a positive correlation with the differential FEV1 (Pearson r=0.384, p<0.001). After adjusting for multiple covariates, the differential FEV1 increased by 0.048 (95% confidence interval, 0.023-0.073) with an increasing number of resected lung segments (R2=0.271, p<0.001). Conclusion: In this study, after pulmonary resection, the number of resected segments showed a positive correlation with the differential FEV1.

Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging for Language Mapping in Brain Tumor Surgery: Validation With Direct Cortical Stimulation and Cortico-Cortical Evoked Potential

  • Koung Mi Kang;Kyung Min Kim;In Seong Kim;Joo Hyun Kim;Ho Kang;So Young Ji;Yun-Sik Dho;Hyongmin Oh;Hee-Pyoung Park;Han Gil Seo;Sung-Min Kim;Seung Hong Choi;Chul-Kee Park
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.553-563
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    • 2023
  • Objective: Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging-derived tractography (DTI-t) contribute to the localization of language areas, but their accuracy remains controversial. This study aimed to investigate the diagnostic performance of preoperative fMRI and DTI-t obtained with a simultaneous multi-slice technique using intraoperative direct cortical stimulation (DCS) or corticocortical evoked potential (CCEP) as reference standards. Materials and Methods: This prospective study included 26 patients (23-74 years; male:female, 13:13) with tumors in the vicinity of Broca's area who underwent preoperative fMRI and DTI-t. A site-by-site comparison between preoperative (fMRI and DTI-t) and intraoperative language mapping (DCS or CCEP) was performed for 226 cortical sites to calculate the sensitivity and specificity of fMRI and DTI-t for mapping Broca's areas. For sites with positive signals on fMRI or DTI-t, the true-positive rate (TPR) was calculated based on the concordance and discordance between fMRI and DTI-t. Results: Among 226 cortical sites, DCS was performed in 100 sites and CCEP was performed in 166 sites. The specificities of fMRI and DTI-t ranged from 72.4% (63/87) to 96.8% (122/126), respectively. The sensitivities of fMRI (except for verb generation) and DTI-t were 69.2% (9/13) to 92.3% (12/13) with DCS as the reference standard, and 40.0% (16/40) or lower with CCEP as the reference standard. For sites with preoperative fMRI or DTI-t positivity (n = 82), the TPR was high when fMRI and DTI-t were concordant (81.2% and 100% using DCS and CCEP, respectively, as the reference standards) and low when fMRI and DTI-t were discordant (≤ 24.2%). Conclusion: fMRI and DTI-t are sensitive and specific for mapping Broca's area compared with DCS and specific but insensitive compared with CCEP. A site with a positive signal on both fMRI and DTI-t represents a high probability of being an essential language area.

A Study of Influences of p53 Mutation, Cyclin D1 Over Expression, Ki67 Index, Mitotic Index on the Prognosis of Esophageal Squamous Cell Carcinoma (p53 변이, Cyclin D1의 과발현, Ki67 지수, 세포분열지수가 식도의 편평상피암의 예후에 미치는 영향)

  • Lee Hae Won;Cho Suk Ki;Sung Sook Whan;Lee Hyun Joo;Kim Young Tae;Kang Moon Chul;Kim Joo Hyun
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.835-843
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    • 2005
  • Background: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. Material and Method: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. Result: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, Iymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6$\%$). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). Conciusion: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer, Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.

Comparison of PCR-RFLP and Real-Time PCR for Allelotyping of Single Nucleotide Polymorphisms of RRM1, a Lung Cancer Suppressor Gene (폐암 억제유전자 RRM1의 단일염기다형성 검사를 위한 PCR-RFLP법과 Real-Time PCR법의 유용성 비교)

  • Jeong, Ju-Yeon;Kim, Mi-Ran;Son, Jun-Gwang;Jung, Jong-Pil;Oh, In-Jae;Kim, Kyu-Sik;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.406-416
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    • 2007
  • Background: Single nucleotide polymorphisms (SNPs), which consist of a substitution of a single nucleotide pair, are the most abundant form of genetic variations occurring with a frequency of approximately 1 per 1000 base pairs. SNPs by themselves do not cause disease but can predispose humans to disease, modify the extent or severity of the disease or influence the drug response and treatment efficacy. Single nucleotide polymorphisms (SNPs), particularly those within the regulatory regions of the genes often influence the expression levels and can modify the disease. Studies examining the associations between SNP and the disease outcome have provided valuable insight into the disease etiology and potential therapeutic intervention. Traditionally, the genotyping of SNPs has been carried out using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP), which is a low throughput technique not amenable for use in large-scale SNP studies. Recently, TaqMan real-time PCR chemistry was adapted for use in allelic discrimination assays. This study validated the accuracy and utility of real-time PCR technology for SNPs genotyping Methods: The SNPs in promoter sequence (-37 and -524) of lung cancer suppressor gene, RRM1 (ribonucleotide reductase M1 subunit) with the genomic DNA samples of 89 subjects were genotyped using both real-time PCR and PCR-RFLP. Results: The discordance rates were 2.2% (2 mismatches) in -37 and 16.3% (15 mismatches) in -524. Auto-direct sequencing of all the mismatched samples(17 cases) were in accord with the genotypes read by real-time PCR. In addition, 138 genomic DNAs were genotyped using real-time PCR in a duplicate manner (two separated assays). Ninety-eight percent of the samples showed concordance between the two assays. Conclusion: Real-time PCR allelic discrimination assays are amenable to high-throughput genotyping and overcome many of the problematic features associated with PCR-RFLP.

An Evaluation of the Rapid Antimicrobial Susceptibility Test by VITEK MS and VITEK 2 Systems in Blood Culture (혈액배양에서 VITEK MS와 VITEK 2 System을 이용한 신속 항생제 감수성 시험의 유용성 평가)

  • Park, Kang-Gyun;Yu, Young-Bin;Yook, Keundol;Kim, Sang-Ha;Kim, Sunghyun;Kim, Young Kwon
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.3
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    • pp.279-284
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    • 2017
  • The results of rapid antimicrobial susceptibility test (AST) in blood cultures were obtained by inoculating the bacteria directly into the VITEK MS and the VITEK 2 systems without subculturing in the blood culture positive medium. The obtained results were compared with the results using a standard method to evaluate their reliability and accuracy. The direct AST results in blood culture positive specimens were 97.9% (1,936/1,978), consistent with the standard AST results. Gram-positive bacteria showed a concordance rate of 97.2% (1,051/1,081), a very major error rate of 0.5% (5/1,081), a major error rate of 0.1% (1/1,081), and a minor error rate of 2.2% (24/1,081). Staphylococcus epidermidis was the main cause of discordance, and gentamicin (N=9) and fusidic acid (N=8) showed high errors. The overall concordance rate and minor error among the Gram-negative bacteria were 98.6% (885/897) and 1.4% (12/897), respectively. Escherichia coli and Pseudomonas aeruginosa were the major causative bacteria of Gram-negative bacteria. Among them, amoxicillin/clavulanic acid (N=3) showed high error. Direct AST met the CLSI criteria and shortened the reporting time by 24 hours; however, we found that there was a need to perform an addition test via disk diffusion for antimicrobials with very large errors. These results suggest that the method of direct AST in blood culture positive medium may be very useful in efficiently treating patients.

Socio-Economic Factors Affecting the Health and Nutritional Status of the Aged (노인의 건강과 영양상태에 영향을 미치는 사회경제적 요인분석)

  • 김숙희;강혜경;김주현
    • Journal of Nutrition and Health
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    • v.33 no.1
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    • pp.86-101
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    • 2000
  • Various kinds of living circumstances are making population structure of Korean changed. That is, number of the children is decreased and that of the aged is increased. It is predicted that population of the children and the aged will be almost same until 2020. With above, as the expectation of the aged on healthy living might be increased, some special programs for the aged will be needed strongly. At this point, Korean aged population might be economically poor, comparing with other generation. In general, economic factor affects the subjective living-satisfaction and health status of them. Moreover, educational status, household shape and family tieing also affect their health status. According to the foreign articles, health status of the aged might be related to income, educational status, job, employed or/not, marital status, family structure, sex, and childhood condition. decrease of the income or unemployment could make the death rate of the aged higher. During childhood, discordance among the family might affect their health status after. IGUR is also important factor to affect the adulthood health. Positive life style of the aged would lessen their unequality of the health among them. Nutritional status of the Korean aged population might be indicated under the nutritional recommendation. It is affected by their income, education level, social class, and residing place. (Korean J Nutrition 33(1) : 86-101, 2000)

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A Study on Practices and Improvement Factors of Financial Disclosures in early stages of IFRS Adoption - An Integrative Approach of Korean Cases: Embracing Views of Reporting Entities and Users of Financial Statements (IFRS 공시 실태 개선방안에 대한 소고 - 보고기업, 정보이용자 요인을 고려한 통합적 접근 -)

  • Kim, Hee-Suk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.2
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    • pp.113-127
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    • 2012
  • From the end of 1st quarter of 2012, Korean mandatory firms had started releasing financial reports conforming to the K-IFRS(Korean adopted International Financial Reporting Standards). Major characteristics of IFRS, such as 'principles based' features, consolidated reporting, 'fair value' measurement, increased pressure for non-financial disclosures have resulted in brief and various disclosure practices regarding the main body of each statements and vast amount of note description requirements. Meanwhile, a host of previous studies on IFRS disclosures have incorporated regulatory and/or 'compete information' perspectives, mainly focusing on suggesting further enforcement of strengthened requirements and providing guidelines for specific treatments. Thus, as an extension of prior findings and suggestions this study had explored to conduct an integrative approach embracing views of the reporting entities and the users of financial information. In spite of all the state-driven efforts for faithful representation and comparability of corporate financial reports, an overhaul of disclosure practices of fiscal year 2010 and 2011 had revealed numerous cases of insufficiency and discordance in terms of mandatory norms and market expectations. As to the causes of such shortcomings, this study identified several factors from the corporate side and the users of the information; some inherent aspects of IFRS, industry/corporate-specific context, expenditures related to internalizing IFRS system, reduced time frame for presentation. lack of clarity and details to meet the quality of information - understandability, comparability etc. - commonly requested by the user group. In order to improve current disclosure practices, dual approach had been suggested; Firstly, to encourage and facilitate implementation, (1) further segmentation and differentiation of mandates among companies, (2) redefining the scope and depth of note descriptions, (3) diversification and coordination of reporting periods, (4) providing support for equipping disclosure systems and granting incentives for best practices had been discussed. Secondly, as for the hard measures, (5) regularizing active involvement of corporate and user group delegations in the establishment and amendment process of K-IFRS (6) enforcing detailed and standardized disclosure on reporting entities had been recommended.

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TI-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis (좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 TI-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석)

  • Choi, Joon-Young;Lee, Kyung-Han;Kim, Young-Hwan;Lee, Eun-Jeong;Chung, Hyun-Woo;Lee, Su-Jin;Lee, Sang-Hoon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.218-224
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    • 2004
  • We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

Right-Turn Vehicle Supplementary Signal Improvement at Intersections (교차로 우회전 차량 보조등 개선)

  • LEE, Nam Soo;KIM, Yu Chan;LIM, Joon Beom;KIM, Youngchan
    • Journal of Korean Society of Transportation
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    • v.33 no.5
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    • pp.441-448
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    • 2015
  • This study aims to suggest a reasonable signal operation method for right-turn traffic management. It was found that the right-turn vehicle supplementary signal is currently operated without clear regulations or criteria. It was also analyzed that right-turn supplementary signals are used without consistency, there is a risk of traffic accidents due to the discordance between supplementary signals and traffic signals of forward vehicles, there is a lack of basis for prohibition of a right turn when right-turn vehicle's supplementary signal is red and the flashing red signal is used in a different sense from the law. In order to see the effect of the installed right-turn vehicle supplementary signals on traffic signal violation, a field investigation was conducted. As the result, there was a high proportion of signal violation on the approach lane with right-turn supplementary signals and this means that right-turn supplementary signals hardly influenced the reduction in proportion of signal violation during a right turn. Additionally, a survey was carried out to see if there were differences in driver's interpretation of traffic signals depending on the installation of right-turn supplementary signals. As the result of the survey, there were no differences in interpretation of traffic signals depending on the installation of right-turn supplementary signals or the types of right-turn supplementary signals. A right turn when the signal was red did not lead to serious traffic accidents, so it is thought that there should be a careful consideration of a total ban on a right turn when the signal is red, in order to prevent driver's confusion due to the change of the signal system. Unless there is a disturbance to cars and pedestrians after a temporary stop when the signal is red, there is a need to specify that vehicles must stop temporarily in the Road Traffic Act to facilitate a right turn. What this study finally suggested is to use tri-colored arrow signals for right-turn car supplementary signals to convey a signal to a driver clearly.

Effects of the difference between actual body condition and body image perception on nutrient intake, weight control and mental health in Korean adults: Based on the 5th Korea National Health and Nutrition Examination Survey (한국 성인의 체질량 지수에 따른 비만도와 주관적 체형인식 간의 차이가 영양소 섭취와 체중조절 및 정신건강에 미치는 영향 : 제 5기 국민건강영양조사 자료를 이용하여)

  • Seo, Jihyun;Ma, Hyesun;Kim, Sunghee;Kim, Jiyoung;Shin, Minseo;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.153-164
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    • 2016
  • Purpose: The objective of this study was to examine the effect of the body shape discordance, the difference between true body type based on body mass index (BMI) and self-recognized body image, on nutrient intake, weight control attempt, and mental health in Korean adults. Methods: Subjects were persons aged 19~64 years (4,382 men and 6,226 women) who participated in the 2010~2012 Korea National Health and Nutrition Examination Survey. Subjects were categorized as RL (Group recognized as lighter than BMI criteria), RA (Group with agreement between BMI criteria and self-recognized body image), and RH (Group recognized as heavier than BMI criteria) according to the difference between actual body type based on BMI and self-recognized body image. Results: Means of BMI in RH groups were lower than or equal to that of RA groups in all groups. No significant differences in total energy intake were observed among the three groups in men, but total energy intake was higher in the RL group than in the RH group in 30~49 year old women. Proportion of carbohydrate was the highest in the RL group among 30~49 year old women. RH groups paid more attention to weight control and had less weight gain than other groups. Higher proportions of depressive symptoms were reported in the RH group in 19~29 year old men, while a higher proportion of depressive symptoms were reported in the RL group in 50~64 year old men. Conclusion: The current findings suggest an association of perceiving body shape with energy intake, weight control attempt, or depressed mood in some age groups. Body image perception can influence eating, weight control attempt, and depressed mood, therefore proper body image perception should be established in Korean adults.