• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.68-74
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• 2018

Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${\chi}^2$ test for trend, ${\chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.73-81
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• 2018

Purpose : The aims of this study were to compare and assess the effectiveness of Volumetric Modulated Arc Therapy(VMAT) using jaw tracking(JT) and fixed jaw(FJ) in radiation therapy of multiple brain metastasis. Methode and material : Among the patients with Multiple Brain Metastasis treated with jaw tracking, 10 patients with more than 6 tumors and with the size of radiation field $14{\times}14cm^2$ or more were included. Each Treatment plans with jaw tracking(JT) and fixed jaw(FJ) was established with Eclipse (Ver. 13.6 Varian, USA). Gamma Index (3 mm, 3 % confidence interval - 95 %) and maximum dose difference were measured with an electronic portal imaging device(EPID). The $D_{max}$ and $D_{mean}$ of Organ At Risk(OAR) were assessed and compared, and the Conformity Index(CI) and Homogeneity Index(HI) were evaluated. Result : Evaluating jaw tracking(JT) and fixed jaw(FJ) outcomes, in all cases, Gamma Index met the permissible standard of 3 mm, 3 % confidence intervals of 95 %. The maximum dose difference value from the areas with leaf end transmission was measured at a maximum of 98.4 % and an average of 43.6 % in clockwise(CW), and 67.9 % and 41.0 % for each in Counter-Clockwise(CCW). With jaw tracking, the maximum value of $D_{max}$ for each normal organ in OAR decreased in 15.36 %~74.59 % with the average value decreasing in 2.84 %~39.80 %. The maximum value of $D_{mean}$ in OAR decreased in 27.90 %~65.23 %, with the average value decreasing in 7.70 %~41.71 %. No change has been found in Conformity Index and Homogeneity Index values. Conclusion : When Jaw tracking is used in treating patients with multiple brain metastasis with VMAT, the unnecessary exposure due to leakage and transmission of radiation in unspecified areas was reduced, without affecting the dose distribution of the planning target volume(PTV), and the availability of radiation therapy with lower doses in normal organs is expected.

• Journal of the Korean Society of Radiology
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• v.18 no.5
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• pp.551-556
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• 2024

This study aims to evaluate the diagnostic concordance and accuracy by comparing thyroid lesions diagnosed with the artificial intelligence-based computer-aided diagnosis (CAD) system, S-Detect^TM, to the results of fine-needle aspiration biopsy(FNAB). A retrospective study was conducted involving 60 patients at N Hospital in Gyeongnam from May 2023 to September 2023. The study used S-Detect^TM to analyze ultrasound findings and malignancy risk of thyroid nodules and compared these findings with FNAB results to determine accuracy. The study assessed the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of S-Detect^TM and evaluated the diagnostic concordance between the two methods using Kappa analysis. S-Detect^TM demonstrated a sensitivity of 90.5%, specificity of 83.2%, accuracy of 88.3%, PPV of 80.7%, and NPV of 92.7%. The Kappa value for diagnostic agreement between S-Detect^TM and FN AB was 0.719 (p<0.05), indicating a high level of agreement between the methods. Therefore, the CAD system S-Detect^TM proves valuable in distinguishing between malignant and benign thyroid lesions and could reduce unnecessary tissue examinations when used appropriately before thyroid fine-needle aspiration.

• The Journal of the Convergence on Culture Technology
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• v.9 no.3
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• pp.75-79
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• 2023

ESG management means to thoroughly consider the investor's perspective when evaluating corporate value, and environmental, social, and governance issues are continuous and strategic monitoring issues in identifying risk and opportunity factors related to corporate management activities. In other words, the perspective of value creation is reflected in business relationships. The fundamental purpose of ESG management is continuous business value creation and thorough management of investment risks and business transactions in contractual relationships. It is also a requirement of linked investors. The field that Korean companies are currently experiencing the most is the recognition that 'ESG information collection is necessary and maintenance must be prioritized' in investor IR and global sales and marketing departments, and the primary need for this is emerging. In addition, as the legal affairs office, environmental safety department, and human resources department, which conduct compliance management, carry out related tasks, clarity at the organizational level must precede in order to properly establish an information integration and management system. It covers the scope of securing new market opportunities such as management, disclosure and communication. Therefore, in regard to the newly emerging ESG management and response methods, it is necessary to review and implement it repeatedly so that sustainable exchange profits can be created by simultaneously managing non-financial risks as well as efforts to enhance corporate value for financial returns.

• Industry Promotion Research
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• v.8 no.1
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• pp.111-117
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• 2023

Sampling inspection methods for quality control have been proposed a lot in the industry. However, the sampling inspection method for reliability, which is a quality over time, has been relatively less presented, and there are not many literatures that are clearly summarized. Therefore, this paper focuses on the reliability conformity test to verify that the reliability evaluation scale value of the target is satisfied during the reliability test. To this end, first, we look at the conditions that both consumers and producers can satisfy in terms of the OC curve and find out what sampling methods satisfy the desired level of producer risk and consumer risk. Next, two methods of the reliability sampling methods such as attribute and variable reliability sampling methods are examined. Specifically, the attribute reliability sampling method is a form of sampling plan where n samples are tested for a certain period of T hours and the lot is accepted if the number of failures is less than or equal to a certain number c. On the other hand, the variable reliability sampling method is a form of sampling plan where the lot is accepted if the reliability evaluation scale such as MTBF satisfies a certain standard. Both sampling plans may also use inspection tables.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10883-10885
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• 2015

Purpose: Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patients with myelodysplastic syndrome (MDS). Materials and Methods: Between December 2009 and April 2014, 14 female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included in the study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation with mortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluated with adjustment for known confounding risk factors. Results: The mortality rate of the patient group was 55%, and median survival was 18 months. There was no significant correlation between mortality and NLR at a median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there was a significant correlation between mortality and pancytopenia (p=0.017). Conclusions: This first study of NLR and mortality did not show any significant correlation. In centres with limited access to genetic evaluation for the presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than $50{\times}10^9/l$ may be poor prognostic markers in MDS patients.

• Korean Journal of Soil Science and Fertilizer
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• v.50 no.5
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• pp.434-451
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• 2017

For this study, groundwater samples for 3 years from 2011 through 2013 were collected at 106 groundwater monitoring site in Korea. These groundwater samples were analyzed for 13 pesticides such as cabofuran, pentachlorobenzene, hexachlorobenzene, simazine, atrazine, lindane (gamma-HCH), alachlor, heptachlor, chlordane (total), endosulfan (1, 2), dieldrin, endrin, 4,4-DDT. The objectives of this study were to determine the detection frequency and their concentrations of 13 pesticides and evaluate the health risk level considering ingestion, inhalation, and skin contact using concentrations of 13 pesticides in groundwater samples. An analysis was used for the simultaneous determination for 13 pesticides using GC-MS. GC-MS was performed on HP-5ms, using helium ($1ml\;min^{-1}$) as carrier gas. The average recoveries of the pesticides were from 92.8% to 120.8%. The limits of detection (LODs) were between $0.004{\mu}g\;L^{-1}$ and $0.118{\mu}g\;L^{-1}$ and the limits of quantification (LOQs) were between $0.012{\mu}g\;L^{-1}$ and $0.354{\mu}g\;L^{-1}$. 106 groundwater wells were selected. 54 wells were from well to monitor background groundwater quality and 52 wells were from well to monitor groundwater quality in industrial or contamination source area. Eight pesticides including pentachlorobenzene, lindane (Gamma-HCH), heptachlor, chlordane (total), Endosulfan (1, 2), dieldrin, endrin, and 4,4-DDT were not detected in groundwater samples. The detection frequency for hexachlorobenzene, alachlor, carbofuran and simazine was 23.4%, 11.4%, 7.3%, and 1.0%, respectively. Atrazine was detected once in 2011. The average concentrations were $0.00423{\mu}g\;L^{-1}$ for carbofuran, $0.000243{\mu}g\;L^{-1}$ for alachlor, $0.00015{\mu}g\;L^{-1}$ for simazine, and $0.00001{\mu}g\;L^{-1}$ for hexachlorobenzene. The detection frequency of hexachlorobenzene was high, but the average concentration was low. In the contaminated groundwater, the detection frequency for hexachlorobenzene, alachlor, carbofuran, simazine and atrazine was 26.1%, 21.3%, 7.1%, 1.9% and 0.3%, respectively. In the uncontaminated groundwater, detection frequency for hexachlorobenzene, carbofuran and alachlor were 20.2%, 7.5%, and 1.9% respectively. Simazine and atrazine were not detected at uncontaminated groundwater wells. According to the purpose of groundwater use, atrazine was detected for agricultural groundwater use. Hexachlorobenzene showed high detection frequency at agricultural groundwater use area where the animal feeding area and golf course area were located. Alachlor showed more than 50% detection frequency at cropping area, pollution concern river area, and golf course area. Atrazine was detected in agricultural water use area. By land use, the maximum detection frequency of alachlor was found near an orchard. For human risk assessment, the cancer risk for the 5 pesticides was between $10^{-7}$ and $10^{-10}$, while the non-cancer risk (HQ value) was between $10^{-4}$ and $10^{-6}$. For conclusion, these monitoring study needs to continue because of the possibility of groundwater contamination based on various purpose of groundwater use.

• Journal of the Korean GEO-environmental Society
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• v.19 no.12
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• pp.41-46
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• 2018

The wireless sensor network system has the advantage of confirming the behavior of the entire facility by improving the disadvantages of conventional monitoring system. As a result, it is widely proposed as safety diagnosis and measurement of structures, water management systems, and management systems for dam structures. However, there is a lack of research that can evaluate the condition of facilities such as safety at the same time as monitoring. In this study, it is proposed a wireless sensor network system which can evaluate the behavior characteristics of facilities and evaluate the safety status for improving the technical disadvantages on conventional monitoring system. The geotechnical risk factors for the reservoir dam facility were evaluated and the limit values for the risk factors causing the failure of the facility were set. In other words, the system was set up so that the risk factors can be measured and the limit status can be evaluated immediately for each factor. In this study, numerical analysis is carried out for seepage and slope stability analysis using the typical cross section for reservoir dams. The stress-porewater coupling finite difference numerical analysis is performed for establishing the limit displacement for reservoir dam structures. It is developed a system that can estimate the time to reach the critical value by regression analysis using the measured datas.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2301-2305
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• 2016

Background: The early detection of anthracycline- induced cardiotoxicity is very important since it might be useful in prevention of cardiac decompensation. This study was designed with the intent of assessing the usefulness of cardiac troponin T (cTnT) and NT- Pro BNP estimation in early prediction of anthracycline induced cardiotoxicity. Materials and Methods: In this prospective study histologically proven breast cancer patients who were scheduled to receive anthracycline containing combination chemotherapy as a part of multimodality treatment were enrolled. Baseline cardiac evaluation was performed by echocardiography (ECHO) and biomarkers like cardiac troponin T (cTnT) and N terminal- pro brain natriuretic peptide (NT- Pro BNP). All patients underwent cTnT and NT- Pro BNP estimation within 24 hours of each cycle of chemotherapy and were followed up after 6 months of initiation of chemotherapy. Any changes in follow up ECHO were compared to ECHO at baseline and cTnT and NT- Pro BNP levels after each cycle of anthracycline-based chemotherapy. Results: Initial data were obtained for 33 patients. Mean change in left ventricular diastolic diameter (LVDD) within 6 months was $0.154{\pm}0.433cms$ (p value=0.049). Seven out of 33 patients had an increase in biomarker cTnT levels (p value=0.5). A significant change in baseline and follow up LVDD was observed in patients with raised cTnT levels (p value=0.026) whereas no change was seen in ejection fraction (EF) and left atrial diameters (LAD) within 6 months of chemotherapy. NT- Pro BNP levels increased in significant number of patients (p value ${\leq}0.0001$) but no statistically significant change was observed in the ECHO parameters within 6 months. Conclusions: Functional monitoring is a poorly effective method in early estimation of anthracycline induced cardiac dysfunction. Estimation of biomarkers after chemotherapy may allow stratification of patients in various risk groups, thereby opening window for interventional strategies in order to prevent permanent damage to the myocardium.

• The Korean Journal of Nuclear Medicine Technology
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• v.24 no.1
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• pp.33-38
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• 2020

Purpose Vitamin D is essential for maintaining bone health, controling cell proliferation or differentiation, strengthening immune function by controlling calcium metabolism in the body. Vitamin D deficiency can lead to increase the risk of rickets, osteoporosis, cardiovascular disease, diabetes and cancer. Especially, South Korea is one of the highest population proportion of vitamin D deficiency. Accurate determination of levels of 25-OH-VitD or 25-OH-VitD3 in blood serum is required for the diagnosis and treatment of vitamin D deficiency. In this study, radioimmunoassay of 25-OH-VitD and 25-OH-VitD3 was performed and compared to evaluate the effectiveness of Vitamin D radioimmunoassay. Materials and Methods Serum 25-OH-VitD and 25-OH-VitD3 levels were measured using radioimmunoassay. The interrelationship, reproducibility and population distribution rate were evaluated. In addition, the internal quality control was performed at Asan Medical Center from April 2017 to June 2019 and the result of external quality control (Interagency proficiency evaluation) of first and second half of 2018 hosted by the Korean Society of Nuclear Medicine Technology (KSNMT). Both tests were measured by same manufacturer's reagent. Results 25-OH-VitD showed a strong positive correlation on 97 samples, as 25-OH-VitD3 x 0.9 + 0.3 (R>0.9). In repeated measurement, the average Diff(%) value of the reproducibility evaluation of 25-OH-VitD and 25-OH-VitD3 were 7.7% and 7.4%, respectively. Population distribution results showed no statistically significant differences(p>0.05). The resultant value of internal quality control, which measured from April, 2017 to June 2019 in Blood test room of Nuclear Medicine at Asan Medical Center, showed average (CV%) 6.2% and 6.8%, respectively. As a result of the external quality control (interagency proficiency evaluation) Z value obtained under 2.0, as shown below; Conclusion The interrelationship, reproducibility, population distribution rate, internal quality control and external quality control between 25-OH-VitD and 25-OH-VitD3 radioimmunoassay shows superior outcome. Radioimmunoassay, which can be alone measured in the blood as 25-OH-VitD or 25-OH-VitD3, is considered suitable screening tests for the diagnosis of vitamin D deficiency.