• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.239-247
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• 2017

Among the commonly known tools to diagnose diabetes are fasting plasma glucose (FPG), HbA1c., and OGTT known as gold standard. However, there can be many disagreements on the ways to diagnose diabetes. In this study, we examined the differences of the types of diabetes according to the applicability of FPG and HbA1c. Moreover, we evaluated the concordance of diagnosis. We excluded subjects with missing glucose and HbA1c data, as well as those previously diagnosed with diabetes, and those who fasted less than 8 hours. The data of 4,502 subjects (1,956 men and 2,546 women) from the 2015 KNHNES were analyzed. We divided these patients into three categories which are normal, prediabetes, and diabetes, based on the FPG and HbA1c. In men, the number of subjects with FPG ranging from 100 to 125 mg/dL and HbA1c ${\geq}6.5%$ was 23 out of 664, and the number of subjects with FPG < 126 mg/dL and HbA1c ${\geq}6.5%$ was 39 out of 86 newly diagnosed diabetes patients. The concordance rate was as follows: Normal 80.3%, prediabetes 44.9%, and diabetes 54.7%. The coefficient of Cohen's Kappa was 0.322 in men and 0.362 in women; this suggests that both gender showed a low concordance rate. However, when we divided them into two categories (nondiabetes and diabetes), Kappa was 0.582 in men and 0.637 in women, showing a relatively high concordance rate. While all subjects with FPG ${\geq}126mg/dL$ showed a significantly high HOMA IR, all subjects with FPG < 126 mg/dL showed a significantly high QUICKI. Considering the low concordance rate for the diagnosis of diabetes and characteristic of diagnostic tests, it is necessary to combine the related tests for diagnosing diabetes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.511-519
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• 2006

Autogenous bone grafts have been considered the gold standard for maxillofacial bony defects. However, this procedure could entail a complicated surgical procedure as well as potential donor site morbidity. Possibly the best solution for bone-defect regeneration is a tissue engineering approach, i.e. the use of a combination of a suitable scaffold with osteogenic cells. A major source of osteogenic cells is the bone marrow. Bone marrow-derived mesenchymal stem cells are multipotent and have the ability to differentiate into osteoblastic, chondrocytic, and adipocytic lineage cells. However, the isolation of cells from bone marrow has someproblems when used in clinical setting. Bone marrow aspiration is sometimes potentially more invasive and painful procedure and carries of a risk of morbidity and infection. A minimally invasive, easily accessible alternative would be cells derived from periosteum. The periosteum also contains multipotent cells that have the potential to differentiate into osteoblasts and chondrocytes. In the present study, we evaluated the osteogenic activity and mineralization of cultured human periosteal-derived cells. Periosteal explants were harvested from mandibule during surgical extraction of lower impacted third molar. The periosteal cells were cultured in the osteogenic inductive medium consisting of DMEM supplemented with 10% fetal calf serum, 50g/ml L-ascorbic acid 2-phosphate, 10 nmol dexamethasone and 10 mM -glycerophosphate for 42 days. Periosteal-derived cells showed positive alkaline phosphatase (ALP) staining during 42 days of culture period. The formation of ALP stain showed its maximal manifestation at day 14 of culture period, then decreased in intensity during the culture period. ALP mRNA expression increased up to day 14 with a decrease thereafter. Osteocalcin mRNA expression appeared at day 7 in culture, after that its expression continuously increased in a time-dependent manner up to the entire duration of culture. Von Kossa-positive mineralization nodules were first present at day 14 in culture followed by an increased number of positive nodules during the entire duration of the culture period. In conclusion, our study showed that cultured human periosteal-derived cells differentiated into active osteoblastic cells that were involved in synthesis of bone matrix and the subsequent mineralization of the matrix. As the periosteal-derived cells, easily harvested from intraoral procedure such as surgical extraction of impacted third molar, has the excellent potential of osteogenic capacity, tissue-engineered bone using periosteal-derived cells could be the best choice in reconstruction of maxillofacial bony defects.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.12-20
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• 2008

Purpose: Chronic pulmonary disease may be caused by aspiration of gastric contents secondary to gastroesophageal reflux. At present, there is no gold standard for documenting pulmonary aspiration. The purpose of this study was to investigate the usefulness of radionuclide scintigraphy in the detection of gastroesophageal reflux and pulmonary aspiration. Methods: Thirty-five patients with suspected aspiration pneumonia, and five normal control subjects, were included in the study. All subjects underwent gastroesophageal reflux scintigraphy after the ingestion of a $^{99m}Tc$-tin colloid mixture. Dynamic images to detect gastroesophageal reflux were obtained for 1 hour. Additional static images of the chest, to detect lung aspiration, were obtained at 6 and 24 hours after oral ingestion of the tin colloid. In addition to visual analysis, pulmonary aspiration was quantitated by counting the number of pixels labeled with radioactive isotope in the region of interest (ROI) of both lung fields. Aspiration index (AI) was obtained by subtracting the pixel counts of the background from the pixel counts of the ROI. Results: Among 35 patients with suspected aspiration pneumonia, 23 proved to have gastroesophageal reflux by scintigraphy. One patient showed definite pulmonary accumulation of activity by visual analysis of the 6-hour image. Thirty of 35 (85.7%) patients showed higher AI beyond the upper limit of AI in the healthy controls. When we compared the reflux group with the non-reflux group, there was a significantly higher AI at 6 hours in the reflux group (p<0.05). Conclusion: The results suggest that radionuclide scintigraphy is useful in detecting small pulmonary aspiration in patients with suspected aspiration pneumonia secondary to reflux.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.539-553
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• 1996

The study was conducted from May to September in 1994 to investigate applicability of the Hearing Handicap Inventory for the Elderly-Screening version(HHIE-S) in parallel with the pure-tone audiometer to the initial screening test of noise-induced hearing loss(NIHL) in some noise-exposed workers. Subjects were selected by systemic sampling that took every 10th person from 6, 700 workers taking the annual occupational health examination by the department of Health Maintenance of Dongsan Hospital Keimyung University in Taegu. The authors administered the pure-tone audiometric test and self-reported questionnaire of HHIE-S including items of sociodemographic and job-related variables concurrently. The final subjects analysed were 1,019(488 males and 531 females) excluding fourteen persons who had many missing values in their questionnaires. The reliability coefficients of HHIE-S scale by Cronbach's alpha were 0.84. In the univariate analysis of hearing handicap measured by the HHIE-S, work duration, military service and the hearing threshold loss at 1KHz and 4KHz by the initial audiometer were significant in males while age, work duration and hearing threshold loss at 1KHz and 4KHz were significant in females. In the stepwise linear regression analysis, hearing threshold loss at 1KHz and 4KHz, was the only selected variable explaining the hearing handicap in males and hearing threshold loss at 1KHz and 4KHz, age, and work duration were selected in females. In ROC curves for HHIE-S scores against NIHL as gold standard which was defined by the follow-up audiogram as more than 30dB of the average of 0.5/1/2KHz and 50dB at 4KHz, the optimal cutoff for the parallel HHIE-S appeared to be 8. The results suggest that HHIE-S appeared to have some reliability and validity in this data and might be used in screening NIHL in parallel with pure-tone audiometer in noise-exposed workers.

• Journal of Nutrition and Health
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• v.49 no.5
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• pp.378-394
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• 2016

Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

• Journal of Intelligence and Information Systems
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• v.21 no.2
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• pp.131-150
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• 2015

Omission of noun phrases for obligatory cases is a common phenomenon in sentences of Korean and Japanese, which is not observed in English. When an argument of a predicate can be filled with a noun phrase co-referential with the title, the argument is more easily omitted in Encyclopedia texts. The omitted noun phrase is called a zero anaphor or zero pronoun. Encyclopedias like Wikipedia are major source for information extraction by intelligent application systems such as information retrieval and question answering systems. However, omission of noun phrases makes the quality of information extraction poor. This paper deals with the problem of developing a system that can restore omitted noun phrases in encyclopedia documents. The problem that our system deals with is almost similar to zero anaphora resolution which is one of the important problems in natural language processing. A noun phrase existing in the text that can be used for restoration is called an antecedent. An antecedent must be co-referential with the zero anaphor. While the candidates for the antecedent are only noun phrases in the same text in case of zero anaphora resolution, the title is also a candidate in our problem. In our system, the first stage is in charge of detecting the zero anaphor. In the second stage, antecedent search is carried out by considering the candidates. If antecedent search fails, an attempt made, in the third stage, to use the title as the antecedent. The main characteristic of our system is to make use of a structural SVM for finding the antecedent. The noun phrases in the text that appear before the position of zero anaphor comprise the search space. The main technique used in the methods proposed in previous research works is to perform binary classification for all the noun phrases in the search space. The noun phrase classified to be an antecedent with highest confidence is selected as the antecedent. However, we propose in this paper that antecedent search is viewed as the problem of assigning the antecedent indicator labels to a sequence of noun phrases. In other words, sequence labeling is employed in antecedent search in the text. We are the first to suggest this idea. To perform sequence labeling, we suggest to use a structural SVM which receives a sequence of noun phrases as input and returns the sequence of labels as output. An output label takes one of two values: one indicating that the corresponding noun phrase is the antecedent and the other indicating that it is not. The structural SVM we used is based on the modified Pegasos algorithm which exploits a subgradient descent methodology used for optimization problems. To train and test our system we selected a set of Wikipedia texts and constructed the annotated corpus in which gold-standard answers are provided such as zero anaphors and their possible antecedents. Training examples are prepared using the annotated corpus and used to train the SVMs and test the system. For zero anaphor detection, sentences are parsed by a syntactic analyzer and subject or object cases omitted are identified. Thus performance of our system is dependent on that of the syntactic analyzer, which is a limitation of our system. When an antecedent is not found in the text, our system tries to use the title to restore the zero anaphor. This is based on binary classification using the regular SVM. The experiment showed that our system's performance is F1 = 68.58%. This means that state-of-the-art system can be developed with our technique. It is expected that future work that enables the system to utilize semantic information can lead to a significant performance improvement.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.69-74
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• 1996

Background: The diagnosis of pulmonary embolism (PE) based on clinical findings is often elusive and therefore requires confirmative diagnostic method. Pulmonary angiography, though the gold standard for the diagnosis of pulmonary embolism, is an invasive method and requires trained personnel and special equipment. Lung V/Q scan, on the other hand, is a noninvasive method but the diagnostic specificity and sensitivity arc not satisfactory in case that the results are either intermediate or low probability scan. Plasma D-dimer is generated when a thrombus is fibrinolysed by plasmin and is known to be increased in various thrombotic disorders. The aim of this study was to investigate the value of the determination of plasma D-dimer level in the diagnosis of pulmonary embolism. Methods: Pulmonary angiography was performed in 17 patients who were clinically suspected to have pulmonary embolism. 9 patients(PE, $56{\pm}13.4$ yrs, M:F=8:1) were diagnosed to have pulmonary embolism by pulmonary angiography. The control group were the 8 patients with negative pulmonary angiography and 13 orthopedic patients with no evidence of pulmonary embolism on scintigraphic and impedance plethysmographic studies(n=21) (non-PE, $54.5{\pm}11.1$ yrs, M:F=11:10). Plasma D-dimer was measured by latex agglutination method in study subjects and the results were analyzed according to the presence or absence of pulmonary embolism. Results: 1) The increased level of plasma D-dimer was more frequently observed in the patients with pulmonary embolism than in the controls(>0.5 mg/L, 8 in PE, 10 in non-PE; <0.5 mg/L, 1 in PE, 11 in non-PE, p=0.049). 2) The diagnostic value of plasma D-dimer level higher than 0.5 mg/L were as follows: sensitivity 88.9%(8/9), specificity 52.4%(11/21), positive predictive value 44.4%(8/18), and negative predictive value 91.7%(11/12). Conclusion: Plasma D-dimer determination showed high sensitivity and negative predictive value in the diagnosis of pulmonary embolism and is therefore thought to be useful in excluding the possibility of pulmonary embolism.

• KDI Journal of Economic Policy
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• v.30 no.1
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• pp.171-209
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• 2008

The Great Depression is one of the most important economic incidents in the twentieth century. A significant and long-lasting impact of this event is the rise of the government intervention to the economy. Under the catastrophic downturn of the economic condition worldwide, people required their government to play an active role for economic recovery, and this $mentalit{\acute{e}}$ prolonged even after the Second World War. Social science textbooks taught at Korean high schools mostly referred to the Great Depression for explaining the reason of government intervention in economy. However, the mainstream view commonly found in the textbooks provides a misleading theological interpretation. It argues that inherent flaws of the market economy causes over-production/under-consumption, and that this mismatch ends up with economic crisis. The chaotic situation was resolved by substitution of the governments for the market, and the New Deal was introduced as the monumental example ('laissez-faire economy ${\rightarrow}$over-production${\rightarrow}$the Great Depression${\rightarrow}$government intervention${\rightarrow}$economic recovery'). Based on economic historians' researches for past three decades, I argue that this mainstream view commits the fallacy of ex-post justification. Unlike what the mainstream view claims, the Great Depression was neither the result of the 'market failure', nor the recovery from the Great Depression but was due to successful government policies. For substantiating this claim, I suggest three points. First, blaming the weakness or instability of the market economy as the cause of the Great Depression is groundless. Unlike what the textbooks describe, the rise of the U.S. stock price during the 1920s cannot be said as a bubble, and there was no sign of under-consumption during the 1920s. On the contrary, a new consensus emerging from the 1980s among economic historians illustrates that the Great Depression was originated from 'the government failure' rather than from the 'market failure'. Policymakers of European countries tried to return to the gold standard regime before the First World War, but discrepancies between this policy and the reality made the world economy vulnerable. Second, the mainstream view identifies the New Deal as Keynesian interventionism and glorifies it for saving the U.S. economy from the crisis. However, this argument is not true. The New Deal was not Keynesian at all. What the U.S. government actually tried was not macroeconomic stabilization but price and quantity control. In addition, New Deal did not brought about economic recovery that people generally believe. Even after the New Deal, industrial production or employment level remained quite low until the late 1930s. Lastly, studies on individual New Deal policies show that they did not work as they were intended. For example, the National Industrial Recovery Act increased unemployment, and the Agricultural Adjustment Act expelled tenants from their land. Third, the mainstream view characterizes the economic order before the Great Depression as laissez-faire, and it tends to attribute all the vice during the Industrial Revolution era to the uncontrolled market economy. However, historical studies show that various economic and social problems of the Industrial Revolution period such as inequality problems, child labor, or environmental problems cannot be simply ascribed to the problems of the market economy. In conclusion, the remedy for all these problems in high school textbooks is not to use the Great Depression as an example showing the weakness of the market economy. The Great Depression should be introduced simply as a historical momentum that had initiated the growth of government intervention. This reform of high school textbooks is imperative for enhancing the right understanding of economy and history.

• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.773-780
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• 2000

Background : pH measurement is an important test in assessing the etiology of pleurisy and in identifying complicated parapneumonic effusion. Although the blood gas analyzer is the gold standard method' for pleural pH measurement, pH meter & pH strip methods are also used for this purpose interchangably. However, the correlation among the pH data measured by the three different methods needs to be evaluated. In this study, we measured the pH of pleural fluid with the three different methods respectively and evaluated the correlation among the measured data. Methods : From August 1999 to March 2000, we measured the pleural fluid pH in 34 clinical samples with three methods-blood gas analyzer, pH meter, and pH strip. In the blood gas analyzer and pH meter methods, the temperature of pleural fluid was maintained around $0^{\circ}C$ in air-tight condition before analysis and measurement was performed within 30 minutes after collection. As for the pH strip method, the pleural fluid pH was checked in the ward immediately after tapping and in the clinical laboratory of our hospital. This part is unclear. Results : The causes of pleural effusion were tuberculosis pleurisy in 16 cases, malignant pleural effusion 5 cases, parapneumonic effusion 9 cases, empyema 3 cases, and congestive heart failure 1 case. The pH of pleural fluid (mean$\pm$SD) was 7.34$\pm$0.12 with blood gas analyser, 7.52$\pm$0.25 with pH meter, 7.37$\pm$0.16 with pH strip of immediate measurement and 6.93$\pm$0.201 with pH strip of delayed measurement. The pH measured by delayed pH strip measurement was lower than those of other methods (p<0.05). The correlation of the results between the blood gas analyzer and pH meter(p=0.002, r=0.518) and the blood gas analyzer and pH strip of immediate measurement(p<0.001, r=0.607). Conclusion : In the determination of pH of pleural fluid, pH strip method could be a simple and reliable method under immediate measurement conditions after pleural fluid tapping.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.330-337
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• 2003

Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.