• Journal of Trauma and Injury
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• v.19 no.1
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• pp.67-73
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• 2006

Purpose: The arterial base deficit (BD) has proven to be useful in the evaluation and management of trauma patients. Indicators such as the Triage-Revised Trauma Score (t-RTS) and the systemic inflammatory response syndrome (SIRS) score have been used as triage tools for emergency trauma patients in Korea. The purpose of this study was to assess the usefulness of the initial BD in predicting injury severity and outcome in the trauma population. Methods: The medical records of 308 consecutive trauma patients admitted to the Emergency Center of Masan Samsung Hospital from January 2004 to December 2004 were carefully examined prospectively and retrospectively, and 291 patients were selected as subjects for this research. The SIRS score and the t-RTS were calculated based on the records from the emergency department, and the BD was calculated based on the arterial blood gas analysis obtained within 30 minutes of admission. The efficiency of the three indicators as triage tools was evaluated by using cross tabulations in two - by - two matrices and by using a receiver operating characteristic (ROC) curve analysis. Results: When the mortality was used as the outcome parameter, the sensitivity and the accuracy of the initial BD were higher than those of the SIRS score (p<0.05) and were same as those of the t-RTS. The areas under the ROC curves of the initial BD, the SIRS score, and the t-RTS were $0.740{\pm}0.087$, $0.696{\pm}0.082$, and $0.871{\pm}0.072$, respectively (95% confidence interval). When emergency operation and blood transfusion requirements were used as outcome parameters, the comparisons of the sensitivities and the accuracies of the initial BD and the other two indicators showed the same pattern as mentioned above. The areas under the ROC curves of the initial BD were 0.7~0.8 and were larger than those of the SIRS score (p<0.05). Conclusion: The ability of the initial BD to predict injury severity and outcome was similar to those of the t-RTS and the SIRS score. Therefore, the authors suggest that the initial BD may be used as an alternative to previous triage tools for trauma patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2001-2006
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• 2014

The objective of this study was to investigate the diagnostic significance of EBV antibody combined detection for nasopharyngeal carcinoma (NPC) in a high incidence region of southern China. Two hundred and eleven untreated NPC patients, 203 non-NPC ENT patients, and 210 healthy controls were recruited for the study. The titers of VCA/IgA and EA/IgA were assessed by immunoenzyme assay, and the levels of Rta/IgG and EBNA1/IgA were determined by enzyme-linked immunosorbent assay. The levels of VCA/IgA, EA/IgA, Rta/IgG and EBNA1/IgA demonstrated no association with gender or age (p>0.05). The receiver operating characteristic curve and the area under the curve were used to evaluate the diagnostic value. The sensitivity of VCA/IgA (98.1%) and the specificity of EA/IgA (98.5%) were the highest. When a logistic regression model was used to combine the results from multiple antibodies to increase the accuracy, the combination of VCA/IgA+Rta/IgG, whose area under the curve was 0.99, had the highest diagnostic efficiency, and its sensitivity, specificity and Youden index were 94.8%, 98.0% and 0.93 respectively. The data suggest that the combination of VCA/IgA+Rta/IgG may be most suitable for NPC serodiagnosis.

• BMB Reports
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• v.34 no.5
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• pp.484-488
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• 2001

STATs are proteins with a dual function: signal transducers in the cytoplasm and transcriptional activators in the nucleus. Among the six known major STATs (STAT1-6), STAT3 has been implicated in the widest range of signaling pathways that regulate cell growth and differentiation. As a part of our on-going investigation on the pleiotropic functions of STAT proteins, we examined the role of STAT3 as a molecular adaptor that links diverse cell growth signaling pathways. We observed that STAT3 can be specifically activated by multiple cytokines, such as IL-3, in transformed fibroblasts and IL-4 or IFN-$\gamma$ in primary immune cells, respectively. The selective activation of STAT3 in H-ras-transformed NIH3T3 cells is associated with an increased expression of phosphoserioe STAT3 in these cells, compared to the parental cells. Notably phosphoresine-STAT3 interacts with oncogenic ras, shown by immunoprecipitation and Western blots. The results suggest the role of STAT3 in rasinduced cellular transformation as a molecular adaptor linking the Jak/STAT and Ras/MAPK pathways. In primary immune cells, IL-4 and IFN-$\gamma$ each induced (in addition to the characteristic STAT6 and STAT1 homodimers) the formation of STAT3-containing complexes that bind to GAS probes, which correspond to the $Fe{\varepsilon}$ Rll and $Fe{\gamma}$ RI promoter sequences, respectively. Since IL-4 and IFN-$\gamma$ are known to counter-regulate the expression of these genes, the ability of STAT3 to form heterodimeric complexes with STAT6 or STAT1 implies its role in the fine-tuned control of genes that are regulated by IL-4 and IFN-$\gamma$.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1403-1407
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• 2015

Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.11 no.1
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• pp.53-64
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• 2016

Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.285-290
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• 2018

Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.161-169
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• 2017

The cone beam computed tomography(CBCT) which can acquire 3-dimensions images is widely used for confirmation of patient position before radiation therapy. In this study, through the simulation using the Monte Carlo technique, we will analyze the exposure dose by cone beam computed tomography and present the standardized data. For the experiment, MCNPX(ver. 2.5.0) was used and the photon beam spectrum was analyzed after Cone beam was simulated. As a result of analyzing the photon beam spectrum, the average energy ranged from 25.7 to 37.6 keV at the tube voltage of 80 ~ 120 kVp and the characteristic X-ray energy was 9, 60, 68 and 70 keV. As a result of using the water phantom, the percentage depth dose was measured, and the maximum dose appeared on the surface and decreased with depth. The absorbed dose also decreased as the depth increased. The absorbed dose of the whole phantom was 9.7 ~ 18.7 mGy. This is a dose which accounts for 0.2% of about 10 Gy, which is generally used for radiation therapy per week, which is not expected to have a significant effect on the treatment effect. However, it should not be overlooked even if it is small compared with prescription dose.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.170-175
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• 2004

Purpose : We experienced 7 patients with Kikuchi-Fujimoto disease(KFD) who had presented a prolonged fever and lymphadenopathy. The clinical and the laboratory aspects of the patients were analyzed. Methods : The medical records of the 7 KFD patients, who were confirmed by excisional lymph node biopsy from January 1996 through December 2003, were retrospectively analyzed. Results : The mean age of the children was $11.4{\pm}2.8$ years(ranging from 8 to 15 years). The male to female ratio was 1.3 : 1. The median duration of the fever prior to admission and the total duration of the fever were 12 days(ranging from 5 to 65 days) and 27 days(ranging 9 to 75 days), respectively. One patient had supraclavicular lymphadenopathy, 5 had cercical involvement, and 1 had axillary lymphadenopathy. All the histologic findings of the lymph nodes biopsies showed the characteristic findings consistent with KFD such as paracortical necrosis with karyorrhexis and an increase in the number of phagocytic histiocytes and atypical lymphocytes. As for the laboratory findings, leukopenia($3,800{\pm}700/mm^3$), anemia(hemoglobin, $11.0{\pm}1.2g/dL$), an elevated erythrocyte sedimentation rate($42{\pm}17mm/hr$), and a relatively low C-reactive protein level($1.3{\pm}0.9mg/dL$) were noted. Four patients received conservative therapy with antipyretics, and 3 patients were treated with prednisolone. Conclusion : KFD is a rare disease, yet should be considered in the differential diagnosis for older children with prolonged fever and lymphadenopathy.

• Journal of radiological science and technology
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• v.27 no.4
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• pp.43-48
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• 2004

The purpose of this study is to measure cardiothoracic ratio and to report the opinions on it, targeting 500 persons who were conducted simple chest radiography, in terms of clinical symptom, by visiting a medical examination center for S university hospital. As to the general characteristic of 500 research targets, it comprised 263 persons (52%) for males and 237 persons (48%), and the average age is 49.4. Out of 500 persons, it showed 125 persons (25%) in their thirties, 125 persons (25%) in their forties, 125 persons (25%) in their fifties, and 125 persons (25%) in their sixties. 1. In terms of the wholly 500 targets, the average value of cardiothoracic ratio was 0.48, and the average cardiothoracic ratio showed 0.45 in their thirties, 0.46 in their forties, 0.50 in their fifties, and 0.53 in their sixties. 2. The minimum value of cardiothoracic ratio was 0.33, and its maximum value was 0.70, and it showed 319 persons (63.8%) as to a case lower than 0.5, which is a normal value, and 181 persons (36.2%) as to a case more than 0.5, which is a normal value. 3. Among 181 persons who showed cardiothoracic ratio higher than normality, it showed 17 persons (9.4%) in their thirties, 22 persons (12%) in their forties, 54 persons (30%) in their fifties, and 88 persons (49%) in their sixties. 4. The average for the internal diameter (ID) of thorax was 141.8 mm, 229.6 mm at the minimum, and 353.5 mm at the maximum. 5. The average for the maximum transverse diameter of right side of the heart (MRD) was 48.0 mm, 4.95 mm at the minimum, and 84.5 mm at the maximum. The average for the maximum transverse diameter of left side of the heart (MLD) was 93.5 mm, 56.7 mm at the minimum, and 138.5 mm at the maximum. 6. The average for TD (MRD+MLD) of the heart was 292.6 mm, 96.6 mm at the minimum, and 199.2 mm at the maximum. 7. The average of cardiothoracic ratio (MRD+MLD/ID) was 0.48, 0.33 at the minimum, and 0.70 at the maximum.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.375-381
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• 2015

Digital Radiography is a big part of diagnostic radiology. Because uncorrected digital radiography image supported false effect of Patient's health care. We must be manage the correct digital radiography image. Thus, the artifact images can have effect to make a wrong diagnosis. We report types of occurrence by analyzing the artifacts that occurs in digital radiography system. We had collected the artifacts occurred in digital radiography system of general hospital from 2007 to 2014. The collected data had analyzed and then had categorize as the occurred causes. The artifacts could be categorized by hardware artifacts, software artifacts, operating errors, system artifacts, and others. Hardware artifact from a Ghost artifact that is caused by lag effect occurred most frequently. The others cases are the artifacts caused by RF noise and foreign body in equipments. Software artifacts are many different types of reasons. The uncorrected processing artifacts and the image processing error artifacts occurred most frequently. Exposure data recognize (EDR) error artifacts, the processing error of commissural line, and etc., the software artifacts were caused by various reasons. Operating artifacts were caused when the user didn't have the full understanding of the digital medical image system. System artifacts had appeared the error due to DICOM header information and the compression algorithm. The obvious artifacts should be re-examined, and it could result in increasing the exposure dose of the patient. The unclear artifact leads to a wrong diagnosis and added examination. The ability to correctly determine artifact are required. We have to reduce the artifact occurrences by understanding its characteristic and providing sustainable education as well as the maintenance of the equipments.