Lee, Hyunju;Kim, Heejung;Kim, Hae Soon;Sohn, Sejung
Clinical and Experimental Pediatrics
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v.49
no.5
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pp.539-544
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2006
Purpose : The purpose of this study was to determine whether N-terminal fragment of B-type natriuretic peptide(NT-proBNP) may be used to differentiate acute Kawasaki disease(KD) from other clinically similar diseases. Methods : Using electrochemiluminescence immunoassay, NT-proBNP concentrations were measured in the acute phase within 10 days after the onset of KD(n=58) and in the convalescent phase, 60 to 81 days after the onset(n=51), and also in patients with acute febrile disease as a control(n=34). Echocardiography was performed to detect pericardial effusion(PE) and coronary artery lesions(CAL), and to measure the left ventricular dimension at diastole(LVIDd) and ejection fraction(LVEF). The cutoff value of NT-proBNP for separating KD from other diseases was determined. Results : NT-proBNP concentration in the acute phases of KD was significantly higher than that in the control group($1,501.6{\pm}2,132.6$ vs. $139.0{\pm}88.8pg/mL$, P<0.0001). In KD patients, NT-proBNP was elevated in the acute phase and was lowered in the convalescent phase($1,466.0{\pm}2,173.2$ vs. $117.5{\pm}95.5pg/mL$, P<0.0001). The cutoff value of 260 pg/mL discriminated KD patients from other patients, with a sensitivity of 93 percent and a specificity of 88 percent. The NT-proBNP was higher in patients with PE(n=17) compared with those without PE(n=41)($1,784.2{\pm}1,903.1$ vs. $1,384.4{\pm}2,232.6pg/mL$, P=0.52). Comparison of NT-proBNP could not be done between patients with CAL and those without, owing to a small number of patients with CAL(n=3). There was no correlation between NT-proBNP and LVEF index(r=0.104, P=0.46) or LVIDd index(r=0.171, P=0.22). Conclusion : NT-proBNP increases in the acute phase of KD and decreases to within normal range in the convalescent phase. NT-proBNP >260 pg/mL may be highly suggestive of acute KD. NT-proBNP may be used as a diagnostic tool for KD.
Background: Actigraphy is a reliable and valid method for assessing sleep in normal, healthy populations, but it may be less reliable and valid for detecting disturbed sleep in patients. In this study, we attempted to assess the utility of actigraphy in the estimation of sleep quality in patients with obstructive sleep apnea syndrome (OSAS), a major sleep disorder. Method: We analyzed the data of patients who underwent polysomnography (PSG) and actigraphy simultaneously for one night at the Center for Sleep and Chronobiology, Seoul National University Hospital from November 2004 to March 2006. Eighty-nine subjects with OSAS alone and 21 subjects with OSAS and periodic limb movement disorder (PLMD) were included for final data analyses between groups. Polysomnographic and actigraphic data were also compared. Results: In subjects with mild OSAS (RDI<15), modretae ($15{\leq}RDI$<30), and OSAS with PLMD, PSG and actigraphy did not show significant difference in total sleep time and sleep efficiency. However in severe ($30{\leq}RDI$) OSAS subjects, PSG and actigraphy showed significant difference in total sleep time and sleep efficiency. In all patients, no correlations were found between sleep parameters from PSG and from those using actigraphy. Conclusions: We suggest that in severe OSAS patients, PSG is the diagnostic tool. In mild and moderate cases, actigraphy might be used as a screening tool.
Between March 1999 and January 2000, 82 boys with the diagnosis of inguinal hernias (12 bilateral and 70 unilateral hernias), underwent Ultrasound (US) examination of both sides of the groin, a total of 164 inguinal imaging prior to surgery. The patients ages ranged from 3 days to 12 years with a mean of 32.6 months. Ninty four examinations were on the clinically symptomatic side and 70 were on the asymptomatic side. The US criteria for the diagnosis of an inguinal hernia were as follows: 1) visceral hernia, the presence of bowel loops, or omentum in the inguinal canal, 2) communicating hydrocele, the presence of fluid in the processus vaginalis, 3) widening of patent processus vaginalis at the level of internal inguinal ring. The width of patent processus vaginalis at the level of internal inguinal ring over 4 mm is considered an occult hernia. Among the 94 symptomatic groins, US findings showed 31 (33%) visceral hernias, 18 (19%) communicating hydroceles, and 38 (41%) widening of the internal inguinal ring, and 7 (7%) groins without abnormalities. In 70 asymptomatic groins, there were 4 (6%) visceral hernias, 5 (7%) communicating hydroceles, 11 (16%) widening of the internal inguinal ring, and 50 (70%) groins without abnormalities. Among the 70 asymptomatic groins there were US abnormalities in 20 (28%). One hundred and seven groins with positive US findings were surgically explored. Among 107 operated sites, the operative findings were compatible with the US diagnosis in 104, a sensitivity for US of 97.2%. In patients with US findings of widening of internal inguinal ring (>4 mm), there was patent processus vaginalis in 36 out of 38 symptomatic groins and 10 of 11 asymptomatic groins. The sensitivity of US to the operative findings in widening of internal inguinal ring was 93.8%. For visceral hernia and communicating hydrocele, the sensitivity of positive US findings was 100%. Ultrasonography for inguinal hernias appears to be a rapid, reliable, and noninvasive screening diagnostic tool with high positive specificity. Therefore, we recommend the use of US as a routine diagnostic tool in pediatric patients with inguinal hernias and hydroceles.
Seo, Wan-Seok;Lee, Jong-Bum;Park, Hyung-Bae;Suh, Hyea-Soo;Lee, Kwang-Hun;SaKong, Jeong-Kyu
Journal of Yeungnam Medical Science
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v.14
no.1
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pp.123-136
/
1997
The purpose of this study was to examine the reliability and validity of a Korean form of Childhood Attention Problem(CAP) scale. CAP were administered to 98 normal elementary school students as control group and 98 attention deficit hyperactivity disorder patients. Male students showed high scores than female students in both subscale and total scores, but not statistically significant. There were no significant difference in CAP scale between male students and female students in attention deficit hyperactivity disorder patients. In the reliability test, the test-retest reliability coefficient was highly satisfactory and that of inattention subscale was 0.83, impulsivity subscale was 0.70 and total score was 0.82. In the reliability test by internal consistency, the Cronbach $\alpha$ coefficient was highly satisfactory and that of inattention subscale was 0.91, overactivity subscale was 0.89(p<0.05). The concurrent validity between CAP scale and ADDES-BV scale was 0.85 in attention deficit hyperactivity disorder patient group and 0.73 in normal control group(p<0.05). In discriminant validity test between attention deficit hyperactivity disorder patient group and normal control group, the patient group showed higher score(p<0.05). The total discriminant capacity of the patient group in CAP was 93.4%. In this point of view, CAP scale showed high reliability and validity in applying to Korean subjects and was proved to be the good and simple screening test tool for attention deficit hyperactivity disorder research and can help many young patient to treat early.
Journal of agricultural medicine and community health
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v.39
no.3
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pp.137-145
/
2014
Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.
We established a high throughput screening system of African yam tuber lines which contain high contents of total carotenoids, flavonoids, and phenolic compounds using ultraviolet-visible (UV-VIS) spectroscopy and Fourier transform infrared (FT-IR) spectroscopy in combination with multivariate analysis. The total carotenoids contents from 62 African yam tubers varied from 0.01 to $0.91{\mu}g{\cdot}g^{-1}$ dry weight (wt). The total flavonoids and phenolic compounds also varied from 12.9 to $229{\mu}g{\cdot}g^{-1}$ and from 0.29 to $5.2mg{\cdot}g^{-1}$dry wt. FT-IR spectra confirmed typical spectral differences between the frequency regions of 1,700-1,500, 1,500-1,300 and $1,100-950cm^{-1}$, respectively. These spectral regions were reflecting the quantitative and qualitative variations of amide I, II from amino acids and proteins ($1,700-1,500cm^{-1}$), phosphodiester groups from nucleic acid and phospholipid ($1,500-1,300cm^{-1}$) and carbohydrate compounds ($1,100-950cm^{-1}$). Principal component analysis (PCA) and subsequent partial least square-discriminant analysis (PLS-DA) were able to discriminate the 62 African yam tuber lines into three separate clusters corresponding to their taxonomic relationship. The quantitative prediction modeling of total carotenoids, flavonoids, and phenolic compounds from African yam tuber lines were established using partial least square regression algorithm from FT-IR spectra. The regression coefficients ($R^2$) between predicted values and estimated values of total carotenoids, flavonoids and phenolic compounds were 0.83, 0.86, and 0.72, respectively. These results showed that quantitative predictions of total carotenoids, flavonoids, and phenolic compounds were possible from FT-IR spectra of African yam tuber lines with higher accuracy. Therefore we suggested that quantitative prediction system established in this study could be applied as a rapid selection tool for high yielding African yam lines.
For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.
Kim, Ji-Hae;So, Yoo-Kyung;Jung, Yoo-Sook;Lee, Im-Soon;Hong, Sung-Do
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.11
no.2
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pp.282-289
/
2000
This study was designed to examine the validity of HPR subscale in Korean Personality Inventory for Children(KPI-C) and Attention Problems subscale in Korean Child Behavior Checklist(K-CBCL) as diagnostic tool for Attention-Deficit/Hyperactivity Disorder(ADHD). Nineteen ADHD-1 type, twenty-three ADHD-H type, sixteen Neurosis, and fifteen normal children with the age from 6 to12 were selected based on DSM-IV, and their responses of the KPI-C and CBCL were analyzed. Omnibus F-test results showed that there were significant differences in the F scores of HPR and Attention Problems T scores(p<.05). But in Posthoc analysis, the HPR and AP scores in three clinical groups were significantly higher than in normal group, but there was no group difference among three clinical groups(p<.05). These results shows that HPR subscale and Attention Problems subscale may be useful tools for screening clinical groups(vs normal group) but there was a limit to the clinical validity of two subscales as diagnostic tools for the subtypes of ADHD.
The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed $65\%$ agreement to be classified into the same quartile and showed significant correlation (r=0.563 p<0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9mg, female: 6127.6mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9mg, female: 5107.4mg). The sodium intake estimated with DFQ55 (male: 4848.5mg, female: 4884.3mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed $39\~50\%$ agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was $62.5\%,\;81.8\%\;and\;53.2\%$, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were $73.8\%,\;84.0\%,\;62.0\%$, respectively. It seems the short DFQs using Na index 14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.
This experiment was carried out to report some data such as survival rate, tetraploid production efficiency, and agronomic characteristics of offspring from the induced tetraploid by the colchicine treatment in rye. The colchicine was soaked with 0.05%, 12 hours in dark condition and at two growth stages (green seed and 2nd leaf stage) in diploid ryes. Flow cytometry (FC) was proved to be efficient and rapid tool for screening ploidy levels in rye, showing around 40 to 60 in DNA amount (DAP1) corresponding to diploid and 80 to 110 tetraploid. There were 18.5% of survival rate at green seed treatment and 78% at 2nd leaf stage in average of two rye cultivars, Gogu and Jogreen, but in reverse 50.9% and 1.1% in the ratio of tetraploid to total tillers among the plants survived, respectively, resulting in 9.42% of tetraploid production rate in green seed treatment and 0.86% at 2nd leaf stage, respectively. In green seed treatment, there were 33% of survival rate in Gogu, 4% in Jogreen in 1st year, but 56% in Gogu, 21% in Jogreen and 49% in Charmgreen, respectively. The rate of tetraploid to total spikes among survived was 53.7% in Gogu, 32.4% in Jogreen, and 50.9% in average in 1st year, and 64.1% in Gogu, 51.5% in Jogreen, 60% in Charmgreen, and 60.5% in average in 2nd year. In green seed treatment, tetraploid production rate (survival rate ${\times}$ tetraploid ratio ${\times}$ 100) was 17.7% in Gogu and 1.3% in Jogreen and 9.42% in average in 1st year, and 35.9% in Gogu, 10.8% in Jogreen, 29.4% in Charmgreen, and 25.4% in average of three diploid rye cultivars. By the colchicine treatment with 0.05% for 12 hours in Gogu and Jogreen, 35 tetraploid plants were obtained and they produced 2,673 seeds with 148 spikes. There were 3.3-4.4 in the number of spikes per plant, 15.6-18.3 in grain number per spike, and 37.6 g in Gogu and 46.8 g in Jogreen in the 1,000-grain weight.
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