Purpose : We performed this study to compare the TSH and free $T_4$ levels according to gestational age and birth weight, and to reevaluate the cut-off values in the neonatal screening test for congenital hypothyroidism. Methods : Total 2,133 neonates(1,749 healthy newborns and 384 sick neonates) were screened in Dankook University Hospital from May 2000 to January 2003. Neonates with abnormal TSH values (higher than $20{\mu}IU/mL$) or abnormal free $T_4$ levels(lower than 1 ng/dL) were recalled to recheck the thyroid function test. At that time, physical examinations and history-taking regarding perinatal problem, medication history, and mother's illness were undertaken. Results : Serum TSH and free $T_4$ values revealed no significant difference according to sex, delivery type, and Apgar score. The free $T_4$ levels showed statistically significant differences, with gestational age or birth weight(P<0.01). The recall rate of neonates due to abnormal screening test was 7.48 percent. Compared with original cut-off values, the recall rate of the new cut-off values setted to TSH higher than $20{\mu}IU/mL$ or free $T_4$ lower than 0.64 ng/dL decreased from 7.48 percent to 4.8 percent in the healthy group. But, it compromised sensitivity when applied to the sick group. Conclusion : In this study, neonatal free $T_4$ levels were significantly different according to birth weight, gestational age, and the presence of compromised condition. Although the recall rate by TSH > $20{\mu}IU/mL$ or free $T_4$ <1 ng/dL was relatively high, it was impossible to set up new cut-off values without compromising sensitivity. We think studies including a larger study population will be required to change the cut-off values.
Processing steps such as washing and cutting, involved in preparing fresh-cut produce causes tissue damage, leading to rapid quality deterioration. Major defects of fresh-cut produce are discoloration, softening, off-odor development, and microbial growth. Packaging of fresh-cut produce has been changed to reduce these quality problems. Flexible packaging film is widely used to pack fresh-cut produce. Vacuum packaging was the popular packaging method in the beginning of fresh-cut industry in Korea. Vacuum packaging creates high $CO_2$ and low $O_2$ levels to control browning of fresh-cut produce. However, these conditions induce some visual defects and off-odor development. Discoloration problem was also found when fresh-cut produce was packaged with conventional packaging film or plastic tray. Modified atmosphere (MA) packaging is effective for prolonging shelf-life of fresh-cut produce by decreasing $O_2$ and increasing $CO_2$ concentration in the package. Retail MA packaging using different oxygen transmission rate (OTR) film and micro-perforated film has started to be applied to fresh-cut produce in Korea. Proper MA package design that provides optimum range of $O_2$ and $CO_2$ partial pressures is one of the major challenges in the industry. An initial package flushing with $N_2$ or an low $O_2$/high $CO_2$ atmosphere is also used to more rapidly establish steady-state MA condition. Film OTR and $O_2$ flushing affects the fermentative volatile production, off-odor development, electrolyte leakage, discoloration, $CO_2$ injury, microbial population of fresh-cut produce. There is also a demand for convenient packaging to attract consumers. Rigid fresh-cut produce container for retail market has increased since the packaging provides excellent protection from physical damage during transport. Rigid tray used as actual serving vessel for the consumer is increasing in Korea. The tray with flexible lid to wrap or seal fresh-cut produce is more and more gaining popularity. Further practical technology to control quality change and microbial growth for each fresh-cut product has been studied since various fresh-cut items were required. The fresh-cut industry also focuses on searching for more convenient and environmentally friendly packaging.
Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.
Determination of the cause of malignant pleural effusions is important for treatment and management, especially in cases of unknown primaries. There are limited biomarkers available for prediction of the cause of malignant pleural effusion in clinical practice. Hence, we evaluated pleural levels of five tumor biomarkers (CEA, AFP, CA125, CA153 and CA199) in predicting the cause of malignant pleural effusion in a retrospective study. Kruskal-Wallis or Mann-Whitney U tests were carried out to compare levels of tumor markers in pleural effusion among different forms of neoplasia - lung squamous cell carcinoma, adenocarcinoma, or small cell carcinoma, mesothelioma, breast cancer, lymphoma/leukemia and miscellaneous. Receiver operator characteristic analysis was performed to evaluate sensitivity and specificity of biomarkers. The Kruskal-Wallis test showed significant differences in levels of pleural effusion CEA (P<0.01), AFP (P<0.01), CA153 (P<0.01) and CA199 (P<0.01), but not CA125 (P>0.05), among the seven groups. Receiver operator characteristic analysis showed that, compared with other four tumor markers, CA153 was the best biomarker in diagnosing malignant pleural effusions of lung adenocarcinoma (area under curve (AUC): 0.838 (95%confidence interval: 0.787, 0.888); cut-off value: 10.2U/ml; sensitivity: 73.2% (64.4-80.8)%, specificity: 85.2% (77.8-90.8)%), lung squamous cell carcinoma (AUC: 0.716 (0.652, 0.780); cut-off value: 14.2U/ml; sensitivity: 57.6% (50.7-64.3)%, specificity: 91.2% (76.3-98.0)%), and small-cell lung cancer (AUC: 0.812 (0.740, 0.884); cut-off value: 9.7U/ml; sensitivity: 61.5% (55.0-67.8)%, specificity: 94.1% (71.2-99.0)%); CEA was the best biomarker in diagnosing MPEs of mesothelioma (AUC: 0.726 (0.593, 0.858); cut-off value: 1.43ng/ml; sensitivity: 83.7% (78.3-88.2)%, specificity: 61.1% (35.8-82.6)%) and lymphoma/leukemia (AUC: 0.923 (0.872, 0.974); cut-off value: 1.71ng/ml; sensitivity: 82.8% (77.4-87.3)%, specificity: 92.3% (63.9-98.7)%). Thus CA153 and CEA appear to be good biomarkers in diagnosing different causes of malignant pleural effusion. Our findings implied that the two tumor markers may improve the diagnosis and treatment for effusions of unknown primaries.
As a result of life-style changes, consumer's concerns of food have shifted from calories and nutrition to health and convenience. Fresh-cut products are one such new direction for fruit and vegetable consumption. In this study, the vitamin C, mineral, and pesticide contents of various fresh-cut products were analyzed. According to sensory evaluations, the key reason for a lower than expected overall acceptability of many fresh-cut products is that they are likely to have browning and can easily lose their freshness. Also, the sensory evaluation showed that shriveling, the degree of browning, softening around the cut edge, and off-flavors were the primary factors affecting the quality of fresh-cut products. As a nutritional factor of quality, vitamin C content was not practical with regard to fresh-cut lettuce because the level was very low. For product safety, residual pesticides were detected in the fresh-cut products, but the results showed that all items were under permitted levels and considered safe. In evaluation of the microbial levels of the fresh-cut market products, the levels of viable cells, mold, yeast, coliform bacteria, and enterobacteriaceae were not significantly different based on the summer and winter seasons. The levels of S. aureus and Listeria spp. in the products were higher during the summer season than the winter.
Purpose: This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence. Materials and Methods: We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels. Results: The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001). Conclusions: CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.
Ju, Jung Ki;Lee, Hae Lyoung;Lee, Young Ah;Chung, Sang-Keun;Kwak, Min Jung
Journal of Yeungnam Medical Science
/
v.30
no.2
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pp.90-94
/
2013
Background: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. Methods: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. Results: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. Conclusion: The study results showed that serum basal LH levels are useful for screening CPP in girls.
This study was performed in an effort to standardize the quality of fresh-cut products. Here, consumers' perceptions of fresh-cut products were surveyed to determine the quality factors in preparing quality standards for fresh-cut products. According to the surveys, freshness was the most important factor for consumers when choosing fresh-cut products at the market. Secondary indicators of good quality, i.e., "sensory qualities," were determined to be vibrant color, clean taste, nice feel, neat presentation, etc., as well as knowledge of whether it was organically grown. Off-odors decreased a product's marketability. Likewise, the more wilted or brown it appeared, the less a product was desired. From the results, the quality control indices for fresh-cut products were derived as freshness, discoloration, off-flavor, uniformity, prohibition of adulteration by alien substances, packaging and labeling. The quality of fresh-cut lettuce samples was measured against three storage temperatures: $20^{\circ}C,\;10^{\circ}C$ and $5^{\circ}C$. Sensory quality evaluations revealed the following: produce stored at $20^{\circ}C$ lost its marketability in less than one day; produce stored at $10^{\circ}C$ lost its marketability in less than two days; on the other hand, produced stored at $5^{\circ}C$, maintained its marketability for six days. At these respective points, browning started to occur around cut areas, and increased gradually once it began. Vitamin C content decreased with storage time, but storage at $5^{\circ}C$ maintained vitamin content the longest duration. Finally, further examinations were performed on the sensory qualities of fresh-cut lettuce samples at four levels of increased browning. Up to the third level, the product score for marketability was 5.6.
Background Iron overload is a risk factor affecting all patients with thalassemia intermedia (TI). We aimed to determine whether there is a relationship of serum ferritin (SF) and alanine aminotransferase (ALT) with liver iron concentration (LIC) determined by R2 magnetic resonance imaging (R2-MRI), to estimate the most relevant degree of iron overload and best time to chelate in patients with TI. Methods In this cross-sectional study, 119 patients with TI (mean age years) were randomly selected and compared with 120 patients who had a diagnosis of thalassemia major (TM). Correlations of LIC, as determined by R2-MRI, with SF and ALT levels, were assessed in all participants. A P-value <0.05 was considered statistically significant. Results SF and LIC levels were lower in patients with TI than in those with TM; only ferritin values were significant. We found a statistically significant relationship between SF and LIC, with cut-off estimates of SF in patients with TI who had splenectomy and those who entered puberty spontaneously (916 and 940 ng/mL, respectively) with LIC >5 mg Fe/g dry weight (P<0.0001). A significant relationship was also found for patients with TI who had elevated ALT level (63.5 U/L), of 3.15 times the upper normal laboratory limit, using a cut-off for LIC ${\geq}5mg\;Fe/g\;dry\;weight$. Conclusion We determined the cut-off values for ALT and SF indicating the best time to start iron chelation therapy in patients with TI, and found significant correlations among iron overload, SF, and ALT.
Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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2000.06a
/
pp.98-103
/
2000
The cut-off is a unique feature associated with duct acoustics due to the presence of duct walls. Duct geometry effect on sound radiation is another issue of duct acoustics. The radiation of duct internal noise to ambient from duct open ends with various geometries is studied via numerical methods. The linearized Euler's equations in generalized curvilinear coordinates are solved by the DRP finite difference scheme. A number of accurate boundary conditions are used at boundaries for the computational domain to minimize the non-physical reflections. The far field sound pressure levels are computed by the Kirchhoff integration method. We investigate the cut off phenomana and duct geometry effects on sound radiation with numerical results.
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