• Title/Summary/Keyword: cut-off ratio

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Why do Multiple-trauma Patients Stay Longer in the Intensive Care Unit?; - A Comparison of Injury Severity Score and The Number of Injured Regions - (어떤 다발성 외상환자가 중환자실에 오래 있게 되는가?; Injury severity score와 손상부위 수의 비교)

  • Jo, Mu Jin;Lee, Seong Hwa;Cho, Seok Ju;Yeom, Seok Ran;Han, Sang Kyoon;Park, Sung Wook;Lee, Dae Seop
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.47-52
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    • 2013
  • Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

Effects of Flow Rate of Feed Kanjang and Volume Reduction Ratio of Retentate on the Permeate Flux and Rejection of Microbes Cells and Components in Kanjang during Ultrafiltration Operations (재래식 간장의 한외여과시 공급액의 주입속도와 잔류액의 용량감소율이 간장의 투과유속, 미생물균체 및 성분저지율에 미치는 영향)

  • Kwon, Kwang-Il;Lee, Jong-Gu;Choi, Jong-Dong;Chung, Hyun-Chae;Im, Moo-Hyeog;Kim, Ki-Ju;Kim, Woo-Seong;Sung, Jun-Hyun;Kwon, O-Jun;Kim, Young-Ji;Suh, Chung-Sik;Choi, Cheong;Choi, Kwang-Soo
    • Korean Journal of Food Science and Technology
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    • v.35 no.1
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    • pp.72-76
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    • 2003
  • Ultrafiltration (UF) tests performed on traditional soy sauce (kanjang) using UF flat membrane test cell unit with thin film laminar flow similar to the spiral type membrane module in batch operations revealed reduction in permeate flux is proportional to the logarithm values of volume reduction ratio of the retentate kanjang at different feed rate of kanjang. Feed rate of 1.5 L/min was found to be adequate for long-term UF operation of kanjang using the test unit attached with MW cut-off size of 200,000 dalton polyoleffin plastic membrane in batch operation with the least concentration polarization. The higher the feed rate of kanjang, the lower the permeability of total nitrogen and NaCl, resulting in lower optical density at 500 nm and lower permeability of minerals such as Cu, Mn, and Mg. Microbial cells were completely rejected regardless of the feed rate, whereas most free amino acids were not.

Microarray analysis of gene expression in raw cells treated with scolopendrae corpus herbal-acupuncture solution (蜈蚣(오공) 약침액(藥鍼液)이 LPS로 처리된 RAW 세포주(細胞柱)의 유전자(遺傳子) 발현(發顯)에 미치는 영향(影響))

  • Bae, Eun-Hee;Lee, Kyung-Min;Lee, Bong-Hyo;Lim, Seong-Chul;Jung, Tae-Young;Seo, Jung-Chul
    • Korean Journal of Acupuncture
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    • v.23 no.3
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    • pp.133-160
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    • 2006
  • Objectives : Scolopendrae Corpus has a broad array of clinical applications in Korean medicine, including treatment of inflammatory conditions such as arthritis. To explore the global gene expression profiles in human Raw cell lines treated with Scolopendrae Corpus herbal-acupuncture solution (SCHAS), cDNA microarray analysis was performed. Methods : The Raw 264.7 cells were treated with lipopolysaccharide (LPS), SCHAS, or both. The primary data was normalized by the total spots of intensity between two groups, and then normalized by the intensity ratio of reference genes such as housekeeping genes in both groups. The expression ratio was converted to log2 ratio. Normalized spot intensities were calculated into gene expression ratios between the control and treatment groups. Greater than 2 fold changes between two groups were considered to be of significance. Results : Of the 8 K genes profiled in this study, with a cut-off level of two-fold change in the expression, 20 genes (BCL2-related protein A1, MARCKS-like 1, etc.) were upregulated and 5 genes (activated RNA polymerase II transcription cofactor 4, calcium binding atopy-related autoantigen 1, etc.) downregulated following LPS treatment. 139 genes (kell blood group precursor (McLeod phenotype), ribosomal protein S7, etc.) were upregulated and 42 genes (anterior gradient 2 homolog (xenopus laevis), phosphodiesterase 8B, etc.) were downregulated following SCHAS treatment. And 10 genes (yeast saccharomyces cerevisiae intergeneic sequence 4-1, mitogen-activated protein kinase 1, etc.) were upregulated and 8 genes (spermatid perinuclear RNA binding protein, nuclear receptor binding protein 2, etc.) were downregulated following co-stimulation of SCHAS and LPS. Discussions : It is thought that microarrays will play an ever-growing role in the advance of our understanding of the pharmacological actions of SCHAS in the treatment of arthritis. But further studies are required to concretely prove the effectiveness of SCHAS.

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Risk Factors of Allogenous Bone Graft Collapse in Two-Level Anterior Cervical Discectomy and Fusion

  • Woo, Joon-Bum;Son, Dong-Wuk;Lee, Su-Hun;Lee, Jun-Seok;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.450-457
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    • 2019
  • Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

Successful Motor Evoked Potential Monitoring in Cervical Myelopathy : Related Factors and the Effect of Increased Stimulation Intensity

  • Shim, Hyok Ki;Lee, Jae Meen;Kim, Dong Hwan;Nam, Kyoung Hyup;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.78-87
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    • 2021
  • Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

Prevalence of Decreased Myocardial Blood Flow in Symptomatic Patients with Patent Coronary Stents: Insights from Low-Dose Dynamic CT Myocardial Perfusion Imaging

  • Yuehua Li;Mingyuan Yuan;Mengmeng Yu;Zhigang Lu;Chengxing Shen;Yining Wang;Bin Lu;Jiayin Zhang
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.621-630
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    • 2019
  • Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.

The Study on Antenna Performancet Test for Surion Radio Installation and Optimal Positioning (수리온 통신 안테나 장착 및 최적위치 선정을 위한 안테나 성능시험에 관한 연구)

  • No, Sangwan;Lee, Soonyoung;Kim, Minsoo
    • Journal of Aerospace System Engineering
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    • v.14 no.5
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    • pp.122-129
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    • 2020
  • Surion is required to install radios (U/VHF-AM, VHF-FM) capable of omni-directional communication. Therefore, this paper demonstrates the antenna performance test for the installation of the Surion communication antenna and the selection of optimal location. A simulation pattern analysis was performed employing the antenna, and a coupling test was performed by creating a new evaluation criterion. In addition, the results of the pattern flight test conducted at the previously suggested 1:20 turn and separation distance ratio were observed to be normal. However, the occurrence of voice cutoff was noted in the long-distance flight test. Therefore, in this paper, 1:300 (15 NM) is proposed as a new optimal ratio for predicting the long-distance flight test results in advance. Finally, the effectiveness of the proposed evaluation criteria was verified through long-distance flight tests. Consequently, it is expected to reduce the development schedule and cost by reducing the trial and error of the performance test for the Surion model. Also, the results of this study are expected to be used as standards for the installation of communication antenna and quality tests for other helicopters.

Relationship of vitamin D status and obesity index in Korean women (한국 성인 여성의 비타민 D 영양상태와 비만지표와의 관계)

  • Park, Ji-Young;Heo, Young-Ran
    • Journal of Nutrition and Health
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    • v.49 no.1
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    • pp.28-35
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    • 2016
  • Purpose: Vitamin D status is associated with several chronic diseases related to obesity. In this study, we evaluate the nutritional status of vitamin D and its relation to obesity indices in Korean women. Methods: A total of 156 healthy women participated. Vitamin D status (serum $25-OH-vitamin\;D_3$ level) and obesity indices (body mass index, body fat mass, waisthip ratio, and body fat percentage etc.) and serum lipid profiles and serum adipokine (leptin and adiponectin) levels were analyzed. Results: The $25(OH)D_3$ level showed an extremely skewed distribution from 4.1 ng/ml to 24.4 ng/ml and mean $25(OH)D_3$ level was $9.0{\pm}4.0ng/ml$. With cut-off level for vitamin D deficiency (< 12.0 ng/ml), insufficiency (12-19.9 ng/ml) and sufficiency (${\geq}20ng/ml$), 77.6%, 19.2%, and 3.2% of subjects showed vitamin D deficiency, insufficiency, and sufficiency status, respectively. The $25(OH)D_3$ level showed positive correlation with weight (r = 0.2461, p < 0.01), body mass index (r = 0.2913, p < 0.001), body fat contents (r = 0.1691, p < 0.05), fat free mass (r = 0.2330, p < 0.01), and waist hip ratio (r = 0.1749, p < 0.05) after adjusted by age. The $25(OH)D_3$ level showed no significant correlation with serum lipid profiles and adipokine levels. Conclusion: Most subjects (76.6%) in this study, who had a vitamin D deficient status and serum $25(OH)D_3$ level, showed positive correlation with several obesity indices, however further research based on a large Korean population is needed to confirm the relationship.

Variation of Soil Properties by Permeating Injection of Chemical Grouts (약액(藥液)의 침투주입(浸透注入)에 의한 토질성상변화(土質性狀變化))

  • Chun, Byung Sik
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.2 no.4
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    • pp.1-9
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    • 1982
  • Variation of soil properties is studied by permeating injection of chemical grouts, such as cement type, water-glass type and acrylamide type, to the same soil samples with different densities. Moreover, injection tests using specially prepared equipments of 1.0 shot system and 1. 5 shot system are attempted to investigate permeating injection effects in highly compacted soil and in the presence of ground water. The main factor which causes the improvement of cut-off effect and shearing strength is the cohesion of soil. The strength in the loose state is fundamentally governed by the membrane cohesion, meanwhile, in the loose state is governed by the structural cohesion. Injection effects under the ground water flow is considerably decreased, and effective gelling ratio of approximate 45~80% is observed by variation of velocity and gel time, besides grading of injection materials has high relation with permeation and traveling length but has little relation with effective gelling ratio. Permeating injection effects, such as gelling scope, gelling strength in highly compaoted soil conditions can be confirmed by penetration resistance diagram and iso-strength curve.

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Predictive Value of IHC4 Score for Pathological Response to Neoadjuvant Chemotherapy in Hormone Receptor-Positive Breast Cancer

  • Elsamany, Shereef;Elmorsy, Soha;Alzahrani, Abdullah;Rasmy, Ayman;Abozeed, Waleed N;Mohammed, Amrallah A;Sherisher, Mohamed A;Abbas, Mohammed M;Mashhour, Miral
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7975-7979
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    • 2015
  • Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a lower IHC4 score was associated with an increased probability of pCR (low; 52.9% vs. High; 21.6%, OR=4.1, 95% CI=1.28-13.16, p=0.018) and a lower pathological stage (OR=3.9, 95% CI=1.34-11.33, p=0.012). When the IHC4 score was treated as a continuous variable, a lower score was again associated with an increased probability of pCR (OR=1.010, 95% CI=1.001-1.018, p=0.025) and lower pathological stage (OR=1.009, 95% CI=1.002-1.017, P=0.008). Lower clinical stage was associated with a better pCR rate that was of borderline significance (P=0.056). When clinical stage and IHC4 score were incorporated together in a logistic model, the likelihood ratio test gave a P-value of 0.004 after removal of the IHC4 score and 0.011 after removal of the stage, indicating a more significant predictive value of the IHC4 score for pCR. Conclusions: This study suggests that the IHC4 score can predict pathological response to neoadjuvant chemotherapy in HR-positive BC patients. This finding now needs to be validated in a larger cohort of patients.