• Title/Summary/Keyword: kappa values

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Hepatic and Renal Safety of Concurrent Use of Conventional and Herbal Medications for Musculoskeletal Disorders: A Retrospective Observational Study (근골격계 질환에 대한 양약 및 한약 병용의 간과 신장에 대한 안전성: 후향적 관찰 연구)

  • Kim, Se-Yoon;Kim, Hyungsuk;Kang, Doyoung;Ko, Junhyuk;Kim, Jongyeon;Kim, Koh-Woon;Kim, Bo-Hyung;Cho, Jae-Heung;Song, Mi-Yeon;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.131-140
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    • 2022
  • Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

Symmetric dimethylarginine correlates with the urea, creatinine, potassium, and clinical scores in feline urethral obstructions

  • Jessica Cavalcante da Nobrega;Heloise Rangel Dinallo;Silvano Salgueiro Geraldes;Maria Gabriela Picelli de Azevedo;Reiner Silveira de Moraes;Suellen Rodrigues Maia;Fabiana Ferreira de Souza;Alessandra Melchert ;Henry David Mogollon Garcia;Raphael Lucio Andreatti Filho;Adriano Sakai Okamoto;Priscylla Tatiana Chalfun Guimaraes Okamoto
    • Journal of Veterinary Science
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    • v.25 no.2
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    • pp.27.1-27.12
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    • 2024
  • Background: A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. Objectives: This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. Methods: Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. Results: A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. Conclusions: A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.

Development of Low-fat Meat Processing Technology using Interaction between Meat Proteins and Hydrocolloids-II Development of Low-fat Sausages Using the Results of Model Study (식육단백질과 친수성 콜로이드의 상호결합 특성을 이용한 저지방 육제품 제조기술 개발 - II 모델연구결과를 이용한 저지방 소시지의 개발)

  • Chin, Koo-Bok;Lee, Hong-Chul
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.4
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    • pp.629-635
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    • 2002
  • This study was performed to develop low-fat comminuted sausages (LFSs, < 3%) manufactured with 1% single (Konjac flour, KF; kappa-carrageenan, k-CN and Locust bean gum, LBG) or mixed hydrocolloids and to select the best combination which had similar textural characteristics to those with regular-fat (~25% fat) control. In experiment 1, LFSs were formulated with each 1% hydrocolloid, smoked and cooked to an internal temperature of 71.7$^{\circ}C$. The pH range of LFSs was 6.29 to 6.34 and approximately 23~24% of fat was removed in the final products, resulting in the higher moisture and protein contents (%) in LFSs, as compared to regular-fat control. No differences (p>0.05) in cooking loss (CL, %), expressible moisture (EM, %), and hunter color values (L, a, b) were observed with the addition of each 1% hydrocolloid. However, LFSs containing 1% k-CN had textural hardness values similar to those with low-/regular-fat controls, whereas LFSs having either KF or LBG had similar cohesiveness values to those with regular-fat counterpart. Tn experiment 2, two or three mixed hydrocolloids were added to the low-fat sausage formulation. The addition of mixed KF+LBG (KLL) and KF+CN+LBG(KCL) reduced EM and textural hardness values, as compared to low-fat control. Among the treatments, LFSs containing two or three combinations of CN with KF or/and LBG had similar textural characteristics to those with regular-fat control. These results suggested that multiple addition of CN with other hydrocolloids (KF or LBG) for the replacement of fats in LFSs would be recommended for the proper functional and textural properties.

Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome (외상 후 복합부위통증증후군 환자에서 시행한 삼상 뼈 스캔의 판독 신뢰도에 관한 연구)

  • Park, Jung-Mi;Kim, Seon-Jung;Chung, Seung-Hyun;Lee, Yong-Taek
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.44-51
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    • 2008
  • Purpose: We performed this study to evaluate reliability on interpretation of three phase bone scintigraphy (TPBS) in patients with post-traumatic complex regional pain syndrome (PT-CRPS). Methods: Based on International Association for the Study of Pain guideline in 1994, 34 patients with PT-CRPS were selected for this study. Two nuclear medicine physicians evaluated identical TPBS according to the uptake pattern, extent and intensity of the lesion, and their agreements (kappa values) were analysed. The final diagnosis based on arbitrary criteria of each physician were compared with those obtained by the criteria for PT-CRPS established in this study, which are hyperactivity on all phases (criteria 1), hyperactivity of whole joints on delayed phase (criteria 2), and hyperactivity of either whole or FDGal joints on delayed phase (criteria 3). Results: Intra-observer agreements were good for uptake pattern, intensity, and extent on TPBS. Inter-observer agreements were also good, except extent on blood pool phase (0.55). The inter-observer agreements on final diagnosis improved when criteria 1-3 were applied (0.77-0.88), compared to when physician's own criteria were used (0.63). Those also improved from 0.29 to 0.47-0.82 for acute stage, and from 0.37 to 1.0 for chronic stage. The sensitivities of chronic stage were relatively lower to those of acute stage. Conclusions: Inter-observer's variations in diagnosis of the patients with PT-CRPS using TPBS were observed. These results were attributed to different criteria set by observers. In order to improve agreement on interpretation of TPBS, common positive criteria should be established, especially considering uptake pattern and clinical stages.

Reliability of a Questionnaire for Evaluation of Dry Mouth Symptoms (구강건조증 증상 평가를 위한 설문지의 신뢰도에 관한 연구)

  • Lee, Jeong-Yun;Lee, Young-Ok;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.383-389
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    • 2005
  • Xerostomia is defined as a subjective complaint of dry mouth that may be perceived when there is insufficient mucosal wetting. However, the diagnosis and treatment of xerostomia is not that simple because of the fact that the subjective awareness of dry mouth is not always correlated with a diminution in the flow of saliva and there is always a difference between individuals in salivary flow rates needed for normal oral function. In the present study, the aim was to develop a questionnaire to evaluate the dry mouth symptoms and to analyze its reliability and usability as a diagnostic and analytic tool for xerostomia. The questionnaire which consists of 6 Visual Analogue Scale(VAS) type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to avoid oral dryness was developed and administered twice with 1 week's interval to the healthy 88 young adults without dry mouth symptoms(44 males and 44 females; mean age was $25.6{\pm}3.1$ years in male and $24.3{\pm}2.1$ years in female). The results were as follows. 1 The intraclass correlation coefficients of 6 questions to evaluate the subjective oral dryness were as significantly high as 0.767 for the degree of oral dryness at other times of the day, 0.850 for the amount of saliva in the mouth, and 0.791 for the degree of effect on daily life due to oral dryness and as high as 0.563 for the degree of oral dryness at night or on awakening, 0.674 for the degree of oral dryness during eating, and 0.641 for the degree of difficulty in swallowing foods. 2. Cronbach's alpha value of 6 questions was 0.982. It can be concluded that the series of questions to evaluate the subjective oral dryness has high internal consistency. 3. Cohen's kappa values of 4 questions to evaluate behavior to relieve oral dryness were as significantly high as 0.850 for the frequency of keeping a glass of water at the bedside and as high as 0.506 the frequency of awakening during sleeping due to oral dryness, 0.419 for the frequency of sipping liquids to aid in eating dry foods, and 0.407 for the frequency of using a candy or chewing gum due to oral dryness. From the results, it can be concluded that the questionnaire consisting of 6 VAS type questions to evaluate the subjective oral dryness and 4 questions to evaluate behavior to relieve oral dryness has reliability of good to excellent level, and that the series of 6 VAS type questions has significantly high internal consistency to evaluate the subjective oral dryness.

Reproducibility of the Assessment of Myocardial Function Using Gated Tc-99m-MIBI SPECT and Quantitative Software (게이트 Tc-99m-MIBI SPECT와 Cedars 소프트웨어를 이용한 심근 기능 측정의 재현성)

  • Lee, Dong-Soo;Cheon, Gi-Jeong;Ahn, Ji-Young;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.5
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    • pp.403-413
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    • 1998
  • Purpose: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. Materials and Methods: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT We used 16 frames per cycle for the gating of sequential Tc-99m-MIBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF). Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. Results: Enddiastolic volumes (EDV) ranged from 58 ml to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 ml to 174 ml (65 ml +/- 39 ml), and EF from 20% to 65% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval: 0.83-0.90) for assessment of wall thickening. Conclusion: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.

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The First Newborn Screening Study of T-Cell Receptor Excision Circle and κ-Deleting Recombination Excision Circle for Severe Combined Immunodeficiency in Korea: A Pilot Study (국내 최초 T-Cell Receptor Excision Circle과 κ-Deleting Recombination Excision Circle 신생아 선별검사에 관한 연구)

  • Son, Sohee;Kang, Ji-Man;Kim, Jong Min;Sung, Sein;Kim, Yi-Seoul;Lee, Haejeong;Kim, BitA Reum;Lee, Yeon Kyoung;Ko, Sun Young;Shin, Son Moon;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.134-140
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    • 2017
  • Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.

Preference and Performance Fidelity of Modified Korean Physician Order for Life-Sustaining Treatment (MK-POLST) Items in Hospice Patients with Cancer (수정된 한글 연명의료계획서(Modified Korean Physician Order for Life-Sustaining Treatment, MK-POLST) 분석을 통한 호스피스 병동 환자의 의료 중재 항목별 선호도 및 충실도 조사)

  • Han, Ji Hee;Chun, Hye Sook;Kim, Tae Hee;Kim, Rock Bum;Kim, Jung Hoon;Kang, Jung Hun
    • Journal of Hospice and Palliative Care
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    • v.22 no.4
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    • pp.198-206
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    • 2019
  • Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

Comparison of Two Rapid Antigen Detection Tests for Diagnosis of Group A Streptococcal Pharyngotonsillitis (A군 연쇄구균성 인두편도염 진단을 위한 두 종류 신속항원검사법의 비교)

  • Song, Seung Kyu;Hong, Mi Ae;Oh, Kyung Chang;Ahn, Seung In;Tae, Mi Hyon;Shin, Hye Jung;Chang, Jin Keun;Cha, Sung Ho
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.973-979
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    • 2002
  • Purpose : Recently, a number of rapid antigen detection tests have been available to diagnose group A streptococcal pharyngotonsillitis. The purpose of this study was to determine the sensitivity, specificity and consistency of the two rapid antigen detection tests. Methods : Among the patients who visited our clinic from November 2001 to February 2002, 61 patients who had clinical findings of pharyngeal erythema or edema, pharyngeal exudates and soft palatine petechiae were enrolled in our study. A total of 61 patients were tested with rapid antigen detection tests and throat culture. BD $LINK2^{TM}$ Strep A(Becton, Dickinson & Company, U.S.A.) and $QuickVue^{(R)}$ $In-Line^{TM}$(Quidel Corporation, U.S.A.) were selected for rapid antigen detection tests. Results : Of the 61 patients tested, 22 patients were confirmed as group A streptococcal pharyngotonsillitis by throat culture. The BD $LINK2^{TM}$ Strep A had a sensitivity of 81.8% and a specificity 89.7%. The positive and negative predictive values were 81.8% and 89.7%, respectively. The $QuickVue^{(R)}$ $In-Line^{TM}$ had a sensitivity of 77.3% and a specificity of 100%. The positive and negative predictive values were 100% and 88.6%, respectively. The kappa values of BD $LINK2^{TM}$ Strep A and $QuickVue^{(R)}$ $In-Line^{TM}$ were 0.72 and 0.81, respectively. Conclusion : In addition to high sensitivity, specificity and consistency, both kits are easy to use and simple to interpret, and therefore have the potential to be used with backup throat culture for diagnosis of acute pharyngotonsillitis.

A Recombinant $Plasmodium$ $vivax$ Apical Membrane Antigen-1 to Detect Human Infection in Iran

  • Haghi, Afsaneh Motevalli;Khoramizade, Mohammad Reza;Nateghpour, Mehdi;Mohebali, Mehdi;Edrissian, Gholam Hossein;Eshraghian, Mohammad Reza;Sepehrizadeh, Zargham
    • Parasites, Hosts and Diseases
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    • v.50 no.1
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    • pp.15-21
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    • 2012
  • In Iran, $Plasmodium$ $vivax$ is responsible for more than 80% of the infected cases of malaria per year. Control interventions for vivax malaria in humans rely mainly on developed diagnostic methods. Recombinant $P.$ $vivax$ apical membrane antigen-1 (rPvAMA-1) has been reported to achieve designing rapid, sensitive, and specific molecular diagnosis. This study aimed to perform isolation and expression of a rPvAMA-1, derived from Iranian patients residing in an endemic area. Then, the diagnostic efficiency of the characterized Iranian PvAMA-1 was assessed using an indirect ELISA method. For this purpose, a partial region of AMA-1 gene was amplified, cloned, and expressed in pET32a plasmid. The recombinant $His-tagged$ protein was purified and used to coat the ELISA plate. Antibody detection was assessed by indirect ELISA using rPvAMA-1. The validity of the ELISA method for detection of anti-$P.$ $vivax$ antibodies in the field was compared to light microscopy on 84 confirmed $P.$ $vivax$ patients and compared to 84 non-$P.$ $vivax$ infected individuals. The ELISA cut-off value was calculated as the mean+2SD of OD values of the people living in malaria endemic areas from a south part of Iran. We found a cut-off point of OD=0.311 that showed the best correlation between the sera confirmed with $P.$ $vivax$ infection and healthy control sera. A sensitivity of 81.0% and specificity of 84.5% were found at this cut off titer. A good degree of statistical agreement was found between ELISA using rPvAMA-1 and light microscopy (0.827) by Kappa analysis.