• Journal of Trauma and Injury
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• v.34 no.1
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• pp.3-12
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• 2021

Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1298-1311
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• 2022

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.

• The Journal of the Korea Contents Association
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• v.13 no.12
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• pp.829-839
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• 2013

This study is a descriptive research study with the purpose of predicting and comparing factors of depression affecting residents in a metropolitan city by using logistic regression analysis and decision-making tree analysis. The subjects for the study were 462 residents ($20{\leq}aged{\angle}65$) in a metropolitan city. This study collected data between October 7, 2011 and October 21, 2011 and analyzed them with frequency analysis, percentage, the mean and standard deviation, ${\chi}^2$-test, t-test, logistic regression analysis, roc curve, and a decision-making tree by using SPSS 18.0 program. The common predicting variables of depression in community residents were social dysfunction, perceived physical symptom, and family support. The specialty and sensitivity of logistic regression explained 93.8% and 42.5%. The receiver operating characteristic (roc) curve was used to determine an optimal model. The AUC (area under the curve) was .84. Roc curve was found to be statistically significant (p=<.001). The specialty and sensitivity of decision-making tree analysis were 98.3% and 20.8% respectively. As for the whole classification accuracy, the logistic regression explained 82.0% and the decision making tree analysis explained 80.5%. From the results of this study, it is believed that the sensitivity, the classification accuracy, and the logistics regression analysis as shown in a higher degree may be useful materials to establish a depression prediction model for the community residents.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.116-127
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• 2021

Purpose To evaluate the feasibility of texture analysis of gray-scale ultrasound (US) images for staging of hepatic fibrosis. Materials and Methods Altogether, 167 patients who had undergone routine US and laboratory tests for a fibrosis-4 (FIB-4) index were included. Texture parameters were measured using a dedicated in-house software. Regions of interest were placed in five different segments (3, 5, 6, 7, 8) for each patient. The FIB-4 index was used as the reference standard for hepatic fibrosis grade. Comparisons of the texture parameters between different fibrosis groups were performed with the Student's t-test or Mann-Whitney U-test. Diagnostic performance was evaluated by receiver operating curve analysis. Results The study population comprised of patients with no fibrosis (FIB-4 < 1.45, n = 50), mild fibrosis (1.45 ≤ FIB-4 ≤ 2.35, n = 37), moderate fibrosis (2.35 < FIB-4 ≤ 3.25, n = 27), and severe fibrosis (FIB-4 > 3.25, n = 53). Skewness in hepatic segment 5 showed a difference between patients with no fibrosis and mild fibrosis (0.2392 ± 0.3361, 0.4134 ± 0.3004, respectively, p = 0.0109). The area under the curve of skewness for discriminating patients with no fibrosis from those with mild fibrosis was 0.660 (95% confidence interval, 0.551-0.758), with an estimated accuracy, sensitivity, specificity of 64%, 87%, 48%, respectively. Conclusion A significant difference was observed regarding skewness in segment 5 between patients with no fibrosis and patients with mild fibrosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.5-13
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• 2003

The purpose of this study is to determine the value of serum concentration of C-reactive protein(CRP) in comparison with ESR and leukocyte as the tools for diagnosis and follow-up study of infection. For this study, thirty-one patients with head and neck infection and thirty-two patients performed the orthognathic surgery were selected for experimental and control groups each other. we analyzed the blood sample daily to measure CRP, ESR and leukocytosis. The results of this study are as the following : 1. Serum C-Reactive Protein levels in the experimental group were higher than control group and the pattern of CRP changes continued to decline in both groups(P<0.001). 2. ESR changes in both groups were scattered without any special pattern. 3. Correlation between CRP and Leukocyte was higher than others(r=0.664, P<0.01). 4. In the Receiver Operating Characteristic(ROC) Curve of experimental group, rapid increase of CRP curve and Area under the curve(AUC) value, 0.774, indicate the high accuracy of estimation. 5. In experimental group, sensitivity of CRP, ESR, and Leukocytosis on recovery day were 83%, 17% and 71%. Based on the results of this study, we could conclude that determination of CRP is more useful method to diagnosis and follow-up study of infection than other commonly used variables in oral and maxillofacial region.

• Clinical and Experimental Pediatrics
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• v.57 no.10
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• pp.451-456
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• 2014

Purpose: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. Methods: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. Results: The mean PCT and CRP concentrations were respectively $56.27{\pm}81.89$ and $71.14{\pm}37.17mg/L$ in the "confirmed sepsis" group; $15.64{\pm}32.64$ and $39.23{\pm}41.41mg/L$ in the "suspected sepsis" group; $9.49{\pm}4.30$ and $0.97{\pm}1.16mg/L$ in the "mild infection" group; and $0.21{\pm}0.12$ and $0.72{\pm}0.7mg/L$ in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). Conclusion: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

• Korean Chemical Engineering Research
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• v.50 no.4
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• pp.718-722
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• 2012

$H_2S$ adsorption characteristics of adsorbent made by sewage sludge were investigated. For analyses of the manufactured adsorbent, various methods such as Iodine adsorptivity, scanning electron microscope (SEM), and measurements of BET surface area and pore volume were adopted. As the major adsorption characteristic, breakthrough curve was measured by using a continuous fixed bed adsorption column for operating variables such as adsorption temperature ($25{\sim}45^{\circ}C$), aspect ratio (L/D)(3~9), gas flow rate (0.1~2.0 liter/min) and $H_2S$ gas concentration (50~200 ppm). The experimental result showed that the carbonization and activation of sewage sludge are very important for the improvement in $H_2S$ adsorption capacity.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.483-497
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• 2014

Objectives: The aims of study were developing cut-off value of Yin-deficiency questionnaire (YDQ) for diagnosis of Yin-deficiency (YD) and compare diagnostic ability between YDQ and Yin-deficiency scale score (YDS) in xerostomia patients. Methods: We recruited 58 xerostomia patients. They were diagnosed YD or non-YD by 3 Korean medicine doctors (KMD). We assessed YD using YDQ and YDS. We evaluated xerostomia using VAS, Dry Mouth Symptom Questionnaire (DMSQ), Salivary Flow Rate (SFR), oral moisture on buccal mucosa and tongue surface (OMB and OMT). We surveyed tongue coatings using Winkel Tongue Coating Index (WTCI). Results: We diagnosed 23 patients YD and 35 patients non-YD. There were no significant differences of age, sex and body mass index between the YD and non-YD groups. Using receiver operating characteristic curve analysis, the optimal cut-off value of YDQ was defined as 304. Sensitivity, specificity and Youden index of YDQ were 86.96%, 71.43% and 1.5839 respectively. Using Cohen's coefficient of agreement, we found that degree of agreement between KMD and YDQ diagnosis was moderate (${\kappa}$=0.524, p<0.001). Using Pearson's correlation analysis, we found concurrent validity of YDQ and YDS were significant correlated. Using area under curve value, we found diagnostic ability between YDQ and YDS were not significantly different (p=0.505), but there were more strong correlations between DMSQ-symptoms and YDQ (r=0.731, p<0.001) than correlations between DMSQ-symptoms and YDS (r=0.418, p<0.01). Conclusions: The cut-off value of YDQ can diagnose YD in xerostomia and diagnostic ability of YDQ in xerostomia is better than YDS.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.102-108
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• 2018

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.1-11
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• 2006

"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함. Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.