• Title/Summary/Keyword: power image

Search Result 1,791, Processing Time 0.033 seconds

Real-Time 3D Ultrasound Imaging Method Using a Cross Array Based on Synthetic Aperture Focusing: II. Linear Wave Front Transmission Approach (합성구경 기반의 교차어레이를 이용한 실시간 3차원 초음파 영상화 기법 : II. 선형파면 송신 방법)

  • 김강식;송태경
    • Journal of Biomedical Engineering Research
    • /
    • v.25 no.5
    • /
    • pp.403-414
    • /
    • 2004
  • In the accompanying paper, we proposed a real. time volumetric imaging method using a cross array based on receive dynamic focusing and synthetic aperture focusing along lateral and elevational directions, respetively. But synthetic aperture methods using spherical waves are subject to beam spreading with increasing depth due to the wave diffraction phenomenon. Moreover, since the proposed method uses only one element for each transmission, it has a limited transmit power. To overcome these limitations, we propose a new real. time volumetric imaging method using cross arrays based on synthetic aperture technique with linear wave fronts. In the proposed method, linear wave fronts having different angles on the horizontal plane is transmitted successively from all transmit array elements. On receive, by employing the conventional dynamic focusing and synthetic aperture methods along lateral and elevational directions, respectively, ultrasound waves can be focused effectively at all imaging points. Mathematical analysis and computer simulation results show that the proposed method can provide uniform elevational resolution over a large depth of field. Especially, since the new method can construct a volume image with a limited number of transmit receive events using a full transmit aperture, it is suitable for real-time 3D imaging with high transmit power and volume rate.

Principle and Recent Advances of Neuroactivation Study (신경 활성화 연구의 원리와 최근 동향)

  • Kang, Eun-Joo
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.41 no.2
    • /
    • pp.172-180
    • /
    • 2007
  • Among the nuclear medicine imaging methods available today, $H_2^{15}O-PET$ is most widely used by cognitive neuroscientists to examine regional brain function via the measurement of regional cerebral blood flow (rCBF). The short half-life of the radioactively labeled probe, $^{15}O$, often allows repeated measures from the same subjects in many different task conditions. $H_2^{15}O-$ PET, however, has technical limitations relative to other methods of functional neuroimaging, e.g., fMRI, including relatively poor time and spatial resolutions, and, frequently, insufficient statistical power for analysis of individual subjects. However, recent technical developments, such as the 3-D acquisition method provide relatively good image quality with a smaller radioactive dosage, which in turn results in more PET scans from each individual, thus providing sufficient statistical power for the analysis of individual subject's data. Furthermore, the noise free scanner environment $H_2^{15}O$ PET, along with discrete acquisition of data for each task condition, are important advantages of PET over other functional imaging methods regarding studying state-dependent changes in brain activity. This review presents both the limitations and advantages of $^{15}O-PET$, and outlines the design of efficient PET protocols, using examples of recent PET studies both in the normal healthy population, and in the clinical population.

In Vitro Effect of 808-nm Diode Laser on Proliferation and Glycosaminoglycan Synthesis of Rabbit Articular Chondrocytes (토끼 관절 연골세포의 증식과 글리코스아미노글리칸 합성에 대한 808-nm 다이오드 레이저의 효능 평가)

  • Minar, Maruf;Hwang, Ya-won;Choi, Seok-hwa;Kim, Gonhyung
    • Journal of Veterinary Clinics
    • /
    • v.32 no.4
    • /
    • pp.295-300
    • /
    • 2015
  • The aim of the study was to assess the in vitro effect of 808-nm InGaAs diode laser on rabbit articular chondrocyte proliferation and sulphated glycosaminoglycan (sGAG) synthesis in alginate bead. Previous studies revealed either positive or negative stimulatory effects of laser on different types of cells. A 808-nm InGaAs diode laser at 1.0W power output was used to irradiate the rabbit chondrocytes in alginate beads with energy densities of $31J/cm^2$ (G 1) and $62J/cm^2$ (G 2) corresponding to the experimental groups for 10 seconds and 20 seconds, respectively at 24, 48, 72 and 96 hours after seeding. Control group was left untreated. MTT assay was performed at 1 week and 2 weeks after the $1^{st}$ laser irradiation in alginate beads. sGAG synthesis in alginate beads at 1 week and 2 weeks were determined by DMMB assay. Histological evaluation for cellular distribution and sGAG deposition around the cells were performed by alcian blue stain. MTT assay revealed no positive stimulatory effect in cell proliferation in alginate bead. DMMB assay results showed significantly increased sGAG production in G 2 chondrocytes at 2 weeks. Image analysis of alcian blue stained slides also showed significantly higher percentage of positive alcian blue stain in G 2 chondrocytes. This result suggests that 808-nm InGaAs diode laser with 1.0 W power output although cannot stimulate cell proliferation it can increase the cell secretion activity and sGAG deposition in alginate beads.

The Influence of Number of Targets on Commonness Knowledge Generation and Brain Activity during the Life Science Commonness Discovery Task Performance (생명과학 공통성 발견 과제 수행에서 대상의 수가 공통성 지식 생성과 뇌 활성에 미치는 영향)

  • Kim, Yong-Seong;Jeong, Jin-Su
    • Journal of Science Education
    • /
    • v.43 no.1
    • /
    • pp.157-172
    • /
    • 2019
  • The purpose of this study is to analyze the influence of number of targets on common knowledge generation and brain activity during the common life science discovery task performance. In this study, 35 preliminary life science teachers participated. This study was intentionally made a block designed for EEG recording. EEGs were collected while subjects were performing common discovery tasks. The sLORETA method and the relative power spectrum analysis method were used to analyze the brain activity difference and the role of activated cortical and subcortical regions according to the degree of difficulty of common discovery task. As a result of the study, in the case of the Theta wave, the activity of the Theta wave was significantly decreased in the frontal lobe and increased in the occipital lobe when the difficult difficulty task was compared with the easy difficulty task. In the case of Alpha wave, the activity of Alpha decreased significantly in the frontal lobe when performing difficult task with difficulty. Beta wave activity decreased significantly in the frontal lobe, parietal lobe, and occipital lobe when performing difficult task. Finally, in the case of Gamma wave, activity of Gamma wave decreased in the frontal lobe and activity increased in the parietal lobe and temporal lobe when performing the difficult difficulty task compared to the task of easy difficulty. The level of difficulty of the commonality discovery task is determined by the cingulate gyrus, the cuneus, the lingual gyrus, the posterior cingulate, the precuneus, and the sub-gyral where it was shown to have an impact. Therefore, the difficulty of the commonality discovery task is the process of integrating the visual information extracted from the image and the location information, comparing the attributes of the objects, selecting the necessary information, visual work memory process of the selected information. It can be said to affect the process of perception.

Research Framework for International Franchising (국제프랜차이징 연구요소 및 연구방향)

  • Kim, Ju-Young;Lim, Young-Kyun;Shim, Jae-Duck
    • Journal of Global Scholars of Marketing Science
    • /
    • v.18 no.4
    • /
    • pp.61-118
    • /
    • 2008
  • The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.

  • PDF

Case study of Music & Imagery for Woman with Depression (우울한 내담자를 위한 MI(Music & Imagery) 치료사례)

  • Song, In Ryeong
    • Journal of Music and Human Behavior
    • /
    • v.5 no.1
    • /
    • pp.67-90
    • /
    • 2008
  • This case used MI techniques that give an imagery experience to depressed client's mental resource, and that makes in to verbalism. Also those images are supportive level therapy examples that apply to positive variation. MI is simple word of 'Music and Imagery' with one of psychology cure called GIM(Guided Imagery and Music). It makes client can through to the inner world and search, confront, discern and solve with suitable music. Supportive Level MI is only used from safety level music. Introduction of private session can associate specification feeling, subject, word or image. And those images are guide to positive experience. The First session step of MI program is a prelude that makes concrete goal like first interview. The Second step is a transition that can concretely express about client's story. The third step is induction and music listening. And it helps to associate imagery more easily by used tension relaxation. Also it can search and associate about various imagery from the music. The last step is process that process drawing imagery, talking about personal imagery experience in common with therapist that bring the power by expansion the positive experience. Client A case targets rapport forming(empathy, understanding and support), searching positive recourse(child hood, family), client's emotion and positive support. Music must be used simple tone, repetition melody, steady rhythm and organized by harmony music of what therapist and client's preference. The client used defense mechanism and couldn't control emotion by depression in 1 & 2 sessions. But the result was client A could experience about support and understanding after 3 sessions. After session 4 the client had stable, changed to positive emotion from the negative emotion and found her spontaneous. Therefore, at the session 6, the client recognized that she will have step of positive time at the future. About client B, she established rapport forming(empathy, understanding and support) and searching issues and positive recognition(child hood, family), expression and insight(present, future). The music was comfortable, organizational at the session 1 & 2, but after session 3, its development was getting bigger and the main melody changed variation with high and low of tune. Also it used the classic and romantic music. The client avoids bad personal relations to religious relationship. But at the session 1 & 2, client had supportive experience and empathy because of her favorite, supportive music. After session 3, client B recognized and face to face the present issue. But she had avoidance and face to face of ambivalence. The client B had a experience about emotion change according depression and face to face client's issues After session 4. At the session 5 & 6, client tried to have will power of healthy life and fairly attitude, train mental power and solution attitude in the future. On this wise, MI program had actuality and clients' issues solution more than GIM program. MI can solute the issue by client's based issue without approach to unconsciousness like GIM. Especially it can use variety music and listening time is shorter than GIM and structuralize. Also can express client's emotion very well. So it can use corrective and complement MI program to children, adolescent and adult.

  • PDF

The Mediating Effect of Experiential Value on Customers' Perceived Value of Digital Content: China's Anti-virus Program Market (경험개치대소비자대전자내용적인지개치적중개영향(经验价值对消费者对电子内容的认知价值的中介影响): 중국살독연건시장(中国杀毒软件市场))

  • Jia, Weiwei;Kim, Sae-Bum
    • Journal of Global Scholars of Marketing Science
    • /
    • v.20 no.2
    • /
    • pp.219-230
    • /
    • 2010
  • Digital content makes big changes to our daily lives while bringing opportunities and challenges for companies. Creative firms integrate pictures, texts, videos, audios, and data by digitalization to develop new products or services and create digital experiences to promote their brands. Most articles on digital content contribute to the basic concept or development of marketing it in literature. Actually, compared with traditional value chains for common products or services, the digital content industry seems to have more potential value. Because quite a bit of digital content is free to the consumer, price is not necessarily perceived as an indicator of the quality or value of information (Rowley 2008). It becomes evident that a current theme in digital content is the issue of "value," and research on customers' perceived value of digital content is a necessity. This article argues that experiential value has an advantage in customers' evaluations of digital content. Two different but related contributions to the understanding of "value" of digital content are made here. First, based on the comparison of digital content with products and services, the article proposes two key characteristics that make experiential strategy available for digital content: intangibility and near-zero reproduction cost. On top of that, based on the discussion of the gap between company's idealized value and customer's perceived value, this article emphasizes that digital content prices and pricing of digital content is different from products and services. As a result of intangibility, prices may not reflect customer value. Moreover, the cost of digital content in the development stage may be very high while reproduction costs shrink dramatically. Moreover, because of the value gap mentioned before, the pricing polices vary for different digital contents. For example, flat price policy is generally used for movies and music (Magiera 2001; Netherby 2002), while for continuous demand, digital content such as online games and anti-virus programs involves a more complicated matter of utility and competitive price levels. Digital content companies have to explore various kinds of strategies to overcome this gap. Rethinking marketing solutions such as advertisements, images, and word-of-mouth and their effect on customers' perceived value becomes essential. China's digital content industry is becoming more and more globalized and drawing special attention from different countries and regions that have respective competitive advantages. The 2008-2009 Annual Report on the Development of China's Digital Content Industry (CCIDConsulting 2009) indicates that, with the driven power of domestic demand and governmental policy support, the country's digital content industry maintained a fast growth of some 30 percent in 2008, obviously indicating the initial stage of industry expansion. In China, anti-virus programs and other software programs which need to be updated use a quarter-based pricing policy. Customers can download a trial version for free and use it for six months or a year. If they want to use it longer, continuous payment is needed. They examine the excellence of the digital content during this trial period and decide whether to pay for continued usage. For China’s music and movie industries, as a result of initial development, experiential strategy has not been much applied, even though firms in other countries find the trial experience and explore important strategies(such as customers listening to music for several seconds for free before downloading it). For the above reasons, anti-virus program may be a representative for digital content industry in China and an exploratory study of the advantage of experiential value in customer's perceived value of digital content is done in the anti-virus market of China. In order to enhance the reliability of the survey data, this study focused on people who were experienced users of anti-virus programs. The empirical results revealed that experiential value has a positive effect on customers' perceived value of digital content. In other words, because digital content is intangible and the reproduction costs are nearly zero, customers' evaluations are based heavily on their experience. Moreover, image and word-of-mouth do not have a positive effect on perceived value, only on experiential value. That is to say, a digital content value chain is different from that of a general product or service. Experiential value has a notable advantage and mediates the effect of image and word-of-mouth on perceived value. The results of this study help provide an understanding of why free digital content downloads exist in developing countries. Customers can perceive the value of digital content only by using and experiencing it. This is also why such governments support the development of digital content. Other developing countries whose digital content business is also in the beginning stage can make use of the suggestions here. Moreover, based on the advantage of experiential strategy, companies should make more of an effort to invest in customers' experience. As a result of the characteristics and value gap of digital content, customers perceive more value in the intangible digital content only by experiencing what they really want. Moreover, because of the near-zero reproduction costs, companies can perhaps use experiential strategy to enhance customer understanding of digital content.

Efficient Red-Color Emission of InGaN/GaN Double Hetero-Structure Formed on Nano-Pyramid Structure

  • Go, Yeong-Ho;Kim, Je-Hyeong;Gong, Su-Hyeon;Kim, Ju-Seong;Kim, Taek;Jo, Yong-Hun
    • Proceedings of the Korean Vacuum Society Conference
    • /
    • 2012.08a
    • /
    • pp.174-175
    • /
    • 2012
  • (In, Ga) N-based III-nitride semiconductor materials have been viewed as the most promising materials for the applications of blue and green light emitting devices such as light-emitting diodes (LEDs) and laser diodes. Although the InGaN alloy can have wide range of visible wavelength by changing the In composition, it is very hard to grow high quality epilayers of In-rich InGaN because of the thermal instability as well as the large lattice and thermal mismatches. In order to avoid phase separation of InGaN, various kinds of structures of InGaN have been studied. If high-quality In-rich InGaN/GaN multiple quantum well (MQW) structures are available, it is expected to achieve highly efficient phosphor-free white LEDs. In this study, we proposed a novel InGaN double hetero-structure grown on GaN nano-pyramids to generate broad-band red-color emission with high quantum efficiency. In this work, we systematically studied the optical properties of the InGaN pyramid structures. The nano-sized hexagonal pyramid structures were grown on the n-type GaN template by metalorganic chemical vapor deposition. SiNx mask was formed on the n-type GaN template with uniformly patterned circle pattern by laser holography. GaN pyramid structures were selectively grown on the opening area of mask by lateral over-growth followed by growth of InGaN/GaN double hetero-structure. The bird's eye-view scanning electron microscope (SEM) image shows that uniform hexagonal pyramid structures are well arranged. We showed that the pyramid structures have high crystal quality and the thickness of InGaN is varied along the height of pyramids via transmission electron microscope. Because the InGaN/GaN double hetero-structure was grown on the nano-pyramid GaN and on the planar GaN, simultaneously, we investigated the comparative study of the optical properties. Photoluminescence (PL) spectra of nano-pyramid sample and planar sample measured at 10 K. Although the growth condition were exactly the same for two samples, the nano-pyramid sample have much lower energy emission centered at 615 nm, compared to 438 nm for planar sample. Moreover, nano-pyramid sample shows broad-band spectrum, which is originate from structural properties of nano-pyramid structure. To study thermal activation energy and potential fluctuation, we measured PL with changing temperature from 10 K to 300 K. We also measured PL with changing the excitation power from 48 ${\mu}W$ to 48 mW. We can discriminate the origin of the broad-band spectra from the defect-related yellow luminescence of GaN by carrying out PL excitation experiments. The nano-pyramid structure provided highly efficient broad-band red-color emission for the future applications of phosphor-free white LEDs.

  • PDF

The Feminine Factor of the Therapeutic Landscape by Water from a Perspective of the Japanese Hot Spring (일본 온천을 중심으로 본 물을 매개로 하는 치유의 경관에서의 여성적 요소)

  • Park, Sookyung
    • Journal of the Korean association of regional geographers
    • /
    • v.22 no.3
    • /
    • pp.529-552
    • /
    • 2016
  • The purpose of this study is to examine the matter as to how the meaning of the physical therapeutic landscape by water, which is associated with physical, cultural, spatial, and economical aspects, appears in the space centering on women and is to look into the feminine factors in term of a rest area, consideration, and imagery for women. From a perspective of a rest area for women, the meaning of a physical aspect is remarkable and is materialized in thermal waters and bathing, atmosphere, subsidiary facilities and safe nightlife. According to these phenomena, female visitors are able to feel freedom, power, which can return themselves to the best condition by thermal waters, therapeutic equipments provided in a watering place continuously, safe protection and exchange with strangers with an open mind. And the cultural aspect of the therapeutic landscape by water is discovered in consideration for women. It is the fact that joins the Japanese culture based on consideration towards others to the traditional culture of hot springs by itself. For example, women can feel various pleasure, experience the protection or the support by someone and pursuit not only physical beauty but also mental or spiritual one through welcome bus, service of Okami san and Nakai san, decorations, funny installments and secure of private space. Lastly, the imagery of women can be identified in cultural, spatial, and economical aspects extensively somewhat and is embodied by advertising mediums, signs of hot springs, shrines, objets and products variously. It is made into healthiness, relaxation, comfort, familiarity and image that are realized to love or are connected to a happy marriage life. To sum up the results, the healing or therapeutic elements for women appearing in hot springs are gathered to some abstraction such as freedom, safe, effect beyond the body, pleasure, durability of healing or therapy, beauty and hope; furthermore, if these abstraction are combined each other closely, the effect of healing or therapy, which transforms anxiety into a stable condition, can be exposed externally.

  • PDF

Ascitic Fluid Analysis for the Differentiation of Malignancy-Related and Nonmalignant Ascites (악성 복수와 비악성 복수의 감별을 위한 복수액 분석)

  • Lee, Eun-Young;Kim, Byeoung-Deok;Choi, Jae-Hyuk;Lee, Sang-Yeop;Ryu, Hun-Mo;Lee, Kyung-Hee;Hyun, Myung-Soo
    • Journal of Yeungnam Medical Science
    • /
    • v.16 no.1
    • /
    • pp.76-84
    • /
    • 1999
  • The differentiation between malignancy-related ascites(MRA) and non-malignant ascites (NMA) is important for further diagnostic and therapeutic purposes. Although many parameters were investigated, none has provided a complete distinction between MRA and NMA. We investigated several ascitic fluid parameters to determine the differential power, and to differentiate malignant-related from nonmalignant-related ascites with a sequence of sensitive parameters followed by specific parameters. For the present study, 80 patients with ascites were divided into two groups: MRA and NMA, The MRA group was consisted of 27 patients with proven malignancy by image study, biopsy, and follow up: 21 of these patients had peritoneal carcinomatosis, but the remaining 6 showed no evidence of peritoneal carcinomatosis. The NMA group was consisted of 53 patients with no evidence of malignancy: among these patients, one had SLE, and others had liver cirrhosis, The samples of blood and ascites were obtained simultaneously, and then the levels of ascites cholesterol, CEA. protein and LDH, cytology, albumin gradient, ascites/serum concen-tration ratios of LDH(LDH A/S), and ascites/serum concentration ratios of protein(protein A/S) were measured. Applying cut-off limits for determined parameters, we estimated the diagnostic efficacy of each parameter, Among the eight parameters investigated, ascites fluid cholesterol yielded the best sensitive value of 93%(cut-off value 30mg/dl), and cytologic examination and the protein A/S(cut-off value 0.5) showed the most specific value of 100% and 96%, respectively. Based on the above results, the diagnostic sequence with cholesterol as a sensitive parameter followed by the combination of cytologic examination and protein A/S as specific parameters, was tested in 80 patients. This diagnostic sequence identified 81.5% of patients with malignancy, and all patients with peritoneal carcinomatosis were classified as malignancy-related ascites. In spite of many limitations, this proposed diagnostic sequence may permit a cost-effective and simple differentiation of malignancy-related ascites from nonmalignant ascites.

  • PDF