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Efficacy of stool multiplex polymerase chain reaction assay in adult patients with acute infectious diarrhea

World Journal of Clinical Cases 2020年第17期8卷 3708-3717页

作者： Jae Sung Ahn Seung In Seo Jinseob Kim Taewan Kim Jin Gu Kang Hyoung Su Kim Woon Geon Shin myoung kuk jang Hak Yang Kim Department of Internal Medicine Kangdong Sacred Heart HospitalSeoul KS013South Korea Department of Internal Medicine Kangdong Sacred Heart HospitalHallym University College of MedicineSeoul KS013South Korea Institute for Liver and Digestive Diseases Hallym UniversityChuncheon KS013South Korea Department of Epidemiology School of Public HealthSeoul National UniversitySeoul KS013South Korea

BACKGROUND Recently,stool multiplex polymerase chain reaction(PCR)tests have been developed for identifying diarrhea-causing bacterial ***,fecal calprotectin is a well-known effective marker for intestinal mucosal *** To evaluate the efficacy of stool multiplex PCR and fecal calprotectin in acute infectious *** Overall,400 patients with acute infectious diarrhea were enrolled from Kangdong Sacred Heart Hospital(January 2016 to December 2018).Multiplex PCR detected 7 enteropathogenic bacteria including Salmonella,Campylobacter,Shigella,Escherichia coli O157:H7,Aeromonas,Vibrio,and Clostridium *** reviewed clinical and laboratory findings using stool multiplex *** Stool multiplex PCR test detected considerably more bacterial pathogens than stool culture(49.2%vs 5.2%),with Campylobacter as the most common pathogen(54%).Patients with positive stool PCR showed elevated fecal calprotectin expression compared to patients with negative stool PCR(1124.5±816.9 mg/kg vs 609±713.2 mg/kg,P=0.001).C-reactive protein(OR=1.01,95%CI:1.001-1.027,P=0.034)and sigmoidoscopy-detected colitis(OR=4.76,95%CI:1.101-20.551,P=0.037)were independent factors in stool PCR-based detection of bacterial *** and specificity of calprotectin were evaluated to be 70.5%and 60.9%,respectively(adjusted cut-off value=388 mg/kg).CONCLUSION Stool multiplex PCR test has increased sensitivity in detecting pathogens than conventional culture,and it is correlated with calprotectin *** multiplex PCR and calprotectin may be effective in predicting clinical severity of infectious diarrhea.

关键词： Acute infectious diarrhea Stool multiplex polymerase chain reaction Calprotectin

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Differentiation of acute and chronic hepatitis B in IgM antiHBc positive patients

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World Journal of Gastroenterology 2015年第13期21卷 3953-3959页

作者： Ji Won Park Kyeong Min Kwak Sung Eun Kim myoung kuk jang Dong Joon Kim Myung Seok Lee Hyoung Su Kim Choong Kee Park Department of Internal Medicine Hallym University Medical CenterAnyang 431-070South Korea Department of Occupational and Environmental Medicine Hallym University Medical CenterAnyang 431-070South Korea Department of Internal Medicine Hallym University Sacred Heart Hospital of Hallym University Medical Center Seoul 134-701South Korea Department of Internal Medicine Hallym University Medical CenterChuncheon 200-704South Korea

AIM: To identify the factors that differentiate acute hepatitis B(AHB) from chronic hepatitis B with acute exacerbation(CHB-AE).METHODS: From 2004 to 2013, a total of 82 patients(male n = 52, 63.4%; female n = 30, 36.6%) with clinical features of acute hepatitis with immunoglobulin M antibodies to the hepatitis B core antigen(Ig M antiHBc) were retrospectively enrolled and divided into two groups; AHB(n = 53) and CHB-AE(n = 29). The AHB group was defined as patients without a history of hepatitis B virus(HBV) infection before the episode and with loss of hepatitis B surface antigen within 6 mo after onset of acute hepatitis. Biochemical and virological profiles and the sample/cutoff(S/CO) ratio of Ig M anti-HBc were compared to determine the differential diagnostic ***: The multivariate analysis demonstrated that, the S/CO ratio of Ig M anti-HBc and HBV DNA levels were meaningful factors. The S/CO ratio of Ig M anti-HBc was significantly higher in the AHB group, while the HBV DNA level was significantly higher in the CHB-AE group. The optimal cutoff values of Ig M anti-HBc and HBV DNA levels for differentiating the two conditions were 8 S/CO ratio and 5.5 log10 IU/m L, respectively. The sensitivity and specificity were 96.2% and 89.7% for the S/CO ratio of Ig M anti-HBc and 81.1% and 72.4% for HBV DNA levels, respectively. The area under receiver operating characteristic curves of both the S/CO ratio of Ig M anti-HBc and HBV DNA levels were not significantly different(0.933 vs 0.844, P = 0.105). When combining Ig M anti-HBc and HBV DNA, the diagnostic power significantly improved compared to HBV DNA alone(P = 0.0056). The combination of these factors yielded a sensitivity and specificity of 98.1% and 86.2%, ***: The combination of the S/CO ratio of Ig M anti-HBc and HBV DNA levels was a useful tool for differentiating AHB from CHB-AE in patients with positive Ig M anti-HBc.

关键词： Acute hepatitis Differential diagnosis Chronic hep

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Diagnostic value of PIVKA-Ⅱ and alpha-fetoprotein in hepatitis B virus-associated hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第13期21卷 3928-3935页

作者： Seung In Seo Hyoung Su Kim Won Jin Kim Woon Geon Shin Doo Jin Kim Kyung Ho Kim myoung kuk jang Jin Heon Lee Joo Seop Kim Hak Yang Kim Dong Joon Kim Myung Seok Lee Choong Kee Park Department of Internal Medicine Hallym University Medical CenterSeoul 134-701South Korea Digestive Disease Center Hallym University Medical CenterSeoul 134-701South Korea Department of Surgery Hallym University Medical CenterSeoul 134-701South Korea

AIM: To determine the cutoff values and to compare the diagnostic role of alpha-fetoprotein(AFP) and prothrombin induced by vitamin K absence-Ⅱ(PIVKA-Ⅱ) in chronic hepatitis B(CHB).METHODS: A total of 1255 patients with CHB, including 157 patients with hepatocellular carcinoma(HCC), 879 with non-cirrhotic CHB and 219 with cirrhosis without HCC, were retrospectively enrolled. The areas under the receiver operating characteristic(AUROC) curves of PIVKA-Ⅱ, AFP and their combination were calculated and ***: The optimal cutoff values for PIVKA-Ⅱ and AFP were 40 m AU/m L and 10 ng/m L, respectively, for the differentiation of HCC from nonmalignant CHB. The sensitivity and specificity were 73.9% and 89.7%, respectively, for PIVKA-Ⅱ and 67.5% and 90.3% for AFP, respectively. The AUROC curves of both PIVKA-Ⅱ and AFP were not significantly different(0.854 vs 0.853, P = 0.965) for the differentiation of HCC from nonmalignant CHB, whereas the AUROC of PIVKA-Ⅱ was significantly better than that of AFP in patients with cirrhosis(0.870 vs 0.812, P = 0.042). When PIVKA-Ⅱ and AFP were combined, the diagnostic power improved significantly compared to either AFP or PIVKA-Ⅱ alone for the differentiation of HCC from nonmalignant CHB(P < 0.05), especially when cirrhosis was present(P < 0.05).CONCLUSION: Serum PIVKA-Ⅱ might be a better tumor marker than AFP, and its combination with AFP may enhance the early detection of HCC in patients with CHB.

关键词： Hepatitis B virus Hepatocellular carcinoma Alpha-f

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Management of entecavir-resistant chronic hepatitis B with adefovir-based combination therapies

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World Journal of Gastroenterology 2015年第38期21卷 10874-10882页

作者： Hyoung Su Kim Hyung Joon Yim myoung kuk jang Ji Won Park Sang Jun Suh Yeon Seok Seo Ji Hoon Kim Bo Hyun Kim Sang Jong Park Sae Hwan Lee Sang Gyune Kim Young Seok Kim Jung Il Lee Jin-Woo Lee In Hee Kim Tae Yeob Kim Jin-Wook Kim Sook-Hyang Jeong Young Kul Jung Hana Park Seong Gyu Hwang Department of Internal Medicine Hallym University College of Medicine Department of Internal Medicine Korea University Ansan Hospital Department of Internal Medicine Korea University Medical College Department of Internal Medicine Bundang Jesaeng Hospital Department of Internal Medicine Soon Chun Hyang University College of Medicine Department of Internal Medicine Inha University School of Medicine Department of Internal Medicine Chonbuk National University Medical School Department of Internal Medicine Hanyang University College of Medicine Department of Internal Medicine Seoul National University College of Medicine Department of Internal Medicine Gachon University School of Medicine Department of Internal Medicine CHA Bundang Medical CenterCHA University

AIM: To evaluate the long-term efficacy adefovir(ADV)-based combination therapies in entecavir(ETV)-resistant chronic hepatitis B(CHB) patients. METHODS: F i fty CHB pat ient s wi t h genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV(ADV/ETV,n = 23) or ADV plus lamivudine(LMV)(ADV/LMV,n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis B virus(HBV) DNA levels were measured by realtime PCR and logarithmically transformed for analysis. Cumulative rates of virologic response(VR; HBV DNA < 20 IU/m L) were calculated using the Kaplan-Meier method,and the difference was determined by a logrank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR,***: Baseline median HBV DNA levels were 5.53(2.81-7.63) log10 IU/m L. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27(12-45) mo. Overall,cumulative VR rates at 6,12,24,and 36 mo were 26%,36%,45%,and 68%,respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates(35%,43%,65%,and 76%,respectively) than those with the ADV/LAM combination(18%,30%,30%,and 62%,respectively; P = 0.048). In the multivariate analysis,low baseline HBV DNA levels(< 5.2 log10 IU/m L) and initial virologic response at 3 mo(IVR-3; HBV DNA < 3.3 log10 IU/m L after 3 mo) were independent predictive factors for VR. Patients with favorable predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period,the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable ***: If tenof

关键词： Adefovir Chronic hepatitis B Entecavir Lamivudine

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FATIGUE LIVES FOR INDUCTION HARDENED SHAFTS MATERIALS ACCORDING TO THE ENVIRONMENTAL TEMPERATURES

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Acta Metallurgica Sinica(English Letters) 2005年第5期18卷 585-593页

作者： D.G. Lee K.C. jang J.M. kuk I.S. Kim Korea Institute of Industrial Technology Gwangju 506-824 Korea Dept. of Mechanical Engineering Mokpo National University Mokpo 534-729 Korea

Rotary bending fatigue tests were carried out with two kinds of materials, S43C and S50C, using the front engine and front drive shaft （FF shaft） of vehicle. The specimens were induction hardened about 1.0mm depth from the specimen surface, and the hardness value on the surface was about HRC56-60. The tested environment temperatures were -30, 25 and 80℃ in order to look over effect of the induction hardening and the environmental temperatures on the fatigue characteristics. The fatigue limit of induction hardened specimens increased more about 45% than non-hardened specimens showing that the endurances of S43C and S50C were 98.1 and 107.9MPa in non-hardened samples, 147.1 and 156.9MPa in hardened samplesrespectably. The maximum tensile and compressive stress on the small circular defect was about ＋250 and -450MPa respectively when circular defect is situated on top and bottom. The fatigue life increased 80, 25 and -30℃ in order regardless of hardening. In comparison of the fatigue lives on the basis of tested result at 25℃, the fatigue lives of non-hardened specimens decreased about 35%, but that of hardened specimens decreased about only 5% at 80℃ more than at 25℃. And fatigue life of non-hardened and hardened specimens were about 110% and 120% higher at -30℃ than that of 25℃. Based on the result of stress distribution near the defect, the tensile and compressive stress repeatedly generated by load direction were the largest on the small circular defect due to the stress concentration.

关键词： induction hardening fatigue test front engine and front drive shaft,fatigue crack fatigue life fatigue life ratio

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N-terminal pro-B-type natriuretic peptide as prognostic marker for patients of non ST-segment elevation myocardial infarction

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Journal of Central South University 2013年第8期20卷 2226-2232页

作者： SHON Ho Sun HWANG Kyung kuk BAE jang Whan KIM Kyung Ah LEE Jong Yun RYU Keun Ho Database and Bioinformatics Laboratory School of Electrical & Computer Engineering also PSM of School of Medicine Chungbuk National University Department of Medicine School of Medicine Chungbuk National University Department of Biomedical Engineering School of Medicine Chungbuk National University Department of Informatics and Convergence Chungbuk National University Cheongju

In this work, we analyzed only the patients of the NSTEMI (non ST-segment elevation myocardial infarction) who arrived at the hospital within 12 h after symptoms started. Using NSTEMI follow-up data within, the characteristics of the clinical data, the risk factor, and the blood tested in the hospital visit were analyzed for MACE (major adverse cardiac events) patients. MACE includes cardiac death, MI (myocardial infarction), Re-PCI, and CABG (coronary artery bypass graft). As a result, from the NSTEMI patients which can be followed up for over 12 m, NT-ProBNP (p=0.014) and age (p=0.045) are found to be the independent risk factors related to MACE. Accordingly, they can be useful for the diagnosis and prognosis for NSTEMI patients as a biomarker.

关键词： non ST-segment elevation myocardial infarction NT-ProBNP cardiovascular disease

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Differential diagnoses of magnetic resonance imaging for suspected acute appendicitis in pregnant patients

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World Journal of Emergency Medicine 2018年第1期9卷 26-32页

作者： Ji Yong Jung Ji Ung Na Sang kuk Han Pil Cho Choi jang Hee LEE Dong Hyuk Shin Department of Emergency Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

BACKGROUND: Accurate and timely diagnosis of acute surgical disease in pregnant patient is chal enging. Although magnetic resonance imaging(MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant ***: A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016. Differential diagnoses of appendix MRI were analyzed and blood tests were compared between those who had surgical and non-surgical ***: Appendix MRI differentiated two surgical disease; acute appendicitis and ovarian torsion; and various non-surgical conditions such as uterine myoma, hydronephrosis, ureterolithiasis and diverticulitis among clinically suspected acute appendicitis in pregnancy. The diagnostic accuracy of MRI for acute appendicitis in this study was 93.5%. Patients who had surgical disease showed significantly higher WBC count(≥11,000/mm^3), proportion of neutrophils in the WBC(≥79.9%), neutrophil-to-lymphocyte ratio(NLR≥6.4), levels of C-reactive protein(CRP≥1.82 mg/dL) and bilirubin(≥0.66 mg/dL) than those who had non-surgical ***: MRI can reliably differentiate surgical conditions and several blood tests(WBC, proportion of neutrophils in the WBC, NLR, CRP, bilirubin) can help anticipate acute surgical condition among pregnant patients suspected to have acute appendicitis.

关键词： Appendicitis Magnetic resonance imaging Pregnancy Neutrophils

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Unilateral pleuroparenchymal fibroelastosis as a rare form of idiopathic interstitial pneumonia:A case report

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World Journal of Clinical Cases 2020年第18期8卷 4186-4192页

作者： Jae-Ha Lee Hang-Jea jang Jin-Han Park Hyun-kuk Kim Sunggun Lee Ji-Yeon Kim Seong-Ho Kim Department of Internal Medicine Haeundae Paik HospitalInje University College of MedicineBusan 48108South Korea Department of Pathology Haeundae Paik HospitalInje University College of MedicineBusan 48108South Korea

BACKGROUND Pleuroparenchymal fibroelastosis(PPFE)is a rare idiopathic interstitial pneumonia characterized by predominantly upper lobe involvement with pleural fibrosis and subjacent parenchymal ***,there have been increasing reports of PPFE,and PPFE might coexist with other interstitial lung diseases in the lower lobe and upper ***,cases of unilateral PPFE are *** SUMMARY A 75-year-old Korean male presented to our hospital with chronic dry cough and exertional *** patient’s symptoms started 6 mo previously and had been gradually *** the time of presentation,he felt dyspnea when walking at his own *** findings suggested PPFE,but the lesion was localized in the upper lobe of the right *** multidisciplinary discussion,a transbronchial lung biopsy in the right upper lobe revealed collapsed alveoli with parenchymal fibroelastosis,and elastic van Gieson staining demonstrated septal elastosis with intra-alveolar collagenosis,which met the histopathologic criteria of definite *** multidisciplinary discussion in an experienced interstitial lung disease center,we confirmed the diagnosis of unilateral ***,we confirmed the progression of PPFE on radiologic findings during the followup *** Clinicians should consider PPFE,even in cases with unilateral,predominantly upper lung involvement in interstitial lung disease patients through multidisciplinary discussion.

关键词： Interstitial lung disease Pleuroparenchymal fibroelastosis Progression Unilateral Multidisciplinary discussion Case report

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Discussion on “Gaining Effciency via Weight Estimators for Multivariate Failure Time Data” by Fan, Zhou and Chen

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Science China Mathematics 2009年第6期52卷 1129-1130页

作者： kuk Anthony Department of Statistics and Applied Probability National University of Singapore Singapore

The survival analysis literature has always lagged behind the categorical data literature in developing methods to analyze clustered or multivariate data. While estimators based on

关键词： Discussion on Gaining Effciency via Weight Estimators for Multivariate Failure Time Data Zhou and Chen by Fan

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Effect of friction on the contact stress of a coated polymer gear

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Friction 2020年第6期8卷 1169-1177页

作者： Su-Min BAE kuk-Jin SEO Dae-Eun KIM Department of Mechanical Engineering Yonsei UniversitySeoul 03722Republic of Korea

Polymer gears are used extensively in various ***,durability issues have been emerging because of friction at gear tooth contact *** extend the lifetime of polymer gears,a low-frictional coating has been considered as a possible *** this study,a finite element simulation method was performed to investigate the contact stress between a pair of coated polymer *** simulation included various friction coefficients(COFs)for studying the effects of friction during the *** results revealed that the friction causes the contact stress to shift over the roll angle,which is attributed to the direction of the sliding friction based on a free-body *** also investigated the effects of coating and found that a thin coating has little effect on the bulk deformation behavior of the ***,the stress distribution in the coating at the pitch point was investigated as the COF *** zero friction,three notable stress regions were observed:1)the center of the surface,2)the end of the contact,and 3)the overall contact *** COF was increased in the micro-slip region of the contact interface,both tensile and compressive stresses in the coating *** study provides significant aid to engineers for understanding the stress response of the coating applied to polymer gears to achieve an optimal design.

关键词： coating contact stress finite element method(FEM) friction polymer gear

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