• Title/Summary/Keyword: Area under the curve (AUC)

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Plasma Vascular Endothelial Growth Factors A and C in Patients undergoing Prostatic Biopsy and TURP for Suspected Prostatic Neoplasia

  • Singh, A.N.;Gautam, Kirti A.;Dalela, D.;Sankhwar, S.N.;Natu, S.M.;Sankhwar, P.L.;Srivastava, A.N.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2053-2058
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    • 2013
  • Background: Formation of new blood vessels is necessary for the development and spread of neoplasms more than 1 mm3 in volume, angiogenesis being responsible for formation of new from pre-existing blood vessels. Vascular endothelial growth factor (VEGF) is pivotal and the best studied angiogenic factor in all human cancers. Therefore we designed this study to investigate the role of VEGF-A and VEGF-C in prostate cancer in comparison with BPH controls in a north Indian population. Methods: In this case-control study a total of 100 subjects were included on the basis of confirmed histopathological reports, out of which 50 were prostate cancer patients and the other 50 were BPH patients with PSA levels >2 ng/ml and abnormal digital rectal examination (DRE) findings during September 2009 to August 2011 from the Department of Urology, KGMU, Lucknow, India. Plasma levels of VEGF were determined using quantitative immunoassay (ELISA-enzyme linked immunosorbent assay). Statistical analysis was carried out using SPSS 15.0 version. Results: The mean age of prostate cancer ($67.6{\pm}5.72$) patients was significantly higher (p=0.005) than BPH ($63.6{\pm}7.92$) patients. Expression of VEGF-A was not significantly higher in disease stage C1 than D1 or D2 and A or B (p=0.13) while the level of VEGF-A was significantly higher (p=0.04) in prostate cancer as compared to BPH subjects (PCa=13.0 pg/ml, BPH=6.8 pg/ml). Levels of VEGF-C were similar in both groups (PCa=832.6 pg/ml, BPH=823.7 pg/ml). In ROC curve, the area under curve (AUC) was 0.70 (95%CI: 0.60-0.80) and the cut-off value for which a higher proportion of patients was correctly classified (20%) was 26.0 pg/mL. Conclusion: Although VEGF-A is increased in cancer prostate patients a statistically significant correlation could not be established in this study. VEGF-C was not found to be a useful biomarker.

Evaluation of Albumin Creatinine Ratio as an Early Urinary Biomarker for Chronic Kidney Disease in Dogs

  • Hyun-Min Kang;Heyong-Seok Kim;Min-Hee Kang;Jong-Won Kim;Dong-Jae Kang;Woong-Bin Ro;Doo-Won Song;Ga-Won Lee;Hee-Myung Park;Hwi-Yool Kim
    • Journal of Veterinary Clinics
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    • v.40 no.6
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    • pp.399-407
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    • 2023
  • Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.

Validity of the New Caries Activity Test using Real-Time Polymerase Chain Reaction (실시간 중합효소연쇄반응 방법을 이용한 새로운 치아우식 활성 검사법의 유효성)

  • Kwon, Doyoun;Kim, Heejin;Nam, Okhyung;Kim, Misun;Choi, Sungchul;Kim, Kwangchul;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.354-362
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    • 2018
  • Periogen is a new caries activity test using real-time polymerase chain reaction. The aim of this study was to assess the validity of Periogen by evaluating the correlation with dmft, dmfts indices and comparing with Cariview and caries risk assessment tool (CAT). 83 children under 6 participated in this study. Dmft, dmfts indices and CAT were collected through an examination of oral health status. Plaque samples for Periogen and Cariview were collected and manipulated according to the manufactures' instructions. The correlation coefficient of Periogen, Cariview and CAT with the dmfts index were 0.38, 0.56 and 0.66 in each (p < 0.01). The sensitivity of Periogen, Cariview and CAT were 43%, 76% and 95% and specificity were 80%, 72% and 74% respectively. Area under curve under the receiver operating characteristic curves in each method indicated 0.69, 0.81 and 0.85. CAT and Cariview were more effective in evaluation the risk of dental caries than Periogen so far. To be used Periogen clinically, more improvements for higher validity were needed.

Sperm-Associated Antigen 9 is a Promising marker for Early Diagnosis of Endometrial Cancer

  • Baser, Eralp;Togrul, Cihan;Ozgu, Emre;Ayhan, Sevgi;Caglar, Mete;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7635-7638
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    • 2013
  • Background: Sperm-associated antigen 9 (SPAG9) has been recently proposed as a novel biomarker for early diagnosis of several human tumors, including ovarian, cervical and breast cancers. Its clinical value remains to be clarified for endometrial cancer (EC). In this study, we investigated the utility of serum SPAG9 levels in diagnosis of EC and its association with important clinicopathological parameters. Materials and Methods: This cross-sectional study was performed at a tertiary women's referral center in Ankara, Turkey. Preoperative serum samples were collected from patients surgically treated for endometrial cancer between June 2012-April 2013. Similar aged women with a biopsy proven benign endometrium were used as controls. Serum SPAG9 levels were measured with an enzyme-linked immunosorbent assay (ELISA) method and assessed for links with clinicopathological factors. Receiver operating characteristic (ROC) curve analysis was performed to assess power of SPAG9 levels for EC prediction. P values less than 0.05 were considered statistically significant. Results: A total of 63 women with EC and 27 with benign endometrium were included in the study. Mean age in the EC group was $58.7{\pm}1.1$. Median SPAG9 levels in the EC and control groups were 18.3 (range, 12.7-53.8) and 14.1 (range, 4.3-65.3), respectively (p<0.001). A cut-off value of 17 ng/ml for SPAG9 predicted presence of malignant endometrium with 74% sensitivity and 83% specificity [Area under curve (AUC)=0.82, p<0.001]. SPAG9 levels did not demonstrate any significant association with histological type, FIGO stage, tumor grade, size, myometrial invasion, lymphovascular space invasion, cervical involvement, adnexal involvement, peritoneal cytology or lymph node status (all p>0.05). Conclusions: Testing for SPAG9 may be useful for early detection of EC in asymptomatic high-risk women. Its role in post-treatment follow-up and early detection of recurrence should be assessed in future trials.

Effect of Solubilizing and Microemulsifying Excipients in Polyethylene Glycol 6000 Solid Dispersion on Enhanced Dissolution and Bioavailability of Ketoconazole

  • Heo, Min-Young;Piao, Zong-Zhu;Kim, Tae-Wan;Cao, Qing-Ri;Kim, Ae-Ra;Lee, Beom-Jin
    • Archives of Pharmacal Research
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    • v.28 no.5
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    • pp.604-611
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    • 2005
  • Polyethylene glycol (PEG) 6000-based solid dispersions (SDs), by incorporating various pharmaceutical excipients or microemulsion systems, were prepared using a fusion method, t o compare the dissolution rates and bioavailabilities in rats. The amorphous structure of the drug in SDs was also characterized by powder X-ray diffractometry (XRD) and differential scanning calorimetry (DSC). The ketoconazole (KT), as an antifungal agent, was selected as a model drug. The dissolution rate of KT increased when solubilizing excipients were incorporated into the PEG-based SDs. When hydrophilic and lipophilic excipients were combined and incorporated into PEG-based SDs, a remarkable enhancement of the dissolution rate was observed. The PEG-based SDs, incorporating a self microemulsifying drug delivery system (SMEDDS) or microemulsion (ME), were also useful at improving the dissolution rate by forming a microemulsion or dispersible particles within the aqueous medium. However, due to the limited solubilization capacity, these PEG-based SDs showed dissolution rates, below 50% in this study, under sink conditions. The PEG-based SD, with no pharmaceutical excipients incorporated, increased the maximum plasma concentration (C$_{max}$) and area under the plasma concentration curve (AUC$_{0-6h}$) two-fold compared to the drug only. The bioavailability was more pronounced in the cases of solubilizing and microemulsifying PEG-based SDs. The thermograms of the PEG-based SDs showed the characteristic peak of the carrier matrix around 60$^{\circ}C$, without a drug peak, indicating that the drug had changed into an amorphous structure. The diffraction pattern of the pure drug showed the drug to be highly crystalline in nature, as indicated by numerous distinctive peaks. The lack of the numerous distinctive peaks of the drug in the PEG-based SDs demonstrated that a high concentration of the drug molecules was dissolved in the solid-state carrier matrix of the amorphous structure. The utilization of oils, fatty acid and surfactant, or their mixtures, in PEG-based SD could be a useful tool to enhance the dissolution and bioavailability of poorly water-soluble drugs by forming solubilizing and microemulsifying systems when exposed to gastrointestinal fluid.

Analysis of Risk factors & Morphological Ultrasound Image for Gallbladder Polyp in Adults Living in Busan and Gyeongnam Provinces (부산·경남 지역 성인의 담낭용종 위험인자 및 초음파 영상의 형태학적 분석)

  • An, Hyeon;Hwang, Chul-Hwan;Ko, Sung-Jin;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.353-359
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    • 2016
  • This study were to evaluate risk factors of GB polpy in Busan and Gyeongnam area. This study was performed with patients by abdominal ultrasonography among the patients who came to the P hospital from January to May 2016. Among them, risk factors were analyzed on 399 people at the same time when abdominal ultrasonography and hematological test. The statistical analysis of risk factors related to the GB ployp was performed by independent t-test and chi-square test. In consider of difference verification result for calculations odds ratio about independent variables, multiple logistic regression analysis to conduct verify adequacy by calculating forecasting model from variable. As a result, GB polyp risk factors have relevance to male, HBsAg positive, triglyceride. GB polyp risk factors confirmed to male, HBsAg positive, triglyceride were calculated forecasting model and forecasting probability value. Forecasting probability sensitivity 61.0%, specificity 76.8%, ROC area under curve 0.735 showed, it confirmed validity of forecasting model. When analyzing the GB polyps morphologically, among the GB polyp types observed from abdominal ultrasonography, the hyperechoic and homogeneous pattern with neck was the largest as shown from 27.5% and two GB polyps were shown most from 38%, sizes were shown most by maximum diameter, 5 to 10mm from 53%. As a disease accompany with GB polyp showed mild fatty liver(23%), diffuse hepatopathy(21%).

Bioequivalence of Two Clarithromycin Tablets (클래리스로마애신 정제의 생물학적 동등성 평가)

  • 김종국;이사원;최하곤;고종호;이미경;김인숙
    • Biomolecules & Therapeutics
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    • v.6 no.2
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    • pp.219-224
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    • 1998
  • The bioequivalence of two clarithromvcin products was evaluated with 16 normal male volunteers (age 23-28 yr, body weight 57.5-75.517g) following single oral dose. Test product was ReYon Clarithromycin tablets (ReYon Pharm. Corp., Korea) and reference product was Klarici $d_{R}$ tablets (Abbott Korea). Both products contain 250 mg of clarithromucin. One tablet of the test or the reference product was administered to the volunteers, respectively, by randomized two period cross-over study (2$\times$2 Latin square method). The determination of clarithromycin was accomplished using a modified agar well diffusion bioassay. As a result of the assay validation, the quantification of clarithromycin in human serum by this technique was possible down to 0.03$\mu$g/ml using 100$\mu$l of serum. The coefficient of variation (C.V.) was less than 10%. Average drug concentrations at each sampling time and pharmacokinetic parameters calculated were not significantly different between two products P>0.05); the area under the curve to last sampling time (24 hr) (AU $Co_{24hr}$ (8.10$\pm$ 1.26 vs 8.22$\pm$ 1.627g . hr/ml), AUC from time zero to infinite (AU $Co_{\infty}$) (8.61 $\pm$ 1.28 vs 8.84$\pm$ 1.71 $\mu$g . hr/ml), maximum plasma concentration ( $C_{msx}$) (0.87$\pm$0.22 vs 0.88$\pm$0.19 $\mu$g/ml) and time to maximum plasma concentration ( $T_{max}$) (2.69 $\pm$0.48 vs 2.56$\pm$ 0.51 hr). The differences of mean AU $Co_{24h}$, $C_{msx}$ and $T_{msx}$ between the two products (1.44, 1.39, and 4.65%, respectively) were less than 20%. The power (1-$\beta$) and treatment difference ($\Delta$) for AU $Co_{24hr}$, and $C_{max}$ were more than 0.8 and less than 0.2, respectivly. Although the power for $T_{max}$ was under 0.8, $T_{max}$. of the two products was not significantly different each other (p>0.05). These results suggest that the bioavailability of ReYon Clarithromycin tablets is not significantly different from that of Klarici $d_{R}$ tablets. Therefore, two products are bioequivalent based on the current results. results.sults.sults.s.s.s.s.s.s.s.

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Predicting the Potential Distribution of Pinus densiflora and Analyzing the Relationship with Environmental Variable Using MaxEnt Model (MaxEnt 모형을 이용한 소나무 잠재분포 예측 및 환경변수와 관계 분석)

  • Cho, NangHyun;Kim, Eun-Sook;Lee, Bora;Lim, Jong-Hwan;Kang, Sinkyu
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.22 no.2
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    • pp.47-56
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    • 2020
  • Decline of pine forests happens in Korea due to various disturbances such as insect pests, forest fires and extreme climate, which may further continue with ongoing climate change. For conserving and reestablishing pine forests, understanding climate-induced future shifts of pine tree distribution is a critical concern. This study predicts future geographical distribution of Pinus densiflora, using Maximum Entropy Model (MaxEnt). Input data of the model are locations of pine tree stands and their environmental variables such as climate were prepared for the model inputs. Alternative future projections for P. densiflora distribution were conducted with RCP 4.5 and RCP 8.5 climate change scenarios. As results, the future distribution of P. densiflora steadily decreased under both scenarios. In the case of RCP 8.5, the areal reductions amounted to 11.1% and 18.7% in 2050s and 2070s, respectively. In 2070s, P. densiflora mainly remained in Kangwon and Gyeongsang Provinces. Changes in temperature seasonality and warming winter temperature contributed primarily for the decline of P. densiflora., in which altitude also exerted a critical role in determining its future distribution geographic vulnerability. The results of this study highlighted the temporal and spatial contexts of P. densiflora decline in Korea that provides useful ecological information for developing sound management practices of pine forests.

Analysis of Diagnostic Performance of CT and EUS for Clinical TN Staging of Gastric Cancer (위암의 임상적 병기 설정을 위한 전산화단층촬영 및 초음파 내시경의 진단력 평가)

  • Shin, Ru-Mi;Lee, Ju-Hee;Lee, Moon-Soo;Park, Do-Joong;Kim, Hyung-Ho;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.177-185
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    • 2009
  • Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

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A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU (중환자실 섬망 환자와 비섬망 환자 구분에 기여하는 임상 지표에 관한 연구)

  • Ko, Chanyoung;Kim, Jae-Jin;Cho, Dongrae;Oh, Jooyoung;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.101-110
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    • 2019
  • Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.