• Title/Summary/Keyword: Cut-off value

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Evaluation of Risk Factors for Uterine Myoma Diagnosed by Ultrasonography (초음파로 진단된 자궁근종의 위험인자 평가)

  • Yang, Sung-Hee
    • Journal of radiological science and technology
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    • v.44 no.4
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    • pp.307-313
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    • 2021
  • The purpose of this study was to analyze the risk factors for uterine myoma diagnosed by ultrasonography in Korea women and to evaluate the risk. Among the patients who visited the outpatient department of obstetrics and gynecology at I hospital in Busin between January 2019 and March 2021 for the purpose of examination, 98 patients in the experimental group diagnosed with uterine myoma and 163 patients in the normal control group without other diseases were retrospectively conducted. Among the general characteristics of the subjects, age, body mass index, parity, and menopause showed significant differences between the myoma group and the normal control group. ROC(receiver operating characteristic) curve analysis and logistic regression analysis were performed to obtain the cut off value and odds ratio that can predict the occurrence of uterine myoma. The cut off value for the prediction of uterine myoma was determined to be 30 years old and a body mass index of 23 kg/m2. After that adjusting for menopause, non menopausal cases with a body mass index of 23 kg/m2 and over 39 years of age had the highest odds ratio of 6.04. Therefore, premenopausal women over 40 years of age require regular checkups and thorough weight management. This study was conducted with a small number of subjects. Therefore, there is a limit to generalizing to all Korean women. However, based on this study if a large scale prospective study considering various variables is made, it can play a role as a predictive marker in early detection of uterine myoma.

The Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Grafting

  • Hyun Ah Lim;Joon Kyu Kang;Hwan Wook Kim;Hyun Son;Ju Yong Lim
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.99-107
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    • 2023
  • Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.

Hydrocephalus: Ventricular Volume Quantification Using Three-Dimensional Brain CT Data and Semiautomatic Three-Dimensional Threshold-Based Segmentation Approach

  • Hyun Woo Goo
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.435-441
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    • 2021
  • Objective: To evaluate the usefulness of the ventricular volume percentage quantified using three-dimensional (3D) brain computed tomography (CT) data for interpreting serial changes in hydrocephalus. Materials and Methods: Intracranial and ventricular volumes were quantified using the semiautomatic 3D threshold-based segmentation approach for 113 brain CT examinations (age at brain CT examination ≤ 18 years) in 38 patients with hydrocephalus. Changes in ventricular volume percentage were calculated using 75 serial brain CT pairs (time interval 173.6 ± 234.9 days) and compared with the conventional assessment of changes in hydrocephalus (increased, unchanged, or decreased). A cut-off value for the diagnosis of no change in hydrocephalus was calculated using receiver operating characteristic curve analysis. The reproducibility of the volumetric measurements was assessed using the intraclass correlation coefficient on a subset of 20 brain CT examinations. Results: Mean intracranial volume, ventricular volume, and ventricular volume percentage were 1284.6 ± 297.1 cm3, 249.0 ± 150.8 cm3, and 19.9 ± 12.8%, respectively. The volumetric measurements were highly reproducible (intraclass correlation coefficient = 1.0). Serial changes (0.8 ± 0.6%) in ventricular volume percentage in the unchanged group (n = 28) were significantly smaller than those in the increased and decreased groups (6.8 ± 4.3% and 5.6 ± 4.2%, respectively; p = 0.001 and p < 0.001, respectively; n = 11 and n = 36, respectively). The ventricular volume percentage was an excellent parameter for evaluating the degree of hydrocephalus (area under the receiver operating characteristic curve = 0.975; 95% confidence interval, 0.948-1.000; p < 0.001). With a cut-off value of 2.4%, the diagnosis of unchanged hydrocephalus could be made with 83.0% sensitivity and 100.0% specificity. Conclusion: The ventricular volume percentage quantified using 3D brain CT data is useful for interpreting serial changes in hydrocephalus.

Modification of HEART Pathway for Patients With Chest Pain: A Korean Perspective

  • Bora Chae;Shin Ahn;Youn-Jung Kim;Seung Mok Ryoo;Chang Hwan Sohn;Dong-Woo Seo;Won Young Kim
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.635-644
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    • 2023
  • Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m2 with the conventional threshold of 30 kg/m2 in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

Hand drum forms of STD-11 Die-hole in Wire-cut Electronic discharge Machining Conditions (STD-11 Die-hole 와이어 컷 방전가공시 가공조건에 따른 북현상 고찰)

  • 조규재
    • Proceedings of the Korean Society of Machine Tool Engineers Conference
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    • 2000.04a
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    • pp.567-572
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    • 2000
  • From the experimental study of W-EDM for alloyed steel, the characteristics such as Hand Drum Form and surface roughness have been observed and evaluated for various conditions. In square hole, the increase of IP as to made condition, the calculate high value of surface roughness. Also compare dimensionless square hole with circle hole' graph, In circle hole, if a value of surface roughness IP 6 in a side of circle it show a 0.4${\mu}{\textrm}{m}$ and in IP 8, 0.6${\mu}{\textrm}{m}$, in IP 10, 0.7${\mu}{\textrm}{m}$, in IP 12, 0.8${\mu}{\textrm}{m}$ higher than before. This figure show the surface roughness is higher than before, because a table move in either X-axis or Y-axis in square hole, on the contrary, in circle there table move in X-axis and Y-axis at the same time. hand drum form getting small when wire tension increase 1000gf to 1500gf, at the same working conditions. The smaller of off time, the maller of hand drum form in same condition and same wire tension. but if you compare square hole with circle hole' graph, hand drum form displayed in maintained term of working condision, on the contrary, in case of square hole variation of hand drum form is more increase than a grow of IP

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Application of Receiver Operating Characteristics (ROC) Curves for Clinical Diagnostic Tests (임상진단 검사에서 ROC 곡선의 응용)

  • Pak, Son-Il;Koo, Hee-Seung;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.312-315
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    • 2002
  • Diagnostic tests often require the determination of cut-off values that discriminate uninfected from infected individuals. The receiver operating characteristic (ROC) curve has been frequently used to attain this purpose and gives a representation of diagnostic accuracy (sensitivity and specificity) of a prediction model when varying the cut-point of a decision rule on a whole spectrum. We have written and tested a visual basic application program in EXCEL for maximum likelihood estimation of a binormal ROC curve, which also computes univariate statistics of a diagnostic test employed. Examples applying for computed tomographic images in radiology and methicillin-resistant Staphylococcus aureus research are given to illustrate this approach. This stand-alone module is available from the first author on request.

The Value of Postoperative Serum Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels for the Early Detection of Gastric Cancer Recurrence after Curative Resection

  • Lee, Eung-Chang;Yang, Jun-Young;Lee, Kyung-Goo;Oh, Seung-Young;Suh, Yun-Suhk;Kong, Seong-Ho;Yang, Han-Kwang;Lee, Hyuk-Joon
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.221-228
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    • 2014
  • Purpose: This study aimed to evaluate the value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels to detect gastric cancer recurrence. Materials and Methods: We retrospectively reviewed 154 patients who developed recurrence within 2 years after curative gastric cancer surgery and analyzed the relationship between postoperative CEA and CA19-9 levels and recurrence. We readjusted the cut-off values to improve the detection of recurrence. Subgroup analysis according to clinicopathologic variables was performed to further investigate the relationship between recurrence and CEA and CA19-9 levels. Results: The sensitivity and specificity for elevated CEA levels to detect recurrence were 40.6% and 89.5%, respectively, and those for CA19-9 were 34.2% and 93.6%, respectively. The sensitivity and specificity for elevation of either tumor marker were 54.3% and 84.0%, respectively; those for elevation of both tumor markers were 19.2% and 98.4%, respectively. By readjusting the cut-off values from 5.0 ng/ml to 5.2 ng/ml for CEA and from 37.00 U/ml to 30.0 U/ml for CA19-9, the sensitivity was increased from 34.2% to 40.2% for CA19-9, while there was no increase in sensitivity for CEA. In subgroup analysis, the sensitivity of CEA was higher in patients with elevated preoperative CEA levels than in patients with normal preoperative CEA levels (86.7% versus 33.7%; P<0.001). Furthermore, the sensitivity of CA19-9 was higher in patients with elevated preoperative CA19-9 levels than in patients with normal preoperative CA19-9 levels (82.61% versus 26.83%; P<0.001). Conclusions: CEA and/or CA19-9 measurement with the readjusted cut-off values allows for more effective detection of gastric cancer recurrence.

A Study on Method for Screening of Hypercalciuria in Children (소아에서 소변 Na/K 비를 통한 칼슘 배설량 예측)

  • Ko Han Seong;Choi Jeong Hoon;Choi Byoung Min;Yoo Kee Hwan;Hong Young Sook;Lee Joo Won;Kim Soon Kyum
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.11-16
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    • 2000
  • Purpose. Urinary calcium excretion using a 24-hr urine colledtion has been used for the diagnosis of hypercalciuria up to now. But It takes a lot of time and costs much. We have investigated on a more simple method for screening of hypercalciuria in children. Methods: We had retrospectively analyzed sodium, potassium, calcium and creatinine in spot urine of eighty-four patients with urinary symptoms from May 1998 to July 1998 in Korea university Guro hospital and compared the urinary Ca/Cr ratio with the Nin ratio. Using a urinary Nan ratio >2.68 as a cutoff value in predicting the occurrence of hypercalciuria, we measured its sensitivity, specificity, positive predictive value and the negative predictive value. Results: A direct relationship was found between urinary Na/K and Ca/Cr ratio (r=0.496, P<0.001, Ca/Cr : Na/K x 0.0167+0.061). Using a urinary Na/K ratio >2.68 as a cutoff value in predicting the occurrence of hypercalciuria, its sensitivity was found to be $100\%$ and its specificity $54.5\%$. The positive predictive value was $37.5\%$ and the negative predictive value $100\%$. Conclusions : Spot urine Na/K ratio is a valuable test for the screening of hypercalciuria in children.

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Diagnostic Significance of Cholesterol in Pleural Effusion (흉막액내 Cholesterol치 측정의 진단적 의의)

  • Yeo, Dong-Seung;Lee, Dong-Il;Lee, Soo-Keol;Moon, Chang-Hyung;Park, Soon-Kew;Shin, Young-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.248-254
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    • 1992
  • Background: Pleural effusion is one of the most common clinical problems in pulmonology because of high prevalence of pulmonary tuberculosis and bronchogenic carcinoma in Korea. The differential diagnosis between pleural transudate and exudate is very important, but it is very difficult in some cases. Methods: In order to assess the clinical usefulness of cholesterol levels for the differential diagnosis of pleural transudate and exudate, we measured pleural fluid cholesterol levels by enzymatic method in 45 patients who were admitted due to pleural effusion. Results: The mean cholesterol level of transudate was $33.1{\pm}12.9\;mg%$, tuberculous exudate was $97.3{\pm}28.2\;mg%$ and malignant exudate was $97.3{\pm}28.2mg%$. When the cut-off value of pleural cholesterol level was 60 mg%, one case (6.7%) of tuberculous exudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of transudate were classified correctly. When the cut-off value of pleural/serum cholesterol ratio was 0.3, one case (6.7%) of transudate and two cases (13.3%) of malignant exudate were incorrectly classified, but all cases of tuberculous exudate were classified correctly. When the cut-off value of pleural cholesterol level to differentiate pleural transudate from exudate was 60 mg%, sensitivity was 90% and specificity was 100%. When the cut-off value of pleural/serum cholesterol level to differentiate pleural transudate form exuidate was 0.3, sensitivity was 93% and specifiity was 93%. Conclusions: From the above results, it can be concluded that measurement of pleural fluid cholesterol levels is useful for the differential diagnosis between pleural transudate and exudate.

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The Usefulness of Visceral Fat Thickness Measured by Ultrasonography as an Abdominal Obesity Index (초음파로 측정된 내장지방두께의 복부 비만지표로서의 유용성)

  • Kim, Yong-Kyun;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.249-258
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    • 2008
  • Purpose : Abdominal obesity with visceral fat accumulation have been known to be intimately associated with the development of metabolic syndrome. Therefore, it is important to estimate the precise amount of visceral fat. Ultrasonography has been reported that it is a simple and noninvasive method for visceral fat evaluation. Purpose of this study is to evaluate the association of ultrasonographic visceral fat thickness, anthropometric indexes, and risk factor of metabolic syndrome, and to investigate the cut-off value of abdominal visceral fat thickness leading to increased risk of metabolic syndrome. Materials and methods : The subject included 200 men and 200 women who visited D healthcare center in Daejeon from January to April 2008. The subcutaneous fat thickness and visceral fat thickness were measured by ultrasonograph. As anthropometric index, we measured body mass index, waist circumference and waist/height ratio. As for the risk factor of metabolic syndrome, we measured blood pressure, high density lipoprotein cholesterol, triglyceride and fasting serum glucose. Results : VFT was significantly correlated with waist circumference, (r=0.683/M, r=0.604/F), waist to height ratio (r=0.633/M, r=0.593/F) and BMI (r=0.621/M, r=0.534/F) in both men and women. In addition it was significantly correlated with Systolic blood pressure (r=0.229/M, r=0.232/F), Diastolic blood pressure ((r=0.285/M, r=0.254/F), high density cholesterol (r=-0.254/M, r=-0.254/F), Triglyceride (r=0.475/M, r=0.411/F), and Fasting blood sugar (r=0.158/M, r=0.234/F) in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm (sensitivity89.2%, specificity 71.2%) in men and 3.50cm (sensitivity61.2% specificity 80.8%) in women respectively. The odds ratio of the risk of metabolic syndrome was dramatically increased with the abdominal visceral fat thickness level over 6cm in men and 5cm in women. Conclusion : The visceral fat thickness using ultrasonography was significantly correlated with anthropometric indexes and risk factors of metabolic syndrome in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm in men and 3.50cm in women.

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