• Title/Summary/Keyword: Cut-off value

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Evaluation of Various Cardiae Indices and ROC Analysis in Coronary Artery Disease Employing Resting ECG Gated Blood Pool Scan (관상동맥질환에서 휴식기 심전도게이트혈액풀스캔을 이용한 각종 심기능 지표들의 평가 및 ROC 분석)

  • Choi, Chang-Woon;Lee, Dong-Soo;Kim, Sang-Eun;Chung, June-Key;Lee, Myung-Chul;Park, Young-Bae;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.40-48
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    • 1992
  • Gated blood pool scan is frequently used for evaluating the change in cardiac function in various cardiac diseases. But resting gated blood pool scan using only LVEF as a cardiac index has been consitently shown to have a low sensitivity, which is about 50%, in detecting coronary artery disease. So it is recommended to compare exercise gated blood pool scan to resting gated blood pool scan. Exercise tests, however, are not always possible, especially in patients with musculoskeletal diseases, recent myocardial infarction and in elderly persons. We studied the usefulness of resting gated blood pool scan using multiple indices in evaluating the patients with coronary artery disease. Studied cases were 185 patients with coronary artery disease (angina pectoris 31, myocardial infarction 154) and 25 normals with low likelihood of coronary artery disease. We used $^{99m}Tc-labeled$ RBC, 740 MBq labeled by in vivo method. The data were evaluated by Micro DELTA computer program. The results were as following: 1) The ejection rates (PER, AER) and filling rates (PFR, AFR) were different in normls and patients with angina pectoris or myocardial infarction. 2) Mean phase angle, ejection rates and filling rates could separate normals from coronary artery disease patients with normal LVEF. 3) Regional ejection fraction was decreased at the site of the infarct in patients with myocardial infarction. 4) Peak filling rate was the the most detectable index in evaluation of cardiac function in patients with coronary artery disease. 5) The threshold at 1.5 standard deviation of normal range was considered as the most reliable cut-off value from ROC analysis. These data suggest that the resting gated blood pool scan has an important role in the evaluation of cardiac functional changes using various cardiac indices in patients with coronary artery disease.

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The Effect of Operating Conditions on Cross-Flow Ultrafiltration with using Polyethylene Glycol (Polyethylene Glycol을 이용한 Cross-Flow Ultrafiltration에 있어서 운전조건의 영향)

  • Yoo, Kun-Woo;Seo, Hyung-Joon
    • Applied Chemistry for Engineering
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    • v.9 no.7
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    • pp.950-955
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    • 1998
  • The objective of this study was to investigate the effect of running time, operating pressure, feed concentration and circulation rate on the permeation flux and the rejection rate in cross-flow ultrafiltration of polyethylene glycol(PEG) solution of molecular weight($M_w$) 8000 and 20000. The membranes used for this study were MWCO(Molecular Weight Cut-off) of 6 K and 20 K. The experiments were performed at the operating pressures of 7, 14 and 28 psi, the circulation rates of 1000 mL/min and 2000 mL/min, and the feed concentration of 100 mg/L and 1000 mg/L. At a constant pressure, the permeation flux and the observed rejection($R_o$) appeared to be approximately constant within the range of running time, 0~480 min. The permeation flux increased with increasing the operating pressure, and it increased with decreasing the feed concentration and decreasing Mw of PEG at a given pressure. On the other hand, $R_o$ decreased slightly with increasing the operating pressure. However, $R_o$ increased with increasing the feed concentration and increasing of $M_w$ of PEG at a given pressure. The variation in circulation rates did not cause any significant influence on the permeation flux. Increasing of circulation rate caused the increase of $R_o$, and $\alpha$ was increased substantially with the decrease of $M_w$ of PEG. The dimensionless parameter. permeability ratio($\alpha$), which was used to investigate flux-pressure behavior, was increased with the increase in circulation rate and operating presure. The value of $\alpha$ was less than 1 in all cases. The estimated intrinsic rejection(R). which was obtained from mass transfer coefficient, was decreased with the increase of operating pressure. However R increased with the increase of linear velocity of feed and $M_w$ of PEG.

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The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients (심방세동 환자에서 새로 개발된 R2CHA2DS2-VASc score 유용성 및 CHADS2, CHA2DS2-VASc scores와의 비교연구)

  • Kwak, Jae-Hoon;Yeo, Se-Hwan;Kim, Yeo-Un;Lee, Jin-Suk;Kim, Byong-Kyu;Chung, Jin-Wook;Bae, Jun-Ho;Nah, Deuk-Young;Lee, Kwan
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.8-12
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    • 2016
  • Background: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. Methods: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. Results: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. Conclusion: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.

Contrast reference values in panoramic radiographic images using an arch-form phantom stand

  • Shin, Jae-Myung;Lee, Chena;Kim, Jo-Eun;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • v.46 no.3
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    • pp.203-210
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    • 2016
  • Purpose: The purpose of this study was to investigate appropriate contrast reference values (CRVs) by comparing the contrast in phantom and clinical images. Materials and Methods: Phantom contrast was measured using two methods: (1) counting the number of visible pits of different depths in an aluminum plate, and (2) obtaining the contrast-to-noise ratio (CNR) for 5 tissue-equivalent materials (porcelain, aluminum, polytetrafluoroethylene [PTFE], polyoxymethylene [POM], and polymethylmethacrylate [PMMA]). Four panoramic radiographs of the contrast phantom, embedded in the 4 different regions of the arch-form stand, and 1 real skull phantom image were obtained, post-processed, and compared. The clinical image quality evaluation chart was used to obtain the cut-off values of the phantom CRV corresponding to the criterion of being adequate for diagnosis. Results: The CRVs were obtained using 4 aluminum pits in the incisor and premolar region, 5 aluminum pits in the molar region, and 2 aluminum pits in the temporomandibular joint (TMJ) region. The CRVs obtained based on the CNR measured in the anterior region were: porcelain, 13.95; aluminum, 9.68; PTFE, 6.71; and POM, 1.79. The corresponding values in the premolar region were: porcelain, 14.22; aluminum, 8.82; PTFE, 5.95; and POM, 2.30. In the molar region, the following values were obtained: porcelain, 7.40; aluminum, 3.68; PTFE, 1.27; and POM, - 0.18. The CRVs for the TMJ region were: porcelain, 3.60; aluminum, 2.04; PTFE, 0.48; and POM, - 0.43. Conclusion: CRVs were determined for each part of the jaw using the CNR value and the number of pits observed in phantom images.

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.

Detection of Circulating Tumor Cells in Breast Cancer Patients: Prognostic Predictive Role

  • Turker, Ibrahim;Uyeturk, Ummugul;Sonmez, Ozlem Uysal;Oksuzoglu, Berna;Helvaci, Kaan;Arslan, Ulku Yalcintas;Budakoglu, Burcin;Alkis, Necati;Aksoy, Sercan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1601-1607
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    • 2013
  • A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

Changes of Serum antibody Levels by Indirect Hemagglutination Test after Treatment in Clonorchiasis (IHA(Indirect hemagglutination test)를 이용한 간흡충증(肝吸虫症)의 면역혈청학적(免疫血淸學的) 진단(診斷)에 관한 연구(硏究) -ELISA법과의 비교(比較) 및 치료(治療) 전후(前後) 의 혈청항체가(血淸抗體價) 변동(變動)에 관하여-)

  • Joo, Kyoung-Hwan;Kim, Jong-Seong;Chung, Myung-Sook;Rim, Han-Jong
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.117-123
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    • 1987
  • Detection of IgG antibody in clonorchiasis has been accomplished through various serodiagnostic procedure including complement fixation test, gel diffusion test, indirect fluorescent antibody test, indirect hemagglutination test etc. In this report enzyme immunoassay (ELISA) and indirect hemagglutination test (IHA) were used to determine IgG serum antibody levels before and after therapy with praziquantel. Briefly, sera from 62 cases of confirmed human clonorchiasis were examined before and after treatment with praziquantel. Among 62 cases treated 25 cases were categorized as completely cured groups by formalin-ether and careful examination of 4 cellophane thick smered slides at 18 months after treatment. The sera of 25 cases of cured groups were examined again by ELISA and IHA, and com-pared to the previous data. The results obtained were as follows; 1) Sensitivity of IHA test was 83.6% when cut-off titer of 1:8 was applied. No sera obtained from 10 normal healthy control showed positive reaction. 2) Twenty cases (80.0%) out of 25 cured one showed negative results by IHA at 18 months after treatment. 3) Although 5 cases showed positive titer even 18 months after treatment 3 cases of them showed decreased antibody titer. However 2 cases did not show any response. 4) Even though almost all cases showed de- creased ELISA value, only 11 cases (44.0%) out of 25 patients showed negative results by ELISA at 18 months after treatment. In conclusion, it is suggested that, while IgG ELISA for detecting long persisting antibody was more sensitive than IHA, IHA results more conclusively indicated effective treatment in clonorchiasis by negative conversion than did the results of ELISA.

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The Relationship between Age and Pleural Fluid Adenosine Deaminase Activity in Pleural Tuberculosis (흉막 결핵에서 연령과 흉수 Adenosine Deaminase 활성도와의 연관성)

  • Moon, Jin Wook;Han, Chang Hoon;Kang, Shin Myung;Park, Moo Suk;Hwang, Sang Yeon;Byun, Min Kwang;Chung, Wou Young;Hwang, Hye Jin;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.459-464
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    • 2005
  • 연구 배경 : Adenosine deaminase (ADA)는 퓨린 (purine) 대사에 작용하는 효소로서 림 프구, 특히 T-림프구의 증식과 분화에 관여하며, 결핵성 흉수의 진단에 있어서 중요한 생화학적 표지자 중의 하나이다. 한편, 노인의 경우, T-림프구의 수와 기능의 감소에 의하여 면역 기능이 감소하는 것으로 알려져 있다. 이에 저자 등은 노인 결핵성 흉수 환자에서 흉수내의 ADA 수치가 젊은 환자에서보다 감소하는지를 조사하였다. 방 법 : 4년 동안 세브란스 병원에서 1) 흉수 결핵균 배양 양성 또는 2) 흉막 조직 검사상 결핵에 합당한 소견을 보여 결핵성 흉수로 진단받은 환자 80명을 대상으로 후향적으로 조사하였다. 65세를 기준으로 두 군으로 분류하였으며, 연령과 흉수 ADA 수치의 연관 관계를 독립 표본 t-검정 및 선형 회귀 분석을 이용하여 연구하였다. 결 과 : 80명의 환자 중 65세 이상은 21명 (26.3%)이었다. 흉수 내의 ADA 수치는 65세 이상 및 이하 군에서 각각 $71.2{\pm}27.6IU/L$, $68.5{\pm}5.8IU/L$ 이었다 (p=0.69). 선형 회귀 분석에서도 연령과 흉수 내의 ADA 수치는 상관 관계를 보이지 않았다 ($r^2=0.05$, p=0.59). 결 론 : 본 연구의 결과에 의하면, 결핵성 흉수의 진단에서 흉수 ADA 수치를 보조 지표로 사용하는 데 있어서, 노인환자에서도 젊은 환자와 동일한 임상적 유의성을 가지고 동일한 결정 수치 (cut-off value)를 적용할 수 있을 것으로 판단된다.

Usefulness of Plasma Procalcitonin to Predict Severity in Elderly Patients with Community-Acquired Pneumonia

  • Kim, Ji Hye;Seo, Joo Wan;Mok, Jeong Ha;Kim, Mi Hyun;Cho, Woo Hyun;Lee, Kwangha;Kim, Ki Uk;Jeon, Doosoo;Park, Hye-Kyung;Kim, Yun Seong;Kim, Hyung Hoi;Lee, Min Ki
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.5
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    • pp.207-214
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    • 2013
  • Background: Community-acquired pneumonia (CAP) is one of the leading causes of death among the elderly. Several studies have reported the clinical usefulness of serum procalcitonin, a biomarker of bacterial infection. However, the association between the levels of procalcitonin and the severity in the elderly with CAP has not yet been reported. The aim of this study was to evaluate usefulness of procalcitonin as a predictor of severity and mortality in the elderly with CAP. Methods: This study covers 155 CAP cases admitted to Pusan National University Hospital between January 2010 and December 2010. Patients were divided into two groups (${\geq}65$ years, n=99; <65 years, n=56) and were measured for procalcitonin, C-reactive protein (CRP), white blood cell, confusion, uremia, respiratory rate, blood pressure, 65 years or older (CURB-65) and pneumonia severity of index (PSI). Results: The levels of procalcitonin were significantly correlated with the CURB-65, PSI in totals. Especially stronger correlation was observed between the levels of procalcitonin and CURB-65 in the elderly (procalcitonin and CURB-65, ${\rho}$=0.408 with p<0.001; procalcitonin and PSI, ${\rho}$=0.293 with p=0.003; procalcitonin and mortality, ${\rho}$=0.229 with p=0.023). The correlation between the levels of CRP or WBC and CAP severity was low. The existing cut-off value of procalcitonin was correlated with mortality rate, however, it was not correlated with mortality within the elderly. Conclusion: The levels of procalcitonin are more useful than the levels of CRP or WBC to predict the severity of CAP. However, there was no association between the levels of procalcitonin and mortality in the elderly.

The Analysis of Optical Quality in Central Serous Chorioretinopathy by OQAS (OQAS를 이용한 중심장액성맥락망막병증의 광학적 질 분석)

  • Choi, Jong Kil;Lee, Kyung Min;Kim, Heesung;Kim, So Ra;Park, Mijung
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.3
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    • pp.281-288
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    • 2016
  • Purpose: The present study was aimed to investigate the change of optical quality in fully cured eyes from central serous chorioretionopathy(CSC) and CSC under treatment, respectively. Methods: A total of 136 eyes(68 subjects) was divided into CMC under treatment and its asymptomatic contralateral eye, fully cured eyes after being diagnosed with CMC and its contralateral eye, and normal eyes. Objective scattering index, cut-off value in modulation transfer function, focusing rate, PSF(Point Spread Function) width at 50%, 10% and the contrast sensitivity were measured and analyzed. Results: CMC under treatment showed statistically significant decrease in all evaluations of optical quality compared with asymptomatic contralateral eyes, fully cured eyes and normal eyes. Although there was no significant difference in optical quality between asymptomatic contralateral eyes of CMC under treatment and fully cured eyes, there was tendence in optical quality decreasing compared with normal eyes. Conclusions: From the study, it was revealed that the optical quality was different according to the treatment phase in CMC. The use of optical quality assessment for the decision of complete cure and the evaluation of prognosis in CMC is also proposed.