• Title/Summary/Keyword: Cut-off values

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Assessment of Diffusion Tensor Imaging Parameters of Hepatic Parenchyma for Differentiation of Biliary Atresia from Alagille Syndrome

  • Ahmed Abdel Khalek Abdel Razek;Ahmed Abdalla;Reda Elfar;Germeen Albair Ashmalla;Khadiga Ali;Tarik Barakat
    • Korean Journal of Radiology
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    • v.21 no.12
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    • pp.1367-1373
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    • 2020
  • Objective: To assess diffusion tensor imaging (DTI) parameters of the hepatic parenchyma for the differentiation of biliary atresia (BA) from Alagille syndrome (ALGS). Materials and Methods: This study included 32 infants with BA and 12 infants with ALGS groups who had undergone DTI. Fractional anisotropy (FA) and mean diffusivity (MD) of the liver were calculated twice by two separate readers and hepatic tissue was biopsied. Statistical analyses were performed to determine the mean values of the two groups. The optimum cut-off values for DTI differentiation of BA and ALGS were calculated by receiver operating characteristic (ROC) analysis. Results: The mean hepatic MD of BA (1.56 ± 0.20 and 1.63 ± 0.2 × 10-3 mm2/s) was significantly lower than that of ALGS (1.84 ± 0.04 and 1.79 ± 0.03 × 10-3 mm2/s) for both readers (r = 0.8, p = 0.001). Hepatic MD values of 1.77 and 1.79 × 10-3 mm2/s as a threshold for differentiating BA from ALGS showed accuracies of 82 and 79% and area under the curves (AUCs) of 0.90 and 0.91 for both readers, respectively. The mean hepatic FA of BA (0.34 ± 0.04 and 0.36 ± 0.04) was significantly higher (p = 0.01, 0.02) than that of ALGS (0.30 ± 0.06 and 0.31 ± 0.05) for both readers (r = 0.80, p = 0.001). FA values of 0.30 and 0.28 as a threshold for differentiating BA from ALGS showed accuracies of 75% and 82% and AUCs of 0.69 and 0.68 for both readers, respectively. Conclusion: Hepatic DTI parameters are promising quantitative imaging parameters for the detection of hepatic parenchymal changes in BA and ALGS and may be an additional noninvasive imaging tool for the differentiation of BA from ALGS.

Serum Beta-2 Microglobulin: a Possible Marker for Disease Progression in Egyptian Patients with Chronic HCV Related Liver Diseases

  • Ouda, SM;Khairy, AM;Sorour, Ashraf E;Mikhail, Mikhail Nasr
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7825-7829
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    • 2015
  • Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

Analysis of Electronic Endoscopic Image of Intramucosal Gastric Carinoma by Using Homoglobin Index (혈색소지수를 이용한 점막내 위암의 전자내시경 영상 분석)

  • Kim Gwang-Ha;Lim Eun-Kyung;Kim Gwang-Baek
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 2005.11a
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    • pp.535-541
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    • 2005
  • It has been suggested that the endoscopic color of intramucosal gastric carcinoma is correlated with mucosal vascularity within the carcinomatous tissue. The development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, using a hemoglobin index. The aim of this study was to make a software program to calculate the hemoglobin index (IHb) and then investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma, in particular with regard to its value for discriminating between the histologic type. The mean values of IHb for the carcinoma (IHb-C) and the mean values of IHb for the surrounding non-cancerous mucosa ( IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type gastric carcinomas. Then, we analyzed the ratio of the IHb-C to IHb-N. The mean IHb-C/IHb-N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group ($1.28{\pm}0.19$ vs. $0.81{\pm}0.18$, respectively, p<0.001). When the cut-off point of the C/N ratio was set at 1.00, the accuracy rate, the sensitivity, the specificity, and the positive and negative predictive values of a C/N ratio below 1.00 for the differential diagnosis of diffuse-type carcinoma from intestinal-type carcinoma were $94.5\%$, $94.1\%$, $94.7\%$, $88.9\%$ and $97.3\%$, respectively. IHb is useful for quantitative measurement of the endoscopic color in intramucosal gastric carcinoma and the IHb-C/IHb-N ratio would be helpful in distinguishing diffuse-type carcinoma from intestinal -type carcinoma.

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Lake Water Treatment Using a Ultrafiltration Membrane Process of Hollow Fiber Type (중공사형 한외여과 막분리 공정에 의한 하천수 처리)

  • 박진용
    • Membrane Journal
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    • v.7 no.1
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    • pp.39-47
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    • 1997
  • The self-designed membrane system was tested to examine the performance of the hollow fiber type polysulfone ultrafiltration(UF) membrane for the treatment of pure water(the 3rd treated water). The molecular weight cut-off's (MWCO) of the membranes used in this study were 5, 000 and 10, 000, respectively. The recovery rate, the ratio of permeate flow rate to the feed flow rate, increased as the temperature rose. The values of MWCO obtained in this study, using 2, 000 ppm polyethylene glycol and dextran solutions with various molecular weight, showed higher values than those suggested by SKI. Based on the results of the primary experiments, the water of the Gongji-stream, in which water quality is deteriorated by the inflow of domestic wastewater, was selected for the UF membrane test. Biological oxygen demand(BOD), total solids, and turbidity of the treated water had much lower values than those of the source water. Therefore, this study confirmed the possibility of the domestic water treatment using the hollow fiber type UF membrane.

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A Study of Crust Structure at Svalbard Archipelago in Arctic Area by Using Gravity Data (중력자료를 이용한 북극 스발바드 군도의 지각구조연구)

  • Yu, Sang-Hoon;Yi, Song-Suk;Min, Kyung-Duck
    • The Korean Journal of Petroleum Geology
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    • v.13 no.1
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    • pp.17-23
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    • 2007
  • Gravity characteristics are investigated in the vicinity of the DASAN scientific station, located at the Svalbard Archipelago, the Arctic using ArcGP data. Boundary effects of free-air gravity anomalies, which appeared generally at the continental margin, are erased after Bouguer correction was applied. Complete Bouguer anomalies produced after terrain correction by GrOPO30 show that gravity anomalies increase from continent to marine. This phenomena seem to be related to the rise of Moho discontinuity. The cut-off frequency of 0.16 was decided after power spectrum analysis and the gravity anomalies were divided into two parts. Residual anomalies in high frequency part show that characteristics of high values along the faults and of low values related to thick sediments in the continent. Characteristic is low values from basement subsidence of continental slope or thick sediments in the marine. The undulation of Moho discontinuity from 3-D inversion modeling show typical characteristics of continental margin that become higher from Svalbard archipelago to Knipovich ridge bordering Eurasian plate.

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The Neutrophil to Lymphocyte Ratio has a High Negative Predictive Value for Pathologic Complete Response in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

  • Eryilmaz, Melek Karakurt;Mutlu, Hasan;Salim, Derya Kivrak;Musri, Fatma Yalcin;Tural, Deniz;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7737-7740
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    • 2014
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with pancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine the relationship between pathological complete response (pCR) and pretreatment NLR values in locally advanced breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and Methods: Datawere collected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BC patients treated with NACT between January 2000-December 2013. Results: A total of 78 patients were analyzed. Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR-cases (p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patients with PCR+ was 2.33 (AUC:0.544, 95%CI [0.401-0.688], p=0.586) with sensitivity, specificity, positive predictive value and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively. Conclusions: This study showed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV, in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatment may not be recommended.

Analysis of Electronic Endoscopic Image of Intramucosal Gastric Carcinoma Using Hemoglobin Index

  • Kim Gwang-Ha;Lim Eun-Kyung;Kim Kwang-Baek
    • Journal of the Korean Institute of Intelligent Systems
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    • v.16 no.3
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    • pp.332-337
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    • 2006
  • It has been suggested that the endoscopic color of intramucosal gastric carcinoma is correlated with mucosal vascularity within the carcinomatous tissue. The development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, using a hemoglobin index. The aim of this study was to make a software program to calculate the hemoglobin index (IHb) and then investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma, in particular with regard to its value for discriminating between the histologic types. The mean values of IHb for the carcinoma (IHb-C) and the mean values of IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type gastric carcinomas. Then, we analyzed the ratio of the IHb-C to IHb-N. The mean IHb-C/IHb-N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (1.28$\pm$0.19 vs. 0.81$\pm$0.18, respectively, p<0.001). When the cut-off point of the C/N ratio was set at 1.00, the accuracy rate, the sensitivity, the specificity, and the positive and negative predictive values of a C/R ratio below 1.00 for the differential diagnosis of diffuse-type carcinoma from intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for quantitative measurement of the endoscopic color in intramucosal gastric carcinoma and the IHb-C/IHb-N ratio would be helpful in distinguishing diffuse-type carcinoma from intestinal-type carcinoma.

Biomechanical Properties of the Cornea Using a Dynamic Scheimpflug Analyzer in Healthy Eyes

  • Lee, Hun;Kang, David Sung Yong;Ha, Byoung Jin;Choi, Jin Young;Kim, Eung Kweon;Seo, Kyoung Yul;Kim, Tae-im
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1115-1122
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    • 2018
  • Purpose: To investigate biomechanical properties of the cornea using a dynamic Scheimpflug analyzer according to age. Materials and Methods: In this prospective, cross-sectional, observational study, participants underwent ophthalmic investigations including corneal biomechanical properties, keratometric values, intraocular pressure (IOP), and manifest refraction spherical equivalent (MRSE). We determined the relationship of biomechanical parameters and ocular/systemic variables (participant's age, MRSE, IOP, and mean keratometric values) by piecewise regression analysis, association of biomechanical parameters with variables by Spearman's correlation and stepwise multiple regression analyses, and reference intervals (RI) by the bootstrap method. Results: This study included 217 eyes of 118 participants (20-81 years of age). Piecewise regression analysis between Corvis-central corneal thickness (CCT) and participant's age revealed that the optimal cut-off value of age was 45 years. No clear breakpoints were detected between the corneal biomechanical parameters and MRSE, IOP, and mean keratometric values. Corneal velocity, deformation amplitude, radius, maximal concave power, Corvis-CCT, and Corvis-IOP exhibited correlations with IOP, regardless of age (all ages, 20-44 years, and over 44 years). With smaller deformation amplitude and corneal velocity as well as increased CorvisIOP and Corvis-CCT, IOP became significantly increased. We provided the results of determination of confidence interval from RI data using bootstrap method in three separate age groups (all ages, 20-44 years, and over 44 years). Conclusion: We demonstrated multiple corneal biomechanical parameters according to age, and reported that the corneal biomechanical parameters are influenced by IOP.

OCCURENCE AND LUMINOSITY FUNCTIONS OF GIANT RADIO HALOS FROM MAGNETO-TURBULENT MODEL

  • CASSANO R.;BRUNETTI G.;SETTI G.
    • Journal of The Korean Astronomical Society
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    • v.37 no.5
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    • pp.589-592
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    • 2004
  • We calculate the probability to form giant radio halos (${\~}$ 1 Mpc size) as a function of the mass of the host clusters by using a Statistical Magneto-Turbulent Model (Cassano & Brunetti, these proceedings). We show that the expectations of this model are in good agreement with the observations for viable values of the parameters. In particular, the abrupt increase of the probability to find radio halos in the more massive galaxy clusters ($M {\ge} 2{\times}10^{15} M_{\bigodot}$) can be well reproduced. We calculate the evolution with redshift of such a probability and find that giant radio halos can be powered by particle acceleration due to MHD turbulence up to z${\~}$0.5 in a ACDM cosmology. Finally, we calculate the expected Luminosity Functions of radio halos (RHLFs). At variance with previous studies, the shape of our RHLFs is characterized by the presence of a cut-off at low synchrotron powers which reflects the inefficiency of particle acceleration in the case of less massive galaxy clusters.

Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound

  • Arun-Muthuvel, Veluswamy;Jaya, Vijayaraghavan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2929-2932
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    • 2014
  • Purpose: To evaluate the diagnostic performances of risk of malignancy index (RMI), CA-125 and ultrasound score in differentiating between benign and borderline or malignant ovarian tumors and find the best diagnostic test for referral of suspected malignant ovarian cases to gynaecologic oncologists. Materials and Methods: This prospective study covered 467 women with pelvic tumors scheduled for surgery at our hospital between July 2011 and July 2013. The RMI was obtained from ultrasound score, CA125 and menopausal status. The diagnostic values of each parameter and the RMI were determined and compared using Statistical Packages for Social Sciences Version 14.0.1. Results: In our study, 61% of ovarian tumors were malignant in the post-menopausal age group. RMI with a cut-off 150 had sensitivity of 84% and specificity of 97% in detecting ovarian cancer. CA-125>30 had a sensitivity of 84% and a specificity of 83%. An ultrasound score more than 2 had a sensitivity of 96% and specificity of 81%. RMI had the least false malignant cases thus avoiding unnecessary laparotomies. Ultrasound when used individually had the best sensitivity but poor specificity. Conclusions: Our study has demonstrated the RMI to be an easy, simple and applicable method in the primary evaluation of patients with pelvic masses. It can be used to refer suspected malignant patients to be operated by a gynaecologic oncologist. Other models of preoperative evaluation should be developed to improve the detection of early stage invasive, borderline and non-epithelial ovarian cancers.