• Title/Summary/Keyword: Cut-off values

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Performance of HPV DNA Testing with Hybrid Capture 2 in Triaging Women with Minor Cervical Cytologic Abnormalities (ASC-US/LSIL) in Northern Thailand

  • Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Srisomboon, Jatupol;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10961-10966
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    • 2015
  • Background: Minor cervical cytologic abnormalities include atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). Approximately 10-20% of women with minor cytologic abnormalities have histologic high-grade squamous intraepithelial or worse lesions (HSIL+). In Thailand, women with minor cytologic abnormalities have a relatively high risk of cervical cancer, and referral for colposcopy has been suggested. A triage test is useful in the selection of women at risk for histologic HSIL+ to reduce the colposcopy burden. The aim of this study was to assess the performance of high-risk HPV DNA test in triage of women with minor cytologic abnormalities in northern Thailand. Materials and Methods: All women with ASC-US/LSIL cytology who were referred to our colposcopy clinic from October 2010 to February 2014 were included. HPV DNA testing was performed using Hybrid Capture 2 (HC2). All patients received colposcopic examination. Accuracy values of HC2 in predicting the presence of histologic HSIL+ were calculated. Results: There were 238 women in this study (121 ASC-US and 117 LSIL). The HC2 positivity rate was significantly higher in the LSIL group than in ASC-US group (74.8% versus 41.0%, p<0.001). Histologic HSIL+ was detected in 9 women (7.4%) in the ASC-US group and 16 women (13.7%) in the LSIL group (p=0.141). There was no histologic HSIL+ detected among HC2-negative cases (sensitivity and negative predictive value of 100%). The performance of HC2 triage was highest among women aged >50 years with ASC-US cytology. An increase in the cut-off threshold for positive HC2 resulted in a substantial decrease of sensitivity and negative predictive value. Conclusions: HPV DNA testing with HC2 shows very high sensitivity and negative predictive value in triage of women with minor cervical cytologic abnormalities in northern Thailand. An increase of the cut-off threshold for HC2 triage is not recommended in this region.

Effect of Heat-Treat Methods on the Soluble Calcium Levels in the Commercial Milk Products

  • Yoo, Sung-Ho;Kang, Seung-Bum;Park, Jin-Ho;Lee, Kyung-Sang;Kim, Jin-Man;Yoon, Sung-Sik
    • Food Science of Animal Resources
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    • v.33 no.3
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    • pp.369-376
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    • 2013
  • Milk is well known to be rich in some nutrients such as protein, calcium, phosphorus, and vitamins. In particular, absorption and bioavailability of calcium receive lots of attention because calcium is very little absorbed until it is changed to the ionized form in the intestine. In this study, concentration of the soluble calcium was determined in the commercial bovine milk products, which were processed by different heat-treatment methods for pasteurization. As for general constituents, lactose, fat, protein, and mineral were almost same in the liquid milk products by different processors. Ultrafiltration of the skimmed milk caused little change in the permeate as for lactose content but both fat and protein decreased. pH values ranges from 6.57-6.62 at room temperature and slightly increase after centrifugation, 10,000 g, 10 min. Rennet-coagulation activity was the lowest in the ultra high temperature (UHT-)milk compared to the low temperature long time (LTLT-) and high temperature short time (HTST-)milk products. Each bovine milk products contains 1056.5-1111.3 mg/kg of Ca. The content of sulfhydryl group was the lowest in raw milk compared to the commercial products tested. For the skimmed milks after ultrafiltration with a membrane (Mw cut-off, 3 Kd), soluble Ca in the raw milk was highest at 450.2 mg/kg, followed by LTLT-milk 336.4-345.1 mg/kg, HTST-milk 305.5-313.3 mg/kg, UHT-milk 370.3-380.2 mg/kg in the decreasing order. After secondary ultrafiltration with a membrane (Mw cut-off, 1 kD), total calcium in raw milk had a highest of 444.2 mg/kg, and those in the market milk products. As follow: UHT-milk, 371.3 to 378.2 mg/kg; LTLT-milk, 333.3 to 342.2 mg/kg; HTST-milk 301.9 to 311.2 mg/kg in a decreasing order.

Diagnostic Utility of Pleural Fluid CEA and CYFRA 21-1 for Malignant Pleural Effusions (악성 흉막액에서 CEA와 CYFRA 21-1의 진단적 유용성)

  • Chung, Jae Ho;Choi, Jeong Eun;Park, Moo Suk;Hwang, Sang Yon;Moon, Jin Wook;Kim, Young Sam;Chang, Joon;Kim, Joo Hang;Kim, Sung Kyu;Kim, Se Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.32-36
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    • 2004
  • Background : The purpose of this study was to evaluate the usefulness of the pleural fluid carcinoembryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1) tumor markers as complementary tools for the diagnosis of malignant pleural effusions. Patients and Methods : The levels of pleural and serum CEA and CYFRA 21-1 were prospectively assayed in 222 patients with pleural effusions (150 benign effusions, 57 bronchogenic carcinomas and 15 metastatic carcinomas). Results : The levels of pleural fluid CEA and CYFRA 21-1 in the malignant effusions were significantly higher than those in the benign effusions. With a specificity of 95%, the cut off values for the CEA and CYFRA 21-1 in pleural effusions were 5 and 89 ng/ml, respectively. The diagnostic sensitivities of the pleural fluid CEA and CYFRA 21-1 in malignant effusions were 72 and 54%, respectively, whereas using a combination of the two, the sensitivity increased to 87% (p<0.05). Conclusions : These findings suggest that a combination of the pleural fluid CEA and CYFRA 21-1 in pleural effusions can be useful in the diagnosis of malignant pleural effusions.

Analysis of Hematological Factor to Predict Plaque of the Carotid Artery in Ultrasound Images (경동맥초음파에서 죽상경화반을 예측하는 혈액학적 수치의 분석)

  • Yang, Sung Hee;Kang, Se Sik;Lee, Jinsoo
    • Journal of the Korean Society of Radiology
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    • v.10 no.3
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    • pp.187-193
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    • 2016
  • In this study, we performed the carotid artery ultrasound targeting 140 subjects who have conducted to evaluate the changes in intima-media thickness(IMT) and plaque correlated with the presence or absence of a hematological test of the carotid artery. Considering that the IMT thickness more than 1mm is abnormal based on the carotid artery ultrasound to assess the presence or absence of plaque, and examined the correlation by classifying the blood lipid value and the fasting blood glucose level through the serum test. Consequently, the fasting blood glucose level is being analyzed as independent predictors of causing dental plaque(p=0.033), cut off value was determined as 126 mg/dL(sensitivity 56.25%, specificity 68.38%) in ROC curve analysis. Furthermore, the odds ratio appeared 1.01 times the value in the Logistic regression. Therefore, it seemed that the necessity to prospective studies in a number of subjects are considered, and also taking into account a number of blood test values along with the sonography of the carotid artery as a valuable part for effective primary prevention and follow-up observation of the cardiac and brain vascular disease is highly recommended.

Scoring Methods of Polysomnography for Diagnosis of Sleep Apnea in Adolescents (청소년에서 수면 무호흡 진단을 위한 수면 다원 검사의 판독 방법)

  • Lee, Keu Sung;Sheen, Seung Soo;Lee, Il Jae;Choi, Byung-Joo;Choi, Ji Ho;Park, Do-Yang;Kim, Han Tai;Kim, Hyun Jun
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.11
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    • pp.593-599
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    • 2018
  • Background and Objectives Respiratory scoring guidelines for children and adults have been used for evaluating adolescents both in the 2007 and 2012 American Academy of Sleep Medicine (AASM) scoring manuals. We compared the scoring methods of polysomnography used in these scoring manuals, where pediatric and adult scoring rules were adopted for the diagnosis of sleep apnea in adolescents. Subjects and Method 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored according to both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. Results Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method were significantly higher than those using the 2007 method. The difference in AHI compared between pediatric and adult scores with the 2012 AASM scoring system was markedly decreased from that with the 2007 method. There was a significant discordance in sleep apnea diagnosis between pediatric and adult scoring rules in the 2012 method. Conclusion Both pediatric and adult rules were used for the diagnosis of adolescent sleep apnea in the 2012 method. However, there was significant discordance in the diagnosis between pediatric and adult scoring guidelines in the 2012 AASM manual, probably due to different cut-off values of AHI for the diagnosis of sleep apnea in pediatric (${\geq}1$) and adult (${\geq}5$) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis of sleep apnea in adolescents.

The predictability of dentoskeletal factors for soft-tissue chin strain during lip closure

  • Yu, Yun-Hee;Kim, Yae-Jin;Lee, Dong-Yul;Lim, Yong-Kyu
    • The korean journal of orthodontics
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    • v.43 no.6
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    • pp.279-287
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    • 2013
  • Objective: To investigate the dentoskeletal factors which may predict soft-tissue chin strain during lip closure. Methods: The pretreatment frontal and lateral facial photographs and lateral cephalograms of 209 women (aged 18-30 years) with Angle's Class I or II malocclusion were examined. The subjects were categorized by three examiners into the no-strain and strain groups according to the soft-tissue chin tension or deformation during lip closure. Relationships of the cephalometric measurements with the group classification were analyzed by logistic regression analysis, and a classification and regression tree (CART) model was used to define the predictive variables for the group classification. Results: The lower the value of the overbite depth indicator (ODI) and the higher the values of upper incisor to Nasion-Pogonion (U1-NPog, mm), overjet, and upper incisor to upper lip (U1-upper lip, mm), the more likely was the subject to be classified into the strain group. The CART showed that U1-NPog was the most prominent predictor of soft-tissue chin strain (cut-off value of 14.2 mm), followed by overjet. Conclusions: To minimize strain of the soft-tissue chin, orthodontic treatment should be oriented toward increasing the ODI value while decreasing the U1-NPog, overjet, and U1 upper lip values.

Developing Questionnaire of BiJeung(痺證) which is similar to Arthralgia and Paresthesia Syndrome (비증 설문문항 개발)

  • Ahn, Ji Hoon;Lee, Sun-Ho;Park, Young-Jae;Park, Young-Bae
    • The Journal of Korean Medicine
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    • v.34 no.3
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    • pp.96-105
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    • 2013
  • Objectives: Bi Jeung (비증) is a pain syndrome derivative of pathological patterns of East Asian medicine. The purpose of this study was to develop a self-rated questionnaire for Bi Jeung. Methods: Twelve questionnaire items for Bi Jeung (3 items for the Wind Bi, 5 items for the Cold Bi, and 4 items for the Dampness Bi) were extracted through the literature review. These items were presented to the 18 Korean medical doctors who specialized in pain medicine to conduct two sessions of the Delphi method. The Korean medical doctors were asked to rate the importance of each item for the corresponding Bi syndromes, using a Likert 7-point scale, and were asked to propose which item should be additionally included to increase determinant power to each Bi syndrome. We determined the 4 points of the importance as a cut-off point of each item. Results: Through two sessions of the Delphi method, two items were deleted because their mean values of the importance were below 4 point. Korean medical doctors proposed to add three items for the Bi Jeung. However, the mean values of only two among the three items were over 4 points, so finally 12 items (3 items for the Wind Bi, 5 items for the Cold Bi, and 4 items for the Damp Bi) were determined for the Bi Jeung questionnaire. Conclusions: It is concluded that a 12 item-Bi Jeung questionnaire comprising the three subcategories of the Bi Jeung (Wind, Cold, and Dampness Bis) possesses contents validity through literature review and Delphi methods.

Fine Needle Aspiration Cytology of the Breast Lesions - Application of the Masood's Scoring System - (유방 종괴의 세침흡인 세포학적 소견 - Masood 등급에 따른 분류 -)

  • Kim, Ae-Lee;Kim, Hye-Sun;Kim, Han-Kyeom;Won, Nam-Hee;Park, Mee-Ja;Koo, Bum-Hwan
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.45-54
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    • 1998
  • Fine needle aspiration cytology is considered as a useful diagnostic procedure in management of patients with breast lesions. This study was undertaken to evaluate the scoring system of Masood in the interpretation of breast aspirates, to establish the most useful cytologic criteria for the diagnosis of breast lesions, and to subclassify the benign breast diseases. To assess the feasibility of a cytologic grading system, 57 cases of benign breast disease, 61 cases of malignant breast disease were studied, respectively. The aspirates were evaluated for the cellular arrangement, the degree of cellular pleomorphism and anisonucleosis, and the presence of myoepithelial cells and nuceoli. Values ranging from 1 to 4 were assigned to each criterion and the sum of the individual values was made for each case. The presence of stroma, apocrine metaplasia, foamy histiocytes and inflammatory cells, background of the smear, and cellularity were also evaluated. Cut-off value of the scoring system of Masood between benign and malignant lesion was 15. Among the cytologic criteria, cellular arrangement, presence of myoepithelial cells, nucleoli, and stroma, status of chromatin pattern, and background of smear were useful criteria in the differentiation between benign and malignant lesions. Application of the scoring system of Masood does not always make the accurate diagnosis and the subclassification of benign breast disease.

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IgG Western Blot for Confirmatory Diagnosis of Equivocal Cases of Toxoplasmosis by EIA-IgG and Fluorescent Antibody Test

  • Khammari, Imen;Saghrouni, Fatma;Yaacoub, Alia;Meksi, Sondoss Gaied;Ach, Hinda;Garma, Lamia;Fathallah, Akila;Said, Moncef Ben
    • Parasites, Hosts and Diseases
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    • v.51 no.4
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    • pp.485-488
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    • 2013
  • The performance values of available techniques used in serodiagnosis of toxoplasmosis are satisfactory but they raise problems of equivocal and discordant results for very low IgG titers. Recently marketed, LDBio-Toxo II IgG Western blot (IB) showed an excellent correlation with the dye test. We estimated the proportion of equivocal and discordant results between the enzyme immunoassay Platelia Toxo IgG (EIA-IgG) and fluorescent antibody test (FAT) and assessed the usefulness of the IB as a confirmatory test. Out of 2,136 sera collected from pregnant women, 1,644 (77.0%) tested unequivocally positive and 407 (19.0%) were negative in both EIA-IgG and FAT. The remaining 85 (4%) sera showed equivocal or discordant results. Among them, 73 (85.9%) were positive and 12 (14.1%) were negative in IB. Forty-one (89.1%) equivocal sera in EIA-IgG and 46 (86.8%) equivocal sera in FAT were positive in IB. Reducing the cut-off values of both screening techniques improved significantly their sensitivity in detecting very low IgG titers at the expense of their specificity. In conclusion, equivocal results in routine-used techniques and their discordance in determination of the immune status in pregnancy women were not uncommon. IB test appeard to be highly useful in these situations as a confirmatory technique.

Genetic Diversity of Multi-resistant Salmonella enterica Serotype Typhimurium Isolates from Animals and Humans

  • Woo Yong-Ku;Lee Su-Hwa
    • Journal of Microbiology
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    • v.44 no.1
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    • pp.106-112
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    • 2006
  • In this study, the genetic diversities of multi-resistant Salmonella typhimurium (ST) isolates were analyzed via the application of both pulsed field gel electrophoresis (PFGE) and Polymerase chain reaction (PCR) analysis methods, using 6 kinds of primers (REP, ERIC, SERE, BOX, P-1254 and OPB-17). And their discriminative abilities (DA) were also compared in order to determine the most effective and reliable analysis method. 118 S. typhimurium isolates, cultured from diverse animals and human patients in Korea beginning in 1993, were analyzed and subjected to a comparison of Simpson's index of diversity (SID), using both PFGE and PCR methods. PFGE by XbaI enzyme digestion allowed for discrimination into 9 pulsotypes, with high SID values (0.991) on the genomic DNA level. This shows that PFGE is a very discriminative genotypic tool, and also that multiple clones of S. typhimurium isolates had existed in domestic animals and humans in Korea since 1993. However, we could ultimately not to trace the definitive sources or animal reservoirs of specific S. typhimurium isolates examined in this study. Depending on the SID values, the combined method (7 kinds of method) was found to be the most discriminative method, followed by (in order) SERE-PCR, REP-PCR, ERIC-PCR, PFGE & OPB-17 (RAPD), P-1254 (RAPD), and BOX-PCR at the $80\%$ clone cut-off value. This finding suggests that the REP-PCR method (which utilizes 4 primer types) may be an alternative tool to PFGE for the genotyping of S. typhimurium isolates, with comparable cost, time, and labor requirement. The establishment of a highly reliable and discriminatory method for epidemiologic analysis is considered necessary in order for researchers to trace the sources of specific pathogens and, consequently, to control and prevent the spread of epidemic S. typhimurium isolates to humans.