• Title/Summary/Keyword: Discordance

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Alterations in Hormonal Receptor Expression and HER2 Status between Primary Breast Tumors and Paired Nodal Metastases: Discordance Rates and Prognosis

  • Ba, Jin-Ling;Liu, Cai-Gang;Jin, Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9233-9239
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    • 2014
  • Background: We aimed to evaluate the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression discordance in matched pairs of primary breast cancer and lymph node metastasis specimens and determine the effect of discordance on prognosis. Materials and Methods: Among all patients diagnosed with lymph node metastases from 2004 to 2007, primary tumors and paired lymph node metastases were resected from 209 patients. The status of ER, PR, and HER2 expression was analyzed immunohistochemically in 200, 194, and 193 patients, respectively. Discordance was correlated with prognosis. Results: Biomarker discordance between primary tumors and paired lymph node metastases was 25.0% (50/200) for ER status, 28.9% (56/194) for PR status, and 14.0% (27/193) for HER2 status. ER positivity was a significant independent predictor of improved survival when analyzed in primary tumors and lymph node metastases. Patients with PR-positive primary tumors and paired lymph node metastases displayed significantly enhanced survival compared to patients with PR-positive primary tumors and PR-negative lymph node metastases. Patients with ER- and PR-positive primary tumors and paired lymph node metastases who received endocrine therapy after surgery displayed significantly better survival than those not receiving endocrine therapy. Similalry treated patients with PR-negative primary tumors and PR-positive paired lymph node metastases also displayed better survival than those not receiving endocrine therapy. Conclusions: Biomarker discordance was observed in matched pairs of primary tumors and lymph node metastases. Such cases displayed poor survival. Thus, it is important to reassess receptor biomarkers used for lymph node metastases.

Object Recognition Algorithm with Partial Information

  • Yoo, Suk Won
    • International Journal of Advanced Culture Technology
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    • v.7 no.4
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    • pp.229-235
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    • 2019
  • Due to the development of video and optical technology today, video equipments are being used in a variety of fields such as identification, security maintenance, and factory automation systems that generate products. In this paper, we investigate an algorithm that effectively recognizes an experimental object in an input image with a partial problem due to the mechanical problem of the input imaging device. The object recognition algorithm proposed in this paper moves and rotates the vertices constituting the outline of the experimental object to the positions of the respective vertices constituting the outline of the DB model. Then, the discordance values between the moved and rotated experimental object and the corresponding DB model are calculated, and the minimum discordance value is selected. This minimum value is the final discordance value between the experimental object and the corresponding DB model, and the DB model with the minimum discordance value is selected as the recognition result for the experimental object. The proposed object recognition method obtains satisfactory recognition results using only partial information of the experimental object.

Discordance between Clinical Diagnosis and Reading of Computerized Tomography in Nasal Bone Fracture (코뼈 골절의 임상적 진단과 전산단층촬영 판독간의 불일치)

  • Kim, Dong-Hyun;Hwang, Kun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.375-379
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    • 2010
  • Purpose: The nasal bone is the most frequently fractured facial bone. Discordance between the CT reading by the radiologist and the diagnosis by the plastic surgeon is not uncommon. This study examined the discordance and proposes a method for reducing the rate of discordance. Methods: The CT readings by the radiologist were compared with the diagnosis by the plastic surgeon in 716 patients with a clinically suspected nasal bone fracture. The CT reading was classified as the following: a nasal bone fracture, suspicious nasal bone fracture, old nasal bone fracture, no nasal bone fracture. The sensitivity, specificity and positive predictive value of the CT reading were calculated. Results: A nasal bone fracture was diagnosed in 646 patients by the plastic surgeon and confirmed intraoperatively. The reading of a "nasal bone fracture", "suspicious nasal bone fracture", "old nasal bone fracture" and "no nasal bone fracture" was 85.8%, 4.6%, 0.6% and 9.1% respectively. The sensitivity and specificity of the CT reading were 95.0% and 92.9%, respectively. The positive predictive value of the CT reading was 99.3%. The reading of "nasal bone fracture" that was not a nasal bone fracture clinically was 17.1% (12 of 70), and the reading of "no nasal bone fracture" or "old nasal bone fracture" that was found to be a nasal bone fracture clinically was 3.3% (21 of 646). The discordance rate between the CT reading by the radiologist and the diagnosis by the plastic surgeon was 4.6%. Conclusions: To reduce the discordance rate, we propose to hold a meeting with the plastic surgery-radiology staff to communicate the information regarding a suspicious or old nasal bone fracture.

The Study of Diagnostic Results Discordance Analysis on BMD Using DEXA (이중에너지 X선 흡수 계측법을 이용한 골밀도 검사 시 진단불일치에 대한 분석)

  • Park, Won-Kyu;Kang, Yeong-Han;Jo, Gwang-Ho
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.25-31
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    • 2008
  • Purpose : This study was conducted to understand for the diagnostic discordance of bone mineral density(BMD) in DEXA(Dual Energy X-ray Absorptiometry). And the diagnostic difference between lumbar spine and femur neck, forearm was evaluated using T-score. Materials and Methods : We studied 220 females measured BMD on lumbar spine, and femur neck, forearm including ward's triangle and ultra digital(UD). We were distinguished T-score into normal, osteopenia, osteoporosis(WHO classification) and evaluated discordance rate according to age and degree of bone loss. Correlation analysis and chi-square test between L-spine, L-4, femur neck, Ward, Forearm, UD were carried out. Results : In the lumbar spine, the number of normal were in 57(25.9%), osteopenia in 86(39.1%), osteoporosis in 77(35.0%). In the L-4 and ward's triangle, the number of osteoporosis were in 78(35.5%), in 126(57.3%). There was significant correlation between lumbar, femur neck and forearm BMD in all cases. The discordance of BMD between lumbar and femur were 57%, lumbar and forearm 43%, forearm and femur 51%. The discordance rates of normal, osteopenic, osteoporotic groups were 39%, 64%, 43%, respectively, showing the highest discordance rate in osteopenia patients. In normal group of lumbar spine, the discordance rate was 25%, 23%, 11%, 65%, 86% in 30', 40', 50', 60', 70', respectively. In osteopenia, osteoporosis group of lumbar spine, the discordance rate was 62%, 55%, 36%, 20%, 9% in 30', 40', 50', 60', 70', respectively. Conclusion : It was different of the results of BMD with lumbar, femur and forearm site. The discordance rate was decreased with age in osteopenia, osteoporosis lumbar spine. In osteopenia group, the discordance rate was the highest. So, it is necessary that the BMD of lumbar, femur neck and forearm should be checked.

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Survey on Discordance Rate between Final Principal Diagnosis and Principal Diagnosis at Emergency Room (응급실 주진단명과 퇴원시 주진단명의 불일치도 조사)

  • Kim, Kwang Hwan;Seo, Sun Won;Won, Si Yeon;Park, Seok Gun;Kim, Seung Yul;Song, Hwa Sik;Kim, Kab Taug;Jo, Hey Kyung;Bu, You Kung;Lee, Hyun Kyung
    • Quality Improvement in Health Care
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    • v.5 no.2
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    • pp.216-223
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    • 1998
  • We surveyed the discordance rate of principal diagnosis made at emergency room(ER) & made at ward on discharge of the patients. Subjects were four hundred eighty cases who came to the ER of one third-line hospital from January 1, 1998 to January 31, 1998. The discordance rate was higher in patients admitted to medical department(8.2%) than surgical department(1.5%). If the patients were transferred to other department during hospital stay, discordance rate increased from 3.3% to 6.3%. In conclusion, discordance rate of principal diagnosis made at ER and made at ward was higher in patients with complicated problems. Medical record department should keep these findings in mind if it has a plan to support the management of ER record.

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Surgical Correction of Double-outlet Right Ventricle with Atrioventricular Discordance - A case report - (심방심실착위를 동반한 양대혈관 우심실기시증의 수술치험 1례)

  • 최대융
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1471-1475
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    • 1992
  • Within the group of congenital cardiac anomalies manifesting atrioventricular discordance, there exists a subset of hearts characterized by the additional presence of double outlet of the morphological right ventricle. Most of these hearts have associated pulmonary stenosis and abnormal direction of the cardiac apex, and all have a ventricular septal defect. Recently, a 10-year old boy underwent successful surgical correction of double outlet right ventricle with atrioventricular discordance. Diagnostic confirmation was made by 2-D echocardiography, cardiac catheterization and cineangiocardiography. The operation consisted of patch closure of ventricular septal defect so as to leave both great arteries draining the systemic[morphologically right] ventricle, and insertion of an extracardiac valved conduit between the morphological left ventricle and the distal end of the proximally oversewn pulmonary artery. Postoperative course was uneventful.

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Correlation of Clinical and Immunohistochemical Diagnosis in Patients with Pituitary Adenomas

  • Park, Sung-Ku;Jung, Shin;Jung, Tae-Young;Kim, In-Young;Kim, Soo-Han;Kang, Sam-Suk
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.367-370
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    • 2007
  • Objective: Pituitary adenomas are common neurological lesions believed to account for 10% to 15% of all primary brain tumors. There can be diagnostic confusion due to discordance of the preoperative endocrine and the postoperative immunohistochemical diagnosis. In this study, the rate of discordance between preoperative and postoperative findings and their clinical implications were investigated. Methods: From March 2005 to March 2006, 26 patients who underwent surgery for a pituitary adenoma were enrolled in this study. The preoperative pituitary hormone level and postoperative immunohistochemical results were compared and analyzed. Results: The median age of the patients was 38 years [range 15-66 years]. The male to female ratio was 8 to 18. The endocrine evaluation showed 16 hormonally-active and 10 hormonally-inactive adenomas. The immunohistochemical findings showed : 13 prolactin-positive, 1 GH-positive, 1 FSH-positive, 8 pleurihormone-positive and 3 stain-negative adenomas. The percentage of discordance observed between the preoperative endocrine and postoperative immunohistochemical diagnosis was 54%. Nine of 10 endocrine non-functioning adenomas showed : 3 PRL positive, 1 GH positive, 2 PRL+GH positive, 1 TSH+FSH positive, 1 FSH+ACTH+PRL positive and 1 FSH+LH+PRL positive adenomas by immunohistochemistry. Three endocrine PRL+GH secreting adenomas showed 2 PRL positive and 1 FSH+GH positive by immunohistochemistry. One endocrine PRL secreting and 1 GH secreting adenoma showed 1 PRL+ TSH positive and 1 GH+PRL positive by immunohistochemistry, respectively. The diagnosis of the other 12 pituitary adenomas showed concordance. Conclusion : The results of this study showed 54% discordance rate between the preoperative endocrine and postoperative immunohistochemical diagnosis for pituitary adenomas.

Importance of Carbon Monoxide Transfer Coefficient (KCO) Interpretation in Patients with Airflow Limitation (기류제한 환자의 일산화탄소확산능 해석에서 폐용적 보정의 의의)

  • Seo, Yong Woo;Choi, Won-Il;Lee, Jeong Eun;Park, Hun Pyo;Ko, Sung Min;Won, Kyoung Sook;Keum, Dong Yoon;Lee, Mi-Young;Jeon, Young June
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.374-379
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    • 2005
  • Background : The single-breath carbon monoxide diffusion capacity (DLCO) and the per unit alveolar volume (KCO; $D_LCO/VA$) gave discordant values when there was an abnormal alveolar volume (VA). However, the clinical significance of the discordant values in patients with airflow limitation has not been examined. This study investigated the $D_LCO$ and KCO changes after improving the airflow limitation. Methods : The baseline $D_LCO$ and KCO with lung volume were measured in patients with an airflow obstruction. The effective alveolar volume was measured using the single-breath $CH_4$ dilution method. The patients divided into two groups according to the baseline values: (1) increased KCO in comparison with the $D_LCO$ (high discordance) (2) decreased or not increased KCO in comparison with the $D_LCO$ (low discordance). The diffusion capacity and lung volume were measured after treatment. Results : There was no significant difference in the baseline lung volumes including the $FEV_1$ and FVC between the two groups. The $FEV_1$ and FVC were significantly increased in the high discordance group compared with the low discordance group after treating the airflow limitation. The $D_LCO$ and alveolar volume were significant higher in the high discordance group compared with the low discordance group while the TLC was not. Conclusion : The discordance between the $D_LCO$ and KCO could be translated into an airflow reversibility in patients with an airflow limitation.

A Study on the Characteristics of the Crossover Expressed in Modern Fashion -Focused on Sub -Cultures

  • Kim, Moon-Sook;Kim, Hyeon-Ju
    • The International Journal of Costume Culture
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    • v.4 no.2
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    • pp.115-123
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    • 2001
  • The crossover in fashion refers to the coordination of different items, each with a different atmosphere. In a broad sense, it is the mutual exchange across the existing areas, that is, the creation of a new style by disparate and opposite elements coexisting in a look. This paper studies typical features of the crossover shown in modern fashion based on sub-culture by examining the concept and formation factors of the crossover through social aspects rather than particular art modes to predict the current fashion and suggest a new direction. Crossover fashion appeared in social and cultural environments, has four characteristics : the visual discordance of sexes, the appearance of the lingerie look, the mixture of folk style, and the appearance of the reactionary mode. The crossover, appeared in sub-cultures and diffused into the public, may be considered the creation of a new sense of beauty and a possibility for the future. It is expected to keep expanding ifs range in fashion, since it is an expression of human will to restore liberal sensibility not confined to formality.

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Population Genetic Structure of Carassius auratus (Pisces: Cypriniformes) in South Korea Inferred from AFLP Markers: Discordance with Mitochondrial Genetic Structure

  • Jung, Jongwoo
    • Animal Systematics, Evolution and Diversity
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    • v.29 no.1
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    • pp.18-22
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    • 2013
  • A recent study on the mitochondrial genetic variation of the Carassius auratus population in South Korea suggested that there are 3 distinct mitochondrial lineages in the country, and that they are geographically separated between westward rivers and southward rivers, respectively. In this study, the population genetic structure of amplified fragment length polymorphism (AFLP) of Carassius auratus was investigated. The results of analysis of molecular variance (AMOVA) supported the geographic distinction between westward and southward river populations, but only 3.66% of total genetic variance lies among these populations. The panmicticity of the AFLP genetic variation is backed up by the results of the neighbor-joining dendrogram drawn from a linearized pairwise $F_{ST}$ matrix and Bayesian clustering analysis. The discordance of genetic structure between mitochondrial and AFLP genetic variation may come from difference in effective population size between these markers and/or gene flow between westward and southward river populations through river capture events.