• 제목/요약/키워드: Discordance

검색결과 187건 처리시간 0.031초

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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    • 제15권21호
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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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    • 제7권4호
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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.

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

  • 김동현;황건
    • Archives of Plastic Surgery
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    • 제37권4호
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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.

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

  • 박원규;강영한;조광호
    • 대한방사선기술학회지:방사선기술과학
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    • 제31권1호
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    • pp.25-31
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    • 2008
  • 목적: 이중 에너지 X선 흡수 계측(DEXA, Dual Energy X-ray Absorptiometry)을 이용한 골다공증 진단 시 부위 별로 골다공증에 대한 진단 불일치도를 파악하고, 연령의 증가에 따른 골다공증 진단 일치 여부를 조사하여 골절 예방과 치료에 대한 기초 자료를 제공하고자 하였다. 연구대상 및 방법: 골절 및 정형외과적 수술이 없는 여성 220명을 대상으로 요추부 $1{\sim}4$번과 고관절의 대퇴경부, Ward's triangle 그리고 전완부의 Ultra digital 부위의 골밀도를 측정하였다. 요추부와 대퇴경부, 전완부의 진단 일치 여부를 위해 각 부위 별 골감소증, 골다공증을 구별하여 분석하였고, 연령의 증가에 따른 진단의 불일치도를 파악하였다. 통계처리는 전완부와 대퇴 경부, 요추부 골밀도의 상관분석을 하였고, 각 부위 T-score 비교는 $x^2$-test를 사용하여 유의성 검정을 하였고, p < 0.05인 경우를 유의한 차이로 판정하였다. 결과: 대상자의 요추부 골밀도는 정상이 57명(25.9%), 골감소증군 86명(39.1%), 골다공증군은 77명(35.0%)이었다. 요추 4번에서는 골다공증군이 78명(35.5%)이었고, Ward's triangle은 126명(57.3%)에서 골다공증으로 진단되어 Ward's triangle에서 골밀도가 가장 낮았다. 요추부와 대퇴경부의 진단불일치율은 57%였고, 요추부와 전완은 43%, 전완과 대퇴경부는 51%로 나타났다. 정상군, 골감소증군, 골다공증군의 진단불일치율은 각각 39%, 63%, 42%로 나타나, 골감소증군에서 진단불일치율이 가장 높았다. 요추부가 정상일 때 불일치도는 30대, 40대, 50대, 60대, 70대에서 각각 25%, 23%, 11%, 65%, 86%로 나타나 60대 이후 불일치도가 급격히 높아졌다. 요추부가 골감소증이나 골다공증일 때는 30대, 40대, 50대, 60대, 70대에서 각각 62%, 55%, 36%, 20%, 9%로 나타나 연령이 높아질수록 불일치도는 낮아졌다. 결론: 골밀도는 연령증가에 따라 변화되고 부위에 따라 서로 차이가 있으므로 골밀도 검사는 요추와 대퇴경부, 전완을 각각 측정하여 차이를 살펴보는 것이 바람직하다. 진단의 불일치 정도가 60대와 70대, 그리고 골다공증군에서 가장 현저하였으며, 이는 두 부위 이상에서 불일치가 일어날 가능성이 있으므로 골절 위험 한계치의 측정에 각 부위별 골밀도 측정이 필요할 것으로 사료된다.

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

  • 김광환;서순원;원시연;박석건;김승렬;송화식;김갑득;조혜경;부유경;이현경
    • 한국의료질향상학회지
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    • 제5권2호
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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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심방심실착위를 동반한 양대혈관 우심실기시증의 수술치험 1례 (Surgical Correction of Double-outlet Right Ventricle with Atrioventricular Discordance - A case report -)

  • 최대융
    • Journal of Chest Surgery
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    • 제25권12호
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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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    • 제41권6호
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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.

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

  • 서용우;최원일;이정은;박훈표;고성민;원경숙;금동윤;이미영;전영준
    • Tuberculosis and Respiratory Diseases
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    • 제59권4호
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    • pp.374-379
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    • 2005
  • 배 경 : 폐확산능 ($D_LCO$)과 폐용적을 보정한 확산계수($D_LCO/VA$; KCO)는 폐포용적이 비 정상적인 경우 차이가 생긴다. 그러나, 기류제한으로 비 정상적인 폐포용적을 가지는 환자에서 이러한 차이의 의미는 연구되지 않았다. 본 연구는 기류제한이 있는 환자에서 기류제한의 호전에 따른 폐확산능과 확산계수의 변화를 연구하고자 한다. 방 법 : 기류제한이 있는 환자에서 기저 폐기능과 더불어 폐확산능을 측정하고, 일회호흡 $CH_4$ 희석법으로 폐포용적을 측정하였다. 기저치에 따라서 환자는 다음의 두 군으로 나누었다. 확산계수(예측치에 대한 백분율)와 확산능(예측치에 대한 백분율)의 비가 115%를 넘는 경우를 고차이군으로 하였고, 115% 미만인 경우를 저차이군으로 하였다. 기류제한을 치료 한 후 폐기능검사와 폐확산능을 반복해서 측정하였다. 결 과 : 고차이군과 저차이군의 기저 폐기능은 유의한 차이가 관찰되지 않았다. 두 군 모두 확산계수의 예측치에 대한 백분율은 평균 113%와 100%로 정상범위였다. 치료 후 추적 폐기능에서 $FEV_1$과 FVC는 저차이군에 비해 고차이군에서 증가하였다. 고차이군에서 치료 후 측정한 폐기능은 기저치에 비해 폐확산능과 폐포용적은 증가하였으나 저차이군에서는 유의한 차이는 관찰되지 않았다. 전폐용적과 잔기량은 치료 전후에 양군 모두에서 유의한 차이가 관찰되지 않았다. 결 론 : 기류제한이 있는 환자에서 확산계수는 정상 범위에 있지만 확산능이 감소한 경우 확산능이 감소하지 않은 환자에 비해 가역적인 기류폐색이 클 것으로 예측할 수 있다.

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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    • 제4권2호
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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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    • 제29권1호
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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.