• Clinical and Experimental Pediatrics
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• v.57 no.4
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• pp.186-192
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• 2014

Purpose: The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia. Methods: A total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared. Results: The proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L. Conclusion: The proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.

• Clinical and Experimental Pediatrics
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• v.55 no.1
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• pp.11-17
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• 2012

Purpose: Early identification of neonatal sepsis is a global issue because of limitations in diagnostic procedures. The objective of this study was to compare the diagnostic accuracy of neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis. Methods: A prospective study enrolled newborns with documented sepsis (n=11), clinical sepsis (n=12) and control newborns (n=14). CRP, neutrophil CD64, complete blood counts and blood culture were taken at the time of the suspected sepsis for the documented or clinical group and at the time of venipuncture for laboratory tests in control newborns. Neutrophil CD64 was analyzed by flow cytometry. Results: CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis, CD64 and CRP had a sensitivity of 91% and 9%, a specificity of 83% and 83%, a positive predictive value of 83% and 33% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.0 mg/dL for CD64 and 1.0 mg/dL for CRP. The area under the receiver-operating characteristic curves for CD64 index and CRP were 0.955 and 0.527 ($P$ <0.01), respectively. Conclusion: These preliminary data show that diagnostic accuracy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1289-1293
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• 2015

Background: Anal intraepithelial lesions (AIL) are likely to represent a precursor for anal cancer. Women infected with human immunodeficiency virus (HIV) may be at higher risk of anal cancer but a screening program for AIL still is not routinely recommended. We here studied the relationship of dysplastic cells from cervical and anal cytology in HIV-infected women. Materials and Methods: This prospective study was conducted in Prapokklao Hospital, Thailand during 2013-2014. Five hundred and ninety nine HIV-infected women were recruited. Participants who had cytological reports of equally or over "abnormal squamous/glandular cells of undetermined significance" (ASC-US) were classified as abnormal cervical or anal cytology. Descriptive statistics and logistic regression analysis were used to evaluate correlations between groups. Results: HIV-infected women with abnormal cervical cytology had 3.8 times more risk (adjusted odd ratio 3.846, 95% confidence interval 1.247-11.862, p-value. 019) for abnormal anal cytology. The major problem of the anal Pap test in this study was the inadequacy of the collected specimens for evaluation (34.4%, 206/599). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of cervical and anal Pap tests were 93.9/12.0, 87.3/96.9, 39.7/21.4, 99.4/94.1 and 88.1/91.4 percent, respectively. Conclusions: Abnormal cervical cytology in HIV-infected women indicates elevated risk for abnormal anal cytology. The sensitivity of the anal Pap test for detection of AIL 2/3 in HIV-infected women was quite low while specificity was excellent. Inadequacy of specimen collection for evaluation was a major limitation. Improvement of sample collection is recommended for future investigations.

• Imaging Science in Dentistry
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• v.53 no.2
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• pp.101-108
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• 2023

Purpose: The aim of this study was to conduct a scoping review and meta-analysis to provide overall estimates of the recall and precision of artificial intelligence for detection and segmentation using oral and maxillofacial cone-beam computed tomography (CBCT) scans. Materials and Methods: A literature search was done in Embase, PubMed, and Scopus through October 31, 2022 to identify studies that reported the recall and precision values of artificial intelligence systems using oral and maxillofacial CBCT images for the automatic detection or segmentation of anatomical landmarks or pathological lesions. Recall (sensitivity) indicates the percentage of certain structures that are correctly detected. Precision (positive predictive value) indicates the percentage of accurately identified structures out of all detected structures. The performance values were extracted and pooled, and the estimates were presented with 95% confidence intervals(CIs). Results: In total, 12 eligible studies were finally included. The overall pooled recall for artificial intelligence was 0.91 (95% CI: 0.87-0.94). In a subgroup analysis, the pooled recall was 0.88 (95% CI: 0.77-0.94) for detection and 0.92 (95% CI: 0.87-0.96) for segmentation. The overall pooled precision for artificial intelligence was 0.93 (95% CI: 0.88-0.95). A subgroup analysis showed that the pooled precision value was 0.90 (95% CI: 0.77-0.96) for detection and 0.94 (95% CI: 0.89-0.97) for segmentation. Conclusion: Excellent performance was found for artificial intelligence using oral and maxillofacial CBCT images.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.146-151
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• 2008

During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.

• Journal of Veterinary Clinics
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• v.33 no.2
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• pp.102-106
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• 2016

More than 20 years after the first report of porcine reproductive and respiratory syndrome virus (PRRSV) in Korea, the disease is still having major impact on domestic pig health and relevant industries. Although ELISA tests are commonly used by veterinarians to guide herd management, data on diagnostic performance of the test in field settings are very limited. The objective of this study was to evaluate two commercially available PRRSV ELISA (IDEXX PRRS X3 ELISA and Bionote PRRSV ELISA 4.0) to detect antibodies against PRRSV on serum samples. To this end, a total of 1,108 sera were recruited from 35 swine farms located in Gyeonggi province and tested at the Gyeonggi Province Veterinary Service Center. All tests were performed according to the manufacturer's instructions, by laboratory technicians who routinely perform PRRS testing on blood samples. Samples were collected from two sources of swine populations with different PRRS prevalence; 60 samples (5.4%) were originated from breeding farms and the remaining 1,048 samples (94.6%) were from farrow-to-finish farms. We applied Bayesian latent class model (LCM) for two-tests in the two-population when the accuracy of the gold standard is not available. The model estimated that Bionote ELISA was a bit more specific but slightly less sensitive. The estimated sensitivity and specificity of the IDEXX ELISA were 99.8% (95% CI 98.1-100%) and 86.4% (95% CI 81.4-96.5%), respectively. Sensitivity, specificity, positive predictive value and negative predictive value for Bionote kit were 98.7% (95% CI 92.8-100%), 89.8% (95% CI 86.2-93.1%), 93.8% (95% CI 91.5-96.0%), and 97.8% (95% CI 87.1-100%), respectively. Based on the Bayesian 95% credible intervals, the sensitivity and specificity of the two ELISAs were not significantly different each other when assuming that two kits were imperfect, indicating that two kits performed equally well in terms of sensitivity and specificity in our filed setting.

• Neonatal Medicine
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• v.25 no.3
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• pp.102-108
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• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

• Journal of the Korean Geotechnical Society
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• v.37 no.12
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• pp.33-45
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• 2021

In this study, predictive equations of the normalized shear modulus and the damping ratio curves for loose medium sands reinforced by vinyl strip-cement are proposed. Based on the results of a series of resonant-column tests (Yu, et al., 2018) conducted under the confining stresses of 15, 30, 60 kPa on sand specimens prepared with 40% relative density and reinforced by various contents of vinyl strip (0.0, 0.1, 0.3, 0.4%) and cement (0, 1, 2%), the equations estimating the normalized shear modulus and the damping ratio are proposed as functions of reinforcing conditions and confining stresses. The comparison between predicted and measured values of shear modulus and damping ratio shows a good agreement and the reliability of proposed predictive equations are validated by high R2-value greater than 0.9. Therefore, it is expected that the time and the cost required for constructing the normalized shear modulus and the damping ratio curves will be much reduced by using proposed equations in this study since those can easily be estimated without conducting resonant-column test.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1651-1655
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• 2012

Background: Our aim was to investigate the efficacy of the Pap test in combination with the ThinPrep cytological test (TCT) in screening for cervical cancer in China. Design: From March 2006 to October 2008, 988 women with the mean age $46.4{\pm}10.5$ years (range, 23-80 years) were recruited to receive cervical cancer screening. Pap test results ${\geq}$ grade III and TCT findings ${\geq}$ ASCUS/AGUS were considered abnormal. Subjects with a Pap test result ${\geq}$ grade IIb received TCT. Colposcopy and biopsies were performed in all participants, and final diagnosis was based on pathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index for predicting CIN I or above were determined. Results: The sensitivity, specificity, PPV, NPV and Youden index of the Pap test were 43.1%, 97.2%, 70.0%, 91.9%, and 40.3%, respectively. The same values for TCT in predicting CIN were 80.0%, 63.2%, 16.0%, 97.3%, and 43.2%, respectively. The two tests in combination gave values for predicting CIN of 64.8%, 87.6%, 43.6%, 94.4%, and 53.5%, respectively. Combined testing exhibited the highest Youden index (53.4%). Conclusion: The Pap test with a reduced threshold in combination with the TCT has high sensitivity and high specificity in screening for cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7381-7384
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• 2015

This study was conducted to 1206 women who had cervical cancer screening at Chonburi Cancer Hospital. The spilt-sample study aimed to compare the efficacy of abnormal cervical cells detection between liquid-based cytology (LBC) and conventional cytology (CC). The collection of cervical cells was performed by broom and directly smeared on a glass slide for CC then the rest of specimen was prepared for LBC. All slides were evaluated and classified by The Bethesda System. The results of the two cytological tests were compared to the gold standard. The LBC smear significantly decreased inflammatory cell and thick smear on slides. These two techniques were not difference in detection rate of abnormal cytology and had high cytological diagnostic agreement of 95.7%. The histologic diagnosis of cervical tissue was used as the gold standard in 103 cases. Sensitivity, specificity, positive predictive value, negative predictive value, false positive, false negative and accuracy of LBC at ASC-US cut off were 81.4, 75.0, 70.0, 84.9, 25.0, 18.6 and 77.7%, respectively. CC had higher false positive and false negative than LBC. LBC had shown higher sensitivity, specificity, PPV, NPV and accuracy than CC but no statistical significance. In conclusion, LBC method can improve specimen quality, more sensitive, specific and accurate at ASC-US cut off and as effective as CC in detecting cervical epithelial cell abnormalities.