• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4933-4938
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• 2014

Background: Although various tumor markers have been utilized in management of stomach cancer (SC), only a few reports have described relevance of examples such as CYFRA 21-1 and neuron-specific enolase (NSE). The purpose of this study was to evaluate the potential diagnostic performance of carcinoembryonic antigen (CEA), CA 19-9, CA72-4, CYFRA 21-1 and NSE in patients with SC. Materials and Methods: Ninety-six SC patients with pathologic confirmation between 2012 and 2013 were enrolled. Serum levels of five tumor markers were analyzed using a solid-phase immunoradiometric assay. Receiver operating characteristic (ROC) curves were plotted for the five tumor markers to investigate their diagnostic powers and adjusted cutoff values derived from analysis of ROC curves were evaluated to calculate the sensitivity of each for SC with recommended cutoff values. Results: Based on two different cutoff values (recommended and adjusted), CYFRA 21-1 (${\geq}2.0$ and 1.2 ng/ml) had a respective sensitivity of 50% and 78.1%, compared with 8.3% and 18.8% for CEA (${\geq}7.0$ and 3.9 ng/ml), 15.6% and 18.8% for CA 19-9 (${\geq}37$ and 26.7 ng/ml), 28.1% and 9.6% for CA 72-4 (${\geq}4.0$ and 13 ng/ml) and 7.3% and 7.3% for NSE (${\geq}14.7$ and 15.0 ng/ml) in the initial staging of primary SC. The area under the curve (AUC) for CYFRA 21-1, with a value of 0.978 (95% confidence interval, 0.964-0.991) was comparatively the highest. Univariate analysis revealed significant relationships between tumor marker level and lymph node involvement, metastasis and staging with CYFRA 21-1, CA 72-4 and NSE. Conclusions: CYFRA 21-1 was the most sensitive tumor marker and showed the most powerful diagnostic performance among the five SC tumor markers. NSE and CA 72-4 are significantly related to lymph node involvement, metastasis or stage. Further evaluations are warranted to clarify the clinical usefulness and prognostic prediction of these markers in SC.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7635-7638
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• 2013

Background: Sperm-associated antigen 9 (SPAG9) has been recently proposed as a novel biomarker for early diagnosis of several human tumors, including ovarian, cervical and breast cancers. Its clinical value remains to be clarified for endometrial cancer (EC). In this study, we investigated the utility of serum SPAG9 levels in diagnosis of EC and its association with important clinicopathological parameters. Materials and Methods: This cross-sectional study was performed at a tertiary women's referral center in Ankara, Turkey. Preoperative serum samples were collected from patients surgically treated for endometrial cancer between June 2012-April 2013. Similar aged women with a biopsy proven benign endometrium were used as controls. Serum SPAG9 levels were measured with an enzyme-linked immunosorbent assay (ELISA) method and assessed for links with clinicopathological factors. Receiver operating characteristic (ROC) curve analysis was performed to assess power of SPAG9 levels for EC prediction. P values less than 0.05 were considered statistically significant. Results: A total of 63 women with EC and 27 with benign endometrium were included in the study. Mean age in the EC group was $58.7{\pm}1.1$. Median SPAG9 levels in the EC and control groups were 18.3 (range, 12.7-53.8) and 14.1 (range, 4.3-65.3), respectively (p<0.001). A cut-off value of 17 ng/ml for SPAG9 predicted presence of malignant endometrium with 74% sensitivity and 83% specificity [Area under curve (AUC)=0.82, p<0.001]. SPAG9 levels did not demonstrate any significant association with histological type, FIGO stage, tumor grade, size, myometrial invasion, lymphovascular space invasion, cervical involvement, adnexal involvement, peritoneal cytology or lymph node status (all p>0.05). Conclusions: Testing for SPAG9 may be useful for early detection of EC in asymptomatic high-risk women. Its role in post-treatment follow-up and early detection of recurrence should be assessed in future trials.

• Journal of Distribution Science
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• v.12 no.11
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• pp.77-83
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• 2014

Purpose - The National Agricultural Cooperative Federation of Korea and National Fisheries Cooperative Federation of Korea have prosecuted both financial and retail businesses. As cooperatives are public institutions and receive government support, their sound management is required by the Financial Supervisory Service in Korea. This is mainly managed by CAEL, which is changed by CAMEL. However, NFFC's business section, managing the finance and retail businesses, is unified and evaluated; the CAEL model has an insufficient classification to evaluate the retail industry. First, there is discrimination power as regards CAEL. Although the retail business sector union can receive a higher rating on a CAEL model, defaults have often been reported. Therefore, a default prediction model is needed to support a CAEL model. As we have the default prediction model using a subdivision of indexes and statistical methods, it can be useful to have a prevention function through the estimation of the retail sector's default probability. Second, separating the difference between the finance and retail business sectors is necessary. Their businesses have different characteristics. Based on various management indexes that have been systematically managed by the National Fisheries Cooperative Federation of Korea, our model predicts retail default, and is better than the CAEL model in its failure prediction because it has various discriminative financial ratios reflecting the retail industry situation. Research design, data, and methodology - The model to predict retail default was presented using logistic analysis. To develop the predictive model, we use the retail financial statements of the NFCF. We consider 93 unions each year from 2006 to 2012 to select confident management indexes. We also adapted the statistical power analysis that is a t-test, logit analysis, AR (accuracy ratio), and AUROC (Area Under Receiver Operating Characteristic) analysis. Finally, through the multivariate logistic model, we show that it is excellent in its discrimination power and higher in its hit ratio for default prediction. We also evaluate its usefulness. Results - The statistical power analysis using the AR (AUROC) method on the short term model shows that the logistic model has excellent discrimination power, with 84.6%. Further, it is higher in its hit ratio for failure (prediction) of total model, at 94%, indicating that it is temporally stable and useful for evaluating the management status of retail institutions. Conclusions - This model is useful for evaluating the management status of retail union institutions. First, subdividing CAEL evaluation is required. The existing CAEL evaluation is underdeveloped, and discrimination power falls. Second, efforts to develop a varied and rational management index are continuously required. An index reflecting retail industry characteristics needs to be developed. However, extending this study will need the following. First, it will require a complementary default model reflecting size differences. Second, in the case of small and medium retail, it will need non-financial information. Therefore, it will be a hybrid default model reflecting financial and non-financial information.

• Journal of Veterinary Clinics
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• v.23 no.4
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• pp.416-420
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• 2006

Compare to testing sera individually, pooled-serum testing has considered as a cost-effective method, particularly on a large population-based seroprevalence studies. This study was to determine the relationship between individual sera and pooled sera titers for detection of avian infectious bronchitis virus (IBV) and to evaluate suitability of pooled sera by comparing prevalences estimated from both samples. A total of 5,000 individual samples were collected from 500 flocks in Chungcheong, Gyunsgi, and Kangwon provinces between January 2005 and February 2006. Ten samples were randomly selected from each flock. Five-hundred pooled sera were prepared by mixing equal amount of each 10 individual serum from the original samples. IBV antibody titers were measured by hemagglutination inhibition (HI) test. The least squares regression analysis was performed to construct equation between pooled and mean individual titers. To determine whether the flock is infected 4 arbitrary criteria were used: detection of at least 1 chicken with HI titer ${\ge}$ 9 (criterion 1), detection of at least 2 samples with HI titer ${\ge}$9 (criterion 2), detection of at least 1 sample with HI titer ${\ge}$ 10 (criterion 3), and filially detection of at least 1 sample with HI titer ${\ge}$ 11 (criterion 4). The receiver operating characteristic (ROC) curve was used to examine the cut-off points of pooled titers showing optimal diagnostic accuracy. The area under the curve (AUC), sensitivities (Se), specificities (Sp), and positive (PPV) and negative (NPV) predictive values were calculated. The regression equation between pooled titers (pool) and mean individual titers (mean) was: $pool= 1.2498+0.8952{\times}mean$, with coefficient of determination of 87% (p< 0.0001). The optimal cut-off points of pooled titers were titer 8 for criterion 1 (AUC=0.975, Se=0.883, Sp=0.959, PPV=0.985, NPV=0.728), titer 8 for criterion 2 (AUC=0.969, Se=0.954, Sp=0.855, PPV=0.926, NPV=0.907), titer 9 for criterion 3 (AUC=0.970, Se=0.836, Sp=0.967, PPV=0.978, NPV=0.772), and titer 9 for criterion 4 (AUC= 0.946, Se=0.928, Sp=0.843, PPV=0.857, NPV=0.921). The difference of 'prevalence estimated by individual and pooled sample showed a minimum of 2% for criteria 2 and a maximum of 9.1:% for criteria 3. These results indicate that the use of pooled sera in HI test for screening IBV infection in laying hen flocks is considered as a cost-effective method of testing large numbers of samples with high diagnostic accuracy.

• Radiation Oncology Journal
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• v.32 no.1
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• pp.23-30
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• 2014

Purpose: The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum ($Rectum_{overlap}$) or PTV and bladder ($Bladder_{overlap}$) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Materials and Methods: Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. Results: The percentage $Rectum_{overlap}$ and $Bladder_{overlap}$ correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum $V_{45}$ and bladder $V_{50}$ with $R^2$ = 0.78 and $R^2$ = 0.83, respectively, and predicted the boost plan rectum $V_{30}$ and bladder $V_{30}$ with $R^2$ = 0.53 and $R^2$ = 0.81, respectively. The optimal cutoff value of boost $Rectum_{overlap}$ to predict rectum $V_{75}$ >15% was 3.5% (sensitivity 100%, specificity 94%, p < 0.01), and the optimal cutoff value of boost $Bladder_{overlap}$ to predict bladder $V_{80}$ >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). Conclusion: The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.719-722
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• 2015

Objective: To evaluate the values of 4 tumor markers in serum and ascites and their ascites/serum ratios in the identification and diagnosis of benign and malignant ascites. Materials and Methods: A total of 76 patients were selected as subjects and divided into malignant ascites group (45 cases) and benign ascites group (31 cases). Samples of ascites and serum of all hospitalized patients were collected before treatment. The levels of carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), cancer antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were detected by chemiluminescence (CLIA). Results: CEA, AFP and CA19-9 in both serum and ascites as well as CA125 in ascites were evidently higher in the malignant ascites group than in the benign ascites group (P<0.01). Malignant ascites was associated with elevated ascites/serum ratios for AFP and CA125 (P<0.01). The areas under receiver operating characteristic (AUROCs) of CEA and CA125 in ascites and the ratios of ascites/serum of AFP, CEA, CA125 and CA19-9 were all >0.7, suggesting certain values, while those of ascites CA19-9 and serum CEA were 0.697 and 0.629 respectively, indicating low accuracy in the identification and diagnosis of benign and malignant ascites. However, the AUROCs of the remaining indexes were <0.5, with no value for identification and diagnosis. Compared with single index, the sensitivity of combined detection increased significantly (P<0.05), in which the combined detection of CEA, CA19-9 and CA125 in ascites as well as the ratio of ascites/serum of CEA, CA19-9, CA125 and AFP had the highest sensitivity (98.4%) but with relevantly low specificity. Both sensitivity and specificity of combined detection should be comprehensively considered so as to choose the most appropriate index. Conclusions: Compared with single index, combined detection of tumor markers in serum and ascites can significantly improve the diagnostic sensitivity and specificity.

• Tuberculosis and Respiratory Diseases
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• v.70 no.6
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• pp.490-497
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• 2011

Background: It is difficult but important to differentiate between bacterial and viral infections, especially for respiratory infections. Hence, there is an ongoing need for sensitive and specific markers of bacterial infections. We investigated novel biomarkers for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infections. Methods: This was a prospective, observational study of patients with community acquired bacterial pneumonia, 2009 H1N1 Influenza A infection, and healthy controls. Serum samples were obtained on the initial visit to the hospital and stored at $-80^{\circ}C$. We evaluated CRP (C-reactive protein), PCT (procalcitonin), LBP (lipopolysaccharide-binding protein) and copeptin. These analytes were all evaluated retrospectively except CRP. Receiver operating characteristic curve (ROC) analyses were performed on the resulting data. Results: Enrolled patients included 27 with community acquired bacterial pneumonia, 20 with 2009 H1N1 Influenza A infection, and 26 who were healthy controls. In an ROC analysis for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection, areas under the curve (AUCs) were 0.799 for CRP (95% Confidence interval [CI], 0.664~0.934), 0.753 for PCT (95% CI, 0.613~0.892) and 0.684 for LBP (95% CI, 0.531~0.837). Copeptin was not different among the three groups. Conclusion: These findings suggest that serum CRP, PCT and LBP can assist physicians in discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection.

• Imaging Science in Dentistry
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• v.39 no.1
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• pp.13-18
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• 2009

Purpose: This study was designed to determine a proper threshold value and opacity in three-dimensional CT volume rendering of oral and maxillofacial area. Materials and Methods: Three-dimensional CT data obtained from 50 persons who were done orthognatic surgery in department of oral and maxillofacial radiology of Seoul National University retrospectively. 12 volume rendering post-processing protocols of combination of threshold(100HU, 150HU, 221HU, 270HU) and opacity (58%, 80%, 90%) were applied. Five observers independently evaluated image quality using a five-point range scale. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa value. And three oromaxillofacial surgeons chose the all images that they thought proper clinically in the all of images. Results: Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. The highest diagnostic accuracy appear with 100HU and 58% opacity. and the lowest diagnostic accuracy appear with 221HU and 58% opacity that are being used protocol in department of oral and maxillofacial radiology of Seoul National University. But, no statistically significant difference was noted between any of the protocols. And the number of proper images clinically that chosen by three oromaxillofacial surgeons is the largest in the cases of protocol 8 (221HU, opacity 80%) and protocol 11 (270HU, opacity 80%) in one after the other. Conclusion: Threshold and opacity in volume rendering can be controled easily and these can be causes of making an diagnostic accuracy. So we need to select proper values of these factors.

• Korean Journal of Biological Psychiatry
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• v.23 no.1
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• pp.29-36
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• 2016

Objectives Firefighters and rescue workers are likely to be exposed to a variety of traumatic events; as such, they are vulnerable to the risk of post-traumatic stress disorder (PTSD). The psychometric properties of the Korean version of the PTSD Checklist (PCL), a widely used self-report screening tool for PTSD, were assessed in South Korean firefighters and rescue workers. Methods Data were collected via self-report questionnaires and semi-structured clinical interviews administered to 221 firefighters. Internal consistency, item-total correlation, one-week test-retest reliability, convergent validity, and divergent validity were examined. Content validity of the PCL was evaluated using factor analysis and receiver operating characteristic (ROC) analyses were used to estimate the optimal cutoff point and area under the curve. Results The PCL demonstrated excellent internal consistency (${\alpha}=0.97$), item-total correlation (r = 0.72-0.88), test-retest reliability (r = 0.95), and convergent and divergent validity. The total score of PCL was positively correlated with the number of traumatic events experienced (p < 0.001). Factor analysis revealed two theoretically congruent factors: re-experience/avoidance and numbing/hyperarousal. The optimal cutoff was 45 and the area under the ROC curve was 0.97. Conclusions The Korean version of the PCL may be a useful PTSD screening instrument for firefighters and rescue workers, further maximizing opportunities for accurate PTSD diagnosis and treatment.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.4
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• pp.143-148
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• 2015

Objective: The aim of the current study was to determine the predictive value of anti-$M{\ddot{u}}llerian$ hormone (AMH) levels for pregnancy outcomes in patients over 40 years of age who underwent in vitro fertilization or intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods: We retrospectively analyzed the medical records of 188 women aged 40 to 44 years who underwent IVF/ICSI-fresh ET cycles due to unexplained infertility in the fertility center of CHA Gangnam Medical Center. Patients were divided into group A, with AMH levels <1.0 ng/mL (n=97), and group B, with AMH levels ${\geq}1.0ng/mL$ (n=91). We compared the clinical pregnancy rate (CPR) in the two groups and performed logistic regression analysis to identify factors that had a significant effect on the CPR. Results: The CPR was significantly lower in group A than group B (7.2% vs. 24.2%, p<0.001). In multivariate logistic regression analysis, AMH levels were the only factor that had a significant impact on the CPR (odds ratio, 1.510; 95% confidence interval, 1.172-1.947). The area under the receiver operating characteristic curve for AMH levels as a predictor of the CPR was 0.721. When the cut-off level of AMH was set at 1.90 ng/ mL, the CPR was 6.731-fold higher in the group with AMH levels ${\geq}1.90ng/mL$ than in the group with AMH levels <1.90 ng/mL (p<0.001). Conclusion: Our study showed that AMH levels were predictive of clinical pregnancy in infertility patients over 40 years of age. Further prospective studies should be conducted to validate the predictive capability of AMH levels for the outcome of clinical pregnancy.