• Title/Summary/Keyword: Sensitivity and specificity

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Improvement of Validity and Efficiency for Detection of Cryptosporidium Ocysts and Giardia Cysts in Environmental Water Samples (환경수 중 크립토스포리디움 오시스트 및 지아디아 시스트 검출의 정확도 및 회수율 향상을 위한 연구)

  • 이목영;조은주;김도연;변승헌;이의광;오세종;안승구
    • Korean Journal of Microbiology
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    • v.39 no.1
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    • pp.27-35
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    • 2003
  • No currently available methods to monitor pathogenic protozoa, Cryptosporidium and Giardia in environmental water come close to acceptable sensitivity, specificity and reproducibility, and so it has to be accompanied by thorough quality control and performance evaluation to credibly predict the distribution of them. We collected surface water samples from the Han River and spiked our prepared (oo)cysts, determined Matrix Spike recoveries using USEPA Method 1623 and considered what factors influence MS recovery and validity. As a result, average 46% of spiked oocysts and 60% of spike cysts were recovered, but repetitive sampling and statistical approach seemed to be necessary to determine the environmental pollution level of two protozoa as their variation coefficients was so much as 35oio and 26%. And MS recoveries with two acid dissociations during immunomagnetic separation were improved more 10% than that with one dissociations and the use of spiked suspension enumerated by flow cytometry instead of manual preparation enhanced the validity and reliability in spiking tests. Because fluorescence characteristics of (oo)cysts stained on well slides with FITC-labeled monoclonal antibodies and DAPI was not always same, well Elides from spiked field samples were helpful to evaluate the performance of staining. We found many (oo)cyst-like objects with typical fluorescence, not (co)cysts, from the Han River water samples, and then it was concluded that nuclei staining by DAPI (4',6-diamidino-2-phenylindole) and examination by Differential Interference Contrast Microscope should be critical for valid identification.

Importance of Serum SELDI-TOF-MS Analysis in the Diagnosis of Early Lung Cancer

  • Simsek, Cebrail;Sonmez, Ozlem;Yurdakul, Ahmet Selim;Ozmen, Fusun;Zengin, Nurullah;Keyf, Atilla Isan;Kubilay, Dilek;GUlbahar, Ozlem;Karatayli, Senem Ceren;Bozdayi, Mithat;Ozturk, Can
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2037-2042
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    • 2013
  • Background: Different methods of diagnosis have been found to be inefficient in terms of screening and early diagnosis of lung cancer. Cancer cells produce proteins whose serum levels may be elevated during the early stages of cancer development. Therefore, those proteins may be recognized as potential cancer markers. The aim of this study was to differentiate healthy individuals and lung cancer cases by analyzing their serum protein profiles and evaluate the efficacy of this method in the early diagnosis of lung cancer. Materials and Methods: 170 patients with lung cancer, 53 under high risk of lung cancer, and 47 healthy people were included in our study. Proteomic analysis of the samples was performed with the SELDI-TOF-MS approach. Results: The most discriminatory peak of the high risk group was 8141. When tree classification analysis was performed between lung cancer and the healthy control group, 11547 was determined as the most discriminatory peak, with a sensitivity of 85.5%, a specificity of 89.4%, a positive predictive value (PPV) of 96.7% and a negative predictive value (NPV) of 62.7%. Conclusions: We determined three different protein peaks 11480, 11547 and 11679 were only present in the lung cancer group. The 8141 peak was found in the high-risk group, but not in the lung cancer and control groups. These peaks may prove to be markers of lung cancer which suggests that they may be used in the early diagnosis of lung cancer.

Value of FDG PET/Contrast-Enhanced CT in Initial Staging of Colorectal Cancer - Comparison with Contrast-Enhanced CT

  • Kunawudhi, Anchisa;Sereeborwornthanasak, Karun;Promteangtrong, Chetsadaporn;Siripongpreeda, Bunchorn;Vanprom, Saiphet;Chotipanich, Chanisa
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4071-4075
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    • 2016
  • Background: FDG PET/CT is at an equivocal stage to recommend for staging of colorectal cancer as compared to contrast-enhanced CT (ceCT). This study was intended to evaluate the value of FDG PET/ceCT in colorectal cancer staging as compared to ceCT alone. Materials and Methods: PET/ceCT was performed for 61 colorectal cancer patients who were prospectively enrolled in the study. Three patients were excluded due to loss to follow-up. PET/ceCT findings and ceCT results alone were read separately. The treatment planning was then determined by tumor board consensus. The criteria for T staging were determined by the findings of ceCT. Nodal positive by PET/ceCT imaging was determined by visual analysis of FDG uptake greater than regional background blood pool activity. The diagnostic accuracy of T and N staging was determined only in patients who received surgery without any neoadjuvant treatment. Results: Of 58 patients, there were 40 with colon cancers including sigmoid cancers and 18 with rectal cancers. PET/ceCT in pre-operative staging detected bone metastasis and metastatic inguinal lymph nodes (M1a) that were undepicted on CT in 2 patients (3%), clearly defined 19 equivocal lesions on ceCT in 18 patients (31%) and excluded 6 metastatic lesions diagnosed by ceCT in 6 patients (10%). These resulted in alteration of management plan in 15 out of the 58 cases (26%) i.e. changing from chemotherapy to surgery (4), changing extent of surgery (9) and avoidance of futile surgery (2). Forty four patients underwent surgery within 45 days after PET/CT. The diagnostic accuracy for N staging with PET/ceCT and ceCT alone was 66% and 48% with false positive rates of 24% (6/25) and 76% (19/25) and false negative rates of 47% (9/19) and 21% (4/19), respectively. All of the false negative lymph nodes from PET/ceCT were less than a centimeter in size and located in peri-lesional regions. The diagnostic accuracy for T staging was 82%. The sensitivity of the peri-lesional fat stranding sign in determining T3 stage was 94% and the specificity was 54%. Conclusions: Our study suggested promising roles of PET/ceCT in initial staging of colorectal cancer with better diagnostic accuracy facilitating management planning.

Analysis on Physical Traits of Sasang Types Using Bioelectrical Impedance Analysis (임피던스 분석을 활용한 사상인의 신체계측 연구)

  • Lee, Soo-Jin;Park, Soo-Hyun;Ko, You-Sun;Park, Soo-Jin;Eom, Il-Kyu;Kim, Byoung-Chul;Kim, Young-In;Baek, Jin-Ung;Kim, Myoung-Geun;Kwon, Young-Kyu;Chae, Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.433-437
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    • 2009
  • The purpose of this study was to measure circumference of four body parts of each Sasang groups with Bioelectrical Impedance Analysis (BIA), and evaluate its usefulness for Sasang type diagnostic test. We obtained the circumference measures of neck (CN), chest (CC), waist (CW), and hip (CH) of 91 college students using BIA and standardized by sex and age. The validity of Sasang group prediction with CC was evaluated. The Tae-Eum group (104.87${\pm}$5.19, 108.47${\pm}$4.96, 116.00${\pm}$9.39, 110.4${\pm}$5.29. neck, chest, waist and hip, respectively) has significantly (p<0.001) bigger circumferences than So-Yang (97.79${\pm}$3.82, 100.02${\pm}$4.21, 101.02${\pm}$7.88, 101.95${\pm}$4.06) and So-Eum (95.63${\pm}$4.67, 96.93${\pm}$4.80, 97.63${\pm}$7.72, 99.86${\pm}$4.40) groups at very four measures. Discriminant functions with CC can be used for Tae-Eum Sasang type diagnostic test with 91.2% of overall Percentage Correctly Predicted (PCP). Tae-Eum type-specific sensitivity was 73.3% and Tae-Eum type-specific specificity was 94.7%. The strength and weakness of measurement and standardization methods for Sasang type diagnostic test, and the methods for the standardization of physical traits with sex and age were discussed. Our study showed distinctive physical features of Tae-Eum type and the usefulness of BIA for the Sasang type diagnosis.

Application of Joint Detection of AFP, CA19-9, CA125 and CEA in Identification and Diagnosis of Cholangiocarcinoma

  • Li, Yong;Li, Da-Jiang;Chen, Jian;Liu, Wei;Li, Jian-Wei;Jiang, Peng;Zhao, Xin;Guo, Fei;Li, Xiao-Wu;Wang, Shu-Guang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3451-3455
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    • 2015
  • Objective: To explore the application of joint detection of serum AFP, CA19-9, CA125 and CEA in identification and diagnosis of cholangiocarcinoma (CC). Materials and Methods: The levels of serum AFP, CA19-9, CA125 and CEA of both 30 patients with CC and 30 patients with hepatocellular carcinoma (HCC) were assessed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic effects of single and joint detection of those 4 kinds of tumor markers for CC. Results: The levels of serum CA19-9, CA125 and CEA in CC patients were higher than that in HCC patients,whereas that of serum AFP was significantly lower s. The area under ROC curve of single detection of serum AFP, CA19-9, CA125 and CEA were 0.05, 0.86, 0.84 and 0.83, with the optimal cutoff values of 15.4 ng/ml, 125.1 U/ml, 95.7 U/ml and 25.9 ng/ml, correspondingly, and the percentage correct single diagnosis was <79%. With joint detection, the diagnostic effect of combined AFP, CA19-9, CA125 and CEA was the highest, with an area under the ROC curve of 0.94 (95%CI 0.88~0.99). Conclusions: Single detection of serum CA19-9, CA125 and EA is not meaningful. The sensitivity, specificity, the rate of correct diagnosis and the area under ROC curve of joint detection of AFP, CA19-9, CA125 and CEA are highest, indicating that the joint detection of these 4 tumor markers is of great importance in the diagnosis of CC.

The relationships between clinical variables and renal parenchymal disease in pediatric clinically suspected urinary tract infection (소아 요로 감염 및 의심 환아에서 신 실질 병변 및 방광요관 역류와 임상 변수와의 연관성)

  • Byun, Jung Lim;Lee, Sang Taek;Chung, Sochung;Kim, Kyo Sun
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.222-227
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    • 2010
  • Purpose : To evaluate the significance of clinical signs and laboratory findings as predictors of renal parenchymal lesions and vesicoureteral reflux (VUR) in childhood urinary tract infection (UTI). Methods : From July 2005 to July 2008, 180 patients admitted with a first febrile UTI at the Pediatric Department of Konkuk University Hospital were included in this study. The following were the clinical variables: leukocytosis, elevated C-reactive protein (CRP), positive urine nitrite, positive urine culture, and fever duration both before and after treatment. We evaluated the relationships between clinical variables and dimercaptosuccinic acid (DMSA) scan and voiding cystourethrography (VCUG) results. Results : VCUG was performed in 148 patients; of them, 37 (25.0%) had VUR: 18 (12.2%) had low-grade (I-II) VUR, and 19 (10.5%) had high-grade (III-V) VUR. Of the 95 patients who underwent DMSA scanning, 29 (30.5%) had cortical defects, of which 21 (63.6%) had VUR: 10 (30.3%), low-grade (I-II) VUR; and 11 (33.3%), high-grade VUR. Of the 57 patients who were normal on DMSA scan, 8 (14.0%) had low-grade VUR and 6 (10.5%) had high-grade VUR. The sensitivity, specificity, and positive and negative predictive values of the DMSA scan in predicting high-grade VUR were 64.7%, 69.9%, 33.3%, and 89.5%, respectively. Leukocytosis, elevated CRP, and prolonged fever ($36{\geq}$ hours) after treatment were significantly correlated with the cortical defects on DMSA scans and high-grade VUR. Conclusion : Clinical signs, including prolonged fever after treatment, elevated CRP, and leukocytosis, are positive predictors of acute pyelonephritis and high-grade VUR.

Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications (혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구)

  • Lee, Hyung-Chae;Hwang, Youn-Ho;Wi, Jin-Hong;Jun, Hee Jae;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.25-32
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    • 2010
  • Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

The Significance of Serum Thyroid Peroxidase as a New Tumor Marker in Papillary Thyroid Carcinoma after Thyroidectomy (유두상 갑상선암의 수술후 재발예측인자로서 혈청 Thyroid Peroxidase의 의의)

  • Chang Hang-Seok;Na Jae-Wung;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.46-51
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    • 1999
  • Background: Total thyroidectomy and postoperative radiodiodine ablation therapy in differentiated thyroid carcinomas enhance the reliability of serum thyroglobulin(Tg) levels and radioiodine scan in detecting recurrence or distant metastasis. There have been, however, some limitations in using these methods under certain conditions. Recently, several reports have indicated that thyroid peroxidase(TPO) could be used as an alternative tumor marker. We aimed to estimate the significance of serum TPO levels in differentiated thyroid carcinoma. Materials and Methods: Forty-eight patients who had undergone total thyroidectomy due to papillary thyroid carcinomas and who had been followed-up for at least 3 years were classified into two groups: 27 patients without any evidence of recurrence in group 1; and 20 patients with recurrence or distant metastasis in group 2. All patients were examined by radioiodine scans. Serum Tg, TSH, antithyroglobulin antibody, and TPO were measured and the relationships were statistically analyzed. The sensitivity and specificity of $^{131}I$ scan, serum Tg, and serum TPO were evaluated. Results: Serum Tg levels were $3.81{\pm}5.16ng/mL$ in group 1 and $147.02{\pm}193.75ng/mL$ in group 2. Only 2 patients in group 1 showed Tg levels exceeding 10ng/mL. In contrast, 4 patients in group 2 were under 10ng/mL. Serum antithyroglobulin antibody and TSH levels showed no statistical difference between the two groups. In group 1, 16 patients showed negative serum TPO results, and 4 patients in group 2 showed negative results. There was no correlation among serum Tg levels, antithyroglobulin antibody titers, and serum TPO levels in each group. In group 2, 4 patients with negative serum Tg levels showed positive TPO results and positive whole body scans. Two cases with false negative $^{131}I$ scans showed positive serum TPO and Tg results. In 4 cases showing false negative serum TPO levels, serum Tg levels and $^{131}I$ scans were positive. Conclusion: Serum Tg levels, radioiodine scans, and serum TPO levels can be clinically used as complementary methods in the diagnosis of recurrent or metastatic thyroid carcinomas. Serum TPO levels may be helpful when other methods fail to detect recurrences or distant metastasis in highly suspected patients.

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Receiver Operating Characteristic Analysis for Prediction of Postpartum Metabolic Diseases in Dairy Cows in an Organic Farm in Korea

  • Kim, Dohee;Choi, Woojae;Ro, Younghye;Hong, Leegon;Kim, Seongdae;Yoon, Ilsu;Choe, Eunhui;Kim, Danil
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.199-206
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    • 2022
  • Postpartum diseases should be predicted to prevent productivity loss before calving especially in organic dairy farms. This study was aimed to investigate the incidence of postpartum metabolic diseases in an organic dairy farm in Korea, to confirm the association between diseases and prepartum blood biochemical parameters, and to evaluate the accuracy of these parameters with a receiver operating characteristic (ROC) analysis for identifying vulnerable cows. Data were collected from 58 Holstein cows (16 primiparous and 42 multiparous) having calved for 2 years on an organic farm. During a transition period from 4 weeks prepartum to 4 weeks postpartum, blood biochemistry was performed through blood collection every 2 weeks with a physical examination. Thirty-one (53.4%) cows (9 primiparous and 22 multiparous) were diagnosed with at least one postpartum disease. Each incidence was 27.6% for subclinical ketosis, 22.4% for subclinical hypocalcemia, 12.1% for retained placenta, 10.3% for displaced abomasum and 5.2% for clinical ketosis. Between at least one disease and no disease, there were significant differences in the prepartum levels of parameters like body condition score (BCS), non-esterified fatty acid (NEFA), total bilirubin (T-bil), direct bilirubin (D-bil) and NEFA to total cholesterol (T-chol) ratio (p < 0.05). The ROC analysis of each of these prepartum parameters had the area under the curve (AUC) <0.7. However, the ROC analysis with logistic regression including all these parameters revealed a higher AUC (0.769), sensitivity (71.0%), and specificity (77.8%). The ROC analysis with logistic regression including the prepartum BCS, NEFA, T-bil, D-bil, and NEFA to T-chol ratio can be used to identify cows that are vulnerable to postpartum diseases with moderate accuracy.

T2 Mapping with and without Fat-Suppression to Predict Treatment Response to Intravenous Glucocorticoid Therapy for Thyroid-Associated Ophthalmopathy

  • Linhan Zhai;Qiuxia Wang;Ping Liu;Ban Luo;Gang Yuan;Jing Zhang
    • Korean Journal of Radiology
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    • v.23 no.6
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    • pp.664-673
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    • 2022
  • Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.