• Journal of Gastric Cancer
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• v.16 no.3
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• pp.141-151
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• 2016

Purpose: The aim of the present study was to elucidate the clinicopathological significance and diagnostic accuracy of immunohistochemistry (IHC) for determining the mesenchymal epidermal transition (c-MET) expression in patients with gastric cancer (GC). Materials and Methods: The present meta-analysis investigated the correlation between c-MET expression as determined by IHC and the clinicopathological parameters in 8,395 GC patients from 37 studies that satisfied the eligibility criteria. In addition, a concordance analysis was performed between c-MET expression as determined by IHC and c-MET amplification, and the diagnostic test accuracy was reviewed. Results: The estimated rate of c-MET overexpression was 0.403 (95% confidence interval [CI], 0.327~0.484) and it was significantly correlated with male patients, poor differentiation, lymph node metastasis, higher TNM stage, and human epidermal growth factor receptor 2 (HER2) positivity in IHC analysis. There was a significant correlation between c-MET expression and worse overall survival rate (hazard ratio, 1.588; 95% CI, 1.266~1.992). The concordance rates between c-MET expression and c-MET amplification were 0.967 (95% CI, 0.916~0.987) and 0.270 (95% CI, 0.173~0.395) for cases with non-overexpressed and overexpressed c-MET, respectively. In the diagnostic test accuracy review, the pooled sensitivity and specificity were 0.56 (95% CI, 0.50~0.63) and 0.79 (95% CI, 0.77~0.81), respectively. Conclusions: The c-MET overexpression as determined by IHC was significantly correlated with aggressive tumor behavior and positive IHC status for HER2 in patients with GC. In addition, the c-MET expression status could be useful in the screening of c-MET amplification in patients with GC.

• Journal of Korean Medicine for Obesity Research
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• v.8 no.1
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• pp.53-61
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• 2008

Objectives We have investigated a questionnaire on syndrome differentiation pertaining to obesity. To calculate data from this questionnaire, we can simply sum up the degree of symptoms. However, this does not reflect the difference in contribution of syndrome differentiation. In order to improve the level of precision of this questionnaire, we gather the weight of each symptom from experts and apply them to overweight persons. Method Nine Experts from The Society of Korean Medicine for Obesity Research nominated weights for the symptoms. We created a program based on weight survey results and applied to 1487 overweight persons and 26 oriental medical doctors. The concordance rate between the result obtained from the oriental medical doctors and that obtained using three methods was analyzed. Results 1. The reliability of this questionnaire is very high (Cronbach' ${\alpha}$=0.963). 2. The concordance level between diagnosis by oriental medical doctors and the result of general calculation is 0.347, between diagnosis by oriental medical doctors and the result of weighted calculation by syndrome differentiation is 0.362, between diagnosis by oriental medical doctors and the result of weighted calculation by symptoms is 0.1. Conclusions Weighted calculation by syndrome differentiation is relative more appropriate among three methods studied.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.927-930
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• 2012

Background and Objectives: Artificial neural networks (ANNs) are flexible and nonlinear models which can be used by clinical oncologists in medical research as decision making tools. This study aimed to predict distant metastasis (DM) of colorectal cancer (CRC) patients using an ANN model. Methods: The data of this study were gathered from 1219 registered CRC patients at the Research Center for Gastroenterology and Liver Disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran (January 2002 and October 2007). For prediction of DM in CRC patients, neural network (NN) and logistic regression (LR) models were used. Then, the concordance index (C index) and the area under receiver operating characteristic curve (AUROC) were used for comparison of neural network and logistic regression models. Data analysis was performed with R 2.14.1 software. Results: The C indices of ANN and LR models for colon cancer data were calculated to be 0.812 and 0.779, respectively. Based on testing dataset, the AUROC for ANN and LR models were 0.82 and 0.77, respectively. This means that the accuracy of ANN prediction was better than for LR prediction. Conclusion: The ANN model is a suitable method for predicting DM and in that case is suggested as a good classifier that usefulness to treatment goals.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10607-10611
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• 2015

Background: HER2 expression in the primary tumor and its lymph node metastases vary in gastric cancer, reflecting intratumoral heterogeneity. This finding also suggests that proliferation of a different clone in metastatic nodes is possible. In the current study, we aimed to determine the cause of discordance in HER-2 expression in the primary tumor and lymph node metastases for patients with gastric cancer. Materials and Methods: Eighty-one patients with gastric cancer who had undergone radical gastrectomy and were found to have lymph node metastasis upon pathological examination were included. Histopathological samples were obtained from biopsies obtained during patient gastrectomies and lymph node dissection. HER2 status was evaluated by both immunohistochemistry (IHC) and silver in situ hybridization (SISH). Results: Sixty-four (79%) patients were SISH (-), while 17 (21%) were SISH (+) in the primary tumor. However, in metastatic lymph nodes, HER2 status was SISH positive in 5 (28.3%) of the 64 SISH (-) primary tumor specimens. One of the 17 SISH (+) primary tumors was SISH (-) in the metastatic lymph nodes. Thus, SISH results for HER2 in both primary tumors and lymph node metastases were comparable, showing a concordance of 92.5%. In total, six patients demonstrated discordance between the primary tumor and lymph node metastases. The prevalence of HER2 discordance was significantly higher for patients in the pN2 and N3 stages (p=0.007). Although discordant patients had worse survival rates than concordant patients, the differences were not significant (p>0.05).Conclusions: Our study indicates that the frequency of concordance in HER2 status, as determined by IHC or SISH, is high in primary tumors and their corresponding lymph node metastases for patients with gastric cancer. If there is a discrepancy in HER2 status, its evaluation by both IHC and SISH may be useful for detecting patients who would benefit from trastuzumab, and it would therefore help guide decision-making processes in administering treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5729-5732
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• 2014

Background: Cervical cancer is the third most common gynecological cancer and a widespread malignancy in women, accounting for a large proportion of the cancer burden in developing countries. We compared accuracy of MRI staging with clinical staging and also concordance between the two methods for newly diagnosed patients with cervical cancer, using clinical staging as the reference. Materials and Methods: This prospective study was conducted on 27 newly diagnosed patients with cervical cancer from Imam Khomeini hospital from June 2012 to Feb 2014. New cases of cervical cancer with positive PAP test were staged separately with a clinical exam based on the FIGO system by a gynecologist, oncologist and also with MRI by an expert radiologist. Then we compared the predicted stage for each patient with the two methods. Results: Based on clinical staging 9 patients (33%) were observed at stage 1. MRI staging was in coordination with clinical staging in eight of them and for one patient MRI accorded stage 2B (88% concordance). Conclusions: MRI is a reliable noninvasive method with high accuracy for cervical cancer staging. Also presently it is easily obtainable, so we recommend using this technique along with clinical examination for staging cervical cancer patients. We also recommend to radiologists and residents of radiology to get experience with this method of staging.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.148-153
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• 2009

Purpose: The osmolar gap increases in proportion to the ethanol level. Some previous studies have shown that the correlation between the osmolar gap and the ethanol level is weak in trauma patient by using an indirect comparison with other patients. We conducted a direct comparison of the correlation of the osmolar gap to the ethanol level between trauma patients and non-trauma patients. We also analyzed the accuracy of the estimated ethanol level between the two groups. Methods: The research candidates were adult patients who had visited the emergency department of our hospital from December 2003 to November 2008. By using a retrospective chart review, we classified them into three subgroups: non-trauma without shock, trauma without shock, and trauma with shock. In each group, we compared the correlation between the osmolar gap and the measured ethanol level, and we analyzed the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient. Results: Four hundred forty-seven patients were enrolled in this study. For correlation of the osmolar gap and the measured ethanol level, Pearson's correlation coefficient was 0.916 in all patients, 0.939 in non-trauma without shock patients, 0.917 in trauma without shock patients, and 0.844 in trauma with shock patients. In the analysis of the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient, the accuracy in trauma with shock patients was lower than that in non-trauma without shock patients. Conclusion: We found that the correlation between the osmolar gap and the measured ethanol level in the patient group with trauma was lower than it was in the patient group without trauma. Moreover trauma patients with shock had a lower accuracy of the estimated ethanol level than non-trauma patients.

• Korean Journal of Veterinary Service
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• v.41 no.2
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• pp.71-78
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• 2018

Bovine tuberculosis (bTB) is a wide-spread zoonotic disease in cattle, which is casued by Mycobacterium bovis that is a part of Mycobacterium tuberculosis complex (MTC). This study describes a field trial conducted in 42 herds with the history of prevalence bovine tuberculosis. Two cell-mediated immunity tests, the gamma-interferon (${\gamma}-IFN$) assay and the single intradermal tuberculin test (SIT) were applied for the diagnosis of bovine tuberculosis in 5,289 animals. The ${\gamma}-IFN$ assay presented 144 (2.7%) head of cattle with the positive result, and 112 (2.1%) head of cattle were shown to be bTB-positive by the SIT. The positive concordance was 45.5%, and the negative concordance was 98.2%. The ${\gamma}-IFN$ assay showed more positive results in younger cattle, especially between 12 and 23 months of age. It is shown that the strategic combination of both cell-mediated immunity test methods is more efficient for the detection of bTB to reduce the number of false positive individuals which are being slaughtered.

• 한국균학회소식:학술대회논문집
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• 2014.10a
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• pp.29-29
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• 2014

Since Darwin and Wallace introduced the concept on the evolution of species, scientists have been furiously debating what species are, and how to define them. This basic yet intriguing question has bothered us ever since, as communicating to fellow biologists about fungal species is the very cornerstone of mycology. For the species presently known, this has largely been accomplished via Latin binomials linked to morphology in the absence of DNA barcodes. In recent years mycologists have embraced the ribosomal ITS as official barcode region for Fungi, and this locus is also mainly used in environmental pyrosequencing studies. Furthermore, DNA data can now also be used to describe sterile species in the absence or lack of distinct morphological structures. Recent developments such as the registration of names in MycoBank, and linking the phenotype to the genotype, have significantly changed the face of fungal systematics. By employing the Consolidated Species Concept, incorporating genealogical concordance, ecology and morphology, robust species recognition is now possible. Several international initiatives have since built on these developments, such as the DNA barcoding of holdings of Biological Resource Centres, followed by the Genera of Fungi Project, aiming to recollect, and epitypify all type species of all genera. What these data have revealed, is that most genera are poly- and paraphyletic, and that morphological species normally encompass several genetic entities, which may be cryptic species. Once we provide a stable genetic backbone capturing our existing knowledge of the past 250 years, we will be able to accommodate novelties obtained via environmental sequencing platforms. Being able to communicate these species to other biologists in a clear manner that is DNA-based, will enable scientists to elucidate the importance, role and ecological interactions that these fungi have on our planet.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.114-121
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• 2018

Purpose: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. Materials and Methods: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. Results: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. Conclusions: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.

• Journal of Korean Academy of Nursing
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• v.50 no.4
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• pp.621-630
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• 2020

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.