• Title/Summary/Keyword: incidence estimation

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Serum Beta-2 Microglobulin: a Possible Marker for Disease Progression in Egyptian Patients with Chronic HCV Related Liver Diseases

  • Ouda, SM;Khairy, AM;Sorour, Ashraf E;Mikhail, Mikhail Nasr
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7825-7829
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    • 2015
  • Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

Analysis and Uncertainty Estimation of Zearalenone in Cereal-Based Products by LC-MS/MS (LC-MS/MS를 이용한 곡류가공품의 제랄레논 분석과 측정불확도 추정)

  • Choi, Eun Jung;Kang, Sung Tae;Jung, So Young;Shin, Jae Min;Jang, Min Su;Lee, Sang Me;Kim, Jung Hun;Chae, Young Zoo
    • Korean Journal of Food Science and Technology
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    • v.44 no.6
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    • pp.658-665
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    • 2012
  • A survey of zearalenone contamination was conducted on cereal-based products by using an immunoaffinity column with LC-MS/MS. The calibration curve showed good lineality, with correlation coefficients ($R^2$) of 0.999 in the concentration range from 1 to 250 ng/mL. The limits of detection and quantification were approximately $0.3{\mu}g/kg$ and $1.0{\mu}g/kg$, respectively. The recoveries in the barley tea, Misutgaru and snack ranged from 73.6-107.8%. Zearalenone was detected in 10 samples (11.2% incidence). The highest zearalenone contamination level was $29.7{\mu}g/kg$ in the Misutgaru. This survey was conducted with uncertainty of measurement. The expanded uncertainty for zearalenone was estimated to be $44.9{\pm}5.0{\mu}g/kg$ (k=2, 95% confidence level) and $128.7{\pm}7.9{\mu}g/kg$ (k=2, 95% confidence level) for barley tea, $30.7{\pm}5.8{\mu}g/kg$ (k=2, 95% confidence level) and $173.7{\pm}14.9{\mu}g/kg$ (k=2.26, 95% confidence level) for Misutgaru, and $37.2{\pm}7.4{\mu}g/kg$ (k=2.31, 95% confidence level) and $151.0{\pm}10.4{\mu}g/kg$ (k=2, 95% confidence level) snack at the level of $41.7{\mu}g/kg$ and $166.7{\mu}g/kg$, respectively.

The Application of the Forensic Dental Identification to Unidentified Individual Remains in Korea (신원불명 사망자의 개인식별에서 법치의학적 방법의 활용성에 관한 연구)

  • Park, Hee-Kyung
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.27-36
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    • 2006
  • The cases of unidentified individual remains submitted to Forensic dentistry section in National Institute of Scientific Investigation, Korea were analyzed to study the application of forensic dental identification into individual identification in the period 2002-2005. The identification cases of unidentified remains were 405 out of 493, which accounted about 82% of whole cases. The incidence of submission of skeletons at least including the skull was increased from 58% in 2002 to 80% in 2005. The numbers of cases for the full examinations were 4 times more than that for age estimation in 2005. Twenty-four cases were submitted for skull to photographic superimposition and 15 out of 24 cases were examined, and the other 9 cases were examined by DNA analysis only. The submitted cases for dental comparison were 23 cases, 9 cases were positively identified, 4 cases were possible, 7 cases were excluded, and 3 cases ended up with insufficient evidences. The proportion of positive identification by dental methods was increased gradually from 9% in 2002 to 46% in 2005. Forensic dental identification has become important and useful because the availability of dental records and radiographs has been increasing. Compared to DNA analysis, forensic dental identification has several advantages such as no needs for high cost equipments and low expenses. And the interpretation of results is straightforward and speedy. These advantages are based on using primary their own dental records of the individuals rather than secondary DNA reference samples from family members. The application of the forensic dental identification to unidentified individual remains will be increased because the dental comparison can complement the limitation of DNA analysis and skull to photographic superimposition in many cases. In order to obtain positive identifications of unidentified remains, a close collaboration between the police and forensic scientists is important. The systemic approach including legislation to preserve dental records of unidentified remains and missing persons for the identification of unidentified remains should be needed.