• Title/Summary/Keyword: Cutoff values

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A Study on the Modified Elliptic Function with Progressively Diminishing Ripple Characteristics (점진적 감소 파상 특성을 갖는 변형된 elliptic 함수에 관한 연구)

  • 윤창훈;최석우;김동용
    • Journal of the Korean Institute of Telematics and Electronics B
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    • v.31B no.12
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    • pp.45-50
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    • 1994
  • The elliptic filters are optimal in the sense that the magnitude characteristic exhibits the steepest slope at the cutoff frequency. The other characteristics such as delay and step response, however, are rather undesirable. In this paper, the modified elliptic low-pass filter function is proposed. The modified elliptic function possesses progressively diminishing ripples in both passband and stopband, and the lower pole-Q, values when compared to the elliptic counterparts, thus producting the flatter delay characteristics and improved time-domain performances. And it is realizable in the doubley-terminated ladder structures for the order n even or odd, thus lending themselves amaenable to high-quality active RC or switched capacitor filters through the simulation techniques.

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Added Value of Contrast Leakage Information over the CBV Value of DSC Perfusion MRI to Differentiate between Pseudoprogression and True Progression after Concurrent Chemoradiotherapy in Glioblastoma Patients

  • Pak, Elena;Choi, Seung Hong;Park, Chul-Kee;Kim, Tae Min;Park, Sung-Hye;Won, Jae-Kyung;Lee, Joo Ho;Lee, Soon-Tae;Hwang, Inpyeong;Yoo, Roh-Eul;Kang, Koung Mi;Yun, Tae Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.10-19
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    • 2022
  • Purpose: To evaluate whether the added value of contrast leakage information from dynamic susceptibility contrast magnetic resonance imaging (DSC MRI) is a better prognostic imaging biomarker than the cerebral blood volume (CBV) value in distinguishing true progression from pseudoprogression in glioblastoma patients. Materials and Methods: Forty-nine glioblastoma patients who had undergone MRI after concurrent chemoradiotherapy with temozolomide were enrolled in this retrospective study. Twenty features were extracted from the normalized relative CBV (nCBV) and extraction fraction (EF) map of the contrast-enhancing region in each patient. After univariable analysis, we used multivariable stepwise logistic regression analysis to identify significant predictors for differentiating between pseudoprogression and true progression. Receiver operating characteristic (ROC) analysis was employed to determine the best cutoff values for the nCBV and EF features. Finally, leave-one-out cross-validation was used to validate the best predictor in differentiating between true progression and pseudoprogression. Results: Multivariable stepwise logistic regression analysis showed that MGMT (O6-methylguanine-DNA methyltransferase) and EF max were independent differentiating variables (P = 0.004 and P = 0.02, respectively). ROC analysis yielded the best cutoff value of 95.75 for the EF max value for differentiating the two groups (sensitivity, 61%; specificity, 84.6%; AUC, 0.681 ± 0.08; 95% CI, 0.524-0.837; P = 0.03). In the leave-one-out cross-validation of the EF max value, the cross-validated values for predicting true progression and pseudoprogression accuracies were 69.4% and 71.4%, respectively. Conclusion: We demonstrated that contrast leakage information parameter from DSC MRI showed significance in differentiating true progression from pseudoprogression in glioblastoma patients.

Pre- and Immediate Post-Kasai Portoenterostomy Shear Wave Elastography for Predicting Hepatic Fibrosis and Native Liver Outcomes in Patients With Biliary Atresia

  • Haesung Yoon;Kyong Ihn;Jisoo Kim;Hyun Ji Lim;Sowon Park;Seok Joo Han;Kyunghwa Han;Hong Koh;Mi-Jung Lee
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.465-475
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    • 2023
  • Objective: To evaluate the feasibility of ultrasound shear wave elastography (SWE) for predicting hepatic fibrosis and native liver outcomes in patients with biliary atresia. Materials and Methods: This prospective study included 33 consecutive patients with biliary atresia (median age, 8 weeks [interquartile range, 6-10 weeks]; male:female ratio, 15:18) from Severance Children's Hospital between May 2019 and February 2022. Preoperative (within 1 week from surgery) and immediate postoperative (on postoperative days [PODs] 3, 5, and 7) ultrasonographic findings were obtained and analyzed, including the SWE of the liver and spleen. Hepatic fibrosis, according to the METAVIR score at the time of Kasai portoenterostomy and native liver outcomes during postsurgical follow-up, were compared and correlated with imaging and laboratory findings. Poor outcomes were defined as intractable cholangitis or liver transplantation. The diagnostic performance of SWE in predicting METAVIR F3-F4 and poor hepatic outcomes was analyzed using receiver operating characteristic (ROC) analyses. Results: All patients were analyzed without exclusion. Perioperative advanced hepatic fibrosis (F3-F4) was associated with older age and higher preoperative direct bilirubin and SWE values in the liver and spleen. Preoperative liver SWE showed a ROC area of 0.806 and 63.6% (7/11) sensitivity and 86.4% (19/22) specificity at a cutoff of 17.5 kPa for diagnosing F3-F4. The poor outcome group included five patients with intractable cholangitis and three undergoing liver transplantation who showed high postoperative liver SWE values. Liver SWE on PODs 3-7 showed ROC areas of 0.783-0.891 for predicting poor outcomes, and a cutoff value of 10.3 kPa for SWE on POD 3 had 100% (8/8) sensitivity and 73.9% (17/23) specificity. Conclusion: Preoperative liver SWE can predict advanced hepatic fibrosis, and immediate postoperative liver SWE can predict poor native liver outcomes in patients with biliary atresia.

Serum procalcitonin as a diagnostic marker of neonatal sepsis

  • Park, In Ho;Lee, Seung Hyun;Yu, Seung Taek;Oh, Yeon Kyun
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.451-456
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    • 2014
  • Purpose: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. Methods: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. Results: The mean PCT and CRP concentrations were respectively $56.27{\pm}81.89$ and $71.14{\pm}37.17mg/L$ in the "confirmed sepsis" group; $15.64{\pm}32.64$ and $39.23{\pm}41.41mg/L$ in the "suspected sepsis" group; $9.49{\pm}4.30$ and $0.97{\pm}1.16mg/L$ in the "mild infection" group; and $0.21{\pm}0.12$ and $0.72{\pm}0.7mg/L$ in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). Conclusion: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.

Lake Water Treatment Using a Ultrafiltration Membrane Process of Hollow Fiber Type (중공사형 한외여과 막분리 공정에 의한 하천수 처리)

  • 박진용
    • Membrane Journal
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    • v.7 no.1
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    • pp.39-47
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    • 1997
  • The self-designed membrane system was tested to examine the performance of the hollow fiber type polysulfone ultrafiltration(UF) membrane for the treatment of pure water(the 3rd treated water). The molecular weight cut-off's (MWCO) of the membranes used in this study were 5, 000 and 10, 000, respectively. The recovery rate, the ratio of permeate flow rate to the feed flow rate, increased as the temperature rose. The values of MWCO obtained in this study, using 2, 000 ppm polyethylene glycol and dextran solutions with various molecular weight, showed higher values than those suggested by SKI. Based on the results of the primary experiments, the water of the Gongji-stream, in which water quality is deteriorated by the inflow of domestic wastewater, was selected for the UF membrane test. Biological oxygen demand(BOD), total solids, and turbidity of the treated water had much lower values than those of the source water. Therefore, this study confirmed the possibility of the domestic water treatment using the hollow fiber type UF membrane.

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Gender specific effect of major dietary patterns on the metabolic syndrome risk in Korean pre-pubertal children

  • Park, Soo Jin;Lee, Seung Min;Kim, Seon Mee;Lee, Myoungsook
    • Nutrition Research and Practice
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    • v.7 no.2
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    • pp.139-145
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    • 2013
  • There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.

Ki-67 Labeling Indices in 'Classic' versus 'Blastoid' Mantle Cell Lymphomas - Proposed Cutoff Values for Routine Diagnostic Workup

  • Pervez, Shahid;Haroon, Saroona;Awan, Dreema
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6591-6594
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    • 2015
  • Background: Mantle-cell lymphoma (MCL) is a unique entity of peripheral B-cell lymphoma that has a discrete morphologic, immunologic, and genetic phenotype, with more common 'classic' and less frequent 'blastoid' and 'pleomorphic' variants, associated with an aggressive clinical course. The aim of this study was to analyze proliferation (Ki-67) indices of 'classic' (c-MCL) and 'blastoid' (b-MCL) variants of a cohort of MCL and to suggest cut off values for the Ki-67 proliferation index in these two subsets. Materials and Methods: MCL cases diagnosed over $4{\frac{1}{2}}$ years at Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi were retrieved and reviewed. Ki-67 labelling was scored and analysed. Results: A total of 90 of cases of MCL were scrutinized. Mean age ${\pm}SD$ was $60.2{\pm}12.5$ years and the male to female ratio was 4:1, with 67 (75%) cases of c-MCL and 23 (25%) cases of b-MCL. Most samples were lymph node biopsies (n=68), whereas the remainder were from various extranodal sites The mean Ki-67 proliferation index was $29.5%{\pm}14.4%$ in classic variants and $64.4{\pm}15.2%$ for the blastoid variant, the difference being statistically significant (p = 0.029). Conclusions: It was concluded that differential cut-off values of Ki-67 labeling may be used in more objective way to reliably classify MCL into classic or blastoid variants by diagnostic pathologists. We propose a < 40 proliferative index to be suggestive of c-MCL and one of > 50 for the blastoid variant.

Prediction and visualization of CYP2D6 genotype-based phenotype using clustering algorithms

  • Kim, Eun-Young;Shin, Sang-Goo;Shin, Jae-Gook
    • Translational and Clinical Pharmacology
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    • v.25 no.3
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    • pp.147-152
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    • 2017
  • This study focused on the role of cytochrome P450 2D6 (CYP2D6) genotypes to predict phenotypes in the metabolism of dextromethorphan. CYP2D6 genotypes and metabolic ratios (MRs) of dextromethorphan were determined in 201 Koreans. Unsupervised clustering algorithms, hierarchical and k-means clustering analysis, and color visualizations of CYP2D6 activity were performed on a subset of 130 subjects. A total of 23 different genotypes were identified, five of which were observed in one subject. Phenotype classifications were based on the means, medians, and standard deviations of the log MR values for each genotype. Color visualization was used to display the mean and median of each genotype as different color intensities. Cutoff values were determined using receiver operating characteristic curves from the k-means analysis, and the data were validated in the remaining subset of 71 subjects. Using the two highest silhouette values, the selected numbers of clusters were three (the best) and four. The findings from the two clustering algorithms were similar to those of other studies, classifying $^*5/^*5$ as a lowest activity group and genotypes containing duplicated alleles (i.e., $CYP2D6^*1/^*2N$) as a highest activity group. The validation of the k-means clustering results with data from the 71 subjects revealed relatively high concordance rates: 92.8% and 73.9% in three and four clusters, respectively. Additionally, color visualization allowed for rapid interpretation of results. Although the clustering approach to predict CYP2D6 phenotype from CYP2D6 genotype is not fully complete, it provides general information about the genotype to phenotype relationship, including rare genotypes with only one subject.

Delta neutrophil index as a predictor of vesicoureteral reflux in children with febrile urinary tract infection

  • Kim, Jae Eun;Oh, Jun Suk;Yoon, Jung Min;Ko, Kyung Ok;Cheon, Eun Jung
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.46-51
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    • 2022
  • Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.

A Retrospective Study of Radiographic Measurements of Small Breed Dogs with Myxomatous Mitral Valve Degeneration: A New Modified Vertebral Left Atrial Size

  • Soyon An;Gunha Hwang;Seul Ah Noh;Young-Min Yoon;Hee Chun Lee;Tae Sung Hwang
    • Journal of Veterinary Clinics
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    • v.40 no.1
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    • pp.31-37
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    • 2023
  • Vertebral left atrial size (VLAS) is an important indicator to predict myxomatous mitral valve degeneration (MMVD) in dogs. When the caudal margin of cardiac silhouette and the dorsal margin of caudal vena cava (CdVC) could not be seen exactly, another way to evaluate VLAS is needed. The objective of this study was to assess whether a new modified VLAS (m-VLAS) could be used as an indicator to predict MMVD in 57 small breed dogs with MMVD. The m-VLAS was also used to classify American College of Veterinary Internal Medicine staging groups and left heart enlargement confirmed with echocardiograph (EchoLHE) groups. The m-VLAS was measured as the distance from the ventral aspect of the carina to the dorsal aspect of the intersection of the cardiac silhouette and the farthest LA caudal margin, not the CdVC, followed by drawing the same line beginning at the cranial edge of T4. Based on VLAS values and m-VLAS values measured for dogs with MMVD, correlations between these values and left heart enlargement groups were then evaluated. There were significant differences in both the VLAS and the m-VLAS between EchoLHE groups. The AUC of the ROC curve of the m-VLAS to detect EchoLHE was higher than that of the VLAS. The optimal cutoff value for the m-VLAS was >2.7, which had a higher specificity (86.84%) than the VLAS specificity (71.05%). This study reveals that a new m-VLAS is a more specific indicator than the VLAS for predicting left side heart enlargement in small breed dogs. Therefore, the m-VLAS can be used as a clinically useful radiographic measurement alternative to or better than the VLAS.