• Title/Summary/Keyword: Diagnostic utility

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Application of Bioinformatics for the Functional Genomics Analysis of Prostate Cancer Therapy

  • Mousses, Spyro
    • Proceedings of the Korean Society for Bioinformatics Conference
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    • 2000.11a
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    • pp.74-82
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    • 2000
  • Prostate cancer initially responds and regresses in response to androgen depletion therapy, but most human prostate cancers will eventually recur, and re-grow as an androgen independent tumor. Once these tumors become hormone refractory, they usually are incurable leading to death for the patient. Little is known about the molecular details of how prostate cancer cells regress following androgen ablation and which genes are involved in the androgen independent growth following the development of resistance to therapy. Such knowledge would reveal putative drug targets useful in the rational therapeutic design to prevent therapy resistance and control androgen independent growth. The application of genome scale technologies have permitted new insights into the molecular mechanisms associated with these processes. Specifically, we have applied functional genomics using high density cDNA microarray analysis for parallel gene expression analysis of prostate cancer in an experimental xenograft system during androgen withdrawal therapy, and following therapy resistance, The large amount of expression data generated posed a formidable bioinformatics challenge. A novel template based gene clustering algorithm was developed and applied to the data to discover the genes that respond to androgen ablation. The data show restoration of expression of androgen dependent genes in the recurrent tumors and other signaling genes. Together, the discovered genes appear to be involved in prostate cancer cell growth and therapy resistance in this system. We have also developed and applied tissue microarray (TMA) technology for high throughput molecular analysis of hundreds to thousands of clinical specimens simultaneously. TMA analysis was used for rapid clinical translation of candidate genes discovered by cDNA microarray analysis to determine their clinical utility as diagnostic, prognostic, and therapeutic targets. Finally, we have developed a bioinformatic approach to combine pharmacogenomic data on the efficacy and specificity of various drugs to target the discovered prostate cancer growth associated candidate genes in an attempt to improve current therapeutics.

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Premature Ejaculation and Erectile Dysfunction in Iranian Prostate Cancer Patients

  • Lin, Chung-Ying;Burri, Andrea;Pakpour, Amir H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1961-1966
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    • 2016
  • Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ${\geq}11$ (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ${\leq}17$ for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

Cyclooxygenase-2 Expression in Invasive Breast Carcinomas of No Special Type and Correlation with Pathological Profiles Suggest a Role in Tumorigenesis Rather than Cancer Progression

  • Misron, Nurul Akmar;Looi, Lai-Meng;Mustapha, Nik Raihan Nik
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1553-1558
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    • 2015
  • Background: COX-2 has been shown to play an important role in the development of breast cancer and increased expression has been mooted as a poor prognostic factor. The purpose of this study was to investigate the relationship between COX-2 immunohistochemical expression and known predictive and prognostic factors in breast cancer in a routine diagnostic histopathology setting. Materials and Methods: Formalin-fixed paraffin-embedded tumour tissue of 144 no special type (NST) invasive breast carcinomas histologically diagnosed between January 2009 and December 2012 in Hospital Sultanah Bahiyah, Alor Setar, Kedah were immunostained with COX-2 antibody. COX-2 overexpression was analysed against demographic data, hormone receptor status, HER2-neu overexpression, histological grade, tumour size and lymph node status. Results: COX-2 was overexpressed in 108/144 (75%) tumours and was significantly more prevalent (87%) in hormone receptor-positive tumours. There was no correlation between COX-2 overexpression and HER2/neu status. Triple negative cancers had the lowest prevalence (46%) (p<0.05). A rising trend of COX-2 overexpression with increasing age was observed. There was a significant inverse relationship with tumour grade (p<0.05), prevalences being 94%, 83% and 66% in grades 1, 2 and 3 tumours, respectively. A higher prevalence of COX-2 overexpression in smaller size tumours was observed but this did not reach statistical significance. There was no relationship between COX-2 expression and lymph node status. Conclusions: This study did not support the generally held notion that COX-2 overexpression is linked to poor prognosis, rather supporting a role in tumorigenesis. Larger scale studies with outcome data and basic studies on cancer pathogenetic pathways will be required to cast further light on whether COX-2 inhibitors would have clinical utility in cancer prevention or blockage of cancer progression. In either setting, the pathological assessment for COX-2 overexpression in breast cancers would have an important role in the selection of cancer patients for personalized therapy with COX-2 inhibitors.

Clinical Significances of $^{99m}TC-DMSA$ Renal Scan in Patients with Acute Pyelonephritis (급성신우신염에서 $^{99m}TC-DMSA$ 신장스캔의 임상적 의의)

  • Mok, Cha-Soo;Shin, Dong-Jin;Choi, Ho-Cheon;Kim, Gyeong-Wook;Yi, Gang-Wook;Choi, Dae-Seop
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.201-207
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    • 1989
  • Patients with acute pyleonephritis may present with a spectrum of clinical symptoms and signs. There are few noninvasive diagnostic studies, however, to confirm or exclude this diagnosis. To evaluate the clinical utility of $^{99m}Tc-DMSA$ renal scan in diagnosis of acute pyelonephritis, we performed $^{99m}Tc-DMSA$ renal scan in 37 patients suspected with urinary tract infection. Simultaneously, kidney ultrasonography was done in 21 patients diagnosed with acute pyelonephritis, clinically. And we performed the followup scan after treatment in two to six weeks. The results were as follows: 1) $^{99m}Tc-DMSA$ renal scan disclosed single or multiple cortical defects and decreased radiouptake ratio of affected kidney in 23 patients among 25 patients diagnosed with acute pyleonephritis. 2) In the 21 patients with acute pyelonephritis, kidney ultrasonography showed abnormal finding in the 7 patients. And $^{99m}Tc-DMSA$ renal scan disclosed abnormal cortical defects in this 7 patients also. 3) Between the patients with acute pyelonephritis and those with lower urinary tract infection, asymptomatic bacteriuria or pyuria. right-to-left radiouptake ratios (R/L ratio) were significantly different (p < 0.001). 4) In two to six weeks after antibiotic therapy, we performed followup $^{99m}Tc-DMSA$ renal scan for 5 patients among 25 acute pyelonephritis patients. And we have found the improvement of cortical defects and the right-to-left radiouptake ratio. In conclusion, we thought that $^{99m}Tc-DMSA$ renal scan should be useful in diagnosis of acute pyelonephritis and follow-up examination.

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Utility of Lateral Circumflex Femoral Artery Perforator's 3D Image with MD-CT (MD-CT로 얻은 가쪽넙다리휘돌이 관통동맥 3D 영상의 유용성)

  • Park, Soo Ho;Shim, Jeong Su;Lee, Sang Kon;Park, Dae Hwan
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.379-384
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    • 2008
  • Purpose: Currently, using perforator artery flaps especially anterolateral thigh flaps are widely used for reconstruction of extremities, head and neck. Obtaining a precise anatomical picture prior to operation will translate to a more accurate, efficient and safe procedure. Authors used 3D-image work up via 64-slice MDCT to make a more precise preoperative plan. Methods: A total of 10 patients underwent soft tissue reconstruction with anterolateral thigh flap from December 2006 to December 2007. The 64-Channel MDCT (LightSpeed VCT, GE, USA) was used and 3D images were reconstructed. Findings from MDCT were applied to the preoperative planning and confirmed with intraoperative findings. Results: The average number of perforator arteries from lateral circumflex femoral artery was 2. The average lengths of vascular pedicle from the origin of lateral circumflex femoral artery to the first and second perforator artery were 11.0 cm and 20.0 cm, respectively. The average diameter of the pedicle artery was 2.2 mm. The locations of the perforator arteries were mapped and localized on the body surface based on the MDCT result. These were confirmed through direct visualization intraoperatively. Conclusion: MDCT has an advantage of obtaining accurate images of the general anatomy and even fine structures like perforator arteries. By using this state-of-the-art diagnostic imaging technique, it is now possible to make an operative plan safely and easily.

The Utility of Ultrasonography in the Emergency Department for the Diagnosis of Finger Tendon Injury (응급실에서 손가락의 힘줄 손상에 대한 초음파의 유용성)

  • Park, Jung Woo;Lee, Jang Young;Lee, Won Suck;Sung, Won Young;Seo, Sang Won;Yang, Jung Il
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.139-144
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    • 2014
  • Purpose: Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury. Methods: In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries. Results: The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980). Conclusion: Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.

Availability of Toxicologic Screening Tests in the Emergency Department (응급센터에서 시행하는 약물선별현장검사의 유용성)

  • Um, In-Kyung;Park, Jong-Su;Han, Kap-Su;Cho, Han-Jin;Choi, Sung-Hyuck;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.26-29
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    • 2011
  • Purpose: The role of a point of care test (POCT) is currently becoming important when treating patients and making decisions in the emergency department. It also plays a role for managing patients presenting with drug intoxication. But the availability of the test has not yet been studied in Korea. Therefore, we investigated the utility and the availability of POCT for drug screening used in the emergency department. Methods: This was a retrospective study for those patients with drug intoxication between January 2007 and December 2010 in an urban emergency department. Results: Between the study period, 543 patients were examined with a Triage$^{(R)}$-TOX Drug Screen. Among those, 248 (45.7%) patients showed negative results and 295 (54.3%) patients showed positive results. The sensitivity of the test for benzodiazepine, acetaminophen and tricyclic antidepressants were 85.9%, 100%, 79.2%, respectively. Conclusion: POCT of drug screening in emergency department showed good accuracy especially in patient with benzodiazepine, acetaminophen and tricyclic antidepressant intoxication. Therefore, it can be useful diagnostic tool for the management of intoxicated patients.

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The Application of the Clinician Administered Posttraumatic Stress Disorder Scale to Identify Combat Related Posttraumatic Stress Disorder (전투 관련 외상 후 스트레스 장애 진단에 있어서 임상가를 위한 외상 후 스트레스 장애 척도의 적용)

  • Kim, Hae Jung;Kim, Tae Yong;Choi, Jin Hee;So, Hyung Seok;Chung, Moon Yong;Kim, Dong Su;Bang, Yu Jin;Chung, Hae Gyung
    • Anxiety and mood
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    • v.8 no.2
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    • pp.113-119
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    • 2012
  • Objective : The purpose of this study is to assess the utility of clinician administered posttraumatic stress disorder scale (CAPS) to diagnose combat related posttraumatic stress disorder (PTSD) in Korean veterans of the Vietnam War. Methods : Sixty-one Korean male veterans of the Vietnam war participated in this study. We compared the diagnostic values of CAPS, Korean version of mini international neuropsychiatric interview (MINI) against the Structured Clinical Interview for DSM-IV (SCID) in diagnosing PTSD. Results : The overall internal consistency of CAPS was 0.93. Compared to the SCID, total severity 45 (TSEV45) showed the best results among 5 CAPS scoring rules. In detail, sensitivity was 71.4%, specificity was 85.1, positive predictive value was 58.8%, negative predictive value was 90.9%, and accuracy was 82.0. Conclusion : CAPS was demonstrated as a reliable tool to diagnose combat related PTSD in the elderly. The optimum CAPS scoring was TSEV45.

Utility of Serum Procalcitonin for Diagnosis of Sepsis and Evaluation of Severity (혈청 프로칼시토닌(serum procalcitonin) 측정을 통한 패혈증 진단 및 중등도 평가의 유용성)

  • Park, Tae-Jin;Lim, Chae-Man;Koh, Youn-Suck;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.51-57
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    • 2011
  • Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.

TS Fuzzy Classifier Using A Linear Matrix Inequality (선형 행렬 부등식을 이용한 TS 퍼지 분류기 설계)

  • Kim, Moon-Hwan;Joo, Young-Hoon;Park, Jin-Bae
    • Journal of the Korean Institute of Intelligent Systems
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    • v.14 no.1
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    • pp.46-51
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    • 2004
  • his paper presents a novel design technique for the TS fuzzy classifier via linear matrix inequalities(LMI). To design the TS fuzzy classifier built by the TS fuzzy model, the consequent parameters are determined to maximize the classifier's performance. Differ from the conventional fuzzy classifier design techniques, convex optimization technique is used to resolve the determination problem. Consequent parameter identification problems are first reformulated to the convex optimization problem. The convex optimization problem is then efficiently solved by converting linear matrix inequality problems. The TS fuzzy classifier has the optimal consequent parameter via the proposed design procedure in sense of the minimum classification error. Simulations are given to evaluate the proposed fuzzy classifier; Iris data classification and Wisconsin Breast Cancer Database data classification. Finally, simulation results show the utility of the integrated linear matrix inequalities approach to design of the TS fuzzy classifier.