• Title/Summary/Keyword: kappa values

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Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

The Efficacy of Added Montelukast in Persistent Asthmatics Who Were Not Completely Controlled on Inhaled Corticosteroids and Inhaled Long-acting β2-agonists (흡입 스테로이드와 지속성 베타2 항진제의 병용요법으로 완전히 조절되지 않는 천식 환자에서 추가 montelukast의 효과)

  • Choi, Jeong-Hee;Park, Hae-Sim;Lee, Kwan-Ho;Shim, Jae-Jeong;Uh, Soo-Taek;Lee, Sang-Pyo;Lee, Yong-Chul;Choi, Won-Il;Lee, Jae-Ho;Kim, Joo-In;Lee, Myung-Goo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.337-345
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    • 2007
  • Backgrounds: Although glucocorticoids are one of the most potent anti-inflammatory agents, they have limited effect on cysteinyl leukotriene biosynthesis. In addition, the response to inhaled corticosteroids (ICS) and inhaled long-acting ${\beta}_2-agonists$ (LABA) combination therapy in moderate to severe persistent asthmatics varies. Additional therapy with leukotriene receptor antagonists (LTRA) in patients with moderate to severe asthma suboptimally controlled with ICS and LABA combination therapy would be complementary to asthma control. Methods: One hundred and ninety eight asthmatics entered a 2 month, open-label descriptive study. Patients suffering from persistent asthma and suboptimally controlled on a combination therapy of fluticasone/salmeterol or budesonide/formoterol were given montelukast 10 mg daily as an add-on therapy. The level of asthma control was assessed using the Asthma Control Questionnaire (ACQ) including $FEV_1%$ predicted at the baseline and after a 2-month treatment with montelukast. A global evaluation of the treatment was also made by the patients and physicians. Results: The mean ACQ score decreased significantly on montelukast ($11.5{\pm}5.4$ at baseline vs. $6.7{\pm}5.0$), with a significant improvement in all individual symptom scores (p<0.01). The $FEV_1%$ predicted values did not show any significant change. 59.9% of patients and 59.4% of physicians reported global improvement in their asthma (${\kappa}=0.85$). Conclusion: These results suggest that the addition of montelukast in patients with persistent asthma that is suboptimally contolled by combination therapy of ICS and LABA might confer complementary effects on asthma control.

An Improved PCR-RFLP Assay for Detection and Genotyping of Asymptomatic Giardia lamblia Infection in a Resource-Poor Setting

  • Hawash, Yoursry;Ghonaim, M.M.;Al-Shehri, S.S.
    • Parasites, Hosts and Diseases
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    • v.54 no.1
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    • pp.1-8
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    • 2016
  • Laboratory workers, in resource-poor countries, still consider PCR detection of Giardia lamblia more costly and more time-consuming than the classical parasitological techniques. Based on 2 published primers, an in-house one-round touchdown PCR-RFLP assay was developed. The assay was validated with an internal amplification control included in reactions. Performance of the assay was assessed with DNA samples of various purities, 91 control fecal samples with various parasite load, and 472 samples of unknown results. Two cysts per reaction were enough for PCR detection by the assay with exhibited specificity (Sp) and sensitivity (Se) of 100% and 93%, respectively. Taking a published small subunit rRNA reference PCR test results (6%; 29/472) as a nominated gold standard, G. lamblia was identified in 5.9% (28/472), 5.2%, (25/472), and 3.6% (17/472) by PCR assay, $RIDA^{(R)}$ Quick Giardia antigen detection test (R-Biopharm, Darmstadt, Germany), and iodine-stained smear microscopy, respectively. The percent agreements (kappa values) of 99.7% (0.745), 98.9% (0.900), and 97.7% (0.981) were exhibited between the assay results and that of the reference PCR, immunoassay, and microscopy, respectively. Restriction digestion of the 28 Giardia-positive samples revealed genotype A pattern in 12 and genotype B profile in 16 samples. The PCR assay with the described format and exhibited performance has a great potential to be adopted in basic clinical laboratories as a detection tool for G. lamblia especially in asymptomatic infections. This potential is increased more in particular situations where identification of the parasite genotype represents a major requirement as in epidemiological studies and infection outbreaks.

Anti-atherosclerotic Effect of Green Tea in Poluynsaturated Fatty Acids-treated Apo E KO Mice (식이불포화지방산을 섭취한 Apo E KO Mice에서의 녹차의 항동맥경화억제 효과)

  • Kim, Hyo-Sook;Lee, Myoung-Sook
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.465-473
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    • 2011
  • Dietary fatty acids are under intense research to identify anti-atherogenic mechanisms, so we investigated green tea powder (GT) as a protector against atherogenesis originating from lipid peroxidation such as 4-hydroxynonemal (4-HNE) and malondialdehyde (MDA) in different dietary fatty acid-treated apo E KO mice. Growth rate and dietary efficiency were lower in apo E KO mice with or without LA compared to wild type. Plasma total cholesterol (TC) and triacylglycerol (TG) did not correspond to values in other tissues, but TG in heart tissue decreased significantly by GT after linoleic acid (LA) or docosahexaenoic acid (DHA) was administered. LA induced apoptosis as evidenced by changes in aorta morphology and immunohistochemistry. Lipid peroxides (LPO) was increased in apo E KO mice with or without LA corresponding to the accumulation of 4-HNE or MDA in the proximal aorta above the atria. GT consumption tended to reduce the primary causal mechanism of atherogenic phenomena such as oxidizability in both LA and DHA treated atherogenic mice. A high polyunsaturated fatty acids (PUFA) diet involved the changes on stress-induced apoptotic signaling by increasing caspase 3, cytochrome c, and nuclear factor-${\kappa}B$ in the heart tissue, but decreasing the bcl-2 protein. However, GT remarkably reduced the expression of apoptotic signaling, in contrast to the PUFA diet. Therefore, the potential of GT as an anti-atherosclerotic dietary antioxidant was tested in this study.

The Actual State of Industrial Accidents in Small-medium Manufacturing Industries (중·소규모 제조업 사업장의 산업재해 실태)

  • Hong, Seong-Ja;Jeon, Man-Joong;Kim, Chang-Yoon
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.1
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    • pp.93-103
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    • 2011
  • Purpose: This study was conducted to assess reported industrial accidents and non-reported industrial accidents that took place in 63 small and medium sized manufacturing industries located in Daegu and Gyeongsangbuk-do in the year of 2009. Methods: During the period from January to December 2009, the number of industrial accidents that happened each month was examined according to the characteristics of industry, industrial accidents, workers with industrial accidents, treatment, as well as causes and treatment of the non-reported. Results: The total incidence rate of industrial accidents was 3.48%, of which only 0.31% reported. The incidence rate in packing and distribution among manufacturing workplace, and in the industry with 50~99 employees, was higher than the other groups. Of the non-reported, over 80% in required under 10 days of medical treatment, and 56% in required cost of less than 100,000 won. Kappa values were 0.771 concurrence in opinions for causes of non-reported, and 0.571 concurrence in opinions for management termination of non-reported between the employees and employer. Conclusion: It is suggested that more supportive policy and precise, nationwide survey on the actual state of industrial accidents, including non-reported cases, be implemented to efficiently manage industrial accidents.

The Effects of 120 Hz High Frequency Electroacupuncture on the Gastric Mucosa in Cold-Restraint Stressed Rats (고빈도 120 Hz 전침이 Cold-Restraint 스트레스 유발 흰쥐의 위점막에 미치는 영향(影響))

  • Jo, Mee-Hyeong;Ahn, Chang-Beohm;Song, Choon-Ho;Yoon, Hyoun-Min;Kim, Cheol-Hong;Jang, Kyung-Jeon
    • Korean Journal of Acupuncture
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    • v.21 no.4
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    • pp.101-115
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    • 2004
  • Objective : The present studies investigated the effects of 120 Hz high frequency electroacupuncture (EA) on the stress-induced stomach dysfunction in relation to its effect on the level of stress hormones and gastric mucosal damages. The gastric mucosal injury was induced by cold-restraint stress and two acupoints corresponding to Zusanli and Sanyinjiao in man were used. Methods : Cold-restraint stress produced typical gastric lesions in all rats of the stressed groups, but the number of ulcers as well as the mean ulcer diameter were reduced by 120 Hz EA pre-treatment. Results : The degranulation value of gastric mast cell was significantly higher in cold-restrained rats than in control ones. However, with the significant reduction of degranulation values of gastric mast cells in EA pre-treated rats compared with cold-restrained rats. Cold-restarint stress induced an elevated mRNA expression of pro-inflammatory gene such as cyclooxygenases-2 and tumor necrosis factor $(TNF)-{\alpha}$, but these expression were down-regulated in EA pre-treated rats. Immunohistochemical analysis showed that while the $inhibitory-{\kappa}B{\alpha}$ and $TNF-{\alpha}$ immunorection in the surface epithelium of the stomach tended to increase, both reactions in the EA pre-treated rats showed similar pattern as observed in controls. Conclusion : These results suggest that 120 Hz EA may act as a therapeutical means for gastric mucosal damages through an activation of pituitary adrenal system. It could be concluded that 120 Hz high frequency electroaucupuncture affords a good protective potential against stress-induced gastrointestinal dysfunction.

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Pulping Properties of Bast Fibers of Paper Mulberry by Pre-steaming and 2-stage Cooking System (증기 전처리 및 2단 증해 시스템에 의한 닥 인피부의 펄프화 특성)

  • Hwang, Ji Hyun;Seo, Jin Ho;Kim, Hyoung Jin
    • Journal of Korea Technical Association of The Pulp and Paper Industry
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    • v.45 no.1
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    • pp.75-82
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    • 2013
  • The traditional Hanji-making was confronted with lots of industrial disadvantages and economic problems, due to the original hand-made process. Recently, the studies on the automation of overall Hanji manufacturing process is carried out by applying the commercial chemical pulping method in order to expand industrial application or efficiency of non-wood fibrous materials. However, the application of commercial pulping methods to the bast tissues of paper mulberry leads to the chemical and mechanical deterioration of cellulosic fibers. In this study, the optimal cooking method using the bast parts of paper mulberry produced by an auto-scraping device was applied to minimize the damage of fiber strength for the paper yarn manufacture. The pre-steaming treatment and alkaline pulping systems were evaluated in removal efficiency of lignin and pectin materials within the bast tissue of paper mulberry. With the application of pre-steaming treatment and 2 stage pulping system using potassium carbonate and then sodium hydroxide, kappa values were decreased two times more in lignin removal than the single stage of pulping method. It was also identified from SEM images and ATR-FTIR spectra that the pectin components within cellular structure of bast tissue were easily removed and the debarked bast parts by a auto-scraping device were easily defiberized by 2-stage pulping sequence using potassium carbonate/sodium hydroxide pulping system.

Comparison of Validity of Food Group Intake by Food Frequency Questionnaire Between Pre- and Post-adjustment Estimates Derived from 2-day 24-hour Recalls in Combination with the Probability of Consumption

  • Kim, Dong-Woo;Oh, Se-Young;Kwon, Sung-Ok;Kim, Jeong-Seon
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2655-2661
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    • 2012
  • Validation of a food frequency questionnaire (FFQ) utilising a short-term measurement method is challenging when the reference method does not accurately reflect the usual food intake. In addition, food group intake that is not consumed on daily basis is more critical when episodically consumed foods are related and compared. To overcome these challenges, several statistical approaches have been developed to determine usual food intake distributions. The Multiple Source Method (MSM) can calculate the usual food intake by combining the frequency questions of an FFQ with the short-term food intake amount data. In this study, we applied the MSM to estimate the usual food group intake and evaluate the validity of an FFQ with a group of 333 Korean children (aged 3-6 y) who completed two 24-hour recalls (24HR) and one FFQ in 2010. After adjusting the data using the MSM procedure, the true rate of non-consumption for all food groups was less than 1% except for the beans group. The median Spearman correlation coefficients against FFQ of the mean of 2-d 24HRs data and the MSM-adjusted data were 0.20 (range: 0.11 to 0.40) and 0.35 (range: 0.14 to 0.60), respectively. The weighted kappa values against FFQ ranged from 0.08 to 0.25 for the mean of 2-d 24HRs data and from 0.10 to 0.41 for the MSM-adjusted data. For most food groups, the MSM-adjusted data showed relatively stronger correlations against FFQ than raw 2-d 24HRs data, from 0.03 (beverages) to 0.34 (mushrooms). The results of this study indicated that the application of the MSM, which was a better estimate of the usual intake, could be worth considering in FFQ validation studies among Korean children.

Classification of tree species using high-resolution QuickBird-2 satellite images in the valley of Ui-dong in Bukhansan National Park

  • Choi, Hye-Mi;Yang, Keum-Chul
    • Journal of Ecology and Environment
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    • v.35 no.2
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    • pp.91-98
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    • 2012
  • This study was performed in order to suggest the possibility of tree species classification using high-resolution QuickBird-2 images spectral characteristics comparison(digital numbers [DNs]) of tree species, tree species classification, and accuracy verification. In October 2010, the tree species of three conifers and eight broad-leaved trees were examined in the areas studied. The spectral characteristics of each species were observed, and the study area was classified by image classification. The results were as follows: Panchromatic and multi-spectral band 4 was found to be useful for tree species classification. DNs values of conifers were lower than broad-leaved trees. Vegetation indices such as normalized difference vegetation index (NDVI), soil brightness index (SBI), green vegetation index (GVI) and Biband showed similar patterns to band 4 and panchromatic (PAN); Tukey's multiple comparison test was significant among tree species. However, tree species within the same genus, such as $Pinus$ $densiflora-P.$ $rigida$ and $Quercus$ $mongolica-Q.$ $serrata$, showed similar DNs patterns and, therefore, supervised classification results were difficult to distinguish within the same genus; Random selection of validation pixels showed an overall classification accuracy of 74.1% and Kappa coefficient was 70.6%. The classification accuracy of $Pterocarya$ $stenoptera$, 89.5%, was found to be the highest. The classification accuracy of broad-leaved trees was lower than expected, ranging from 47.9% to 88.9%. $P.$ $densiflora-P.$ $rigida$ and $Q.$ $mongolica-Q.$ $serrata$ were classified as the same species because they did not show significant differences in terms of spectral patterns.

Objective assessment of cleft lip nose deformity by neural network (구순열 비변형의 객관적 평가를 위한 Neural Network의 적용)

  • Park, Joong-Hoon;Kim, Jin-Tae;Hong, Hyun-Ki;Kim, Soo-Chan;Kim, Deok-Won
    • Proceedings of the KIEE Conference
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    • 2006.04a
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    • pp.45-47
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    • 2006
  • Cleft palate is a congenital deformity condition with separation of the two sides of the lip resulting in nose deformity. Evaluation of surgical corrections and outcome assessments for nose deformity due to the cleft lip depends mainly on doctor's subjective judgment. An objective method for evaluation of the condition and surgical outcome of nose deformity due to the cleft palate is needed. This study aimed at objective assessment of a cleft palate nose deformity condition by analyzing the following parameters obtained from photographic images of a cleft palate patients: (1) angle difference between two nostril axes. (2) center of the nostril and distance between two centers. (3) overlapped area of two nostrils, and (4) the overlapped area ratio of the two nostrils. A regression equation of doctor's grades was obtained using the eight parameters. Three plastic surgeons gave us the grades for the each photographic image by 10 increments with maximum grade of 100. The average reproducibility of the grades given by the three plastic surgeons and the three laymen using the developed program was $10.8{\pm}4.6%$ and $7.4{\pm}1.8%$, respectively. Kappa values representing the degree of consensus of the plastic surgeons and the three laymen were 0.43 and 0.83. respectively. Correlation coefficient of the grades evaluated by the surgeons and obtained by the neural network was 0.798. In conclusion. the developed neural network model provided us better reproducibility and much better consensus than doctor's subjective evaluation in addition to objectiveness and easy application.

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