scholarly journals Study On Coronary Dissection Complication Caused by Uneven Rotational Atherectomy Due To Guidewire Bias for Severe Calcified Lesions

2021 ◽  
Author(s):  
Fei Ye ◽  
Wei You ◽  
Hong-li Zhang ◽  
Tian Xu ◽  
Pei-na Meng ◽  
...  
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Coronary Calcification ◽  
Rotational Atherectomy ◽  
Cross Sectional ◽  
Actual Meaning ◽  
Oct Imaging ◽  
Calcified Coronary Lesions ◽  
Catheter Location

Abstract BACKGROUND In the treatment of coronary calcification by rotational atherectomy (ROTA), guidewire bias is often considered to lead to procedure associated coronary dissections or perforations. However, the actual meaning of guidewire bias is unclear, though it usually refers to the cross-section location of the intravascular imaging (IVI) catheter in the coronary artery. OBJECTIVES This study tentatively explores the quantitative criteria in optical coherence tomography (OCT) imaging of guidewire bias which may cause ROTA induced coronary dissection. METHODS A total of twenty-one patients with severe calcified coronary lesions who has undergone ROTA treatment were enrolled in our study. These patients were detected by OCT successfully pre- and post-ROTA. All the observational coronary segments were analyzed cross-sectionally at every mm interval after manual coregistration of OCT imaging pre- and post-ROTA. ROTA related coronary dissection was the primary endpoint. RESULTS A total of 388 OCT cross-sectional images were effectively measured and analyzed for distribution and characteristics of plaque and OCT catheter location pre-ROTA, and the presence or absence of coronary dissections post-ROTA after manual coregistration. According to the receiver operating characteristic (ROC) analysis, distance from the center of OCT catheter to media at the bias direction (Dcmb) (area under the curve (AUC): 1.000, p<0.001, 95% confidence intervals (CI): 0.999 to 1.000) and touch angle (AUC: 0.988, p<0.001, 95%CI: 0.968 to 1.000) had a higher correlation with ROTA-related coronary dissection with the corresponding cutoff value of 0.720mm and 98.2º significantly. CONCLUSIONS Dcmb and touch angle detected by OCT are two very valuable and convenient independent predictors of ROTA-related coronary intimal dissections caused by guidewire bias.

scholarly journals Swallowing Speed as Potential Predictor of Aspiration in Parkinson’s Disease Patients

2019 ◽  
Author(s):  
Christina Pflug ◽  
Almut Niessen ◽  
Carsten Buhmann ◽  
Moritz Bihler
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Cross Sectional Study ◽  
Water Area ◽  
Clinical Test ◽  
Endoscopic Evaluation ◽  
Cross Sectional ◽  
Methodological Errors ◽  
Insufficient Sensitivity

There is still a lack of a clinical test to reliably identify patients with Parkinson&rsquo;s disease (PD) being at risk for aspiration. In this prospective, controlled, cross-sectional study we assessed if swallowing speed for water is a useful clinical test to predict aspiration proven by flexible endoscopic evaluation of swallowing (FEES). Due to this we measured the swallowing speed for 90 ml water in 115 consecutive and unselected PD outpatients of all clinical stages and 32 healthy controls. Average swallowing speed was lower in patients compared with controls (6.5 &plusmn; 3.9 ml/s vs. 8.5 &plusmn; 3.2 ml/s; p &lt; 0.01). The disease-independent widely used threshold of &lt; 10 ml/s showed insufficient sensitivity of 88% and specificity of 19% with unacceptable false-positive rates of 63% for patients and 69% for controls. Receiver operating characteristic (ROC) analysis was carried out to define a suitable cut-off value for detection of aspiration of water (area under the curve 0.72, p &lt; 0.001) in PD patients. The optimized cut-off value was 5.5 ml/s with a sensitivity of 69% and a specificity of 64%. Overall, measuring swallowing speed is prone to methodological errors and not suitable as a screening instrument to predict aspiration in PD patients.

The potential value of a pictorial atlas for aid in the visual diagnosis of 123I FP-CIT SPECT scans

2009 ◽  
Vol 48 (04) ◽  
pp. 173-178 ◽  
Author(s):  
H. Ham ◽  
A. Dobbeleir ◽  
P. Santens ◽  
Y. D'Asseler ◽  
I. Goethals
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Interobserver Variability ◽  
Area Under The Curve ◽  
Visual Assessment ◽  
Added Value ◽  
Related Disorder ◽  
Visual Diagnosis ◽  
Spect Images

SummaryThe aim of our study was to evaluate the value of a pictorial atlas of 123I FP-CIT SPECT images for aid in the visual diagnosis. Patients, materials, methods: Sixty patients, of whom 20 were clinically diagnosed as ‘non-parkinsonian’ and 40 as having Parkinson's disease or any related disorder, were included in the study. An atlas consisting of 12 123I FP-CIT SPECT images was constructed first. Validity of the atlas was investigated by performing a receiver operating characteristic (ROC) analysis with the clinical diagnosis as the gold standard. The remaining 48 SPECT images were visually assessed twice by 5 observers, first with and secondly without consulting the atlas, or vice versa. The added value of the atlas was investigated by comparing the diagnostic accuracy and the interobserver variability for both methods. Results: ROC analysis performed on the atlas yielded an area under the curve of 1 for a threshold discriminating between clinically non-parkinsonian and parkinsonian patients that was situated between image 4 and 5 of the atlas. For the diagnostic accuracy, we found that the area under the ROC curve was systematically higher if observers had access to the atlas compared to when they had not (Wilcoxon's test, p<0.05). Also, the interobserver variability was significantly lower when observers used the atlas when compared to when they did not (p = 0.05). Conclusion: Diagnostic accuracy was significantly higher and interobserver variability significantly lower if observers had access to the atlas compared to when they had not. Hence, having a pictorial atlas available may facilitate the visual assessment of 123I FP-CIT SPECT scans.

scholarly journals Expression Analysis of Circulating miR-22, miR-122, miR-217 and miR-367 as Promising Biomarkers of Acute Lymphoblastic Leukemia

2021 ◽  
Author(s):  
Fatemeh hosseinpour-soleimani ◽  
Gholamreza Khamisipour ◽  
Zahra Derakhshan ◽  
Bahram Ahmadi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Lymphoblastic Leukemia ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Healthy Individuals ◽  
Quantitative Real Time Pcr ◽  
Expression Levels

Abstract Background Currently, the role of serum-based biomarkers such as microRNAs in cancer diagnosis has been extensively established. This study aimed to determine expression levels of bioinformatically selected miRNAs and whether they can be used as biomarkers or a new therapeutic target in patients with Acute Lymphoblastic Leukemia (ALL). Materials and Methods The expression levels of serum miR-22, miR-122, miR-217, and miR-367 in 21 ALL patients and 21 healthy controls were measured using quantitative real-time PCR. The receiver operating characteristic (ROC) curve and the associated area under the curve (AUC) was used to assess candidate miRNAs' diagnostic value as a biomarker. Results The results showed that miR-217 was markedly decreased in patients with ALL compared to controls. Moreover, miR-22, miR-122, and miR-367 were found to be upregulated. Furthermore, ROC analysis showed that serum miR-217 and miR-367 could differentiate ALL patients from the healthy individuals, while miR-22 has approximate discriminatory power that requires further investigation. Conclusion Collectively, the results suggested that miR-217 may play a tumor suppressor role in ALL, whereas miR-22, miR-122, and miR-367 could function as an oncogene. Overall, miR-22, miR-217, and miR-367 could be considered possible biomarkers for the early diagnosis of ALL.

scholarly journals A model of visual limitation in patients with keratoconus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Antonio Pérez-Rueda ◽  
Gracia Castro-Luna
Keyword(s):  
Visual Acuity ◽  
Logistic Regression ◽  
Operating Characteristic ◽  
Spherical Aberration ◽  
Area Under The Curve ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Corrected Visual Acuity

Abstract This paper aims to calculate a relevance model of visual limitation (V.L.) in keratoconus patients based on refractive and topographic parameters. A cross-sectional study was carried out in Torrecárdenas Hospital, Almería, Spain, between February 2018 and July 2019. It included 250 keratoconus patients. Two groups were created according to a grading system of V.L. based on RETICS (Red Temática de Investigación Cooperativa en Salud) classification: keratoconus patients with no V.L. (best spectacle-corrected visual acuity (BSCVA) ≤ 0.05 logMAR) and keratoconus patients with V.L. (BSCVA > 0.05 logMAR). Correlations and a binary logistic regression were established. V.L. was correlated with maximum curvature (r = 0.649, p < 0.001) and root mean square higher-order aberrations (HOARMS) (r = 0.625, p < 0.001). Binary logistic regression included V.L. as the dependent variable and spherical equivalent, HOARMS, spherical aberration and interaction between the anterior and posterior vertical coma as independent variables. The model was a good fit. Area under the curve (A.U.C.) of receiver operating characteristic (R.O.C.) curve was 0.924, sensitivity 91.90%, specificity 83.60%, accuracy 88.94%; and precision 91.17%. Binary logistic regression model of V.L. is a good fit model to predict the early loss of visual acuity in keratoconus patients.

CA549 and TPS Patterns in the Diagnosis and Staging of Patients with Breast Carcinoma

1996 ◽  
Vol 11 (4) ◽  
pp. 198-202 ◽  
Author(s):  
H.G. Vibert ◽  
A.S. Houston ◽  
G.P. Wilkins ◽  
P.M. Kemp ◽  
M.A. Macleod
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Benign Breast Disease ◽  
Area Under The Curve ◽  
Breast Disease ◽  
Clinical Value ◽  
Variable Threshold ◽  
Individual Marker ◽  
The Difference ◽  
Active Disease

This study compares the clinical value of the breast cancer tumour markers CA549 and TPS, and their tandem use when one or both markers indicate abnormality. For 144 patients presenting with active disease, 33 were classified as Stage I, 37 as Stage II, 40 as Stage III and 34 as Stage TV. For these patients the sensitivity of CA549 using a cut-off of 10 U/ml was 27%, 32%, 42% and 79%, respectively. The sensitivity of TPS for each stage using a cut-off of 100 U/l was 12%, 22%, 28% and 73%, respectively. At these cut-off levels, 36%, 46%, 63% and 91% of patients, respectively, have either CA549 or TPS or both markers raised. For 161 patients with diagnosed benign breast disease, the specificity of marker levels was 96% for CA549, 88% for TPS and 84% for tandem use. CA549 is shown to be superior to TPS and this was confirmed by Receiver Operating Characteristic (ROC) analysis using variable threshold levels, with the areas under the curves for all stages combined being 0.74 ± 0.03 (1SD) and 0.66 ± 0.03, respectively. The corresponding area under the curve for tandem use (0.75 ± 0.03) is marginally greater than for either individual marker, although the difference with respect to CA549 is statistically insignificant.

scholarly journals Serum Epiplakin Might Be a Potential Serodiagnostic Biomarker for Bladder Cancer

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5150
Author(s):  
Soichiro Shimura ◽  
Kazumasa Matsumoto ◽  
Yuriko Shimizu ◽  
Kohei Mochizuki ◽  
Yutaka Shiono ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Healthy Volunteers ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Early Stage ◽  
Area Under The Curve ◽  
Stone Disease ◽  
Dot Blot ◽  
Expression Levels ◽  
Clinicopathological Findings

Tumor markers that can be detected at an early stage are needed. Here, we evaluated the epiplakin expression levels in sera from patients with bladder cancer (BC). Using a micro-dot blot array, we evaluated epiplakin expression levels in 60 patients with BC, 20 patients with stone disease, and 28 healthy volunteers. The area under the curve (AUC) and best cut-off point were calculated using receiver-operating characteristic (ROC) analysis. Serum epiplakin levels were significantly higher in patients with BC than in those with stone disease (p = 0.0013) and in healthy volunteers (p < 0.0001). The AUC-ROC level for BC was 0.78 (95% confidence interval (CI) = 0.69–0.87). Using a cut-off point of 873, epiplakin expression levels exhibited 68.3% sensitivity and 79.2% specificity for BC. However, the serum epiplakin levels did not significantly differ by sex, age, pathological stage and grade, or urine cytology. We performed immunohistochemical staining using the same antibody on another cohort of 127 patients who underwent radical cystectomy. Univariate and multivariate analysis results showed no significant differences between epiplakin expression, clinicopathological findings, and patient prognoses. Our results showed that serum epiplakin might be a potential serodiagnostic biomarker in patients with BC.

scholarly journals Assessment of enamel demineralization using conventional, digital, and digitized radiography

2006 ◽  
Vol 20 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Rívea Inês Ferreira ◽  
Francisco Haiter-Neto ◽  
Cínthia Pereira Machado Tabchoury ◽  
Guilherme Assumpção Neves de Paiva ◽  
Frab Norberto Bóscolo
Keyword(s):  
Roc Analysis ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Enamel Demineralization ◽  
Contrast Enhanced ◽  
Chi Square Test ◽  
Approximal Surfaces

This experimental research aimed at evaluating the accuracy of enamel demineralization detection using conventional, digital, and digitized radiographs, as well as to compare radiographs and logarithmically contrast-enhanced subtraction images. Enamel subsurface demineralization was induced on one of the approximal surfaces of 49 sound third molars. Standardized radiographs of the teeth were taken prior to and after the demineralization phase with three digital systems - CygnusRay MPS®, DenOptix® and DIGORA® - and InSight® film. Three radiologists interpreted the pairs of conventional, digital, and digitized radiographs in two different occasions. Logarithmically contrast-enhanced subtraction images were examined by a fourth radiologist only once. Radiographic diagnosis was validated by cross-sectional microhardness profiling in the test areas of the approximal surfaces. Accuracy was estimated by Receiver Operating Characteristic (ROC) analysis. Chi-square test, at a significance level of 5%, was used to compare the areas under the ROC curves (Az) calculated for the different imaging modalities. Concerning the radiographs, the DenOptix® system (Az = 0.91) and conventional radiographs (Az = 0.90) presented the highest accuracy values compared with the other three radiographic modalities. However, logarithmically contrast-enhanced subtraction images (Az = 0.98) were significantly more accurate than conventional, digital, and digitized radiographs (p = 0.0000). It can be concluded that the DenOptix® system and conventional radiographs provide better performance for diagnosing enamel subsurface demineralization. Logarithmic subtraction significantly improves radiographic detection.

scholarly journals Serum Indoleamine 2,3-Dioxygenase Activity Predicts Prognosis of Pulmonary Tuberculosis

2012 ◽  
Vol 19 (3) ◽  
pp. 436-442 ◽  
Author(s):  
Yuzo Suzuki ◽  
Takafumi Suda ◽  
Kazuhiro Asada ◽  
Seiichi Miwa ◽  
Masako Suzuki ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Major Health Problem ◽  
Major Health ◽  
Indoleamine 2,3 Dioxygenase ◽  
Rate Limiting Step ◽  
Limiting Step ◽  
Rate Limiting

ABSTRACTTuberculosis (TB) continues to be a major health problem, and there are few biomarkers for predicting prognosis. Indoleamine 2,3-dioxygenase (IDO), a potent immunoregulatory molecule, catalyzes the rate-limiting step of tryptophan (Trp) degradation in the kynurenine (Kyn) pathway. An increase in IDO activity determined by the serum Trp/Kyn ratio has been shown to be associated with poor prognosis in cancers and bacteremia. In TB, however, there are no studies measuring serum IDO activity to determine its clinical significance. We evaluated serum IDO activity with 174 pulmonary TB (PTB) patients and 85 controls, using liquid chromatography/electrospray ionization tandem mass spectrometry. IDO activity was estimated by calculating the serum Kyn-to-Trp ratio. PTB patients had significantly higher Kyn concentrations and IDO activity and significantly lower Trp concentrations (P< 0.0001,P< 0.0001, andP< 0.0001, respectively) than the controls. Of 174 PTB patients, 39 (22.4%) died. The patients who died had significantly higher concentrations of Kyn and significantly lower Trp concentrations, resulting in significantly higher IDO activity (P< 0.0001,P< 0.0001, andP< 0.0001, respectively). In a receiver operating characteristic (ROC) analysis, serum IDO activity had the highest area under the curve (0.850), and this activity was an independent prognostic factor in multivariate analysis. These results suggest that serum IDO activity can be used as a novel prognostic marker in PTB.

When Calcium Gets Tough, the Tough Cardiologist Starts to Play …

Cardiology ◽  
2018 ◽  
Vol 141 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Eliezer Joseph Tassone ◽  
Cesare Tripolino ◽  
Gaetano Morabito ◽  
Placido Grillo ◽  
Bindo Missiroli
Keyword(s):  
Coronary Angiography ◽  
Coronary Calcification ◽  
Rotational Atherectomy ◽  
Sound Waves ◽  
Diagonal Branch ◽  
Coronary Syndrome ◽  
First Case ◽  
Coronary Lesions ◽  
Angioplasty And Stenting ◽  
Calcified Coronary Lesions

Coronary calcification is a hard challenge for the interventional cardiologist, as it is associated with incomplete stent expansion and frequently stent failure. In recent years, innovative techniques, such as rotational atherectomy, have been developed to treat coronary calcification. However, these are burdened with an increased procedural risk. We report the case of a 60-year-old Caucasian man treated 1 month before at another center with primary coronary angioplasty and stenting of the ramus intermedius for coronary syndrome. Coronary angiography showed a critical stenosis of the left main coronary artery as well as critical calcified stenosis of the left anterior descending artery and the diagonal branch. Coronary calcification was treated with rotational atherectomy that preceded the angioplasty and stenting. Because of persistence of the symptomatology, coronary angiography was repeated 1 month later and showed a critical calcified restenosis of the ramus intermedius at the site of the previous stenting. Considering the high risk of traditional atherectomy, we performed lithotripsy-enhanced disruption of calcium beyond the stents with the Shockwave Coronary Lithoplasty System. The Shockwave Coronary Lithoplasty System has been introduced recently in order to treat calcified coronary lesions with greater safety. The procedure allows most calcified coronary lesions to be treated with simplicity and safety. This system employs sound waves, similar to those used for treating kidney stones, to crush the calcified lesions. We present the first case described to date in whom this technique was successfully used to treat calcified restenosis in a previous stent.

scholarly journals Early Cutoff Criteria for Strong Performance on the Test of Memory Malingering

2019 ◽  
Vol 35 (4) ◽  
pp. 429-433
Author(s):  
Angelina J Polsinelli ◽  
Jane H Cerhan
Keyword(s):  
Clinical Setting ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Cognitive Status ◽  
Neuropsychological Evaluation ◽  
Performance Validity ◽  
Test Of Memory Malingering ◽  
Perfect Score ◽  
Strong Performance

Abstract Objective The Test of Memory Malingering (TOMM) is widely used to assess performance validity. To improve efficiency, we investigated whether abbreviated administration (i.e., only the first 25 items of Trial 1 [T1]) is possible when effort is very strong (≥49/50 on T1 or T2). Method We collected TOMM scores of 501 consecutive adult patients ranging in cognitive status who underwent standard neuropsychological evaluation at Mayo Clinic, Rochester, MN. Results Receiver Operating Characteristic (ROC) analysis showed excellent area under the curve (AUC) (0.94; CI95% [0.92, 0.97]) and a cutoff of 25/25 had 100% specificity for identifying strong performance. Of the 224 patients who obtained a perfect score on the first 25 items, 197 (88%) obtained ≥49 on T1 and the remaining patients (n = 27) obtained ≥49 on T2. Conclusion A perfect score on the first 25 items of the TOMM predicted overall strong performance 100% of the time, supporting abbreviated administration in select cases in a general outpatient clinical setting.

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