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PubMed1989

A discussion on the conventional estimator of sensitivity and specificity in multiple tests.

Both the variation of positive responses (negative responses) among individuals and the internal correlation among responses for the same individual affect the precision of the estimate of sensitivity (specificity). To estimate the sensitivity (specificity) of a medical diagnostic test, this paper proposes a Bayesian approach with a simple Markov model to evaluate the performance of the conventional estimator under different situations. On the basis of the assumed model, we derive a general formula for the variance of the conventional estimator regarding multiple tests and present a quantitative discussion on the limitations of this estimator.

Analysis of Variance↗
PubMed1992

Progetto ATENA, a study on the etiology of major chronic diseases in women: design, rationale and objectives.

In spite of their important impact on populations, a number of diseases--all types of cancer and coronary heart disease in women--are "rare" events for statistical analysis and often analyzed in designs affected by selection and information biases, such as case-control studies. Large cohort studies based on the storage of biological specimens appear to be the most suitable solution for identifying risks for those diseases. Progetto ATENA, a study on the etiology of major chronic diseases in women is based on this design. Ten thousand women, aged 30-69 years, living in the area of the city of Naples, free of cancer and cardiovascular disease, are being recruited over a four-year period. Ten per cent of the cohort is being randomly selected from the electoral roles, the rest will be volunteers. Information on dietary habits, reproductive history, familiarity for chronic disease, active smoking habits and passive smoking exposure, physical activity, and socio-demographic data are being collected. Clinical data such as blood pressure, anthropometry, and electrocardiogram are also taken. All the participants provide biological samples of blood (fasting drawing) and urine (timed morning spot). The biological samples are processed in order to explore the main areas under study (nutritional markers, metabolism, endocrinology, genetics, environmental exposure markers, thrombogenesis). The samples are stored in liquid nitrogen (-196 degrees C) as soon as the blood and urine processing have been finished. An appropriate follow-up information system on the health status of the participants is being set up to estimate incidence and mortality rates.

Adult↗
PubMed1993

Hepatocellular carcinoma: the diagnostic difficulties of ultrasonography and analysis of risk factors in MHTS.

Thirty-nine cases of hepatocellular carcinoma (HCC) out of 55,135 examinees were examined. The diagnostic problems of ultrasonography (US) in detecting HCC and the risk value of 10 factors in HCC were discussed. We also propose the surveillance programs for HCC in Multiphasic Health Testing and Services (MHTS). US will be performed at 3-, or 6 monthly intervals in conjunction with AFP monitoring for the examinees over 50 males and over seventy females with liver dysfunction (GOT > 38 IU/ml) is recommended.

Adult↗
PubMed1993

Correlative evaluation of serum lipid, blood glucose, blood pressure, serum immunoreactive insulin, and liver function in persons undergoing regularly scheduled health evaluations.

Two hundred and thirty eight persons were examined to evaluate the interrelations among seven key factors for arteriosclerosis: body mass index (BMI), systolic blood pressure (BPs), plasma glucose (PG), serum cholesterol (CHO), serum triglyceride (TG), serum glutamic-pyruvic transaminase (SGPT), and serum insulin (IRI). BPs showed the significant positive correlation with PG (r = 0.346), BMI (r = 0.318), and IRI (r = 0.200). However, there were no significant correlations between BPs and CHO, between BPs and TG, between BPs and SGPT. SGPT showed the significant positive correlation with IRI (r = 0.367), BMI (r = 0.268), and TG (r = 0.343); but no significant correlations were observed in relations between SGPT and PG, between SGPT and BPs, between SGPT and CHO. IRI showed the significant positive correlations with TG (r = 0.234), and PG (r = 0.427). These data suggest that IRI has an effect on BPs and SGPT. The effect of IRI on BPs relates with PG but does not relate with serum lipid. The effect of IRI on SGPT relates with TG but not with PG.

Adult↗
PubMed1993

A study on the development of a filing system for funduscopic images with a personal computer for Twin AMHTS.

A filing system for ocular funduscopic image data was developed by using a personal computer for the Twin AMHTS. The development of the system was tried as one of the data transfer system including image data between two similar AMHTSs named the Twin AMHTS through the information network system. The filing system is capable of storing 26782 data of ophthalmoscopic pictures with a data compression mode by using a magneto-optical disk (MOD) whose storage capacity of both sides is 616 MB. It takes no long time for retrieval and display of the image data in the filing system. Good quality of compression and decompression obtained and reproducibility of the ocular fundus picture is favorable regardless of normal or abnormal cases. As a result, it is suggested that the developed system has practical utility although it requires more improvement.

Computer Communication Networks↗
PubMed1996

Adenosquamous carcinoma of the stomach associated with separate early gastric cancer (type IIc).

Adenosquamous carcinoma originating in the stomach is a relatively rare entity. It comprises less than 0.5% of all gastric cancers. Recently, we encountered a patient with gastric adenosquamous carcinoma associated with separate early gastric cancer (type IIc). The patient was a 72-year-old man who was diagnosed as having gastric cancer in a multiphasic health screening examination conducted in May 1992. The patient subsequently underwent pylorogastrectomy. Examination of the resected specimen revealed two lesions, advanced cancer (Borrmann 2) and early cancer (type IIc). The lesions were histopathologically diagnosed as adenosquamous carcinoma and adenocarcinoma, respectively. The majority of gastric adenosquamous carcinomas are stage III or IV advanced cancers, and are treated according to the therapeutic protocol for adenocarcinomas. Their prognosis is generally poor. Continuous follow up is required for patients with these adenosquamous cancers, even after curative resection has been performed, because of the advanced nature of these lesions.

Adenocarcinoma↗
PubMed1994

Evaluation of an automated DNA profiling system employing multiplex amplification of four tetrameric STR loci.

We have examined the performance and reproducibility of an automated DNA profiling system which is based on the multiplex amplification of 4 tetrameric STR loci-HUMVWFA31/A. HUMTH01, HUMF13A1 and HUMFES/FPS. The system was able to type 100 pg of purified, undegraded, genomic DNA. At lower concentrations of DNA (below 100 pg), allelec drop-out occurred due to stochastic differences in allele copy number. Minor variation of individual PCR reagent concentrations or cycling temperatures did not result in a significant effect on the efficiency of amplification of any of the 4 loci in the quadruplex system. More substantial variation of reagent concentrations or cycling temperatures outside the optimum range of the system resulted in a reduction or complete loss of signal for one or more loci. This was also observed at high ionic strength or extreme pH. However, under all reagent concentrations and conditions studied, no artefact bands that could potentially result in the mistyping of a sample were apparent within the read region (130-240 bases) of the gel. Evaluation of both native and denaturing polyacrylamide gels revealed that, although native gels displayed faster run times, the sizing precision of such gels for certain STR loci was lower than that of denaturing gels. Also, artefact bands may be present within the read region of native gels. In conclusion the quadruplex amplification system described, coupled with automated fluorescence-based detection on denaturing polyacrylamide gels, appeared to be a robust and reliable system for individual identification.

Alleles↗
PubMedDate not supplied

Biochemical profiles and serotypes of nosocomial Enterobacter cloacae strains in Northern Norway: biochemical identification problems with commercial test systems.

During a period of 2 years, 118 strains of Enterobacter cloacae were collected consecutively in connection with nosocomial infections in Northern Norway; identified by conventional methods and by the API 20E system. The API 20E profile 3305573 predominated and was present in 73 of 118 strains. Among 96 serotyped strains, 73 were serotypable, 20 nontypable and two polyagglutinable. Predominating serotypes were 3 (29 strains), 8 (21 strains) and 23 (nine strains). When the API 20E profiles of the 118 strains were read in the new ATB (automated computer-assisted) 20E data base system, 97 of 118 (82.2%) strains were identified as E. cloacae. The 118 strains were tested in the new ATB Rapid ID 32E and ATB ID 32E (ATB system, bioMérieux, France) systems. Only 69 of 118 (58.5%) strains were identified as E. cloacae in both systems. The ATB Rapid ID 32E identified 97 of 118 strains (82.2%), and the ATB ID 32E only 80 of 118 strains (67.8%). Among 73 serotypable strains, the ATB Rapid ID 32E identified 79.5% as E. cloacae, while the ATB ID 32E identified only 64.4%. Among 40 serotypable strains with API 20E profile 3305573, all 40 were identified as E. cloacae by the ATB Rapid ID 32E, while only 27 (67.5%) by the ATB ID 32E system. Further improvements may increase the value of biochemical identification of E. cloacae in diagnostic work.

Bacterial Typing Techniques↗
PubMed1990

Follow-up study of participants in an extensive health examination programme at a Swedish industry.

Two years after an extensive health examination at a Swedish industry, a follow-up study was carried out in 110 employees (94% of those initially examined). The control included a history of the subject's health, a physical examination, an electrocardiogram, urine and faeces examinations and 16 chemical analyses of whole blood or serum. Except for repeat examinations of those who had had initial values outside reference values, most of the chemical analyses meant nothing, leading to unnecessary expense and possible risk of either worried or complacent participants. The history and physical and laboratory examinations, aimed at finding factors which can be improved by changing the life style seem to be most beneficial. It is concluded that extensive health examinations, including a large number of laboratory examinations which are carried out at many industries as a health control, should be critically evaluated at these industries.

Adult↗
PubMed1977

[Health education within the scope of family-health evaluation].

Multiphasic health screening an increasingly used preventive tool, may represent major milestones in health natural history of individuals as well as groups (in addition to their own specific goals) in terms of basis for a preference educational action. Based on their own experience in such a screening Center in France working mainly with families, the operating of the health screening itself is shown by the authors to offer a nice back up for health education. The concluding talk with families, specific to this Center's policy yields a unique opportunity for all family members to ask questions on their health problems, as well as for each physician involved to promote changes in their health behaviour. This kind of educational action is exacting for the physician, who has to be able to hear and to communicate easily, and who has to be specifically trained for it.

Adolescent↗
PubMed1980

The effects of diphenylhydantoin on the relationship between high-density lipoprotein cholesterol and several biochemical assays.

Correlations have been calculated between high-density lipoprotein cholesterol and total plasma cholesterol, albumin, gamma-glutamyl transpeptidase, aspartate aminotransferase, alkaline phosphatase, triglyceride, urea, creatinine and uric acid for diphenylhydantoin (DPH) users and for subjects attending a multiphasic health screening centre. For women DPH users, high-density lipoprotein levels correlated significantly with gamma glutamyl transpeptidase, cholesterol and alkaline phosphatase. These correlations were significantly different from those found for male DPH users and from subjects attending the health screening centre. In male DPH users, high-density lipoprotein cholesterol correlates negatively with urea and uric acid levels, a relationship which is found neither in women DPH users nor in the health screening centre population.

Adolescent↗
PubMed1996

Plasma lysosomal glycohydrolases in a general population.

In this study we evaluated the differences in plasma levels of some glycohydrolases of lysosomal origin that appear to be the most interesting for possible usefulness for diagnosis (N-acetyl-beta-D-glucosaminidase, beta-D-glucuronidase, alpha-D-galactosidase, beta-D-galactosidase, alpha-L-fucosidase and alpha-D-mannosidase) in a general population of 417 subjects, as related to age and sex and also to body mass and to some habits, such as smoking and consumption of alcohol. The enzymatic activities were assayed by fluorimetric techniques with 4-methylumbelliferyl-glycosides as substrates. Particular attention was given to some technical aspects. Enzymatic activity was preserved by addition of ethylene glycol and stable liquid material was employed for calibration purposes. Blood was sampled rigorously at the same time of day and all the samples were obtained within a short period of time to exclude effects of the circadian and circannual rhythms. beta-Glucuronidase levels were the most affected by sex and body mass. beta-D-Galactosidase was not affected by differences in age, sex, body mass or by smoking, but appeared to be the most sensitive to modification by alcohol consumption. The data in this report emphasize that, whenever changes or differences in the levels of lysosomal enzymes in body fluids are studied, it is essential to have a reference population rigorously correlated with the study population. When possible, repetitive measurements in the same subject could better indicate a clinical trend.

Adult↗