0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.]]>
Area Under Curve ; Blood Transfusion ; Calibration ; Cesarean Section ; Cohort Studies ; Discrimination (Psychology) ; Early Intervention (Education) ; Erythrocytes ; Female ; Humans ; Logistic Models ; Maternal Age ; Nomograms ; Placenta Previa ; Placenta ; Placentation ; Postpartum Hemorrhage ; Pregnancy ; ROC Curve ; Ultrasonography

Neuroinflammation is an important process underlying a wide variety of neurodegenerative diseases. Carvacrol (CAR) is a phenolic monoterpene commonly used as a food additive due to its antibacterial properties, but it has also been shown to exhibit strong antioxidative, anti-inflammatory, and neuroprotective effects. Here, we sought to investigate the effects of CAR on inflammation in the hippocampus and prefrontal cortex, as well as the molecular mechanisms underlying these effects. In our study, lipopolysaccharide was injected into the lateral ventricle of rats to induce memory impairment and neuroinflammation. Daily administration of CAR (25, 50, and 100 mg/kg) for 21 days improved recognition, discrimination, and memory impairments relative to untreated controls. CAR administration significantly attenuated expression of several inflammatory factors in the brain, including interleukin-1β, tumor necrosis factor-α, and cyclooxygenase-2. In addition, CAR significantly increased expression of brain-derived neurotrophic factor (BDNF) mRNA, and decreased expression of Toll-like receptor 4 (TLR4) mRNA. Taken together, these results show that CAR can improve memory impairment caused by neuroinflammation. This cognitive enhancement is due to the anti-inflammatory effects of CAR medicated by its regulation of BDNF and TLR4. Thus, CAR has significant potential as an inhibitor of memory degeneration in neurodegenerative diseases.
Animals ; Brain ; Brain-Derived Neurotrophic Factor ; Cyclooxygenase 2 ; Cytokines ; Discrimination (Psychology) ; Food Additives ; Hippocampus ; Inflammation ; Lateral Ventricles ; Lipopolysaccharides ; Memory ; Necrosis ; Neurodegenerative Diseases ; Neuroprotective Agents ; Phenol ; Prefrontal Cortex ; Rats ; RNA, Messenger ; Toll-Like Receptor 4

BACKGROUND AND OBJECTIVES: Adults with congenital heart disease (CHD) are an increasing group of patients thanks to the survival of over 85% of children with CHD. 20% of these patients shall warrant a surgical procedure during their life span. However, currently there is no one risk score that assess correctly the mortality of these procedures. Thus, we analyse the risk scores used at our institution. METHODS: From May 1991 till June 2017, 608 procedures in adults with CHD were performed. The 3 risk scores (risk adjustment for congenital heart surgery [RACHS-1], Aristotle, and Euroscore I) of each procedure were analysed. We used area under the receiver operating characteristic curve (c-index) to measure model discrimination, and Hosmer-Lemeshow (H-L) statistic along with calibration plots to measure calibration. RESULTS: There was no statistical difference between the area under the curve for the 3 scores (χ²=0.58 with 2 df, p=0.750). There was no evidence of lack of fit for RACHS-1 (H-L, χ²=2.61; p=0.271) and Aristotle score (H-L, χ²=5.69; p=0.459). However, there was evidence in lack of calibration in the Euroscore I scoring system (H-L, χ²=33.69; p<0.001). The calibration slope for RACHS-1 was 0.912, for Aristotle (stratified in risk groups) was −0.14 and for Euroscore 1 (stratified in risk groups) was 0.46. CONCLUSIONS: RACHS-1 seems to be best risk scoring system for calculating mortality applied to surgery in adults with CHD.
Adult ; Calibration ; Child ; Discrimination (Psychology) ; Heart Defects, Congenital ; Humans ; Mortality ; ROC Curve ; Thoracic Surgery

We reviewed past studies on the identification of familial relationships using 22 short tandem repeat markers. As a result, we can obtain a high discrimination power and a relatively accurate cut-off value in parent-child and full sibling relationships. However, in the case of pairs of uncle-nephew or cousin, we found a limit of low discrimination power of the likelihood ratio (LR) method. Therefore, we compare the LR ranking method and data mining techniques (e.g., logistic regression, linear discriminant analysis, diagonal linear discriminant analysis, diagonal quadratic discriminant analysis, K-nearest neighbor, classification and regression trees, support vector machines, random forest [RF], and penalized multivariate analysis) that can be applied to identify familial relationships, and provide a guideline for choosing the most appropriate model under a given situation. RF, one of the data mining techniques, was found to be more accurate than other methods. The accuracy of RF is 99.99% for parent-child, 99.44% for full siblings, 90.34% for uncle-nephew, and 79.69% for first cousins.
Classification ; Data Mining ; Discrimination (Psychology) ; Forests ; Humans ; Logistic Models ; Methods ; Microsatellite Repeats ; Siblings ; Support Vector Machine ; Trees

“Yong-yi” means “quack” in English, which generally refers to a doctor who does not have good medical skills. In the Ming and Qing dynasties in China, various criticism about “Yong-yi” became popularized, and by the late Qing period, “quacks” had become a serious social issue. The theory of traditional Chinese medicine was developed during the Ming and Qing dynasties, and local medical resources also increased. Moreover, the prevalence of medical book publishing led to the openness and generalization of medical knowledge. As a result, not only the number of doctors increased, but also the number of doctors who lack medical knowledge and clinical experience increased. However, at the outset, “Yong-yi” did not only mean doctors with poor medical skills. “Yong-yi” also reflected conflicts and contradictions between doctors. Doctors consistently criticized quacks in an attempt to maintain their identity as a “good” doctor or a Confucian doctor. In this sense, “Yong-yi” was used among physicians as an expression of discrimination and exclusion. The concept of “quackery” was also determined by the relationship between patients and doctors. In general, itinerant doctors, midwives and shaman doctors were regarded as “Yong-yi”; however, they served the medical needs of various patients. Thus, to some extent, “Yong-yi” were also useful medical resources. On the contrary, in certain situations, “shiyi,” physicians who serviced a family for generations and were generally believed to be reliable and as trustworthy doctors, were also labelled as quacks, especially when the patient did not trust them or was not satisfied with the treatment. Therefore, doctors' thoughts about “Yong-yi” did not always coincide with patients' thoughts about “Yong-yi.” However, by the late Qing period, the description of quacks in media reports found a singular connotation, and the divergent social image of quacks disappeared. By this time, quacks were uniformly described as ignorant and irresponsible Chinese medicine practitioners. Specifically, in one murder case in which a “Yong-yi” was accused as the murderer, the report unilaterally reported the patient's claims. Consequently, Chinese medicine practitioners who failed in their treatment of patients became labeled as “quack” doctors. In newspaper reports, “Yong-yi” no longer simply referred to individual cases of “quacks” but had come to represent the entirety of the Chinese medicine practitioner community. On the contrary, Western medical doctors who replaced the status of traditional doctors were positively portrayed. Pictorials also had similar perspectives with newspapers, supporting the narrative of the news with ironic drawings and articles. Overall, media reports regarding “Yong-yi” did not focus on reporting facts, but they had the purpose of making quacks a serious social problem.
Asian Continental Ancestry Group ; China ; Discrimination (Psychology) ; Family Characteristics ; Generalization (Psychology) ; Homicide ; Humans ; Iron ; Medicine, Chinese Traditional ; Midwifery ; Periodicals ; Prevalence ; Social Perception ; Social Problems

Lee Kap-Soo (April 23, 1889–December 5, 1973) graduated from Gyeongseong Medical College in 1920, went to Germany to study, and returned to Korea after graduating from Berlin University in 1924. On September 14, 1933, he played a leading role in the founding of the Joseon Eugenics Society, and he contributed eugenic ideas through written publications and lectures. He was a leading eugenicist who continued his activities related to eugenics, such as re-establishing the Korean National Eugenics Society and making efforts to enact the Eugenics Act after Korea's liberation from Japanese occupation. His ideas on eugenics were then a rapid acceptance of the world's times and science, and his ideas were an expanded eugenics that emphasized the nation. He actively carried out the campaign for eugenics and maintained a consistent stance before and after liberation. His eugenic ideas and activities show that Korean society was not free from the influence of eugenics that was gaining popularity around the world. His eugenic ideas were related to enlightenment, but the basis of eugenics was the logic of discrimination and exclusion. In particular, his eugenic ideas and activities have caused pain to Hansen's patients through forced isolation and discontinuation. In addition, his doctrine of eugenics still holds sway in Korean society. The history of Lee Kap-Soo's life and eugenics-related activities shows the important points and characteristics of the history of eugenics in Korean society before and after the liberation from Japan, and furthermore provides an important clue in understanding and explaining the colonial vestige in Korean society, economic growth first ideology, enthusiasm for scientific development, and competitive social culture.
Asian Continental Ancestry Group ; Berlin ; Discrimination (Psychology) ; Economic Development ; Eugenics ; Germany ; Humans ; Japan ; Korea ; Lectures ; Leprosy ; Logic ; Occupations

The purpose of this research is to describe how Hansen's disease patients experienced the modern system of control of Hansen's disease introduced by Japan, and the inimical attitude of society against them in colonial Korea. The study also seeks to reveal the development of the system to eliminate Hansen's disease patients from their home and community to larger society and leprosarium in this era. Sorokdo Charity hospital (SCH), a hospital for Hansen's disease patients, was built in 1916, and vagrant Hansen's disease patients began to be isolated in this hospital beginning in 1917 by the Japanese Government-General of Korea (JGGK). Once the police detained and sent vagrant Hansen's disease patients to SCH, stigma and discrimination against them strengthened in Korean society. Because of strong stigma and discrimination in Korean society, Hansen's disease patients suffered from daily threats of death. First, their family members were not only afraid of the contagiousness of Hansen's disease but also the stigma and discrimination against themselves by community members. If a family had a Hansen's disease patient, the rest of community members would discriminate against the entire family. Furthermore, because Hansen's disease patients were excluded from any economic livelihood such as getting a job, the existence of the patients was a big burden for their families. Therefore, many patients left their homes and began their vagrancy. The patients who could not leave their homes committed suicide or were killed by their family members. The victims of such deaths were usually women, who were at the lower position in the family hierarchy. In the strong Confucian society in Korea, more female patients were killed by themselves than male patients. Moreover, all of patients victims in the murder were women. This shows that the stigma and discrimination against Hansen's disease patients within their families were stronger against women than men. Strong stigma and discrimination made the patients rely on superstition such as cannibalism. Patients believed that there were not any effective medicine. There were a few reports of patients who were cured, and many were treated with chaulmoogra oil in the modern Hansen's disease hospitals. Eating human flesh was known as a folk remedy for Hansen's disease. As such, patients began to kill healthy people, usually children, to eat their flesh. Increased stigma led to increased victims. Hansen's disease patients who left their homes faced many threats during their vagrancy. For survival, they established their own organizations in the late 1920's. The patients who were rejected to be hospitalized in the Western Hansen's disease hospital at Busan, Daegu, and Yeosu organized self-help organizations. The purpose of these organizations was first to secure the medicine supply of chaulmoogra oil. However, as stigma and discrimination strengthened, these organizations formed by Hansen's disease patients demanded the Japanese Government-General of Korea to send and segregate them on Sorok island. They did not know the situation of the inside of this island because news media described it as a haven for patients, and very few patients were discharged from this island to tell the truth. On this island, several hundreds of patients were killed by compulsory heavy labor, starvation, and violence. They were not treated as patients, but as something to be eliminated. Under strong suppression on this island, the patients resisted first by escaping this island. However, in 1937, some patients tried to kill a Korean staff but failed. Attempted murderers were all put in the jail, also located on this island. In 1941, a patient murdered another patient who had harassed other patients, and in 1942, Chunsang Lee, a patient, killed the director of Sorok island. These instances show that there was a system to eliminate Hansen's disease patients in colonial Korea.
Asian Continental Ancestry Group ; Busan ; Cannibalism ; Charities ; Child ; Daegu ; Discrimination (Psychology) ; Eating ; Female ; Homicide ; Humans ; Japan ; Jeollanam-do ; Korea ; Leprosy ; Male ; Medicine, Traditional ; Police ; Starvation ; Suicide ; Superstitions ; United Nations ; Violence

Estimating the risk of Helicobacter pylori (H. pylori)-induced gastric cancer during endoscopic examination is important. Owing to recent advances in gastrointestinal endoscopy, the gross appearance of the background gastric mucosa has enabled discrimination of subjects with active, chronic, and past H. pylori infection from those with no history of infection. To provide subjective criteria for H. pylori infection-related endoscopic findings with increased risk of gastric cancer, the Kyoto classification of gastritis was proposed at the 85th annual meeting of the Japanese Society for Gastrointestinal Endoscopy in May 2013 in Kyoto. The main contents focus on determining the gastric cancer risk by scoring the endoscopic findings of the background gastric mucosa from 0 to 8. These important findings are not described in the Kyoto Global Consensus Conference proceedings published in English. To better estimate the gastric cancer risk during screening endoscopy in an H. pylori-prevalent population, knowledge of the Japanese version of the Kyoto classification is important. This new classification emphasizes the discrimination of subjects with H. pylori infection by assessing 19 endoscopic findings (presence of atrophy, intestinal metaplasia, diffuse redness, spotty redness, mucosal swelling, enlarged folds, sticky mucus, chicken skin-like nodularity, foveolar-hyperplastic polyp, xanthoma, depressed erosion, regular arrangement of collecting venules, fundic gland polyp, linear red streak, raised erosion, hematin deposit, multiple white and flat-elevated lesions, patchy redness, and map-like redness). In this review, the validity of the Kyoto classification is summarized in conjunction with several suggestions to resolve emerging H. pylori infection-related problems in Korea.
Asian Continental Ancestry Group ; Atrophy ; Chickens ; Classification ; Consensus ; Discrimination (Psychology) ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Gastritis ; Helicobacter pylori ; Helicobacter ; Hemin ; Humans ; Korea ; Mass Screening ; Metaplasia ; Mucus ; Polyps ; Stomach Neoplasms ; Venules ; Xanthomatosis

PURPOSE: To validate and update a nomogram for predicting ductal carcinoma in situ (DCIS) upstaging in preoperative biopsy. MATERIALS AND METHODS: Medical records of 444 preoperative DCIS patients were evaluated and used to validate a previous version of the Severance nomogram for predicting DCIS upstaging in preoperative biopsy. Patients were divided into two groups according to the final postoperative pathology. Univariate and multivariate analyses with the chi-square test, Student's t-test, and binary logistic regression method identified new significant variables. The updated nomogram was evaluated with the C-index and Hosmer—Lemeshow goodness of fit test. RESULTS: The area under a receiver operating characteristic curve for comparison with the previous nomogram was 0.48. In postoperative pathology, the pure DCIS and invasive cancer groups comprised 345 and 99 cases, respectively. Approximately 22.3% of patients preoperatively diagnosed with DCIS were upstaged to invasive cancer. Significant variables in the univariate analysis were operation type, human epidermal growth factor receptor 2 overexpression, comedo necrosis, sonographic mass, mammographic mass, preoperative biopsy method, and suspicious microinvasion in preoperative biopsy. In multivariate analysis, operation type, sonographic mass, mammographic mass, and suspicious microinvasion were risk factors for upstaging. The updated model with these variables showed moderate discrimination and was appropriate in the calibration test. CONCLUSION: The previous nomogram did not effectively discriminate upstaging of preoperative DCIS in an independent cohort. An updated version of the nomogram appears to provide more accurate information for predicting preoperative DCIS upstaging.
Biopsy ; Breast Neoplasms ; Breast ; Calibration ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Cohort Studies ; Discrimination (Psychology) ; Humans ; Logistic Models ; Medical Records ; Methods ; Multivariate Analysis ; Necrosis ; Nomograms ; Pathology ; Receptor, Epidermal Growth Factor ; Risk Factors ; ROC Curve ; Ultrasonography

PURPOSE: Identification of lymph node (LN) metastasis in non-small cell lung cancer (NSCLC) is critical for disease staging and selection of therapeutic modalities. Sometimes it is not possible to obtain LN core tissue by endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA), resulting in low diagnostic yield. MATERIALS AND METHODS: In this study, 138 specimens were collected from 108 patients who underwent EBUS-TBNA under the suspicion of LN metastasis of NSCLC. Diagnostic yields of anti-CD45 and anti-methionyl-tRNA synthetase (MRS), immunofluorescent (IF) staining on cytology specimens were compared with those of conventional cytology and positron emission tomography-computed tomography (PET-CT). RESULTS: MRS was strongly expressed in NSCLC cells metastasized to LNs, but weakly expressed in cells at the periphery of the LN germinal center. The majority of cells were CD20 positive, although a few cells were either CD3 or CD14 positive, indicating that CD45 staining is required for discrimination of non-malignant LN constituent cells from NSCLC cells. When the diagnostic efficacy of MRS/CD45 IF staining was evaluated using 138 LN cellular aspirates from 108 patients through EBUS-TBNA, the sensitivity was 76.7% and specificity was 90.8%, whereas those of conventional cytology test were 71.8% and 100.0%, respectively. Combining the results of conventional cytology testing and those of PET-CT showed a sensitivity and specificity of 71.6% and 100%, and the addition of MRS/CD45 dual IF data to this combination increased sensitivity and specificity to 85.1% and 97.8%, respectively. CONCLUSION: MRS/CD45 dual IF staining showed good diagnostic performance and may be a good tool complementing conventional cytology test for determining LN metastasis of NSCLC.
Amino Acyl-tRNA Synthetases ; Carcinoma, Non-Small-Cell Lung ; Complement System Proteins ; Discrimination (Psychology) ; Electrons ; Germinal Center ; Humans ; Ligases ; Lymph Nodes ; Methionine-tRNA Ligase ; Needles ; Neoplasm Metastasis ; Sensitivity and Specificity