(Am J Ophthalmol 2009;148:459-465. (C) 2009 by Elsevier Inc. All rights reserved.)”
“New series of substituted glutamine 5a-1 and glutamic acid diamides, diureide and dihydrazide 7a-e were synthesized from parent glutamic acid compound 3 and evaluated for their cytotoxic activity against tumor cell line PC3 (prostate cancer cell line). Most of the tested compounds exploited potent growth inhibitory activity with IC50 values ranging 0.034-3.97 mu M.
Particularly, compounds 5a, 3, 5j, 5b, 7c, 7e, 5l, and 5k exhibited superior potency (IC50=0.034, 0.04, 0.05, 0.074, 0.25, 0.4, 0.49, 0.522 mu m, respectively) to the reference drug Doxorubicin (IC50=0.63 mu M), while compound 7b showed IC50, 0.71 mu M, comparable to that of Doxorubicin. In summary, the newly synthesized compounds provided promising new lead
for the future design and development of glutamine JQEZ5 mw and glutamic acid derivatives as novel antitumor agents. The quantitative structure activity relationship (QSAR) study was applied to find a mathematical correlation between the structures of compounds and their activity against PC3 cell line expressed as IC50 values.”
“Objective To determine the relationship between the timing of chemistry and timing of prenatal diagnosis and S3I-201 datasheet pregnancy termination in pregnancies with chromosomal abnormalities.\n\nMethod Singleton pregnancies with chromosomal abnormalities from 2005 to 2009 were identified. Records were reviewed to identify timing of chemistry, nuchal translucency (NT), prenatal diagnosis and pregnancy termination. Mann-Whitney
U and Fisher’s exact test were used for statistical analysis.\n\nResults A total of 110 pregnancies were included. Seventy-eight had biochemistry performed at the time of NT and 32 had biochemistry a median of 9 days prior. Aneuploidy risks were similar between the two groups. Although the timing of NT was similar, those having biochemistry before NT had prenatal diagnosis and pregnancy A-1210477 mw termination at significantly earlier gestational ages. Those with early biochemistry were more likely to have chorionic villus sampling (CVS) (69% vs 37%; p = 0.003) compared to those who had biochemistry at the time of NT.\n\nConclusion There was a strong correlation between the timing of biochemistry and prenatal diagnosis and pregnancy termination. Copyright (C) 2010 John Wiley & Sons, Ltd.”
“Aseptic meningitis related to hydrogel-coated coils is a known complication, but it is extremely rare after platinum bare coil aseptic meningitis. Here we report the development of aseptic meningitis causing brain stem and cerebellar infarct in a patient with a giant aneurysm treated with bare platinum coils. We conclude that aneurysm size is an important factor affecting the occurrence of aseptic meningitis associated with stroke.”
“Objective: In multiple endocrine neoplasia type 1, the main risk factor for metastases is pancreatic turnout size.
Here we review the progress made in addressing the influence of a compromised in utero environment on the behavior of imprinted genes. We also examine whether these
environmental influences may have an impact on the later development of human disease. (C) 2009 Elsevier Ltd. All rights reserved.”
“Background: The methylation status of the human glucocorticoid receptor gene NR3C1 in newborns has been reported to be sensitive to prenatal maternal mood. This study investigates both the association between maternal cortisol and emotional state during pregnancy and the methylation state of the promoter region of NR3C1 gene.\n\nMethods: We examined 83 pregnant women. Psychological data and diurnal cortisol CCI-779 data were assessed to evaluate maternal stress once each trimester. DNA methylation at different loci of the NR3C1 gene, including exon 1(B), 1(D)
and 1(F). was analyzed in genomic DNA from cord blood mononuclear cells.\n\nResults: Univariable analyses indicated pregnancy related anxiety to be the strongest psychological parameter throughout pregnancy. Most significant findings concerned 1(F). Particularly the methylation state of CpG9 was significantly associated with maternal emotional wellbeing. In a multivariable model the proportion of variance in methylation state of F9 explained (PVE) by pregnancy related anxiety was 7.8% (p = 0.023) during T1.\n\nFurthermore different CpG-units located at the nerve growth factor SN-38 cost inducible protein A (NGFI-A) binding sites of 1(F) were associated with maternal anxiety [(F20.21: PC PRAQ and fear of integrity in T1: respectively PVE:8.9% and PVE:9.0%; Fear of delivery T2: PVE:8.0%, Fear of integrity T2: PVE:6.0% and STAI T2: PVE:5.9%) - (F12.13: PC PRAQ T1: PVE:6.9%, fear of integrity T2: MK-0518 PVE:6.0%
and fear of delivery T2: PVE:8.0%)] and cortisol (F38.39: PVE:8.9%) in T2.\n\nConclusion: These data indicate that prenatal maternal emotional state, particularly pregnancy related anxiety, are associated with the methylation state of the NR3C1 gene in the child. (C) 2013 Elsevier Ltd. All rights reserved.”
“The evolution of host resistance to parasites, shaped by associated fitness costs, is crucial for epidemiology and maintenance of genetic diversity. Selection imposed by multiple parasites could be a particularly strong constraint, as hosts either accumulate costs of multiple specific resistances or evolve a more costly general resistance mechanism. We used experimental evolution to test how parasite heterogeneity influences the evolution of host resistance. We show that bacterial host populations evolved specific resistance to local bacteriophage parasites, regardless of whether they were in single or multiple-phage environments, and that hosts evolving with multiple phages were no more resistant to novel phages than those evolving with single phages.
In experiment 3, rats were injected with palonosetron (0.1 mg/kg) 2 h before each of three sucrose-fluoxetine (20 mg/kg) or sucrose-lithium chloride (LiCl, 25 mg/kg) pairings. In experiment 4, rats were pretreated with the 5-HT1A
autoreceptor NVP-LDE225 Stem Cells & Wnt inhibitor agonist, 8-OH-DPAT (DPAT, 0.1 mg/kg) 30 min before each of three sucrose-fluoxetine (20 mg/kg) pairings.\n\nAfter two sucrose-fluoxetine pairings, the highest dose of fluoxetine tested (20 mg/kg) produced conditioned gaping reactions. These conditioned gaping reactions were prevented by pretreatment with DPAT, but not with the 5-HT3 antagonists. On the other hand, palonosetron administered 2 h prior to sucrose-LiCl pairings attenuated conditioned gaping reactions.\n\nThese results suggest that the conditioned nausea produced by SSRIs, but not LiCl, may be resistant to treatment with 5-HT3 antagonists, but not 5-HT1A autoreceptor agonists.”
“A high-fat (HF) diet, the serotonergic system and stromal elements have all been implicated in colon carcinogenesis. We investigated whether the colonic serotonergic system could play a main role in the development of colonic dysplasia and stromal reactivity in carcinogen-treated rats under HF diet. For this, dimethylhydrazine-treated rats were fed with standard diet and a HF diet. Fat distribution was quantified by computerized tomography exam, serotonergic activity was analyzed by high-performance liquid
chromatography, gene expression, and immunohistochemistry, which along with histopathological technique enabled us to enumerate dysplasia, microvessels
density, cell proliferation and COX-2 expression. We found that the HF diet induced an increase Selleckchem FK506 in the amount of viscera! adipose tissue, even without expressive changes in the average body weight. This was correlated with a loss of serotonergic balance in colon tissue. Moreover, the HF diet promoted dysplasia and microvessel density in association with increased proliferation and COX-2 expression within pericryptal colonic stroma. Our current findings suggest that a HF diet promotes the enlargement of adipose tissue via loss of control in colon serotonergic activity, which enhances colonic dysplasia by supporting microvessel development. (C) 2012 Selleck YH25448 Elsevier Ireland Ltd. All rights reserved.”
“Tumor cytology has proven to be inadequate for precise diagnosis of thyroid follicular adenoma. This suggests the need for a molecular approach for its diagnosis. Expression of CD26/DPPIV (dipeptidyl peptidas IV), p53, and PTEN was analyzed in smears or sections obtained from 19 patients with histologically proven thyroid follicular adenoma. Papanicolaou staining, CD26/DPPIV activity staining, and HE staining were performed and the specimens were observed morphologically. Immunohistochemical analysis using antibodies against p53 and PTEN was performed. Genetic mutation of PTEN exons was performed using the laser capture microdissection method.
There were 21 left-atrium myxomas and two in right atrium. The mean age was 42.73 year, (range 21 to 60 years). The sex-ratio was 2.28 (16 women and seven men). In four cases, the myxomas were chance findings at echocardiography Ricolinostat order but the 19 symptomatic patients had different symptoms: dyspnea, palpitations, left ventricular failure, positional syncope, systemic embolism, chest pain or right ventricular failure. The diagnostic of myxoma was realized in all cases by echocardiography. The resection of the tumor and a wide part of the inter-atrial
septurn were performed in all case, The post-operative course was usually uncomplicated: only one patient had double recurrence and died of mediastinitis after the third operation.\n\nConclusion. – The myxoma is considered to be rare, and remains classical emergency with low operative risk, however the risk of recurrence
imposes a long-term follow-up by echocardiography. (C) 2008 Publie par Elsevier Masson SAS.”
“The objective of this study was to determine the effect of inclusion of essential oil thymol on the incubation on gas production kinetics, volatile fatty acids (VFA), organic matter AG-120 solubility dmso digestibility (OMD) and metabolizable energy (ME) contents of alfalfa hay. Gas productions were determined at 0, 3, 6, 12, 24, 48, 72 and 96 h incubation times. Thymol were added in the ratio of 0, 50, 100 and 200 mg/L. Gas production kinetics were determined using the equation Y = A (1-exp-ct). The thymol addition had a significant effect on the gas production kinetics, OMD and ME of alfalfa hay. Thymol at 200 mg/L resulted in 22.77% of decrease in potential gas production (A). The mean decrease in potential gas production per mg thymol supplementation
was 0.0836 ml. The mean decreases in ME and OMD per mg thymol supplementation were 0.0132 (ME unit) and 0.086 (digestibility unit) respectively. The mean decreases in truly digestible dry matter (TDDM) and neutral detergent fibre (NDFD) per mg thymol supplementation were 0.0546 and 0.0748 digestibility units respectively (P < 0.05; GSK1838705A molecular weight P < 0.001). As a conclusion, thymol exhibit significant anti-microbial activity causing an inhibition of the overall fermentation process.”
“We examine the feasibility of a drift-induced instability of Dirac fermions in monolayer graphene in a weak periodic potential, taking into account of a steady current. In this work, we treat magnetic field induced Landau quantization including the effects of drift induced current (an in-plane dc electric field), and analyze both the inter-and the intra-Landau band aspects of the magnetoplasmon spectrum. We employ the framework of self-consistent-field approximation to determine the plasmon spectrum. The existence of the drift induced instability regions in the intra-Landau band magnetoplasmon spectrum as a function of inverse magnetic field is shown and discussed.
“A child’s growth plate is at risk for injury during a standard “adult-style” transphyseal ACL reconstruction. Unfortunately, children who tear their ACL and return to sports without surgery are at an extremely high risk for recurrent instability episodes. This frequently causes permanent damage to articular and meniscal cartilage that can lead to osteoarthritis. More recent “all-epiphyseal” techniques of anatomic ACL reconstruction P005091 supplier in which the graft, the tunnels, and the fixation devices do not cross the growth plate may be the safest way to prevent a growth disturbance in
a very young child.”
“Bacterial wilt, caused by strains belonging to the Ralstonia solanacearum selleck species complex, inflicts severe economic losses in many crops worldwide. Host resistance remains the most effective control strategy against this disease. However, wilt resistance is often overcome due to the considerable variation among pathogen strains. To help breeders circumvent this problem, we assembled a worldwide collection
of 30 accessions of tomato, eggplant and pepper (Core-TEP), most of which are commonly used as sources of resistance to R. solanacearum or for mapping quantitative trait loci. The Core-TEP lines were challenged with a core collection of 12 pathogen strains (Core-Rs2) representing the phylogenetic diversity of R. solanacearum. We observed six interaction phenotypes, from highly susceptible to highly resistant. Intermediate phenotypes resulted from the plants’ ability to tolerate latent infections (i.e., bacterial colonization of vascular elements with limited or no wilting). The Core-Rs2 strains partitioned into three pathotypes on pepper accessions, five on tomato, and six on eggplant. A “pathoprofile” concept was developed to characterize the strain clusters, which displayed six virulence patterns on the whole set of Core-TEP host accessions. Neither pathotypes nor pathoprofiles were phylotype specific. Pathoprofiles HDAC inhibitor review with high aggressiveness were mainly found in strains from phylotypes I, IIB, and III. One pathoprofile included
a strain that overcame almost all resistance sources.”
“Rodent models of nerve injury have increased our understanding of peripheral nerve regeneration, but clinical applications have been scarce, partly because such models do not adequately recapitulate the situation in humans. In human injuries, axons are often required to extend over much longer distances than in mice, and injury leaves distal nerve fibres and target tissues without axonal contact for extended amounts of time. Distal Schwann cells undergo atrophy owing to the lack of contact with proximal neurons, which results in reduced expression of neurotrophic growth factors, changes in the extracellular matrix and loss of Schwann cell basal lamina, all of which hamper axonal extension.
Procedure-specific GM6001 Proteases inhibitor qualitative metrics are improved with expert feedback,
but nonexpert facilitators can also enhance the quality of training and may represent a valuable alternative to expert clinical faculty. (J Vase Surg 2011;54:240-8.)”
“The phylum Apicomplexa comprises over 5000 species of obligate intracellular parasites, many responsible for diseases that significantly impact human health and economics. To aid drug development programs, global sequencing initiatives are generating increasing numbers of apicomplexan genomes. The challenge is how best to exploit these resources to identify effective therapeutic targets. Because of its important role in growth and maintenance, much interest has centred on metabolism. However, in the absence of detailed biochemical data, reconstructing the metabolic potential from a fully sequenced genome remains problematic. In this review current resources and tools facilitating the metabolic reconstruction for apicomplexans are examined. Furthermore, how these datasets can be utilized to explore the metabolic capabilities of apicomplexans are discussed Epigenetic signaling pathway inhibitor and targets for therapeutic intervention are prioritized.”
“When BaZrO3 is doped with Y in 12.5% of Zr sites, density functional theory with the PBE functional predicts octahedral distortions within a cubic phase yielding a greater variety of proton binding sites than undoped BaZrO3. Proton binding sites,
transition states, and normal modes are found and used to calculate transition state theory rate constants. The binding sites are used to represent vertices in a graph. The rate constants connecting binding sites are used to provide weights for graph edges. Vertex and color coding are used to find proton conduction pathways in BaZr0.875Y0.125O3. Many similarly probable proton conduction pathways which can be periodically replicated to yield long range proton conduction are found. The average limiting barriers at 600 K for seven step and eight step periodic pathways GSK1904529A are 0.29 and 0.30 eV, respectively. Inclusion of a lattice reorganization barrier raises these to 0.42
and 0.33 eV, respectively. The majority of the seven step pathways have an interoctahedral rate limiting step while the majority of the eight step pathways have an intraoctahedral rate limiting step. While the average limiting barrier of the seven step periodic pathway including a lattice reorganization barrier is closer to experiment, how to appropriately weight different length periodic pathways is not clear. Likely, conduction is influenced by combinations of different length pathways. Vertex and color coding provide useful ways of finding the wide variety of long range proton conduction pathways that contribute to long range proton conduction. They complement more traditional serial methods such as molecular dynamics and kinetic Monte Carlo. (C) 2010 American Institute of Physics. [doi:10.1063/1.
pylori vesicles. Furthermore, uptake of vesicles by both clathrin-dependent and -independent pathways was sensitive to depletion, but not sequestering, of cholesterol in the host cell membrane suggesting that membrane fluidity influences the efficiency of H. pylori vesicle uptake. IMPORTANCE Bacterial vesicles act as long-distance tools to deliver toxins
and effector molecules to host cells. Vesicles can cause a variety of host cell responses via cell surface-induced cell signaling or internalization. Vesicles of diverse bacterial species enter host Vorinostat datasheet cells via different endocytic pathways or via membrane fusion. With the combination of a fluorescence-based quantification assay that quantifies internalized vesicles in a large number of cells and either chemical inhibition or RNA interference, we show that clathrin-mediated endocytosis is the major pathway for uptake of Helicobacter pylori vesicles and that lipid microdomains of the host cell membrane affect
uptake of vesicles via clathrin-independent pathways. Our results provide important insights about membrane fluidity and its important role in the complex process that directs the H. pylori vesicle to a specific endocytic pathway. Understanding the mechanisms that operate in vesicle-host interactions is important to fully recognize the impact of vesicles in pathogenesis.”
“We aimed at investigating the effect of honokiol on heatstroke in an
experimental rat model. Sprogue-Dawley Angiogenesis inhibitor rats were divided into 3 groups: normothermic diabetic rats treated with vehicle solution (NTDR+V), heatstroke-diabetic rats treated with vehicle (HSDR+V), and heatstroke rats treated with konokiol (0.5-5mg/ml/kg) (HSDR+H). Sixty minutes before the start of heat stress, honokiol or vehicle solution was administered. (HSDR+H) significantly (a) attenuated hyperthermia, hypotension and hypothalamic ischemia, hypoxia, and neuronal apoptosis; (b) reduced the plasma index of the toxic oxidizing radicals; (c) diminished the indices of hepatic and renal dysfunction; (d) attenuated the plasma systemic inflammatory response molecules; (e) promoted plasma levels of an anti-inflammatory cytokine; (f) reduced the index of infiltration of polymorphonuclear neutrophils in AZD6738 solubility dmso the serum; and (g) promoted the survival time fourfold compared with the (HSDR+V) group. In conclusion, honokiol protected against the outcome of heatstroke by reducing inflammation and oxidative stress-mediated multiple organ dysfunction in diabetic rats.”
“Waldenstrom macroglobulinemia (WM) is a distinct B-cell lymphoproliferative disorder for which clearly defined criteria for the diagnosis, initiation of therapy, and treatment strategy have been proposed as part of the consensus panels of International Workshops on WM(IWWM).
Through empathic evidence-based education, such perceptions and beliefs can be modified. By applying these strategies, concordance between the child’s Selleckchem HDAC inhibitor family and the medical team can be achieved, resulting in optimal adherence to the jointly created treatment plan. (C) 2013 Elsevier Ltd. All rights reserved.”
“Background The proliferation of multi-unit
for-profit dialysis chains in the ESRD industry has raised concerns for patient quality of care including access to renal transplantation therapy (RTT). The effect of dialysis facility chain status on RTT is unknown. Methods Data from the United States Renal Data System were used to identify 4,465 dialysis facilities and 56,714 dialysis patients who started hemodialysis in 2006. Patients were followed from initiation of hemodialysis in 2006 to placement on the renal transplant waiting list or to December 31, 2009. The role of dialysis facility chain status (affiliation, size, and ownership) on placement on the renal transplant waiting list was evaluated by multi-level mixed-effect regression models that account for clustering within facilities. Results Patients from for-profit chain facilities, compared to nonprofit chain facilities, were 13% (95% CI
0.77-0.98) less likely to be waitlisted. In contrast, among nonchains, facility ownership did not influence likelihood of being waitlisted. There was also a marginally significant difference in CX-6258 JAK/STAT inhibitor waiting list placement by chain size: large chains compared with mid or small chains were 8% (95% CI 0.84-1.00) less likely to place patients on the waiting list. After adjustment for patient and facility characteristics, dialysis facility chain affiliation (chain-affiliated or not) was not found to be independently associated with the likelihood of placement on the transplant waitlist. Conclusion Dialysis chain affiliation expands previously observed ownership-related differences in placement on the waiting list. For-profit ownership of dialysis chain
facilities appears to be a significant impediment to access to renal transplants.”
“Background: Plasmodium vivax is one of the major species of malaria infecting humans. Although MLN8237 emphasis on P. falciparum is appropriate, the burden of vivax malaria should be given due attention. This study aimed to synthesize the evidence on severe malaria in P. vivax infection compared with that in P. falciparum infection. Methods/Principal Findings: We searched relevant studies in electronic databases. The main outcomes required for inclusion in the review were mortality, severe malaria (SM) and severe anaemia (SA). The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Overall, 26 studies were included. The main meta-analysis was restricted to the high quality studies. Eight studies (n = 27490) compared the incidence of SM between P. vivax infection and P.
“Background: Excessive accumulation of retinol-based toxins has been implicated in the pathogenesis of geographic atrophy (GA). Fenretinide, an orally available drug that reduces retinol delivery to the eye through antagonism of VS-6063 manufacturer serum retinol-binding protein (RBP), was used in a 2-year trial to determine whether retinol reduction would be effective in the management of geographic atrophy.\n\nMethods: The efficacy of fenretinide (100 and 300 mg daily, orally) to slow lesion growth in geographic atrophy patients was examined in a 2-year, placebo-controlled double-masked trial that enrolled 246 patients
at 30 clinical sites in the United States.\n\nResults: Fenretinide treatment produced dose-dependent reversible reductions
in serum RBP-retinol that were associated with trends in reduced lesion growth rates. Patients in the 300 mg group who achieved selleck products serum retinol levels of <1 mu M (<2 mg/dL RBP) showed a mean reduction of 0.33 mm(2) in the yearly lesion growth rate compared with subjects in the placebo group (1.70 mm(2)/year vs. 2.03 mm(2)/year, respectively, P = 0.1848). Retinol-binding protein reductions <2 mg/dL correlated with further reductions in lesion growth rates (r(2) = 0.478). Fenretinide treatment also reduced the incidence of choroidal neovascularization (approximately 45% reduction in incidence rate in the combined fenretinide
groups vs. placebo, P = 0.0606). This therapeutic effect was not dose dependent and is consistent with anti-angiogenic properties of fenretinide, which have been observed in other disease states.\n\nConclusion: The findings of this study and the established safety profile of fenretinide in chronic dosing regimens warrant further study of fenretinide in the treatment of geographic atrophy. RETINA 33: 498-507, 2013″
“Understanding the life history correlates of ontogenetic differences in hominoid brain growth requires information from multiple species. At present, however, data on how brain size changes over the course of development are only available from chimpanzees and modern humans. In this study, we examined buy Bindarit brain growth in wild Virunga mountain gorillas using data derived from necropsy reports (N = 34) and endocranial volume (EV) measurements (N = 86). The youngest individual in our sample was a 10-day-old neonatal male with a brain mass of 208 g, representing 42% of the adult male average. Our results demonstrate that Virunga mountain gorillas reach maximum adult-like brain mass by 3-4 years of age; adult-sized EV is reached by the time the first permanent molars emerge. This is in contrast to the pattern observed in chimpanzees, which despite their smaller absolute brain size, reportedly attain adult brain mass approximately 1 year later than Virunga mountain gorillas.
Here, the clinical manifestations of 2 patients that ingested raw A odora are described. Two patients experienced oral numbness and intractable tongue pain, and I patient required endotracheal intubation because of upper respiratory tract obstruction. Although conservative treatment is the primary approach to A odora poisoning, physicians should be aware of the potential for upper respiratory obstruction in patients exposed to A odora, as well as the need for controlling tongue pain.”
“Laboratory receiver operating characteristic (ROC) studies, that are often used to evaluate medical imaging systems, differ from `live’ clinical interpretations in several respects which could selleck compound compromise their clinical
relevance. The aim was to develop methodology for quantifying the clinical relevance of a laboratory ROC study. A simulator was developed to generate ROC ratings data and binary clinical interpretations classified as correct or incorrect for a common set of images interpreted under clinical and laboratory conditions. The area under the trapezoidal ROC
curve (AUC) was used as the laboratory figure-of-merit and the fraction of correct clinical decisions as the clinical figure-of-merit. Conventional agreement measures (Pearson, Spearman, Kendall and kappa) between the bootstrap-induced fluctuations Selleck GDC973 of the two figures of merit were estimated. A jackknife pseudovalue transformation applied to the figures of merit was also investigated as a way to capture agreement existing at the individual image level that could
be lost at the figure-of-merit level. It is shown that the pseudovalues define a relevance-ROC curve. The area under this curve (rAUC) measures the ability of the laboratory figure-of-merit- based pseudovalues to correctly classify incorrect versus correct clinical interpretations. Therefore, rAUC is a measure of the clinical relevance of an ROC study. The conventional measures Pitavastatin and rAUC were compared under varying simulator conditions. It was found that design details of the ROC study, namely the number of bins, the difficulty level of the images, the ratio of disease-present to disease-absent images and the unavoidable difference between laboratory and clinical performance levels, can lead to serious underestimation of the agreement as indicated by conventional agreement measures, even for perfectly correlated data, while rAUC showed high agreement and was relatively immune to these details. At the same time rAUC was sensitive to factors such as intrinsic correlation between the laboratory and clinical decision variables and differences in reporting thresholds that are expected to influence agreement both at the individual image level and at the figure-of-merit level. Suggestions are made for how to conduct relevance-ROC studies aimed at assessing agreement between laboratory and clinical interpretations.