• Title/Summary/Keyword: 임상 결과 예측

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Parameter Calibrations of a Daily Rainfall-Runoff Model Using Global Optimization Methods (전역최적화 기법을 이용한 강우-유출모형의 매개변수 자동보정)

  • Kang, Min-Goo;Park, Seung-Woo;Im, Sang-Jun;Kim, Hyun-Jun
    • Journal of Korea Water Resources Association
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    • v.35 no.5
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    • pp.541-552
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    • 2002
  • Two global optimization methods, the SCE-UA method and the Annealing-Simplex(A-S) method for calibrating a daily rainfall-runoff model, a Tank model, was compared with that of the Downhill Simplex method. In synthetic data study, 100% success rates for all objective functions were obtained from the A-S method, and the SCE-UA method was also consistently able to obtain good estimates. The Downhill Simplex method was converged to the true values only when the initial guess was close to the true values. In the historical data study, the A-S method and the SCE-UA method showed consistently good results regardless of objective function. An objective function was developed, which puts more weight on the low flows.

Predictors of Emergency Medical Transports Use Based on 2009 Korea Health Panel (응급환자 이송 서비스의 이용 특성과 예측 인자: 한국의료패널 2009년 데이터를 중심으로)

  • Kang, Kyunghee
    • Fire Science and Engineering
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    • v.28 no.3
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    • pp.80-86
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    • 2014
  • Based on 2009 Korea Health Panel, this study investigated socio-economic and clinical characteristics associated with emergency medical transport use, and analyzed a simple predictive model of emergency medical transport use. Analysis results were summarized as follows: First, emergency medical transports such as 119 ambulance were more used than private cars, taxis, or walk-in. Second, between a user group and a non-user group of emergency medical transports, there were statistically significant differences in age, the level of education, family composition, house type, household income, the relationship with the head of household, insurance types, the presence of handicap, the presence of chronic disease, reasons to emergency medical service use, and treatment after emergency medical service completed. Third, age, household income, the presence of handicap, reasons to emergency medical service use, and treatment after emergency medical service completed were statistically significant predictors associated with emergency medical transports use. To improve emergency medical service system, the characteristics and predictors associated with emergency medical transports are more concerned.

The Behavior of Evapotranspiration in Youngsan Lake Watershed by Future Vegetation Change Prediction (미래 식생분포 변화에 따른 영산호 유역의 증발산량 연구)

  • Shjn, Hyung-Jin;Park, Geun-Ae;Park, Min-Ji;Park, Jong-Yoon;Kim, Seong-Joon
    • Proceedings of the Korea Water Resources Association Conference
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    • 2010.05a
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    • pp.1471-1475
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    • 2010
  • 본 연구에서는 미래 기후변화 시나리오를 이용하여 우리나라의 미래 산림식생 분포 변화를 예측하고 이를 SWAT 모형에 적용하여 영산강호유역의 증발산량 변화를 분석하고자 하였다. 현 기상관측자료(1971~2000)를 이용하여 현재의 기후를 판정하고, 기상청에서 제공한 GCM(MIROC3.2)의 통계학적 다운스케일링으로 구성된 RCM 자료를 이용하였다. 산림식생의 분포는 임상도에 의한 현존 식생군락과 환경인자(강수량, 기온, 지형인자, 토양유기물 함량 등)간의 상관분석을 실시하여 상관관계가 높은 주요 환경변수들을 결정하고, 이들을 종속변수로 하는 다항로짓모형을 구성하여 추정하였다. 이 모형을 이용하여 미래의 주요 환경변수들을 입력, 미래 2020s, 2050s, 2080s의 우리나라 산림식생 분포를 예측하였다. 예측된 산림식생 분포를 적용하여 미래 증발산량을 분석하기 위해 남쪽의 따뜻한 지역으로서 활엽수림이 있는 영산호유역($3,455.0km^2$)을 선택하였다. 1998~2002 5년간의 유출량 자료를 이용 모형을 보정하였다. 모형의 검증은 보정 매개변수의 평균값들을 통해 2003~2008년 유출량을 모의 하였다. 예측된 미래식생분포를 이용하여 토지이용도를 재구축하였으며 재구축 결과 활엽수는 $715.2km^2$ 늘어나며 혼효림은 현재에 비해 2080s에 $167.1km^2$ 침엽수는 $548.1km^2$ 줄어드는 경향을 보였다. 영산호유역에서는 미래의 증발산량이 증가하며, 식생분포를 고려하였을 경우 2080s년에는 고려하지 않은 경우에 비해 약 4.52mm 감소하는 것으로 분석되었다.

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Clinical Significance of the Expression of Oncosuppressor Gene Protein and Epidermal Growth Factor Receptor in Squamous Cell Carcinomas of Larynx (후두 편평세포암에서 암억제유전자 단백 및 상피성장인자 수용체 발현의 임상적 의의)

  • 정광윤;최종욱
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.85-85
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    • 1993
  • The clinical staging system for laryngeal cancers is not sufficient for prognosticator due to different biologic characteristics and their microenvironment according to primary sites. For determining the prognosticators, the authors peformed immunohistochemical staining to EGFR, p53 protein, and pRB in 40 cases of surgically treated squamous cell carcinomas of larynx in our institute during the past 5 years. The results are as followings; 1. The positive expression rate of p53 protein and negative expression rate of pRB showed correlations with clinical parameters. 2. The three-year survival rate for p53 protein positive cases was worse than the p53 protein negative cases. 3. Expression rate of EGFR was not correlated with the clinical parameters. As a conclusion, expression rates of p53 protein and pRB not only reflect well the biologic behavior of laryngeal cancer, but correlate closely with the tumor factors. Therefore they may be useful as the prognosticator to predict the malignant potency of laryngeal squamous cell carcinomas.

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Model Patient Safety Management Activities for Nursing Students with Clinical Experience (임상실습 경험이 있는 간호대학생의 환자안전 관리 활동 구조모형)

  • Jae-Woo Oh
    • Journal of Industrial Convergence
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    • v.22 no.3
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    • pp.121-135
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    • 2024
  • This study is a structural equation modeling study that describes patient safety incident management activities for nursing students with clinical practice experience and uses Ajzen's theory of planned behavior and safety culture climate-safety behavior model as conceptual bases, proposes a hypothetical model of nursing students' patient safety incident management activities based on the literature review, and verifies the appropriateness of the model and hypotheses through the collected data. Data were collected from 251 nursing students with clinical practice experience using a structured questionnaire. The results of this study confirmed that the model is appropriate and that patient safety management attitude, patient safety culture, and safety motivation are predictors of nursing students' patient safety management activities. Therefore, in order to improve patient safety management activities, it is necessary to provide effective patient safety incident management education programs for nursing students so that nursing students can perform correct patient safety management behaviors from the clinical practice site to the clinical practice site after graduation, and it is necessary to explore how to continuously lead such education programs to the practice site.

Correlation of gingival biotypes with clinical parameters (치은두께와 임상검사지수들과의 상관관계)

  • Kim, Sung-Jun;Kim, Tae-Il;Seol, Yang-Jo;Cho, Ki-Young;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung;Han, Soo-Boo;Lee, Yong-Moo
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.537-548
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    • 2005
  • 1. 목적 이 연구의 목적은 기존의 평가기준에 따라 관찰자에 의해 주관적으로 판단된 치은형과 실제 치은두께와의 상관관계를 규명하고 임상검사 시에 측정할 수 있는 변수들과 치은두께의 연관성을 평가하는 것이다. 2 방법 211명의 치과대학생(22-43세, 평균 24.7세)을 연구대상으로 하여 상악중절치부위에서 국소마취하에 근관 치료용 파일을 치은에 삽입하여 두께를 측정하고 임상검사를 통해 치주낭깊이, 치태지수, 치은지수, 치은퇴축, 체형 및 비만도, 피부형, 치경부의 형태, 관측자가 임의로 판단한 치은형을 기록하였다. 임상사진으로 치관의 폭경과 길이의 비율, 치은외형의 만곡정도를 조사하고 평행촬영법을 이용한 방사선사진으로 치아의 장평비율 및 치아의 치관 폭경과 치경부 폭경의 비율을 조사하였다. 전체 대상을 치은의 두께를 기준으로 평균두께보다 얇은 군과 두꺼운 군의 두 개의 군으로 분류하여 임상검사 사에 측정한 변수들이 각 군 간에 유의할 만한 차이를 보이는지와 임의로 판단한 치은형이 실제 치은두께와 연관이 있는지를 알아보았다. 통계처리는 Student t-test를 이용하였다. 3. 결과 치주낭 깊이, 치은지수, 체형 및 비만도, 피부형, 치아의 형태, 치경부의 형태, 치아의 장평비율의 경우 실제 측정하여 얻은 치은의 두께와의 상관관계는 통계적으로 유의성이 없었다. 치은의 형태는 치은의 두께와 상관성은 보이고 있으나 통계적으로 유의하지 않았다. 관측자가 임의로 평가한 치은형과 실제 측정치도 유의할만한 일치를 보이지 않고 있다. 4. 결론 치은의 형태는 치은의 두께를 예상하는데 약간의 도움이 될 수 있으나 실제 치은의 두께는 임상적으로 간단히 측정할 수 있는 겸사지수들과 직접적인 상관관계를 보이지 않았다. 따라서 치료결과의 예측에 있어서 치은형을 분류하여 예상하는 것은 큰 도움이 되지 않는다고 할 수 있다.

Mixed dentition analysis using a multivariate approach (다변량 기법을 이용한 혼합치열기 분석법)

  • Seo, Seung-Hyun;An, Hong-Seok;Lee, Shin-Jae;Lim, Won Hee;Kim, Bong-Rae
    • The korean journal of orthodontics
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    • v.39 no.2
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    • pp.112-119
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    • 2009
  • Objective: To develop a mixed dentition analysis method in consideration of the normal variation of tooth sizes. Methods: According to the tooth-size of the maxillary central incisor, maxillary 1st molar, mandibular central incisor, mandibular lateral incisor, and mandibular 1st molar, 307 normal occlusion subjects were clustered into the smaller and larger tooth-size groups. Multiple regression analyses were then performed to predict the sizes of the canine and premolars for the 2 groups and both genders separately. For a cross validation dataset, 504 malocclusion patients were assigned into the 2 groups. Then multiple regression equations were applied. Results: Our results show that the maximum errors of the predicted space for the canine, 1st and 2nd premolars were 0.71 and 0.82 mm residual standard deviation for the normal occlusion and malocclusion groups, respectively. For malocclusion patients, the prediction errors did not imply a statistically significant difference depending on the types of malocclusion nor the types of tooth-size groups. The frequency of prediction error more than 1 mm and 2 mm were 17.3% and 1.8%, respectively. The overall prediction accuracy was dramatically improved in this study compared to that of previous studies. Conclusions: The computer aided calculation method used in this study appeared to be more efficient.

Early Recurrence of Breast Cancer after the Primary Treatment: Analysis of Clinicopathological and Radiological Predictive Factors (유방암 일차치료 후 조기 재발: 임상병리학적 및 영상의학적 예측인자 분석)

  • Sun Geun Yun;Yeong Yi An;Sung Hun Kim;Bong Joo Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.395-408
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    • 2020
  • Purpose To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

Clinical Factors Predicting the Pathologic Tumor Response after Preoperative Concurrent Chemoradiotherapy for Rectal Cancer (직장암에 수술 전 항암화학방사선 동시 병용요법 후 종양의 병리학적 반응에 영향을 주는 임상적 예측 인자)

  • Lee, Ji-Hae;Lee, Kyung-Ja
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.213-221
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    • 2008
  • Purpose: The objective of this retrospective study was to identify predictive factors for the complete pathologic response and tumor downstaging after preoperative concurrent chemoradiotherapy for locally advanced rectal cancer. Materials and Methods: Between the years 2000 and 2008, 39 patients with newly diagnosed rectal cancer without prior evidence of distant metastasis received preoperative concurrent chemoradiotherapy followed by surgery. The median radiation dose was 50.4 Gy (range, $45{\sim}59.4\;Gy$)). Thirty-eight patients received concurrent infusional 5-fluorouracil and leucovorin, while one patient received oral capecitabine twice daily during radiotherapy. Results: A complete pathologic response (CR) was demonstrated in 12 of 39 patients (31%), while T-downstaging was observed in 24 of 39 patients (63%). N-downstaging was observed in 18 of 28 patients (64%), with a positive node in the CT scan or ultrasound. Two patients with clinical negative nodes were observed in surgical specimens. The results from a univariate analysis indicated that the tumor circumferential extent was less than 50% (p=0.031). Moreover, the length of the tumor was less than 5 cm (p=0.004), while the post-treatment carcinoembryonic antigen (CEA) levels were less than or equal to 3.0 ng/mL (p=0.015) and were significantly associated with high pathologic CR rates. The univariate analysis also indicated that the adenocarcinoma (p=0.045) and radiation dose greater than or equal to 50 Gy (p=0.021) were significantly associated with high T-downstaging, while a radiotherapy duration of less than or equal to 42 days (p=0.018) was significantly associated with N-downstaging. The results from the multivariate analysis indicated that the lesser circumferential extent of the tumor (hazard ratio [HR] 0.150; p=0.028) and shorter tumor length (HR, 0.084; p=0.005) independently predicted a higher pathologic CR. The multivariate analysis also indicated that a higher radiation dose was significantly associated with higher T-downstaging (HR, 0.115; p=0.025), while the shorter duration of radiotherapy was significantly associated with higher N-downstaging (HR, 0.028; p=0.010). Conclusion: The circumferential extent of the tumor and its length was a predictor for the pathologic CR, while radiation dose and duration of radiotherapy were predictors for tumor downstaging. Hence, these factors may be used to predict outcomes for patients and to develop further treatment guidelines for high-risk patients.

Association between Pulse Pressure and Impaired Pulmonary Function in Non-Smoking Adults (비흡연 성인에서 맥압과 폐기능 장애의 상관성)

  • Yoon, Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.119-127
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    • 2020
  • According to previous studies, an impaired pulmonary function is associated with arterial stiffness (AS). The pulse pressure (PP) is an important predictor of AS, but the association of an impaired pulmonary function with the PP is unclear. Therefore, this study assessed the associations between the PP and the predicted forced vital capacity (predicted FVC) and predicted forced expiratory volume in one second (predicted FEV1) in Korean non-smoking adults. The data obtained from 6,857 adults during the 2013~2015 Korean National Health and Nutrition Examination Survey were analyzed. After adjusting for the related variables, the ORs of restrictive pulmonary disease (RPD, the predicted FVC<80.0% with FEV1/FVC≥70.0%) using the normal PP group (PP≤60 mmHg) as a reference group was significant for the high PP group (PP>60 mmHg; 1.337 [95% confidence interval (CI), 1.049~1.703]). In addition, the ORs of obstructive pulmonary disease (OPD, FEV1/FVC<70.0%) using the normal PP group as a reference group were significant for the high PP group (1.339 [95% CI, 1.093~1.642]). In conclusion, a high PP is positively associated with both RPD and OPD in Korean non-smoking adults.