• Title/Summary/Keyword: 임상 결과 예측

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The Usefulness According to the Incubation Time of PTH as Prediction Index of Hypocalcemia (저칼슘혈증 예측지표로서 부갑상선 호르몬 검사반응시간에 따른 유용성)

  • Au, Doo-Hee;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.138-142
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    • 2010
  • Purpose: PTH (parathyroid hormone) level is a useful index for prediction of hypocalcemia after thyroidectomy. The fast results are required for an early diagnosis of hypocalcemia. In this study, we evaluated the PTH change according to incubation time, and investigated the usefulness of hypocalcemia diagnosis of PTH results in early incubation time. Materials and Methods: The subjects were 131 patients who had taken the PTH test from July to August in 2009. All experiments were used IRMA method. PTH value were evaluated with the correlation between precision (10 times repeat) and recovery rate and at 0.5, 3, 6 and $18{\pm}2$ (below overnight) hours following incubation time. Data analysis was investigated with relationship of the sensitivity, specificity, PPV (positive predictive value) and accuracy. Results: The correlation was time-dependent with levels reaching $R^2$=0.987 at 0.5 hours, $R^2$=0.993 at 3 hours and $R^2$=0.996 at 6 hours compare to overnight levels. The precision (%CV${\pm}$SD) were $15.92{\pm}15.54$ at 0.5 hours, $6.91{\pm}7.38$ at 3 hours, $4.30{\pm}4.69$ at 6 hours and $4.59{\pm}2.59$ at overnight. The recovery rate (%Mean${\pm}$SD) were $96.8{\pm}5.44$ at 0.5 hours, $102.6{\pm}4.35$ at 3 hours, $100.7{\pm}2.56$ at 6 hours and $102.2{\pm}5.98$ at overnight. When 15 pg/ml of overnight density was set up as criteria, we measured the sensitivity, specificity and PPV, accuracy at 0.5, 3, 6 hours. The sensitivity was shown to 97.5% at all times. The specificity was 96.0% at 0.5 hours, 100% at 3 hours and 92.3% at 6 hours for control, respectively. The PPV was 86.6% at 0.5 hours, 100% at 3 hours and 92.8% at 6 hours. The accuracy was shown to 84.7% at 0.5 hours, 97.5% at 3 hours and 90.6% at 6 hours. These data were accompanied by a corresponding PTH value of overnight incubation time, which significantly correlated with early time results. Conclusion: The values of PTH at 3 hours has favorable the rate of concordance of 94.1% and may be useful for prediction of hypocalcemia, and it responses to overnight incubation PTH values. Therefore, This method may be an attractive alternative to proper treatment to stop symptom revelation by giving a calcium agent to the patient.

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Landslide Susceptibility Mapping Using Ensemble FR and LR models at the Inje Area, Korea (FR과 LR 앙상블 모형을 이용한 산사태 취약성 지도 제작 및 검증)

  • Kim, Jin Soo;Park, So Young
    • Journal of Korean Society for Geospatial Information Science
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    • v.25 no.1
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    • pp.19-27
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    • 2017
  • This research was aimed to analyze landslide susceptibility and compare the prediction accuracy using ensemble frequency ratio (FR) and logistic regression at the Inje area, Korea. The landslide locations were identified with the before and after aerial photographs of landslide occurrence that were randomly selected for training (70%) and validation (30%). The total twelve landslide-related factors were elevation, slope, aspect, distance to drainage, topographic wetness index, stream power index, soil texture, soil sickness, timber age, timber diameter, timber density, and timber type. The spatial relationship between landslide occurrence and landslide-related factors was analyzed using FR and ensemble model. The produced LSI maps were validated and compared using relative operating characteristics (ROC) curve. The prediction accuracy of produced ensemble LSI map was about 2% higher than FR LSI map. The LSI map produced in this research could be used to establish land use planning and mitigate the damages caused by disaster.

Rapid Extraction of DNA using Ion Exchange Resin for Early Detection of Mycobacterium tuberculosis by the Polymerase Chain Reaction (결핵균 PCR에서 이온교환수지를 이용한 신속한 DNA 분리)

  • Kim, Cheol-Min;Park, Seung-Kyu;Shon, Mal-Hyun;Song, Sun-Dae;Kim, Young;Jun, Eun-Sook;Son, Han-Chul;Jung, Byung-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.30-37
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    • 1996
  • Background: The extraction methods of DNA from clinical samples are the major obstacle to use the PCR(polymerase Chain Reaction) in routine labortary for early detection of M. tuberculosis. We tried to improve the extraction method of DNA from sputum for establishment of the PCR in routine labortary by reducing the possibility of cross contamination and performing it easily and safely. Methods: We used the $InstaGene^{TM}$ DNA extraction kit(BioRad Co.) using Chelex 100 ion exchange resin for preparation of DNA. We compared InstaGene method in 100 cases of sputum from proteinase K method which is known as the most commonly used method for DNA purification(Experiment 1). And we compared InstaGene method in 98 cases of sputum from Microwave method developed by a company in Korea(Experiment 2). In experiment 1,245bps of IS6110 were amplified and then 188bps were amplified by nested PCR. In experiment 2,536bps in primary PCR and 276bps in nested PCR were amplified and analysed by agarose gel electrophoresis and EtBr staining. Results: When we chose AFB smear, culture, or AFB smear and culture as a standard test, PCR had low specificity and positive predictive value in both experiments. The InstaGene method has higher value in sensitivity and negative predictive value significantly than proteinase K method. The InstaGene method and the Microwave methods were similar in sensitivity, specificity, positive predictive value and negative predictive value. Conclusion: Even though both methods had lower possibility of cross contamination, shorter time requirement, simplicity, and economic advantages than Proteinase K method, the InstaGene method was a little simpler than the Microwave method. Therefore, in terms of usefulness in clinical application, the Instagene method seems to be the most useful method in DNA extraction for detection of M. tuberculosis using PCR. The reliability of this method will be clarified by further studies with enough clinical samples.

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Analysis of Pressure Ulcer Nursing Records with Artificial Intelligence-based Natural Language Processing (인공지능 기반 자연어처리를 적용한 욕창간호기록 분석)

  • Kim, Myoung Soo;Ryu, Jung-Mi
    • Journal of the Korea Convergence Society
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    • v.12 no.10
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    • pp.365-372
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    • 2021
  • The purpose of this study was to examine the statements characteristics of the pressure ulcer nursing record by natural langage processing and assess the prediction accuracy for each pressure ulcer stage. Nursing records related to pressure ulcer were analyzed using descriptive statistics, and word cloud generators (http://wordcloud.kr) were used to examine the characteristics of words in the pressure ulcer prevention nursing records. The accuracy ratio for the pressure ulcer stage was calculated using deep learning. As a result of the study, the second stage and the deep tissue injury suspected were 23.1% and 23.0%, respectively, and the most frequent key words were erythema, blisters, bark, area, and size. The stages with high prediction accuracy were in the order of stage 0, deep tissue injury suspected, and stage 2. These results suggest that it can be developed as a clinical decision support system available to practice for nurses at the pressure ulcer prevention care.

Etiology and Clinical Features of Viral Lower-respiratory Tract Infections in Children in Winter, 2003 (2003년 겨울철 소아의 바이러스성 하기도 감염증에 대한 원인 및 바이러스별 임상양상)

  • Yun, Byung Ho;Lee, Hee Chul;Chun, Jung Mi;Yoon, So Young;Lee, Woo Gill;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.723-730
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    • 2005
  • Purpose : This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections(LRI). Methods : Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI(253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively. Results : Ninety two cases(36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus(RSV, 76.0%), adenovirus(ADV, 12.0%), influenza virus type A(INFA, 9.8 %), influenza virus type B(INFB, 1.1%) and parainfluenza virus(PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia(56.5%), bronchiolitis(35.9%), tracheobronchitis(4.3%) and croup(3.3%). The clinical symptoms and signs were cough(98.8%), rhinorrhea(82.6%), fever(70.7%), rale(67.4%), wheezing(29.3%), chest retraction(28.3%) and cyanosis(4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of $38.5^{\circ}C$ or higher and their most common etiologic agent was INFA(66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA(77.8%). The elevated WBC count($>14{\times}10^3/{\mu}L$) was in 14.1%, and common etiologic agents were INFA(22.2%) and ADV(18.2%). C-reactive protein(CRP >4.0 mg/dL) was increased in 13.0%, and common in ADV(63.6 %). Increased aspartate aminotransferase(AST)/alanine aminotransferase(ALT) was detected in 10.9%, and the most common etiologic agent was RSV(12.9%). Conclusion : The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.

Clinical and MR Predictors of Retro-Odontoid Pseudotumor Regression Following Posterior Fixation in Patients with Atlantoaxial Instability (환축 불안정 환자에서 후방 고정술 후 치상돌기 후방 가성종양 퇴행의 임상 및 자기공명영상 예측 인자)

  • Jisu Kim;Youngjune Kim;Eugene Lee;Joon Woo Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.754-768
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    • 2024
  • Purpose To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability. Materials and Methods We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann-Whitney and Fisher's exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression. Results We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31-84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression (p = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression. Conclusion Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.

Predictive indicators of coronary artery complications in Kawasaki disease (가와사키 병 환아에서 관상동맥 합병증의 예측인자)

  • Park, Min Jee;Jeon, In-sang;Tchah, Hann;Choi, Kang Ho;Jung, Mi-Jin;Choi, Deok Young
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1161-1166
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    • 2009
  • Purpose : Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. Methods : Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. Results : Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2-3-fold, respectively. Conclusion : The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.

Prediction of High Grade Vesicoureteral Reflux in Infants Less than 3 Months with Urinary Tract Infection (3개월 미만 요로감염 영아에서 중증 방광 요관 역류의 예측인자)

  • Yi, Dae-Yong;Kim, Na-Yeon;Cho, Hee-Yeon;Kim, Ji-Eun;Sim, So-Yeon;Son, Dong-Woo;Jeon, In-Sang;Cha, Han
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.178-185
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    • 2008
  • Purpose : Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI). Methods : Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated. Results : Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11$\pm$5.18 vs. 3.27$\pm$3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR. Conclusion : We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.

The Relationship between Visual Outcome and Ocular Trauma Score after Open Globe Injuries in Children (소아청소년 개방안구손상 환자에서의 시력예후와 안외상 점수와의 연관성)

  • Park, Su Jin;Son, Byeong Jae
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.11
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    • pp.1062-1070
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    • 2018
  • Purpose: We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS). Methods: We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity. Results: By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (${\geq}20/32$). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems. Conclusions: Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.

Prediction Model for Hypertriglyceridemia Based on Naive Bayes Using Facial Characteristics (안면 정보를 이용한 나이브 베이즈 기반 고중성지방혈증 예측 모델)

  • Lee, Juwon;Lee, Bum Ju
    • KIPS Transactions on Software and Data Engineering
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    • v.8 no.11
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    • pp.433-440
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    • 2019
  • Recently, machine learning and data mining have been used for many disease prediction and diagnosis. Chronic diseases account for about 80% of the total mortality rate and are increasing gradually. In previous studies, the predictive model for chronic diseases use data such as blood glucose, blood pressure, and insulin levels. In this paper, world's first research, verifies the relationship between dyslipidemia and facial characteristics, and develops the predictive model using machine learning based facial characteristics. Clinical data were obtained from 5390 adult Korean men, and using hypertriglyceridemia and facial characteristics data. Hypertriglyceridemia is a measure of dyslipidemia. The result of this study, find the facial characteristics that highly correlated with hypertriglyceridemia. FD_43_143_aD (p<0.0001, Area Under the receiver operating characteristics Curve(AUC)=0.652) is the best indicator of this study. FD_43_143_aD means distance between mandibular. The model based on this result obtained AUC value of 0.662. These results will provide a basis for predicting various diseases with only facial characteristics in the screening stage of disease epidemiology and public health in the future.