• Title/Summary/Keyword: 임상 결과 예측

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Development of a Landslide Hazard Prediction Model using GIS (GIS를 이용한 산사태 위험지 판정 모델의 개발)

  • Lee, Seung-Kii;Lee, Byung-Doo;Chung, Joo-Sang
    • Journal of the Korean Association of Geographic Information Studies
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    • v.8 no.4
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    • pp.81-90
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    • 2005
  • Based on the landslide hazard scoring system of Korea Forest Research Institute, a GIS model for predicting landslide hazards was developed. The risk of landslide hazards was analyzed as the function of 7 environmental site factors for the terrain, vegetation, and geological characteristics of the corresponding forest stand sites. Among the environmental factors, slope distance, relative height and shapes of slopes were interpreted using the forestland slope interpretation module developed by Chung et al. (2002). The program consists of three modules for managing spatial data, analyzing landslide hazard and report-writing, A performance test of the model showed that 72% of the total landslides in Youngin-Ansung landslides area took place in the highly vulnerable zones of grade 1 or 2 of the landslide hazard scoring map.

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The Assessment of Framingham Risk Score and 10 Year CHD Risk according to Application of LDL Cholesterol or Total Cholesterol (LDL Cholesterol 또는 Total Cholesterol의 적용에 따른 Framingham Risk Score와 10년 내 심혈관질환 발생 위험도 평가)

  • Kwon, Se Young;Na, Young Ak
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.54-61
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    • 2016
  • Studies on assessment tools for predicting cardiovascular disease risk (CDR), along with the studies to prevent CDR have been consistently reported. The validity of the Framingham risk score (FRS), a commonly known tool, has been verified through the precedent studies. In this study, we examined the differences of FRS according to the application of categories of LDL cholesterol (LDL-C) or Total cholesterol (TC), and attempted to evaluate the agreement of 10 yr CHD risk judgment based on the above-mentioned application. Excluding those diagnosed as cardiovascular diseases, data on subjects (755 men and 775 women) from the 2011 Korean National Health and Nutrition Examination Survey were used. We found differences of FRS and 10 yr CHD risk depending on the application of categories of LDL cholesterol (LDL-C) or Total cholesterol (TC). FRS of TC points were higher than those of LDL-C in both men and women. In classification of low risk (<10%), intermediate risk (10~19%), and high risk (${\geq}20%$), there were disagreements for 106 men and 26 women. Women showed almost perfect agreement from Coefficient of Cohen's Kappa (0.718 in men, and 0.884 in women). In assessment of 10 yr CHD risk, R-squared value from regression including TC was higher than that of LDC-C in both men and women (0.972 vs 0.885). From this result, we can draw a conclusion that correlation coefficients of FRS and CHD risk including TC were higher than those of LDC-C, and women showed a greater degree of agreement than men.

The Verification of Korean Version Swallowing Disturbance Questionnaire (K-SDQ) (한국판 삼킴 곤란 척도(K-SDQ)의 번안본 검증)

  • Jung, SoWoon;Kim, JungWan
    • 재활복지
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    • v.22 no.4
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    • pp.43-58
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    • 2018
  • Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.

Analysis of the Correlation between Expressions of HSP90α, HSP90β, and GRP94, and the Clinicopathologic Characteristics in Tissues of Non-Small Cell Lung Cancer Patients (비소세포 폐암 환자 조직에서 Hsp90α, Hsp90β, GRP94의 발현과 임상병리학적 특성과의 상관관계 분석)

  • Kim, Mi Kyeong
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.4
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    • pp.460-469
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    • 2017
  • Heat shock proteins (HSPs) are induced as a self-defense mechanism of cells when exposed to various external stresses, such as high fever, infection, free radicals, and heavy metals. They affect the prognosis in the process of tumor formation. HSP is classified into four families: HSP27, HSP60, HSP90, and HSP100, depending on molecular weight. Heat shock protein 90 (HSP90), a molecular chaperone, plays an important role in the cellular protection against various stressful stimuli and in the regulation of cell cycle progression and apoptosis. In the present study, we assessed the differential expression of HSP90 family proteins in non-small cell lung cancer (NSCLC), and the correlation of their expression levels with clinicopathologic factors and patient survival rates. The result of this study can be summarized as follows; $HSP90{\alpha}$ showed higher expression in patients with no lymphovascular invasion (p=0.014). $HSP90{\beta}$ showed a higher expression of squamous cell carcinoma (p=0.003), and an over expression of glucose-related protein (GRP94) was significantly associated with poor differentiation (p=0.048). However, none of the HSP90 proteins showed a significant association with the survival status in patients with NSCLC. This study also indicates that $HSP90{\alpha}$ might contribute more to the carcinogenesis of NSCLC than $HSP90{\beta}$, and GRP94 and isoform selectivity should be considered when HSP90 inhibitors are studied or utilized in the treatment of NSCLC.

Study on the Agreement Values of Pulmonary Arterial Hypertension Measured by Cardiac Sonographers (심장초음파 검사자 간의 폐동맥고혈압 진단 측정값 일치도 분석 연구)

  • Seol Hwa KIM;Sundo JUNG
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.269-275
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    • 2023
  • Echocardiography is a non-invasive method that is useful for diagnosing pulmonary arterial hypertension. It is known that echocardiography depends on the experience, education, and knowledge level of the cardiac sonographer. This study aimed to compare the agreement values between cardiac sonographer with different practical experiences in the diagnosis of pulmonary arterial hypertension using echocardiography. Three readers re-evaluated the echocardiography images of 148 patients who were diagnosed with pulmonary arterial hypertension at the S Medical Center from January 1, 2020, to December 31, 2020. The echocardiography values measured by each reader were compared and analyzed. The results of the analysis of discrete variables revealed that the agreement values of the cardiac sonographers showed excellent consistency for both reader 3 and the cardiologist group, indicating that more experience leads to better predictive accuracy for diagnosis of the condition. Furthermore, in terms of continuous variables, all the cardiac sonographer demonstrated good agreement in the measured values of the right atrium, which was easier to assess and clearer than the structurally complex measurements of the right ventricle. This study represents the first analysis in Korea of the agreement values measured by medical technologists who are cardiac sonographers.

Deep Learning in Thyroid Ultrasonography to Predict Tumor Recurrence in Thyroid Cancers (인공지능 딥러닝을 이용한 갑상선 초음파에서의 갑상선암의 재발 예측)

  • Jieun Kil;Kwang Gi Kim;Young Jae Kim;Hye Ryoung Koo;Jeong Seon Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1164-1174
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    • 2020
  • Purpose To evaluate a deep learning model to predict recurrence of thyroid tumor using preoperative ultrasonography (US). Materials and Methods We included representative images from 229 US-based patients (male:female = 42:187; mean age, 49.6 years) who had been diagnosed with thyroid cancer on preoperative US and subsequently underwent thyroid surgery. After selecting each representative transverse or longitudinal US image, we created a data set from the resulting database of 898 images after augmentation. The Python 2.7.6 and Keras 2.1.5 framework for neural networks were used for deep learning with a convolutional neural network. We compared the clinical and histological features between patients with and without recurrence. The predictive performance of the deep learning model between groups was evaluated using receiver operating characteristic (ROC) analysis, and the area under the ROC curve served as a summary of the prognostic performance of the deep learning model to predict recurrent thyroid cancer. Results Tumor recurrence was noted in 49 (21.4%) among the 229 patients. Tumor size and multifocality varied significantly between the groups with and without recurrence (p < 0.05). The overall mean area under the curve (AUC) value of the deep learning model for prediction of recurrent thyroid cancer was 0.9 ± 0.06. The mean AUC value was 0.87 ± 0.03 in macrocarcinoma and 0.79 ± 0.16 in microcarcinoma. Conclusion A deep learning model for analysis of US images of thyroid cancer showed the possibility of predicting recurrence of thyroid cancer.

Study on the Professionalism of Medical Technologists' Work in Health Examination Centers: Focusing on the General Health Examination (건강검진센터에서 임상병리사의 업무 전문성 연구: 일반건강검진을 중심으로)

  • Sung, Hyun Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.271-277
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    • 2020
  • "Health examinations" means medical examinations conducted by health examination institutions, including a physical examination, consultation, physical measurement, diagnostic laboratory test (also known as clinical laboratory test, clinical pathology test), pathology test, and Imaging test for checking the health condition and the prevention and early detection of diseases. The types of health examinations include general health examinations, comprehensive health examinations, special health examinations, and other health examinations. The proportion of the general health examination work of medical technologists working at health examination centers has been estimated to comprise more than 50% of the total work. The cost aspect of suspicious diseases can be estimated to be more than 25%. The cost of diagnostic laboratory test has been estimated to be approximately 5%, and the proportion of medical diagnosis use is 70%. The results show that it is time to revisit whether medical technologists are receiving appropriate social, economic, and reasonable policy treatment in health examination work. The future of medical technologists will further expand their professionalism in diagnostic laboratory test and quality control in precision medicine and telemedicine in the future. Therefore, medical technologists will need to participate proactively in government policy decisions related to national health examinations and make efforts to improve treatment.

Development and Validation of Figure-Copy Test for Dementia Screening (치매 선별을 위한 도형모사검사 개발 및 타당화)

  • Kim, Chobok;Heo, Juyeon;Hong, Jiyun;Yi, Kyongmyon;Park, Jungkyu;Shin, Changhwan
    • 한국노년학
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    • v.40 no.2
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    • pp.325-340
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    • 2020
  • Early diagnosis and intervention of dementia is critical to minimize future risk and cost for patients and their families. The purpose of this study was to develop and validate Figure-Copy Test(FCT), as a new dementia screening test, that can measure neurological damage and cognitive impairment, and then to examine whether the grading precesses for screening can be automated through machine learning procedure by using FCT imag es. For this end, FCT, Korean version of MMSE for Dementia Screening (MMSE-DS) and Clock Drawing Test were administrated to a total of 270 participants from normal and damaged elderly groups. Results demonstrated that FCT scores showed high internal constancy and significant correlation coefficients with the other two test scores. Discriminant analyses showed that the accuracy of classification for the normal and damag ed g roups using FCT were 90.8% and 77.1%, respectively, and these were relatively higher than the other two tests. Importantly, we identified that the participants whose MMSE-DS scores were higher than the cutoff but showed lower scores in FCT were successfully screened out through clinical diagnosis. Finally, machine learning using the FCT image data showed an accuracy of 73.70%. In conclusion, our results suggest that FCT, a newly developed drawing test, can be easily implemented for efficient dementia screening.

Prognostic Value of Serum Ferritin in Terminally Ill Cancer Patients (말기암환자에서 예후인자로서 혈청 Ferritin의 유용성)

  • Lee, Soo Hee;Choi, Youn Seon;Hwang, In Cheol;Yeom, Chang Hwan;Lee, June Yeong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.51-59
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    • 2015
  • Purpose: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. Methods: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. Results: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. Conclusion: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.

Role of neutrophil/lymphocyte ratio as a predictor of mortality in organophosphate poisoning (유기인계 살충제 중독환자의 사망 예측 인자로서 중성구/림프구 비율의 역할)

  • Jeong, Jae Han;Sun, Kyung Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.384-390
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    • 2020
  • Purpose: Organophosphate insecticide poisoning can have clinically fatal results. This study aimed to evaluate the relationship between the neutrophil/lymphocyte ratio (NLR) and the occurrence of death in patients with organophosphate insecticide poisoning. Methods: For this retrospective study, data on patients with organophosphate insecticide poisoning who visited the emergency room between January 2008 and November 2018 were collected. The NLR was measured at the time of arrival in the emergency room. The patients were divided into survival and death groups. Results: Overall, 150 patients were enrolled: 15 (10%) in the death group and 135 (90%) in the survival group. In the univariate analysis, the following variables were significantly different between the two groups: age, white blood cell count, amylase level, creatinine level, Acute Physiology And Chronic Health Evaluation (APACHE) II score, and NLR. In the logistic regression analysis of variables with significant differences in the univariate analysis, there were significant differences between the two groups with respect to age, APACHE II score, and NLR. The NLR was significantly higher in the death group than in the survival group (20.83 ± 22.24 vs. 7.38 ± 6.06, p=0.036). Conclusion: High NLR in patients with organophosphate insecticide poisoning may be useful in predicting mortality.