• Title/Summary/Keyword: Classification of Disease

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A Comparison between Asia-Pacific Region Criteria and Entropy Model Criteria about Body Mass Index of Elderly Females Using Morbidity of Chronic Disease (만성질환 이환율을 이용한 여자노인의 체질량지수에 대한 아시아-태평양지역 기준과 Entropy모델 기준 비교)

  • Jeong, Gu-Beom;Park, Jin-Yong;Kwon, Se-Young;Park, Kyung-Ok;Park, Pil-Sook;Park, Mi-Yeon
    • Korean Journal of Community Nutrition
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    • v.19 no.5
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    • pp.490-498
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    • 2014
  • Objectives: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). Methods: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. Results: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p < 0.001). Conclusions: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was $24kg/m^2$ (ENT-C) rather than $23kg/m^2$ (APR-C).

Analysis of sedation and general anesthesia in patients with special needs in dentistry using the Korean healthcare big data

  • Kim, Jieun;Kim, Hyuk;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.3
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    • pp.205-216
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    • 2022
  • Background: People with special needs tend to require diverse behavioral management in dentistry. They may feel anxious or uncomfortable or may not respond to any communication with the dentists. Patients with medical, physical, or psychological disorders may not cooperate and therefore require sedation (SED) or general anesthesia (GA) to receive dental treatment. Using the healthcare big data in Korea, this study aimed to analyze the trends of SED and GA in special needs patients undergoing dental treatment. It is believed that these data can be used as reference material for hospitals and for preparation of guidelines and related policy decisions of associations or governments for special needs patients in dentistry. Methods: The study used selected health information data provided by the Korean National Health Insurance Service. Patients with a record of use of one of the eight selected drugs used in dental SED between January 2007 and September 2019, those with International Classification of Diseases-10 codes for attention deficit hyperactivity disorder (ADHD), phobia, brain disease, cerebral palsy, epilepsy, genetic disease, autism, mental disorder, mental retardation, and dementia were selected. The insurance claims data were analyzed for age, sex, sedative use, GA, year, and institution. Results: The number of special needs patients who received dental treatment under SED or GA from January 2007 to September 2019 was 116,623. Number of SED cases was 136,018, performed on 69,265 patients, and the number of GA cases was 56,308, implemented on 47,257 patients. In 2007, 3100 special needs patients received dental treatment under SED while in 2018 the number of cases increased 6 times to 18,528 SED cases. In dentistry, ADHD was the most common disability for SED cases while phobia was the most common cause of disability for GA. The male-to-female ratio with respect to SED cases was higher for males (M : F = 64.36% : 35.64%). Conclusion: The application of the SED method and GA for patients with special needs in dentistry is increasing rapidly; thus, preparing guidelines and reinforcing the education and system are necessary.

Significance of Supraclavicular Lymph Node Involvement on Determination of Clinical Staging for Thoracic Esophageal Carcinoma (흉부 식도암의 병기 결정에 있어서 채골상 림프절 전이의 의미)

  • Wu Hong-Gyun;Park Chan Il;Ha Sung Whan;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.108-112
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    • 1999
  • Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.

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Podiatric Clinical Diagnosis using Decision Tree Data Mining (결정트리 데이터마이닝을 이용한 족부 임상 진단)

  • Kim, Jin-Ho;Park, In-Sik;Kim, Bong-Ok;Yang, Yoon-Seok;Won, Yong-Gwan;Kim, Jung-Ja
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.2
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    • pp.28-37
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    • 2011
  • With growing concerns about healthy life recently, although the podiatry which deals with the whole area for diagnosis, treatment of foot and leg, and prevention has been widely interested, research in our country is not active. Also, because most of the previous researches in data analysis performed the quantitative approaches, the reasonable level of reliability for clinical application could not be guaranteed. Clinical data mining utilizes various data mining analysis methods for clinical data, which provides decision support for expert's diagnosis and treatment for the patients. Because the decision tree can provide good explanation and description for the analysis procedure and is easy to interpret the results, it is simple to apply for clinical problems. This study investigate rules of item of diagnosis in disease types for adapting decision tree after collecting diagnosed data patients who are 2620 feet of 1310(males:633, females:677) in shoes clinic (department of rehabilitation medicine, Chungnam National University Hospital). and we classified 15 foot diseases followed factor of 22 foot diseases, which investigated diagnosis of 64 rules. Also, we analyzed and compared correlation relationship of characteristic of disease and factor in types through made decision tree from 5 class types(infants, child, adolescent, adult, total). Investigated results can be used qualitative and useful knowledge for clinical expert`s, also can be used tool for taking effective and accurate diagnosis.

Gene-gene Interaction in Cerebral Infarction Patients : A Study on Relationship Between Apolipoprotein E, ACE Gene Polymorphism and Sasang Constitution

  • Kim Jong Kwan;Kim Hyoung Soon;Bae Young Chun;Lee Sang Min;Kim Kyung Yo;Joo Jong Cheon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.4
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    • pp.1192-1198
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    • 2004
  • Sasang Constitutional Medicine is a major branch of Korean Traditional Medicine. The differences of disease susceptibility to be shown in Sasang constitution may be due to genetic factors. Therefore, I examined interrelationship among cerebral infarction (CI), apolipoprotein E (apo E) gene polymorphism, and Sasang constitutional classification. Apo E is a key protein modulating the highly atherogenic apoB containing lipoproteins and is a candidate gene for the development of coronary artery disease (CAD). The ε2 and/or ε4 alleles were the first to be implicated in premature CAD, which resulted in this polymorphism being extensively studied. I investigated the association between apo E genotype and CI by case-control study in a Korean population. I also classified CI patients and control group into groups according to Sasang Constitutional Medicine. 218 CI patients and 379 controls without CI were examined. Apo E genotype was determined by 8% polyacrylamide gel separation after DNA amplification. A frequency of apo E ε3/ε3 in the apo E genotype distribution was higher in the CI patients compared with that in controls. Also, it was widely known that Taeumin was easily attacked with CI, but there was no association between apo E polymorphim and Taeumin. However, the Taeumin constitution did not enhance the relative risk for CI in the subjects with apo E ε2 and/or ε4 alleles. No differences in the apo E genotypes frequencies were observed in the Taeumin compared with that in the other constitutions. In addition, I investigated whether the DD(deletion/deletion) or ID(insertion/deletion) genotype of angiotensin converting enzyme (ACE) gene, a candidate gene for CI, was associated with CI, Taeumin constitution, and apo E polymorphism. As a result, the frequency of Taeumin constitution was significantly higher in CI patients with both apo E ε3/ε4 and ACE ID/DD genotypes than in the remaining Sasang constitutions. In summary, it was concluded that the apo E polymorphism is a major risk factor for CI in Koreans and the ACE ID/DD genotype enhanced the relative risk for CI in the subjects with apo E ε3/ε4 genotype and Taeumin constitution.

Long Term Efficacy of Posterior Lumbar Interbody Fusion with Standard Cages alone in Lumbar Disc Diseases Combined with Modic Changes

  • Kwon, Young-Min;Chin, Dong-Kyu;Jin, Byung-Ho;Kim, Keun-Su;Cho, Yong-Eun;Kuh, Sung-Uk
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.322-327
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    • 2009
  • Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.

Convolution Neural Network for Prediction of DNA Length and Number of Species (DNA 길이와 혼합 종 개수 예측을 위한 합성곱 신경망)

  • Sunghee Yang;Yeone Kim;Hyomin Lee
    • Korean Chemical Engineering Research
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    • v.62 no.3
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    • pp.274-280
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    • 2024
  • Machine learning techniques utilizing neural networks have been employed in various fields such as disease gene discovery and diagnosis, drug development, and prediction of drug-induced liver injury. Disease features can be investigated by molecular information of DNA. In this study, we developed a neural network to predict the length of DNA and the number of DNA species in mixture solution which are representative molecular information of DNA. In order to address the time-consuming limitations of gel electrophoresis as conventional analysis, we analyzed the dynamic data of a microfluidic concentrating device. The dynamic data were reconstructed into a spatiotemporal map, which reduced the computational cost required for training and prediction. We employed a convolutional neural network to enhance the accuracy to analyze the spatiotemporal map. As a result, we successfully performed single DNA length prediction as single-variable regression, simultaneous prediction of multiple DNA lengths as multivariable regression, and prediction of the number of DNA species in mixture as binary classification. Additionally, based on the composition of training data, we proposed a solution to resolve the problem of prediction bias. By utilizing this study, it would be effectively performed that medical diagnosis using optical measurement such as liquid biopsy of cell-free DNA, cancer diagnosis, etc.

The latest trend of research and clinical usage about Bojungikki-Tang in Japan -searching medical science articles published from 2003 to 2008- (일본에서 보중익기탕(補中益氣湯)에 대한 최신 연구와 임상 응용 동향 -2003년에서 2008년까지 학술논문 분석-)

  • Park, Ju-Yeon;Yi, Hyo-Seung;Park, Sun-Dong
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.11-29
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    • 2008
  • Objective : The aim of this study was to analyse the latest trend of medical science articles about Bojungikki-Tang published in Japan. Methods : We searched medical science articles published from 2003 to 2008 in Japan on the web site, CiNii and then these articles were reviewed and classified according to experimental subject and method. Results : Fifty-two articles, related to Bojungikki-Tang were searched and these were classified into three classes, pharmacological signaling studies, clinical case studies and the others. As a result of classification, clinical case studies were most abundant by 38 cases, pharmacological signaling studies were 10 and the others were 4. This result suggested that the study of Bojungikki-Tang was mainly focused on clinical study rather than experimental study. Among the clinical case studies, clinical studies related to immune disease took the most greatest number and number of other clinical studies were evenly distributed over the various disease. Immune intensification effect of Bojungikki-Tang can be thought continuous with reinforce the middle Jiao Qi in company with improvement effect on growth hormone failure and male infertility. A fact that the one prescription, Bojungikki-Tang could be used to treat various diseases reflects a viewpoint of Oriental medicine that is based on the respect for and understanding of individual constitution and disposition while paying attention to the gender difference and individuality. The clinical usefulness of Bojungikki-Tang on obstructive sleep apnea syndrome and visceroptosis concerns with ascend Yang and treat Qi sinking. Pharmacological signaling studies were mainly focused on diseases that were treated Bojungikki-Tang in clinic, however, there was one study that experimented on changes of numerous gene expression according to the treatment of Bojungikki-Tang using DNA array. Conclusion : The therapeutic system of Oriental medicine is different in various aspects form that of Western medicine and appropriate harmonization of east and west is expected to improve the quality of medical care. In this regard, continuous investigation and analysis about herbal medical science papers in Japan can also be useful to make progress in Korean traditional medicine.

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Combined Modality Therapy of Non-Hodgkin's Lymphoma of Waldeyer's Ring (Waldeyer's Ring 비호치킨 림프종의 병합요법)

  • Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.22-28
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    • 1999
  • Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

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Factors of Determining N-acetylcysteine Administration in Patients with Acute Acetaminophen Poisoning (급성 아세트아미노펜 중독에서 N-acetylcysteine 투여 결정 관련 인자)

  • Lee, Jeong Hwa;Choi, Sangchun;Yoon, Sang Kyu;Shin, Kyu Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.78-84
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    • 2020
  • Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.