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Multivariate Analysis for Clinicians (임상의를 위한 다변량 분석의 실제)

  • Oh, Joo Han;Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.63-72
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    • 2013
  • In medical research, multivariate analysis, especially multiple regression analysis, is used to analyze the influence of multiple variables on the result. Multiple regression analysis should include variables in the model and the problem of multi-collinearity as there are many variables as well as the basic assumption of regression analysis. The multiple regression model is expressed as the coefficient of determination, $R^2$ and the influence of independent variables on result as a regression coefficient, ${\beta}$. Multiple regression analysis can be divided into multiple linear regression analysis, multiple logistic regression analysis, and Cox regression analysis according to the type of dependent variables (continuous variable, categorical variable (binary logit), and state variable, respectively), and the influence of variables on the result is evaluated by regression coefficient${\beta}$, odds ratio, and hazard ratio, respectively. The knowledge of multivariate analysis enables clinicians to analyze the result accurately and to design the further research efficiently.

Parental response, recognition and management about fever in children (소아의 열에 대한 부모의 반응과 이해 및 처치)

  • Kim, Eugene;Hur, Jae Kyun
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.55-61
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    • 2007
  • Purpose : Fever, the most common presenting symptom in pediatric clinics, has been believed to be a dangerous symptom by many parents. Proper recognition about fever will relieve unnecessary anxiety of parents and help them understand the course of the disease. Our objectives of this study were to investigate current parental recognition about fever and to compare these results with those described in 1992. Methods : Between May and July 2006, we questioned caregivers who visited the pediatric outpatient clinic in St.Paul hospital. The questionnaire consisted of 19 items asking about recognition, attitude and management of fever. Results : A total of 136 caregivers were interviewed. Compared with 10 years ago, there were no significant improvements in misconception about fever. Many caregivers (61%) had wrong information about a definition and the way to measure body temperature. There were still high concerns about febrile convulsion and brain damage from fever. Caregivers started treatment at the body temperature which actually needed no therapy. Conclusion : Parents were not aware that fever is just one of physiologic responses and has benefits, which led to unnecessary anxiety and treatment. This misconception has not been changed over the years. Pediatrician should inform parents that fever itself is not harmful and only rational reason for use of antipyretics is to relieve a discomfort of a febrile child. An educational interventions offered by pediatricians will be helpful for parents to have right attitude and understandings toward fever.

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PD-1 Expression in LPS-Induced Raw264.7 Cells Is Regulated via Co-activation of Transcription Factor NF-κB and IRF-1 (Lipopolysaccharide 유도된 Raw264.7 세포주에서 전사조절인자 NF-κB와 IRF-1의 공동작용에 의해 조절되는 PD-1 발현연구)

  • Choi, Eun-Kyoung;Lee, Soo-Woon;Lee, Soo-Woong
    • Korean Journal of Microbiology
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    • v.49 no.4
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    • pp.301-308
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    • 2013
  • Programmed Death-1 (PD-1) is one of the important immune-inhibitory molecules which was expressed in T cells, B cells, NKT cells, and macrophages activated by various immune activating factors. Lipopolysaccharide (LPS), the major component of the outer membrane of Gram-negative bacteria, is one of the crucial immunogens for PD-1 expression. However, there are only a few reports on the expression mechanisms of PD-1 in innate immune cells. In this study, we investigate the expression mechanisms of PD-1 in LPS-stimulated Raw264.7 cell lines by RT-PCR, Western Blot, flow cytometry as well as ChIP assay and co-immunoprecipitation. When Raw264.7 cells were stimulated with LPS, PD-1 expression was greatly up-regulated via PI3K and p38 signaling. Primary macrophages isolated from LPS-injected mice were also shown the increased expression of PD-1. In promoter assay, NF-${\kappa}B$ and IRF-1 binding regions in mouse PD-1 promoter are important for PD-1 expression. We also found that the co-activation of NF-${\kappa}B$ and IRF-1 is indispensable for the maximum PD-1 expression. These results indicate that the modulation of PD-1 expressed in innate immune cells could be a crucial for the disease therapy such as LPS-induced mouse sepsis model.

IL-23 P19 Expression Induced by IL-17 and $IL-1{\beta}$ in Rheumatoid Arthritis Synovial Mononuclear Cells (류마티스관절염 환자의 활액 세포에서 IL-17과 $IL-1{\beta}$에 의한 IL-23p19의 발현 증가)

  • Cho, Mi-La;Heo, Yu-Jung;Oh, Hye-Jwa;Kang, Chang-Min;Lee, Seon-Yeong;Hong, Yeon-Sik;Kim, Ho-Youn
    • IMMUNE NETWORK
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    • v.8 no.1
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    • pp.29-37
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    • 2008
  • Interleukin-23 (IL-23) is a novel pro-inflammatory cytokine which has been implicated to play a pathogenic role in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-23 inductive activity of the proinflammatory cytokine IL-17, $IL-1{\beta}$ and tumor necrosis factor (TNF-${\alpha}$) in RA synovial fluid mononuclear cells (SFMC). Expression of IL-23p19, IL-17, $IL-1{\beta}$ and TNF-${\alpha}$ in joint was examined by immunohistochemistry (IHC) of patients with RA and osteoarthritis (OA). The effects of IL-17 and $IL-1{\beta}$ on expression of IL-23p19 in human SFMC from RA patients were determined by reverse transcriptase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). IL-23p19 was expressed in the RA fibroblast like synoviocyte (FLS), but not from OA FLS. Similar to the protein expression, IL-23p19 mRNA could be detected by RT-PCR in RA SFMC. IL-17 and $IL-1{\beta}$ could induce RA SFMC to produce the IL-23p19. The effects of IL-17 were much stronger than $IL-1{\beta}$ or TNF-${\alpha}$. These responses were observed in a doseresponsive manner. In addition, IL-17 or $IL-1{\beta}$ neutralizing antibody down-regulated the expression of IL-23p19 induced by LPS in RA-SFMC. Our results demonstrate that IL-23p19 is overexpressed in RA synovium and IL-17 and $IL-1{\beta}$ appears to upregulate the expression of IL-23p19 in RA-SFMC.

Vitrification, in vitro fertilization, and development of Atg7 deficient mouse oocytes

  • Bang, Soyoung;Lee, Geun-Kyung;Shin, Hyejin;Suh, Chang Suk;Lim, Hyunjung Jade
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.1
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    • pp.9-14
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    • 2016
  • Objective: Autophagy contributes to the clearance and recycling of macromolecules and organelles in response to stress. We previously reported that vitrified mouse oocytes show acute increases in autophagy during warming. Herein, we investigate the potential role of Atg7 in oocyte vitrification by using an oocyte-specific deletion model of the Atg7 gene, a crucial upstream gene in the autophagic pathway. Methods: Oocyte-specific Atg7 deficient mice were generated by crossing Atg7 floxed mice and Zp3-Cre transgenic mice. The oocytes were vitrified-warmed and then subjected to in vitro fertilization and development. The rates of survival, fertilization, and development were assessed in the Atg7 deficient oocytes in comparison with the wildtype oocytes. Light chain 3 (LC3) immunofluorescence staining was performed to determine whether this method effectively evaluates the autophagy status of oocytes. Results: The survival rate of vitrified-warmed $Atg7^{f/f}$;Zp3-Cre ($Atg7^{d/d}$) metaphase II (MII) oocytes was not significantly different from that of the wildtype ($Atg7^{f/f}$) oocytes. Fertilization and development in the $Atg7^{d/d}$ oocytes were significantly lower than the $Atg7^{f/f}$ oocytes, comparable to the $Atg5^{d/d}$ oocytes previously described. Notably, the developmental rate improved slightly in vitrified-warmed $Atg7^{d/d}$ MII oocytes when compared to fresh $Atg7^{d/d}$ oocytes. LC3 immunofluorescence staining showed that this method can be reliably used to assess autophagic activation in oocytes. Conclusion: We confirmed that the LC3-positive signal is nearly absent in $Atg7^{d/d}$ oocytes. While autophagy is induced during the warming process after vitrification of MII oocytes, the Atg7 gene is not essential for survival of vitrified-warmed oocytes. Thus, induction of autophagy during warming of vitrified MII oocytes seems to be a natural response to manage cold or other cellular stresses.

Evaluation of Carbon Dioxide Concentrations and Ventilation Rates in Elementary, Middle, and High Schools (초·중·고등학교의 이산화탄소 농도 및 환기량 평가)

  • Choe, Youngtae;Heo, Jung;Park, Jinhyeon;Kim, Eunchae;Ryu, Hyoensu;Kim, Dong Jun;Cho, Mansu;Lee, Chaekwan;Lee, Jongdae;Yang, Wonho
    • Journal of Environmental Health Sciences
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    • v.46 no.3
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    • pp.344-352
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    • 2020
  • Objectives: Much attention has been paid to indoor air quality. Ventilation within schools is important because of indoor air quality and its effect on health and learning performance. In this study, we evaluated the carbon dioxide (CO2) concentrations and ventilation rates in schools. Methods: This study measured the concentration of CO2 in elementary, middle, and high school classrooms over six months. The seasons during the study were summer, fall, and winter. Sensor-based monitoring was used and the basic characteristics of the classroom were investigated. The body surface area of the students was used to calculate the CO2 generation rate, and the air change per hour (ACH) was evaluated using mass balance modeling. Results: The average CO2 concentration measured in most schools exceeded 1000 ppm. The ventilation rates varied from season to season. Compared to the recommended ventilation rate of 4.9 ACH, the roughly 3 ACH calculated in this study indicates that most schools possessed insufficient ventilation. Conclusions: The concentration of CO2 in school classrooms could be an indicator of indoor air quality and can affect students' learning ability. In this study, CO2 concentrations exceeding the standard indicate a lack of ventilation along with problems with indoor air quality. Therefore, appropriate improvements are needed to overcome these problems.

Correlation between Dementia and Lead, Cadmium, Mercury, and Manganese Concentrations in the Blood (치매환자 여부와 혈중 납, 카드뮴, 수은 및 망간 농도와의 상관성)

  • Shin, Mi Hey;Lee, Seung Kil;Kim, Kyong Hee;Choi, Jae Wook
    • Journal of Environmental Health Sciences
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    • v.46 no.3
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    • pp.267-275
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    • 2020
  • Objectives: The causes of dementia have been reported in various ways, but there has been little research on the interrelationship between heavy metals and dementia, and the results also show little consistency. Therefore, it is imperative to compare the levels of heavy metal exposure between the dementia-suffering group and a control group to confirm the correlation between the level of heavy metal exposure and the likelihood of dementia. Methods: In order to assess the dementia level of the elderly, the Global Deterioration Scale (GDS) and Mini Mental State Examination (MMSE) were applied. To analyze the concentration of heavy metals in the blood, blood was collected from the veins of study subjects and measured using Inductively Coupled Plasma-mass spectrometry (ICP-MS). Results: There was a statistically significant correlation between lead and manganese concentrations in the blood and the MMSE and GDS. It was found that there was a statistically significant correlation between cadmium concentration in the blood and the GDS, but the MMSE was less relevant. It was found that the blood mercury concentration and the MMSE and GDS were less relevant. The lead concentration in the blood was 0.95±0.74 ㎍/dL in the dementia patient group and 0.33±0.22 ㎍/dL in the normal group, while cadmium was 0.69±0.37 ㎍/L in the dementia group and 0.18±0.10 ㎍/L in the normal group. Mercury was 0.81±0.31 ㎍/L in the dementia group and 1.16±0.80 ㎍/L in the normal group. Manganese was 6.83±2.01 ㎍/L in the dementia group and 4.78±1.59 ㎍/L in the normal group. All of these show statistically significant differences. Conclusions: As the concentration of lead, cadmium and manganese in the blood increases, the MMSE scores and GDS scores were found to worsen, and it was confirmed that there is a correlation between heavy metal exposure and cognitive degradation.

N-glycoproteomic analysis of human follicular fluid during natural and stimulated cycles in patients undergoing in vitro fertilization

  • Lim, Hee-Joung;Seok, Ae Eun;Han, Jiyou;Lee, Jiyeong;Lee, Sungeun;Kang, Hee-Gyoo;Cha, Byung Heun;Yang, Yunseok
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.2
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    • pp.63-72
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    • 2017
  • Objective: Hyperstimulation methods are broadly used for in vitro fertilization (IVF) in patients with infertility; however, the side effects associated with these therapies, such as ovarian hyperstimulation syndrome (OHSS), have not been well studied. N-glycoproteomes are subproteomes used for the remote sensing of ovarian stimulation in follicular growth. Glycoproteomic variation in human follicular fluid (hFF) has not been evaluated. In this study, we aimed to identify and quantify the glycoproteomes and N-glycoproteins (N-GPs) in natural and stimulated hFF using label-free nano-liquid chromatography/electrospray ionization-quad time-of-flight mass spectrometry. Methods: For profiling of the total proteome and glycoproteome, pooled protein samples from natural and stimulated hFF samples were selectively isolated using hydrazide chemistry to obtain the total proteomes and glycoproteomes. N-GPs were validated by the consensus sequence N-X-S/T (92.2% specificity for the N-glycomotif at p<0.05). All data were compared between natural versus hyperstimulated hFF samples. Results: We detected 41 and 44 N-GPs in the natural and stimulated hFF samples, respectively. Importantly, we identified 11 N-GPs with greater than two-fold upregulation in stimulated hFF samples compared to natural hFF samples. We also validated the novel N-GPs thyroxine-binding globulin, vitamin D-binding protein, and complement proteins C3 and C9. Conclusion: We identified and classified N-GPs in hFF to improve our understanding of follicular physiology in patients requiring assisted reproduction. Our results provided important insights into the prevention of hyperstimulation side effects, such as OHSS.

The Strategy for Diagnosis and Treatment of Isovaleric Acidemia (아이소발레릭산혈증의 신생아선별검사 후 진단 및 치료 전략)

  • Ko, Jung Min;Lee, Kyung-A
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.57-61
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    • 2016
  • Isovaleric acidemia (IVA) is an autosomal recessively inherited organic acid disorder due to a defect of the enzyme isovaleryl-CoA dehydrogenase in the leucine metabolic pathway. Deficiency of this enzyme results in the accumulation of derivatives of isovaleryl-CoA. In acute illness in IVA, isovaleric acid and its derivatives accumulate and profound metabolic acidosis with ketosis, characteristic pungent body odor, hypoglycemia, and hyperammonemia can be developed. Additionally, recurrent vomiting, failure to thrive, developmental delay, epilepsy and mental retardation are chronic presenting symptoms and signs for IVA. On the result of newborn screening for inherited metabolic disorders, increased levels of isovalerylcarnitine (C5) are shown. However, C5 elevation can be accompanied with short/branched-chain acyl-CoA dehydrogenase (SBCAD) and therapy with certain antibiotics containing pivalic acid. Quantitative measurement of organic acids in urine and acylcarnitine profiles in plasma are necessary to differential diagnosis. Molecular genetic analysis of the IVD gene for IVA and ACADSB is also helpful to confirm IVA and SBCAD deficiency, respectively. Considering that IVA can be associated with significant morbidity and mortality at acute presentation of metabolic crisis, early diagnosis prior to the onset of symptoms by newborn screening enable to introduction of early treatment and prevention of acute and chronic complications.

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Exposure Assessment and Asbestosis Pulmonum among Inhabitants near Abandoned Asbestos Mines Using Deposited Dust (폐석면광산 주변 지역의 주택 침적먼지의 석면 검출과 석면폐증의 관련성)

  • Ahn, Hoki;Yang, Wonho;Hwangbo, Young;Lee, Yong Jin
    • Journal of Environmental Health Sciences
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    • v.41 no.6
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    • pp.369-379
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    • 2015
  • Objectives: The lack of reliable information on environmental pollution and health impacts related to asbestos contamination from abandoned mines has drawn attention to the need for a community health study. This study was performed to evaluate asbestos-related health symptoms among residents near abandoned asbestos mines located in the Chungcheong Provinces. In addition, exposure assessment for asbestos is needed although the exposure to asbestos was in the past. Methods: Past exposure to asbestos among inhabitants near abandoned asbestos mines was estimated by using surface sampling of deposited dust in indoor and outdoor residences. A total of 54 participants were divided into two groups with (34 cases) and without (20 controls) diseases related to asbestos. Surface sampling of deposited dust was carried out in indoor and outdoor residences by collecting 105 samples. Deposited dust for sampling was analyzed by polarization microscope (PLM) and scanning electron microscope?energy dispersive x-ray spectrometer (SEM-EDX) to detect asbestos. Subsequently, the elements of the deposited dust with asbestos were analyzed by SEM-EDX to assess the contribution of sources such as abandoned mines, slate and soil. Results: Among the 105 samples, asbestos was detected by PLM in 29 (27.6%) sampling points, and detected by SEM in 56 (48.6%) sampling points. Asbestos in indoor residences was detected by PLM in four sampling points, and by SEM in 12 sampling points. Asbestos detection in indoor residences may be due to ventilation between indoors and outdoors, and indicates long-term exposure. The asbestos detection rate for outdoor residences in the case group was higher than that in the control group. This can be explained as the case group having had higher exposure to asbestos, and there has been continuous exposure to asbestos in the control group as well as the case group. Conclusion: Past residential asbestos exposure may be associated with asbestosis among local residents near abandoned asbestos mines. Odds ratios were calculated for asbestos detection in outdoor residence by logistic regression analysis. Odds ratio between asbestos detection and asbestosis pulmonum was 3.36 (95% CI 0.90-12.53) (p=0.072), adjusting for age, sex, smoking status and work history with multi-variable logistic regression by PLM analysis method.