• Title/Summary/Keyword: Multiple predictors

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A Study on Change Trajectories of Self-Rated Health in Middle Aged: Longitudinal Study Using Latent Class Growth Analysis (중·장년기 주관적 건강상태의 변화궤적 유형과 예측요인 탐색: 잠재계층성장분석(LCGA)을 이용한 종단연구)

  • Kim, Ho Jeong;Nam, Seok In
    • 한국노년학
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    • v.39 no.4
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    • pp.941-958
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    • 2019
  • The purpose of this study was to explore change trajectories patterns of Self-Rated Health in middle aged, to identify socioeconomic factors, self-esteem, family relationship factors, and to identify relevant predictors. For this purpose, the 2,418 middle aged, who married couples were extracted from the 2nd to 12st waves of Korea Welfare Panel Survey data. The data analysis included Latent Class Growth Analysis, multiple logistic regression. The change trajectories patterns of self-rated health in middle aged were classified into four types: (1) high state-retained type(46.3%), (2) low state-retained type(19.6%), (3) reduced type(17.5%), (4) increasing type(16.6%). Despite the control of chronic diseases that are closely related to health, when the low state-retained type, which is a crisis group, was set as the reference group for the self-rated health, the economic participation, self-esteem and satisfaction of the family relationship had a more inadequate effect than the high state-retained type. Likewise, when the reduced type, which is a crisis group, was set as the reference group for the self-rated health, the economic participation, self-esteem, satisfaction of the family relationship, and family stress had a more effect than the increasing type. Based on the analysis results, this study suggest political and practical intervention to maintain the proper health, and the details are as follows.

Differentiation between Clear Cell Sarcoma of the Kidney and Wilms' Tumor with CT

  • Choeum Kang;Hyun Joo Shin;Haesung Yoon;Jung Woo Han;Chuhl Joo Lyu;Mi-Jung Lee
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1185-1193
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    • 2021
  • Objective: Clear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms' tumor and to assess the features with diagnostic value for identifying CCSK. Materials and Methods: We reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3-10 years), 7 with CCSK, and 51 with Wilms' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher's exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed. Results: The age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770-104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337-25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively. Conclusion: Perinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms' tumor in children aged below 10 years.

Impact of Collateral Circulation on Futile Endovascular Thrombectomy in Acute Anterior Circulation Ischemic Stroke

  • Yoo Sung Jeon;Hyun Jeong Kim;Hong Gee Roh;Taek-Jun Lee;Jeong Jin Park;Sang Bong Lee;Hyung Jin Lee;Jin Tae Kwak;Ji Sung Lee;Hee Jong Ki
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.31-41
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    • 2024
  • Objective : Collateral circulation is associated with the differential treatment effect of endovascular thrombectomy (EVT) in acute ischemic stroke. We aimed to verify the ability of the collateral map to predict futile EVT in patients with acute anterior circulation ischemic stroke. Methods : This secondary analysis of a prospective observational study included data from participants underwent EVT for acute ischemic stroke due to occlusion of the internal carotid artery and/or the middle cerebral artery within 8 hours of symptom onset. Multiple logistic regression analyses were conducted to identify independent predictors of futile recanalization (modified Rankin scale score at 90 days of 4-6 despite of successful reperfusion). Results : In a total of 214 participants, older age (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.56 to 3.67; p<0.001), higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR, 1.12; 95% CI, 1.04 to 1.21; p=0.004), very poor collateral perfusion grade (OR, 35.09; 95% CI, 3.50 to 351.33; p=0.002), longer door-to-puncture time (OR, 1.08; 95% CI, 1.02 to 1.14; p=0.009), and failed reperfusion (OR, 3.73; 95% CI, 1.30 to 10.76; p=0.015) were associated with unfavorable functional outcomes. In 184 participants who achieved successful reperfusion, older age (OR, 2.30; 95% CI, 1.44 to 3.67; p<0.001), higher baseline NIHSS scores (OR, 1.12; 95% CI, 1.03 to 1.22; p=0.006), very poor collateral perfusion grade (OR, 4.96; 95% CI, 1.42 to 17.37; p=0.012), and longer door-to-reperfusion time (OR, 1.09; 95% CI, 1.03 to 1.15; p=0.003) were associated with unfavorable functional outcomes. Conclusion : The assessment of collateral perfusion status using the collateral map can predict futile EVT, which may help select ineligible patients for EVT, thereby potentially reducing the rate of futile EVT.

Impact of Pulmonary Vascular Compliance on the Duration of Pleural Effusion Duration after Extracardiac Fontan Procedure (수술 전 폐혈관 유순도가 심장 외 도판을 이용한 Fontan 수술 후 늑막 삼출 기간에 미치는 영향)

  • Yun Tae-Jin;Im Yu-Mi;Song Kwang-Jae;Jung Sung-Ho;Park Jeong-Jun;Seo Dong-Man;Lee Moo-Song
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.579-587
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    • 2006
  • Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.

Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

Factors Influencing Compliance with Anti-Tuberculosis Therapy (폐결핵 환자의 치료 순응과 관련된 요인)

  • Kim, Cheon-Tae;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.79-90
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    • 1996
  • The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-City, Dalseong-Gun in Teagu and Kumi-City. Data were collected between September and October 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication (p<0.05) wis a predictor of improvement and knowledge about anti-tuberculosis therapy(p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075) were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.

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An Analytical Study of the Quality of Life in Dental Hygienists in Seoul (서울지역 치과위생사의 삶의질(Quality of Life)에 관한 분석 연구)

  • Kim, Yeun-Sun
    • Journal of dental hygiene science
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    • v.5 no.1
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    • pp.39-43
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    • 2005
  • This study was carried out to provide fundamental data for an examination of a health promotion program by determining the influence of the Health Promoting Lifestyle Profile on the quality of life of female dental hygienists. The sample was selected from the population of 1,148 who were registered in the Association of Seoul Dental Hygienists. 800 subjects were randomly selected from 25 districts in Seoul. The data was collected by calling the dental hygienists to, explaining the contents and objective of our study, and sending them a questionnaire by post. The questionnaire consists of the total number of 97 questions: 62 questions on the Health Promoting Lifestyle Profile, 26 questions on the quality of life and 9 general characteristics questions. The data was collected from August 16 to October 15, 2004. Out of 800 subjects, 481(60.1%) completed the questionnaires. For statistical analysis, the frequency, percentage, arithmetic mean, ANOVA, and multiple regression analysis, were analyzed using the SAS 8.1 Analysis program. The significance level was set to 0.05. The results of this study were as follows: First, The average score of the subjects' quality of life was 3.1. For the sub-categories, it was shown that the degree of satisfaction on the condition of society was the highest at 3.2, and the degree of satisfaction on the condition of the individuals was the lowest at 3.1. The average score of the Health Promoting Lifestyle Profile variable was 2.5. For the sub-categories, it was shown that the degree of sanitary life was at 3.2, and degree of the professional health maintenance was the lowest at 1.7. Second, There were significant differences in the Quality of Life benefits of action with the general characteristics. There were significant differences in age, educational level, income, marital status, career, and Perceived Health Status. There were significant difference in Health Promoting Lifestyle Profile benefits of action with the general characteristics. There were significant differences in terms of age, educational level, income, marital status, career, and the Perceived Health Status. Finally, The stepwise multiple regression analysis revealed that the powerful predictors were Health Promoting Lifestyle Profile, income and the Perceived Health Status. These factors accounted for 37.6% of the variance in the Quality of Life patterns. As the subjects were limited to dental hygienists in Seoul, care should be taken when applying these results to all dental hygienists in Korea. In order to generalize the study, a large number of subjects selected from all regions in Korea will be needed.

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An Exploratory Study on Forecasting Sales Take-off Timing for Products in Multiple Markets (해외 복수 시장 진출 기업의 제품 매출 이륙 시점 예측 모형에 관한 연구)

  • Chung, Jaihak;Chung, Hokyung
    • Asia Marketing Journal
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    • v.10 no.2
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    • pp.1-29
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    • 2008
  • The objective of our study is to provide an exploratory model for forecasting sales take-off timing of a product in the context of multi-national markets. We evaluated the usefulness of key predictors such as multiple market information, product attributes, price, and sales for the forecasting of sales take-off timing by applying the suggested model to monthly sales data for PDP and LCD TV provided by a Korean electronics manufacturer. We have found some important results for global companies from the empirical analysis. Firstly, innovation coefficients obtained from sales data of a particular product in other markets can provide the most useful information on sales take-off timing of the product in a target market. However, imitation coefficients obtained from the sales data of a particular product in the target market and other markets are not useful for sales take-off timing of the product in the target market. Secondly, price and product attributes significantly influence on take-off timing. It is noteworthy that the ratio of the price of the target product to the average price of the market is more important than the price ofthe target product itself. Lastly, the cumulative sales of the product are still useful for the prediction of sales take-off timing. Our model outperformed the average model in terms of hit-rate.

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Factors Related to Serum Level of Carbohydrate Antigen 19-9 and Cancer Antigen 125 in Healthy Rural Populations in Korea (일부 농촌지역 주민에서 혈청 CA19-9 및 CA125 농도에 영향을 미치는 인자에 관한 연구)

  • Lee, SK;Yoo, KY;Park, SK;Kang, DH;Kim, JQ;Chung, JK;Lee, MC
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.71-80
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    • 1998
  • This study examines the levels of carbohydrate antigen 19-9(CA19-9) and cancer antigen 125(CA125) in serum and its related factors in healthy Korean population. Although CA19-9 and CA125 have been widely used tumor markers for gastroenteric cancers and ovarian cancer in Western countries, there are no information available on the serum levels of CA19-9 and CA125 in healthy population and the factors affecting the levels of these tumor markers in Korea. A cross-sectional study was performed to measure CA19-9 and CA125 among 76 healthy males and 95 healthy females in Korea. CA19-9 and CA125 were quantitated using solid-phase radioimmunoassay kits. Informations on the factors which might be related to the levels of these markers were collected by questionnaire(e.g., smoking, alcohol consumption, menstruation, oral pill use, breast-feeding history, etc.). There was no statistically significant difference in the mean of CA19-9 concentration between men(10.4 u/ml) and women(10.1 u/ml), whereas the mean of CA125 levels(11.2 u/ml) was higher in women than that(2.5 u/ml) in men. Although there was a statistically significant association between CA19-9 and average number of cigarette consumed per day(r=0.59, p=0.026) and total number of cigarettes consumed in women(r=0.74, p=0.003), the significance disappeared by multiple regression analysis after adjusting age and body mass index. Later age of menopause(p=0.035) and longer duration of breast-feeding(p=0.050) were significant predictors for CA125 levels in women by multiple regression analysis after adjusting age and body mass index. In conclusion, CA19-9 can be used as a stable tumor marker in clinical practices, however, menstruation and breast-feeding should be considered when CA125 is used in women.

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The Prognostic Role of B-type Natriuretic Peptide in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환의 급성 악화시 예후 인자로서의 혈중 B-type Natriuretic Peptide의 역할)

  • Lee, Ji Hyun;Oh, So Yeon;Hwang, Iljun;Kim, Okjun;Kim, Hyun Kuk;Kim, Eun Kyung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.600-610
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    • 2004
  • Background : The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). Method : We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared. Results : Multiple logistic regression analysis identified three independent predictors of mortality: $FEV_1$, APACHE II score and plasma BNP level. The decedents group showed a lower $FEV_1$($28{\pm}7$ vs. $37{\pm}15%$, p=0.005), a higher APACHE II score($22.4{\pm}6.1$ vs. $15.8{\pm}4.7$, p=0.000) and a higher BNP level ($201{\pm}116$ vs. $77{\pm}80pg/mL$, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL. Conclusion : The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the $FEV_1$ and APACHE II score.