• 제목/요약/키워드: Patients Clustering

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Transcriptomic profiles and their correlations in saliva and gingival tissue biopsy samples from periodontitis and healthy patients

  • Jeon, Yoon-Sun;Cha, Jae-Kook;Choi, Seong-Ho;Lee, Ji-Hyun;Lee, Jung-Seok
    • Journal of Periodontal and Implant Science
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    • 제50권5호
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    • pp.313-326
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    • 2020
  • Purpose: This study was conducted to analyze specific RNA expression profiles in gingival tissue and saliva samples in periodontitis patients and healthy individuals, and to determine their correlations in light of the potential use of microarray-based analyses of saliva samples as a periodontal monitoring tool. Methods: Gingival tissue biopsies and saliva samples from 22 patients (12 with severe periodontitis and 10 with a healthy periodontium) were analyzed using transcriptomic microarray analysis. Differential gene expression was assessed, and pathway and clustering analyses were conducted for the samples. The correlations between the results for the gingival tissue and saliva samples were analyzed at both the gene and pathway levels. Results: There were 621 differentially expressed genes (DEGs; 320 upregulated and 301 downregulated) in the gingival tissue samples of the periodontitis group, and 154 DEGs (44 upregulated and 110 downregulated) in the saliva samples. Nine of these genes overlapped between the sample types. The periodontitis patients formed a distinct cluster group based on gene expression profiles for both the tissue and saliva samples. Database for Annotation, Visualization and Integrated Discovery analysis revealed 159 enriched pathways from the tissue samples of the periodontitis patients, as well as 110 enriched pathways In the saliva samples. Thirty-four pathways overlapped between the sample types. Conclusions: The present results indicate the possibility of using the salivary transcriptome to distinguish periodontitis patients from healthy individuals. Further work is required to enhance the extraction of available RNA from saliva samples.

입원환자 시장세분화에 관한 연구 (Study on the Market Segmentation of inpatients)

  • 이은환
    • 한국병원경영학회지
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    • 제17권2호
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    • pp.21-33
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    • 2012
  • Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

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설문지를 이용한 암환자의 동반 자각 증상에 관한 연구 - 홍삼투여 인체적용시험에 참여한 48명 환자를 중심으로 - (Research on Subjective Symptoms of Cancer Patients Using Questionnaire - Based on the 48 Patients Who Have Participated in Clinical Trial about Korean Red Ginseng -)

  • 김은정;정찬영;김갑성;이승덕
    • 대한한의학회지
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    • 제33권3호
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    • pp.1-9
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    • 2012
  • Objectives: This research was aimed 1) to find out various subjective symptoms cancer patients had, 2) to find out the quantitative difference of symptoms occurring according to the area of cancer, current treatment methods, and relapse of the cancer and 3) to analyze the relationship between the occurrence of symptoms. Methods: This study was a survey about the various subjective symptoms cancer patients had. The subjects were 48 cancer patients in a double-blinded randomized controlled trial about the effectiveness of Korean Red Ginseng (KRG) treatments. Surveys were examined before Korean Red Ginseng (KRG) treatments. The questionnaire consisted of demographic research, patient history and accompanying symptoms. The symptoms part consisted of 4 questions on general symptoms (vertigo, hot flush, rash, insomnia), 2 questions on digestion symptoms (anorexia, dyspepsia), 2 questions on excretions (diarrhea, constipation), and 5 questions on symptoms in different body parts (headache, dryness of lips, chest pain, aphthous ulcer, nose bleeding). The questionnaire was used to research presence of symptoms and relationships between the occurrence of symptoms. Results: A total of 48 patients took part in this survey. Dizziness was the most frequent subjective symptom patients had (64.58%), followed by dry mouth (43.75%), headache (43.75%), insomnia (41.67%), anorexia (37.5%) and chest discomfort (37.5%). The presence of these subjective symptoms was partially related to the patient's history details - type of cancer, method of cancer treatment (chemotherapy, radiotherapy), termination of treatment, presence of pain, fatigue and recurrence, etc. Factor analysis was conducted to analyze the relationship between the occurrence of symptoms. It suggested 5 factors as a result, but there was a limitation that only a low level of correlation was shown among them. Conclusions: We were able to analyze the occurrences and the relationships among them for accompanying subjective symptoms in cancer patients. However the results of the study are limited in that only 48 patients participated. The symptoms in cancer patients showed a tendency for clustering, occurring simultaneously or continuously rather than occurring alone. The study of these symptom clusters is worth further study, for it is similar to the Symptom Differentiation System in Traditional Korean Medicine. For effective approach to the treatment of cancer in Traditional Korean Medicine, further research on the Korean traditional view of cancer patients should be done based on this research, regarding various symptoms and those relationships on a larger scale.

17세 이하에 발견된 위암 2예 (Two Cases of Teenage Gastric Cancer Patients)

  • 김훈엽;박도중;박효진;이혁준;양한광;김우호;이건욱;최국진
    • Journal of Gastric Cancer
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    • 제4권3호
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    • pp.180-185
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    • 2004
  • Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5$\times$4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3$\times$2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.

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Multiscale Clustering and Profile Visualization of Malocclusion in Korean Orthodontic Patients : Cluster Analysis of Malocclusion

  • Jeong, Seo-Rin;Kim, Sehyun;Kim, Soo Yong;Lim, Sung-Hoon
    • International Journal of Oral Biology
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    • 제43권2호
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    • pp.101-111
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    • 2018
  • Understanding the classification of malocclusion is a crucial issue in Orthodontics. It can also help us to diagnose, treat, and understand malocclusion to establish a standard for definite class of patients. Principal component analysis (PCA) and k-means algorithms have been emerging as data analytic methods for cephalometric measurements, due to their intuitive concepts and application potentials. This study analyzed the macro- and meso-scale classification structure and feature basis vectors of 1020 (415 male, 605 female; mean age, 25 years) orthodontic patients using statistical preprocessing, PCA, random matrix theory (RMT) and k-means algorithms. RMT results show that 7 principal components (PCs) are significant standard in the extraction of features. Using k-means algorithms, 3 and 6 clusters were identified and the axes of PC1~3 were determined to be significant for patient classification. Macro-scale classification denotes skeletal Class I, II, III and PC1 means anteroposterior discrepancy of the maxilla and mandible and mandibular position. PC2 and PC3 means vertical pattern and maxillary position respectively; they played significant roles in the meso-scale classification. In conclusion, the typical patient profile (TPP) of each class showed that the data-based classification corresponds with the clinical classification of orthodontic patients. This data-based study can provide insight into the development of new diagnostic classifications.

Pattern analysis of lower limb magnetic resonance images in Korean patients with distal myopathy

  • Park, Hyung Jun;Shin, Ha Young;Kim, Seung Min;Park, Kee Duk;Choi, Young-Chul
    • Annals of Clinical Neurophysiology
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    • 제21권2호
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    • pp.79-86
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    • 2019
  • Background: Magnetic resonance (MR) images are useful for diagnosing myopathy. The purpose of this study was to determine the usefulness of lower-limb MR images in Korean patients with distal myopathy. Methods: We reviewed medical records in the myopathy database from January 2002 to October 2016. We selected 21 patients from 91 unrelated families with distal myopathy: four with GNE myopathy, 11 with dysferlinopathy, and six with ADSSL1 myopathy. Results: Ten (48%) of the 21 patients were men. The ages of the participants at symptom onset and imaging were $19.2{\pm}9.5$ and $30.4{\pm}9.0$ years (mean${\pm}$standard deviation), respectively. Their grade on the modified Gardner-Medwin and Walton grade was $3.3{\pm}1.7$. The strength grade of the knee extensors was not correlated with the Mercuri scale for the quadriceps (r = -0.247, p = 0.115). However, the Medical Research Council grades of the knee flexors, ankle dorsiflexors, and ankle plantar flexors were significantly correlated with the Mercuri scale ratings of the knee flexors (r = -0.497, p = 0.001), tibialis anterior (r = -0.727, p < 0.001), and ankle plantar flexors (r = -0.620, p < 0.001), respectively. T1-weighted MR images showed characteristic fatty replacement patterns that were consistent with the causative genes. Unsupervised hierarchical clustering of the Mercuri scale showed that the main factors contributing to the dichotomy were the causative gene and the clinical severity. Conclusions: This study is the first to reveal the usefulness of lower-limb MR images in the differential diagnosis of distal myopathy in Korea.

Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

  • Sanchez-Fernandez, Elena;Magan-Fernandez, Antonio;O'Valle, Francisco;Bravo, Manuel;Mesa, Francisco
    • Journal of Periodontal and Implant Science
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    • 제51권1호
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    • pp.63-74
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    • 2021
  • Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.

Trend Analysis of Thyroid Cancer Research in Korea with Text Mining Techniques

  • Lee, Tae-Gyeong;Heo, Seong-Min;Shin, Seung-Hyeok;Yang, Ji-Yeon
    • 한국컴퓨터정보학회논문지
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    • 제23권12호
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    • pp.153-161
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    • 2018
  • In this paper, we propose a text-centered approach to identify the research trend of thyroid cancer in Korea. We incorporate statistical analysis, text mining and machine learning techniques with our clinical insights to find connective associations between terminologies and to discover informative clusters of literatures. The incidence of thyroid cancer in Korea increased rapidly in the 2000s, which fueled the debate regarding overdiagnosis, but recently the number of patients undergoing surgery has decreased significantly due to conscious reform efforts from various circles. We analyzed the abstracts and keywords of related research papers from DBpia. It was found that most were case reports in the 1980s, and some papers in the 1990s discussed the early detection of thyroid cancer by mass screening. While many papers focused on different diagnostic techniques and the detection of small cancers in the 2000s, many emphasized more on the quality of life of patients in the 2010s. There was an apparent change in the topics of thyroid cancer research over past decades. The results of this study would serve as a reference guide for current and future research directions.

Unexpected Presence of Blastocystis Subtype 1-3 DNA in Human Vaginal and Sperm Samples Coinfected with Trichomonas vaginalis

  • Villalobos, Guiehdani;Sanchez-Aguillon, Fabiola;Carmona-Maldonado, Marcia Veronica;Gonzalez-Arenas, Nelly Raquel;Lopez-Escamilla, Eduardo;Hernandez-Castro, Rigoberto;Romero-Valdovinos, Mirza;Martinez-Flores, Williams Arony;Ramirez-Hinojosa, Juan Pablo;Maravilla, Pablo;Martinez-Hernandez, Fernando
    • Parasites, Hosts and Diseases
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    • 제60권3호
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    • pp.195-200
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    • 2022
  • There have been few reports on extra-enteric infections by Blastocystis STs and none have been molecularly identified in samples from human reproductive organs. We report for the first time the identification of 3 different subtypes of Blastocystis (ST1-3) in vaginal and sperm samples, from patients infected with Trichomonas vaginalis. Blastocystis STs were identified by PCR-sequencing and by phylogenetic inferences using 28 vaginal swab samples and 7 sperm samples from patients trichomoniasis. Blastocystis STs were identified in 6 of 28 vaginal swabs (21.4%) and in 3 of 7 sperm samples (42.8%). In both biological samples, STs 1-3 were found; one vaginal sample showed subtype co-infection with ST1 and ST3. High genetic variation was observed in the sequences obtained and no specific clustering in the phylogenetic trees was detected. Most of the haplotypes identified were placed far from the main dispersal centers. Our finding suggested that incorrect cleaning of the genital area or a contamination by combination of anal and vaginal intercourse.

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • 제23권5호
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.