• Title/Summary/Keyword: Predicting

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Roles of Perceived Use Control consisting of Perceived Ease of Use and Perceived Controllability in IT acceptance (정보기술 수용에서 사용용이성과 통제가능성을 하위 차원으로 하는 지각된 사용통제의 역할)

  • Lee, Woong-Kyu
    • Asia pacific journal of information systems
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    • v.18 no.2
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    • pp.1-14
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    • 2008
  • According to technology acceptance model(TAN) which is one of the most important research models for explaining IT users' behavior, on intention of using IT is determined by usefulness and ease of use of it. However, TAM wouldn't explain the performance of using IT while it has been considered as a very good model for prediction of the intention. Many people would not be confirmed in the performance of using IT until they can control it at their will, although they think it useful and easy to use. In other words, in addition to usefulness and ease of use as in TAM, controllability is also should be a factor to determine acceptance of IT. Especially, there is a very close relationship between controllability and ease of use, both of which explain the other sides of control over the performance of using IT, so called perceived behavioral control(PBC) in social psychology. The objective of this study is to identify the relationship between ease of use and controllability, and analyse the effects of both two beliefs over performance and intention in using IT. For this purpose, we review the issues related with PBC in information systems studies as well as social psychology, Based on a review of PBC, we suggest a research model which includes the relationship between control and performance in using IT, and prove its validity empirically. Since it was introduced as qa variable for explaining volitional control for actions in theory of planned behavior(TPB), there have been confusion about concept of PBC in spite of its important role in predicting so many kinds of actions. Some studies define PBC as self-efficacy that means actor's perception of difficulty or ease of actions, while others as controllability. However, this confusion dose not imply conceptual contradiction but a double-faced feature of PBC since the performance of actions is related with both self-efficacy and controllability. In other words, these two concepts are discriminated and correlated with each other. Therefore, PBC should be considered as a composite concept consisting of self-efficacy and controllability, Use of IT has been also one of important areas for predictions by PBC. Most of them have been studied by analysis of comparison in prediction power between TAM and TPB or modification of TAM by inclusion of PBC as another belief as like usefulness and ease of use. Interestingly, unlike the other applications in social psychology, it is hard to find such confusion in the concept of PBC in the studies for use of IT. In most of studies, controllability is adapted as PBC since the concept of self-efficacy is included in ease of use explicitly. Based on these discussions, we can suggest perceived use control(PUC) which is defined as perception of control over the performance of using IT and composed of controllability and ease of use as sub-concepts. We suggest a research model explaining acceptance of IT which includes the relationships of PUC with attitude and performance of using IT. For empirical test of our research model, two user groups are selected for surveying questionnaires. In the first group, there are freshmen who take a basic course for Microsoft Excel, and the second group consists of senior students who take a course for analysis of management information by Excel. Most of measurements are adapted ones that have been validated in the other studies, while performance is real score of mid-term in each class. In result, four hypotheses related with PUC are supported statistically with very low significance level. Main contribution of this study is suggestion of PUC through theoretical review of PBC. Specifically, a hierarchical model of PUC are derived from very rigorous studies in the relationship between self-efficacy and controllability with a view of PBC in social psychology. The relationship between PUC and performance is another main contribution.

Context Prediction Using Right and Wrong Patterns to Improve Sequential Matching Performance for More Accurate Dynamic Context-Aware Recommendation (보다 정확한 동적 상황인식 추천을 위해 정확 및 오류 패턴을 활용하여 순차적 매칭 성능이 개선된 상황 예측 방법)

  • Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.51-67
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    • 2009
  • Developing an agile recommender system for nomadic users has been regarded as a promising application in mobile and ubiquitous settings. To increase the quality of personalized recommendation in terms of accuracy and elapsed time, estimating future context of the user in a correct way is highly crucial. Traditionally, time series analysis and Makovian process have been adopted for such forecasting. However, these methods are not adequate in predicting context data, only because most of context data are represented as nominal scale. To resolve these limitations, the alignment-prediction algorithm has been suggested for context prediction, especially for future context from the low-level context. Recently, an ontological approach has been proposed for guided context prediction without context history. However, due to variety of context information, acquiring sufficient context prediction knowledge a priori is not easy in most of service domains. Hence, the purpose of this paper is to propose a novel context prediction methodology, which does not require a priori knowledge, and to increase accuracy and decrease elapsed time for service response. To do so, we have newly developed pattern-based context prediction approach. First of ail, a set of individual rules is derived from each context attribute using context history. Then a pattern consisted of results from reasoning individual rules, is developed for pattern learning. If at least one context property matches, say R, then regard the pattern as right. If the pattern is new, add right pattern, set the value of mismatched properties = 0, freq = 1 and w(R, 1). Otherwise, increase the frequency of the matched right pattern by 1 and then set w(R,freq). After finishing training, if the frequency is greater than a threshold value, then save the right pattern in knowledge base. On the other hand, if at least one context property matches, say W, then regard the pattern as wrong. If the pattern is new, modify the result into wrong answer, add right pattern, and set frequency to 1 and w(W, 1). Or, increase the matched wrong pattern's frequency by 1 and then set w(W, freq). After finishing training, if the frequency value is greater than a threshold level, then save the wrong pattern on the knowledge basis. Then, context prediction is performed with combinatorial rules as follows: first, identify current context. Second, find matched patterns from right patterns. If there is no pattern matched, then find a matching pattern from wrong patterns. If a matching pattern is not found, then choose one context property whose predictability is higher than that of any other properties. To show the feasibility of the methodology proposed in this paper, we collected actual context history from the travelers who had visited the largest amusement park in Korea. As a result, 400 context records were collected in 2009. Then we randomly selected 70% of the records as training data. The rest were selected as testing data. To examine the performance of the methodology, prediction accuracy and elapsed time were chosen as measures. We compared the performance with case-based reasoning and voting methods. Through a simulation test, we conclude that our methodology is clearly better than CBR and voting methods in terms of accuracy and elapsed time. This shows that the methodology is relatively valid and scalable. As a second round of the experiment, we compared a full model to a partial model. A full model indicates that right and wrong patterns are used for reasoning the future context. On the other hand, a partial model means that the reasoning is performed only with right patterns, which is generally adopted in the legacy alignment-prediction method. It turned out that a full model is better than a partial model in terms of the accuracy while partial model is better when considering elapsed time. As a last experiment, we took into our consideration potential privacy problems that might arise among the users. To mediate such concern, we excluded such context properties as date of tour and user profiles such as gender and age. The outcome shows that preserving privacy is endurable. Contributions of this paper are as follows: First, academically, we have improved sequential matching methods to predict accuracy and service time by considering individual rules of each context property and learning from wrong patterns. Second, the proposed method is found to be quite effective for privacy preserving applications, which are frequently required by B2C context-aware services; the privacy preserving system applying the proposed method successfully can also decrease elapsed time. Hence, the method is very practical in establishing privacy preserving context-aware services. Our future research issues taking into account some limitations in this paper can be summarized as follows. First, user acceptance or usability will be tested with actual users in order to prove the value of the prototype system. Second, we will apply the proposed method to more general application domains as this paper focused on tourism in amusement park.

Asthma predictive index in children with recurrent wheezing (반복성 천명을 가진 소아에서 천식 발생 예측 지표의 적용)

  • Jang, Joo Young;Kim, Hyo Bin;Lee, So Yeon;Kim, Ja Hyung;Kim, Bong Seong;Seo, Hee Jung;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.298-304
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    • 2006
  • Purpose : We compared the asthma predictive index(API) and the modified asthma predictive index (mAPI) of the Tuscon Children's Respiratory Study Group in Korean children with recurrent wheezing. We investigated the atopic profiles and presence of allergen sensitization of each risk group, and ascertained the significant clinical risk factors. Methods : Two hundred and sixty two children, who visited for recurrent wheezing from 1998 to 2005, were enrolled and divided into groups by API and mAPI. We investigated the history of the patients and their families, atopic profiles, and sensitization to aeroallergen and food allergens. Twenty nine children were followed up to 6 years of age and we evaluated the sensitivity, specificity and positive and negative predictive value of both indices. Results : The high risk group of API were of older age, were more likely to be sensitized to aeroallergen(P=0.001) and food allergen(P=0.034) and had higher levels of total eosinophil count, eosinophil percent, serum ECP, total IgE, and D.p-, D.f-specific IgE. High risk group of mAPI showed higher levels of atopic markers such as egg-, milk-, D.p- and D.f-specific IgE. Even though API did not include allergen sensitization, the high risk group was more significantly sensitized to common allergens than the low risk group. Twenty nine children were followed up until 6 years of age; therefore 15 children were diagnosed as asthma, clinically. The sensitivity, specificity, positive and negative predictive values of mAPI were higher than API. Conclusion : Both high risk groups of API and mAPI had higher levels of atopic markers and were more sensitized to common allergens. These findings suggest that sensitization to aeroallergens and food allergens are more objective markers as asthma predictive indices. In addition, mAPI is a more reliable index in predicting asthma in Korean children with recurrent wheezing than is API. But only 29 patients were followed until the age of 6, so we need to include more children with long term follow up for future study.

Magnetic Resonance Imaging Factors Predicting Re-excision in Breast Cancer Patients Having Undergone Conserving Therapy (유방보존술을 시행받는 유방암환자에서 재절제 예측의 자기공명영상소견)

  • Jang, Mijung;Kim, Sun Mi;Yun, Bo La;Kim, Sung-Won;Kang, Eun Young;Park, So Yeon;Kim, Jee Hyun;Kim, Yeongmi;Ahn, Hye Shin
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.133-143
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    • 2014
  • Purpose : The aim of this study was to determine the magnetic resonance imaging (MRI) features associated with re-excision due to the presence of a positive margin after breast conserving therapy (BCT) in breast cancer patients. Materials and Methods: We reviewed the records of 286 consecutive breast cancer patients who received BCT between January 2006 and December 2007. Among 246 patients who had undergone BCT, 38 (15.4%) underwent immediate further surgery due to positive margin status. We analyzed the MRI findings using ${\chi}^2$ test, Fisher's exact test and t tests. Multivariate logistic regression was conducted for prediction of re-excision. Results: Tumor size (p < 0.001), lesion multiplicity (p = 0.003), and non-mass-like enhancement (NMLE) type on MRI (p < 0.001) were associated with margin involvement in BCT. On preoperative MRI, larger size (${\geq}5cm$) (odds ratio = 2.96), NMLE (odds ratio = 3.81), and multifocal lesions (odds ratio = 2.54) were positively associated with re-excision. In cases involving NMLE, segmental distribution was associated with a greater likelihood of immediate re-excision. Conclusion: Larger size, multiplicity, and NMLE on MRI are significantly associated with re-excision after BCT in breast cancer patients. For NMLE lesions, the segmental distribution pattern was predictive of re-excision.

A Study of Estimation of Forest Ecosystem Carbon Storage in Gyeryongsan National Park, Korea (계룡산 국립공원 산림생태계의 탄소축적량 산정에 관한 연구)

  • Jang, Ji-Hye;Yi, Joon-Seok;Jeong, Ji-Sun;Song, Tae-Young;Lee, Kyengjae;Suh, Sang-Uk;Lee, Jaeseok
    • Korean Journal of Ecology and Environment
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    • v.47 no.4
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    • pp.319-327
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    • 2014
  • Understanding and quantifying of carbon storage in ecosystem is very important factor for predicting change of global carbon cycle under the global climate change. We estimated total ecosystem carbon in Gyeryongsan National Park with naturally well preserved ecosystem in Korea. Vegetation of Gyeryongsan National Park was classified with mainly four communities with Quercus mongolica (1,743.5 ha, 38.0%), Quercus variabilis (1,174.0 ha, 25.6%), Quercus serrata (971.9 ha, 21.2%), Pinus densiflora (695.2 ha, 15.2%). Biomass and soil carbons were calculated from biomass allometric equations based on the DBH and carbon contents of soil and litter collected in quadrat in each community. The tree biomass carbon was in Quercus variabilis ($130.1tCha^{-1}$), Pinus densiflora ($111.1tCha^{-1}$), Quercus mongolica ($76.2tCha^{-1}$), Quercus serrata ($39.0tCha^{-1}$). Soil carbon storage was in Quercus mongolica ($159.7tCha^{-1}$), Quercus serrata ($121.0tCha^{-1}$), Pinus densiflora ($110.5tCha^{-1}$), Quercus variabilis ($90.8tCha^{-1}$). Ecosystem carbon storage was Pinus densiflora ($239.9tCha^{-1}$), Quercus mongolica ($235.9tCha^{-1}$), Quercus variabilis ($226.0tCha^{-1}$), Quercus serrata ($165.9tCha^{-1}$), total amount was $867.7tCha^{-1}$. The area of each vegetation carbon storage was Quercus mongolica ($411,200tCha^{-1}$), Quercus variabilis ($265,300tCha^{-1}$), Pinus densiflora ($166,800tCha^{-1}$), Quercus serrata ($161,200tCha^{-1}$) and the total ecosystem carbon amount estimated $1,045,400tCha^{-1}$ at Gyeryongsan National Park. Theses results indicate that different in naturally well preserved ecosystem.

GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection

  • Zhou, Hang;Li, Xiong;Zhang, Yuan;Jia, Yao;Hu, Ting;Yang, Ru;Huang, Ke-Cheng;Chen, Zhi-Lan;Wang, Shao-Shuai;Tang, Fang-Xu;Zhou, Jin;Chen, Yi-Le;Wu, Li;Han, Xiao-Bing;Lin, Zhong-Qiu;Lu, Xiao-Mei;Xing, Hui;Qu, Peng-Peng;Cai, Hong-Bing;Song, Xiao-Jie;Tian, Xiao-Yu;Zhang, Qing-Hua;Shen, Jian;Liu, Dan;Wang, Ze-Hua;Xu, Hong-Bing;Wang, Chang-Yu;Xi, Ling;Deng, Dong-Rui;Wang, Hui;Lv, Wei-Guo;Shen, Keng;Wang, Shi-Xuan;Xie, Xing;Cheng, Xiao-Dong;Ma, Ding;Li, Shuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3773-3777
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    • 2015
  • Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

Habitat Distribution Change Prediction of Asiatic Black Bears (Ursus thibetanus) Using Maxent Modeling Approach (Maxent 모델을 이용한 반달가슴곰의 서식지 분포변화 예측)

  • Kim, Tae-Geun;Yang, DooHa;Cho, YoungHo;Song, Kyo-Hong;Oh, Jang-Geun
    • Korean Journal of Ecology and Environment
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    • v.49 no.3
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    • pp.197-207
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    • 2016
  • This study aims at providing basic data to objectively evaluate the areas suitable for reintroduction of the species of Asiatic black bear (Ursus thibetanus) in order to effectively preserve the Asiatic black bears in the Korean protection areas including national parks, and for the species restoration success. To this end, this study predicted the potential habitats in East Asia, Southeast Asia and India, where there are the records of Asiatic black bears' appearances using the Maxent model and environmental variables related with climate, topography, road and land use. In addition, this study evaluated the effects of the relevant climate and environmental variables. This study also analyzed inhabitation range area suitable for Asiatic black and geographic change according to future climate change. As for the judgment accuracy of the Maxent model widely utilized for habitat distribution research of wildlife for preservation, AUC value was calculated as 0.893 (sd=0.121). This was useful in predicting Asiatic black bears' potential habitat and evaluate the habitat change characteristics according to future climate change. Compare to the distribution map of Asiatic black bears evaluated by IUCN, Habitat suitability by the Maxent model were regionally diverse in extant areas and low in the extinct areas from IUCN map. This can be the result reflecting the regional difference in the environmental conditions where Asiatic black bears inhabit. As for the environment affecting the potential habitat distribution of Asiatic black bears, inhabitation rate was the highest, according to land coverage type, compared to climate, topography and artificial factors like distance from road. Especially, the area of deciduous broadleaf forest was predicted to be preferred, in comparison with other land coverage types. Annual mean precipitation and the precipitation during the driest period were projected to affect more than temperature's annual range, and the inhabitation possibility was higher, as distance was farther from road. The reason is that Asiatic black bears are conjectured to prefer more stable area without human's intervention, as well as prey resource. The inhabitation range was predicted to be expanded gradually to the southern part of India, China's southeast coast and adjacent inland area, and Vietnam, Laos and Malaysia in the eastern coastal areas of Southeast Asia. The following areas are forecast to be the core areas, where Asiatic black bears can inhabit in the Asian region: Jeonnam, Jeonbuk and Gangwon areas in South Korea, Kyushu, Chugoku, Shikoku, Chubu, Kanto and Tohoku's border area in Japan, and Jiangxi, Zhejiang and Fujian border area in China. This study is expected to be used as basic data for the preservation and efficient management of Asiatic black bear's habitat, artificially introduced individual bear's release area selection, and the management of collision zones with humans.

Effect of Sample Preparation on Predicting Chemical Composition and Fermentation Parameters in Italian ryegrass Silages by Near Infrared Spectroscopy (시료 전처리 방법이 근적외선분광법을 이용한 이탈리안 라이그라스 사일리지의 화학적 조성분 및 발효품질 평가에 미치는 영향)

  • Park, Hyung Soo;Lee, Sang Hoon;Choi, Ki Choon;Lim, Young Chul;Kim, Jong Gun;Seo, Sung;Jo, Kyu Chea
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.257-266
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    • 2012
  • Near infrared reflectance spectroscopy (NIRS) has become increasingly used as a rapid, accurate method of evaluating some chemical constituents in cereal and dired animal forages. Analysis of forage quality by NIRS usually involves dry grinding samples. Costs might be reduced if samples could be analyzed without drying or grinding. The objective of this study was to investigate effect of sample preparations on prediction ability of chemical composition and fermentation parameter for Italian ryegrass silages by NIRS. A population of 147 Italian ryegrass silages representing a wide range in chemical parameters were used in this investigation. Samples were scanned at 1nm intervals over the wavelength range 680-2500 nm and the optical data recorded as log 1/Reflectance (log 1/R) and scanned in oven-dried grinding and fresh ungrinding condition. The spectral data were regressed against a range of chemical parameters using partial least squares (PLS) multivariate analysis in conjunction with four spectral math treatments to reduced the effect of extraneous noise. The optimum calibrations were selected on the basis of minimizing the standard error of cross validation (SECV) and maximizing the correlation coefficient of cross validation (${R^2}_{CV}$). The results of this study show that NIRS predicted the chemical parameters with high degree of accuracy in oven-dried grinding treatment except for moisture contents. Prediction accuracy of the moisture contents was better for fresh ungrinding treatment (SECV 1.37%, $R^2$ 0.96) than for oven-dried grinding treatments (SECV 4.31%, $R^2$ 0.68). Although the statistical indexes for accuracy of the prediction were the lower in fresh ungrinding treatment, fresh treatment may be acceptable when processing is costly or when some changes in component due to the processing are expected. Results of this experiment showed the possibility of NIRS method to predict the chemical composition and fermentation parameter of Italian ryegrass silages as routine analysis method in feeding value evaluation and for farmer advice.

Non-radiologic Methods for Predicting Vesicoureteral Reflux in Childhood Urinary Tract Infection (요로감염 환아에서 비방사선학적 방법에 의한 방광요관역류의 조기 예측에 관한 연구)

  • Jeon Seong-Hoi;Lee K.C.;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.38-45
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    • 1997
  • Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

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