• 제목/요약/키워드: Predictive value of tests

검색결과 113건 처리시간 0.026초

The Impact of Educational Status on the Postoperative Perception of Pain

  • Lanitis, Sophocles;Mimigianni, Christina;Raptis, Demetris;Sourtse, Gionous;Sgourakis, George;Karaliotas, Constantine
    • The Korean Journal of Pain
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    • 제28권4호
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    • pp.265-274
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    • 2015
  • Background: Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods: This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the $1^{st}$ PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results: There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the $2^{nd}$ to the $6^{th}$). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions: The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old.

The Histopathological Examination for Diagnosis of MALT Lymphoma in the Stomach

  • Lee, Tae Hee;Hyun, Sung Hee;Kim, In Sik
    • 대한임상검사과학회지
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    • 제46권3호
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    • pp.91-98
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    • 2014
  • Primary gastric lymphoma (PGL) is derived from mucosa-associated lymphoid tissue (MALT) and it differs from nodal lymphoma in histologic features and biologic behavior. Recent studies have showed that Helicobacter pylori (H.pylori ) infection is closely related to the development of low grade gastric lymphoma, and eradication of the infection induces regression of the tumor. H. pylori infection is known to be important to the development of gastric MALT lymphoma. The aim of this study was to elucidate the histopathological behavior of PGL according to the concept of MALT and to compare the predictive value of tests frequently used for diagnosis of H. pylori. The histological features of gastric lymphoma arising from MALT are the replacement of glands by uniform dense infiltration of centrocyte-like cells in the lamina propria and lymphoidepithelial lesion. H. pylori-associated histologic changes of neutrophilic infiltration, lymphoid follicle or aggregates formation and intestinal metaplasia, and H. pylori immunoreactivity were analyzed. Detection of H. pylori in chronic active gastritis and peptic ulcer suggests a possible role of H. pylori in the pathogenesis. Giemsa, Toluidine blue and Long H&E stains were used in H. pylori detection. Histopathological examination of gastric biopsy specimens revealed lymphoepithelial lesions pathognomonic of MALT lymphoma, and immunohistochemical staining for CD20 was diffusely positive. CD3 was positive in reactive T cells. PAX-5 was negative except the follicle. Bcl-2, cytokeratin, Ki-67, and c-myc were positive. The findings may indicate a predictable transition of low grade to high grade, and c-myc may be used as a valuable marker before molecular pathology diagnosis.

아세트아미노펜 중독 환자에서 간독성 발생 예측인자들의 유용성 (Usefulness of Predictors for Hepatotoxicity in Acetaminophen Poisoning Patient)

  • 김은영;정성필;고동률;공태영;유제성;좌민홍;김민정
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.149-156
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    • 2018
  • Purpose: The purpose of this study was to determine whether hepatotoxicity could be predicted early using biochemical markers in patients with acetaminophen (AAP) poisoning and to assess the usefulness of predictive factors for acute liver injury or hepatotoxicity. Methods: This study was a retrospective observational study involving a medical records review. The participants were patients who were admitted to the emergency department (ED) with AAP overdose at two hospitals over a 10-year period. Demographic data, age, time from ingestion to visit, initial AAP level, initial hepatic aminotransferases, and initial prothrombin time were recorded. Acute liver injury was defined as a peak serum ALT >50 U/L or double the admission value, and hepatotoxicity was defined as a peak ALT >1,000 U/L. Receiver operating characteristic curve analyses were performed to compare the prognostic performance among variables. Results: A total of 97 patients were admitted to the ED with AAP overdose, of whom 26 had acute liver injury and 6 had hepatotoxicity. Acute liver injury was associated with the time interval after taking the drug, and hepatotoxicity was associated with the initial PT and the ALT level. The scoring system proposed by the authors has a significant ability to predict both acute liver injury and hepatotoxicity. Conclusion: To predict the prognosis of AAP poisoning patients, the time interval after taking AAP was important, and initial prothrombin time and ALT level were useful tests. Also a scoring system combining variables may be useful.

Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

  • Yu, Jung;Shin, Ha Young;Lee, Sun Hee;Kim, You Sung;Kim, Jae Hyun
    • Clinical and Experimental Pediatrics
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    • 제58권8호
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    • pp.294-300
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    • 2015
  • Purpose: It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods: This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results: A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, $2.45{\pm}0.50cm$ vs. $2.63{\pm}0.49cm$, P=0.015; uterine volume, $0.95{\pm}0.62cm^3$ vs. $1.35{\pm}0.76cm^3$, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least $1.07cm^3$ was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion: Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls.

Cognitive and other neuropsychological profiles in children with newly diagnosed benign rolandic epilepsy

  • Kwon, Soonhak;Seo, Hye-Eun;Hwang, Su Kyeong
    • Clinical and Experimental Pediatrics
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    • 제55권10호
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    • pp.383-387
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    • 2012
  • Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

Deep learning-based AI constitutive modeling for sandstone and mudstone under cyclic loading conditions

  • Luyuan Wu;Meng Li;Jianwei Zhang;Zifa Wang;Xiaohui Yang;Hanliang Bian
    • Geomechanics and Engineering
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    • 제37권1호
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    • pp.49-64
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    • 2024
  • Rocks undergoing repeated loading and unloading over an extended period, such as due to earthquakes, human excavation, and blasting, may result in the gradual accumulation of stress and deformation within the rock mass, eventually reaching an unstable state. In this study, a CNN-CCM is proposed to address the mechanical behavior. The structure and hyperparameters of CNN-CCM include Conv2D layers × 5; Max pooling2D layers × 4; Dense layers × 4; learning rate=0.001; Epoch=50; Batch size=64; Dropout=0.5. Training and validation data for deep learning include 71 rock samples and 122,152 data points. The AI Rock Constitutive Model learned by CNN-CCM can predict strain values(ε1) using Mass (M), Axial stress (σ1), Density (ρ), Cyclic number (N), Confining pressure (σ3), and Young's modulus (E). Five evaluation indicators R2, MAPE, RMSE, MSE, and MAE yield respective values of 0.929, 16.44%, 0.954, 0.913, and 0.542, illustrating good predictive performance and generalization ability of model. Finally, interpreting the AI Rock Constitutive Model using the SHAP explaining method reveals that feature importance follows the order N > M > σ1 > E > ρ > σ3.Positive SHAP values indicate positive effects on predicting strain ε1 for N, M, σ1, and σ3, while negative SHAP values have negative effects. For E, a positive value has a negative effect on predicting strain ε1, consistent with the influence patterns of conventional physical rock constitutive equations. The present study offers a novel approach to the investigation of the mechanical constitutive model of rocks under cyclic loading and unloading conditions.

A Real-Time Embedded Speech Recognition System

  • Nam, Sang-Yep;Lee, Chun-Woo;Lee, Sang-Won;Park, In-Jung
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2002년도 ITC-CSCC -1
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    • pp.690-693
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    • 2002
  • According to the growth of communication biz, embedded market rapidly developing in domestic and overseas. Embedded system can be used in various way such as wire and wireless communication equipment or information products. There are lots of developing performance applying speech recognition to embedded system, for instance, PDA, PCS, CDMA-2000 or IMT-2000. This study implement minimum memory of speech recognition engine and DB for apply real time embedded system. The implement measure of speech recognition equipment to fit on embedded system is like following. At first, DC element is removed from Input voice and then a compensation of high frequency was achieved by pre-emphasis with coefficients value, 0.97 and constitute division data as same size as 256 sample by lapped shift method. Through by Levinson - Durbin Algorithm, these data can get linear predictive coefficient and again, using Cepstrum - Transformer attain feature vectors. During HMM training, We used Baum-Welch reestimation Algorithm for each words training and can get the recognition result from executed likelihood method on each words. The used speech data is using 40 speech command data and 10 digits extracted form each 15 of male and female speaker spoken menu control command of Embedded system. Since, in many times, ARM CPU is adopted in embedded system, it's peformed porting the speech recognition engine on ARM core evaluation board. And do the recognition test with select set 1 and set 3 parameter that has good recognition rate on commander and no digit after the several tests using by 5 proposal recognition parameter sets. The recognition engine of recognition rate shows 95%, speech commander recognizer shows 96% and digits recognizer shows 94%.

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Respiratory Syncytial Virus 감염의 조기 진단 kit "바이오라인 알에스브이TM"의 평가 (Evaluation of a rapid diagnostic kit "BIOLINE RSVTM" for the detection of respiratory syncytial virus)

  • 김소희;성지연;양미애;은병욱;이진아;최은화;이환종
    • Pediatric Infection and Vaccine
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    • 제14권1호
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    • pp.91-96
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    • 2007
  • 목 적 : RSV 감염증 진단을 위한 여러 가지 신속 진단법이 이용되고 있다. 본 연구는 하기도 감염 소아의 비인두흡인물에서 RSV를 검출하는데 있어서 lateral-flow immunoassay 법을 이용하여 국내에서 개발된 RSV 조기 진단 kit인 바이오라인 알에스브이$^{TM}$(Standard Diagnostics, Inc., 용인, 대한민국)의 성적을 세포배양과 면역 형광법 결과와 비교 평가하기 위하여 수행되었다. 방 법 : 2002년 7월부터 2007년 2월까지 서울대학교 어린이병원의 응급실을 방문하거나 입원한 하기도 감염소아로부터 채취한 비인두 흡인물 319개를 대상으로 하여 RSV를 검출하는데 있어서 바이러스 배양과 면역 형광법을 기준으로 하여 바이오라인 알에스브이$^{TM}$ 검사의 성적을 평가하였다. 바이오라인 알에스브이$^{TM}$ 검사는 각 검체의 바이러스 배양과 면역 형광법 결과를 모르는 검사자에 의해서 두번 이상씩 시행되었다. 결 과 : 면역 형광법과 바이러스 배양이 모두 양성인 검체 110개 중 107개(97.3%), 면역 형광법만 양성인 검체 33개 중 29개(87.9%), 바이러스 배양법만 양성인 검체 26개 중 20개(76.9%)가 바이오라인 알에스브이$^{TM}$로 검사한 결과 양성으로 나타났으며, 두 가지 기준 검사에서 모두 음성인 검체 150개 중 140개(93.3%)가 바이오라인 알에스브이$^{TM}$ 검사 결과 음성이었다. 면역 형광법 또는 바이러스 배양법에 대한 바이오라인 알에스브이$^{TM}$ 검사의 민감도는 92.3%(156/169, 95% confidence interval[CI], 87.1-97.5%), 특이도는 93.3%(140/150, 95% CI, 88.4-98.2%), 양성 예측도는 94.0%(156/166, 89.5-98.5%), 음성 예측도는 91.5%(140/143, 95% CI, 86.0-97.0%), 일치도는 95.9%(306/319, 92.1-99.7%)이었다. 결 론 : 국내에서 개발된 RSV 감염 조기 진단 kit인 바이오라인 알에스브이$^{TM}$는 높은 민감도와 특이도를 보였다. 간단한 검사 방법과 신속한 결과라는 장점이 있어 향후 유행 시기에 유용한 진단법으로 사용될 수 있을 것으로 보인다.

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65세 이상 고령자에서 대사증후군 예측을 위한 지질비율 지표의 유용성 비교 (Comparison of the Usefulness of Lipid Ratio Indicators for Prediction of Metabolic Syndrome in the Elderly Aged 65 Years or Older)

  • 신경아;김은재
    • 한국융합학회논문지
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    • 제13권1호
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    • pp.399-408
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    • 2022
  • 본 연구에서는 65세 이상 고령자를 대상으로 대사증후군 진단을 위한 지질비율 지표의 유용성을 비교하고자 하였다. 2018년 1월부터 2020년 12월까지 서울지역 종합병원에서 건강검진을 받은 65세 이상 1,464명을 대상으로 하였다. 혈액검사를 통해 혈장 동맥경화 지수를 포함한 지질비율 지표를 측정하였다. 지질비율 지표의 사분위수에 따른 대사증후군 유병률은 로지스틱 회귀분석으로 확인하였다. 또한 수신자 조작 특성(receiver operating characteristic, ROC) 곡선으로 지질비율 지표의 대사증후군 예측능력과 절단값을 추정하였다. 동맥경화 지수와 허리둘레의 상관성이 남녀 모두에서 가장 높았으며(r=0.278, p<0.001 vs r=0.252, p<0.001), 지질비율 지표는 1사분위수와 비교하여 4사분위수에서 대사증후군 발병률이 높았다. 혈장 동맥경화 지수는 다른 지질비율 지표보다 ROC 곡선 아래의 면적(area under the ROC curve; AUC)값이 남녀 각각 0.826(95% CI=0.799-0.850), 0.852(95% CI=0.820-0.881)로 가장 높게 나타났으며, 최적 절단값은 남녀 모두 0.44였다(p<0.001). 따라서 지질비율 지표 중 혈장 동맥경화 지수는 65세 이상 고령자의 대사증후군 진단에 가장 유용한 지표로 나타났다.

Performances of Prognostic Models in Stratifying Patients with Advanced Gastric Cancer Receiving First-line Chemotherapy: a Validation Study in a Chinese Cohort

  • Xu, Hui;Zhang, Xiaopeng;Wu, Zhijun;Feng, Ying;Zhang, Cheng;Xie, Minmin;Yang, Yahui;Zhang, Yi;Feng, Chong;Ma, Tai
    • Journal of Gastric Cancer
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    • 제21권3호
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    • pp.268-278
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    • 2021
  • Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease. The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59-0.72), 0.60 (0.54-0.65), and 0.63 (0.56-0.69), respectively. Conclusions: Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.