• Title/Summary/Keyword: multivariate data analysis

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Investigation of False Positive Rates Newborn Screening using Tandem Mass Spectrometry (TMS) Technology in Single Center (단일기관에서 이중 질량 분석법(tandem mass spectrometry technology)을 이용한 선천성 대사이상 검사의 위양성율에 대한 연구)

  • Kim, Hyunsoo;Shin, Son Moon;Ko, Sun Young;Lee, Yeon Kyung;Park, Sung Won
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.18-23
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    • 2016
  • Objective: Newborn screening leads to improved treatment and disease outcomes, but false-positive newborn screening results may impact include parental stress and anxiety, perception of child as unhealthy, parent-child relationship dysfunction, and increased infant hospitalizations. The purpose of this study was to investigate of the false positive rates and the causative factors of false positive results in Tandem Mass Spectrometry (TMS) in single center. Methods: Records were reviewed for all 18,872 subjects who were born in Cheill General Hospital, during January 1st, 2012 to December 31st, 2014. 17,292 neonates (91.62%) were tested for tandem mass screening almost in 2-5th day of life. Newborn babies whose first results were abnormal had been tested repeatedly by same methods in 7-14 day. If the results were abnormal again, further evaluation was performed. TMS analysis included data for the 43 disorders screened for using TMS broken down into three categories: fatty acid oxidation disorders, organic acidurias, and aminoacidopathies. The impact of several factors on increased false positive rates was analyzed using a multivariate analysis: time from birth to sample collection, birth weight, birth height, BMI, gender, gestational age, delivery type. Results: Males of the subjects were 8942 (51.7%), female 8350 (48.3%), the mean gestational age was $38.6{\pm}1.7$ weeks, the average birth weight $3,155.6{\pm}502.4g$, the average birth height $49.1{\pm}2.9cm$, and the average BMI $13.0{\pm}3.8(kg/m^2)$. Vaginal delivery cases were 9713 (56.2%), caesarean section 7,579 (43.8%). The average date of the inspection was $2.8{\pm}1.1$ days. 224 cases were identified as TMS positive. All the subjects were false positive (222/17,292, 1.30%) except 2 cases (1 male; benign phenylketonuria and 1 female; Short chain acyl-CoA dehydrogenase deficiency). The false positive rates were 0.61% in fatty acid oxidation disorders, 0.25% in organic acidurias, and 0.45% in aminoacidopathies. In our study, the date of inspection got late, the false positive rates got higher. Because almost the cases of late test date were in treatment in neonatal intensive care unit so their test date was affected by their medical conditions. False positive rate was higher in extreme immaturity${\leq}27$ weeks than newborns of gestational age >27 weeks [OR=6.957 (CI=1.273-38.008), p<0.025] and extremely low birth weight<1,000 g than newborns of birthweight ${\geq}1,000g$ [OR=5.616 (CI=1.134-27.820), p<0.035]. Conclusion: False positive rate of TMS was 1.30% in Cheil General Hospital. Lower gestational age and birth weight impacted on increased false positive rates. Better understanding of factors that influence the reporting of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting. of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting.

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The Prognostic role of Electrocardiographic Signs of Cor Pulmonale in Chronic Obstructive Pulmonary Disease (폐성심을 시사하는 심전도 소견 유.무에 따른 만성폐쇄성 폐질환 환자의 예후)

  • Shin, Moo-Chul;Park, Jae-Yong;Bae, Moon-Seob;Bae, Nack-Cheon;Chae, Po-Hee;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.944-955
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    • 2000
  • Background : In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low $FEV_1$ low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate if the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. Method : We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right strial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups ; group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor, pulmonale. Results : Poor, prognostic factors by univariate analysis were low $FEV_1$, $FEV_1$ % pred., VC % pred., DLco, DLco % pred., $PaO_2$ and $SaO_2$ high $PaCO_2$ presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long term use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05-1.23), DLco % pred. (risk ratio=0,97. 95% confidence interval 0.94-0.99), $PaO_2$ (risk ratio=0.95, 95% confidence interval 0.90-0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40-19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. Conclusion : These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.

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Prevalence and Predictors of Nocturia in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성수면무호흡증 환자의 야간뇨 유병률 및 관련인자)

  • Kang, Hyeon Hui;Lee, Jongmin;Lee, Sang Haak;Moon, Hwa Sik
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.14-20
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    • 2014
  • Objectives: Several studies suggest that nocturia may be related to obstructive sleep apnea syndrome (OSAS). The mechanism by which OSAS develops nocturia has not been determined. The present study aimed to determine the prevalence of nocturia among adults with OSAS and to identify factors that may be predictive in this regard. Methods: Retrospective review of clinical and polysomnographic data obtained from patients evaluated at the sleep clinics of the St. Paul's Hospital between 2009 and 2012. The urinary symptoms were assessed on the basis of the International Prostate Symptom Score (IPSS). Pathologic nocturia was defined as two or more urination events per night. OSAS was defined as apnea-hypopnea index (AHI) ${\geq}5$. A multivariate analysis using logistic regression was performed to examine the relationship between polysomnographic variables and the presence of pathologic nocturia, while controlling for confounding factor. Results: A total of 161 men >18 years of age (mean age $46.7{\pm}14.1$), who had been referred to a sleep laboratory, were included in the present study. Among these, 27 patients with primary snoring and 134 patients with obstructive sleep apnea were confirmed by polysomnography. Nocturia was found in 53 patients with OSAS (39.6%) and 8 patients with primary snoring (29.6%). The AHI was higher in patients with nocturia than in those without nocturia (p=0.001). OSAS patients with nocturia had higher arousal index (p=0.044), and lower nadir oxyhemoglobin saturation (p=0.001). Multiple regression analysis showed that age (${\beta}$=0.227, p=0.003), and AHI (${\beta}$=0.258, p=0.001) were associated with nocturia, and that the presence of pathologic nocturia was predicted by age (OR 1.04 ; p=0.004) and AHI (OR 1.02 ; p=0.001). Conclusion: Nocturia is common among patients with OSAS. The strongest predictors of nocturia are age and AHI in patients with OSAS.

Obstetric Complications by the Accessibility to Local Obstetric Service (지역별 분만서비스 접근도에 따른 산과적 합병증 비교)

  • Choi, Young Hyun;Na, Baeg Ju;Lee, Jin Yong;Hwang, Ji Hye;Lim, Nam Gu;Lee, Seong Ki
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.14-24
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    • 2013
  • Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).

Concurrent Chemoradiotherapy in Locally Advanced Esophageal Cancer (국소적으로 진행된 식도암에서 동시항암화학방사선치료의 결과)

  • Byun, Sang-Jun;Kim, Jin-Hee;Kim, Ok-Bae;Song, Hong-Suk
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.20-27
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    • 2011
  • Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

Associations of serum 25(OH)D levels with depression and depressed condition in Korean adults: results from KNHANES 2008-2010 (한국 성인의 혈청 25(OH)D 수준과 우울증 및 우울증상 경험과의 연관성: 국민건강영양조사 2008-2010 분석 결과)

  • Koo, Sle;Park, Kyong
    • Journal of Nutrition and Health
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    • v.47 no.2
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    • pp.113-123
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    • 2014
  • Purpose: Vitamin D has been known to play an important role in the central nervous system and brain functions in the human body, and cumulative evidence has shown that vitamin D deficiency might be linked with various mental health conditions. Epidemiologic studies have shown that vitamin D deficiency may be associated with higher risk of depression in the US and European populations. However, limited information is available regarding the association between vitamin D status and depression in the Korean population. The objective of this study was to examine the associations between vitamin D levels and prevalence of depression. Methods: We conducted a cross-sectional analysis using nationally representative data from the 2008-2010 Korean National Health and Nutrition Examination Survey from which serum 25-hydroxyvitamin D concentrations were available. A total of 18,735 adults who had available demographic, dietary, and lifestyle information were included in our analysis. We defined "depression" with a diagnosis by a physician. "Depressed condition" was defined as having feelings of sadness or depression without diagnosis by a physician. Results: The prevalence of depression was 1.63% and 5.43% in Korean men and women, respectively; 12.5% of men and 26.1% of women were defined as the group having depressed conditions. In multivariate logistic regression models, no significant associations were observed between vitamin D status and prevalence of depression or depressed conditions in Korean men and women. Conclusion: We found no association between vitamin D insufficiency and depression/depressed conditions in Korean adults. Future large prospective studies and randomized controlled trials are needed to confirm this relationship.

Risk Factor for Poor Clinical Outcome in Patients with Retear after Repair of the Rotator Cuff (회전근 개 파열 봉합술 후 재파열 환자에서 불량한 임상 결과의 원인 인자)

  • Lee, Hee Jae;Joo, Il Han;Hur, Jeong Min;Oh, Hyun Keun;Lee, Bong Gun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.61-67
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    • 2021
  • Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.

Exploring the contextual factors of episodic memory: dissociating distinct social, behavioral, and intentional episodic encoding from spatio-temporal contexts based on medial temporal lobe-cortical networks (일화기억을 구성하는 맥락 요소에 대한 탐구: 시공간적 맥락과 구분되는 사회적, 행동적, 의도적 맥락의 내측두엽-대뇌피질 네트워크 특징을 중심으로)

  • Park, Jonghyun;Nah, Yoonjin;Yu, Sumin;Lee, Seung-Koo;Han, Sanghoon
    • Korean Journal of Cognitive Science
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    • v.33 no.2
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    • pp.109-133
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    • 2022
  • Episodic memory consists of a core event and the associated contexts. Although the role of the hippocampus and its neighboring regions in contextual representations during encoding has become increasingly evident, it remains unclear how these regions handle various context-specific information other than spatio-temporal contexts. Using high-resolution functional MRI, we explored the patterns of the medial temporal lobe (MTL) and cortical regions' involvement during the encoding of various types of contextual information (i.e., journalism principle 5W1H): "Who did it?," "Why did it happen?," "What happened?," "When did it happen?," "Where did it happen?," and "How did it happen?" Participants answered six different contextual questions while looking at simple experimental events consisting of two faces with one object on the screen. The MTL was divided to sub-regions by hierarchical clustering from resting-state data. General linear model analyses revealed a stronger activation of MTL sub-regions, the prefrontal lobe (PFC), and the inferior parietal lobule (IPL) during social (Who), behavioral (How), and intentional (Why) contextual processing when compared with spatio-temporal (Where/When) contextual processing. To further investigate the functional networks involved in contextual encoding dissociation, a multivariate pattern analysis was conducted with features selected as the task-based connectivity links between the hippocampal subfields and PFC/IPL. Each social, behavioral, and intentional contextual processing was individually and successfully classified from spatio-temporal contextual processing, respectively. Thus, specific contexts in episodic memory, namely social, behavior, and intention, involve distinct functional connectivity patterns that are distinct from those for spatio-temporal contextual memory.

Incidence and Risk Factor of Pneumothorax After Percutaneous Fine Needle Aspiration Biopsy of the Lung (경피폐세침흡인생검시 기흉의 발생빈도와 위험인자)

  • Choi, Cheon Woong;Yoo, Jee Hong;Chin, Hyoun Jung;Park, Myoung Jae;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.628-637
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    • 2004
  • Background : Percutaneous needle aspiration biopsy(PNAB) of the lung is a safe procedure for diagnosis of various pulmonary diseases but complications such as pneumothorax can occasionally develop. We reviewed the complications arising after PNAB and analysed the risk factors of pneumothorax. Method : We collected data by reviewing medical records and radiographic studies of 403 patients who underwent PNAB of the lung between 1988 and 2002 and analyzed the risk factors of pneumothorax. Result : The incidence of complication was 12.9%, 48 patients with pneumothorax and 4 patients with mild hemoptysis. Among the 48 pneumothorax patients, 35 patients showed mild(<20%) and was treated by only oxygen supply, 11 patients had severe pneumothorax(>50%) and chest tube insertion was done and 2 patients were treated by needle aspiration. As the results of multivariate analysis, size and location of lesion, location of approach, diagnosis of lesion showed no significant relationship, while age and gender of patients(p<0.05) and the depth of approach(p<0.001) were significantly related to pneumothorax. Smoking amount(p<0.001) as well as the smoking history(p<0.005) were also significantly related and the examiner displaying various incidence of pneumothorax from 4.0% to 23.1% among individuals also was a significant independent risk factor(p<0.05). While the average depth of approach for 13 patients treated by chest tube insertion or needle aspiration was $8.2{\pm}1.2cm$, 35 patiens treated only by oxygen supply was $6.7{\pm}1.6cm$ suggesting that the depth of approach was lead to a severe pneumothorax. Conclusion : The independent risk factors of pneumothorax, the most common complication after PNAB, are age and gender of patients, depth of approach, examiner of procedure, smoking history and smoking amount.

Difference Test of CRM Strategic Factors by university type for building customer strategy of university (대학의 고객경영전략 수립을 위한 대학유형별 CRM 전략 요소의 차별성 분석)

  • Park, Keun;Kim, Hyung-Su;Park, Chan-Wook
    • CRM연구
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    • v.3 no.2
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    • pp.43-68
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    • 2010
  • One of the recent research trends that universities are increasingly adopting the concept of 'customer' and the customer-oriented strategy has urged us to research enterprise-wide CRM strategy adaptable to university administration. As the first step of CRM strategy for university management, we try to validate the difference of CRM strategic factors among university types. Drawing upon both CRM process and customer equity drivers, which have been recognized as core frameworks for CRM strategy, we developed those survey instruments adoptable into university industry, and validated statistically-significant difference among 12 types of university group constructed by the levels of university evaluation and the location of the universities. We collected 261 responses from 177 universities from all over the country and analyzed the data to see the levels of CRM processes consisting of customer acquisition, retention, and expansion, and customer equity drivers consisting of value equity, brand equity, and relationship equity by using multivariate ANOVA(MANOVA). The result confirms the explicit differences of the levels of CRM processes and customer equity drivers between the groups by university evaluation levels(high/middle/low). However, the analysis failed to show the significant differences of those between the group by university locations(the capital/the suburbs/the six megalopolises/other countries). More specifically, the level of activities for customer acquisition and retention of the universities in the higher-graded group are significantly different from those in the lower-graded group from the perspective of CRM process. In terms of customer equity drivers, the levels of both brand equity and relationship equity of the higher-graded group are significantly higher than those of both middle and lower-graded group. In addition, we found that the value equity between the higher and lower-graded groups, and the brand equity between the middle and lower-graded groups are different each other. This study provides an important meaning in that we tried to consider CRM strategy which has been mainly addressed in profit-making industries in terms of non-profit organization context. Our endeavors to develop and validate empirical measurements adoptable to university context could be an academic contribution. In terms of practical meaning, the processes and results of this study might be a guideline to many universities to build their own CRM strategies. According to the research results, those insights could be expressed in several messages. First, we propose to universities that they should plan their own differentiated CRM strategies according to their positions in terms of university evaluation. For example, although it is acceptable that a university in lower-level group might follow the CRM process strategy of the middle-level group universities, it is not a good idea to imitate the customer acquisition and retention activities of the higher-level group universities. Moreover, since this study reported that the level of universities' brand equity is just correlated with the level of university evaluation, it might be pointless for the middle or lower-leveled universities if they just copy their brand equity strategies from those of higher-leveled ones even though such activities are seemingly attractive. Meanwhile, the difference of CRM strategy by university position might provide universities with the direction where they should go for their CRM strategies. For instance, our study implies that the lower-positioned universities should improve all of the customer equity drivers with concerted efforts because their value, brand, and relationship equities are inferior compared with the higher and middle-positioned universities' ones. This also means that they should focus on customer acquisition and expansion initiatives rather than those for customer retention because all of the customer equity drivers could be influenced by the two kinds of CRM processes (KIm and Lee, 2010). Surely specific and detailed action plans for enhancing customer equity drivers should be developed after grasping their customer migration patterns illustrated by the rates of acquisition, retention, upgrade, downgrade, and defection for each customer segment.

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