• 제목/요약/키워드: predictive diagnosis

검색결과 494건 처리시간 0.024초

Factors Associated with Place of Death in Korean Patients with Terminal Cancer

  • Hyun, Min Kyung;Jung, Kyung Hae;Yun, Young Ho;Kim, Young Ae;Lee, Woo Jin;Do, Young Rok;Lee, Keun Seok;Heo, Dae Seog;Choi, Jong Soo;Kim, Sam Yong;Kim, Heung Tae;Hong, Seok-Won
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7309-7314
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    • 2013
  • Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

Anemia and Iron Deficiency according to Feeding Practices in Infants Aged 6 to 24 Months

  • 김순기
    • Journal of Nutrition and Health
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    • 제31권1호
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    • pp.96-101
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    • 1998
  • The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

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내시경 초음파 영상의 점막하 종양 분석 (Submucosal Tumor Analysis of Endoscopic Ultrasonography Images)

  • 김광백
    • 한국멀티미디어학회논문지
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    • 제13권7호
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    • pp.1044-1050
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    • 2010
  • 내시경 초음파는 초음파 진동자를 내시경 끝에 부착하여 그 주위의 장기를 관찰할 목적으로 개발된 의료기기이다. 내시경 초음파 검사는 점막하 종양을 직접 관찰 할 수 있어 종양의 병리 소견이 예측 가능하지만, 종양의 악성화 여부 등에 대해 주관적인 소견이 개입될 수 있는 문제점이 있다. 따라서 본 논문에서는 주관적인 소견으로 인해 나타나는 문제점을 객관화하여 질병의 정확도와 재현성을 높이기 위해 종양의 각 특징을 분석하는 방법을 제안한다. 제안된 방법을 적용하기 위해서 내시경 초음파 검사로 얻어진 초기 영상에서 분석에 필요한 초음파 영역을 추출한다. 초음파 영역은 여러 요인으로 인하여 명암도 값의 차이가 발생하는데, 이는 객관적인 분석에는 비효율적이다. 따라서 초기 검사 시에 매질로써 주입되는 물 영역의 명암도를 기준으로 하여 초음파 영역의 명암도를 표준화 한다. 표준화된 초음파 영역에서 전문의에 의하여 선택된 종양 영역에 LVQ 알고리즘과 비트 평면 분할 방법을 각각 적용하여 에코가 높은 spot 영역과 칼슘이 침착된 영역을 추출하고 분석한다. 종양 영역의 세밀한 분석을 위하여 명암도 값과, 종양 영역 내에서 전문의가 임의로 선택한 두 지점의 거리에 포함된 명암도 정보를 추출한다. 또한 선택된 종양의 악성도를 구분하기 위하여 종양 영역에서 외곽의 기울기를 계산한다. 내시경 초음파 영상에서 각 질병의 특징을 분석한 결과, 제시된 방법이 종양이 가지는 특징을 분석하는데 도움이 되는 것을 확인할 수 있었다.

내시경 초음파 영상의 특징 분석 (Feature Analysis of Endoscopic Ultrasonography Images)

  • 김광백;강효주;김미정;김광하
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2009년도 춘계 종합학술대회 논문집
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    • pp.390-397
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    • 2009
  • 내시경 초음파는 초음파 진동자를 내시경 끝에 부착하여 그 주위의 장기를 관찰할 목적으로 개발된 의료기기이다. 내시경 초음파 검사는 점막하 종양을 직접 관찰 할 수 있어 종양의 병리 소견이 예측 가능하지만, 종양의 악성화 여부 등에 대해 주관적인 소견이 개입될 수 있는 문제점이 있다. 따라서 본 논문에서는 주관적인 소견으로 인해 나타나는 문제점을 객관화하여 질병의 정확도와 재현성을 높이기 위해 종양의 각 특징을 분석하는 방법을 제안한다. 제안된 방법을 적용하기 위해서 내시경 초음파 검사로 얻어진 초기 영상에서 분석에 필요한 초음파 영역을 추출한다. 초음파 영역은 여러 요인으로 인하여 명암도 값의 차이가 발생하는데, 이는 객관적인 분석에는 비효율적이다. 따라서 초기 검사 시에 매질로써 주입되는 물의 영역의 명암도를 기준으로 하여 초음파 영역의 명암도를 표준화 한다. 표준화 된 초음파 영역에서 전문의에 의하여 선택된 종양 영역에 LVQ 알고리즘과 비트 평면 분할 방법을 각각 적용하여 에코가 높은 spot 영역과 칼슘이 침착된 영역을 추출하고 분석한다. 종양 영역의 세밀한 분석을 위하여 명암도 값과, 종양 영역 내에서 전문의가 임의로 선택한 두 지점의 거리에 포함된 명암도 정보를 추출한다. 또한 선택된 종양의 악성도를 구분하기 위하여 종양 영역에서 외곽의 기울기를 계산한다. 내시경 초음파 영상에서 각 질병의 특징을 분석한 결과, 제시된 방법이 종양이 가지는 특징을 분석하는데 도움이 되는 것을 확인할 수 있었다.

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유도전동기의 고장 진단을 위한 효과적인 특징 추출 방법 (An Effective Feature Extraction Method for Fault Diagnosis of Induction Motors)

  • 흥 뉘엔;김종면
    • 한국컴퓨터정보학회논문지
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    • 제18권7호
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    • pp.23-35
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    • 2013
  • 본 논문은 고장 분류 시스템을 위해 진동 신호로부터 특징 벡터를 자동적으로 추출하는 효과적인 기법을 제안한다. 기존의 멜-주파수 캡스트럼 계수는 진동신호의 노이즈에 민감하여 분류 정확도를 감소시키는 단점이 있다. 이러한 문제를 해결하기 위해 본 논문은 4단계 필터 뱅크로 구성된 스펙트럴 엔벨로프 캡스트럼 계수 분석을 제안하며, 4단계는 (1) 모든 진동 신호의 스펙트럴 엔벨로프를 기술하기 위한 선형 예측 코딩 알고리즘 사용 단계, (2) 일반적인 스펙트럴 모양을 얻기 위해 모든 엔벨로프의 평균화 단계, (3) 평균 엔벨로프와 그 주파수의 최대값을 찾기 위한 기울기 하강 방법 사용 단계, (4) 엔벨로프의 주파수 사이의 거리로부터 계산된 중앙값을 얻는데 사용되는 비 중첩 필터 뱅크 단계로 구성된다. 이4-단계필터뱅크는 특징벡터를 추출하기위해 캡스트럼 계수 계산에 사용된다. 마지막으로 유도전동기의 결함 형태를 구분하기 위해 이러한 특수 파라미터를 사용하는 다중 계층 서포트 벡터 머신을 사용한다. 모의실험 결과, 제안하는 방법은 약 99.65%의 분류 성능을 보이며, 동시에 기존 방법들보다 우수한 성능을 보인다.

Interferon-${\gamma}$ Enzyme-Linked Immunospot Assay in Patients with Tuberculosis and Healthy Adults

  • Kim, Cheol-Hong;Kim, Jong-Yeop;Hwang, Yong Il;Lee, Chang Youl;Choi, Jeong-Hee;Park, Yong-Bum;Jang, Seung-Hun;Woo, Heungjeong;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Hyun Soo
    • Tuberculosis and Respiratory Diseases
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    • 제76권1호
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    • pp.23-29
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    • 2014
  • Background: Interferon-${\gamma}$ assays based on tuberculosis (TB)-specific antigens have been utilized for diagnosing and ruling out latent TB and active TB, but their utility is still limited for TB incidence countries. The aim of this study is to understand the clinical utility of enzyme-linked immunospot (ELISpot) assays among patients with clinically suspected TB and healthy adults in clinical practices and community-based settings. Methods: The ELISpot assays (T SPOT.TB, Oxford Immunotec, UK) were prospectively performed in 202 patients. After excluding those with indeterminate results, 196 were included for analysis: 41 were TB patients, 93 were non-TB patients, and 62 were healthy adults. Results: The sensitivity and negative predictive values of the T SPOT.TB assays for the diagnosis of TB were 87.8% and 89.1%, respectively, among patients with suspected TB. The agreement between the tuberculin skin test (10-mm cutoff) and the T SPOT.TB assay was 66.1% (kappa=0.335) in all participants and 80.0% (kappa=0.412) in TB patients. Among those without TB (n=155), a past history of TB and fibrotic TB scar on chest X-rays were significant factors that yielded positive T SPOT.TB results. There was a significant difference in the magnitude of T SPOT.TB spot counts between TB patients and non-TB patients or healthy adults. Conclusion: The T SPOT.TB assay appeared to be a useful test for the diagnostic exclusion of TB. A positive result, however, should be cautiously interpreted for potential positives among those without active TB in intermediate TB incidence areas.

Ki67 Frequency in Breast Cancers without Axillary Lymph Node Involvement and its Relation with Disease-free Survival

  • Shandiz, Fatemeh Homaei;Shabahang, Hossein;Afzaljavan, Fahimeh;Sharifi, Nourieh;Tavasoli, Alireza;Afzalaghaee, Monavar;Roshanzamir, Emane;Pasdar, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1347-1350
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    • 2016
  • Background: Breast cancer prognosis is influenced by several histopathology and clinical factors including expression of Ki67 which may have a predictive role in lymph node negative breast cancer patients. The aim of this study was to assess Ki67 expression in breast cancers without axillary lymph node involvement and to evaluate its prognostic value with regard to disease-free survival. Materials and Methods: Subjects were selected from non-metastatic invasive breast cancer patients who were referred to the oncology department of Ghaem hospital during 1 April 2001 to 1 April 2008. Ki67 levels were measured using immunohistochemistry (IHC) and compared with clinicopathological features. The relation of Ki67 expression with disease-free survival was also analysed. Results: A total of 106 women with a mean age of 49 were examined. Some 94.3% were classified as having invasive ductal carcinomas and the mean tumour diameter at the time of diagnosis was 2.8 cm. Some 50.9% of cases were ER positive and 47.2% were PR positive. P53 expression was positive in 48.1% of the cases. According to the IHC results, only 8.5% of the patients were Her2/neu positive. Ki67 was positive in 66 (62.3%) with a significant relation to lower age (p=0.0229) and P53 positivity (p=0.005). After an average of 40-months follow up, 13 (12.3%) demonstrated recurrence, most commonly systemic. Of 13 cases with relapse, 10 patients (77%) were Ki67 positive. Conclusions: In our population Ki67 appeared to be an independent prognostic factor for three-year survival. However, we stress that a survival study with a bigger sample size would help to support this conclusion.

진동 데이터 기반 설비고장예지를 위한 신호처리기법 (A Signal Processing Technique for Predictive Fault Detection based on Vibration Data)

  • 송예원;이홍성;박훈석;김영진;정재윤
    • 한국전자거래학회지
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    • 제23권2호
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    • pp.111-121
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    • 2018
  • 항공기 엔진, 풍력발전기, 모터 등 회전기기에서 발생하는 많은 문제들은 진동이나 소음과 같은 신호 데이터를 측정하여 이상감지를 할 수 있으며, 주파수 분석 등 여러 가지 신호처리가 데이터 전처리 단계에서 필요하다. 본 논문에서는 진동 데이터를 분석하여 설비 이상상태를 감지하는 기법을 소개한다. 정상상태 데이터를 기반으로 마할라노비스 거리를 측정하여 이상상태 유무를 모니터링 하는 방식을 사용한다. 특히 신호 데이터의 전처리 기법들을 도입하여 이상상태 감지의 성능을 개선할 수 있음을 보여준다. 전처리 단계에서 신호 데이터 수집 과정에서 발생한 누설오차(leakage)를 없애기 위해 해밍 윈도우(Hamming window)를 적용하고, 신호 데이터의 원신호인 포먼트(formant)를 분리하기 위하여 켑스트럼(cepstrum) 분석을 실시한다. IMS 베어링 진동 공개데이터를 대상으로 시간 구간별로 6가지 통계지표를 추출한 후 마할라노비스 거리 분류기를 적용하여 성능을 검증하였다. 제시된 신호처리 전처리 기법을 적용함으로써 성능이 획기적으로 향상되는 것을 실험에서 보여주었다.

남성 불임의 진단 및 체외수정의 예후인자로서 정자 형태의 정밀 분석과 정자 첨체반응 및 햄스터 난자 침투 분석의 비교 연구 (Comparison of Sperm Morphology Evaluation Using Strict Criteria, Acrosome Reaction Following Ionophore Challenge and Zona-free Hamster Ova Sperm Penetration Assay as Prognostic Factors in Diagnosis of Male Infertility and In Vitro Fertilization)

  • 문신용;류범용;방명걸;오선경;이재훈;서창석;김석현;최영민;김정구;이진용
    • Clinical and Experimental Reproductive Medicine
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    • 제29권1호
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    • pp.57-66
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    • 2002
  • Objective : This study was designed to investigate the interrelationship and clinical usefulness of sperm morphology by strict criteria (SM), acrosome reaction following ionophore challenge test (ARIC) and sperm penetration assay (SPA) using zona-free hamster ova as prognostic factors in in vitro fertilization. Materials and Methods: Semen samples were provided by 83 patients undergoing IVF. We first evaluated the differences between normal fertilization group and poor fertilization group on three andrologic tests. Secondly, we analyzed the relationship between the three andrologic tests and in vitro fertilization on IVF settings. Finally, we evaluated the effectiveness of the three andrologic tests as the prognostic indicators for fertilizing ability. Results: The fertilization rate of all men in the poor fertilization group was less than 30%; but there was no evidence that this poor fertilization was due to oocyte defects. The results of three andrologic tests were significatly higher in normal fertilization group. Fertilization rate (%) in vitro was highly correlated (p<0.001) with % normal sperm by SM, ARIC value (%), and SPA result. By using Receiver-Operator-Characteristic curve (ROC), we evaluated the effectiveness of these three tests. The sensitivity and specificity of SM, ARIC test and SPA in predicting fertilization potential in IVF setting were 76% and 75%, 84% and 90%, and 76% and 95%, respectively. Conclusion: Our data suggest that the three andrologic tests can be reliable tools as prognostic factors of sperm fertilizing ability. Among these test, ARIC test and SPA gave more accurate information on fertilizing capacity. ARIC test was shown to have a predictive value for fertilizing ability comparable to that of SPA that appears to be a simple and cost-effective addition to current andrology laboratory. Combined application of these three tests may give more information on predicting sperm fertilizing capacity.

Clinical analysis and review of literature on pilomatrixoma in pediatric patients

  • Hu, Ju Long;Yoo, Hyokyung;Kwon, Sung Tack;Kim, Sukwha;Chung, Jee Hyeok;Kim, Hyeonwoo;Kim, Jinhyun;Yu, Na Hee;Kim, Byung Jun
    • 대한두개안면성형외과학회지
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    • 제21권5호
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    • pp.288-293
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    • 2020
  • Background: Pilomatrixoma is a benign tumor that originates from the hair follicle matrix. It usually presents as a hard, slow growing, solitary mass that can be easily misdiagnosed as other skin masses. The aim of this study was to clinically analyze a case series of pilomatrixoma in pediatric patients from Korea. Methods: A total of 165 pediatric patients from 2011 to 2018 with a histological diagnosis of pilomatrixoma were included. A retrospective review was performed using the electronic medical records, including patient demographics, number and location of the mass, clinical and imaging presentation, and postoperative outcomes. Results: There were 61 male and 104 female patients with 152 solitary and 13 multiple pilomatrixomas. Among solitary pilomatrixomas, the lesion commonly occurred in the head and neck (84.2%), followed by upper limbs (11.2%), lower limbs (3.3%), and trunk (1.3%). The pilomatrixoma lesion presented as the following types based on our clinical classification: mass (56.02%), pigmentation (25.31%), mixed (12.65%), ulceration (4.82%), and keloid-like (1.2%). Ultrasonography showed a high positive predictive value (95.56%). There were no specific complications observed except for two cases of recurrence. Conclusion: Pilomatrixoma has various clinical feature presentations and commonly occurs in the head and neck. Ultrasonography is a helpful diagnostic tool. Surgical removal of the lesion is the main treatment method with a low recurrence rate.