• Journal of Gastric Cancer
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• 제9권1호
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• pp.26-30
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• 2009

목적: 위암환자에서 면역기능이 암 발생과 치료후의 예후와 관련이 있는 것으로 알려져 있어 본 연구에서는 위암 환자에서 수술 전 말초혈액내 림프구 수와 예후와의 관계를 알아보고자 하였다. 대상 및 방법: 1990년부터 1999년까지 10년 동안 위선암으로 근치적 수술을 받은 환자들 중에서 수술 전 백혈구 수와 림프구 수를 확인할 수 있었던 1,054명의 환자들을 대상으로 하였다. 결과: 대상환자 중 림프구 수가 1,500/ul 미만인 환자는 289명이었고 1,500/ul 이상인 환자는 765명이었다. 60세 이상의 환자에서(P<0.001), 종양의 크기가 5 cm 이상의 경우에 림프구 수가 통계학적으로 유의하게 낮았고(P<0.001), 병기에 따라서 림프구 수가 통계학적으로 유의한 차이를 보였다(P=0.038). 단변량 분석 결과 림프구 수가 1,500/ul 미만인군의 5년 및 10년 생존율은 각각 72.4%, 63.5%였고, 림프구수가 1,500/ul 이상인 군의 5년 및 10년 생존율은 각각 80.1%, 76.6%로 통계학적으로 유의한 차이가 있었다(P=0.002). 그러나 다변량 분석 결과 림프구 수에 따른 생존율은 통계학적으로 유의한 차이가 없었다. 결론: 근치적 위절제술을 받은 위암환자의 수술 전 말초혈액의 림프구 수의 측정은 쉽고 간편하게 할 수 있고 림프구 수에 따라서 예후에 유의한 차이가 있으나 독립적인 예후 인자로서의 가치는 없는 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제61권5호
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• pp.156-159
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• 2018

Purpose: Sepsis is a major cause of neonatal morbidity and mortality. Early diagnosis is a major problem because of the lack of specific clinical signs. Therefore, a reliable diagnostic marker is needed to guide the use of antimicrobial agents. The objective of our study was to assess the value of proadrenomedullin (pro-ADM) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. Methods: This study enrolled 60 newborn infants with sepsis proven with positive blood cultures and 30 healthy neonates. Complete blood count, C-reactive protein levels, and pro-ADM levels were obtained from all neonates. Results: The pro-ADM levels were significantly higher ($14.39{\pm}0.75nmol/L$) in the sepsis group than in the control group ($3.12{\pm}0.23nmol/L$). The optimal cutoff value for pro-ADM was 4.3 nmol/L, with a sensitivity of 93.3% and a specificity of 86.7%. The pro-ADM levels were also higher in nonsurvivors (P=0.001). Conclusion: Pro-ADM can be used as a reliable biomarker for neonatal sepsis. High pro-ADM levels were associated with mortality and could be an early indicator of disease outcome.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1045-1054
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• 2020

Objective: This study aimed to evaluate the diagnostic value of combining the quantitative parameters of shear wave elastography (SWE) and superb microvascular imaging (SMI) to breast ultrasound (US) to differentiate between benign and malignant breast masses. Materials and Methods: A total of 200 pathologically confirmed breast lesions in 192 patients were retrospectively reviewed using breast US with B-mode imaging, SWE, and SMI. Breast masses were assessed based on the breast imaging reporting and data system (BI-RADS) and quantitative parameters using the maximum elasticity (Emax) and ratio (Eratio) in SWE and the vascular index in SMI (SMI_VI). The area under the receiver operating characteristic curve (AUC) value, sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of B-mode alone versus the combination of B-mode US with SWE or SMI of both parameters in differentiating between benign and malignant breast masses was compared, respectively. Hypothetical performances of selective downgrading of BI-RADS category 4a (set 1) and both upgrading of category 3 and downgrading of category 4a (set 2) were calculated. Results: Emax with a cutoff value of 86.45 kPa had the highest AUC value compared to Eratio of 3.57 or SMI_VI of 3.35%. In set 1, the combination of B-mode with Emax or SMI_VI had a significantly higher AUC value (0.829 and 0.778, respectively) than B-mode alone (0.719) (p < 0.001 and p = 0.047, respectively). B-mode US with the addition of Emax, Eratio, and SMI_VI had the best diagnostic performance of AUC value (0.849). The accuracy and specificity increased significantly from 68.0% to 84.0% (p < 0.001) and from 46.1% to 79.1% (p < 0.001), respectively, and the sensitivity decreased from 97.6% to 90.6% without statistical loss (p = 0.199). Conclusion: Combining all quantitative values of SWE and SMI with B-mode US improved the diagnostic performance in differentiating between benign and malignant breast lesions.

• Korean Journal of Radiology
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• 제22권3호
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• pp.324-333
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• 2021

Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

• Journal of Chest Surgery
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• 제53권5호
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• pp.297-300
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• 2020

Background: This study aimed to assess the effect of vessel size and flow characteristics on the maturation of autogenous radiocephalic arteriovenous fistulae (RCAVFs). Methods: We retrospectively reviewed records of patients undergoing RCAVF creation at a single medical center from January 2013 to December 2019. Operative variables were compared between patients whose fistulae matured and those whose fistulae failed to mature. Results: Overall, 152 patients (33 of whom were women) with a mean age of 62.6±13.6 years underwent RCAVF creation; functional maturation was achieved in 123. No statistically significant differences were observed between patients in whom maturation was or was not achieved in terms of the following variables: female sex (20.3% vs. 25.0%), radial artery size (2.5 vs. 2.4 mm), and pulsatility index (0.69 vs. 0.62). Low intraoperative transit time flowmetry (TTF; 150.4 vs. 98.1 mL/min) and small vein size (2.4 vs. 2.0 mm) were associated with failure of maturation. The best cutoff diameter for RCAVF TTF and cephalic vein size were 105 mL/min and 2.45 mm, respectively. Conclusion: In patients who undergo RCAVF creation, vein diameter on preoperative ultrasonography and intraoperative TTF are predictors of functional maturation. We identified an intraoperative TTF cutoff value that can be used for intraoperative decision-making.

• 한국전자통신학회논문지
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• 제8권4호
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• pp.561-567
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• 2013

음성 인식을 위해 추출되는 특징벡터 중 일부는 드물게 나타나는 특이 패턴이다. 이들은 음성인식 시스템의 훈련에서 파라미터의 과도맞춤을 일으키며, 그 결과 새로운 입력 패턴의 인식을 저해하는 구조적 위험을 초래한다. 본 논문에서는 이러한 특이 패턴을 제거하는 하나의 방법으로서, 어느 크기 이상의 벡터를 제외시켜 음성인식 시스템의 훈련을 수행하는 방법에 대해 연구한다. 본 연구의 목적은 인식률을 저해시키지 않는 한도에서 가장 많은 특이 특징벡터를 제외시키는 것이다. 이를 위하여 우리는 하나의 절단 파라미터를 도입하고, 그 값의 변화가 FVQ(Fuzzy Vector Quantization)/HMM(Hidden Markov Model)을 사용한 화자독립 음성 인식에 미치는 영향을 조사하였다. 실험 결과, 인식률을 저하시키지 않는 특이 특징벡터의 수가 3%~6% 정도임을 확인하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.381-385
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• 2015

Background:Hepatocellular carcinoma (HCC) is the second most common malignancy in Egypt. Data mining is a method of predictive analysis which can explore tremendous volumes of information to discover hidden patterns and relationships. Our aim here was to develop a non-invasive algorithm for prediction of HCC. Such an algorithm should be economical, reliable, easy to apply and acceptable by domain experts. Methods: This cross-sectional study enrolled 315 patients with hepatitis C virus (HCV) related chronic liver disease (CLD); 135 HCC, 116 cirrhotic patients without HCC and 64 patients with chronic hepatitis C. Using data mining analysis, we constructed a decision tree learning algorithm to predict HCC. Results: The decision tree algorithm was able to predict HCC with recall (sensitivity) of 83.5% and precession (specificity) of 83.3% using only routine data. The correctly classified instances were 259 (82.2%), and the incorrectly classified instances were 56 (17.8%). Out of 29 attributes, serum alpha fetoprotein (AFP), with an optimal cutoff value of ${\geq}50.3ng/ml$ was selected as the best predictor of HCC. To a lesser extent, male sex, presence of cirrhosis, AST>64U/L, and ascites were variables associated with HCC. Conclusion: Data mining analysis allows discovery of hidden patterns and enables the development of models to predict HCC, utilizing routine data as an alternative to CT and liver biopsy. This study has highlighted a new cutoff for AFP (${\geq}50.3ng/ml$). Presence of a score of >2 risk variables (out of 5) can successfully predict HCC with a sensitivity of 96% and specificity of 82%.

• Clinical and Experimental Pediatrics
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• 제61권3호
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• pp.84-89
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• 2018

Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was $84.0{\pm}54.8months$, and the mean hospital stay was $4.6{\pm}1.7days$. Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at $9.6{\pm}6.1mg/dL$. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ${\geq}103.5months$ (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ${\geq}4.55mg/dL$ (sensitivity, 80%; specificity, 69%). Conclusion: Age (${\geq}103.5months$) and higher CRP level (${\geq}4.55mg/dL$) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.

• 한국학교보건학회지
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• 제22권2호
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• pp.169-181
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• 2009

Purpose: Mood disorders such as depression and bipolar disorder are a major mental health problem in college students. We investigate the prevalence of depression and bipolar disorder and the relevance of risk factors for these mood disorders among one college freshmen. Methods: The subjects were 2,865 college students who entered one university located in Seoul and Ansung in 2009. We used BDI (Beck Depression Inventory) for depression assessment and K-MDQ (Mood Disorder Questionnaire) for bipolar disorder assessment. Demographic and socioeconomic factors were measured by questionnaire. Height, weight, blood pressure, total cholesterol, complete blood cell count, and liver function test data were obtained by physical examination for freshmen. Chi-square test and multiple logistic regression were performed to analyze the possible risk factors for depression and bipolar disorder. Results: With different BDI cutoff value, 16 and 21, the prevalence of depression was 8.7% (male: 7.6%, female: 10.1%) and 2.4% (male: 2.5%, female: 2.3%), separately. 'Low economic status', 'urban birth place', and 'low grade at entrance' were significantly associated with depression. Using the original cutoff criterion, defined as clustering of 7 or more symptoms that caused moderate or severe problems, the prevalence of bipolar disorder was 1.3% (male: 1.4%, female: 1.1%). The risk factor of bipolar disorder was academic fields (art fields). Conclusion: Depression and bipolar disorder are common disease in college freshmen. Therefore, Campus-based mental health service program is needed to help with prevention of and early intervention of these mood disorders.

• 지능정보연구
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• 제12권4호
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• pp.109-126
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• 2006

성공적인 고객관계관리(CRM : customer relationship management)를 수행하기 위해서는 효과적인 고객 등급화가 필요하다. 일반적으로 고객등급화는 고객별로 LTV를 산정한 다음 일정한 비율로 고객을 분류하여 등급을 정하는 방법이 사용되어 왔다. 그러나 이러한 방법은 등급간의 이질성을 명확하게 반영하지 못하기 때문에 적지 않은 문제점을 내포하고 있다. 본 논문에서는 Holistic Profit을 이용해서 고객을 등급화 하는 방법을 제시하고, A 생명보험회사의 고객자료을 이용해서 이를 검증하였다. Holistic Profit은 신용대출 승인정책에서 승인임계점수(Cutoff Point) 책정에 활용되고 있는 방법들 중의 하나이다. 요약하면, 본 논문의 목적은 Holistic Profit을 활용하여 보다 효과적이고 과학적인 방법으로 고객 등급화 하는 방법의 개발과 검증에 있다. 본 논문에서 제시된 방법을 사용해서 고객을 등급화 함으로써 기업은 보다 효과적인 고객관계관리(CRM)와 마케팅 활동을 수행할 수 있을 것으로 기대된다.