• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.827-833
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• 2020

Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.

• 한국산림과학회지
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• 제107권2호
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• pp.174-183
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• 2018

본 연구는 편백 조림 임분을 대상으로 임분관리 체계 수립을 위해 임분밀도관리도를 개발하였다. 조사 표본점 216 plots을 활용하여 수확량-임분밀도 관계를 추정하였으며($R^2=0.743$), 추정된 모수를 바탕으로 임분밀도관리도를 구축 하였다. 생장을 예측한 결과, ha당 3,000 본 조림 후 80년간 솎아베기 시업을 하지 않았을 경우 고사 본수는 $12.0{\sim}18.1trees{\cdot}ha^{-1}{\cdot}year^{-1}$로 분석되었고, 임분 재적은 $463.1{\sim}695.4m^3{\cdot}ha^{-1}$, 임분밀도는 $1,555{\sim}2,038trees{\cdot}ha^{-1}$로 나타났다. 향후 임분밀도관리도는 시업 기준과 수확목표 설정 등 산림 경영 계획 수립에 있어서 효과적으로 활용될 수 있을 것으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.582-590
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• 2022

Objective : Hydrocephalus after intracerebral hemorrhage (ICH) is known to be related to poor prognosis and mortality. We analyzed predictors of permanent hydrocephalus in the patients with surgically treated supratentorial ICH. Methods : From 2004 to 2019, a total of 414 patients with surgically treated primary supratentorial ICH were included. We retrospectively analyzed age, sex, preexisting hypertension and diabetes, location and volume of ICH, presence and severity of intraventricular hemorrhage (IVH), and type of surgery. Results : Forty patients (9.7%) required shunt surgery. Concomitant IVH was higher in the 'shunt required' group (92.5%) than in the 'shunt not required' group (67.9%) (p=0.001). IVH severity was worse in the 'shunt required' group (13.5 vs. 7.5, p=0.008). Craniectomy (47.5%) was significantly high in the 'shunt required' group. According to multivariable analysis, the presence of an IVH was 8.1 times more frequent and craniectomy was 8.6 times more frequent in the 'shunt required' group. In the comparison between craniotomy and craniectomy group, the presence of an IVH was related with a 3.9 times higher (p=0.033) possibility and craniectomies rather than craniotomies with a 7-times higher possibility of shunt surgery (p<0.001). Within the craniectomy group, an increase in the craniectomy area by 1 cm² was correlated with a 3.2% increase in the possibility of shunt surgery (odds ratio, 1.032; 95% confidence interval, 1.005-1.061; p=0.022). Conclusion : Presence of IVH, the severity of IVH and decompressive craniectomy were related to the development of shunt dependent hydrocephalus in the patients with ICH. The increasing size of craniectomy was related with increasing rate of shunt requirement.

• ALGAE
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• 제34권3호
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• pp.237-251
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• 2019

The dinoflagellate genus Alexandrium is known to often form harmful algal blooms causing human illness and large-scale mortality of marine organisms. Therefore, the population dynamics of Alexandrium species are of primary concern to scientists and aquaculture farmers. The growth rate of the Alexandrium species is the most important parameter in prediction models and nutrient conditions are critical parameters affecting the growth of phototrophic species. In Korean coastal waters, Alexandrium affine and Alexandrium fraterculus, of similar sizes, often form red-tide patches together. Thus, to understand bloom dynamics of A. affine and A. fraterculus, growth rates and nitrate uptake of each species as a function of nitrate ($NO_3$) concentration at $100{\mu}mol\;photons\;m^{-2}s^{-1}$ under 14-h light : 10-h dark and continuous light conditions were determined using a nutrient repletion method. With increasing $NO_3$ concentration, growth rates and $NO_3$ uptake of A. affine or A. fraterculus increased, but became saturated. Under light : dark conditions, the maximum growth rates of A. affine and A. fraterculus were 0.45 and $0.42d^{-1}$, respectively. However, under continuous light conditions, the maximum growth rate of A. affine slightly increased to $0.46d^{-1}$, but that of A. fraterculus largely decreased. Furthermore, the maximum nitrate uptake of A. affine and A. fraterculus under light : dark conditions were 12.9 and $30.1pM\;cell^{-1}d^{-1}$, respectively. The maximum nitrate uptake of A. affine under continuous light conditions was $16.4pM\;cell^{-1}d^{-1}$. Thus, A. affine and A. fraterculus have similar maximum growth rates at the given $NO_3$ concentration ranges, but they have different maximum nitrate uptake rates. A. affine may have a higher conversion rate of $NO_3$ to body nitrogen than A. fraterculus. Moreover, a longer exposure time to the light may confer an advantage to A. affine over A. fraterculus.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제8권11호
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• pp.433-440
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• 2019

최근에 이르러, 기계학습 및 데이터마이닝은 수많은 질병 예측 및 진단에 활용되고 있다. 만성질환은 전체 사망률의 약 80%를 차지하는 질병으로, 점점 증가하는 추세이다. 만성질환 관련 예측 모델을 연구한 기존 연구들은 예측 모델을 구성하는 데이터로 혈당, 혈압, 인슐린 수치 등의 건강검진 수준의 데이터를 이용한다. 본 논문은 만성질환의 위험 요인인 이상지질혈증과 안면 정보의 연관성을 검증하고, 기계학습 기반 안면 정보를 이용한 이상지질혈증 예측 모델을 세계 최초로 개발한다. 본 연구는 5390명의 임상 데이터 중 안면 정보와 중성지방혈증 정보를 바탕으로 수행하였다. 중성지방혈증은 이상지질혈증을 판단하는 척도이다. 연구의 결과로 얼굴의 하악(mandibular) 간의 거리를 나타내는 FD_43_143_aD(p<0.0001, Area Under the receiver operating characteristics Curve(AUC)=0.652) 와 고중성지방혈증이 매우 높은 연관성을 가진 것을 밝혀냈고, 이를 기반으로 구축한 모델은 0.662의 AUC값을 획득하였다. 이러한 연구결과는 향후 질병 역학 및 대중 보건 영역의 스크리닝 단계에서 안면정보만으로 다양할 질병을 예측할 수 있는 기반을 제공할 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3971-3977
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• 2016

Background: Breast cancer, the commonest cancer among women in the world, ranks top in India with an incidence rate of 1,45,000 new cases and mortality rate of 70,000 women every year. Chemotherapy outcome for breast cancer is hampered due to poor response and irreversible dose-dependent cardiotoxicity which is determined by genetic variations in drug metabolizing enzymes and transporters. Pregnane X receptor (PXR), a member of the nuclear receptor superfamily, induces expression of drug metabolizing enzymes (DMEs) and transporters leading to regulation of xenobiotic metabolism. Materials and Methods: A genomic region spanning PXR 3' UTR was amplified and sequenced using genomic DNA isolated from 96 South Indian breast cancer patients. Genetic variants observed in our study subjects were queried in miRSNP to establish SNPs that alter miRNA binding sites in PXR 3' UTR. In addition, enrichment analysis was carried out to understand the network of miRNAs and PXR in drug metabolism using DIANA miRpath and miRwalk pathway prediction tools. Results: In this study, we identified SNPs rs3732359, rs3732360, rs1054190, rs1054191 and rs6438550 in the PXR 3; UTR region. The SNPs rs3732360, rs1054190 and rs1054191 were located in the binding site of miR-500a-3p, miR-532-3p and miR-374a-3p resulting in the altered PXR level due to the deregulation of post-transcriptional control and this leads to poor treatment response and toxicity. Conclusions: Genetic variants identified in PXR 3' UTR and their effects on PXR levels through post-transcriptional regulation provide a genetic basis for interindividual variability in treatment response and toxicity associated with chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6163-6166
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• 2015

Objective: To analyze the relationship between a prethrombotic state and the occurrence of thrombosis, as well as survival time for patients with cervical cancer. Methods: Patients with first diagnosis of cervical cancer were subgrouped according to FIGO staging, and two D-dimer levels were assessed. According to the results, patients are divided into an observation group (abnormal) and control group (normal). Results: For 106 patients with cervical cancer, 38 with abnormal D-dimer, the abnormal rate is 35.9%, of which stage I accounted for 6.5%, stage II 38.5%, stage III 50%, and stage IV 61.1% (p=0.013); The level of D-dimers in stageI wass $0.87{\pm}0.68ug/ml$, while in stage II it was $1.50{\pm}1.35ug/ml$, stage III $2.60{\pm}1.86ug/ml$ and stage IV $18.6{\pm}53.4ug/ml$ (P=0.031); after follow-up of patients for 2-30 months, the mortality of observation group is 21.1%, while for control group it was 2.94% (p <0.01). In the observation group, survival time was $15.1{\pm}5.8$ months, while for control group it was $21.0{\pm}5.4$ months, the difference between two groups being highly significant (p=0.000). Conclusion: There is a direct correlation between prethrombotic state and the grade malignancy of cervical cancer. The level is positively correlated with clinical stage, and is inversely related to survival time, so that a prethrombotic state could be used to predict the prognosis for patients with cervical cancer.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.60-65
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• 2001

Objective : The popular grading systems in use, such as Hunt-Hess grade and Fisher scale score, are based primarily on the patient's clinical conditions or computerized tomography score after aneurysmal subarachnoid hemorrhage(SAH). The author investigated whether the need for ventriculoperitoneal(VP) shunt for chronic hydrocephalus and outcome can be predicted by Hunt-Hess grade and Fisher scale. Methods : A series of 146 patients admitted to our hospital from August 1991 to July 1999, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage which required shunting. Patients were evaluated based on following factors : Hunt-Hess grade, Fisher scale, age, sex, hypertension, aneurysm location, and intervals from aneurysm rupture to operation. Results : The overall mortality rate of the study group was 8.2%. Hunt-Hess grade(p=0.001) or Fisher scale (p=0.001) at all pretreatment times was significantly correlated with outcome. In addition, there was an increased risk of poor outcome in older age(65<). However, there were statistically no significant relationship between outcome and sex, location of aneurysm, hypertension, and interval from aneurysmal rupture to operation(p>0.05). Of 134 surviving patients, 16 patients(12%) underwent VP shunt placement secondary to chronic hydrocephalus. Hunt-Hess grade(p=0.001) is more predictive of chronic hydrocephalus than Fisher scale(p=0.146). Aneurysm location was significantly correlated with development of chronic hydrocephalus (p<0.05), without significant correlations in sex, age, hypertension. IVH, and ICH. Conclusion : This study suggests that there is a high clinical correlation between outcome and Hunt-Hess grades and Fisher scales on admission, but Hunt-Hess grade is more predictive for chronic hydrocephalus than Fisher scale. In addition, age(<65 yrs) is the significant factor for prediction of outcome. There was a trend of increasing risk for chronic hydrocephalus according to aneurymal location.

• 한국컴퓨터그래픽스학회논문지
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• 제28권1호
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• pp.1-9
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• 2022

비소세포폐암(NSCLC)은 전체 폐암 중 85%의 높은 비중을 차지하며 사망률(22.7%)이 다른 암에 비해 현저히 높은 암으로 비소세포폐암 환자의 수술 후 예후에 대한 예측은 매우 중요하다. 본 연구에서는 종양을 관심영역으로 갖는 비소세포폐암 환자의 수술 전 흉부 CT 영상 패치의 종류를 종양 관련 정보에 따라 총 다섯 가지로 다양화하고, 이를 입력데이터로 갖는 사전 학습 된 ResNet 과 EfficientNet CNN 네트워크를 사용하여 단일 모델과 간접 투표 방식을 이용한 앙상블 모델, 그리고 3 개의 입력 채널을 활용한 앙상블 모델에서의 실험 결과 및 성능을 오분류의 사례와 Grad-CAM 시각화를 통해 비교 분석한다. 실험 결과, 종양 주변부 패치를 학습한 ResNet152 단일 모델과 EfficientNet-b7 단일 모델은 각각 87.93%와 81.03%의 정확도를 보였다. 또한 ResNet152 에서 총 3 개의 입력 채널에 각각 영상 패치, 종양 주변부 패치, 형상 집중 종양 내부 패치를 넣어 앙상블 모델을 구성한 경우에는 정확도 87.93%를, EfficientNet-b7 에서 간접 투표 방식으로 영상 패치와 종양 주변부 패치 학습 모델을 앙상블 한 경우에는 정확도 84.48%를 도출하며 안정적인 성능을 보였다.

• Tuberculosis and Respiratory Diseases
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• 제50권2호
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• pp.236-244
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• 2001

연구배경 : 중환자의 예후를 계량화 하려는 채점 체계 중 APACHE III 체계는 중환자실 제1병일 접수는 물론 일 갱선점수도 중환자의 예후를 예측할 수 있는 것으로 알려져 왔다. 평균 재원일이 외국과 비교하여 3-4배의 차이가 나는 점을 감안하면, 일 갱신점수는 예후를 판정하는 지표로서 경제적 효율성이 떨어진다. 이에 제7병일(평균 중간 재원일)의 APACHE III 점수의 임상적 유용성에 관해 알아 보고자 하였다. 방 법 : 1997년 6월부터 1998년 4월까지 한양대학교 구리병원 내파계 중환자실에 입원한 241명의 제1병일과 7병일 APACHE III 점수를 조사하여 생존군과 비생존군 간의 차이를 분석하였다. 결 과 : 전체 환자 수는 241명으로 이 중 사망자가 65명으로 26.6%의 사망률을 나타내었으며 평균 재원일 수는 $10.3{\pm}13.8$일이였다. 제1병일 APACHE III 점수는 $59.7{\pm}30.9$, 제7병일 APACHE III 점수는, $37.9{\pm}27.7$점이였다. 제1병일과 제7병일 APACHE III 점수는 생존군과 비생존군에서 $49.9{\pm}23.8$, $86.3{\pm}32.3$점, $30.1{\pm}18.5$, $81.1{\pm}30.4$점으로 유의한 차이를 보였다(P<0.0001, P<0.0001). APACHE III 점수가 사망률에 미치는 영향을 알아보기 위하여 로지스틱 회귀분석을 시행한 결과 제1병일과 제7병영일의 비차비(odds ratio)는 각각 1.0507, 1.0779로 유의한 결과를 나타내었다(P<0.0001). 결 론 : 이상의 결과로서 제1병일 APACHE III 점수 뿐 아니라 제7병일 점수 또한 사망률 예측과 입원 후 치료 경과에 의해 변화된 예후를 평가하기에 유용한 척도임을 알 수 있었다. 평균 중간 재원일인 제7병일 APACHE III 점수는 일 갱선점수가 경제적으로 물적, 인적 비용이 많이 드는 상황에서 비용효과면에서 임상의에게 도움을 줄 수 있다고 판단된다.