• Title/Summary/Keyword: model factor

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Gamma Knife Radiosurgery for Brain Metastases from Breast Cancer

  • Jo, Kyung Il;Im, Young-Hyuck;Kong, Doo Sik;Seol, Ho Jun;Nam, Do-Hyun;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • v.54 no.5
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    • pp.399-404
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    • 2013
  • Objective : The authors conducted a retrospective cohort study to determine prognostic factors and treatment outcomes of brain metastases (BM) from breast cancer (BC) after Gamma Knife radiosurgery (GKS). Methods : Pathologic and clinical features, and outcomes were analyzed in a cohort of 62 patients with BM from BC treated by GKS. The Kaplan- Meier method, the log-rank test, and Cox's proportional hazards model were used to assess prognostic factors. Results : Median survival after GKS was 73.0 weeks (95% confidence interval, 46.0-100.1). HER2+ [hazard ratio (HR) 0.441; p=0.045], Karnofsky performance scale (KPS) ${\geq}70$ (RR 0.416; p=0.050) and systemic chemotherapy after GKS (RR 0.282; p=0.001) were found to be a favorable prognostic factor of overall survival. Actuarial local control (LC) rate were $89.5{\pm}4.5%$ and $70.5{\pm}6.9%$ at 6 and 12 months after GKS, respectively. No prognostic factors were found to affect LC rate. Uni- and multivariate analysis revealed that the distant control (DC) rate was higher in patients with; a small number (${\leq}3$) of metastasis (HR 0.300; p=0.045), no known extracranial metastasis (p=0.013, log-rank test), or the HER2+ subtype (HR 0.267; p=0.027). Additional whole brain radiation therapy and metastasis volume were not found to be significantly associated with LC, DC, or overall survival. Conclusion : The treatment outcomes of patients with newly diagnosed BM from BC treated with GKS could be affected primarily by intrinsic subtype, KPS, and systemic chemotherapy. Therapeutic strategy and prognosis scoring system should be individualized based on considerations of intrinsic subtype in addition to traditionally known parameters related to stereotactic radiosurgery.

Association between Glycemic Index, Glycemic Load, Dietary Carbohydrates and Diabetes from Korean National Health and Nutrition Examination Survey 2005 (2005 국민건강영양조사 자료 분석을 통한 한국 성인 남녀의 식이 중 Glycemic Index, Glycemic Load 및 탄수화물 섭취 수준과 당뇨 발병과의 관련성 연구)

  • Kim, Eun-Kyung;Lee, Jung-Sug;Hong, Hee-Ok;Yu, Choon-Hie
    • Journal of Nutrition and Health
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    • v.42 no.7
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    • pp.622-630
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    • 2009
  • The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose < 100 mg/dL), impaired glucose tolerance (100 ${\leq}$ serum fasting glucose < 126 mg/dL), diabetes (serum fasting glucose > 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1:2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1:2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

Association between Cigarette Smoking History and Mortality in 36,446 Health Examinees in Korea

  • Kim, Kyoungwoo;Yoo, Taiwoo;Kim, Yeonju;Choi, Ji-Ho;Myung, Seung-Kwon;Park, Sang-Min;Hong, Yun-Chul;Cho, Belong;Park, Sue K.;Yoo, Keun-Young
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5685-5689
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    • 2014
  • Background: It is well known that smoking is a preventable factor for all-cause mortality; however, it is still questionable how many years after smoking cessation that people will have reduced risk for mortality, in particular in those with a high interest in their own health. We aimed to examine the association between time since quitting smoking and total mortality among past-smokers relative to current smokers. Materials and Methods: We enrolled 36,446 health examinees that voluntarily taken with diverse health check-up packages of high cost burden in 1995-2003 and followed them till death by 2004. The history of cigarette smoking consumption was collected using a self-administrative questionnaire at the first visit time. Mortality risk by smoking cessation years was analyzed using Cox's proportional hazard model. Results: Compared to non-smokers, male smokers over 15 pack-years had higher risk for total mortality (HR=1.60, 95%CI 1.23-2.14). The mortality risk in female smokers with same pack-years was more pronounced than that in male smokers (HR=2.83, 95%CI 1.17-7.04) despite a small number of cases. Compared to current smokers, a decrease of total mortality was observed among those who ceased smoking, and inverse dose-response was found with years after cessation: RR 0.98 (95%CI, 0.64-1.41) (<2 yrs), 0.60 (95%CI, 0.43-0.83) (3-9 yrs), and 0.58 (95%CI, 0.43-0.79) (${\geq}10$ yrs). Conclusions: A reduced risk of total mortality was observed after 3 years of smoking cessation. Our findings suggest that at least 3 years of smoking cessation may contribute to reduce premature mortality among Asian men.

Clinical Risk Factor Analysis for Breast Cancer: 568,000 Subjects Undergoing Breast Cancer Screening in Beijing, 2009

  • Pan, Lei;Han, Li-Li;Tao, Li-Xin;Zhou, Tao;Li, Xia;Gao, Qi;Wu, Li-Juan;Luo, Yan-Xia;Ding, Hui;Guo, Xiu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5325-5329
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    • 2013
  • Objectives: Although there are many reports about the risk of breast cancer, few have reported clinical factors including history of breast-related or other diseases that affect the prevalence of breast cancer. This study explores these risk factors for breast cancer cases reported in Beijing in 2009. Materials and Methods: Data were derived from a Beijing breast cancer screening performed in 2009, of 568,000 women, from 16 districts of Beijing, all aged between 40 and 60 years. In this study, multilevel statistical modeling was used to identify clinical factors that affect the prevalence of breast cancer and to provide more reliable evidence for clinical diagnostics by using screening data. Results and Conclusion: Those women who had organ transplants, compared with those with none, were associated with breast cancer with an odds ratio (OR)=65.352 [95% confidence interval (CI): 8.488-503.165] and those with solid breast mass compared with none had OR=1.384 (95% CI: 1.022-1.873). Malignant tendency was strongly associated with increased risk of breast cancer, OR=207.999(95% CI: 151.950-284.721). The risk of breast cancer increased with age, $OR_1$=2.759 (95% CI: 1.837-4.144, 56-60 vs. 40-45), $OR_2$=2.047 (95% CI: 1.394-3.077, 51-55 vs. 40-45), $OR_3$=1.668 (95% CI: 1.145-2.431). Normal results of B ultrasonic examination show a lower risk among participants, OR= 0.136 (95% CI: 0.085-0.218). Those women with ductal papilloma compared with none were associated with breast cancer, OR=6.524 (95% CI: 1.871-22.746). Therefore, this study suggests that clinical doctors should pay attention to these high-risk factors.

Process of Change Corresponding to the Stage of Change of Exercise in Elderly (노인운동의 변화단계에 따른 변화과정에 관한 연구)

  • 전영자;김소인;이평숙;김순용;이숙자;박은숙;장성옥
    • Journal of Korean Academy of Nursing
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    • v.30 no.2
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    • pp.354-365
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    • 2000
  • Purpose: This study was performed to identify the factors that change exercise behave. This study will also classify and identify the characteristics of excercise stages to which the elderly belong Also, to identify the processes of change which influence on the changes in exercise performed by the elderly. Methods: Convenient samples of 198 subjects over the age 60 in Seoul Korea(mean age=70) were selected from elderly communities and were all mentally conpetant older adults. The data were collected from April 1,1999 to May 30, 1999. The research instruments were measured the change in exercise (Marcus et al., 1992b), such as Stage of Change measure(Marcus et al,1992a). The data were analyzed by SAS Program. Results: 1. According to the measure of change without missing data, 191 subjects were distributed each stage of change for exercise: 50 subjects (26.1%), 7 subjects (3.6%), 52 subjects (27.2%), 4 subjects (2%), and 78 (40.8%) belonged to the precontemplation stage, the contemplation stage, the preparation stage, the action stage and the maintenace stage. 2. According to the factor analysis, 6 factors of change were identified as appropriate processes of change and were named by the researchers. The names were; 'Supportive helping relationship', 'Self cognitive determination', 'Environmental reinforcement', Consciousness raising', Reinforcement of negative condition and 'Conversion of negative condition'. 3. According to the stage of change, there were significant mean differences in the 'Supportive helping relationship(F=22.04, p=.0001)', 'Self cognitive determination (F=50.87, p=.0001)', 'Reinforcement of negative condition(F=7.84,p=.0006)'. 4. Through the discriminant analysis, it was found that Self cognitive determination is the most influential variable as one of the processes of change which can discrimiate the three stages of change (precontemplation, preparation, and maintenance). Also the next significant variable was Reinforcement of negative condition. Conclusion: The process of the dey change is one of concepts of The transtheoretical model known as strategies and the techniques people use as they go through the different stages of change. Even though this study is cross- sectional not longitudinal study, the finding of this study gives useful information for exercise intervention, by using this strategy of exercise for elderly in different stages of change in exercise.

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Interleukin-$1{\beta}$ induces bone resorption by regulation of prostaglandin $E_2$ synthesis and plasminogen activator activity, and TGF-$\beta$ inhibits bone resorption of rat bone cells (쥐의 골세포에서 $PGE_2$ 합성과 plasminogen activator 활성 조절에 의한 IL-$1{\beta}$의 골 흡수유도와 TGF-$\beta$에 의한 골 흡수 억제 기전에 관한 연구)

  • Kim, Young-Hun;Lee, Young-Jun;Chung, Kyu-Rhim;Park, Young-Guk
    • The korean journal of orthodontics
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    • v.30 no.6 s.83
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    • pp.713-721
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    • 2000
  • Bone cells produce multiple growth factors and cytokines that have effects on bone metabolism and can be incorporated into the bone matrix. The present study was designed to extend these observations by examining the interactions between transforming growth factor-$\beta$(TGF-$\beta$) or interleukin-$1\beta$(rhIL-$1\beta$) and bone cells in a rat long bone culture model. IL-$1\beta$ regulates several activities of the osteoblast cells derived from rat long bone explants in vitro. IL-$1\beta$ stimulated cellular proliferation as well as the synthesis of prostaglandin $E_2$ and Plasminogen activator activity in the cultured cells in a dose-dependent manner. TGF-$\beta$ is present in the bone matrix and potentially released during bone resorption. TGF-$\beta$ reduced basal bone resorption and inhibited vitamin $D_3[1,25(OH)_2D_3]$-induced bone resorption in rat long bone cells. These results support the role of IL-$1\beta$ in the pathological modulation of bone cell metabolism, with regard to implication in the Pathogenesis of osteoporosis by IL-$1\beta$, and that TGF-$\beta$ positively inhibits the bone resorption.

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Synergistic Effect of Notopterygium incisum and Saposhnikovia divaricata in the Anti-inflammatory Activity (강활과 방풍의 항염증 상승작용에 관한 연구)

  • Lee, Do-Yeon;Choi, Go-Ya;Yoon, Tae-Sook;Cheon, Myeong-Sook;Kim, Seung-Ju;Yasukawa, Ken;Yu, So-Yeon;Kim, Ho-Kyoung
    • The Korea Journal of Herbology
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    • v.23 no.4
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    • pp.39-44
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    • 2008
  • Objectives: Notopterygium incisum(N. incisum) and Saposhnikovia divaricata(S. divaricata) have been clinically used in traditional oriental medicine for treatment of inflammatory diseases. Also, a herbal mixture prepared with N. incisum and S. divaricata has been strongly linked to the anti-inflammatory effect. In this study, we evaluate the synergistic anti-inflammatory effect of N. incisum and S. divaricata. Methods: For evaluating the anti-inflammatory activity of a herbal mixture of N. incisum and S. divaricata in vivo, we measured the changed ear thickness in 12-O-tetradecanoyl-phorbol-13-acetate(TPA)-induced mouse ear edema model after topical application of herbal mixture. In addition, the levels of markers for inflammation, such as tumore necrosis factor (TNF)-${\alpha}$, interleukin (IL)-1${\beta}$, and nitric oxide(NO), were determined by ELISA assay in lipopolysaccharide-stimulated Raw 264.7 cells. Results: We reported that water extracts of N. incisum and S. divaricata combination significantly inhibited the mouse ear edema induced by TPA. Moreover, the water extracts of N. incisum and S. divaricata combination exhibited synergistic effects in down-regulating IL-1${\beta}$ level, but not TNF-${\alpha}$ and NO. Conclusions: These results suggest that combined treatment of N. incisum and S. divaricata, based on seven methods in prescription compatibility, has a synergistic effect in down-regulating inflammatory response both in vivo and in vitro models. Especially, it seems that IL-1${\beta}$ is a one of main target of the mixture of N. incisum and S. divaricata on anti-inflammatory activity.

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THE EFFECTS OF THE LOW CALCIUM DIET AND IRRADIATION ON THE MANDIBULAR CONDYLE OF RATS (저칼슘식이와 방사선조사가 백서하악과두에 미치는 영향에 관한 실험적 연구)

  • Ahn Hee-Mun;Lee Sang-Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.1
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    • pp.27-44
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    • 1993
  • This study was performed to investigate the changes of mandibular condyle by low calcium diet and the effects of irradiation on the bone in osteoporotic state. In order to carry out this experiment, 80 seven-week old Sprague-Dawley strain rats weighing about 150 gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condyle was measured by use of dual energy X-ray bone densitometer(model DDX-alpha, Lunn Corp., U. S. A.). The mandibular condyle was radiographed with Hitex HA-80(Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-a observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observations, the number nd size of trabeculae were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and coarse of the trabeculae of the condyle were observed. These findings were extended rather than in non-irradiated group with low calcium diet. On microscopic observations, many osteoclasts were detected and the number and size of trabeculae were somewhat decreased after 7 days. Also there was degenerative changes of tissues of bone marrow on the 14th day but that condition was restored on the 21st day of experiment. 3. In the irradiated group with normal diet, the bone mineral density of the condyle was somewhat decreased with times and degree of decrease of the number of trabeculae was somewhat larger than in the non-irradiated group with normal diet. On microscopic observations, the tissues of bone marrow were atrophic and degenerative changes but that condition was restored on the 21st day of experiment. 4. In immunocytochemical findings, in the irradiated and non-irradiated groups with low calcium diet, negative or partial positive response to TNF was observed, but positive response in the normal diet groups.

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VRIFA: A Prediction and Nonlinear SVM Visualization Tool using LRBF kernel and Nomogram (VRIFA: LRBF 커널과 Nomogram을 이용한 예측 및 비선형 SVM 시각화도구)

  • Kim, Sung-Chul;Yu, Hwan-Jo
    • Journal of Korea Multimedia Society
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    • v.13 no.5
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    • pp.722-729
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    • 2010
  • Prediction problems are widely used in medical domains. For example, computer aided diagnosis or prognosis is a key component in a CDSS (Clinical Decision Support System). SVMs with nonlinear kernels like RBF kernels, have shown superior accuracy in prediction problems. However, they are not preferred by physicians for medical prediction problems because nonlinear SVMs are difficult to visualize, thus it is hard to provide intuitive interpretation of prediction results to physicians. Nomogram was proposed to visualize SVM classification models. However, it cannot visualize nonlinear SVM models. Localized Radial Basis Function (LRBF) was proposed which shows comparable accuracy as the RBF kernel while the LRBF kernel is easier to interpret since it can be linearly decomposed. This paper presents a new tool named VRIFA, which integrates the nomogram and LRBF kernel to provide users with an interactive visualization of nonlinear SVM models, VRIFA visualizes the internal structure of nonlinear SVM models showing the effect of each feature, the magnitude of the effect, and the change at the prediction output. VRIFA also performs nomogram-based feature selection while training a model in order to remove noise or redundant features and improve the prediction accuracy. The area under the ROC curve (AUC) can be used to evaluate the prediction result when the data set is highly imbalanced. The tool can be used by biomedical researchers for computer-aided diagnosis and risk factor analysis for diseases.

Research on the Visual Characteristics of a Representative View of the Skyline; - Referring to Landscape Assessment of Mt. Mudeung from Various Viewpoints - (도시 배후 산 지형 스카이라인 경관의 조망 특성과 경관 대표성 평가 - 시점 위치에 따른 무등산 조망경관 분석을 중심으로 -)

  • Cho, Tong-Buhm
    • Journal of the Korean Institute of Landscape Architecture
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    • v.35 no.6
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    • pp.84-96
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    • 2008
  • This research investigated the landscape characteristics of the skyline and the cognitive characteristics of Mt. Mudeung (1,186m) from various viewpoints. Mt. Mudeung, the representative landscape of Gwangju City, has been recognized as a natural landmark and theme of paintings. By analyzing the perspective from 32 points with a digital terrain model, some landscape indices of the skyline were derived and the relationships are discussed. Assessment of the semantic differential scale with 21 adjective variables and representativeness to 15 landscape photographs of the mountain were accomplished. 1. Through regression analysis of the skyline indices, significant relationships were found between them the angle from the visual axis and number of skyline jumps, the vertical angle fluctuation and number of jumps per degree, the visual depth fluctuation and vertical angle fluctuation of skyline, and between the vertical angle mean and number of jumps per degree. Meaningful relations were found between the number of jumps of skyline to number of jumps per degree and the angle from visual axis to visual distance. However, in the representative assessment no difference was found on the angle from visual axis of viewpoints. On the other hand, it seemed to relate representativeness with visual clarity based on visual distance. 2. We found 4 factors "familiarity", "fluctuation of skylines", "openness", and "feeling of texture" in the results of factor analysis of semantic differential assessment. When considering the results of assessment for representativeness, adjective words for familiarity and openness seemed to have a close assessment. Specifically, the research showed that the landscape representation was highly assessed in a view which could be seen from the higher parts to the lower part of hills. This result indicates that the management of viewpoints which could get a scene from intermediate to distant, and locating a high elevation is important. 3. In the picturesque expression of Mt. Mudeung, various impressions from the different points, a skyline based on the top of Mt. Mudeung and a mono structure by overlapping hills were common characteristics. These common characteristics were also partially found through the analysis of topographical landscape indices and landscape images. Therefore, the viewpoints for the representative landscape management should be selected in natural or open spaces.