Cluster Analysis of Inhalant Allergens in South Korea: A Computational Model of Allergic Sensitization

Objectives@#. Sensitization to specific inhalant allergens is a major risk factor for the development of atopic diseases, which impose a major socioeconomic burden and significantly diminish quality of life. However, patterns of inhalant allergic sensitization have yet to be precisely described. Therefore, to enhance the understanding of aeroallergens, we performed a cluster analysis of inhalant allergic sensitization using a computational model. @*Methods@#. Skin prick data were collected from 7,504 individuals. A positive skin prick response was defined as an allergen-to-histamine wheal ratio ≥1. To identify the clustering of inhalant allergic sensitization, we performed computational analysis using the four-parameter unified-Richards model. @*Results@#. Hierarchical cluster analysis grouped inhalant allergens into three clusters based on the Davies-Bouldin index (0.528): cluster 1 (Dermatophagoides pteronyssinus and Dermatophagoides farinae), cluster 2 (mugwort, cockroach, oak, birch, cat, and dog), and cluster 3 (Alternaria tenus, ragweed, Candida albicans, Kentucky grass, and meadow grass). Computational modeling revealed that each allergen cluster had a different trajectory over the lifespan. Cluster 1 showed a high level (>50%) of sensitization at an early age (before 19 years), followed by a sharp decrease in sensitization. Cluster 2 showed a moderate level (10%–20%) of sensitization before 29 years of age, followed by a steady decrease in sensitization. However, cluster 3 revealed a low level (<10%) of sensitization at all ages. @*Conclusion@#. Computational modeling suggests that allergic sensitization consists of three clusters with distinct patterns at different ages. The results of this study will be helpful to allergists in managing patients with atopic diseases.

Computerized analysis of fetal heart rate in normal term pregnant women categorized by birth weight and fetal sex / 대한주산의학회잡지

PURPOSE: The objective of this study is to compare the difference of each fetal heart rate (FHR) variables between each categorized group according to birth weight and fetal sex using computerized analysis system of fetal heart rate. METHODS: Non stress test (NST) of four hundred normal pregnant women were grouped based on birth weight to 4 groups, <2,500 g, 2,500~<3000 g, 3,000~<3,500 g and above 3,500 g. Fifty male and 50 female babies entered to each group. So, 100 normal pregnant women entered for the study in each group. For collection and analysis of data and values of each variables, our own FHR interpretation sofware, HYFM-II (Windows version 1.0) was used. RESULT: From the comparison between each group classified by each criteria, there were no specific significant differences in baseline FHR, FHR variability (amplitude & mean minute range), signal loss rate, number of fetal movements, the number of FHR acceleration & the number of FHR deceleration those were obtained by our computerized FHR analysis system. CONCLUSION: We confirm that there were no specific differences in each FHR varibles according to birth weight and fetal sex at least in term normal pregnancy.

Meta Analysis of Clinical Studies of Pregnancy and Delivery in Elderly Gravida / 대한산부인과학회지

OBJECTIVE: Our purpose was to identify the age-related inceased risks of the elderly gravida over 35 or 40 years at delivery by clarifying the effects of age and parity, their combination, and their interaction and the relationships of other complications. METHODS: We have made meta analysis about general and clinical characteristics of elderly gravida over the aged 35 or 40 years, based on the 7 domestic theses since 1996 year at the department of Obstetrics and Gynecology. RESULTS: The results were obtained as follows; In elderly gravida over the aged 35 or 40 years at delivery, maternal and neonatal outcomes were generally good, but in study group, there were a high incidence of gestational (preterm delivery, fetal presentation, pregnancy-induced hypertension, gestational diadetes, placenta previa, premature rupture of membranes) complications, uterine myoma during pregnancy and low birth weight in neonate after delivery. CONCLUSION: The increased risks of the elderly gravida over the aged 35 or 40 years at delivery may have been overshadowed by the previous focus on the elderly nullipara. In spite of high incidence of maternal morbidity, the overall maternal and neonatal outcomes were generally good. It is important to recognize what is more important in age-related pregnant-risks of the elderly gravida over the aged 35 or 40 years at delivery to appropriate counsel and manage this group of patients. This informations may be helpful for counsel in elderly gravida over the aged 35 or 40 years who are considering pregnancy.

The Approximate Entropy in Maternal Anemia during Pregnancy according to Gestational Age / 대한주산의학회잡지

OBJECTIVES: Maternal anemia is common hematologic disorders during pregnancy. Although mild maternal anemia is not associated with fetal anemia, neonatal morbidity including fetal anemia are common with severe maternal anemia during pregnancies. We aim to analyze each variable of FHR using linear and nonlinear methods to detect maternal anemia during pregnancies. METHODS: Seventy antepartal anemic pregnant women(Hb<10.0g/dL) and the contrast group, 70 normal pregnant women were selected among the women who underwent nonstress test(NST) during 3rd trimester in Hanyang University Hospital. The calculated FHR parameters(NST time=20 min) from collected FHR data(40-50min) were made by HYFM II data file. To assess the difference between the anemic and normal pregnancy group, the parameters such as baseline FHR, variability (AMP, MMR), acceleration and deceleration(15bpm-15seconds), gestational age at the time of NST, loss of record, the number of fetal movement, FHR were evaluated. We compared the canonical correlation between each groups using variables of NST. The overall complexity of each FHR time series was quantified by its approximate entropy(ApEn), measure of regularity derived from nonlinear dynamics, "chaos theory". Finally we extract the value of ApEn and were compared between two groups, normal and anemic pregnant women. RESULTS: There were significant decrease of FHR variability(amplitude and mean minute interval) in anemic group. Canonical correlation ensemble was significantly high in 36th-37th and 38th-39th gestational weeks in anemic group(p-value=0.03048 and 0.03421). The value of ApEn was significantly low(0.68+0.26) in anemic group comparing with normal pregnant group(0.95+0.08), respectively. CONCLUSIONS: This study shows that FHR of maternal anemia is different from that of normal pregnant women, and that subtle behavioral differences could be demonstrated in uterus using computerized FHR analysis. The anemic women during pregnancy have more linear and less complicated FHR than the normal pregnancy group. ApEn, which is bound to be used as an index of fetal well-being would be used as an evaluating tool of intrauterine fetal function in the near future.

Correlation analysis of Each Variable of Fetal Heart rate in Pregnancy induced hypertension and Intrauterine fetal growth restriction / 대한산부인과학회잡지

OBJECTIVE: We aim to analyze each variable of FHR in high risk pregnancies, namely intrauterine growth restriction (IUGR) and pregnancy-induced hypertension (PIH) including chronic hypertensive vascular disease (CHVD), mild and severe preeclampsia to build an objective decision basis using correlation analysis. METHODS: The patients were divided into two groups (500 normal pregnancies and 500 high risk pregnancies related to IUGR, CHVD, mild and severe preeclampsia), and then subdivided into intrauterine pregnancy before 24 weeks, 25-39 weeks, and after 40 weeks. We compared the canonical correlation between each group using variables of FHR after nonstress test (NST). RESULTS: In high risk pregnancies, the linearity was 0.6-0.8 in intrauterine pregnancy before 24 weeks, 0.53-0.68 in 25-29 weeks, 0.50-0.60 in 30-34 weeks, 0.38-0.45 in 35-39 weeks and 0.42-0.55 in after 40 weeks. In normal pregnancies, the linearity was 0.44-0.52 in intrauterine pregnancy before 24 weeks, 0.38-0.45 in 25- 39 weeks which was stable, and there was no specific change in after 40 weeks. Before 32 weeks, canonical variates of FHR_D and FHR_I revealed highest (0.36, 0.47 respectively) in high risk pregnancy and fetal movement and signal loss was the most valuable factors in normal pregnancy. In between 33 to 37 weeks, fetal movement (0.40) and signal loss (0.48) were related most closely in high risk pregnancies and 0.34 and 0.49 respectively in normal pregnancies which show similar pattern. In contrast, FHR_D was most highly related to the duration of pregnancy and FHR_I to fetal movement (0.38) in high risk pregnancy. In normal pregnancies, fetal movement (0.40) and signal loss (0.52) showed the highest linearity. CONCLUSION: The pregnancy with intrauterine growth restriction and pregnancy induced hypertension has more linear relation and less complexity in each variable of FHR than the normal pregnancy group. The formal, functional underdevelopment of fetus may results in the increasement of the linear depedent relation in each variable of FHR in these type of high risk pregnancies.

Variables of Fetal Heart Rate and Neonatal Outcome according to Fetal Sex / 대한산부인과학회잡지

OBJECTIVE: The differences between two fetal sexes have been a matter of great concern from ancient times to present day. This study was initiated to research the varying fetal behaviors which would differ according to the fetal sex. METHODS: With every 1,500 cases of each fetal sex selected, the patterns which the varying factors related to FHR and prognosis of neonates in normal pregnancy were compared by means of Factor Analysis (a linear method). Canonical Ensemble was performed to compare the relationship of intrauterine fetal behavioral developments, and neonatal prognosis of each fetal sex. And whether the different types of the fetal sex would have influence also on the chaotic behavior was analyzed by the methods of linear Power Spectrum of FHR and Approximate Enthropy. RESULTS: The consequences of Factor Analysis showed that it is Apgar score on the factor 1 axis, and signal loss on the factor 2 axis in the case of male babies. In the case of female babies it is Apgar score on the factor 1 axis, and fetal movement on the factor 2 axis. Speaking of the specific value regarding FHR, male babies displayed higher frequency only in terms of fetal movement sign than female babies (p=0.0394). No other differences between two fetal sexes in abnormal findings were indicated (p>0.05). Among the babies at 30~33 weeks' gestation female babies were more likely to reveal higher Canonical Ensemble (male=0.41+/-0.05, female=0.05+/-0.04; p=0.00411), whereas male babies have a higher Approximate Entropy (male=0.926+/-0.01, female=0.871+/-0.01; p=0.0037). However Power Spectrum Analysis indicated that there were no significant differences as I compared LF/HF (p>0.05), the ratio of LF and HF of two fetal sexes, and same result was also drawn by Power Low beta-slope (p>0.05). CONCLUSION: The linear patterns of the FHR signal from the fetus suggest that there is no variables resulting from the type of fetal sex, except for the fetal movement frequency and the height and weight of neonates. The sympathetic and parasympathetic balance of both fetal sexes also showed a similar development pattern. In the mean time the differences which could be visible were made among the male and female babies specifically at 30~33 weeks' gestation. This may correspond to the fact that the lung maturation of the female fetus is completed before the third trimester of pregnancy, and the male fetus after the period, and finally the differences between the fetal sexes generally become insignificant toward term.

Analysis of Multiple Variables Related with Duration of Labor Using Labor Curves / 대한주산의학회잡지

No abstract available.

The Analysis of FHR Parameters and Canonical Correlation of Fetuses with Breech Presentation / 대한주산의학회잡지

No abstract available.

The analysis of FHR parameters, approximate entropy and canonical correlation of fetuses with mild baseline tachycardia / 대한산부인과학회잡지

OBJECTIVE: This study was to determine differences of fetal heart rate (FHR) parameters, approximate entropy, canonical correlation coefficient and perinatal outcome between fetuses with mild baseline tachycardia (FHR range : 161-180 bpm) and fetuses with normal baseline FHR. METHODS: Using our own software developed by Hanyang University Hospital in Korea, non-stress tests were performed for 20 minutes and cases were divided into two groups; mild tachycardia group (FHR range ; 161-180 bpm, 100 cases) and normal group (FHR ranges ; 120-160 bpm, 197 cases). And then, we analyzed various FHR parameters, approximate entropy, adjusted canonical correlation coefficient and perinatal outcome in each group. RESULTS: Perinatal outcomes between two groups were not significant. However, mean minute range (MMR) was lower and the number of deceleration (15 bpm for 15 sec, more than one) was significantly higher in fetuses with mild tachycardia than normal group (p<0.05). The apprximate entropy and canonical correlation coefficient showed respectively 0.77+/-0.02, 0.45+/-0.06 in mild tachycardia group and 0.80+/-0.01, 0.43+/-0.07 in normal group, there were no significant differences. CONCLUSIONS: The results showed that mild baseline tachycardia in this range were not associated with an increase in the incidence of adverse perinatal outcome, although decreased MMR and increased number of deceleration in mild tachycardia group may suggest hidden subtle change of FHR parameters. Fetuses with mild tachycardia were not different irregularity of FHR quantified by approximate entropy from normal fetuses and were also similar tendency to correlation with perinatal outcome by adjusted canonical correlation coefficient, which is a multivariate extension of the univariate correlation analysis.

The analysis of FHR parameters, approximate entropy and canonical correlation of fetuses with mild baseline tachycardia / 대한산부인과학회잡지

OBJECTIVE: This study was to determine differences of fetal heart rate (FHR) parameters, approximate entropy, canonical correlation coefficient and perinatal outcome between fetuses with mild baseline tachycardia (FHR range : 161-180 bpm) and fetuses with normal baseline FHR. METHODS: Using our own software developed by Hanyang University Hospital in Korea, non-stress tests were performed for 20 minutes and cases were divided into two groups; mild tachycardia group (FHR range ; 161-180 bpm, 100 cases) and normal group (FHR ranges ; 120-160 bpm, 197 cases). And then, we analyzed various FHR parameters, approximate entropy, adjusted canonical correlation coefficient and perinatal outcome in each group. RESULTS: Perinatal outcomes between two groups were not significant. However, mean minute range (MMR) was lower and the number of deceleration (15 bpm for 15 sec, more than one) was significantly higher in fetuses with mild tachycardia than normal group (p<0.05). The apprximate entropy and canonical correlation coefficient showed respectively 0.77+/-0.02, 0.45+/-0.06 in mild tachycardia group and 0.80+/-0.01, 0.43+/-0.07 in normal group, there were no significant differences. CONCLUSIONS: The results showed that mild baseline tachycardia in this range were not associated with an increase in the incidence of adverse perinatal outcome, although decreased MMR and increased number of deceleration in mild tachycardia group may suggest hidden subtle change of FHR parameters. Fetuses with mild tachycardia were not different irregularity of FHR quantified by approximate entropy from normal fetuses and were also similar tendency to correlation with perinatal outcome by adjusted canonical correlation coefficient, which is a multivariate extension of the univariate correlation analysis.

Development of Algorithm for Estimation of Gestational Age using each Variable of Fetal Heart Rate / 대한산부인과학회잡지

OBJECTIVE: The objective of this study is to estimate gestational age by using FHR parameters after linear and nonlinear analysis of FHR data. Linear spectral decomposition has a limit to describe and analyze the nonlinear and complex physiological nature. Random processing and chaotic analysis assist to quantify some patterned energies, interaction of the physiological system in body system, which the constancy is preserved, and complexity of physical cardiovascular system. But there are no great development of new device which notify fetal age. METHODS: From March 1995 to December 2000, 2,548 cases who received NST during antenatal visit were included in this study. Among these cases, 1000 cases were sampled randomly. We divided this cases into a study and a control group, 500 cases for model building set and the other 500 cases for validation set. Each FHR parameters such as baseline FHR, variability (AMP, MMR), acceleration & deceleration (15 bpm-15 seconds), loss of signal, the number of fetal movement were analysed by using our own computerized HYFM-I, II software system. The linear and non-linear analysis of FHR were done after extracting approximate entropy (ApEn) value. Finally, we performed regression analysis and extract an equation for estimation of gestational weeks using bootstrap method. RESULTS: We extract a following equation using above study method: Log(GA)=5.870-0.051(Sloss*)-0.065(Mean FHR*)+0.049(Mean FHR*)2-0.058(FM*)+0.048(AMP*)2+0.121(A1515*)-0.031(A1515*)2+0.036(ApEn*)2. CONCLUSIONS: Accurate dating of pregnancy, namely gestational week is very important for antenatal diagnosis in the field of perinatal medicine. This study will propose scientific research results which are useful for studying normal and morbid generating physiological fetal condition. We extract an appropriate equation for estimation of gestational weeks only using FHR parameters. We hope to compare our result with other authors' results in the near future.

Development of Algorithm for Estimation of Gestational Age using each Variable of Fetal Heart Rate / 대한산부인과학회잡지

OBJECTIVE: The objective of this study is to estimate gestational age by using FHR parameters after linear and nonlinear analysis of FHR data. Linear spectral decomposition has a limit to describe and analyze the nonlinear and complex physiological nature. Random processing and chaotic analysis assist to quantify some patterned energies, interaction of the physiological system in body system, which the constancy is preserved, and complexity of physical cardiovascular system. But there are no great development of new device which notify fetal age. METHODS: From March 1995 to December 2000, 2,548 cases who received NST during antenatal visit were included in this study. Among these cases, 1000 cases were sampled randomly. We divided this cases into a study and a control group, 500 cases for model building set and the other 500 cases for validation set. Each FHR parameters such as baseline FHR, variability (AMP, MMR), acceleration & deceleration (15 bpm-15 seconds), loss of signal, the number of fetal movement were analysed by using our own computerized HYFM-I, II software system. The linear and non-linear analysis of FHR were done after extracting approximate entropy (ApEn) value. Finally, we performed regression analysis and extract an equation for estimation of gestational weeks using bootstrap method. RESULTS: We extract a following equation using above study method: Log(GA)=5.870-0.051(Sloss*)-0.065(Mean FHR*)+0.049(Mean FHR*)2-0.058(FM*)+0.048(AMP*)2+0.121(A1515*)-0.031(A1515*)2+0.036(ApEn*)2. CONCLUSIONS: Accurate dating of pregnancy, namely gestational week is very important for antenatal diagnosis in the field of perinatal medicine. This study will propose scientific research results which are useful for studying normal and morbid generating physiological fetal condition. We extract an appropriate equation for estimation of gestational weeks only using FHR parameters. We hope to compare our result with other authors' results in the near future.

Correlation Analysis of each variable of Fetal Heart Rate Observed through Computerized Monitoring / 대한산부인과학회잡지

OBJECTIVE: We aim to analyze each variable affecting FHR to build objective decision basis using canonical correlation analysis METHODS: The sixty four hundred and fifty five cases of NST from 1988 to 1997 at Hanyang University hospital were collected. We used FHR interpretation softwares, HYFM-I & II those were already developed by author, for extraction of each variable of FHR. We classified the variables into 2 groups, F.A.M(FHR, Amplitude, Mean minute range) and N.S.F(NST weeks, Signal loss, Fetal movement) groups. The Canonical correlation was compared between each variable and group. RESULTS: The canonical correlation between F.A.M & N.S.F are as follows; r=0.40 (p=0.001) in preterm, r=0.34 (p=0.001) in term, and r=0.41 (p=0.004) in postterm. The high linear dependency is shown as r=0.79 (p=0.013) before 23 weeks, the irregular changes shown from 23 weeks to 30 weeks (r=0.47 in 23-24 weeks, r=0.29 in 25-26 weeks, r=0.56 in 27-28 weeks, r=0.24 in 29-30 weeks) and the stable relative changes shown (about r=0.3-0.4) after 30 weeks (r=0.32 in 31-32 weeks, r=0.33 in 33-34 weeks, r=0.37 in 35-36, r=0.33 in 37-38 weeks, r=0.37 in 39-40 weeks, r=0.35 after 41 weeks) (p<0.02). In the linear correlation of FHR, two indicies of FHR variables, AMP and MMR pertaining to N.S.F., FHR(r) is 0.06, AMP and MMR seem to be identical as r=0.30 and then the canonization in term and postterm[FHR(r)=-0.27, AMR(r)=0.23, and MMR(r)=0.35]lies in the regular pattern. Moreover, there is rather a linear correlation between F.A.M and the gestational weeks in preterm and it is changed into linearity similar to zero in term and postterm pregnancies[term(r)=0.01, postterm(r)=0.06] CONCLUSIONS: This study shows the linearity of FHR and the variable which are based on the gestational weeks organically, comprehensibly, and quantitatively. It would be utilized as the fundamental standard of the linearity. The changes from the irregular linear correlation to the regular pattern according to advancing gestational weeks means the changes from the immature and transitional level to the mature level. The closer investigation of the linear and

Correlation Analysis of Each Variable of Fetal Heart Rate in Normal and Abnormal Pregnancies / 대한주산의학회잡지

No abstract available.

Statistical Investigation of Each Variable of Fetal Heart Rate According to Birth Weight / 대한주산의학회잡지

No abstract available.

Correlation Analysis of Each Variable of Fetal Heart Rate After Maternal Hearing of Alpha-Brain Wave Induced Sound and Natural Sounds / 대한주산의학회잡지

No abstract available.

Statistical Analysis on Each variable of Fetal Heart Rate and Outcomes of Newborn Infants / 대한주산의학회잡지

OBJECTIVE: Nonstress test(NST) has become an important method of antepartum evaluation of fetal well-being. The fetal heart rate(FHR) testing is used frequently as a nonstress test(NST). However, NST highly depends on whom to interpret the result of FHR testing. Recently, for interpretation of FHR, objective decision methods using softwares have been introduced. In this study, we aim to analyse the correlation between each variable affecting FHR and fetal outcome using objective decision basis with principal component analysis and multiple regression analysis. MATERIALS AND METHODS: The clinical observation was made on 5,314 data from pregnant women who took a NST which had been collected from 1989 to 1997 at Hanyang University Hospital. For collection of data and values of each variable, we used our own FHR interpretation softwares, HYFM-I(DOS version, 1989) and HYFM-II(Window-version, 1998). Then, the principal component analysis is performed to find significant variable and multiple regression analysis using these variables. RESULTS: Each groups were divided and classified as followings ; 1 minute Apgar score-normal, 1 minute Apgar score-abnormal, 5 minute Apgar score-nomal, 5 minutes Apgar score-abnormal; there is significant difference between signal loss and 1 minute Apgar score only. And significant difference was shown between mean baseline FHR, FHR variability-amplitude, FHR variability-MMR, and fetal outcomes(body weight of newborn & Apgar score). The FHR variability-amplitude, FHR variability-MMR, and weight of baby were important values in predict of fetal well-being. CONCLUSIONS: In conclusion, there are close relation in each variable of FHRand fetal outcome. The result of this study would be useful background data in the development of objective and automated FHR analysis software, especially in the computerized FHR analysis system.

Multivariate Analysis of Variables Affecting on Fetal Heart Rate / 대한산부인과학회잡지

OBJECTIVE: We aim to statistically analyze the variables affecting FHR using principal component analysis and multiple regression analysis. It is tried to find which variables significantly affect FHR. Thus, it would help further work of building objective decision basis to analyze variables affecting FHR. METHODS: The samples are chosen from pregnant women who took a NST at Hanyang University Hospital. It consists of 5,314 data which have been collected from 1989 to 1997. For collection of data and values of each variable, our own FHR interpretation softwares, HYFM-I (DOS version, since 1989) and HYFM-II (Windows version, since 1998) were used. Then, the principal component analysis is performed to find significant variable and multiple regression analysis is performed using these variables. RESULTS: The mean baseline FHR is not influenced by a specific factor in abnormal group. The gestational week, loss of signal, variability, and 5 minutes Apgar score are chosen as main effects through principal component analysis. From the results of regression analysis, it is noticed that 5 minutes Apgar score which is one of neonate prognosis after birth causes an increase of estimated FHR score (EFS), whereas the loss of signal causes a decrease of EFS. The variability in normal group is more active increasing factor of EFS than abnormal group. CONCLUSIONS: Based on gestational week, 5 minutes Apgar score is highly related with fetal maturity in both normal and abnormal groups. Also, it is found that different patterns of each variable by groups are due to delay of fetal growth that is caused by disease of a pregnant women. Thus, the further studies to build objective decision basis are need.