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Using multivariate analysis on multielemental data.

In the search for correlation between elements or among the analyzed samples, much time and effort can be devoted to the examination of multielemental data when the elements are taken two at a time, especially when the number of analyzed elements is relatively large. By representing the samples as points in an n-dimensional space, in which the coordinates are proportional to the elemental content, an overall view of all the available information may be obtained by visualization of the interrelationships among the points through several of the multivariate analysis methods that have been described. Such visualization is a useful step in the classification of samples into groups, particularly so when no a priori group criteria existed. The true significance of the grouping often becomes evident when other known information is superimposed on the multielemental analysis plots. Indeed, though it is not an essential part of the evaluation process, the importance of visualization of multiparameter data has been stressed most strongly(10), because in this way, the area for further intensive statistical analysis can be clearly demarcated.

Analysis of Variance↗

Independence of the prognostic value of tumor suppressor protein expression in ovarian adenocarcinomas: A multivariate analysis of expression of p53, retinoblastoma, and related proteins.

Accurate estimation of prognosis of ovarian cancer is difficult. For this report, in a group of 73 patients with ovarian adenocarcinomas, clinical factors and protein expression status of p53, retinoblastoma (Rb), and related proteins were evaluated for potential prognostic values. Clinical factors included FIGO stage, age, histopathologic type, and protein expression of p53, Rb, MDM2, p14ARF, p21WAF(1)/CIP(1) was determined by an immunohistochemical technique. Univariate Cox proportional hazard regression analysis was used to determine the significant prognostic value of FIGO stage (P < 0.0001), p53 status (0.0021), and patient age (P = 0.0255), and we report here, for the first time, the significant (P = 0.0072) prognostic value of Rb status. Histopathologic type and MDM2, p14ARF, p21WAF(1)/CIP(1) status did not show any prognostic value. To examine further the independence of prognostic values, we next applied multivariate analysis: We found that FIGO stage (P < 0.0001) and p53 status (P = 0.0108) were independent prognostic factors, while age and Rb status were not. Independence of prognostic value of p53 has heretofore been controversial, but we found a definite independent prognostic value for p53 status in ovarian adenocarcinomas. We also found that selection of appropriate antibodies for immunohistochemistry was essential to obtain significant results. We used five kinds of antibodies for p53 immunolocalization, and correlation with prognosis was obtained by three of these with different grades of statistical significance.

Adenocarcinoma↗

Reasons for failure of glyceryl trinitrate treatment of chronic fissure-in-ano: a multivariate analysis.

PURPOSE: Although glyceryl trinitrate ointment has become the first-line treatment for chronic anal fissure, healing rates are lower than after lateral internal sphincterotomy. The purpose of this study was to identify which factors are associated with treatment failure of glyceryl trinitrate ointment. METHODS: All patients who presented with chronic anal fissure from March 1997 to November 1998 were treated with 0.2 percent glyceryl trinitrate ointment. They were prospectively evaluated until healing or lateral internal sphincterotomy occurred, and long-term follow-up was obtained by standardized telephone questionnaire. A Cox model multivariate analysis was used with seven variables to determine significant factors related to healing. RESULTS: Sixty-four patients (42 men and 22 women; mean age, 37.5 years) with chronic fissure-in-ano were treated with 0.2 percent glyceryl trinitrate ointment. Sentinel piles were observed in 19 patients (29.7 percent). Twenty-six patients (40.6 percent) were healed initially, but 12 (46.2 percent) experienced recurrence. Mean follow-up time was 15.6 (+/-5.5) months. Twenty-nine patients (45.3 percent) had known risk factors for anal fissure, including constipation (n = 21; 32.8 percent), recent childbirth (n = 6; 9.3 percent), colonoscopy (n = 1; 1.6 percent), and anoreceptive intercourse (n = 1; 1.6 percent). Fissures were significantly less likely to heal initially (P < 0.05), more likely to recur (P < 0.05), and more likely to remain unhealed in the long term (P < 0.05) in the presence of a sentinel pile. Fissures with a history of more than six months were less likely to heal initially (P < 0.05). CONCLUSION: The presence of a sentinel pile adversely affects the outcome of treatment of chronic anal fissures with glyceryl trinitrate ointment, and a long history of the fissure reduces the rate of initial healing. Reasons for these findings are discussed.

Administration, Topical↗

Multivariate analysis of diaphragm EMG power spectral moments.

A single derived index of the power spectrum of the diaphragm electromyogram (EMG) has been used in detecting fatigue. Additional information in the EMG could be used to study diaphragm function in other respiratory conditions. Diaphragm EMGs and calculated power spectra at 12 frequencies were measured in normal subjects and patients with severe chronic obstructive pulmonary disease during several respiratory maneuvers both before and after treadmill exercise to dyspnea. The power spectra were characterized by the first five moments. Changes in the EMG were similar when assessed by multivariate analysis of variance of the spectral estimates or of the moments. Factor analysis provided two latent variables that correlated with the first and second moment respectively. The first moment was found to be the most sensitive single discriminant of fatigue and is only slightly improved by adding other information. It is concluded that the first and second moments of the EMG power spectra provide a concise, parsimonious description of the changes in the EMG.

Adult↗

Multivariate analysis of Hodgkin's disease prognosis. Fitness and use of a directly predictive equation.

The main purpose of this work is to give methodologic details and further verification regarding the predictive system recently elaborated for Hodgkin's disease (HD) patients, by which, under standard accuracy and conventional treatment, patient survival can be directly estimated (within a given confidence interval) when six of the best prognostic factors are suitable computed. The factors are, in decreasing order of importance, erythrocyte sedimentation rate (ESR), clinical stage, histologic subtype, age, serum albumin and sex. They were selected on the basis of a multivariate analysis applied to the exponential model for survival time distribution that proved to fit the original data from 586 HD patients accurately. A linear equation with these six variables was elaborated to calculate the estimated mean (or median) survival time or the estimated probability of surviving a given time. In the present work the validity of that estimate was successfully checked on a new external group of 261 patients, observed at the University of Bologna. Staging and treatment of these patients were similar to those in the Pavia series, the only exception being the combined radiochemoterapeutic treatment in patients presenting the nodular sclerosis histologic subtype and early clinical stage. A very good agreement was found between estimated survival (according to the Pavia data) and observed survival (in the Bologna series) for patients with any combination of the six prognostic factors, except those including nodular sclerosis and early stage. In these patients the observed survival exceeded that expected. These results demonstrate that (a) the choice of the six prognostic factors and the statistical weight allotted them were correct, and (b) the predictive system is sensitive to effective therapy modifications, which can be identified even in selected patient subsets of a general series. Thus, this prognostic equation can really be a powerful tool in clinical HD research. Explicative notes for the correct use of the predictive equation, together with an example, are reported in the Appendix.

Female↗

Multivariate analysis suggests improved perioperative outcome in Crohn's disease patients receiving immunomodulator therapy after segmental resection and/or strictureplasty.

BACKGROUND: Medical management of moderate to severe Crohn's disease (CD) using immunomodulator agents has not eliminated surgical treatment of disease complications. The effect of improved medical treatment on perioperative CD surgical outcome is not known. We analyzed the impact of immunomodulator therapy on the rate of intraabdominal septic complications (IASC) in CD patients undergoing bowel reanastomosis or strictureplasty. METHODS: Surgical outcome was reviewed in 100 consecutive CD patients who underwent segmental resection with primary anastomosis or strictureplasty between 1998 and 2002. Multivariate analysis was performed to determine the effect of immunomodulator therapy on rate of IASC (intraabdominal abscess, anastomotic leak, or enterocutaneous fistulae). Immunomodulator agents included azathioprine, 6-MP, methotrexate, and infliximab. RESULTS: IASC developed in 11 of 100 (11%) operations. Immunomodulator use was associated with fewer IASC (4/72 procedures; 5.6%), compared with 7/28 (25%) cases with patients not on therapy (P<.01). IASC were not influenced by steroid use, smoking status, preoperative abscess, or fistula or albumin levels. Immunomodulator use did not affect the length of resection or the rate and number of strictureplasties. CONCLUSION: Medical management with immunomodulator therapy is safe and significantly decreases postoperative IASC in CD patients undergoing surgical procedures requiring bowel anastomosis or strictureplasty.

Abdominal Abscess↗

Prognostic factors of adult metastatic renal carcinoma: a multivariate analysis.

In order to define the prognostic factors for metastatic renal carcinoma, we reviewed 134 patients who were treated from 1971 through 1986. Survival rates were 72, 45, and 25% at 6, 12, and 18 months, respectively. Seventeen variables were tested using the logrank test. Improved survival was correlated with normal performance status, and an absence of fever, weight loss, hepatic metastasis, and lung metastasis (or, if lung metastasis was present, less than 2 cm in diameter and limited to one site), a disease-free interval, sedimentation rate less than 100, and renal surgery. Four variables retained significant value in the multivariate analysis: hepatic metastasis, lung metastasis, disease-free interval, and a variable combining the sedimentation rate and the weight loss (SWRL). Predictive survival rates based on these variables were calculated from the Cox model. Six subgroups of patients were identified. The estimation of survival is clinically of value for future phase II trials of chemotherapy in patients with adult metastatic renal carcinoma.

Adolescent↗

Univariate and multivariate analysis of associated factors of retinopathy in 894 Italian adult diabetics.

The prevalence of diabetic retinopathy and the evaluation of its risk factors is poorly known in Italian population. Therefore, we have studied 894 diabetic outpatients (420 males, 474 females, 27.6% IDDs, 38.1% insulin-treated) in order to investigate the effect of clinical and metabolic characteristics on the frequency of diabetic retinopathy, classified into six different classes. In univariate analyses age, duration of disease, systolic and diastolic blood pressure, blood urea nitrogen, 24 hr proteinuria and fasting glycemia significantly correlated (p less than 0.001) with severity of retinopathy. The significance was confirmed in multivariate analysis for duration, age and systolic blood pressure (p less than 0.001). Stratification by type of diabetes showed that undefined onset of diabetes probably reduced in NID patients the power of duration as an associated factor of retinopathy. Worsening of this complication in three clinical classes of therapy (diet, oral and insulin-treatment) is evident too. Finally, our 11 variables in the step-wise multiple-regression analysis explain only 16.8% of diabetic retinopathy in all patients, but 36.6% in selected ID subjects.

Adolescent↗

Factors associated with failure in managing pelvic sepsis after ileal pouch-anal anastomosis (IPAA)--a multivariate analysis.

BACKGROUND: Pelvic sepsis is known to cause a detrimental outcome after ileal pouch-anal anastomosis (IPAA). The aim of this study was to examine potential factors associated with failure in managing pelvic sepsis after IPAA. METHODS: We performed univariate and multivariate logistic regression analysis on 2518 IPAA patients between 1983 and 2005. Failure was defined as pouch failure, the need for a permanent ileostomy, or mortality as a result of sepsis. There were 157 patients (6.2%) with pelvic sepsis after IPAA. These involved anastomotic leak 34% (54/157) and fistula 25% (40/157). There were 5 mortalities related to sepsis. Mean age at surgery was 38.1 +/- 14.4 years and mean follow-up was 5.5 +/- 4.7 years. RESULTS: Pouches were saved in 75.8% patients. Univariate analysis identified early sepsis (P = .040), preoperative steroid use (P = .007), and need for percutaneous drainage (P = .004) as significant factors associated with treatment success. Factors associated with failure were hypertension (P = .026), hand-sewn anastomosis (P = .038), associated fistula (P = .0003), need for transanal drainage (P = .0002), need for laparotomy to control septic complications (P < .0001), delayed ileostomy closure (P = .0003), and need for a new diverting ileostomy (P < .0001). By using multivariate analysis with selected covariates, significant factors associated with failure were associated fistula (P = .0013), need for transanal drainage (P = .003), delayed ileostomy closure (P = .022), need for a new ileostomy diversion (P = .004), and hypertension (P = .039). We developed a predictive scoring system for failure to use in management plans and decision-making for the treatment of septic complications of IPAA. CONCLUSIONS: Pelvic sepsis after IPAA has a significant impact on pouch failure. This predictive model for failure may play an important role in providing risk estimates for successful outcomes.

Abdominal Abscess↗

Carcinoma of the intact uterine cervix treated with radiotherapy alone: a French cooperative study: update and multivariate analysis of prognostics factors.

PURPOSE: To determine independent prognostic factors in a group of 1875 patients with invasive carcinoma of the intact uterine cervix treated with radiotherapy alone in a French cooperative study from 1970 to 1993. MATERIALS AND METHODS: Patients were staged according to the UICC-FIGO and MDAH substaging. The distribution per FIGO stage was Ia-Ib: 25.5%; IIa: 12%; IIb: 29%; IIIa: 5%; IIIb: 25%, and IV: 3.5%. Ninety-two percent had squamous cell carcinoma. The maximum diameter of the clinically detectable cervical disease was less than 3 cm in 24.5% of Stages I-II and in 10% of Stages III-IV, more than 5 cm in 13.5% of Stages I-II, and in 16% of Stages III-IV. Nodal involvement was shown on lymphangiogram in 16% of Stages I-II and in 32.5% of Stages III-IV. RESULTS: 1) Univariate analysis of Stages I and II: stage, cervical disease diameter, and nodal involvement are significant prognostic factors. Five-year specific survival rate (5ySS) is 83.5% in Stage Ib, 81% in IIa and 71% in IIb. Five-year disease-free survival rate (5yDFS) is 86% in tumors less of 3 cm, 76% in tumors of 3 to 5 cm, and 61.5% in tumor larger than 5 cm. Lymphangiogram strongly influences the 5-year pelvic disease-free survival rate (5yPDFS): respectively, 90% in nonpositive lymphangiogram vs. 65% when positive. A significant drop in specific and disease-free survival is observed (10 and 14%, respectively (p = 0.04) when comparing adenocarcinoma and squamous cell carcinoma. Age is a significant prognostic factor for specific survival because patients aged less than 30 years old have 91% vs. about 75% for patients over 30 years (p = 0.03). 2) Univariate analysis of Stages III-IV: Stage and positive lymphangiogram are predictive factors for relapse and death. The MDAH substaging is more reliable to predict the probability of pelvic disease-free survival in Stage III. At 5 years, the FIGO Stages IIIa and IIIb have a rather similar PDFS (65% vs. 59%). Conversely, the difference of survival rates between MDAH Stage IIIA and Stage IIIB is more demonstrative (69% vs. 47.5%). 3) Multivariate analysis (Cox P. H. R. model). Nodal involvement and stage remain significant for all three models in all stages (p < 0.0001). Age above 70 years influences specific survival for Stage I-II (p = 0.01). Tumors larger than 5 cm and adenocarcinoma also appear to be independent prognostic factors for specific and disease-free survival in Stage I-II (p = 0.05 and p = 0.005, respectively). CONCLUSIONS: The relevance of tumor size (less or greater than 4 cm) is now recognized in the 1995 revised FIGO staging in Stage Ib but unfortunately not in other stages. Tumor size per stage and nodal status should be systematically recorded to allow a better prediction of failure rates and to compare literature reports.

Adenocarcinoma↗

DYS19 and DYS390 Y-STR polymorphism in the Iberian Peninsula: a multivariate analysis.

Genetic polymorphism of two Y-specific short tandem repeats (DYS19 and DYS390) was investigated in six populations from the Iberian Peninsula (Andalusia, Castilla-La Mancha, Castilla-Leon, Extremadura, Galicia and South East Spain) comprising a total of 895 unrelated and native individuals, and a complete database of DYS19 and DYS390 allele frequency distributions in 34 world-wide populations collected from literature was analysed. DYS19 and DYS390 polymorphism was screened by automated fluorescence analysis of PCR-amplified labelled sample fragments performed with and ABI PRISM 377 Genetic Analyser. The degree of population differentiation was analysed using the STP Test to calculate G Statistic values. Correspondence Analysis based on the allelic frequencies of each locus and combining both was performed using the NTSYS-PC version 1.70 computer package. The diversity of the genetic profiles of gene frequencies suggests an important population heterogeneity in the Iberian Peninsula as a whole (DYS390 being particularly evident), which is corroborated after statistical analyses (G = 139.8457, p = 1.7822 x 10(-14) for DYS19, G = 116.0293, p = 4.6845 x 10(-12) for DYS390). However, multivariate analysis indicates a well defined cluster of the populations of the Central region, and sets them apart from the positions within which peripheral Iberian Peninsula populations are distributed. The Galician population shows trends which bring it closer to the positions throughout which European Atlantic populations are distributed. The results shown by the Central Iberian Peninsula seem to lend support to a model of settlement population stocks which came from the region of Castilla-Leon after the Islam invasions, whereas in the South-East populations the genetic record of Middle Eastern populations is still present, a consequence of the expansion of Islam in Southern Europe in the Middle Ages.

Alleles↗

Prognostic factors in patients with advanced gastric cancer treated by noncurative resection: a multivariate analysis.

BACKGROUND/AIMS: The relationship between prognostic factors and survival time after noncurative gastric resection in patients with advanced gastric cancer was examined by a retrospective review of data on 364 patients. METHODOLOGY: There were 168 patients without metastasis to the liver or peritoneum (group A), 127 with peritoneal metastasis and no liver metastasis (group B), 50 with liver metastasis and no peritoneal metastasis (group C) and 19 with synchronous liver and peritoneal metastases (group D). Patients were primarily treated with the following 3 drugs: the fluorinated pyrimidines, cisplatin, and mitomycin C. RESULTS: Patients in group D had a very poor prognosis as compared with the other groups. Multivariate analysis using the Cox's proportional hazard model adjusted for sex, age, and other covariants indicated that lymph node metastasis, lymph node dissection, and fluorinated pyrimidines for group A, cisplatin for group B, and lymph node dissection for group C were independent prognostic factors. An analysis of patients excluding cases who died within 30 days after surgery revealed that lymph node dissection for group A, lymph node dissection and cisplatin for group B, and lymph node dissection for group C were independent prognostic factors. CONCLUSIONS: Treatment protocol specific for the residual disease may improve the survival of patients with advanced gastric cancer treated by noncurative resection.

Aged↗

Inflammatory breast cancer. Determination of prognostic factors by univariate and multivariate analysis.

Between January 1977 and June 1983, 64 consecutive patients were treated for unilateral inflammatory nonmetastatic breast cancer. Our protocol included three or four courses of induction chemotherapy, then locoregional irradiation therapy with Co-60, followed by maintenance chemotherapy only if induction chemotherapy had proven effective. Eight patients with a residual tumor after radiotherapy underwent a modified radical mastectomy. Actuarial 3-year overall survival for the whole group was 38%, and the median disease-free survival time was 19 months. The effect of 17 factors on overall survival or disease-free survival was analyzed. With univariate analysis, eight factors were found to affect overall survival or disease-free survival: extent of initial erythema, size of initial edema, lymph node involvement, erythema present at the end of initial chemotherapy, erythema present at the end of radiotherapy, tumor size at the end of induction chemotherapy, residual breast tumor at the end of maintenance chemotherapy, and performance of a radical mastectomy. Age at diagnosis, menopausal status, type of chemotherapy, and date of appearance of inflammatory signs did not influence prognosis. Multivariate analysis using the Cox proportional hazard model isolated three bad prognosis factors: erythema involving the whole breast at initial diagnosis, erythema present at the end of initial chemotherapy, and lymph node involvement.

Actuarial Analysis↗

Stratified multivariate analysis of prognostic markers in breast cancer: a preliminary report.

Published results using prognostic markers in breast cancer have been very confusing to oncologists, surgeons, and pathologists alike. As a result, there is a wide variation in opinion among oncologists about the utility of these markers in clinical practice. This study was undertaken to determine the utility of stratified multivariate survival analysis in integrating the commonly used prognostic factors into a user-friendly prognostic scheme, and its implication for treatment decision making. 300 women with invasive ductal carcinoma of the breast who were followed-up for 28-112 months (median 72 months) were entered in the study. Patients with distant metastases, those with bilateral or multifocal tumors, and special types of carcinoma were excluded. Variables included in the stratified multivariate survival analysis were estrogen receptor (ER) status, tumor size, nodal status, histological grade, number of mitotic figures per ten high power fields (MF/10HPF), and type of initial therapy. Data was subjected to Kaplan-Meier survival analysis and the log rank test for statistical significance at different steps of the analysis. Cut-off values for ER that produced a significant difference in survival varied from 9 fmol/mg protein to as high as 76 fmol/mg protein in different patient groups, and MF/10HPF varied from 6 to 21. Patients were stratified into different groups that enabled better evaluation of treatment outcome. Patients could also be combined into three groups with significantly different survival rates (p < 0.0001). Stratified multivariate survival analysis show that prognostic markers a) are interdependent, and their cut-off values vary depending on other tumor characteristics, and b) if used in a systematic way, they can be used to guide treatment decisions.

Adult↗

Advanced methods in meta-analysis: multivariate approach and meta-regression.

This tutorial on advanced statistical methods for meta-analysis can be seen as a sequel to the recent Tutorial in Biostatistics on meta-analysis by Normand, which focused on elementary methods. Within the framework of the general linear mixed model using approximate likelihood, we discuss methods to analyse univariate as well as bivariate treatment effects in meta-analyses as well as meta-regression methods. Several extensions of the models are discussed, like exact likelihood, non-normal mixtures and multiple endpoints. We end with a discussion about the use of Bayesian methods in meta-analysis. All methods are illustrated by a meta-analysis concerning the efficacy of BCG vaccine against tuberculosis. All analyses that use approximate likelihood can be carried out by standard software. We demonstrate how the models can be fitted using SAS Proc Mixed.

BCG Vaccine↗

Sedentism, seasonality, and economic status: A multivariate analysis of maternal dietary and health statuses between pastoral and agricultural Ariaal and Rendille communities in northern Kenya.

This paper examines longitudinal data to assess the effects of the recent transition from pastoralism to sedentary agriculture for Ariaal and Rendille mothers in northern Kenya. Dietary, morbidity, and anthropometric data resulting from bimonthly repeated surveys of the pastoral community of Lewogoso and the sedentary agricultural community of Songa, covering the period from September 1994-July 1995, were used to test two hypotheses: 1) that sedentism is associated with changes in diet, seasonality, morbidity, and socioeconomic differentiation, and 2) that these changes affect maternal body composition. The first hypothesis is partly supported, with starch replacing milk in the sedentary diet. Repeated-measures multivariate analysis of variance revealed no seasonal effects for diet in the agricultural sample, while starch consumption was significantly affected by seasonality for the pastoral sample. The agricultural community also featured economic dietary disparities favoring wealthier mothers, while no such effect was found in the pastoral community. However, no seasonal or economic effects were found for morbidity patterns in either sample. The second hypothesis is also partially supported, as a generalized estimating equations analysis revealed differences in the way diet and economic strata influence maternal anthropometric values. Economic status was significantly associated with maternal arm-fat area in Lewogoso. Milk was a significant factor associated with maternal weight and arm-muscle area in Songa. These findings are discussed in light of development policy implications.

Adipose Tissue↗

Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma. A multivariate analysis, report of 106 cases, and review of the literature.

The authors have reviewed 106 cases of primary gastrointestinal non-Hodgkin's lymphoma (GI-NHL) treated at the Institut Gustave-Roussy (IGR), France, between 1975 and 1986. The occurrence was 55 in the stomach, 26 in the small intestine, ten ileocecal, seven in the large intestine, and eight patients had multiple involvement. Patients were clinically staged according to the Ann Arbor staging system using the modification of Musshoff for Stage IIE. All histologic material of the 106 patients were reviewed and graded according to the Working Formulation (WF) and the Kiel classifications. Most patients received combination chemotherapy as part or all of their primary treatment program (95 patients, 90%). Seventy five patients (71%) had a multimodality treatment. The overall 5-year survival rate was 60%. Sixteen variables were tested by univariate analyses for prognostic influence on survival. Of these, only clinical stage (P less than 0.001), the achievement of initial complete remission (CR) (P less than 0.001), erythrocyte sedimentation rate (ESR) (P = 0.01), mesenteric involvement (P = 0.03), and serosal infiltration (P = 0.05) were significant prognostic factors. Important variables were tested by a multivariate analysis using the Cox model taking into account different treatment modalities. Only three variables entered the regression analysis at a significant level: clinical stage (P = 0.02), surgical resection (P = 0.03), and histologic grade (Kiel) (P = 0.04). When the achievement of initial CR was introduced into the model, it was the most significant variable (P less than 0.001) whereas all other variables became nonsignificant except for the histologic grade (Kiel) (P = 0.004). Based on results of the multivariate analyses we propose two prognostic classifications of patients: one at the initial evaluation depending on clinical stage, surgical resectability, and histologic grade (Kiel); the other at the end of primary treatment depending on the achievement or not of CR and the histologic grade.

Adolescent↗

[A quantitative study of brain atrophy on computed tomography--multivariate analysis for comparison between the linear measurement method and the pixel count method].

We previously reported the newly developed quantitative measurement of the cerebral atrophy. The data indicated that the volume of the cerebrospinal fluid not always gradually increases during the life course but remains relatively constant until age 50 and thereafter increases with a wide variation. Though the technique, which is called the pixel count method, is highly quantitative, it is quite troublesome as it needs the computer to count out each pixels. On the other hand, the linear measurement method is easier than the pixel count method, but is far less quantitative. We examined seventy four subjects using both the linear measurement method and the pixel count method, and compared them by means of the multivariant analysis. Three different linear measurement methods were selected by the stepwise multiple regression analysis, those are B (distance between the caudate nuclei), E (greatest distance between the lateral ventricles at the level of the cella media) and G (number of visible sulci whose width are more than 3.1 mm at the level of 3 cm above the corpus callosum). B and E were calibrated by the maximum internal width of the skull (H). The highest correlation was achieved with a formula employing these parameters as follows; y = 42.66 X B/H + 12.52 X E/H + 0.232 X G - 2.92 (y means the estimated value of the CCR (CSF-cranial ratio), which is obtained by dividing the CSF volume by the cranial cavity). Multiple correlation coefficient was 0.76, and was statistically significant (p less than 0.001). The authors emphasized that using this formula we can easily predict CCR as the index of the brain atrophy without any computer.

Adult↗