공간정보 역학

1. 공간정보(GIS) 기반의
MULTI-NATIONAL
MORTALITY DATA 및 다변량
데이터 탐색적 분석 기법
Namkug Kim, PhD
Medical Imaging & Robotics Lab.
Dept. of Convergence Medicine/Radiology
University of Ulsan College of Medicine
Asan Medical Center
South Korea

2. Arterial Oxygen Saturation in Tibetan and
Han Infants bone in Lhasa
4NEJM, 1995

3. Suicide vs Altitude
5
Utah/Statistical claims/Suicide rate among Mormons, 2007

4. Suicide vs Altitude
High attitude
sickness or Mild
Hypoxia
↑ Depression
↑ Suicide
Why? Any Brain
Metabolites
change?
Kim N, et al, AJP, 2011 Jan.
Boston
(sea level)
Salt lake city
(1280m)
• Schema
• Age Adjusted Suicide Rate (CDC Wonder)
• Unemployment Rate (90-08)
• Averaging 90-98
• Historical Comparability of Local Area Unemployment
Statistics (LAUS) Data by Bureau of Labor Statistics
• Mean altitude
• Arc-GIS from County Boundary (US Census,
NASA STRM)
• Latitude/Longitude
• Arc-GIS from County Boundary
• Population Density / County Area (sqrt miles)
• 1990-98 from CDC Wonder/ Arc-GIS from County
Boundary (US Census, NASA STRM)
• Per capita income (1969-2007)
• Averaging 90-98
• Bureau of Economic Analysis
• Gun Ownership
• State basis
• Behavioral Risk Factor Surveillance System (BRFSS).

5. 7
1999-2001 Definition: Figure D1. ALABAMA

6. 8J Addict Med 2012;6: 166–171

7. 9

8. 10Geospatial Health, 2014 Nov., In Press

9. Mortality Micro-data : USA
USA : CDC
Wide-ranging Online Data for Epidemiologic
Research
Birth, Environment, Mortality, Population, …
Mortality Data (68-11)
Online/Offline
Schema
– Month of Death/Sex/Race/Age*/Date/Marital status/Hispanic
origin/Education/….
– Address(FIPS)* : ZIP, Census, County, State
– GIS (530 counties, 1982-1988 )
» Altitude/ Latitude / Longitude
– Cause of Death (ICD-9/10)**
11*Address Screening **Age adjust

10. Area Resource File (ARF), etc
U.S. Department of Health and Human Services
Health Resources and Services Administration
ASCII file, 2010 103MB
12

11. Mortality Micro-data : Others
Korea
통계청
사망원인통계 Raw 데이터 CD 판매 (98~13)
국가통계포털 : 국내통계, 지역 통계로 Access(http://kosis.kr)
– 250 counties (Si, Gun, Gu)
– County (Si, Gun, Gu) based 50 causes of death (2005~2013)
Japan
E-Stat, Portal Site of Official Statistics of Japan, http://www.e-
stat.go.jp/
System of Social and Demographic Statistics(SSDS) ,
Statistics Bureau, Ministry of Internal Affairs and Communications
Swiss
Swiss Federal Statistical Office FSO
Since 1969
Chile
Instituto Nacional de Estadisticas
Italy
CDC EPI Info Data
92 counties
20 provinces
China
Suicide rates in China, 1995—99 Lancet 2002
Woman suicide
14
Chile
05
1015
SuicideRate
-100 0 100 200 300
Min Altitude(m)
Suicide_rate Fitted values
Italy

12. Elevation Data : DEM
15

13. DEM + County Boundary
Alaska : USGS DEM + County
Boundary
SWISS, STRM 90m
Korea/Japan, STRM 90m, Boundary
Italy 94 counties

14. USA maps
Magnetic anomaly maps
Bouguer gravity anomaly map
Aeroradiometric map : Radioactivity and Gamma-ray Exposure
potassium percentage, uranium and thorium ppm
National Geochemical map
Climate
Rainfall, daylight, humidity, Solar radiation, …
Geology map
Magnetic anomaly mapsSelenium maps
Solar radiation map

15. 0 2 4 6 8 10 12
0
500
1000
1500
2000
Month
TotalSuicideNumber
Monthly Suicide in Korea
0 2 4 6 8 10 12
200
400
600
800
1000
Month
TotalSuicideNumber/Year
2000~2008 Monthly Suicide in Korea
0 2 4 6 8 10 12
50
100
150
200
250
300
Month
SuicideNumber/Day
2000~2008 Monthly Suicide in Korea
2000
2001
2002
2003
2004
2005
2006
2007
2008
Total
Male
Female
Total
Male
Female
0 50 100 150 200 250 300 350 400
0
10
20
30
40
50
60
70
80
90
100
Day
SuicideNumber
Daily Suicide in Korea
Suicide Num/day
AhnDate
ChoiDate
0 10 20 30 40 50 60
0
100
200
300
400
500
600
Day
SuicideNumber
Weekly Suicide in Korea
Suicide Num/week
choiweek
ahnweek
WeekDay

16. Copycat; actress Choi Jinshil, 2008/10/2
Day Model
Regression
rsquare: 0.7005
adjrsquare: 0.6971
Week Model
Regression
rsquare: 0.9405
adjrsquare: 0.9351
0 10 20 30 40 50 60 70 80 90
-10
0
10
20
30
40
50
60
0 2 4 6 8 10 12 14
0
50
100
150
200
250
300
Week
Day

17. Copycat; Actress Lee Eunjoo, 2005/2/22
0 50 100 150 200 250 300 350 400
0
10
20
30
40
50
60
70
Day
SuicideNumber
Daily Suicide in Korea
Suicide Num/day
LeeDate
0 10 20 30 40 50 60
0
50
100
150
200
250
300
350
Week
SuicideNumber
Weekly Suicide in Korea
Suicide Num/week
leeweek

18. Copycat; Businessman
JeongMongHun,2003/8/4
0 50 100 150 200 250 300 350 400
0
10
20
30
40
50
60
70
Day
SuicideNumber
Daily Suicide in Korea
Suicide Num/day
mongdate
0 10 20 30 40 50 60
0
50
100
150
200
250
300
350
Day
SuicideNumber
Weekly Suicide in Korea
Suicide Num/week
mongweek

19. Spatial-Temporal Analysis
27
Suicide rate / 100,000, Regional

20. 31Depress Res Treat. 2011
31P MRS1H MRS

21. Mild Hypoxia Animal Exp.
-Controlled study 모델 : Mild Hypoxia vs Normal controls
-저산소증 동물 모형 : 산소 농도 10%, Baseline, 1주, 2주, 3주 followup scan
-MRS SVS scan 부위 : parietal, pons, prefrontal, thalamus
Metabolite Water NAA Cr Cho Lactate
Parietal 1.391E6 2.031 3.072 3.348 2.66
Pons 1.074E6 2.015 3.088 3.125 2.69
Prefrontal 1.145E6 2.057 3.832 3.752 2.16
Thalamus 1.262E6 2.215 2.954 3.112 2.52
32

22. Acknowledgements
• MIRL, Dept. of Radiology, Asan Medical Center
– Director : JoonBeom Seo(MD,PhD), Namkug Kim (PhD), Sangmin Lee (MD) , Donghyun Yang (MD)
– Postdoc research fellow:, Dongjin Han (PhD), Yongjun Chang (PhD), Daekwan Kim (PhD), Anjan Kumar Paul
(PhD)
– Researcher : Jangpyo Bae (PhDc) , Minho Lee (PhDc), Joonho Jung (PhDc), Jongsoo Kim (BS), Kyesam Jung
(MS), Taekjin Jang (BS)
– Research Nurse : Junghye Kang
– Radiographer : Jooyoung Park, Youngsin Kim, Heejun Park, Songyi Baek, Koeun Lee, Eunjin Park, Haekang
Kim
– Management : Seongsuk Kim, Sunhee Lee, Dajung Kim, Hyunjung Ahn,
• Clinical Collaborators, Asan Medical Center
– Radiology : Joon beom Seo, Sangmin Lee, Donghyun Yang, Hyungjin Won, Seungsoo Lee, Joohee Cha,
Hyuckjae Choi, Sangjoon Kim, Hosung Kim, Deokhee Lee, Hyunwoo Goo, Jinsung Lee, Heungkyu Ko, Dongil
Kwon, Junghwan Baek
– Neurology :Dongwha Kang, Chongsik Lee, Jaehong Lee, Sangbeom Jun, Misun Kwon, Beomjun Kim
– Cardiology ; Younghak Kim, Jongmin Song
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