• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.719-722
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• 2015

Objective: To evaluate the values of 4 tumor markers in serum and ascites and their ascites/serum ratios in the identification and diagnosis of benign and malignant ascites. Materials and Methods: A total of 76 patients were selected as subjects and divided into malignant ascites group (45 cases) and benign ascites group (31 cases). Samples of ascites and serum of all hospitalized patients were collected before treatment. The levels of carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), cancer antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were detected by chemiluminescence (CLIA). Results: CEA, AFP and CA19-9 in both serum and ascites as well as CA125 in ascites were evidently higher in the malignant ascites group than in the benign ascites group (P<0.01). Malignant ascites was associated with elevated ascites/serum ratios for AFP and CA125 (P<0.01). The areas under receiver operating characteristic (AUROCs) of CEA and CA125 in ascites and the ratios of ascites/serum of AFP, CEA, CA125 and CA19-9 were all >0.7, suggesting certain values, while those of ascites CA19-9 and serum CEA were 0.697 and 0.629 respectively, indicating low accuracy in the identification and diagnosis of benign and malignant ascites. However, the AUROCs of the remaining indexes were <0.5, with no value for identification and diagnosis. Compared with single index, the sensitivity of combined detection increased significantly (P<0.05), in which the combined detection of CEA, CA19-9 and CA125 in ascites as well as the ratio of ascites/serum of CEA, CA19-9, CA125 and AFP had the highest sensitivity (98.4%) but with relevantly low specificity. Both sensitivity and specificity of combined detection should be comprehensively considered so as to choose the most appropriate index. Conclusions: Compared with single index, combined detection of tumor markers in serum and ascites can significantly improve the diagnostic sensitivity and specificity.

• Journal of the Korean Society of Propulsion Engineers
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• v.16 no.2
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• pp.25-33
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• 2012

A genetic algorithm (GA) has been employed to optimize the major design variables of the liquid rocket engine. Pressure of the main combustion chamber, nozzle expansion ratio and O/F ratio have been selected as design variables. The target engine has the open gas generator cycle using the LO2/RP-1 propellant. The gas properties of the combustion chamber have been obtained from CEA2 and the mass has been estimated using reference data. The objective function has been set as multi-objective function with the specific impulse and thrust to weight ratio using the weight method. The result shows about 4% improvement of the specific impulse and 23% increase of the thrust to weight ratio. The Pareto frontier line has been also obtained for various thrust requirements.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2011.11a
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• pp.127-134
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• 2011

A genetic algorithm (GA) has been employed to optimize the major design variables of the liquid rocket engine. Pressure of the main combustion chamber, nozzle expansion ratio and O/F ratio have been selected as design variables. The target engine has the open gas generator cycle using the LO2/RP-1 propellant. The gas properties of the combustion chamber have been obtained from CEA2 and the mass has been estimated using reference data. The objective function has been set as multi-objective function with the specific impulse and thrust to weight ratio using the weight method. The result shows about 4% improvement of the specific impulse and 23% increase of the thrust to weight ratio. The Pareto frontier line has been also obtained for various thrust requirements.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.747-751
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• 2015

Background: Stage III colon cancer patients demonstrate diverse clinical outcomes. The aim of this study was to develop a prognostic model in order to better predict their survival. Materials and Methods: From 2004 to 2010, 548 patients were retrospectively analyzed, among whom 328 were defined as the study group and the remaining 220 served as a validation group. Clinico-pathologic features, including age, gender, histological grade, T stage, number of positive lymph nodes, number of harvest lymph nodes, pretreatment carcinoembryonic antigen (CEA) levels and pretreatment neutrophil lymphocyte ratio (NLR), were collected. Kaplan-Meier survival curves were used to detect prognostic factors and multivariate analysis was applied to identify independent examples on which to develop a prognostic model. Finally, the model was further validated with the validation group. Results: Histological grade (p=0.002), T stage (p=0.011), number of positive lymph nodes (p=0.003), number of harvested lymph nodes (p=0.020), CEA (p=0.005), and NLR (p<0.001) were found as prognostic factors while histological grade [RR(relative risk):0.632, 95%CI (Confidence interval) 0.405~0.985, p=0.043], CEA (RR:0.644, 95%CI:0.431~0.964, p=0.033) and NLR (RR:0.384, 95%CI:0.255~0.580, p<0.001) levels were independent. The prognostic model based on these three factors was able to classify patients into high risk, intermediate and low risk groups (p<0.001), both in study and validation groups. Conclusions: Histological grade, pretreatment CEA and NLR levels are independent prognostic factors in stage III colon cancer patients. A prognostic model based on these factors merits attention in future clinical practice.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.22-28
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• 2016

Background: Carotid endarterectomy (CEA) with selective shunting is the surgical method currently used to treat patients with carotid artery disease. We evaluated the incidence of major postoperative complications in patients who underwent CEA with selective shunting under transcranial Doppler (TCD) at our institution. Methods: The records of 45 patients who underwent CEA with TCD-based selective shunting under general anesthesia from November 2009 to June 2015 were reviewed. The risk factors for postoperative complications were analyzed using univariate and multivariate analysis. Results: Preoperative atrial fibrillation was observed in three patients. Plaque ulceration was detected in 10 patients (22.2%) by preoperative computed tomography imaging. High-level stenosis was observed in 16 patients (35.5%), and 18 patients had contralateral stenosis. Twenty patients (44.4%) required shunt placement due to reduced TCD flow or a poor temporal window. The 30-day mortality rate was 2.2%. No cases of major stroke were observed in the 30 days after surgery, but four cases of minor stroke were noted. Univariate analysis showed that preoperative atrial fibrillation (odds ratio [OR], 40; p=0.018) and ex-smoker status (OR, 17.5; p=0.021) were statistically significant risk factors for a minor stroke in the 30-day postoperative period. Analogously, multivariate analysis also found that atrial fibrillation (p<0.001) and ex-smoker status (p=0.002) were significant risk factors for a minor stroke in the 30-day postoperative period. No variables were identified as risk factors for 30-day major stroke or death. No wound complications were found, although one (2.2%) of the patients suffered from a hypoglossal nerve injury. Conclusion: TCD-based CEA is a safe and reliable method to treat patients with carotid artery disease. Preoperative atrial fibrillation and ex-smoker status were found to increase the postoperative risk of a small embolism leading to a minor neurologic deficit.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.243-251
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• 2000

Purpose: This prospective study was performed to evaluate the usefulness of preoperative radioimmunoscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment. Materials and Methods: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioactivities from excised tumor and lymph nodes were also measured and compared with pathology. Results: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology Preoperative radioimmunoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it could not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity However, radioactivity from excised tumor was higher than normal rectum (T/B ratio; $3.47{\pm}2.25$). When excised lymph node activity/background activity ratio >1.5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. Conclusion: Radioimmunoscintigraphy using $^{99m}Tc-anti-CEA\;F(ab')_2$ has no additional value for preoperative staging and use of early RIGS using $^{99m}Tc-anti-CEA\;F(ab')_2$ is inappropriate. For early RIGS using $^{99m}Tc$ labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.83-92
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• 1988

The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.44-52
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• 2024

Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14-7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90-14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion: In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.185-188
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• 2009

Purpose: Standard of retests were discrepant and inconsistent due to inaccuracy and lack of standardization within normal range limit of tumor marker test. To enhance the standardization of retests set standard value below normal range and the Order Communication System Quality Control (OCS QC) program was put in place. This program enables managing the results within lower limit of normal range which were used for tumor marker test in Health Center. Materials and Methods: At present the tumor marker study for AFP, CEA, CA19-9, CA125, and PSA included outpatients in Asan Medical Center from February to March, 2009. The standard value was obtained by using the percentage of CV of Inter Assay according to the normal range of each tumor test. The results were confirmed by using the OCS QC program via formatted assessment of screening test such as test items, standard value and medical department. The number of out-of-range results within plus and minus 30 percents regarding the five primary items of tumor marker test was assessed. The next step was to obtain the number of AFP, CEA, and CA125 according to the ratio of comparison between prior and post test result, 60%, 50%, and 40% within normal range, respectively. In addition, set standard value below normal range. Results: The first screening test with percentage of sample number was resulted between 30%-40% and the second one was AFP 26.1%, CEA 18.9%, CA19-9 17.3%, CA125 18.7%, and PSA 21.0% obtained screening percentage of average 20 percents. The limited value of retest was AFP less than 5.0 and more than 10.0, CEA less than 1.0 and more than 3.0, CA19-9 less than 10.0 and more than 30.0, and PSA less than 1.0 and more than 2.0 to set and the number of retest was obtained by applying to the limited value of retest to screening percentage of average 20 percents For two months, the number of retest was AFP 0, CEA 15, CA19-9 3, CA125 2, and PSA 5. Conclusions: Through using the OCS QC program in establishing the standard of retest systemically, there appeared to be reduced discrepancy among the examiners and to be expected improvement in relation to the error of results.

• Journal of the Korean Society of Propulsion Engineers
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• v.15 no.6
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• pp.56-62
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• 2011

An experimental study on design of a catalytic ignitor was performed to use an ignition source for a small bi-propellant liquid rocket engine which use hydrogen peroxide and kerosene as propellants. In the catalytic ignitor, hot gas of hydrogen peroxide which was decomposed by a catalyst induced autoignition of kerosene. Mass flow rate and O/F ratio for the ignitor were calculated by CEA code. A combustion chamber which had a quartz window and thermocouples was manufactured to determine whether the ignition is successful. Ignition performance was investigated according to exit area of fixed rings and mixture ratio. Results showed that reliable ignition performance was achieved at non-choking exit area of fixed ring and O/F ratio of 6~8.