• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3451-3455
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• 2015

Objective: To explore the application of joint detection of serum AFP, CA19-9, CA125 and CEA in identification and diagnosis of cholangiocarcinoma (CC). Materials and Methods: The levels of serum AFP, CA19-9, CA125 and CEA of both 30 patients with CC and 30 patients with hepatocellular carcinoma (HCC) were assessed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic effects of single and joint detection of those 4 kinds of tumor markers for CC. Results: The levels of serum CA19-9, CA125 and CEA in CC patients were higher than that in HCC patients,whereas that of serum AFP was significantly lower s. The area under ROC curve of single detection of serum AFP, CA19-9, CA125 and CEA were 0.05, 0.86, 0.84 and 0.83, with the optimal cutoff values of 15.4 ng/ml, 125.1 U/ml, 95.7 U/ml and 25.9 ng/ml, correspondingly, and the percentage correct single diagnosis was <79%. With joint detection, the diagnostic effect of combined AFP, CA19-9, CA125 and CEA was the highest, with an area under the ROC curve of 0.94 (95%CI 0.88~0.99). Conclusions: Single detection of serum CA19-9, CA125 and EA is not meaningful. The sensitivity, specificity, the rate of correct diagnosis and the area under ROC curve of joint detection of AFP, CA19-9, CA125 and CEA are highest, indicating that the joint detection of these 4 tumor markers is of great importance in the diagnosis of CC.

• Clinical and Experimental Pediatrics
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• 제53권2호
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• pp.222-227
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• 2010

목 적 : 본 연구는 소아 요로 감염증에서 치료 전 발열 기간과 치료 후 발열 기간 등의 임상변수와 혈액 및 소변 등의 검사 결과가 신 실질 병변 및 방광요관 역류 등을 예측하는 데 있어서 인자로 작용할 수 있는지를 평가해 보고자 하였다. 방 법 : 2005년 7월부터 2008년 7월까지 첫 번째 열성 요로 감염으로 본원 소아과에 입원한 1개월부터 만 17세까지의 환아 180명을 대상으로 하였다. 환아의 혈액 검사 소견 중 C-반응 단백, 백혈구수와 소변 검사 중 배양 검사 결과, 소변 질산염 및 치료전 발열기간, 치료 후 발열 기간 등을 변수로 하여 신장 초음파 배뇨 방광, 요도 조영술, 신 스캔 등의 영상 검사 결과와 비교하여 연관성을 평가하였다. 결 과 : C-반응 단백 수치가 높고 백혈구 증가증이 있으며 입원 치료 후 긴 발열 기간을 가진 경우 신 실질 병변이 유의하게 증가하였고 3단계 이상의 방광 요관 역류 발생도 높았다. 신 스캔 검사상 이상 소견을 보인 경우는 신 스캔 검사상 정상 소견을 가진 군과 비교하였을 때 3단계 이상의 방광 요관 역류가 더 증가되어 있었다. 결 론 : C-반응 단백 수치, 백혈구 증가증, 입원 치료 후 긴 발열기간 등의 임상 변수는 신 실질 병변과 3단계 이상의 방광 요관 역류의 예측 인자가 될 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제43권1호
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• pp.25-32
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• 2010

배경: 혈관질환 환자는 관상동맥질환 및 심장질환을 많이 동반함으로 인하여 혈관 수술 후 잠재되어 있는 심장질환이 악화 또는 유발될 수 있는 가능성이 있다. 이러한 심장질환을 확인하기 위한 검사중 비교적 간단하고 비침습적인 SPECT 촬영에 대한 효용성은 아직 논란이 되고 있다. 본 연구에서는 수술 전 SPECT를 촬영하고, 그 결과에 따른 검사 및 처치들이 혈관 수술 후 심장 합병증 발생에 미치는 임상적인 효과를 평가하고자 한다. 대상 및 방법: 2004년 4월부터 2007년 9월까지 3년 6개월간 본 병원에서 혈관 수술 전 아데노신 부하 Tc-99m 테트로포스민 SPECT를 촬영한 63명의 환자를 대상으로 하였다. 결과: SPECT 촬영 유소견의 심장 합병증 발생 예측에 대한 민감도와 특이도는 각각 41.2%와 52.2%로 비교적 낮게 나왔다. 그러나 비정상적인 SPECT 촬영결과를 보인 환자에게 관상동맥 조영술을 시행하고 관상동맥 병변에 대한 비정상 소견이 있을 때 관상동맥 중재적 시술 및 관상동맥 우회로술 등의 적극적인 처치를 한 경우 심장 합병증의 발생률이 낮은 경향을 보였다. 결론: SPECT 촬영은 혈관수술 후 심장 합병증 발생위험을 예측하기 위한 선별검사로서 효용성이 떨어진다.

• 대한두경부종양학회지
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• 제15권1호
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• pp.46-51
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• 1999

Background: Total thyroidectomy and postoperative radiodiodine ablation therapy in differentiated thyroid carcinomas enhance the reliability of serum thyroglobulin(Tg) levels and radioiodine scan in detecting recurrence or distant metastasis. There have been, however, some limitations in using these methods under certain conditions. Recently, several reports have indicated that thyroid peroxidase(TPO) could be used as an alternative tumor marker. We aimed to estimate the significance of serum TPO levels in differentiated thyroid carcinoma. Materials and Methods: Forty-eight patients who had undergone total thyroidectomy due to papillary thyroid carcinomas and who had been followed-up for at least 3 years were classified into two groups: 27 patients without any evidence of recurrence in group 1; and 20 patients with recurrence or distant metastasis in group 2. All patients were examined by radioiodine scans. Serum Tg, TSH, antithyroglobulin antibody, and TPO were measured and the relationships were statistically analyzed. The sensitivity and specificity of $^{131}I$ scan, serum Tg, and serum TPO were evaluated. Results: Serum Tg levels were $3.81{\pm}5.16ng/mL$ in group 1 and $147.02{\pm}193.75ng/mL$ in group 2. Only 2 patients in group 1 showed Tg levels exceeding 10ng/mL. In contrast, 4 patients in group 2 were under 10ng/mL. Serum antithyroglobulin antibody and TSH levels showed no statistical difference between the two groups. In group 1, 16 patients showed negative serum TPO results, and 4 patients in group 2 showed negative results. There was no correlation among serum Tg levels, antithyroglobulin antibody titers, and serum TPO levels in each group. In group 2, 4 patients with negative serum Tg levels showed positive TPO results and positive whole body scans. Two cases with false negative $^{131}I$ scans showed positive serum TPO and Tg results. In 4 cases showing false negative serum TPO levels, serum Tg levels and $^{131}I$ scans were positive. Conclusion: Serum Tg levels, radioiodine scans, and serum TPO levels can be clinically used as complementary methods in the diagnosis of recurrent or metastatic thyroid carcinomas. Serum TPO levels may be helpful when other methods fail to detect recurrences or distant metastasis in highly suspected patients.

• 한국임상수의학회지
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• 제39권5호
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• pp.199-206
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• 2022

Postpartum diseases should be predicted to prevent productivity loss before calving especially in organic dairy farms. This study was aimed to investigate the incidence of postpartum metabolic diseases in an organic dairy farm in Korea, to confirm the association between diseases and prepartum blood biochemical parameters, and to evaluate the accuracy of these parameters with a receiver operating characteristic (ROC) analysis for identifying vulnerable cows. Data were collected from 58 Holstein cows (16 primiparous and 42 multiparous) having calved for 2 years on an organic farm. During a transition period from 4 weeks prepartum to 4 weeks postpartum, blood biochemistry was performed through blood collection every 2 weeks with a physical examination. Thirty-one (53.4%) cows (9 primiparous and 22 multiparous) were diagnosed with at least one postpartum disease. Each incidence was 27.6% for subclinical ketosis, 22.4% for subclinical hypocalcemia, 12.1% for retained placenta, 10.3% for displaced abomasum and 5.2% for clinical ketosis. Between at least one disease and no disease, there were significant differences in the prepartum levels of parameters like body condition score (BCS), non-esterified fatty acid (NEFA), total bilirubin (T-bil), direct bilirubin (D-bil) and NEFA to total cholesterol (T-chol) ratio (p < 0.05). The ROC analysis of each of these prepartum parameters had the area under the curve (AUC) <0.7. However, the ROC analysis with logistic regression including all these parameters revealed a higher AUC (0.769), sensitivity (71.0%), and specificity (77.8%). The ROC analysis with logistic regression including the prepartum BCS, NEFA, T-bil, D-bil, and NEFA to T-chol ratio can be used to identify cows that are vulnerable to postpartum diseases with moderate accuracy.

• Korean Journal of Radiology
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• 제23권6호
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• pp.664-673
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• 2022

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1142-1150
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• 2023

Objective: To evaluate ^99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (^99mTc-3PRGD₂) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms. Materials and Methods: We prospectively enrolled 26 patients with primary malignant lung tumors who underwent ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semiquantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard. Results: Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974). Conclusion: ^99mTc-3PRGD₂ SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8063-8067
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• 2014

Background: Cervical cancer is a major public health problem in Bangladesh. Persistence of high risk human papillomavirus (HRHPV) influences the progression of the disease, with an important role in followup for cervical intraepithelial neoplasia (CIN). Objective: To establish application of high risk HPV DNA test in the follow-up of women after treatment of CIN. Materials and Methods: This cross-sectional and hospital based study was carried out among 145 CIN treated women during the previous six months to three years at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, between January 2011 and June 2012. Pap smear and HPV samples were collected and colposcopy was performed to find out the persistence of the disease. Cervical samples obtained were tested for HPV DNA using the Hybrid Capture II (HC-II) test. A cervical biopsy was collected whenever necessary. The results were compared to assess the efficacy of different methods during follow up such as Pap smear, HPV test and colposcopy. Results: Mean age of the recruited women (n=145) was 33.6 (${\pm}7.6$), mean age of marriage was 16.8 (${\pm}2.9$) and mean age of 1st delivery was 18.8 (${\pm}3.5$) years. More than half had high grade CIN before treatment and 115 (79.3%) women were managed by LEEP and 20.7% were managed by cold coagulation. Among the 145 treated women, 139 were negative for HPV DNA and six of them (4.1%) were HPV positive. Sensitivity of Pap smear (40.0) and HPV DNA test (40.0) was poor, but specificity was quite satisfactory (>93.0) for all the tests. Conclusions: The high risk HPV DNA test can be an effective method of identifying residual disease. It can be added to colposcopy and this should be applied to all treated women attending for their first or second post-treatment follow-up visit at 6 months to one year, irrespective of the grade of treated CIN.

• 한국가정과교육학회지
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• 제28권3호
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• pp.79-88
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• 2016

패스트푸드는 간단한 조리를 거쳐 신속히 제공되는 음식으로 정의하고 있는데, 어떤 종류의 음식을 패스트푸드로 분류할 수 있는지, 패스트푸드와 패스트푸드가 아닌 음식을 구분하는 특징은 무엇인지 분명하지 않다. 본 연구는 선행 연구에서 패스트푸드로 제시한 14종 음식을 대상으로 패스트푸드의 인정 여부를 조사하였으며, 패스트푸드 인정 여부를 결정하는 패스트푸드의 특징에 대하여 조사하였다. 남 여 고등학생 306명을 대상으로 설문조사를 실시하였으며, 그 결과를 분석하였다. 조사대상자는 패스트푸드가 맛있고 편리한 음식이지만 영양가가 낮은 음식 즉, 고지방, 저비타민 음식으로 평가하였다. 햄버거, 피자, 프라이드치킨, 라면, 핫도그는 80% 이상의 조사대상자가 패스트푸드로 인정하였으나, 떡볶이, 스파게티, 샌드위치, 김밥, 샐러드의 경우 패스트푸드 인정 비율이 50%에 미치지 못하였다. 패스트푸드의 5가지 특징 중 음식의 패스트푸드 인정 여부를 결정하는 가장 확실한 특징은 건강에 해로운 음식이었고, 가장 불확실한 특징은 신속한 제공과 저렴한 가격으로 조사되었다. 패스트푸드가 흔히 fast, cheap foods로 지칭되지만 조사대상 남 여 고등학생은 패스트푸드를 신속히 제공되는 값싼 음식으로 인식하지 않는다는 것을 확인할 수 있었다.

• Investigative Magnetic Resonance Imaging
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• 제6권1호
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• pp.55-63
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• 2002

목적 급성 허혈성 뇌졸중에서 관류 MR영상으로 측정한 상대적 뇌혈용적과 단광자방출전산화단층촬영으로 측정한 상대적 뇌혈류량이 나중에 발생할 뇌경색을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법 급성 일측성 중대뇌동맥 폐색 환자에서 증상 발생 6시간 이내에 관류 MR영상과 99mTc-HMPAO 단광자방출전산화단층촬영을 모두 시행한 13명을 대상으로 하였다. 동맥 폐색에 의한 허혈 부위와 반대측 정상 부위에서 각 관류 변수를 측정하여 그 비(허혈 부위 관류변수 값 / 정상 부위 관류 변수 값)를 구한 후, 나중에 경색으로 이행할 부위와 그렇지 않을 부위를 판별할 수 있는 관류변수 비의 절단값을 계산하였다. 결과 : 경색으로 이행한 부위와 그렇지 않은 부위에서 상대적 뇌혈용적 비의 평균값은 각각 $0.58{\pm}0.27{\;}and{\;}0.99{\pm}0.17$ (p<0.001)이었고, 상대적 뇌혈류량 비의 평균 값은 $0.41{\pm}0.22{\;}and{\;}0.71{\pm}0.14$ (p<0.001)이었다. 경색으로 이행할 부위와 그렇지 않을 부위를 판별하는 절단값은 상대적 뇌혈용적 비가 0.80, 상대적 뇌혈류량 비가 0.56이었다. 각 절단값의 민감도, 특이도, 능률은 뇌혈용적 비가 80.6, 87.5, 82.7%이었고 상대적 뇌혈류량 비가 72.2, 75.0, 73.0%이었다. (두 관류변수 사이에서 p>0.05). 결론 : 급성 허혈성 뇌졸중에서 상대적 뇌혈용적과 상대적 뇌혈류량의 측정은 뇌경색의 발생을 예측하는 데에 유용한 것으로 사료된다.