• Title/Summary/Keyword: characteristics curve

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Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

Diagnostic Usefulness of Serum Level of Cyfra 21-1, SCC Antigen and CEA in Lung Cancer (폐암에서 혈중 Cyfra 21-1, SCC 항원 및 CEA의 진단적 유용성)

  • Kim, Kyoung-Ah;Lee, Me-Hwa;Koh, Youn-Suck;Kim, Seon-Hee;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Moon, Dae-Hyuk
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.846-854
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    • 1995
  • Background: Cytokeratin 19 is a subunit of cytokeratin intermediate filament expressed in simple epithelia such as respiratory epithelial cells and their malignant counterparts. An immunoradiometric assay is available to detect a fragment of the cytokeratin, referred to as Cyfra 21-1 in the serum. This study was conducted to evaluate the clinical utility of this new marker in the diagnosis of lung cancer compared with established markers of squamous cell carcinoma antigen (SCC Ag) and carcino-embryonic antigen(CEA). In addition, we compared the diagnostic sensitivity and specificity of Cyfra 21-1 with those of SCC Ag in squamous cell carcinoma of the lung. We also measured the level of Cyfra 21-1 in the different stages of squamous cell carcinoma of the lung. Method: We measured Cyfra 21-1(ELSA-CYFRA 21-1), SCC Ag(ABBOTT SCC RIABEAD) and CEA(ELSA2-CEA) in 79 patients with primary lung cancer and in 78 persons as a comparison group including 32 patients with pulmonary tuberculosis, 23 patients with benign lung disease and 23 cases with healthy individual. Cyfra 21-1 is measured by a solid-phase immunoradiometric assay(CIS Bio International, France) based on the two-site sandwich method. SCC Ag is measured by a radioimmunoassay(Abbott Laboratories, USA). CEA is measured by a immunoradiometric assay(CIS Bio International, France). All data were expressed as the mean$\pm$standard deviation. Results: 1) The mean value of Cyfra 21-1 was $18.38{\pm}3.65\;ng/mL$ in the lung cancer and $1.l6{\pm}0.53\;ng/mL$ in the comparison group(p<0.0001). SCC Ag was $3.53{\pm}6.06\;ng/mL$ in the lung cancer and $1.19{\pm}0.5\;ng/mL$ in the comparison group(p<0.01). CEA was $35.03{\pm}13.9\;ng/mL$ in the lung cancer and $2.89{\pm}1.01\;ng/mL$ in the comparison group(p<0.0001). 2) Cyfra 21-1 level in squamous cell carcinoma($31.52{\pm}40.13\;ng/mL$) was higher than that in adenocarcinoma($2.41{\pm}1.34\;ng/mL$)(p<0.0001) and small cell carcinoma($2.15{\pm}2.05\;ng/mL$)(p=0.007). SCC Ag level in squamous cell carcinoma($5.1{\pm}7.68\;ng/mL$) was higher than that in adenocarcinoma($1.36{\pm}0.69\;ng/mL$)(p=0.009) and small cell carcinoma($1.1{\pm}0.24\;ng/mL$) (p=0.024). 3) The level of Cyfra 21-1 was not correlated with the progression of stage in squamous cell carcinoma of the lung. 4) Using the cut-off value of 3.3ng/mL, the diagnostic sensitivity of Cyfra 21-1 was 83% in squamous cell carcinoma, 22% in adenocarcinoma and 17% in small cell carcinoma. The sensitivity of SCC Ag and CEA were 39% and 20%, respectively in squamous cell carcinoma, 11% and 39% in adenocarcinoma, and 0% and 33% in small cell carcinoma. 5) Comparison of the receiver operating characteristics curves(ROC curve) for Cyfra 21-1, SCC Ag and CEA revealed that Cyfra 21-1 showed highest diagnostic sensitivity among them in the diagnosis of lung cancer. Conclusion: Cyfra 21-1 is thought to be a better tumor marker for the diagnosis of lung cancer than SCC Ag and CEA, especially in squamous cell carcinoma of the lung.

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A Study on the Excavated Sab(a funeral fan) from Lime-filled Tomb and Lime-layered Tomb during the Joseon Dynasty (조선시대 회격·회곽묘 출토 삽(翣)에 대한 고찰)

  • Yi, Seung Hae;An, Bo Yeon
    • Korean Journal of Heritage: History & Science
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    • v.41 no.2
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    • pp.43-59
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    • 2008
  • Sap(?, a funeral fan) is a funeral ceremonial object used in association with a Confucian ceremonial custom, which was crafted by making a wooden frame, attaching a white cloth or a thick paper onto it, drawing pictures on it, and making a holder for a handle. According to Liji(Records of Rites), Sap was used since the Zhou Dynasty, and these Chinese Sap examples are no big different than the Korean Sap examples, which were described in Joseon Wangjo Sillok(Annals of the Joseon Dynasty), Gukjo Oryeui(the Five Rites of the State), and Sarye Pyeollam(Handbook on Four Rituals). This study explored Sap excavated in lime-filled tombs and lime-layered tombs of aristocrats dating back to Joseon, as well as their historical records to examine Sap's characteristics according to their examples, manufacturing methods, and use time. The number and designs of Sap varied according to the deceased' social status aristocrats used mainly one pair of 亞-shaped Bulsap, and a pair of Hwasap with a cloud design depicted on it. A Sap was wrapped twice with Chojuji paper or Jeojuji paper, and for the third time with Yeonchangji paper. Then, it was covered with a white ramie, a hemp, a cotton, a silk satin, etc. Bobul(an axe shape and 亞-shape design) was drawn on both sides of Sap, and a rising current of cloud was drawn at the peripheral area mainly with red or scarlet pigments. Sap, which were excavated from aristocrats'lime-filled and lime-layered tombs, are the type of Sap which were separated from its handle. These excavated Sap are those whose long handles were burnt during the death carriage procession, leaving Sap, which later were erected on both sides of the coffin. The manufacturing process of excavated relics can be inferred by examining them. The excavated relics are classified into those with three points and those with two points according to the number of point. Of the three-point type(Type I), there is the kind of relic that was woven into something like a basket by using a whole wood plate or cutting bamboo into flat shapes. The three-point Sap was concentrated comparatively in the early half of Joseon, and was manufactured with various methods compared with its rather unified overall shape. In the meantime, the two-point Sap was manufactured with a relatively formatted method; its body was manufactured in the form of a rectangle or a reverse trapezoid, and then its upper parts with two points hanging from them were connected, and the top surface was made into a curve(Type II) or a straight line(Type III) differentiating it from the three-point type. This manufacturing method, compared with that of the three-point type, is simple, but is not greatly different from the three-point type manufacturing method. In particular, the method of crafting the top surface into a straight line has been used until today. Of the examined 30 Sap examples, those whose production years were made known from the buried persons'death years inscribed on the tomb stones, were reexamined, indicating that type I was concentrated in the first half of the $16^{th}$ century. Type II spanned from the second half of the $16^{th}$ century to the second half of the $17^{th}$ century, and type III spanned from the first half of the $17^{th}$ century to the first half of the $18^{th}$ century. The shape of Sap is deemed to have changed from type I to type II and again from type II to type III In the $17^{th}$ century, which was a time of change, types II and III coexisted. Of the three types of Sap, types II and III re similar because they have two points; thus a noteworthy transit time is thought to have been the middle of the $16^{th}$ century. Type I compared with types II and III is thought to have required more efforts and skills in the production process, and as time passed, the shape and manufacturing methods of Sap are presumed to have been further simplified according to the principle of economy. The simplification of funeral ceremonies is presumed to have been furthered after Imjinwaeran(Japanese invasion of Joseon, 1592~1598), given that as shown in the Annals of King Seonjo, state funerals were suspended several times. In the case of Sap, simplification began from the second half of the $16^{th}$ century, and even in the $18^{th}$ century, rather than separately crafting Sap, Sap was directly drawn on the coffin cover and the coffin. However, in this simplification of form, regulations on the use of Sap specified in Liji were observed, and thus the ceremony was rationally simplified.