• Title/Summary/Keyword: test specificity

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Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

Diagnostic Value of Serum Cytokeratin 8, 18 and 19 in Lung Cancer (폐암에서 혈중 Cytokeratin 8, 18, 19의 진단적 가치)

  • Choi, Chang Min;Kim, Woo Jin;Oh, Jin Young;Kang, Young Ae;Yoo, Chul Gyu;Lee, Choon Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.388-394
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    • 2003
  • Background : Monoclonal antibodies directed against well-known epitopes on cytokeratin (CK) 8, 18 and 19 (Monototal) have been used in the development of a new diagnostic tool for lung cancer. In the mid-1990s, CK 19 fragments (Cyfra 21-1) became popular and widely used for such diagnosis. This is the first study specifically designed to compare these two markers. Method : The serum levels of CK 8, 18 and 19 were measured using two-site monoclonal/polyclonal immunoradiometric assay kit in 57 healthy adults and 289 patients who were admitted to Seoul National University Hospital from May to September, 2002. The lung cancer group comprised 129 primary lung cancer patients; 116 with non-small cell lung cancer(NSCLC) and 13 with small cell lung cancer (SCLC). The control group comprised 160 non-malignant pulmonary lung disease patients and 57 healthy adults. A total of 166 twin Monototal and Cyfra 21-1 serum assays were obtained; 76 with lung cancer, 70 with non-malignant pulmonary lung disease and 20 healthy adults. Results : The mean serum value of Monototal was $412.47{\pm}455.45U/L$ in NSCLC, $237.08{\pm}145.15U/L$ in SCLC, $126.54{\pm}95.72U/L$ in non-malignant pulmonary lung disease, and $63.68{\pm}31.66U/L$ in healthy adults. The serum values of the lung cancer groups were significantly higher than those of the control group (p<0.01). Using a cut off value of 188U/L, sensitivity and specificity was 66.4% and 81.9% in NSCLC, and 43.8% and 81.9% in SCLC, respectively. The serum levels of CK 8, 18 and 19 were higher in advanced NSCLC than in early stage disease. Conclusion : The serum levels of CK 8, 18 and 19 may be useful in the diagnosis of NSCLC.

Psychological Make-up of Korean Green Consumerism: A Path Model Analysis (한국록색소비심리구성(韩国绿色消费心理构成):일개로경분석모형(一个路径分析模型))

  • Kim, Joo-Ho;Kim, Yeon-Shin
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.249-261
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    • 2010
  • As consumers' concern for the environment has continued to increase, many firms have actively engaged in environmental marketing to achieve their objectives. However, consumers' high concerns about the environment are not always reflected in their purchasing behavior. This indicates the need for an in-depth understanding of the development of green consumption within the individual's belief system. In consideration of psychological approaches, a large body of research has examined the factors underlying ecologically conscious "green" consumer behavior and the interrelationships of these factors. However, most previous studies have concentrated on Western countries. Using a sample of Korean consumers, this study attempts to understand the basis of Korean green consumerism and find universal values that are cross-culturally important in guiding consumers' environmental attitudes and behaviors. To this end, this study relates Schwartz's 10 universal values (Schwartz 1992) to environmental behaviors in a hierarchical model of value-attitude-behavior. With reference to the value-attitude-behavior framework, the conceptual model developed for the study explains what motivations can be manifested in Korean consumers' environmental attitudes, and subsequently how the attitudes affect their green choices. Using the pattern of relationships among values that can be related to environmentalism, the first hypothesis holds that there would be particular relationships between motivational value types and environmental attitudes. Hypothesis 2 assumes that environmental attitudes predict environmental behaviors. On the basis of the claim that favorable attitudes toward the environment may be expressed in many different behaviors, the assumption is that consumers' favorable attitudes toward the environment would be linked to a variety of environmental behaviors because people with high environmental attitudes can be more interested in and knowledgeable about environmental actions. Consistent with H2, H3 hypothesizes that there would be a positive relationship between different types of environmental behavior. A total of 564 university students participated in the study. The sample included 308 men, 254 women, and two participants who did not indicate their gender. The average age of the participants was 22.5 years, with a range of 19 to 39. Regarding majors, special efforts were made to draw the participants from different departments of the university. Data were collected by a survey administered via self-completion questionnaires., which assessed the participants' value priorities, environmental attitudes, and behaviors. Path analysis conducted to test the proposed model found the overall fit to be ${\chi}^2$=72.01 (p=0.00), GFI=0.983, CFI=0.982, NFI=0.970, RMR=0.070, and REMSEA=0.050. Thus, most of the fit measures indicated a good fit of the model with the data, and a hierarchical relationship from values to environmental attitudes to environmental non-purchasing behavior to environmental purchasing behavior was confirmed. An assessment of all the predicted paths by path coefficients led to several major hypothesized effects being confirmed. Out of the ten value types, universalism and power were significantly but conversely related to environmental attitudes. In line with the other studies, these findings confirm that environmental attitudes are an important factor in leading to a variety of green behaviors. Finally, significant relationships were found between environmental purchasing and non-purchasing behaviors. The path analysis supported the idea that universalism values provide a motivation for Korean consumers' greenness and indirectly promote environmental acts through favorable attitudes toward the environment. Participants with high environmental attitudes were found to actively engage in diverse forms of green consumer behavior. This research provides an opportunity to examine cross-cultural differences with respect to values leading to environmentalism, and, further, to verify previous findings. The study also examined the attitude-behavior relationship with respect to three distinct types of environmental behaviors. The different strengths of paths between green attitudes and behaviors suggest that researchers should consider the specificity of behavior explained as an effort to improve the low attitude-behavior correlation. Finally, the findings here illustrate that with increased environmental concerns among people, they come to include more such behaviors in their green portfolios.

Microsatellite Alterations of Plasma DNA in Non Small Cell Lung Cancer (비소세포폐암 환자의 혈장 DNA를 이용한 Microsatellite 분석)

  • Kim, Kyu-Sik;Kim, Eun-Jung;Kim, Soo-Ock;Oh, In-Jae;Park, Chang-Min;Jeong, Ju-Yeon;Kim, Yu-Il;Lim, Sung-Chul;Park, Jong-Tae;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.352-358
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    • 2005
  • Microsatellites are short tandem repeated nucleotide sequences that are present throughout the human genome. Variations in the repeat number or a loss of heterozygosity around the microsatellites have been termed a microsatellite alteration (MA). A MA reflects the genetic instability caused by an impairment in the DNA mismatch repair system and is suggested to be a novel tumorigenic mechanism. A number of studies have reported that MA in the DNA extracted from the plasma occurs at varying frequencies among patients with a non-small cell lung carcinoma (NSCLC). The genomic DNA from 9 subjects with a non-small cell lung cancer (squamous cell cancer 6, adenocarcinoma 2, non-small cell lung cancer1) and 9 age matched non-cancer control subjects (AMC: tuberculosis 3, other inflammatory lung disease 6) and 12 normal control subjects (NC) were extracted from the peripheral blood leukocytes and plasma. Three microsatellite loci were amplified with the primers targeting the Gene Bank sequence D21S1245, D3S1300, and D3S1234. MA in the form of an allelic loss or a band shift was examined with 6% polyacrylamide gel electrophoresis and silver staining. None (0/12) of the NC subjects less than 40 years of age showed a MA in any of the three markers, while 88.9%(8/9) of the AMC above 40 showed a MA in at least one of the three markers (p<0.05). Sixty percent(6/10) of the control subjects with a smoking history showed a MA in one of the three markers, while 9.1%(1/11) of the control subjects without smoking history showed a MA (p<0.05). However, not only did 66.7%(6/9) of lung cancer patients show a MA in at least one of the three markers but so did 88.9%(8/21) of the AMC patients (p>0.05). In conclusion, a MA in the D21S1245, D3S1300, and D3S1234 loci using DNA extracted from the plasma was detected in 66.7% of lung cancer while no MA was found in the young non-smoking control subjects. However, many of the non-cancer control subjects (aged smokers) also showed a MA, which compromised the specificity of the MA analysis as a screening test. Therefore, a further study with a larger sample size will be needed.

Correlation of Pre-treatment FDG Uptake to Therapeutic Response and Relapse in Patients with Small Cell Lung Cancer (소세포폐암의 치료전 FDG섭취와 치료반응 및 재발과의 연관성)

  • Seo, Young-Soon;Kwon, Seong-Young;Jeong, Shin-Young;Song, Ho-Chun;Min, Jung-Joon;Kim, Kyu-Sik;Kim, Young-Chul;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.538-545
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    • 2007
  • Purpose: We evaluated correlation of $^{18}F$-FDG uptakes, therapeutic response and relapse in pre-treatment $^{18}F$-FDG PET/CT in patients with SCLC. Materials and methods: We included 26 patients with pathologically proven small cell lung cancer. Total 102 lesions (26 lungs, 69 lymph nodes and 8 metastatic lesions) were evaluated. All patients underwent $^{18}F$-FDG PET/CT for staging. The maxSUV was used as a parameter of $^{18}F$-FDG uptake. The patients were divided into responders and non-responders according to response criteria on chest CT scan after 3 cycles of chemotherapy. We compared maxSUV between two groups by using independent t-test. To access correlation with $^{18}F$-FDG uptake and relapse, maxSUV and interval time to relapse was analyzed by correlation analysis. The cutoff value of maxSUV was evaluated by ROC curve. Results: Twelve-one patients (81%) were responders and five patients were non-responders on follow-up chest CT scan. The mean maxSUV of main lung lesions in responders and non-responders were $14.15{\pm}3.72$ and $9.17{\pm}2.15$, respectively. The maxSUV in the responders was significantly lower than that in non-responders (p<0.05). According to ROC curve, point of cut that predicts therapeutic response was 8.98 with 100% sensitivity and 57% specificity. The correlation analysis between $^{18}F$-FDG uptakes and interval time to relapse showed a significant negative correlation (p<0.05, r=-0.757). Conclusion: The pre-treatment $^{18}F$-FDG uptake of responders was significantly lower than that of non-responders. Patients with high $^{18}F$-FDG uptake in pre-treatment $^{18}F$-FDG PET/CT relapse earlier.

The Social Influence of the Landscape Architecture Engineer Examination on the Establishment of Authenticity in Landscaping History Department (조경기사 '조경사' 과목이 조경역사학(造景歷史學) 분야의 진정성 확립에 미친 사회적 영향)

  • Lee, Chang-Hun;Shin, Hyun-Sil;Kim, Kyu-Seob;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.128-136
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    • 2018
  • This study was centered on the protested data of the issue of "History of Landscape Architecture" in the handwritten course of landscaping articles of National Qualifications Test. The purpose of this study is to examine the types of social problems in the process of correcting erroneous historical facts. The purpose of this study was to find alternatives for the development of the field of landscape and culture history that can assist in the verification of the historical facts of the landscape sciences examination questions. The main results are as follows. First, as a result of analyzing the contents of the landscape architects' subject matter, the establishment of concept of landscape style and form and the confirmation of historical facts were investigated as important types to be established for development of landscape landscape history department. It seems that the social consensus of the expert group is needed to supplement the lack of data to refer to landscape architectural theory. Second, the analysis of the problematic narrative contents resulted in a total of five types of questionnaires. The appeared in the Undefined style and form(52.94%), Unproven historical facts(25.13%), Obscurity Era classification(11.77%), Lack of specificity(6.95%), Content scope of obscurity events(3.21%) Third, it is not only the lack of information to learn the theory by comparing and analyzing the contents of the statements in the landscape architect 's question items, but also the difference of contents between books was analyzed as the main cause of the problem. As a result of examining the characteristics and examples of the issues raised in landscape architectural problems, it was related to the social phenomenon, and it was classified into cultural factors and political factors. Fourth, the resolution of problematic issues in landscape architects' landscaping articles, which are national technical qualification tests, shows positive results. The information determined in the process of solving the perceived content can be used directly in landscaping field, and it helps the accuracy of the verification process by identifying the types and characteristics of the issues.

Classification of Cordyceps spp. by Morphological Characteristics and Protein Banding Pattern (동충하초(冬蟲夏草)(Cordyceps) 속균의 형태적인 특징과 단백질 Pattern에 의한 계통 분류)

  • Sung, Jae-Mo;Lee, Hyun-Kyung;Yang, Keun-Joo
    • The Korean Journal of Mycology
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    • v.23 no.1 s.72
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    • pp.92-104
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    • 1995
  • Ten species of Cordyceps species were collected throughout Kangwon province including Chuncheon Dongsanmyun KNU forest experiment from June to September, 1993. Collected Cordyceps species were identified as Cordyceps militaris, C. roseostromata, C. kyushuensis, C. scarabaeicola, Phytocordyceps ninchukiospora, C. nutans, Paecilomyces tenuipes, C. sphecocephala, Hymenostilbe odonatae, Torrubiella sp.. C. militaris, type species of Cordyceps species, was mainly formed on pupae of Lepidoptera and found after the rainy season around July. Fruiting body of C. roseostromata was morphologically similar to those of C. militaris, but relatively small in size and they were also found on lawn or pupa of Lepidoptera. Fruiting body of C. scarabaeicola was found on adult Scarabaeidae specifically and collect fruiting bodies of C. kyushuensis were on larva of moth. C. nutans and C. sphecocephala had host specificity on Hemiptera and Hymenoptera, respectively. Each species formed elliptical fertile part attach to the slim and carneous stalk and they were collected the most in specimen number through whole season of the summer. Ascospore of Phytocordyceps ninchukiospora on seed was characterized by two viable, multiseptate, fusiform units linked end-to-end by a long, filiform connective. Paecilomyces tenuipes, imperfect stage of the genus Cordyceps is multi-infective fungi that attack all stages of all groups of insects. Hymenostilbe odonatae attacks only adult Odonata and Torrubiella sp. formed on spider was difficult to collect because it was found the back side of leaf. As results of cultural test PDA medium showed the best mycelial growth. In the experiment of effect of the acidity inside of the media, C. militaris was good on pH 5, C. nutans and Phytocordyceps ninchukiospora were good on pH 6 and Paecilomyces tenuipes was on pH 7 and C. scarabaeicola was on pH 9. All isolates tested showed the best mycelial growth at $20^{\circ}C$. Morphologically similar isolates were used to analyze protein banding pattern among and within species. As a result, C. militaris, C. roseostromata and C. kyushuensis were clustered into close species and C. scarabaeicola and Phytocordyceps ninchukiospora were relatively distant from those species.

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Consideration of Normal Variation of Perfusion Measurements in the Quantitative Analysis of Myocardial Perfusion SPECT: Usefulness in Assessment of Viable Myocardium (심근관류 SPECT의 정량적 분석에서 관류정량값 정상변이의 고려: 생존심근 평가에서의 유용성)

  • Paeng, Jin-Chul;Lim, Il-Han;Kim, Ki-Bong;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.285-291
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    • 2008
  • Purpose: Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. Materials and Methods: In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F = 28:27) of low-likelihood for coronary artery disease were enrolled and $^{201}TI$ rest/$^{99m}Tc$-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. $^{201}TI$ rest/$^{99m}Tc$-MIBI stress / $^{201}TI$ 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, $Q_{delay}$ (perfusion measurement), ${\Delta}_{delay}$ ($Q_{delay}$ - m) and $Z_{delay}$ (($Q_{delay}$ - m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Results: Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was $51.8{\pm}6.5$ and the highest segmental perfusion was $87.0{\pm}5.9$, and they are $58.7{\pm}8.1$ and $87.3{\pm}6.0$, respectively in women. In the viability assessment $Q_{delay}$ showed AUC of 0.633, while those for ${\Delta}_{delay}$ and $Z_{delay}$ were 0.735 and 0.716, respectively. The AUCs of ${\Delta}_{delay}$ and $Z_{delay}$ were significantly higher than that of $Q_{delay}$ (p = 0.001 and 0.018, respectively). The diagnostic performance of ${\Delta}_{delay}$, which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. Conclusion: On automatic quantification of myocardial perfusion SPECT, the normal variation of perfusion measurements were considerable among segments. In the viability assessment, the parameters considering normal variation showed better diagnostic performance than the direct perfusion measurement. This study suggests that consideration of normal variation is important in the analysis of measurements on quantitative myocardial perfusion SPECT.

Development of Efficient Screening Methods for Melon Plants Resistant to Fusarium oxysporum f. sp. melonis (멜론 덩굴쪼김병에 대한 효율적인 저항성 검정법 개발)

  • Lee, Won Jeong;Lee, Ji Hyun;Jang, Kyoung Soo;Choi, Yong Ho;Kim, Heung Tae;Choi, Gyung Ja
    • Horticultural Science & Technology
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    • v.33 no.1
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    • pp.70-82
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    • 2015
  • This study was conducted to establish an efficient screening system to identify melon resistant to Fusarium oxysporum f. sp. melonis. F. oyxsporum f. sp. melonis GR was isolated from infected melon plants collected at Goryeong and identified as F. oxysporum f. sp. melonis based on morphological characteristics, molecular analyses, and host-specificity tests on cucurbits including melon, oriental melon, cucumber, and watermelon. In addition, the GR isolate was determined as race 1 based on resistance responses of melon differentials to the fungus. To select optimized medium for mass production of inoculum of F. oxysporum f. sp. melonis GR, six media were tested. The fungus produced the most spores (microconidia) in V8-juice broth. Resistance degrees to the GR isolate of 22 commercial melon cultivars and 6 rootstocks for melon plants were investigated. All tested rootstocks showed no symptoms of Fusarium wilt. Among the tested melon cultivars, only three cultivars were susceptible and the other cultivars displayed moderate to high resistance to the GR isolate. For further study, six melon cultivars (Redqueen, Summercool, Superseji, Asiapapaya, Eolukpapaya, and Asiahwanggeum) showing different degrees of resistance to the fungus were selected. The development of Fusarium wilt on the cultivars was tested according to several conditions such as plant growth stage, root wounding, dipping period of roots in spore suspension, inoculum concentration, and incubation temperature to develop the disease. On the basis of the test results, we suggest that an efficient screening method for melon plants resistant to F. oxysporum f. sp. melonis is to remove soil from roots of seven-day-old melon seedlings, to dip the seedlings without cutting in s pore s uspension of $3{\times}10^5conidia/mL$ for 30 min, to transplant the inoculated seedlings to plastic pots with horticulture nursery media, and then to cultivate the plants in a growth room at 25 to $28^{\circ}C$ for about 3 weeks with 12-hour light per day.

Vitamin B5 and B6 Contents in Fresh Materials and after Parboiling Treatment in Harvested Vegetables (채소류의 수확 후 원재료 및 데침 처리에 의한 비타민 B5 및 B6 함량 변화)

  • Kim, Gi-Ppeum;Ahn, Kyung-Geun;Kim, Gyeong-Ha;Hwang, Young-Sun;Kang, In-Kyu;Choi, Youngmin;Kim, Haeng-Ran;Choung, Myoung-Gun
    • Horticultural Science & Technology
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    • v.34 no.1
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    • pp.172-182
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    • 2016
  • This study was aimed to determine the changes in vitamin $B_5$ and $B_6$ contents compared to fresh materials after parboiling treatment of the main vegetables consumed in Korea. The specificity of accuracy and precision for vitamin $B_5$ and $B_6$ analysis method were validated using high-performance liquid chromatography (HPLC). The recovery rate of standard reference material (SRM) was excellent, and all analysis was under the control line based on the quality control chart for vitamin $B_5$ and $B_6$. The Z-score for vitamin $B_6$ in food analysis performance assessment scheme (FAPAS) proficiency test was -1.0, confirming reliability of analytical performance. The vitamin $B_5$ and $B_6$ contents in a total of 39 fresh materials and parboiled samples were analyzed. The contents of vitamin $B_5$ and $B_6$ ranged from 0.000 to 2.462 and from 0.000 to $0.127mg{\cdot}100g^{-1}$, respectively. The highest contents of vitamin $B_5$ and $B_6$ were $2.462mg{\cdot}100g^{-1}$ in fresh fatsia shoots (stem vegetables), and $0.127mg{\cdot}100g^{-1}$ in fresh spinach beet (leafy vegetables), respectively. Moreover, the vitamin $B_5$ and $B_6$ contents for parboiling treatment in most vegetables were reduced or not detected. In particular, the contents of vitamin $B_5$ in parboiled fatsia shoots and vitamin $B_6$ in parboiled yellow potato and spinach beet were decreased 20- and 4-fold compared with fresh material, respectively. These results can be used as important basic data for utilization and processing of various vegetable crops, information for dietary life, management of school meals, and national health for Koreans.