Colorectal Cancer in Young Adults

Colorectal cancer(CRC) is the most common gastrointestinal malignancy in the Western world. The total number of CRC cases in Korea is increasing probably due to western-style diets. CRC is relatively uncommon in the young adult group. Nevertheless, these cases warrant special attention because they are often diagnosed in an advanced stage and are more likely to involve a family history of CRC. Controversies still exist over the determination of the age range and over the true value of age factor in the prognosis for the young adults. The aim of this study is to calculate the incidence, to evaluate the clinicopathologic characteristics and the outcome of management of young adult with CRC. A retrospective review of 864 patients with an adenocarcinoma of the colon or rectum, who were surgically treated and followed-up in our Department of the Kang Buk Samsung Hospital, Sung Kwun Kwan University College of Medicine, Seoul, Korea, between January 1970 and December 1995 was performed. Among these patients, 138 were in the young adult group, aged less than 40. All cases accompanied by familial adenomatous polyposis coli and ulcerative colitis were excluded. Young adults accounted for 16.0% of all patients with CRC, showing no significant sex difference compared with the control group. The rectum and sigmoid colon were the most frequent sites of the lesion (80.4%). The incidences of Dukes' stage C and poorly differenciated adenocarcinoma cases were significantly higher in the young adult group (p<0.05). The curative resection rate of tumors in young patients was 93.4%. Despite of the more advanced stage and poorly differenciation, the stage-related and overall 5-year survival rate was not significantly different between old and young patients (57.9% and 59.4% in young and old patients, respectively). CRC in young adults in Korea is increasing in number, but its proportion is decreasing. The results of our study indicate that the prognosis and the stage-related survival for CRC in young adults are not related to age.

Rectal Carcinoid

PURPOSE: This study was designed to evaluate the clinical charateristics, surgical treatment and outcome of carcinoid tumors of the rectum. METHODS: A retrospective review of the charts of all patients treated for rectal carcinoid tumors at Kangbuk Samsung Medical Center between Jan 1989 and April 1998. Thirteen patients with rectal carcinoids tumors were treated. Follow-up data, histopathological information and surgical procedures were obtained from case notes. RESULTS: There were 10 men and 3 women. The ages ranged from 28 to 60 years (mean 41.1 years for all, 43.8 years for men and 32 years for women). Eight patients (61.5%) had no symptoms. Of the five patients, four complained of rectal bleeding (30.8%), and one complained of defecational difficulty (7.7%). Size of rectal carcinoid tumor was less than 1 cm in 7 patients (53.8%), between 1 cm and 2 cm in 2 patients (15.4%), in four patients (30.8%) larger than 2 cm. Three patients were treated in Abdominoperineal resection. Two patients underwent stapled low anterior resection. The remaining 8 patients underwent conservative resection (3 colonoscopic polypectomy and electrocauterization, 2 colonoscopic snaring biopsy, 2 transanal resection and one Mason's operation). The depth of invasion was contained within sutmucosa in 3 patients. Liver metastasis was found in 2 patients. Average follow-up time was 35.6 months. Two patients died of mutiple mestastasis (liver, bone, peritoneum) 9 and 30months later. CONCLUSION: We concluded that tumors smaller than 1 cm could be managed by local treatment whereas larger than 2 cm should be managed by radical treatment.

Status of Bcl-2 expression and Its Relationship to the Other Prognostic Factors in Breast Cancer / 대한암학회지

PURPOSE: There are several well-established prognostic factors to predict the course of breast cancer. Recently, a new category of genes that control the process of programmed cell death, also called apoptosis, has been identified. It includes the bcl-2 proto-oncogene which actively blocks apoptosis. The purpose of this retrospective study is to investigate the relationship between Bcl-2 protein expression in primary breast cancers and other markers of prognostic value. MATERIALS AND METHODS: We analyzed 43 cases of invasive ductal carcinoma of breast cancer, which were consecutively operated in the period from January 1990 to December 1994. Analysis of Bcl-2 protein, ER and PgR expression was carried out using immunohistochemistry on the paraffin-embedded tissue section. The following indices were measured.; size of the tumor, number of axillary metastasis, histological grade, menopausal status, ER, PgR, and Bcl-2 status. RESULTS: Expression of the bcl-2 proto-oncogene was found in 28 cases of 43 patients (65.1%). No relationship could be observed between Bcl-2 status and tumor grade, TNM staging and menopausal status. A strong positive relationship was demonstrated between Bcl-2 immunoreactivity and ER status (P 0.001) and PgR status (P=0.014). A favorable prognostic value was demonstrated for Bcl-2 expression on overall survival (P=0.0427), but no prognostic value was demonstrated on disease-free survival (P=0.1587). CONCLUSION: Our results suggest that the Bcl-2 expression may be a favorable prognostic marker and its important role may be a modulator of response to adjuvant therapy in breast cancer.

Varicose Veins that Well Treated by Sclerosing Agents in Lower Extremity

In the early period (B'C) the definition of the primary varicose vein in lower extremity was dilate, tortuous and elongated vein. It has been known that the varicose vein in lower extremity is more involved in western people than orintal. However nowadays this disease is also well involved in oriental because of incresed economic level and well equipped culture. BACKGROUNDS: We has been tried the clinical reserch because of good result & possibility of therapy by only sclerotheray in well defined selected indication of primary varicose vein. MATERIAL AND METHOD: We reviewed primary varicose vein involved in lower extremity of 23cases that was well treated by sclerosing agents to Dept of Surg, Kangbuk Samsung Hosp, SungKyunKwan University College of Medicine, From January 1996 To December 1997. RESULTS: 1. The distribution of the age were the first in 5th decade (39.1%), followed by 6th decade, 4th decade. The ratio of sex were more prevalent in female than male (6.7:1). The median age was 47.3 years-old. 2. Sx & sign were showed cosmetic problem (82.6%) in most patients, followed by heaviness (47.8%), numbness (39.1%), pain (21.7%). 3. The duration of illness were over 10years in 17cases (73.9%). 4. The size of varicose vein were type II in 16case (69.6%), follwed by type I (21.7%), type III (8.7%) according to the classification by Dr. Weiss. 5. The frequency of injection were 1st injection in 12cases (52.2%), 2nd-4th injection (26.1%), over 5th injection (21.7%). 6. Post injection complication were pigmentation in 1case and thrombosis in 1case. 7. The predisposing factors were corelated with pregnancy in most patients, others were long standing position, familiar tendency, trauma. CONCLUSION: Double therapy (operation and sclerotherapy) has been tried in primary varicose vein, however if we are well select indication of therpy, sclerotherapy is also choice of treatment in the primary varicose vein.

Papillary cystic tumor of the pancreas

No abstract available.