Clinicopathological Characteristics of Colon Cancer Diagnosed at Primary Health Care Institutions

BACKGROUND/AIMS: The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. METHODS: We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. RESULTS: The mean age (+/-SD) of subjects was 60.9+/-10.5 years and 61.1% were men. More than one quarter (28.2%) of patients were asymptomatic. The prevalence of left colon cancer was higher (77.9%) than that for right colon cancer. The most frequent macroscopic and histologic types were depressed (58.9%) and moderately differentiated adenocarcinoma (52.2%), respectively. Asymptomatic subjects displayed protruding or well differentiated adenocarcinoma, while symptomatic patients were more likely to display depressed or moderately differentiated adenocarcinoma (P0.05). CONCLUSIONS: Study results indicated an increase of colon cancer amongst younger demographics in recent years. The effectiveness of colonoscopy screening was also evident, as asymptomatic patients demonstrated frequent findings of well differentiated adenocarcinomas. Study results also suggested a need for closer examination of older patients, as right colon cancer tended to increase with age.

Comparison of Clinical Efficacy of Finasteride and Dutasteride as 5-alpha Reductase Inhibitor / 대한남성과학회지

PURPOSE: To compare the clinical therapeutic efficacy of finasteride and dutasteride as 5-alpha reductase inhibitor (5-ARI) in the medical treatment of benign prostate hyperplasia. MATERIALS AND METHODS: From July 2007 to July 2010, 354 benign prostatic hyperplasia patients with combination medication : alpha blocker plus 5-ARI were enrolled. These patients were classified into a finasteride medication group (F group) and dutasteride medication group (D group) retrospectively. We initially measured the total prostate volume (TPV), prostate specific antigen (PSA), International Prostate Symptom Score (IPSS), quality of life score (QoL), maximal flow rate (Qmax), and post-void residual urine (PVR). After at least twelve months of medication, we rechecked these clinical parameters and during medication, side effects related to medication were also recorded. RESULTS: The F group (n=129) and D group (n=225) showed no differences in baseline characteristics for age, TPV, IPSS, QoL scores, or PSA. After medication, decreases in TPV were relatively higher in the D group than the F group (28.2% vs 20.5%). In addition, the decrease in PSA (43.6% vs 39.2%) and IPSS score (4.6 vs 3.5) were also higher in the D group. There were no significant differences in QoL score, Qmax, PVR change, or side effects between the two groups. CONCLUSIONS: Dutasteride showed greater efficacy in reduction of TPV and PSA and in symptomatic improvement by IPSS score than finasteride. More large scale studies about the differences on clinical efficacy of finasteride and dutasteride are needed.

A Case of Gastritis Cystica Polyposa Presenting as a Hyperplastic Polyp / 대한내과학회지

Gastritis cystica polyposa (GCP) is a rare lesion characterized by hyperplastic and cystic dilatation of the gastric mucosal glands infiltrating into the underlying submucosa. In most cases, it develops in patients who have undergone a gastroenterectomy, but can occasionally be found in an unoperated stomach. GCP may present as a submucosal tumor or polyp, and rarely as a giant gastric mucosal fold. We experienced a case of GCP that presented as a hyperplastic polyp, and it was unrelated to any gastric surgery. Upper endoscopy revealed the presence of a subpedunculated polyp in the posterior wall of the antrum. The lesion was successfully removed by endoscopic mucosal resection and diagnosed as a GCP.

Undifferentiated Adenocarcinoma of the Colon with Rhabdoid Features / 대한소화기내시경학회지

Malignant rhabdoid tumors were first described in 1978 by Beckwith and Palmer as a rare variant of Wilms' tumors with a "rhabdomyosarcomatoid" pattern and a particularly poor prognosis. Week reclassified this disease as a distinct disease in 1989 and thereafter, there have been several reports about malignant rhabdoid tumor that occurred in various organs, including the colon. The histologic characteristics of rhabdoid tumor are noncohesive or loosely cohesive cells with high cellularity, an eccentric large nucleus and eosinophilic cytoplasm, and the cytoplasm is usually positive for vimentin and it contain hyaline inclusions. On immunohistochemical staining, the cells are usually positive for vimentin and cytokeratin and they are negative for desmin. This tumor progresses rapidly and it has a very poor prognosis, but survival is better if there is no lymphatic or distant metastasis. We experienced a patient who suffered with undifferentiated adenocarcinoma with rhabdoid features in the ascending colon.

A Case of Endoscopic Removal of a Broken off Gastric Balloon from a Sengstaken-Blakemore Tube / 대한소화기내시경학회지

A Sengstaken-Blakemore (S-B) tube, when used approximately, still has a place in the management of acute variceal bleeding, and controls bleeding in 40~90% of the cases. However its use is accompanied by number of complications such as esophageal ulcer, pulmonary aspiration, and malfunction of the tube, which requires replacement. We recently observed a very unusual complication: the remaining gastric balloon of a S-B tube was broken off in the fundus of stomach by the patient's traction. The gastric balloon was easily and safely removed using an endoscopic snare after deflating the gastric balloon with a needle puncture.

A Case of Malignant Duodenocolic Fistula Treated with Covered Metallic Stents / 대한소화기내시경학회지

Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure.

Studies on the vivax malaria readmitted in military hospital / 대한내과학회지

BACKGROUND: Vivax malaria reemerged in the Republic of Korea in 1993. Since 1993, many cases with malaria have been reported. But due to the antimalarial activities including chemoprophylaxis and repellents, the annual incidence of malaria has been decreased. Antimalarial chemoprophylaxis is effective to control disease, but will facilitate the spread of drug-resistance or drug-tolerance. Thus, it is needed to analyze the effect of treatment outcome. METHODS: We analyzed the patients diagnosed as vivax malaria who readmitted in military hospital from 1997 to 2003. All cases were confirmed as malaria by peripheral blood smear in military hospital. RESULTS: Forty-five cases were observed in second attack and three cases were observed in third attack. All cases were vivax malaria with fever, and tertian fever developed in 25 cases (55.5%) in first attack, 22 cases (48.8%) in second attack. Various distribution of the interval between first attack remission and second attack was observed (from 8 days to 37 months). Of the all cases, 41 cases (91.1%) developed malaria between May and October in first attack, 39 cases (86.6%) in second attack. Readmission rate were 0.68%. CONCLUSION: We observed that only 45 of 6,566 (0.68%) cases were readmitted. The treatment of vivax malaria in Korea Army is effective in controlling malaria and should be cotinued. But continued surveillance with veterans and with or without chemoprophylaxis are warranted to eliminate the spread of the disease.

Expression of Multidrug Resistance Genes, mdr1, mrp, Topo IIalpha and Topo IIbeta in Childhood Acute Lymphoblastic Leukemia / 대한소아혈액종양학회지

PURPOSE: Multidrug resistance in the treatment of cancer mediated by several drug resistant genes impedes the successful management of cancer. The authors investigated the expression of drug resistant genes, including multidrug resistance (mdr1), multidrug resistance-associated protein (mrp), topoisomerase IIalpha (Topo IIalpha), and topoisomerase IIbeta (Topo IIbeta) in patients with childhood acute lymphoblastic leukemia (ALL; n=24) and in normal controls (n=6). METHODS: The levels of their transcripts in the bone marrow mononuclear cells were compared by semiquantitative RT-PCR, comparing the optical density ratio of PCR products of target genes to that of beta2-microglobulin. RESULTS: The expression of all 4 genes were detected in ALL patients as well as in normal controls except for Topo IIalpha, which were not detected in controls. The expression levels of mdr1, mrp and Topo IIbeta in ALL patients were significantly higher than those of normal controls [(2.1+/-2.2 vs 0.9+/-0.3, P> 0.024), (0.5+/-0.2 vs 0.2+/-0.1, P=0.016), and (0.7+/-0.2 vs 0.3+/-0.1, P=0.016)], respectively. The expression level of mdr1 gene transcript was relatively higher than those of mrp and Topo IIbeta. However, there was no correlation between the expression of multidrug resistant genes and survival and/or relapse of ALL. CONCLUSION: Though multidrug resistance genes did not serve as an independent prognostic factor, they might be used for markers for disease progression or relapse in childhood ALL. A longitudinal study of those genes is necessary to elucidate the prognostic significance in childhood ALL.

A Case of Segmental Ischemic Colitis Associated with Nonsteroidal Antiinflammatory Drugs / 대한류마티스학회지

Acute colonic ischemia is the most common form of gastrointestinal ischemia. The majority of cases of non-occlusive ischemic colitis are associated with severe congestive heart failure with low cardiac output, or disease states resulting in dehydration, or the splanchnic vasoconstrictive effect of some dedications. Reactive splanchnic vasoconstriction is responsible for nonocclusive ischemic colitis. The authors report a case of 37-year-old man, who had a history of 8-year gout and no evidence of heart disease or severe dehydration and developed segmental ischemic colitis during nonsteroidal antinflammatory drug treatment, which ultimitely progressed to transmural infacrction, therby undergone extended right hemicolectomy

T-Cell Lymphoma with Rosai-Dorfman Syndrome-Like Feature / 대한혈액학회지

T-cell lymphoma is heterogeneous with respect to clinical presentation, course, and morphology, but it is rarely associated with sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman Syndrome). We report a case of T-cell lymphoma with Rosai-Dorfman Syndrome like feature in a 31-years-old woman who presented severe non-immune hemolytic anemia and massive retroperitoneal and cervical lymphadenopathy. Her cervical lymph node biopsy revealed histiocytic infiltration showing erythrophagocytosis without marked fibrosis in the capsular and pericapsular areas and distension of sinusoids. After 6 cycles of CHOP (Cyclophosphamide, Adriamycin, Vincristine, and Prednisolone) chemotherapy, cervical and retroperitoneal lymphadenopathy was completely disappeared and according to the resolution of lymphadenopathy hemolytic anemia was also improved.

A Case of Churg - Strauss Syndrome: Presented as Mimic of Rheumatoid Arthritis / 대한류마티스학회지

Churg-Strauss syndrome(CSS) or allergic angiitis and granulomatosis is a disorder characterized by pulmonary and systemic small-vessel vasculitis, extravascular granulomas, and hypereosinophilia. It occurs in individuals with asthma and allergic rhinitis. The diagnosis of CSS is made on the basis of clinical and pathologic features. According to 1990 American College of Rheumatology(ACR) criteria for the classification of CSS, 6 criteria were developed. The presence of 4 or more of these criteria yielded a sensitivity of 85% and a specificity of 99. 7%. We describe a case of CSS in a 62-year-old female who met all of 1990 ACR criteria, but presented as like a as rheumatoid arthritis initially. Clinical symptoms, laboratory and roentgenographic findings gradually responded to high dose prednisolone treatment and resolved 3 weeks later. After discharge, she has been treated with oral prednisolone in a tapering course. Although polyarthritis with eosinophilia, vasculitis, and neuropathy are clinical manifestations of rheumatoid arthritis, those maniestations frequently occur during the vasculitic phase of the CSS. This case suggests that thorough differentiation of extra-articular manifestations of RA from clinical manifestations of CSS is considered when we meet a patient who have polyarthritis and vasculitis.

Two cases of congenital sacrococcygeal teratomas / 대한주산의학회잡지

No abstract available.

Effect of peripheral blood cell counts during remission induction and maintenance therapy on the prognosis and therapy of childhood acute lymphoblastic leukemia / 대한혈액학회지

No abstract available.

Clinical observation of meconium aspiration syndrome: prognostic implication of early meconium suctioning

No abstract available.