Cyclooxygenase-2 Expression in Colorectal Cancer

PURPOSE: Cyclooxygenase (COX) is an important enzyme that transforms arachidonic acid into prostaglandins and exists as two types of isoenzyme, COX-1 and COX-2. Recently, the expression of COX-2 was presented as an important factor in determining the prognosis in colorectal cancer, and the expressed COX-2 was related with recurrence and liver metastasis after an operation for colorectal cancer. Thus this study was to investigate the relationship between COX-2 expression and the prognosis for colorectal cancer. METHODS: We studied colorectal cancer patients who received operations at the Catholic University of Korea from Jan. 1993 through Dec. 2000, by reviewing their medical records and pathological reports. We used immunohistochemistry to determine the expression rate of COX-2 and to study its relationship with other clinical variables, the disease-free survival rat, and the recurrence rate. RESULTS: Among the 217 cases, 171 cases (78.8%) showed positive COX-2 expression. The COX-2 expression increased with the differentiation and was lower in cases with lymph-node metastasis. However, no statistically significant difference in age, sex, location of lesion, invasiveness, stage, organ of metastasis, disease-free survival rate, and recurrence existed between patients with positive COX-2 expression and those with negative COX-2 expression. CONCLUSIONS: There is no evidence that COX-2 expression is associated with a poor prognosis for colorectal cancer.

A Case of Intussuscepting Hemangioma of the Ileum

Intussusception in an adult is an uncommon condition. In contrast to the condition occuring in infants and children in adults, it is usually secondary to an intraluminal tumor. Hemangioma is a very rare cause of intussusception. The most frequent symptoms of intussuscepting hemangioma of the gastrointestinal tract are cramping abdominal pain, vomiting and melena. The treatment is usually resection. We experienced a case of hemangioma in the ileum with intussusception. After laparotomy and resection of the ileal segment, end to end anastomosis was performed.

Preoperative Diagnosis of Strangulated Obturator Hernia Using CT

Obturator hernia is a rare pelvic hernia, occuring most frequently in elderly, debilitated women. Because of nonspecific symptoms, the diagnosis of obturator hernia is often delayed until laparotomy for bowel obstruction. This leads to high bowel resection and mortality rates, which represents a diagnostic and therapeutic challenge for surgeons today. We experienced an unusual case of right obturator hernia with strangulation in an 81-year-old female patient who presented with intermittent generalized, particularly right lower quadrant, abdominal pain and distension. The hernia was diagnosed by computed tomography (CT) scan and repaired using the lower midline transperitoneal approach. CT scan in the evaluation of patients with nonspecific intermittent gastrointestinal symptoms leads to a diagnosis of occult hernia. We report these findings with a brief review of the literature focusing on finding indicators leading to early diagnosis and treatment.