No abstract available.
Cholecystitis ; Emphysematous Cholecystitis* ; Pneumoperitoneum*

A 63-year-old woman was referred to a breast surgeon with a breast mass discovered incidentally during follow-up study after colon cancer surgery. Invasive adenocarcinoma was revealed on core needle biopsy. Wide excision of the breast including the tumor was performed. On standard histological examination the tumor showed features of moderately differentiated adenocarcinoma. The immunohistochemistry study revealed positive results for cytokeratin (CK)20 and CDX2, but negative for CK7. These are typical characteristics for colon cancer. Considering her history of subtotal colectomy for sigmoid colon cancer, it is presumable that the mass in the breast was of colonic origin, and it was an extremely rare case of metastasis to the breast from primary colorectal neoplasm. Although the instance is rare, clinicians should keep the possibility of breast metastasis from colorectal cancer in mind for early and correct diagnosis.
Adenocarcinoma ; Biopsy, Large-Core Needle ; Breast ; Colectomy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratins ; Middle Aged ; Neoplasm Metastasis ; Sigmoid Neoplasms

OBJECTIVES: The EGFR plays an important role in tumorigenesis and tumor progression of colorectal cancer, and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea. METHODS: We reviewed 58 colorectal cancer patients who underwent operations between 2003 and 2006, retrospectively. We analyzed their EGFR mutations in 4 loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features. RESULTS: Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28+/-11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) had stage I, 24 patients (41.38%) had stage II, 20 patients (34.48%) had stage III, and 5 patients (8.62%) had stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). EGFR mutations on exon 18, 19 and 21 were not detected. EGFR mutation increased in the earlier stage and the absence of lymph node metastasis (P=0.028). CONCLUSION: The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation significantly increased in the earlier stage and the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Retrospective Studies ; Sequence Analysis, DNA

OBJECTIVES: In the metastatic process, interactions between circulating tumor cells (CTCs) and the extracellular matrix or surrounding cells are required. β1-integrin may mediate these interactions. The aim of this study was to investigate whether β1-integrin is associated with the detection of CTCs in colorectal cancer. METHODS: We enrolled 30 patients with colorectal cancer (experimental group) and 30 patients with benign diseases (control group). Blood samples were obtained from each group, carcinoembryonic antigen (CEA) mRNA for CTCs marker and β1-integrin mRNA levels were estimated by using reverse transcription-polymerase chain reaction, and the results were compared between the two groups. RESULTS: CEA mRNA was detected more frequently in colorectal cancer patients than in control patients (P=0.008). CEA mRNA was significantly reduced after surgery in the colorectal cancer patients (P=0.032). β1-integrin mRNA was detected more in colorectal cancer patients than in the patients with benign diseases (P<0.001). In colorectal cancer patients, expression of β1-integrin mRNA was detected more for advanced-stage cancer than for early-stage cancer (P=0.033) and was significantly decreased after surgery (P<0.001). In addition, expression of β1-integrin mRNA was significantly associated with that of CEA mRNA in colorectal cancer patients (P=0.001). CONCLUSION: In conclusion, β1-integrin is a potential prognostic factor following surgical resection in colorectal cancer patients. β1-integrin may be a candidate for use as a marker for early detection of micrometastatic tumor cells and for monitoring the therapeutic response in colorectal cancer patients.
Carcinoembryonic Antigen ; Case-Control Studies* ; Colorectal Neoplasms* ; Extracellular Matrix ; Humans ; Integrins ; Neoplastic Cells, Circulating ; RNA, Messenger

PURPOSE: Livin is associated with drug response in several cancers. The aim of this study was to investigate the effect of silencing the livin gene expression on anticancer drug response in colorectal cancer. METHODS: siRNA was transfected at different concentrations (0, 10, and 30nM) into HCT116 cells, then cells were treated with either 5-fluorouracil (FU)/leucovorin (LV) or oxaliplatin (L-OHP)/5-FU/LV. Cellular viability and apoptosis were evaluated following silencing of livin gene expression combined with treatment with anticancer drugs. RESULTS: Livin gene expression was effectively suppressed by 30nM siRNA compared with control and 10nM siRNA. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay showed that proliferation was effectively inhibited in cells treated with a combination of both siRNA and an anticancer drug, compared to cells treated with siRNA-Livin or anticancer drug alone. In particular, the combination of 30nM siRNA and L-OHP/5-FU/LV resulted in a 93.8% and 91.4% decrease, compared to untreated control or L-OHP/5-FU/LV alone, respectively. Cellular proliferation was most effectively suppressed by a combination of 30nM of siRNA and L-OHP/5-FU/LV compared to other combinations. CONCLUSION: siRNA-mediated down-regulation of livin gene expression could significantly suppress colon cancer growth and enhance the cytotoxic effects of anticancer drugs such as 5-FU and L-OHP. The results of this study suggest that silencing livin gene expression in combination with treatment with anticancer drugs might be a novel cancer therapy for colorectal cancer.
Apoptosis ; Cell Proliferation ; Colon* ; Colonic Neoplasms* ; Colorectal Neoplasms ; Down-Regulation ; Fluorouracil ; Gene Expression ; HCT116 Cells ; RNA, Small Interfering

PURPOSE: The epidermal growth factor receptor (EGFR) plays an important role in tumorigenesis and tumor progression of colorectal cancer and leads to the activation of intracellular signaling pathways. The use of anti-EGFR-targeted therapy has increased for patients with colorectal cancer, but patients with EGFR mutations will be resistant to anti-EGFR-targeted therapy. The identification of gene mutations is critical in cancer treatment; therefore, the aim of this study is to investigate the incidences of EGFR mutations in colorectal cancer patients in Korea. METHODS: We retrospectively reviewed 58 colorectal cancer patients who underwent surgery between 2003 and 2006. We analyzed their EGFR mutations in four loci by DNA sequencing. In addition, we analyzed the correlation between the presence of EGFR mutation and patients' clinicopathologic features. RESULTS: Of the 58 patients, 35 patients were male and 23 were female. Their mean age was 63.28 +/- 11.18 years. Two patients (3.45%) were diagnosed as stage Tis, 7 patients (12.07%) as stage I, 24 patients (41.38%) as stage II, 20 patients (34.48%) as stage III, and 5 patients (8.62%) as stage IV. As a result of mutational analysis, EGFR mutations on exon 20 were detected in 13 patients (22.41%, G-->A transitions). No EGFR mutations were detected on exons 18, 19, and 21. EGFR mutation was increased in the earlier stage and in the absence of lymph node metastasis (P = 0.028). CONCLUSION: The incidence of EGFR mutation in Korean colorectal cancer patients is 22.41%. In addition, EGFR mutation was significantly increased in the earlier stage and in the absence of lymph node metastasis.
Cell Transformation, Neoplastic ; Colorectal Neoplasms ; Epidermal Growth Factor ; Exons ; Female ; Humans ; Incidence ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Sequence Analysis, DNA

No abstract available.
Teratoma

PURPOSE: This study aims to assess the diagnostic efficacy of the Alvarado score and to determine cut-off values of Alvarado score according to age for deciding on the options for patients with suspected appendicitis. METHODS: From October 2008 to January 2009, we prospectively reviewed 152 patients with suspected appendicitis. The patients were classified into adults and children groups. We then determined cut-off values of the Alvarado score by analyzing each score's sensitivity and specificity. RESULTS: Of the 147 patients, 96 patients were adults and 51 were children. The mean Alvarado score for adults and children were 6.08+/-1.85, and 6.69+/-1.43 in appendicitis and 4.32+/-2.02, and 4.60+/-1.81 in non-appendicitis, respectively. In adults, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 66.2%, and the specificity was 67.7%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 58.1%, and the specificity was 81.5%. In children, the sensitivity of the Alvarado scores 7 or higher for appendicitis was 80.8%, and the specificity was 68.0%. And the sensitivity of the Alvarado scores 4 or lower for non-appendicitis was 52.0%, and the specificity was 92.3%. CONCLUSION: The cut-off values for Alvarado score were not different according to age of the patient. If the Alvarado score is 7 or higher, surgical management is recommended, and if the Alvarado score is 4 or lower, observation without CT or US is recommended. In equivocal appendicitis as defined by the Alvarado scores 5 to 6, adjunctive CT or US are recommended to confirm appendicitis.
Adult ; Appendicitis ; Child ; Humans ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: The aim of this study is to evaluate long-term survival and prognostic factors for radio-frequency ablation (RFA) in colorectal liver metastases. METHODS: We retrospectively reviewed 35 colorectal liver metastases patients who underwent RFA between 2004 and 2008. We analyzed survival after RFA and prognostic factors for survival. RESULTS: Of the 35 patients, 23 patients were male and 12 were female. Their mean age was 62.40 +/- 12.52 years. Mean overall survival was 38.8 +/- 4.6 months, and mean progression free survival was 19.9 +/- 3.4 months. Three- and 5-year overall survival rates were 42.7 +/- 0.1% and 26.0 +/- 0.1%, respectively. Three- and 5-year progression-free survival rates were 19.6 +/- 0.1% and 4.9 +/- 0.04%, respectively. Overall survival and progression-free survival were significantly improved in male and in patients with carcinoembryonic antigen (CEA) < or = 100 ng/mL, carbohydrate antigen (CA) 19-9 < or = 100 ng/mL, absence of extrahepatic disease, and a unilobar hepatic lesion. In addition, progression-free survival was improved in patients with a solitary hepatic lesion. On the multivariate analysis, significant survival factors were the absence of extrahepatic disease and the presence of a unilobar hepatic lesion. CONCLUSION: RFA for colorectal liver metastases is an effective treatment option in male patients and in patients with CEA or CA19-9 < or = 100, absence of extrahepatic disease, a solitary hepatic lesion, and a unilobar hepatic lesion.
Carcinoembryonic Antigen ; Colorectal Neoplasms ; Disease-Free Survival ; Female ; Humans ; Liver ; Male ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate

PURPOSE: For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer. METHODS: We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases). RESULTS: The mean age of the one-stage group was 58.5+/-16.1, and that of the staged operation group was 65.0+/-13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities. CONCLUSIONS: A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity.
Anastomotic Leak ; Colectomy ; Colon* ; Colonic Neoplasms ; Colostomy ; Female ; Humans ; Length of Stay ; Mortality ; Retrospective Studies ; Stents ; Therapeutic Irrigation ; Wound Infection