BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis. METHODS: Patients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed. RESULTS: ESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection. CONCLUSIONS: Severe fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.
Colorectal Neoplasms ; Fibrosis* ; Humans ; Medical Records ; Multivariate Analysis ; Neoplasms, Glandular and Epithelial ; Retrospective Studies ; Risk Factors

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis. METHODS: Patients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed. RESULTS: ESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection. CONCLUSIONS: Severe fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.
Colorectal Neoplasms ; Fibrosis* ; Humans ; Medical Records ; Multivariate Analysis ; Neoplasms, Glandular and Epithelial ; Retrospective Studies ; Risk Factors

Colorectal cancer (CRC) ranks third in cancer incidence and stands as the second leading cause of cancer-related deaths globally. CRC tumorigenesis results from a cumulative set of genetic and epigenetic alterations, disrupting cancer-regulatory processes like cell proliferation, metabolism, angiogenesis, cell death, invasion, and metastasis. Key epigenetic modifications observed in cancers encompass abnormal DNA methylation, atypical histone modifications, and irregularities in noncoding RNAs, such as microRNAs and long noncoding RNAs. The advancement in genomic technologies has positioned these genetic and epigenetic shifts as potential clinical biomarkers for CRC patients. This review concisely covers the fundamental principles of CRC-associated epigenetic changes, and examines in detail their emerging role as biomarkers for early detection, prognosis, and treatment response prediction.

BACKGROUND: The metabolic syndrome (MS) is a cluster of risk factors of cardiovascular disease. The association between components of the MS and bone mineral density has been researched, but no prior studies have directly evaluated the association with the metabolic syndrome and bone mineral density in Korea. METHODS: We evaluated postmenopausal women who had visited a university hospital from November 2006 to October 2007. Data on their lifestyle, current medical diseases and medications were collected from medical records. Height, body weight, waist circumference and serum lipid profiles were measured. RESULTS: The prevalence of metabolic syndrome was 21.8% in this study. In adjusted analysis including age and other factors, only waist circumference had a close correlation with bone mineral density of femur and lumbar vertebral body (P < 0.05). The bone mineral density of femur and lumbar vertebral body had no correlation with the presence of metabolic syndrome. When stratified by body mass index, corrected bone mineral density revealed no significant correlation with the presence of metabolic syndrome. CONCLUSION: The bone mineral density of postmenopausal women with metabolic syndrome has highly influenced by obesity, especially by abdominal obesity.
Body Height ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Female ; Femur ; Humans ; Life Style ; Medical Records ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Prevalence ; Risk Factors ; Waist Circumference

BACKGROUND: The metabolic syndrome (MS) is a cluster of risk factors of cardiovascular disease. The association between components of the MS and bone mineral density has been researched, but no prior studies have directly evaluated the association with the metabolic syndrome and bone mineral density in Korea. METHODS: We evaluated postmenopausal women who had visited a university hospital from November 2006 to October 2007. Data on their lifestyle, current medical diseases and medications were collected from medical records. Height, body weight, waist circumference and serum lipid profiles were measured. RESULTS: The prevalence of metabolic syndrome was 21.8% in this study. In adjusted analysis including age and other factors, only waist circumference had a close correlation with bone mineral density of femur and lumbar vertebral body (P < 0.05). The bone mineral density of femur and lumbar vertebral body had no correlation with the presence of metabolic syndrome. When stratified by body mass index, corrected bone mineral density revealed no significant correlation with the presence of metabolic syndrome. CONCLUSION: The bone mineral density of postmenopausal women with metabolic syndrome has highly influenced by obesity, especially by abdominal obesity.
Body Height ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Female ; Femur ; Humans ; Life Style ; Medical Records ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Prevalence ; Risk Factors ; Waist Circumference

A 63-year-old female complained of transient dysarthria. MRA was conducted to evaluate this symptom, revealing distal internal carotid artery occlusion with collateral vessel development, suggesting Moyamoya disease, which had not been detected in MRA performed 5 years previously. Vascular risk factors and laboratory findings suggested no cardiac or autoimmune diseases. The diameter of stenosis of the middle cerebral artery on high-resolution MRI was 2.11 mm, and genetic evaluation revealed mutation of the gene encoding ring finger protein 213 (RNF213). High-resolution MRI and gene studies are useful for distinguishing between Moyamoya disease and atherosclerosis.
Adult* ; Atherosclerosis ; Autoimmune Diseases ; Carotid Artery, Internal ; Constriction, Pathologic ; Dysarthria ; Female ; Fingers* ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Middle Cerebral Artery ; Moyamoya Disease* ; Risk Factors

Cranial chordomas are rare and generally slow-growing malignant neoplasms of presumed notochordal origin. They seldom metastasize, but are difficult to manage because of their locally invasive nature and their proximity to critical structures. The clinical presentation and results of operative treatment, radiation therapy, and radiosurgery in a series of 10 patients with cranial chordomas seen at our hospital, between June 1989 and December 1994, are analysed. There were 4 men and 6 women with a mean age of 37.5 years. The most common presenting symptoms were visual loss, motor weakness and diplopia, and the most common presenting sign was visual field defect. The mean interval between symptom onset and initial treatment was 4.8(1-17) months. Three tumors classified as the chondroid type showed better clinical course. Extent of tumor resection included biopsy in 1 patient and subtotal or greater in 9. Four patients received postoperative radiation therapy and 4 patients stereotactic radiosurgery using Leksell gamma unit. Among them 1 patient showed tumor progression after radiation therapy but none after radiosurgery. One patient died due to tumor recurrence and two patients due to therapy but none after radiosurgery. One patient died due to tumor recurrence and two patients due to postoperative complications. At the time of analysis 7 patients were alive. The average length of follow-up for the alive patients was 34 months. The results of this study suggest that multimodality treatment using surgical debulking, radiation therapy and stereotactic radiosurgery is necessary for the optimal management of chordoma.
Biopsy ; Chordoma* ; Diplopia ; Female ; Follow-Up Studies ; Humans ; Male ; Notochord ; Postoperative Complications ; Radiosurgery ; Recurrence ; Visual Fields

OBJECTIVE: To determine whether unexplained elevation of maternal serum alpha-fetoprotein(MSAFP) is associated with adverse outcomes in pregnancies complicated by placenta previa. METHODS: One hundred and five pregnant women with placenta previa between January 1995 and March 1999 were included in this study. They underwent the triple test at 14 to 22 gestational weeks. These 105 pregnant women were stratified into two groups by MSAFP at 2.0MOM. The outcomes of pregnancy in high MSAFP(>or=2.0MOM) group were compared with those in normal MSAFP(or=2.0 MOM). Eleven out of 632 pregnant women with high MSAFP were having placenta previa. 3. The incidence of preterm birth was significantly high in high MSAFP group with placenta previa.(p<0.001) 4. Women with unexplained elevated MSAFP and having placenta previa showed the increased risk for preterm delivery (p<0.05), preeclamsa (p<0.001), and bleeding in third trimester (p<0.001), but not placenta accreta, placenta abruption, cesarean hysterctomy and intrauterine fetal death. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP in complicated placenta previa were associated with the elevated risk of preterm delivery, preeclamsia and bleeding in the early third trimester, but not placenta accreta, placenta abruption, cearean hysterectomy and intrauterine fetal death.
alpha-Fetoproteins* ; Female ; Fetal Death ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Premature Birth

Gerbil has no Willis circle so we can make the model of cerebral ischemia simply by occluding the common carotid artery. In this study, we occluded the common carotid arteries of the gerbil for 5 minutes, and at the designated reperfusion time (0.5, 3, 6, 12 and 24 hrs), the experimental animals were killed for histopathological and neurofilament 68 kDa immunohistochemical study. At 12 hrs after ischemia the neuronal cell change occurred in inner nuclear layer (INL)and ganglion cell layer (GCL). At 24 hrs after ischemia the disappearance of neurons were observed in GCL and severe edema, pyknotic degeneration were observed in INL and outer nuclear layer (ONL ). On immunohistochemical study, the NF 68 kDa antibody labelled the cell bodies in the GCL and some nerve fibers in nerve fiber layer (NFL). In addition, the processes of horizontal cells also showed the slight NF 68 kDa immunoreactivity. After ischemic insult, the intensity of NF 68 kDa immunoreactivity in GCL and NFL was slightly decreased. But, its intensity in the process of horizontal cells was increased. And the NF 68 kDa immunoreacticity was detected in some neurons of INL and ONL. This represents the neurofilament protein has the important role in the cell death at the ischemic retina as well as at the ischemic brain.
Animals ; Brain ; Brain Ischemia ; Carotid Artery, Common ; Cell Death ; Circle of Willis ; Edema ; Ganglion Cysts ; Gerbillinae* ; Ischemia ; Nerve Fibers ; Neurons ; Reperfusion ; Retina*

Essential thrombocythemia, a subcategory of chronic myeloproliferative disorder, is characterized by absolute thrombocytosis due to excessive clonal proliferation of platelets, hyperaggregability of platelets and increased incidence of thrombosis and hemorrhage. Essential thrombocythemia may cause frequent vascular thrombosis, but it can be a rare cause of acute ischemic heart diseases such as acute myocardial infarction without atherosclerosis, unstable angina and angina pectoris. We report a case of essential thrombocythemia complicated by acute myocardial infarction. A patient with a previous history of vascular thrombotic complications (such as transient ischemic attack and deep vein thrombosis) was managed with 2.8 million units of intravenous urokinase, antiplatelet agent, ACEI, antianginal medications and hydroxyurea. There were clinically remarkable improvements and no further episodes of thrombotic ischemic vascular complications, including acute myocardial infarction.
Angina Pectoris ; Angina, Unstable ; Atherosclerosis ; Hemorrhage ; Humans ; Hydroxyurea ; Incidence ; Ischemic Attack, Transient ; Myeloproliferative Disorders ; Myocardial Infarction* ; Myocardial Ischemia ; Thrombocythemia, Essential* ; Thrombocytosis ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Veins