No abstract available.
Progeria*

BACKGROUND: It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer. METHODS: Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements. RESULTS: The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05). CONCLUSION: Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
Dibucaine ; Humans ; Life Expectancy ; Myofascial Pain Syndromes ; Trigger Points ; Visual Analog Scale

Lipoma is a very frequent benign soft tissue tumor, but its occurrence in the hands is rare. Lipoma in the hands is generally asymptomatic; however, symptoms may develop if local neurovascular structures are compressed due to size or location of the lipoma. Carpal tunnel syndrome, which is a compressive neuropathy of the median nerve, is the most common neuropathy in the hands and presents pain, numbness, hypoesthesia, and atrophy of the thenar muscle. We present a case of carpal tunnel syndrome by deep-seated giant lipoma with a literature review.

Purpose: TNM stage I colorectal cancer (CRC) can recur, although the recurrence rate is low. Few studies have evaluated the risk factors for TNM stage I CRC recurrence. This study aimed to evaluate the TNM stage I CRC recurrence rate, as well as risk factors for recurrence. Methods: In this retrospective study, we reviewed the database of patients who had undergone surgery for TNM stage I CRC between November 2008 and December 2014 without receiving neoadjuvant therapy or transanal excision for rectal cancer. Our analysis included 173 patients. Primary lesions were found in the colon of 133 patients and in the rectum of 40 patients. Results: The CRC recurrence rate was 2.9% (5 out of 173 patients). For colon cancer patients, tumor size was not associated with higher recurrence risk (P = 0.098). However, for rectal cancer patients, both tumor size (≥3 cm) and T stage were associated with higher recurrence risk (P = 0.046 and P = 0.046, respectively). Of the 5 recurrent cases, 1 patient exhibited disease progression despite treatment, 1 patient maintained stable disease status after recurrence treatment, and 3 patients had no evidence of a tumor after recurrence treatment. Conclusion Our findings suggest that tumor size and T stage are predictors of stage I rectal cancer recurrence, and careful monitoring and follow-up of patients with larger tumors may be warranted.

PURPOSE: Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope. METHODS: A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group. RESULTS: Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients. CONCLUSION: Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.
Adenocarcinoma ; Colon* ; Colonic Polyps ; Colonography, Computed Tomographic* ; Colonoscopes ; Colonoscopy ; Colorectal Neoplasms* ; Diagnosis ; Female ; Humans ; Male ; Methods ; Polyps ; Sensitivity and Specificity

A male, 67 years old, visited the emergency room because of a foreign body impacted in his rectum. While he was being treated for grade-II hemorrhoids conservatively, he heard that massage of the peri-anal area could be helpful for preventing hemorrhoids. Thus, while using an electronic massager after placing the head of the machine into a short round bar, the head became separated from the machine, and this was inserted into the anus and impacted. The patient had anal discomfort without abdominal pain. His vital signs were stable, and no abnormal physical findings were found for the abdomen. On digital rectal examination, the rim of the foreign body was palpated about 8 cm from the anal verge. Anal bleeding, abnormal discharge, or foul odor was not found. On a simple abdominal X-ray, a radio-opaque foreign body was observed in the pelvic cavity, and mild leukocytosis was noted on the laboratory test. To avoid injury to the anal sphincter, we tried to remove the foreign body under the spinal anesthesia. After anesthesia had been administered, the foreign body was palpated more distally at 5-6 cm from the anal verge by digital examination, and the foreign body was found to have a hole in its center. This was held using a Kelly clamp, and with digital guiding, was removed through the anus. After removal, an anoscopic examination was performed to determine if mucosal injury had occurred in the rectum or anal canal. The patient was discharged without complication after 24 hours of close observation.
Abdomen ; Abdominal Pain ; Anal Canal ; Anesthesia ; Anesthesia, Spinal ; Digital Rectal Examination ; Electronics ; Electrons ; Emergencies ; Foreign Bodies ; Head ; Hemorrhage ; Hemorrhoids ; Humans ; Leukocytosis ; Male ; Massage ; Odors ; Rectum ; Vital Signs

PURPOSE: To evaluate the efficacy of carcinoembryonic antigen (CEA) measurement for monitoring tumor progression during palliative chemotherapy in metastatic colorectal cancer. MATERIALS AND METHODS: Forty-eight patients with initially unresectable metastatic colorectal cancer (n=26, 54.2%) or recurrent unresectable metastatic colorectal cancer (n=22, 45.8%) received FOLFOX-4 chemotherapy for palliation. Serum CEA levels and carbohydrate antigen 19-9 levels were measured and computed tomography (CT) studies were performed prior to chemotherapy and after 3 cycles of chemotherapy. From the CT images, tumor responses were evaluated according to the Response Evaluation Criteria in Solid Tumors criteria and categorized as complete response, partial response, stable disease, and progressive disease. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of tumor marker assessments for determining tumor response were calculated. RESULTS: The sensitivity, specificity and diagnostic accuracy of CEA assessment for prediction of disease progression were 50%, 77% and 69%, respectively. When the patients were dichotomized according to baseline CEA level, the initially elevated CEA group showed higher sensitivity and higher diagnostic accuracy compared to the initially normal CEA group (sensitivity=67% vs. 20%; diagnostic accuracy=71% vs. 62%). CONCLUSION: CEA assessment could be useful for monitoring tumor progression during palliative chemotherapy in only patients with initially elevated CEA level.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; CA-19-9 Antigen/metabolism ; Carcinoembryonic Antigen/*blood ; Colorectal Neoplasms/drug therapy/*metabolism ; Disease Progression ; Female ; Fluorouracil/therapeutic use ; Humans ; Leucovorin/therapeutic use ; Male ; Middle Aged ; Organoplatinum Compounds/therapeutic use ; Palliative Care ; Predictive Value of Tests ; Recurrence ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tumor Markers, Biological/blood

PURPOSE: Combination therapy of alpha-blockers and 5alpha-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy. MATERIALS AND METHODS: A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared. RESULTS: A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696). CONCLUSIONS: Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.
Adrenergic alpha-Antagonists ; Aged ; Doxazosin ; Finasteride ; Humans ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Urinary Retention

BACKGROUND: The purpose of this study was to investigate the relationship between sleep patterns and health in Korea, using data from the Korea National Health and Nutrition Examination Survey 2016–2017.METHODS: In total, 12,646 individuals were divided into those who sleep more than 5 hours and less than 5 hours per day during the week. In addition, 512 people who slept less than 5 hours a day on weekdays were further classified into those sleeping on average less than 5 hours a day and those sleeping more than 5 hours a day on weekends.RESULTS: People who slept on average for more than 5 hours on weekdays were taller, had lower body mass index, and lower fasting blood sugar and glycated hemoglobin levels than those who slept less than 5 hours on weekdays. In addition, the percentage of people with osteoporosis, cervical cancer, and depression was lower in the group that slept on average 5 hours or more on weekdays than in the group that slept less than 5 hours on weekdays. Among those who slept on average less than 5 hours a day on weekdays, individuals who slept more than 5 hours a day on weekends were taller and had lower fasting blood glucose and glycated hemoglobin than those who slept less than 5 hours a day on weekends. The prevalence of patients with angina, arthritis, osteoporosis, colon cancer, and depression was higher in the group who slept less than 5 hours a day on weekends.CONCLUSION: There are differences in height, body mass index, fasting blood sugar level and glycated hemoglobin level and in the prevalence of angina, arthritis, osteoporosis, colon cancer, and depression according to weekday and weekend sleep times.
Adult ; Arthritis ; Blood Glucose ; Body Height ; Body Mass Index ; Colonic Neoplasms ; Depression ; Fasting ; Hemoglobin A, Glycosylated ; Humans ; Korea ; Nutrition Surveys ; Osteoporosis ; Prevalence ; Uterine Cervical Neoplasms

Purpose: We aimed to investigate whether adjuvant oxaliplatin-based chemotherapy after treatment for hepatic metastasis affects recurrence or survival and to determine the risk factors for recurrence or survival. Methods: Forty-six patients who underwent curative treatment for hepatic metastasis from colorectal cancer between July 2009 and December 2017 were included from a retrospectively collected patient database. Curative resection included hepatic resection, radiofrequency ablation (RFA), or a combination of both, followed by adjuvant chemotherapy with oxaliplatin-based chemotherapy. Results: Thirty-seven patients (80.4%) had colon cancer and 9 (19.6%) had rectal cancer. Twenty-six patients (56.5%) underwent hepatic resection, 7 (15.2%) RFA, and 13 (28.3%) hepatic resection and RFA. Thirty-two patients (69.6%) underwent chemotherapy after hepatic treatment. The recurrence incidence was 50% in the non-chemotherapy group and 46.9% in the chemotherapy group (P > 0.999). The incidence of death was 7.1% in the non-chemotherapy group and 18.8% in the chemotherapy group (P = 0.657). The recurrence risk factors were N stage (N0 vs. N2; P = 0.013, P = 0.005) and bilobed hepatic metastasis (P = 0.027, P = 0.009) in the univariate and multivariate analyses, respectively. However, chemotherapy after hepatic treatment was not a risk factor for disease-free survival (DFS) or overall survival (OS) in the univariate and multivariate analyses (P = 0.656 and P = 0.414, respectively; P = 0.510 and P = 0.459, respectively). Conclusion Oxaliplatin-based adjuvant chemotherapy after colorectal hepatic metastasis treatment did not affect the DFS or OS. The N stage of the primary tumor and bilobed hepatic metastasis are risk factors for recurrence and death.