Although the incidence and mortality for most cancers such as lung and colon are decreasing in several countries, they are increasing in several developed countries because of an unhealthy western lifestyles including smoking, physical inactivity and consumption of calorie-dense food. The incidences for lung and colon cancers in a few of these countries have already exceeded those in the United States and other western countries. Among them, lung cancer is the main cause of cancer death in worldwide. The cumulative survival rate at five years differs between 13 and 21 % in several countries. Although the most important risk factors are smoking for lung cancer, however, the increased incidence of lung cancer in never smokers(LCINS) is necessary to improve knowledge concerning other risk factors. Environmental factors and genetic susceptibility are also thought to contribute to lung cancer risk. Patients with lung adenocarcinoma who have never smoking frequently contain mutation within tyrosine kinase domain of the epidermal growth factor receptor(EGFR) gene. Also, K-ras mutations are more common in individuals with a history of smoking use and are related with resistance to EFGR-tyrosine kinase inhibitors. Recently, radon(Rn), natural and noble gas, has been recognized as second common reason of lung cancer. In this review, we aim to know whether residential radon is associated with an increased risk for developing lung cancer and regulated by several genetic polymorphisms.
Adenocarcinoma ; Colon ; Colonic Neoplasms ; Developed Countries ; Epidermal Growth Factor ; Genetic Predisposition to Disease ; Humans ; Incidence ; Life Style ; Lung Neoplasms* ; Lung* ; Mortality ; Phosphotransferases ; Polymorphism, Genetic ; Protein-Tyrosine Kinases ; Radon* ; Risk Factors ; Smoke ; Smoking ; Survival Rate ; United States

PURPOSE: The purpose of this study was to compare the findings on high-resolution CT (HRCT) of the chest with those on video-assisted thoracoscopy for the detection of bullae in patients who had undergone an operation for spontaneous pneumothorax, and we also wished to evaluate the relationship between the characteristics of bullae on HRCT and development of spontaneous pneumothorax. MATERIALS AND METHODS: Fifty patients with spontaneous pneumothorax who had undergone both HRCT of the chest and video-assisted thoracoscopic surgery were included in the study. Spontaneous pneumothoraces were classified as either primary or secondary pneumothorax, and as initial or recurrent pneumothorax. The HRCT scans were obtained with 1 mm slice thickness and a 5 mm scan interval. Two radiologists retrospectively compared the HRCT findings of the chest with those findings on video-assisted thoracoscopy for the detection of bullae, and they evaluated the value of HRCT for diagnosing bullae. In addition, we assessed the size and number of bullae in these patients, and we also evaluated the relationship between those findings of bullae and the development of spontaneous pneumothorax. RESULTS: Bullae were detected in 40 patients by using video-assisted thoracoscopy, and HRCT showed bullae in 38 of these patients. Bullae were not identified with video-assisted thoracoscopy in the remaining ten patients, and among these ten patients, bullae were not demonstrated by HRCT in eight of them. Therefore, the sensitivity and specificity of HRCT for the detection of bullae were 95% (38/40) and 80% (8/10), respectively. The average size of the bullae of the affected hemithorax and the contralateral un-affected hemithorax was 1.97 cm+/-2.30 and 1.24 cm+/-1.46, respectively. Pneumothorax was more frequently observed in the hemithorax with larger bullae (p<0.05). The average numerical grade of the bullae (3.38+/-1.60) was higher in the affected hemithorax than in the contralateral un-affected hemithorax (2.96+/-1.86), but there was no statistically significant difference between both groups of hemithoraces (p>0.05). The average size of bullae in patients with secondary pneumothorax and those bullae of patients with primary pneumothorax was 4.44 cm+/-4.06 and 1.42 cm+/-1.26, respectively. The bullae were significantly larger in the patients with secondary pneumothorax than in those patients with primary pneumothorax (p<0.05). Although the average numerical grade of bullae was higher in the patients with secondary pneumothorax (4.00+/-1.58) than in those patients with primary pneumothorax (3.24+/-1.61), the difference between two groups was not statistically significant (p>0.05). CONCLUSION:HRCT of the chest would be a useful modality for detecting the bullae of those patients with spontaneous pneumothorax. The development of spontaneous pneumothorax is associated with the size of bullae rather than the number of bullae.
Humans ; Pneumothorax* ; Retrospective Studies ; Sensitivity and Specificity ; Thoracic Surgery, Video-Assisted ; Thoracoscopy* ; Thorax

Cystic fibrosis (CF) is an autosomal recessive inherited multisystem disorder caused by mutations of the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Respiratory failure remains the most frequent cause of morbidity and mortality. Lung transplantation is the only option to treat end-stage lung disease. Very few cases of CF occur in Koreans. We report the case of a 12-year-old girl with respiratory failure due to CF who underwent lung transplantation. She had been diagnosed with CF 8 years previously after being treated for recurrent Pseudomonas aeruginosa pneumonia and malnutrition based on sweat chloride concentrations and the CFTR protein gene mutation test. Progression to end-stage lung disease and respiratory failure led to registration with the Korean Network for Organ Sharing. She underwent successful double lung transplantation in 2014. Although she has diabetes mellitus and chronic kidney disease, she has a better quality of life and a prolonged life expectancy.
Child* ; Cystic Fibrosis Transmembrane Conductance Regulator ; Cystic Fibrosis* ; Diabetes Mellitus ; Female ; Humans ; Korea ; Life Expectancy ; Lung Diseases ; Lung Transplantation* ; Lung* ; Malnutrition ; Mortality ; Pneumonia ; Pseudomonas aeruginosa ; Quality of Life ; Renal Insufficiency, Chronic ; Respiratory Insufficiency ; Sweat

BACKGROUND: Melanoma is a malignant neoplasm originating from melanocytes. It has been recently suggested that syndecan-2 may contribute to the aggressive phenotype and metastatic potential of melanoma in cell line studies. However, there is no quantitative analysis of syndecan-2 expression using human melanoma tissue. OBJECTIVE: This study aimed to examine the specific expression of syndecan-2 in human melanoma tissue. METHODS: A total of 35 sections of formalin-fixed, paraffin-embedded tissues were investigated for syndecan-2 expression using immunohistochemical staining. Also, a total of 6 tissues and two kinds of cell lines were analyzed by reverse-transcriptase polymerase chain reaction (RT-PCR) and western blot. RESULTS: Immunohistochemical staining of 23 cases of melanoma tissue was done, and in 5 cases (21.7%), strong expression of syndecan-2 was seen. Also, syndecan-2 was detected in human melanoma tissue and MNT-1 melanoma cells by RT-PCR and western blot analysis. CONCLUSION: We suggest that syndecan-2 expression is increased in melanoma compared to nevus. The results of this study may help to explain the clinical features of melanoma and syndecan-2.
Blotting, Western ; Cell Line ; Humans ; Melanocytes ; Melanoma* ; Nevus ; Nevus, Pigmented* ; Phenotype ; Polymerase Chain Reaction ; Syndecan-2*

PURPOSE: In recent years, the incidence of early-stage colorectal cancer (CRC) has markedly increased in the population within the Republic of Korea. The aim of this study was to evaluate the clinicopathologic features of adenomatous polyps in TNM stage I CRC patients and in the general population. METHODS: Between March 2003 and September 2009, 168 patients with stage I CRC were enrolled in this study. In addition, the records of 4,315 members of the general population without CRC, as determined by colonoscopy during a health check-up, were reviewed. RESULTS: Of the 168 patients with stage I CRC, 68 (40.5%) had coexisting colorectal adenomatous polyps and of the 4,315 members of the general population, 1,112 (26.0%) had coexisting adenomatous polyps (P = 0.006). The prevalences of adenomatous polyp multiplicity in early CRC and in the general population were 32% and 15%, respectively (P = 0.023). Patients with coexisting adenomatous polyps had a higher frequency of tubulovillous or villous adenomas than members of the general population with polyps (7.5% vs. 2.0%, P = 0.037). Furthermore, a subgroup analysis showed that the occurrence (44% vs. 34%, P = 0.006) and the multiplicity (32% vs. 15%, P = 0.023) of adenomatous polyps were greater for T2 than T1 cancer. CONCLUSION: The prevalence and the multiplicity of adenomatous polyps in TNM stage I CRC is higher than it is in the general population. The findings of this study suggest that depth of invasion of early stage CRC affects the prevalence and the number of adenomatous polyps in the remaining colon and rectum.
Adenoma, Villous ; Adenomatous Polyps ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Humans ; Incidence ; Korea ; Polyps ; Prevalence ; Rectum ; Republic of Korea

BACKGROUND/AIMS: A diagnosis of acute diverticulitis is based on computed tomography (CT). Colonoscopy is commonly performed after the acute event to exclude other diagnoses. This study aimed to determine whether colonoscopy is necessary and what additional information is gained from a colonoscopy after acute diverticulitis. METHODS: Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. We analyzed the number of patients in whom colorectal cancers were diagnosed and other incidental findings of polyps and other diseases. RESULTS: A total of 177 patients were analyzed retrospectively. The mean age was 43.3+/-15.3 years (range, 13-82 years) and 97 patients (54.8%) were male. Sixty-one patients had undergone a colonoscopy within 1 year of the acute attack. Advanced adenomatous lesions and colonic malignancy were not detected. Nineteen patients (31.1%) had > or =1 polyp and 11 patients (18.0%) had an adenomatous polyp. No new or different diagnosis was made after colonoscopy. None of the 116 patients who did not undergo colonoscopy within a year after acute diverticulitis had a diagnosis of colorectal cancer registered with the Korea Central Cancer Registry. CONCLUSIONS: Routine colonoscopy yields little benefit in patients with acute diverticulitis diagnosed by typical clinical symptoms and CT. The current practice of a colonoscopy after acute diverticulitis needs to be reevaluated.
Adenomatous Polyps ; Colon ; Colonoscopy* ; Colorectal Neoplasms ; Diagnosis* ; Diverticulitis* ; Humans ; Incidental Findings ; Korea ; Male ; Polyps ; Retrospective Studies

The radiographic appearance of a unilateral hyperlucent lung is related to various conditions, the accurate radiographic interpretation of which requires a structured approach as well as an awareness of the spectrum of these entities. Firstly, it is important to determine whether a hyperlucent hemithorax is associated with artifacts resulting from rotation of the patient, grid cutoff, or the heel effect. The second step is to determine whether or not a hyperlucent lung is abnormal. Lung that is in fact normal may appear hyperlucent because of diffusely increased opacity of the opposite hemithorax. Thirdly, thoracic wall and soft tissue abnormalities such as mastectomy or Poland syndrome may cause hyperlucency. Lastly, abnormalities of lung parenchyma may result in hyperlucency. Lung abnormalities can be divided into two groups: a) obstructive or compensatory hyperinflation; and b) reduced vascular perfusion of the lung due to congenital or acquired vascular abnormalities. In this article, we describe and illustrate the imaging spectrum of these causes and outline a structured approach to accurate radiographic interpretation.
Artifacts ; Heel ; Humans ; Lung* ; Lung, Hyperlucent ; Mastectomy ; Perfusion ; Poland Syndrome ; Thoracic Wall

BACKGROUND/AIMS: Serrated polyposis syndrome (SPS) has been shown to increase the risk of colorectal cancer (CRC). However, little is known about the characteristics of Asian patients with SPS. This study aimed to identify the clinicopathological features and risk of CRC in Korean patients with SPS as well as the differences between Korean and Western patients based on a literature review. METHODS: This retrospective study included 30 patients with SPS as defined by World Health Organization classification treated at Samsung Medical Center, Korea, between March 1999 and May 2011. RESULTS: Twenty patients (67%) were male. The median patient age at diagnosis was 56 years (range, 39–76 years). A total of 702 polyps were identified during a median follow-up of 43 months (range, 0–149 months). Serrated polyps were noted more frequently in the distal colon (298/702, 55%). However, large serrated polyps and serrated adenomas were mainly distributed throughout the proximal colon (75% vs. 25% and 81% vs. 19%, respectively); 73.3% had synchronous adenomatous polyps. The incidence of CRC was 10% (3/30 patients), but no interval CRC was detected. A total of 87% of the patients underwent esophagogastroduodenoscopy and 19.2% had significant lesions. CONCLUSIONS: The phenotype of SPS in Korean patients is different from that of Western patients. In Korean patients, SPS is more common in men, there were fewer total numbers of serrated adenoma/polyps, and the incidence of CRC was lower than that in Western patients. Korean patients tend to more frequently have abnormal gastric lesions. However, the prevalence of synchronous adenomatous polyps is high in both Western and Korean patients.
Adenoma ; Adenomatous Polyps ; Asian Continental Ancestry Group ; Classification ; Colon ; Colorectal Neoplasms ; Diagnosis ; Endoscopy, Digestive System ; Follow-Up Studies ; Humans ; Incidence ; Korea* ; Male ; Phenotype ; Polyps ; Prevalence ; Retrospective Studies ; World Health Organization

Background/Aims: Although balloon-assisted enteroscopy (BAE) enables endoscopic visualization of small bowel (SB) involvement in Crohn’s disease (CD), there is no data on the changes in outcomes over time. We therefore investigated the changes in BAE use on CD patients over different time periods in terms of its role and clinical outcomes. Methods: We used a multicenter enteroscopy database to identify CD patients with SB involvement who underwent BAE (131 procedures, 116 patients). We compared BAE-related factors and outcomes between the first period (70 procedures, 60 patients) and the second period (61procedures, 56 patients). The specific cutoff point for dividing the two periods was 2007, when BAE guidelines were introduced. Results: Initial diagnosis of SB involvement in CD was the most common indication for BAE during each period (50.0% vs 31.1%, p=0.034). The largest change was in the number of BAE uses for stricture evaluation and/or treatment, which increased significantly in the latter period (2.9% vs 21.3%, p=0.002). The diagnostic yield in patients with suspected CD was 90.7% in the first period and 95.0% in the second (p=0.695). More endoscopic interventions were performed in the second period than in the first (5.1% vs 17.6%, p=0.041). Enteroscopic success rates were high throughout (100% in the first period vs 80.0% in the second period, p>0.999). In the first and second periods, therapeutic plans were adjusted in 62.7% and 61.4% of patients, respectively. Conclusions The overall clinical indications, outcomes, and effectiveness of BAE were constant over time in CD patients with SB involvement, with the exception that the frequency of enteroscopic intervention increased remarkably.

Background/Aims: Although balloon-assisted enteroscopy (BAE) enables endoscopic visualization of small bowel (SB) involvement in Crohn’s disease (CD), there is no data on the changes in outcomes over time. We therefore investigated the changes in BAE use on CD patients over different time periods in terms of its role and clinical outcomes. Methods: We used a multicenter enteroscopy database to identify CD patients with SB involvement who underwent BAE (131 procedures, 116 patients). We compared BAE-related factors and outcomes between the first period (70 procedures, 60 patients) and the second period (61procedures, 56 patients). The specific cutoff point for dividing the two periods was 2007, when BAE guidelines were introduced. Results: Initial diagnosis of SB involvement in CD was the most common indication for BAE during each period (50.0% vs 31.1%, p=0.034). The largest change was in the number of BAE uses for stricture evaluation and/or treatment, which increased significantly in the latter period (2.9% vs 21.3%, p=0.002). The diagnostic yield in patients with suspected CD was 90.7% in the first period and 95.0% in the second (p=0.695). More endoscopic interventions were performed in the second period than in the first (5.1% vs 17.6%, p=0.041). Enteroscopic success rates were high throughout (100% in the first period vs 80.0% in the second period, p>0.999). In the first and second periods, therapeutic plans were adjusted in 62.7% and 61.4% of patients, respectively. Conclusions The overall clinical indications, outcomes, and effectiveness of BAE were constant over time in CD patients with SB involvement, with the exception that the frequency of enteroscopic intervention increased remarkably.