Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Some studies have reported a decrease in the natural killer (NK) cell activity in smokers. However, large-scale data on the relationshipbetween NK cell activity and smoking are unavailable. A cross-sectional study was performed on 12,249 asymptomatic examineeswho underwent an NK cell activity test, between January 2016 and May 2017. The test quantitated the amount of interferon-γsecreted into the plasma by NK cells, using a patented stimulatory cytokine. The mean age of the study population was 39.1 years,and the proportions of “never”, “former”, and “current” smokers were 65.5%, 20.9%, and 13.6%, respectively. Current smokers (1,422pg/mL) had a lower median level of NK cell activity than never smokers (1,504 pg/mL, P = 0.039) and former smokers (1,791 pg/mL, P < 0.001). Among current smokers, NK cell activity decreased with increase in the number of cigarettes smoked among currentsmokers (median, 1,537, 1,429, and 1,175 pg/mL at <10, 10-19, and ≥ 20 pack-years, respectively; P < 0.001). Additionally, itdecreased linearly with increasing quartiles of cotinine levels (median, 1,707, 1,636, 1,348, and 1,292 pg/mL at cotinine levels < 292,292-879, 880-1,509, and ≥ 1,510 ng/mL, respectively; r = –0.122, P < 0.001). NK cell activity was lower in current smokers. It alsodecreased with an increase in the number of cigarettes smoked, and it was negatively correlated with cotinine levels among currentsmokers. Our findings indicate a clear relationship between smoking and decreased NK cell activity.

PURPOSE: Several studies have reported relationships among physical activity, healthy metabolic status, and increased natural killer (NK) cell activity. However, large-scale data thereon are lacking. Thus, the present study aimed to assess NK cell activity according to physical activity and metabolic status. MATERIALS AND METHODS: A cross-sectional study was performed on 12014 asymptomatic examinees. Using a patented stimulatory cytokine, NK cell activity was quantitated by the amount of interferon-γ secreted into the plasma by NK cells. Physical activity levels were assessed using the validated Korean version of the International Physical Activity Questionnaire Short Form. RESULTS: The physically inactive group showed lower NK cell activity than the minimally active group (median, 1461 vs. 1592 pg/mL, p < 0.001) and health-enhancing physically active group (median, 1461 vs. 1712 pg/mL, p=0.001). Compared to women with a body mass index (BMI) of 18.5–27.5 kg/m2, those with a BMI < 18.5 kg/m2 had significantly lower NK cell activity (1356 vs. 1024 g/mL, p < 0.001), and those with a BMI ≥27.5 kg/m2 tended to have lower NK cell activity (1356 vs. 1119 g/mL, p=0.070). Subjects with high hemoglobin A1c levels and low high-density lipoprotein cholesterol levels, as well as men with high blood pressure and women with high triglyceride levels, exhibited lower NK cell activity. Moreover, physical inactivity and metabolic abnormalities were independently associated with low NK cell activity, even after adjusting for confounders. CONCLUSION: Physical inactivity and metabolic abnormalities are associated with reduced NK cell activity. Immune systems may become altered depending on physical activity and metabolic status.
Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; Immune System ; Killer Cells, Natural* ; Lipoproteins ; Male ; Motor Activity ; Plasma ; Triglycerides

STUDY DESIGN: A retrospective review of prospectively collected data. PURPOSE: To introduce the sternum-disk distance (SDD) method for approaching the exact surgical level without C-arm guidance during anterior cervical discectomy and fusion (ACDF) surgery and to evaluate its accuracy and reliability. OVERVIEW OF LITERATURE: Although spine surgeons have tried to optimize methods for identifying the skin level for accessing the operative disk level without C-arm guidance during ACDF, success has rarely been reported. METHODS: In total, 103 patients who underwent single-level ACDF surgery with the SDD method were enrolled. The primary outcome measure was the accuracy of the SDD method. The secondary outcome measures were the mean SDD value at each cervical level from the cranial margin of the sternum in the neutral and extension positions of the cervical spine and the inter- and intra-observer reliability of the SDD outcome determined using repeated measurements by three orthopedic spine surgeons. RESULTS: The SDD accuracy (primary outcome measure) was indicated in 99% of the patients (102/103). The mean SDD values in the neutral-position magnetic resonance imaging (MRI) were 108.8 mm at C3–C4, 85.3 mm at C4–C5, 64.4 mm at C5–C6, 44.3 mm at C6–C7, and 24.1 mm at C7–T1; and those in the extension-position MRI were 112.9 mm at C3–C4, 88.7 mm at C4–C5, 67.3 mm at C5–C6, 46.5 mm at C6–C7, and 24.3 mm at C7–T1. The Cohen kappa coefficient value for intra-observer reliability was 0.88 (excellent reliability), and the Fleiss kappa coefficient value for inter-observer reliability as reported by three surgeons was 0.89 (excellent reliability). CONCLUSIONS: Based on the results of the present study, we recommend performing ACDF surgery using the SDD method to determine the skin level for approaching the surgical cervical segment without fluoroscopic guidance.
Cervical Vertebrae ; Diskectomy* ; Female ; Fluoroscopy* ; Humans ; Magnetic Resonance Imaging ; Methods* ; Orthopedics ; Outcome Assessment (Health Care) ; Prospective Studies ; Retrospective Studies ; Skin* ; Spinal Fusion ; Spine ; Sternum ; Surgeons

Emphysematous osteomyelitis, especially that involving the extra-axial skeleton, is an extremely rare presentation but associated with significant morbidity and mortality. Here, we report a case in which a 58-year-old female patient with diabetes mellitus presented with emphysematous osteomyelitis that involved the sternum, clavicle, and pelvic bone and was caused by Escherichia coli via hematogenous spread of urinary tract infection. We successfully treated her with urgent and aggressive surgical drainage with prolonged antibiotics therapy. Early diagnosis and immediate surgical intervention are required for better outcomes in cases of emphysematous osteomyelitis.
Anti-Bacterial Agents ; Clavicle ; Diabetes Mellitus ; Drainage ; Early Diagnosis ; Escherichia coli* ; Escherichia* ; Female ; Humans ; Middle Aged ; Mortality ; Osteomyelitis* ; Pelvic Bones ; Skeleton ; Sternum ; Urinary Tract Infections

BACKGROUND: Seborrheic dermatitis (SD) is a chronic, relapsing inflammatory disease, mainly affecting the scalp and face. The pathogenesis of SD has been not fully understood yet, but may be related to the skin colonization of Malassezia species, lipophilic yeasts. Phototherapy with light emitting diode (LED) device has been become a new therapeutic modality for some skin diseases such as acne. OBJECTIVE: To evaluate effectiveness and safety of phototherapy with home-use LED in the treatment of patients with SD of the scalp. METHODS: Eight patients with mild-to-moderate SD of the scalp participated. The patients used a home-use LED device combined 395 nm blue light with 660 nm red light for 6~7 min twice daily for 8 weeks. Patients' assessments were made by clinical findings including erythema (0~15), scales (0~15), itching (0~10), and lesional extent (0~15). And clinical photographs were taken at 0, 2, 4 and 8 weeks, respectively. RESULTS: At 8 weeks after LED treatment, erythema (7.75 to 5.13, p=0.018), scales (7.38 to 4.13, p=0.017), itching (6 to 3, p=0.011) and lesional extent (8.25 to 5.25, p=0.017) were significantly decreased, respectively. Satisfactory scores were also relatively high (mean 8.13 of 10). No severe adverse reaction was reported, excepting hair dryness (n=1) and brief stinging sense (n=1). CONCLUSION: Home-use LED was effective and safe in the treatment of SD of the scalp. These results suggest the LED device might be an adjuvant therapeutic tool in the treatment of Malassezia species associated diseases such as dandruff and SD. Further long-term and large-scale studies are required to assess the efficacy and safety of home-use LED.
Acne Vulgaris ; Bites and Stings ; Colon ; Dandruff ; Dermatitis, Seborrheic* ; Erythema ; Hair ; Humans ; Malassezia ; Phototherapy ; Pruritus ; Scalp* ; Skin ; Skin Diseases ; Weights and Measures ; Yeasts

Eccrine porocarcinoma is a rare cutaneous neoplasm arising from the eccrine sweat duct. It may arise de novo or evolve from a pre-existing poroma or hidroacanthoma simplex. The pigmented variant of porocarcinoma is very rare, and its heavy pigmentation can lead to misdiagnosis of seborrheic keratosis or melanoma. An 82-year-old male patient presented with a painful, brown-to-black colored plaque measuring 4x4.5 cm with a central pedunculated nodule that measured 2.5x2 cm on his right posterior thigh. A small, pigmented papule had developed 10 years prior and had gradually increased in size. Histopathologic examination of the nodule revealed lobulated tumor islands composed of atypical basaloid cells in the periphery, eosinophilic squamous cells in the center, and pigmented dendritic cells scattered throughout nests of the tumor. Carcinoembryonic antigen and epithelial membrane antigen were expressed in the tumor cells and the dendritic cells stained positive for S-100 and HMB45. Histopathologic findings from the plaque showed many pigmented nests embedded within the epidermis that were composed of small, polygonal, pigmented basaloid cells. Pigmented eccrine porocarcinoma arising from pigmented hidroacanthoma simplex was diagnosed clinically and histopathologically. The tumor was completely excised. We report a case of pigmented porocarcinoma, which should be included among clinically important differential diagnoses apart from melanoma.
Aged, 80 and over ; Carcinoembryonic Antigen ; Dendritic Cells ; Diagnosis, Differential ; Diagnostic Errors ; Eccrine Porocarcinoma* ; Eosinophils ; Epidermis ; Humans ; Islands ; Keratosis, Seborrheic ; Male ; Melanoma ; Mucin-1 ; Pigmentation ; Poroma ; Sweat ; Thigh

PURPOSE: The purpose of this study was to define the experience of nursing education in the Jinju area of Gyeongsang-Namdo from the 1940s to 1960s. METHODS: An oral history study was done using personal interviews with 8 nurses who graduated in nursing in Gyeong Nam area during the period under study. RESULTS: In this study, the individual's educational background before entering the nursing school, school life, and life as a nurse after graduating from nursing school were defined. CONCLUSION: For most of the respondents, their educational background before entering nursing school was middle school. They studied very hard in poor surroundings. After graduation from a nursing school, they worked in hospitals, public health centers, midwifery centers, and schools. Half of the respondents had experience as a midwife. Their income as a midwife was relatively high at that time. They all had positive identities and lived a life devoted to the individual, society, and the nation.
Surveys and Questionnaires ; Education, Nursing ; History of Nursing ; Hospitals, Public ; Humans ; Midwifery ; Schools, Nursing

The development of a serological marker for early diagnosis of isocyanate-induced occupational asthma (isocyanate-OA) may improve clinical outcome. Our previous proteomic study found that expression of vitamin D-binding protein (VDBP) was upregulated in the patients with isocyanate-OA. In the present study, we evaluated the clinical relevance of VDBP as a serological marker in screening for isocyanate-OA among exposed workers and its role in the pathogenesis of isocyanate-OA. Three study groups including 61 patients with isocyanate-OA (group I), 180 asymptomatic exposed controls (AECs, group II), 58 unexposed healthy controls (NCs, group III) were enrolled in this study. The baseline serum VDBP level was significantly higher in group I compared with groups II and III. The sensitivity and specificity for predicting the phenotype of isocyanate-OA with VDBP were 69% and 81%, respectively. The group I subjects with high VDBP (> or = 311 microg/ml) had significantly lower PC20 methacholine levels than did subjects with low VDBP. The in vitro studies showed that TDI suppressed the uptake of VDBP into RLE-6TN cells, which was mediated by the downregulation of megalin, an endocytic receptor of the 25-hydroxycholecalciferol-VDBP complex. Furthermore, toluene diisocyanate (TDI) increased VEGF production and secretion from this epithelial cells by suppression of 1,25-dihydroxycholecalciferol [1,25(OH)2D3] production. The findings of this study suggest that the serum VDBP level may be used as a serological marker for the detection of isocyanate-OA among workers exposed to isocyanate. The TDI-induced VEGF production/secretion was reversed by 1,25(OH)2D3 treatment, which may provide a potential therapeutic strategy for patients with isocyanate-OA.
Adult ; Animals ; *Asthma/blood/chemically induced/pathology ; Cell Line ; Epithelial Cells ; Female ; Gene Expression/drug effects ; Humans ; Isocyanates/toxicity ; Male ; Middle Aged ; *Occupational Diseases/blood/chemically induced/pathology ; Rats ; Toluene 2,4-Diisocyanate/toxicity ; Vitamin D-Binding Protein/*blood