This report is a retrospective clinical analysis fo 84 cases more than 65 years of colorectal carcinoma treated surgically by the Department of General Surgery, College of Medicine, Soon Chun Hyang University from January 1991 to December 1995. The average age was 71.3 years; 49 patients were male and 35 were female. Tumor location was as follows; rectum 39(46.4%), sigmoid 22(26.2), ascending colon 12(14.3%), descending colon 8(9.5%), transverse colon 3(3.6%). The most frequent symptom in colorectal cancer was abdominal pain. The patients whose clinical symptom had been for less than 1 month before the hospitalization was about 31.0%. The rate of curative resection was 88.1%, Emergency operation was performed about 19.0%(16 cases). By Astler Coller classification, there were stage A 2 cases(2.5%), Bl 13 cases(16.5%), B2 28 cases(35.4%), Cl 2 cases(2.5%), C2 24 cases(30.4%), D 10 cases(12.7%). The average size of mass was 4.41 on. The most common pathologic type was moderately differentiated adenocarcinoma. Postoperative mortality rate was 4.7%(4 cases). The 5 year cumulative survival rate was 42.9%. In conclusion, the postoperative mortality and survival rates obtained in this study encourage us not to consider age as a limiting factor for curative surgical treatment. Early detection of colorectal cancer, adequate management of preoperative underlying disease and aggresive curative resection are improving outcome in the surgery of old aged patients with colorectal cancer.
Abdominal Pain ; Adenocarcinoma ; Aged* ; Classification ; Colon, Ascending ; Colon, Descending ; Colon, Sigmoid ; Colon, Transverse ; Colorectal Neoplasms* ; Emergencies ; Female ; Hospitalization ; Humans ; Male ; Mortality ; Rectum ; Retrospective Studies ; Survival Rate

OBJECTIVE: The impact of beta blockers (BBs) on survival outcomes in ovarian cancer was investigated. METHODS: By using Korean National Health Insurance Service Data, Cox proportional hazards regression was performed to analyze hazard ratios (HRs) with 95% confidence intervals (CIs) adjusting for confounding factors. RESULTS: Among 866 eligible patients, 206 (23.8%) were BB users and 660 (76.2%) were non-users. Among the 206 BB users, 151 (73.3%) were non-selective beta blocker (NSBB) users and 105 (51.0%) were selective beta blocker (SBB) users. BB use in patients aged ≥60 years, longer duration use (≥1 year), in patients with Charlson Comorbidity Index (CCI) ≥3, and in cardiovascular disease including hypertension was associated with better survival outcome. These findings were observed in both NSBB and SBB. When duration of medication was analyzed based on number of days, NSBB (≥180 days) was associated with improved overall survival (OS) with a relatively shorter period of use compared to SBB (≥720 days). In multivariate Cox proportional hazards model, longer duration of BB medication (≥1 year) was an independent favorable prognostic factor for both OS and disease-specific survival in ovarian cancer patients. CONCLUSION: In our nationwide population-based cohort study, BB use was associated with better survival outcomes in ovarian cancer in cases of long term duration of use, in older patients, and in cardiovascular and/or other underlying disease (CCI ≥3).
Adrenergic beta-Antagonists ; Cardiovascular Diseases ; Cohort Studies* ; Comorbidity ; Humans ; Hypertension ; National Health Programs ; Ovarian Neoplasms* ; Proportional Hazards Models ; Treatment Outcome

BACKGROUND: Proteinase-activated receptor 2 (PAR2) is cleaved, and it is activated by trypsin or mast cell tryptase. PAR2 plays an important role in inflammation. The aim of this study is to examine the potential of PAR2 agonists to modulate TNF-alpha secretion from the human astrocytoma cell line CCF-STTG1. METHODS: PAR2 expression in CCF-STTG1 was examined using reverse transcriptase polymerase chain reaction and immunocytochemistry. The potential of PAR2 agonists to modulate TNF-alpha secretion from CCF-STTG1 was examined by enzyme-linked immunosorbent assays. RESULTS: CCF-STTG1 expresses PAR2. PAR2 agonists such as trypsin, mast cell tryptase, and activating peptide SLIGKV-NH2 (corresponding to the PAR2 tethered ligand) directly signal CCF-STTG1 to induce the secretion of TNF-alpha but not in the case of the soybean trypsin inhibitor (SBTI) or VKGILS-NH2 (control peptide). Furthermore, the secretion of TNF-alpha was significantly reduced in CCF-STTG1 cells pre-treated with either 50 microM PD98059 (mitogen-activated protein/extracellular signal-regulated kinase kinase (MEK) inhibitor) or 1 microM SB203580 (p38 MAPK inhibitor) 30 min before trypsin stimulation. CONCLUSIONS: These results show that trypsin may induce TNF-alpha secretion through the activation of MEK and p38 MAPK via PAR2 in astrocytoma cell line CCF-STTG1.
Astrocytes* ; Astrocytoma ; Cell Line* ; Enzyme-Linked Immunosorbent Assay ; Humans* ; Immunohistochemistry ; Inflammation ; p38 Mitogen-Activated Protein Kinases ; Phosphotransferases ; Reverse Transcriptase Polymerase Chain Reaction ; Soybeans ; Trypsin ; Tryptases ; Tumor Necrosis Factor-alpha*

OBJECTIVE: To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS: The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. RESULTS: Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis (p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72–9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. CONCLUSION: Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.
Carcinoma, Squamous Cell ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Epithelial Cells ; Head ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Multivariate Analysis ; Neck ; Neck Dissection ; Prognosis ; Sensitivity and Specificity

PURPOSE: The renin-angiotensin-aldosterone system activation has been suggested as a potential risk factor for renal progression in autosomal dominant polycystic kidney disease (ADPKD). This study was performed to evaluate urinary angiotensinogen as a biomarker of renal progression in ADPKD. METHODS: Patients with estimated glomerular filtration rate (eGFR) > or =30 mL/min/1.73m2 were enrolled in the study. Specimens (blood and urine) and computed tomography (CT) were taken from each subject. The eGFR was calculated by 4-variable MDRD equation and total kidney volume (TKV) was measured from CT images by modified ellipsoid method. Urinary angiotensinogen (AGT) and neutrophil gelatinaseassociated lipocalin (NGAL) were measured by ELISA. The concentration of AGT was adjusted with random urine creatinine (Cr). The association between urinary biomarkers, TKV and eGFR were evaluated. RESULTS: A total of 59 (M:F=31:28) subjects were enrolled in the study and their mean age was 46 years. The eGFR and TKV at the enrollment were 77.3+/-15.6 mL/min/1.73m2 and 1389.8+/-925.1 mL, respectively. Log AGT/Cr was associated with TKV (r2=0.117, p=0.01) in the earlier stage of disease (TKV<3,000 mL). However, it did not show significant correlation with eGFR. Log NGAL was not associated with either TKV or eGFR. Urinary AGT/Cr was closely related to the number of anti-hypertensive medication, TKV, and the presence of albuminuria, although there was no correlation with plasma renin activity or aldosterone level. CONCLUSION: Urinary angiotensinogen may be a useful biomarker of disease progression in ADPKD patients.
Albuminuria ; Aldosterone ; Angiotensinogen ; Biomarkers ; Creatinine ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Glomerular Filtration Rate ; Humans ; Kidney ; Lipocalins ; Neutrophils ; Organ Size ; Plasma ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant ; Renin ; Renin-Angiotensin System