PURPOSE: In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred. METHODS: Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging. RESULTS: The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively. CONCLUSION: CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.
Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

With the increase of industrialization, leisures, sports activities and traffic, the risk of trauma has increased markedly. Midfacial bones are relatively common sites of trauma, and are difficult sites of correct reduction and reconstruction, because midface is composed of mostly thin cortical bone surrounding cavities filled with either air or fat with discrete areas of bony condensation. A clinical study on 208 patients with midfacial bone fracture who visited Sanggye Paik Hospital during 5 years(1990~1995) was done by analyzing sex, age, cause, fracture site, treatment method, complication and involvement of other body part, etc. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with ratio of 2.7 : 1 and most frequently in twenties. 2. Traffic accident was the most common cause of midface fractures. 3. Zygoma was the most frequently occurred site(50%) of midface fractures. 4. Simple fracture(75%) was more frequently occurred than compound fracture(25%). 5. As treatment method, open reduction(76.4%) was used more frequently than closed reduction(23.6%) 6. Generally, operations are done in 5 days after admission(59.1%), and intermaxillary fixation was done in 78.4% of cases. 7. Teeth and alveolar bone damages were occurred in 32.2% of cases. 8. Other injuries that were related to midface fracture occurred in 63.3% of cases. 9. Post-operative complications occurred in 9% of cases.
Accidents, Traffic ; Female ; Fractures, Bone ; Humans ; Leisure Activities ; Male ; Sports ; Tooth ; Zygoma

The IRB approval number should be corrected.

PURPOSE: Many studies have demonstrated that sporadic MSI-H colorectal cancers share several clinicopathological features with hereditary nonpolyposis colorectal cancers. However, microsatellite instability (MSI) in HNPCC and sporadic colorectal cancer occur through two different mechanisms. The aim of this study was to define the clinicopathological significance of MSI in sporadic colorectal cancers. METHODS: Using paraffin-embedded specimens from 291 consecutive sporadic colorectal cancer patients, a total of 5 microsatellite markers (D2S123, D5S346, D17S250, BAT25 and BAT26) were used to evaluate the MSI status. Age, gender, tumor size, site, grade, stage, vascular invasion and CEA level were evaluated. RESULTS: The incidence of MSI-H was 7.9% (23/291) in sporadic colorectal cancer. These were more likely to be right-sided (56.5% vs 17.5%, P<0.05) and poorly differentiated (31.8% vs 5.5%, P<0.05), compared with microsatellite stable cancers. However, there was no significant difference according to gender, tumor size, grade, stage, and vascular invasion. MSI-H cancers had a tendency for an earlier age and lower CEA level but this did not reach statistical significance. CONCLUSION: These results suggest that sporadic MSI-H colorectal cancers are more likely to be right-sided, and poorly differentiated. Although sporadic MSI-H colorectal cancers show MSI as with HNPCC, the carcinogenesis and clinicopathological features are different from those of HNPCC. Additional more study will be needed to further define the role of MSI in the survival and adjuvant chemotherapy of sporadic colorectal cancer.
Carcinogenesis ; Chemotherapy, Adjuvant ; Colorectal Neoplasms* ; Humans ; Incidence ; Microsatellite Instability* ; Microsatellite Repeats*

BACKGROUND: The medically unexplained symptoms present one of the most common problems in medical practice and the role of primary care physicians is becoming greater to manage them. Our goal was to investigate how the primary care physicians conceive and deal with patients complaining of medically unexplained symptoms (MUS). METHODS: A group of 840 primary care physicians, 524 internist and 316 family physicians in Seoul were surveyed. The questionnaire regarding the perception and the way of consultation about MUS was posted by mail. RESULTS: A total of 180 questionnaires were collected via mail and fax. Ten of them were uncompleted, and the response rate was 22%. Over half of the respondents felt that the consultation of MUS was difficult and they were concerned about the possibility of overlooking some of organic problems (57.6%). Average consultation rate of MUS in daily practice was 14%. The anxiety toward failure of treatment was the most common concern during the MUS consultation. Seventeen percent answered they knew the efficient method to deal with MUS patients. Respondents complained of the deficiency of contents and experiences to deal with MUS during the period of training (80%). More family physicians compared to internists perceived patients with MUS to have personality problems and they often tended to prescribe psychotropic drugs. Family physicians also answered that the training courses provided proper knowledge and contents regarding MUS consultation more than the internists. CONCLUSION: MUS consultation imposes a burden on primary care physicians. Therefore, continuing education not only for residency but for post graduates should be considered for effective management for MUS.
Animals ; Anxiety ; Surveys and Questionnaires ; Education, Continuing ; Humans ; Internship and Residency ; Mice ; Physicians, Family ; Physicians, Primary Care* ; Postal Service ; Primary Health Care* ; Psychotropic Drugs ; Seoul