Microorganisms coexist in the human body and its function is essential to maintain normal physiology and homeostasis. Microbiota refers to the entire population of microorganisms that colonizes a particular location; includes not just bacteria but also other microbes. Gut microbiota is vast and complex. It could be changed dynamically according to the variable factors. Well balanced host-microbial symbiotic state is a harmonious ecosystem in the stable individual. But, dysbiosis is a state of deviation in composition or function from the usual gut microbiota. It has been found that this condition is associated with many gastrointestinal, metabolic, allergic and the other diseases. Dysbiosis plays an important role in the pathophysiology of functional bowel disease, such as irritable bowel syndrome and functional constipation. Probiotics is microorganism which, when administrated in adequate amounts, confer a health benefit on the host. Probiotics have beneficial effects to reduce several symptoms of functional bowel diseases. Currently, complementary and alternative medicine therapies with probiotics is recommended for symptomatic relief from functional bowel disease.
Bacteria ; Colon ; Complementary Therapies ; Constipation ; Dysbiosis ; Ecosystem ; Gastrointestinal Microbiome* ; Homeostasis ; Human Body ; Insurance Benefits ; Irritable Bowel Syndrome ; Microbiota ; Physiology ; Probiotics*

PURPOSE: Dihydropyrimidine dehydrogenase (DPD) is a rate-limiting enzyme in 5-FU catabolism, so the enzymatic activity of DPD reflects the 5-FU response. Moreover, recent studies have revealed that microsatellite instability (MSI) status correlates well with the prognosis and the 5-FU chemosensitivity in colorectal cancer (CRC). This study aimed to determine whether DPD mRNA expression is related with the MSI status of primary CRC as a prognostic predictor. METHODS: Tumor samples and adjacent normal colonic mucosal tissues were collected from 59 patients. DPD mRNA expression was calculated by using the real-time RT-PCR method. The MSI status was examined by using multiplex fluorescent PCR with five reference markers. The results of DPD mRNA expression and MSI status were compared with the clinicopathologic variables and with each other. RESULTS: The mean age of the 59 patients was 59 (range: 36~81) years. In 55 patients (93.2%), the colorectal cancers were histologically well or moderately differentiated. Forty-nine of the tumors (49, 83.1%) were located distal to the splenic flexure, and 46 patients (78%) had TNM stage II (n=17) or stage III (n=29) cancer. The DPD mRNA expression level was informative in all 59 cases. The median expression level was 2.5 (range: 0~67.33). There was no correlation between the DPD mRNA expression level and age, gender, location, or TNM stage. MSI status was informative in 43 cases (72.9%). Thirty-six cases (36, 83.7%) were microsatellite-stable (MSS), 4 cases (9.3%) showed low-level microsatellite instability (MSI-L), and 3 cases (7.0%) showed high-level microsatellite instability (MSI-H). Proximal CRC showed a higher proportion of MSI-H than distal CRC (25% vs. 2.9%, P=0.03). We could not find any correlation between the DPD mRNA expression level and the MSI status in tumor tissues (r=0.29, P=0.09). CONCLUSIONS: The expression level of DPD mRNA raried among the tumors studied. The relatively low frequency of MSI in distal CRC prohibits the use of MSI status as a predictor of 5-FU chemosensitivity. We suggest that a well-designed large-scale study would be helpful to confirm the relation between DPD mRNA expression and MSI status as a predictor of 5-FU chemosensitivity in CRC patients.
Colon ; Colon, Transverse ; Colorectal Neoplasms* ; Dihydrouracil Dehydrogenase (NADP)* ; Drug Therapy* ; Fluorouracil* ; Humans ; Metabolism ; Microsatellite Instability* ; Microsatellite Repeats* ; Mucous Membrane ; Polymerase Chain Reaction ; Prognosis ; RNA, Messenger

PURPOSE: The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans. METHODS: A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001. RESULTS: A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted. CONCLUSIONS: Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.
Abscess ; Blood Transfusion ; Colorectal Surgery ; Fissure in Ano ; Hemorrhoids ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Korea ; Male ; Rectal Fistula ; Rectum ; Retrospective Studies ; Sex Ratio ; Ulcer

PURPOSE: Helicobacter pylori infection has been reported as a major factor of chronic gastritis, peptic ulcer, gastric lymphoma, and stomach cancer. In some uncontrolled studies, a high seroprevalence of H. pylori infection unexpectedly has been found in patients with colorectal cancer. The purpose of this study was to investigate the prevalence of H. pylori infection in patients with colorectal neoplasm. METHODS: 93 colonic tissue samples were collected during the colonoscopic biopsy. The specimens included polyp, cancer, and normal colonic mucosa. The CLO testTM kit (Delta West Ltd., Bentley, Western Australia) was used for detection of H. pylori. The SAS program (USA) was used for the Fisher's exact test. RESULTS: H. pylori infection was detected 11 (11.8%) of total 93 specimens, 7 (25.7%) of 27 in cancers and 3 (6.9%) of 43 in polyps. Significantly higher H. pylori infection was detected in the colorectal cancers than non-cancer lesions (p=0.012) and polyps (p=0.038). CONCLUSIONS: These results suggest a statistically significant association between H. pylori and colorectal neoplasm. The mechanism underlying this association needs to be investigated.
Biopsy ; Colon ; Colorectal Neoplasms* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoma ; Mucous Membrane ; Peptic Ulcer ; Polyps ; Prevalence ; Seroepidemiologic Studies ; Stomach Neoplasms

PURPOSE: This study has carried out to clarify the relationship between changes in the anal sphincter muscle thickness and pressure. Also, this study shows the effect of vaginal delivery and benign anal disease on the function and structure of the anal sphincter. METHODS: Women (n=42; mean age: 33.2 +/- 9.6 years old) without defecation problems or history of anal surgery, who came to Ewha Womans University Hospital between July 1999 and October 1999, were chosen. We measured the resting and the squeezing pressure with anal manometry and the thickness of the internal anal sphincter (IAS) and external anal sphincter (EAS) by endoanal sonography. RESULTS: The mean squeezing and resting pressures were 98.3 +/- 38.2 and 53.9 +/-17.4 cmH2O, and the mean EAS and IAS thicknesses were 4.9+/-0.9 and 1.9+/-0.3 mm, respectively. The thickness of the EAS and squeezing pressure did not correlate. Neither did the IAS thickness and the resting pressure. In cases with a history of vaginal delivery (n=15), the squeezing and the resting pressures were 94.0+/-43.0 and 57.1+/-22.2 cmH2O, and the thicknesses of the EAS and the IAS, 4.6+/-0.9 and 2.0+/-0.4 mm, respectively. The number of deliveries had no correlation with the thickness or the pressure of the anal sphincter. In patients with benign anal lesions (n=11), the squeezing and the resting pressure was 113.0+/-42.9 and 57.0+/-14.0 cmH2O, and the thicknesses of the EAS and the IAS were 5.0+/-1.3 and 2.1+/-0.4 mm, respectively. CONCLUSION: Our data suggest that the function and the structure of the anal sphincter are independent. In adult women, the thickness of the anal sphincter, the history of vaginal delivery, and the existence of benign anal lesions had no effect on anal sphincter function.
Adult* ; Anal Canal* ; Defecation ; Female ; Humans ; Manometry

PURPOSE: Establishing the preoperative stage of colorectal cancer is of primary importance in determining the management and the operative procedure. A comparative study of preoperative evaluation of colorectal cancer is necessary for proper management. METHODS: This study reports a 7 years' experience using another two species of CT for preoperative staging. One species of CT (1989, Delta 2060, Technicare, USA) was used from January 1990 to December 1992; the other species of CT (1992, Highlight Advantage, General Electric Company, USA) was used from January 1993 to December 1997. This study included retrospective analysis of 237 cases of colorectal cancer from January 1990 to December 1997. In first group, the preoperative stage evaluation was done with a much older species of CT from January 1990 to December 1992; in the other group, the preoperative stage evaluation was done with a newer species of CT from January 1993 to December 1997. RESULT: The accuracy & sensitivity of preoperative staging between the two groups showed no significant differences. CONCLUSION: CT is recommended in the preoperative staging of rectal cancer and as an aid in choosing the appropriate therapy. In addition to CT, transrectal ultrasonography and MRI are recommend for improving the accuracy of preoperative staging in assessing local invasion by cancer.
Colorectal Neoplasms* ; Magnetic Resonance Imaging ; Rectal Neoplasms ; Retrospective Studies ; Surgical Procedures, Operative ; Ultrasonography

BACKGROUND: Hepatic artery chemoembolization represents an alternative treatment for patients of metastasis or primary hepatic malignant lesions. The aims of this study was confirm the usefulness, the complications and the survival benefits of chemoembolization for patients with colorectal carcinoma metastasis to the liver. METHODS: During 3 years, 23 patients with multiple or bulky unresectable liver metastasis from colorectal cancer were treated with chemoembolization using adriamycin, cisplatin or mitomycin with lipiodol . Repeated treatments were perform at 6- to 8-week intervals. RESULTS: Hepatic metastases were detected at the initial diagnosis of colorectal cancer in 15 patients. The metastatic lesions included 7 cases of a single bulky lesion and 16 cases of multiple lesions. A decrease of at least 25% of the baseline CEA level occurred transiently in 43% of the cases. The median survival for all 23 patients was 10 months after initiation of chemoembolization, and the 1-year survival rate was 36%. Complications were liver abscesses with cholecystitis, thrombocytopenia, and ascites. CONCLUSION: Chemoembolization is feasible treatment modality for patients with multiple or un resectable hepatic metastases from colorectal cancer.
Ascites ; Cholecystitis ; Cisplatin ; Colorectal Neoplasms* ; Diagnosis ; Doxorubicin ; Ethiodized Oil ; Hepatic Artery ; Humans ; Liver ; Liver Abscess ; Mitomycin ; Neoplasm Metastasis* ; Survival Rate ; Thrombocytopenia ; United Nations

PURPOSE: Interest is mounting in developing prevention strategies for patients at high risk of developing colorectal cancer. Recent epidemiological investigations indicate an inverse relationship between the intake of NSAIDs and colorectal cancer risk. Cyclooxygenase (COX) enzyme may be involved in the initiation and/or the promotion of carcinogenesis. A major action of NSAIDs is the inhibition of COX. We have studied the clinical significance of COX-2 expression in colorectal adenoma and carcinoma. METHODS: We studied 19 patients with colorectal adenomas (15 males and 4 females: ages 30~73 years) and 20 patients with colorectal carcinoma (12 males and 8 females: ages 35~80 years). COX-2 status were determined by immunohistochemical methods using the mouse monocolnal antibody for COX-2 (Transduction Lab, USA) on paraffin sections. RESULTS: Immunoreactive COX-2 were expressed in 9 patients (47%) of colorectal adenoma and 9 patients (45%) of colorectal carcinoma. 57% of villous adenoma and 42% of tubular adenoma were positive for COX-2 in colorectal adenoma (p=0.650). COX-2 were expressed in 12.5% of stage B and 73% of stage C of colorectal cancer (p=0.006). COX-2 expression did not relate with the size of adenoma and carcinoma. CONCLUSIONS: The data suggest that COX-2 may be more expressed in villous adenoma and advanced carcinoma. Therefore, enhanced expression of COX-2 may play a role in the carcinogenesis of colorectal cancer.
Adenoma* ; Adenoma, Villous ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; Carcinogenesis ; Chemoprevention ; Colorectal Neoplasms ; Cyclooxygenase 2* ; Female ; Humans ; Male ; Mice ; Paraffin ; Prostaglandin-Endoperoxide Synthases

A case of a papillary thyroid carcinoma presenting as a cystic lateral neck mass is reported. A 73-year-old woman presented with a painless swelling of the right side of the neck which had been noticed for 60 years. The soft tissue mass was clinically and sonographically thought to be branchial cleft cyst. However, excisional biopsy showed it to be a cystic lymph-node metastasis from a papillary thyroid carcinoma. Two weeks later, a total thyroidectomy was performed, but no malignant lesion was found in the thyroid. This case of a metastatic papillary thyroid carcinoma to the lateral neck node mimiced a branchial cleft cyst. In old age, a lateral neck cyst being a cystic metastasis, as well as a benign cyst, should be considered so a careful preoperative evaluation is neccessary.
Aged ; Biopsy ; Branchioma ; Female ; Humans ; Neck* ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

A case of a papillary thyroid carcinoma presenting as a cystic lateral neck mass is reported. A 73-year-old woman presented with a painless swelling of the right side of the neck which had been noticed for 60 years. The soft tissue mass was clinically and sonographically thought to be branchial cleft cyst. However, excisional biopsy showed it to be a cystic lymph-node metastasis from a papillary thyroid carcinoma. Two weeks later, a total thyroidectomy was performed, but no malignant lesion was found in the thyroid. This case of a metastatic papillary thyroid carcinoma to the lateral neck node mimiced a branchial cleft cyst. In old age, a lateral neck cyst being a cystic metastasis, as well as a benign cyst, should be considered so a careful preoperative evaluation is neccessary.
Aged ; Biopsy ; Branchioma ; Female ; Humans ; Neck* ; Neoplasm Metastasis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy