Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

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.

BACKGROUND: A recent investigation has demonstrated that citrus red mite (Panonychus citri) is the most important allergen in citrus-cultivating farmers with asthma or rhinitis. METHODS: A total of 2,005 adolescents (aged 16 to 18 years) living in rural areas were enrolled in this study. Each subject was evaluated by a questionnaire developed by the International Study of Allergy and Asthma in Childhood(ISSAC), and a skin prick test with 11 common inhalant allergens including citrus red mite. RESULTS: Prevalence of recent wheezing, recent rhinoconjunctivitis symptoms and eczema was 13.0%, 13.6% and 9.9%, respectively. On skin prick test, the most common sensitizing allergen was citrus red mite (20.6%), followed by Dermatophagoides pteronyssinus (18.5%), Dermato-phagoides farinae (14.6%) and cockroach (9.8). The prevalence of eczema was higher in those with sensitization to CRM than in those without sensitization to any allergens(p< 0.05) but the prevalence of asthma was not different between adolescents with sensitization to CRM and those without sensitization to any allergens(p> 0.05). On the contrary, the sensitization to house dust mites were significantly associated with the prevalence of asthma and allergic rhinitis. CONCLUSION: Citrus red mite was the most common sensitizing allergen in 16-18 year-old adolescents living in rural areas with citrus farms and sensitization to CRM was significantly associated with the prevalence of atopic dermatitis.
Adolescent* ; Allergens ; Asthma ; Citrus* ; Cockroaches ; Dermatitis, Atopic ; Dermatophagoides pteronyssinus ; Dust* ; Eczema ; Humans ; Hypersensitivity ; Mites* ; Prevalence ; Pyroglyphidae* ; Respiratory Sounds ; Rhinitis ; Skin ; Surveys and Questionnaires

Collaborative work using same samples for the parentage testing, which was intended to see the status and the quality of several DNA typing laboratories in Korea, was described. Samples were consisted of two sets, one was a trio case and the other was a deficient case with two children. Samples were sent to six laboratories, among which five submitted the result. Each laboratory had used different number and set of STR loci using 14 - 23 loci, and total 33 different loci were used. Only one VNTR locus, D1S80 was included and all the remaining were STR loci. The loci included in the commercial kits were used more frequently. One laboratory had used Korean-made commercial kits. All the laboratories gave the same results about the parentage, although results for one locus were not the same through different laboratories. There existed minor difference in the PI calculation, especially in the statistical parameters such as allelic frequences, which might gave confusion to users of the results who were not familiar with the test. Necessity about the standardization and profiling data were discussed.
Academies and Institutes* ; Child ; DNA Fingerprinting ; Humans ; Korea* ; Minisatellite Repeats

INTRODUCTION: Recent investigations have demonstrated that citrus red mite is a common sensitizing allergen in children and adults living in rural areas of Cheju island. OBJECTIVE: The aims of this study were to evaluate the sensitization rate to the citrus red mite and to determine the risk factors for this sensitization in adolescents living in rural areas of Cheju island. SUBJECTS AND METHODS: A total of 3,395 adolescents (from ages 13 to 15 years old) living in rural areas of Cheju island were enrolled in this study. Each subject was evaluated by a modified ISAAC questionnaire, and a skin prick test with 11 common inhalant allergens including citrus red mite. RESULTS: On skin prick test the most common sensitizing allergen was D. pteronyssinus (27.9%), followed by D. farinae (23.9%), citrus red mite (18.3%), and cockroach (16.7%). Sensitization rate to citrus red mite was higher in those living near citrus orchards than in those living far from the orchards, and higher in those visiting citrus orchards more frequently than in those visiting less frequently. CONCLUSION: Citrus red mite is a common sensitizing allergen in adolescents living in rural areas of Cheju island. The sensitization rate to citrus red mite may be partially determined by environ- mental exposure.
Adolescent* ; Adult ; Allergens ; Child ; Citrus* ; Cockroaches ; Humans ; Jeju-do* ; Mites* ; Risk Factors* ; Skin ; Surveys and Questionnaires

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea. Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers, 2 VNTRs, 36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods and the profiling data were described.
Amelogenin ; DNA ; DNA Fingerprinting ; Electrophoresis ; Electrophoresis, Capillary ; Korea ; Microsatellite Repeats

This paper described a collaborative exercise intended to see what kinds of short tandem repeat (STR) loci are used in different DNA typing laboratories in Korea and to compare their results for the demonstration whether uniformity of DNA profiling results from different laboratory could be achieved in Korea. Laboratories were asked to test five tissue DNAs using methods routinely used in each laboratory and to report the results to the coordinating laboratory. The exercise demonstrated that each laboratory was using different STR loci for the typing with different STR numbers, 2 VNTRs, 36 STRs and amelogenin in total, and the direct comparison of the results from all the laboratory for the 18 loci could not be done as only one laboratory submitted typing results. Among 21 loci for which several laboratories submitted typing results, results for 14 loci were the same and results for the other 7 loci were different depending on the participating laboratory. D1S80, F13A01, D16S539, D21S11, D18S51, D3S1744 were the loci with different typing results. Even in the cases where commercial kits were used, the results were not the same depending on the machines used, that is the capillary electrophoresis or the gel based electrophoresis. The reason for the different results, points about the standardization of the methods and the profiling data were described.
Amelogenin ; DNA ; DNA Fingerprinting ; Electrophoresis ; Electrophoresis, Capillary ; Korea ; Microsatellite Repeats

BACKGROUND: This study is to suggest the optimal method as a treatment for the patent ductus arteriosus in the premature infants. MATERIAL AND METHOD: Between April 1994 and April 1997, 45 premature infants with evidence of a hemodynamically significant patent ductus arteriosus associated with cardiopulmonary compromise underwent indomethacin therapy, surgical treatment, or both. Thirty-nine infants received indomethacin and twelve infants among them were surgically ligated because of indomethacin failure(5) or complications(7). Six infants, who weighed less than 1,500 gm at birth, were referred for primary surgical ligation because of contraindication to indomethacin therapy. RESULT: The failure rate of indomethacin therapy was 43%(17/39) and the complications(13/39, 33%) to the indomethacin were associated with a high morbidity and mortality. Among the infants who underwent ligation, there were no failures and complications related to the operation. This data suggests that in the premature neonate with a hemodynamically significant PDA, (1) indomethacin therapy is associated with a high failure rate and significant complications, (2) surgical duct closure is associated with minimal morbidity. CONCLUSION: Although the results of this study cannot suggest the optimal management for PDA in premature infants, primary surgical ligation may be considered. However, long-term studies will be needed to confirm this later.
Ductus Arteriosus, Patent* ; Humans ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature* ; Ligation ; Mortality ; Parturition

Complete circulatory arrest with profound hypothermia has been an indispensable adjunct to the safe management of selected giant intracranial aneurysms. For the conduct of cardiopulmonary bypass, there are usually two kinds of methods, open and closed chest methods. We could manage one case of huge intracranial aneurysm that was successfully operated under circulatory arrest using the closed chest method, especially with percutaneous insertion of arterial and venous cannulas for cardiopulmonary bypass.
Aneurysm* ; Arteries* ; Blood Circulation ; Cardiopulmonary Bypass ; Catheters ; Hypothermia ; Intracranial Aneurysm ; Thorax

BACKGROUND: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. MATERIAL AND METHOD: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. RESULT: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. CONCLUSION: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.
Aluminum Oxide ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Median Nerve ; Pneumothorax ; Postoperative Complications ; Recurrence ; Skin Temperature ; Skin* ; Supine Position ; Sympathetic Nervous System ; Thoracic Surgery, Video-Assisted