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.

Coxsackievirus B3 (CVB3) infection causes acute pancreatitis and myocarditis. However, its pathophysiological mechanism is unclear. Here, we investigated how lipid metabolism is associated with exacerbation of CVB3 pathology using high-fat diet (HFD)-induced obese mice. Mice were intraperitoneally inoculated with 1×10 6 pfu/mouse of CVB3 after being fed a control or HFD to induce obesity. Mice were treated with mitoquinone (MitoQ) to reduce the level of mitochondrial ROS (mtROS). In obese mice, lipotoxicity of white adipose tissue-induced inflammation caused increased replication of CVB3 and mortality.The coxsackievirus adenovirus receptor increased under obese conditions, facilitating CVB3 replication in vitro. However, lipid-treated cells with receptor-specific inhibitors did not reduce CVB3 replication. In addition, lipid treatment increased mitochondria-derived vesicle formation and the number of multivesicular bodies. Alternatively, we found that inhibition of lipid-induced mtROS decreased viral replication. Notably, HFD-fed mice were more susceptible to CVB3-induced mortality in association with increased levels of CVB3 replication in adipose tissue, which was ameliorated by administration of the mtROS inhibitor, MitoQ. These results suggest that mtROS inhibitors can be used as potential treatments for CVB3 infection.

OBJECTIVE: If bowels and other structures are in the pathway of high-intensity focused ultrasound (HIFU) beam during magnetic resonance image-guided HIFU (MRgFUS) therapy, filling to the bladder and the rectum and then emptying the bladder (i.e., the BRB technique) is used to avoid them. A modified BRB technique might be useful method to using a uterine elevator method or by inducing uterus downward traction to lower the position of the uterus. METHODS: A total of 156 patients who had undergone MRgFUS surgery treatment for uterine fibroids from March 2015 to February 2016 were included in this retrospective study. Of the 156 patients, 40 were treated using a uterine elevator while 29 were treated using downward traction of uterus. HIFU was performed using Philips Achieva 1.5 Tesla MR and Sonalleve HIFU system. RESULTS: MRgFUS surgery was feasible with modified BRB technique in 69 cases. Using uterine elevator method, the intensity of HIFU for group with antefletxio uteri was significantly lower than that for the group without antefletxio uteri (105.37±17.62 vs. 118.71±26.88 W). The group with downward traction of uterus induced was found to have significantly lower intensity of HIFU compared to the group without downward traction of uterus induced (110.26±22.60 vs. 130.51±27.81 W). CONCLUSION: Modified BRB technique was useful in avoiding bowels and other structures located in HIFU beam pathway during MRgFUS treatment to ablate uterine fibroids.
Elevators and Escalators ; Humans ; Leiomyoma* ; Methods ; Rectum ; Retrospective Studies ; Traction ; Ultrasonography* ; Urinary Bladder ; Uterus

OBJECTIVE: This study was performed to assess our clinical experience with single-port access (SPA) laparoscopic cystectomy and myomectomy and the surgical outcomes of those procedures at our institution. METHODS: The authors evaluated the surgical outcomes of SPA laparoscopic cystectomy in 293 patients and SPA laparoscopic myomectomy in 246 patients. The surgical outcomes comprised operation time, the amount of blood loss during the operation, the change in hemoglobin (before and after the operation), the change in hematocrit (before and after the operation), switching to the multi-port access method, complications, transfusions, and the duration of the postoperative hospital stay. RESULTS: The Pearson correlation coefficient and the Spearman correlation coefficient between the operation time and the amount of blood loss were 0.312 and 0.321 for SPA laparoscopic cystectomy, respectively, and 0.706 and 0.674 for SPA laparoscopic myomectomy, respectively. The drops in hemoglobin and hematocrit were 1.33~0.78 g/dL and 4.14%~2.45%, respectively, in SPA laparoscopic cystectomy, while the corresponding figures were 1.34~1.13 g/dL and 4.17%~3.24% in SPA laparoscopic myomectomy, respectively. CONCLUSION: This study reported the surgical outcomes of SPA laparoscopic cystectomy and myomectomy and compared them to previously published findings on traditional laparoscopic cystectomy and myomectomy. No significant differences were found in the surgical outcomes between SPA and traditional laparoscopic cystectomy and myomectomy.
Cystectomy* ; Hematocrit ; Humans ; Laparoscopy ; Length of Stay ; Surgical Procedures, Minimally Invasive ; Uterine Myomectomy

OBJECTIVES: The aim of this study is to investigate the association between serum uric acid level and metabolic syndrome according to menopausal status in Korean women. METHODS: A total of 2,241 women who visited to the health promotion center at Pusan National University Hospital from 2010 to 2014 were included in this cross-sectional study. Self-report questionnaires and interviews with healthcare providers were used to assess disease history, medication history, menstrual history and body size measuring. Anthropometric measurements and laboratory results were compared as presence of metabolic syndrome and menopausal status by student-t test. Logistic regression analysis was performed between presence of metabolic syndrome and presumable predictive factors, such as age, menopause and serum uric acid. RESULTS: The prevalence rate of metabolic syndrome were 7.45% (63/846) in pre-menopausal group and 23.87% (333/1395) in menopausal group. Serum uric acid level was higher in menopausal women than premenopausal women (4.6 +/- 1.1 vs. 4.3 +/- 0.9. P = 0.000). And, its concentration was also higher in metabolic syndrome than normal women regarding of menopausal statue (premenopause 4.7 +/- 1.1 vs. 4.2 +/- 0.8, P = 0.001, menopause 4.9 +/- 1.3 vs. 4.5 +/- 1.0, P = 0.000). Multiple logistic regression analysis showed serum uric acid and age have relationship with metabolic syndrome (OR: 1.453, 95% confidence interval [CI]: 1.074-1.111, P = 0.000; OR: 1.092, 95% CI: 1.305-1.619, P = 0.000). CONCLUSION: We could find out some potential of uric acid as predictive factor for metabolic syndrome in premenopausal and menopausal group. Further investigation is required to clarify the relationship between serum uric acid, menopause and metabolic syndrome.
Body Size ; Busan ; Cross-Sectional Studies ; Female ; Health Personnel ; Health Promotion ; Humans ; Incidence* ; Logistic Models ; Menopause ; Metabolic Syndrome X ; Prevalence ; Surveys and Questionnaires ; Uric Acid*

We aimed to determine the changes in 18F-fluorodeoxyglucose (FDG) uptake in the spinal cord on two serial positron emission tomography/computed tomography (PET/CT) scans in a healthy population. We retrospectively enrolled healthy people who underwent PET/CT twice for cancer screening. We excluded those who had degenerative vertebral disease, neurologic disease, or a history of a vertebral operation. The standardized uptake value (SUVmax) of the spinal cord of each mid-vertebral body was obtained by drawing a region of interest on an axial image of PET/CT. For analysis, the cord-to-background ratio (CTB) was used (CTB=SUVmax of each level/SUVmax of L5 level). Differences in pattern, sex, age, and intervals of the two serial PET/CT scans were analyzed. A total of 60 PET/CT images of 30 people were analyzed. The mean interval between the two PET/CT imaging studies was 2.80+/-0.94 years. On the follow-up PET/CT, significant change was shown only at the level of the C6 and T10 vertebrae (p<0.005). Mean CTB showed a decreasing pattern from cervical to lumbar vertebrae. There were two peaks at the lower cervical level (C4-6) and at the lower thoracic level (T12). Neither sex nor age significantly affected CTB. The FDG uptake of the spinal cord changed significantly on follow-up PET/CT only at the level of the C6 and T10 vertebrae. This finding is valuable as a baseline reference in the follow-up of metabolic changes in the spinal cord.
Early Detection of Cancer ; Electrons ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Lumbar Vertebrae ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Spinal Cord ; Spine

Accurate measurement of fat mass has become increasingly important with the increasing incidence of obesity. We assessed fat and muscle mass of Koreans with the Korea National Health and Nutrition Examination Survey IV (KNHANES IV). We studied 10,456 subjects (aged 20 to 85 yr; 4,476 men, 5,980 women). Fat and muscle mass were measured by dual-energy x-ray absorptiometry. Reference values of body compositions were obtained using the LMS method. The fat mass index (FMI, body fat mass/height2; kg/m2) of Korean men did not correlate with age (P = 0.452), but those of Korean women (P < 0.001) did. The ratio of percentage of fat in the trunk and legs was positively related with age in both the genders. The appendicular lean mass/height2 (kg/m2) of Korean men was negatively related to age (P < 0.001). In women, this ratio increased with age (P < 0.001). When we defined obesity according to the FMI classification, the rates of obesity were 6.1% (FMI > 9 kg/m2) in men and 2.7% (FMI > 13 kg/m2) in women. It is concluded that the muscle mass decreases and obesity increases with aging in Korean men, whereas both fat mass and obesity increase with aging in Korean women.
Absorptiometry, Photon ; Adipose Tissue ; Age Factors ; *Body Composition ; *Body Fat Distribution ; *Body Mass Index ; Body Weight ; Female ; Humans ; Male ; Nutrition Surveys ; *Obesity ; Republic of Korea

Patients with acromegaly have high incidence of benign or malignant neoplasia than general population. Around fifteen percent of the deaths reported in acromegaly are attributable to malignancy of cancer. On the whole, mortality in acromegaly has been shown to be correlated with the degree of growth hormone (GH) control. Especially, the levels of insulin like growth factor-1 (IGF-1) may be higher in neoplasm, but there is no clear evidence to prove that tumor development is triggered by IGF-1 in acromegaly. Henceforth, we report a case of acromegaly associated with lung and gastric cancer in a 58-year-old man, suggesting the possible carcinogenic role of IGF-1.
Acromegaly* ; Growth Hormone ; Humans ; Incidence ; Insulin ; Insulin-Like Growth Factor I ; Lung Neoplasms ; Lung* ; Middle Aged ; Mortality ; Stomach Neoplasms*

Carcinomas of the lung, breast and lymphoma account for approximately 75% of malignant pleural effusions and the metastatic ovarian carcinoma is the fourth leading cause of malignant pleural effusions. The diagnosis of a malignant pleural effusion is established by demonstrating malignant cells in the pleural fluid or in the pleural biopsy. Chemical pleurodesis should be considered in cases of patients with malignant pleural effusion, who were not responded with systemic chemotherapy. We experienced a case of malignant pleural effusion treated by chemical pleurodesis, which was developed in a patient with ovarian carcinoma and we report it with the brief review or literatures.
Biopsy ; Breast ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Lymphoma ; Pleural Effusion, Malignant* ; Pleurodesis*

BACKGROUND: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer MATERIAL AND METHOD: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. RESULT: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) CONCLUSION: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.
Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Mortality ; Neoplasm Staging ; Pathology ; Radiotherapy ; Retrospective Studies ; Survival Rate