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.

PURPOSE: The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. MATERIALS AND METHODS: A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. RESULTS: After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. CONCLUSION: Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.
Biopsy ; Chemoradiotherapy* ; Disease-Free Survival ; Follow-Up Studies ; Glioblastoma* ; Humans ; Korea* ; Methylation ; Radiotherapy ; Retrospective Studies* ; Survival Rate

Dural arteriovenous fistulas (AVFs) are uncommon, representing only 10% to 15% of all intracranial AVFs. Here we present the case of a patient with cerebral infarction who experienced a dural AVF after craniotomy for superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery. A 48-year-old man presented with dysarthria and right side hemiparesis. A brain magnetic resonance imaging scan revealed multiple acute infarctions and severe stenosis of the left MCA. Therefore, STA-MCA bypass surgery was performed. A follow-up angiography performed 2 weeks after the surgery showed an abnormal vascular channel from the left middle meningeal artery (MMA) to the middle meningeal vein (MMV) just anterior to the border of the craniotomy margin. This fistula originated from a screw used for cranial fixation. The screw injured the MMA and MMV, and this resulted in the formation of a fistula. The fistula was successfully treated with transarterial embolization. Surgeons should be careful when fixing bones with screws and plates as fistulas can develop if vessels are injured.
Angiography ; Brain ; Central Nervous System Vascular Malformations* ; Cerebral Infarction ; Cerebral Revascularization ; Constriction, Pathologic ; Craniotomy ; Dysarthria ; Fistula ; Follow-Up Studies ; Humans ; Infarction ; Magnetic Resonance Imaging ; Meningeal Arteries ; Middle Aged ; Middle Cerebral Artery* ; Paresis ; Temporal Arteries* ; Veins

OBJECTIVE: The purpose of this study was to compare clinical findings and outcomes of Enterprise and Solitaire stent-assisted coiling (SAC). MATERIALS AND METHODS: Between January 2012 and March 2014, 86 patients (mean age, 60.3 years) harboring 89 aneurysms were treated with Enterprise (n = 57) or Solitaire (n = 32) SAC. The patients' demographics, angiographic results, and clinical outcomes were reviewed retrospectively. RESULTS: There were no cases of stent navigation, deployment failure, arterial dissection, or intraoperative aneurysmal rupture. Angiographic follow-up imaging was available for 86 (96.6%) aneurysms (Enterprise group, n = 55; Solitaire group, n = 31). Immediate postoperative and follow-up angiographic results showed no flow or only minimal flow into the neck in 83% (Enterprise group, 77.2%; Solitaire group, 93.8%) and 95.3% (Enterprise group, 92.7%; Solitaire group, 100%) of SAC-treated aneurysms, respectively. Both stent groups showed good immediate postoperative and follow-up clinical outcomes. Excepting 2 cases, all patients achieved modified Rankin Scale scores of 0. Coil loop or tail protrusion into the parent artery was observed in 17 (29.8%) and 7 (21.9%) cases in the Enterprise and Solitaire groups, respectively. No statistically significant difference in terms of angiographic results or clinical outcomes was observed between the groups. CONCLUSION: Excellent and comparable clinical and angiographic outcomes for wide-neck intracranial aneurysms were achieved using both stents. Because of its higher radial strength and better vessel wall apposition, we cautiously propose that the Solitaire stent may be more effective for SAC of aneurysms harboring a large or severe tortuous parent artery.
Aneurysm* ; Arteries ; Demography ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Parents ; Retrospective Studies ; Rupture ; Stents* ; Tail

OBJECTIVE: The purpose of this study was to compare clinical findings and outcomes of Enterprise and Solitaire stent-assisted coiling (SAC). MATERIALS AND METHODS: Between January 2012 and March 2014, 86 patients (mean age, 60.3 years) harboring 89 aneurysms were treated with Enterprise (n = 57) or Solitaire (n = 32) SAC. The patients' demographics, angiographic results, and clinical outcomes were reviewed retrospectively. RESULTS: There were no cases of stent navigation, deployment failure, arterial dissection, or intraoperative aneurysmal rupture. Angiographic follow-up imaging was available for 86 (96.6%) aneurysms (Enterprise group, n = 55; Solitaire group, n = 31). Immediate postoperative and follow-up angiographic results showed no flow or only minimal flow into the neck in 83% (Enterprise group, 77.2%; Solitaire group, 93.8%) and 95.3% (Enterprise group, 92.7%; Solitaire group, 100%) of SAC-treated aneurysms, respectively. Both stent groups showed good immediate postoperative and follow-up clinical outcomes. Excepting 2 cases, all patients achieved modified Rankin Scale scores of 0. Coil loop or tail protrusion into the parent artery was observed in 17 (29.8%) and 7 (21.9%) cases in the Enterprise and Solitaire groups, respectively. No statistically significant difference in terms of angiographic results or clinical outcomes was observed between the groups. CONCLUSION: Excellent and comparable clinical and angiographic outcomes for wide-neck intracranial aneurysms were achieved using both stents. Because of its higher radial strength and better vessel wall apposition, we cautiously propose that the Solitaire stent may be more effective for SAC of aneurysms harboring a large or severe tortuous parent artery.
Aneurysm* ; Arteries ; Demography ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Parents ; Retrospective Studies ; Rupture ; Stents* ; Tail

PURPOSE: This study was conducted for comparison of clinical and second look arthroscopic results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. MATERIALS AND METHODS: Thirty-six patients who underwent ACL reconstruction between March 2008 and October 2011 were enrolled in this study. We divided the patients into two groups, those in the early reconstruction group underwent surgery before one week, and those in the delayed reconstruction group underwent surgery after three weeks, before six weeks. We checked clinical results and second look arthroscopic results and analyzed correlation of clinical and second look arthroscopic results. RESULTS: At the final follow up, the Lysholm, International Knee Documentation Committee, and Tegner score were not statistically different between the two groups (p=0.173, p=0.154, p=0.109). No difference for the range of motion (p=0.808, p=0.680), Lachman test (p=0.377), and pivot shift test (p=0.894) was observed between the groups. In the results of second look arthroscopy, there was no difference in graft continuity (p=0.936), tension (p=0.944) and synovial coverage (p=0.789). No statistical clinical correlation was observed between clinical and second look arthroscopic results (p>0.05). CONCLUSION: We obtained satisfactory clinical and second look arthroscopic results in both the early and delayed ACL reconstruction groups. Therefore, early reconstruction of ACL performed before one week could be a treatment options for acute ACL injury.
Anterior Cruciate Ligament* ; Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Range of Motion, Articular ; Transplants

OBJECTIVE: This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms. METHODS: From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected. RESULTS: The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%. CONCLUSION: We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.
Aneurysm ; Aneurysm, Dissecting ; Angiography ; Carotid Artery, Internal ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Retrospective Studies ; Stents ; Vertebral Artery

OBJECTIVE: This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms. METHODS: From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected. RESULTS: The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%. CONCLUSION: We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.
Aneurysm ; Aneurysm, Dissecting ; Angiography ; Carotid Artery, Internal ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Neck ; Retrospective Studies ; Stents ; Vertebral Artery

Distal thrombosed aneurysm of the superior cerebellar artery (SCA) is extremely rare and is often associated with cerebellar infarction or subarachnoid hemorrhage. We report herein on a case involving a patient with a ruptured thrombosed distal SCA aneurysm which was treated successfully through the endovascular approach.
Aneurysm ; Arteries ; Humans ; Infarction ; Subarachnoid Hemorrhage

OBJECTIVES: This study investigated changes in the clinical characteristics of foreign patients receiving psychiatric treatment in a public mental hospital in Seoul over the last nine years. METHODS: We compared the sociodemographic and clinical characteristics of a multi-cultural mental health (MCMH) clinic group of 49 foreign psychiatric patients, who had attended the newly opened special clinic for foreigners during the period August 2009-2010, with those of a general group of 71 foreign psychiatric patients, who had been treated in conventional ways during the period 2002-July 2009. RESULTS: The MCMH clinic group was characterized by voluntary attendances with the assistance of family, friends or supporting organizations. The patients were more likely to have resided longer in Korea, to have Korean citizenship, to be young married immigrant women and to have children. They were also more able to communicate by themselves or with the support of bilingual interpreters and were more likely to receive outpatient-based treatment and to experience longer periods of treatment. In contrast, the general group was characterized by involuntary hospital attendances supported by the police or the embassies of their home countries, and patients received inpatient services. They were also discharged sooner to be sent back to their home countries. Depressive disorder, anxiety disorder, and adjustment disorder were more common in the MCMH clinic group, while schizophrenia, bipolar disorder and a past history of psychiatric disorders were more common in general group. In the MCMH clinic group, those patients with Korean citizenship or permanent residency seemed to maintain consistent and stable treatment with a good prognosis. CONCLUSION: The findings from the specialized multi-cultural mental health clinic suggest that specialized setting for foreigners is more efficient in helping them, particularly for married immigrant women. This means that specialized systematic evaluation and treatment approach needs to be developed to provide culturally relevant mental health services for foreigners living in Korea.
Adjustment Disorders ; Anxiety Disorders ; Bipolar Disorder ; Child ; Depressive Disorder ; Emigrants and Immigrants ; Female ; Friends ; Hospitals, Psychiatric ; Humans ; Inpatients ; Internship and Residency ; Korea ; Mental Health ; Mental Health Services ; Police ; Schizophrenia