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.

Most cystic lesions of the liver are found incidentally in imaging studies because they are not symptomatic, and generally do not require treatment. Rarely, however, symptomatic hepatic cysts may develop complications and require treatment. Here, we describe a case of a 77-year-old woman who developed biliary obstruction with abdominal pain due to compression of the bile duct by a simple hepatic cyst. We confirmed the diagnosis based on symptoms and imaging studies. The patient's symptoms improved after simple cyst ablation by sclerotherapy.
Abdominal Pain ; Aged ; Bile Ducts ; Cholestasis ; Diagnosis ; Female ; Humans ; Liver* ; Sclerotherapy

Hook plate fixation is a treatment method for the displaced distal clavicle fracture with favorable results regarding bone union and shoulder function, however possible complications include impingement syndromes, subacrormial erosions, acromial fractures, and periprosthetic fractures. In this report, we observed 3 cases of periprosthetic fracture after hook plate fixation. All cases of periprosthetic fractures were initiated at the medial end screw holes. The causes of these periprosthetic fractures appeared to be the off centered fixation of medial end screws near the anterior or posterior cortex which were specific during operations with hook plates with more than 6 holes and the increased stress on the medial end screw by over-reduced or inferiorly reduced position of the distal end of the clavicle by the hook plate.
Clavicle* ; Periprosthetic Fractures* ; Shoulder

BACKGROUND AND OBJECTIVES: Raman spectroscopy is a vibrational spectroscopic technique capable of providing details on the chemical composition, molecular structure and molecular interactions in cells and tissues. Its application of distinguishing normal and cancer tissue has been studied in a variety of sites, such as the cervix, lung, larynx and skin. The purpose was to explore spectral changes between normal and cancer tissue in the larynx using Raman spectroscopy to assess the feasibility of using Raman spectroscopy for the early diagnosis of laryngeal cancer. MATERIALS AND METHOD: Laryngeal tissue specimens (13 adjacent normal and 13 cancer tissues) were obtained from patients who underwent total laryngetomy or supracricoid laryngectomy with squamous cell carcinoma of the larynx. The specimens were stored -70 degrees C until use. These specimens were defrosted at room temperature. The Raman spectra from laryngeal tissue specimens could be obtained at 300 mW and 250 scan during 15 minutes of the signal acquisition time using FT-Raman spectroscopy (Bruker Co., Karsruhe, Germany). RESULTS: Raman spectra were different significantly between cancer and adjacent normal tissues of the larynx at 1446 cm-1, 1240 cm-1, 1335 cm-1, and 1655 cm-1 (p=0.007, 0.2, 0.2, 0.3, respectively). The difference of 1446 cm-1 means the change of CH2 bending mode in protein and lipid of malignant tissue. The change of 1335 cm-1 means a decrease in CH3CH2 to a wagging mode of collagen and polynucleotide chain of malignant tissue. The difference of 1240 and 1655 means a decrease in the alpha-helix conformation of collagen. CONCLUSION: This study demonstrates the differences of Raman units between laryngeal cancer and adjacent normal tissue using Raman spectroscopy. In future, Raman spectroscopy may become a useful tool of guided biopsy for accurate pathologic diagnosis and assessment of the adequacy of resection margins.
Biopsy ; Carcinoma, Squamous Cell ; Cervix Uteri ; Collagen ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Laryngeal Neoplasms ; Laryngectomy ; Larynx* ; Lung ; Molecular Structure ; Skin ; Spectrum Analysis ; Spectrum Analysis, Raman*

BACKGROUND AND OBJECTIVES: The reports of normative measurements for inner ear structure using computer-based programs are rare. The purpose of this study was to measure the normative data of the Korean inner ear structures and establish the basic data for diagnosis of congenital inner ear anomaly. SUBJECTS AND METHOD: Temporal bone CT of 38 patients (16 men and 22 women) without apparent disease of middle and inner ear, fractures or major disorder such as seizure or tumor were retrospectively reviewed. Fifteen dimensions on axial views and 9 dimensions on coronal views were measured in PACS using pi-view program. The slice thickness of CT was 0.6 mm. RESULTS: From the axial view, the canal diameter of SSCC was 1.09+/-0.15 mm, the bony island width was 5.70+/-0.50 mm, the bony island width of LSCC was 3.99+/-0.58 mm, the cochlear upper turn width & height were each 5.63+/-1.07 and 3.03+/-0.65 mm. The vestibular aqueduct were observed 95.3%. From the coronal view, the cochlear height was 5.14+/-0.36 mm. The length of IAC was significantly longer in male than female (p<0.05) and the opening site of IAC was significantly wider in the left than the right (p<0.05). The upper turn of cochlea in good bone conduction (< or =10 B) had larger width and smaller height than those in poor bone conduction (>10 dB). CONCLUSION: We established the Korean normative measurements of the inner ear structures, which can be used for further diagnosis of the inner ear anomaly.
Bone Conduction ; Cochlea ; Diagnosis ; Ear, Inner* ; Female ; Humans ; Male ; Retrospective Studies ; Seizures ; Temporal Bone* ; Vestibular Aqueduct

OBJECTIVE: Granulocyte-macrophage colony stimulating factors known to be secreted in murine and human reproductive tract. The development of human, bovine and murine embryos could be promoted by addition of GM-CSF in culture medium. However, the pregnancy and implantation rate of embryos cultured in GM-CSF have not been evaluated. The aim of this study was to assess the effect of GM-CSF in embryo development, pregnancy and implantation rate. METHODS: A total of 191 IVF cycles were divided into control and GM-CSF supplement group (control =96, GM-CSF=95). The embryos were cultured for three day with or without 2 ng/ml of recombinant human GM-CSF. The quality of embryo, developmental velocity, pregnancy and implantation rates were compared. RESULTS: There was no difference in age, number of gonadotropin ampules used, number of oocytes and fertilization. The number of ICSI cycle was higher in GM-CSF group. In GM-CSF group, G-1 grade embryos were the highest in proportion (56.4%), while G-2 grade embryos were highest (44.3%) in control group. The developmental velocity of embryos were not different between GM-CSF and control group. The pregnancy and implantation rates were significantly higher in GM-CSF group than control (47.4% vs. 33.3%, 17.0% vs. 11.1% respectively). CONCLUSION: By adding GM-CSF in culture medium, the quality of embryo, pregnancy and implantation rate could be improved.
Colony-Stimulating Factors ; Embryonic Development ; Embryonic Structures ; Female ; Fertilization ; Gonadotropins ; Granulocyte-Macrophage Colony-Stimulating Factor* ; Humans* ; Oocytes ; Pregnancy ; Sperm Injections, Intracytoplasmic

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.
Acanthamoeba Keratitis ; Bacteria ; Epidemiologic Studies ; Epidemiology* ; Fungi ; Humans ; Keratitis ; Keratitis, Herpetic ; Male ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors

Infectious keratitis is the most common serious ocular infection, and may be caused by various bacteria, fungi, viruses and parasites. The authors performed prospectively an epidemiological study to identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis under the identical protocol from April 1995 to September 1997. Logistic regression analysis [univariate analysis and multivariate analysis] was used to evaluate possible risk factors. Six hundred sixty cases of infectious keratitis reported from 19 hospitals were studied. Two hundred eighty-three organisms[247 bacteria, 32 fungi, 4 acanthamoeba] were detected in 626 eyes with infectious keratitis excluding 34 pherpetic keratitis. The Pseudomonas aeruginosa, coagulase negative staphylococcus, Staphylococcus aureus and Serratia marcescens were the major orgnisms in bacterial keratitis. Aspergillus, Fusarium and Candida were the major isolates in fungal keratitis. Contact lens wear was a risk factor for bacterial keratitis. Female, age[less than 40 years] and occupation[student, house-wife, office worker, servise] were associated with bacterial keratitis. Risk factors in herpetic keratitis were age[between 40 and 59 years] and ocular adnexal diseases. Male was associated factor with herpetic keratitis.
Adnexal Diseases ; Aspergillus ; Bacteria ; Candida ; Coagulase ; Epidemiologic Studies ; Epidemiology* ; Eye Infections ; Female ; Fungi ; Fusarium ; Humans ; Keratitis ; Keratitis, Herpetic ; Logistic Models ; Male ; Parasites ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus

BACKGROUND AND OBJECTIVES: Total laryngectomy has become a usual treatment for any advanced carcinoma of the larynx, but most patients who have undergone total laryngectomy have shown permanent disability in voice production. To solve this problem, studies of voice rehabilitation after total laryngectomy have been done. MATERIALS AND METHODS: We have developed an accurate method to measure the vocal tract shape along its length from magnetic resonance images acquired during the sustained phonation of Korean vowels by T-E shunt patients and normal subject. We estimated the accuracy of MRI and also compared the vocal tract spape of the normal and T-E shunt patients by comparing the first three formant frequencies estimated from MRI to those measured directly from speech data of the T-E patients and the normal subject. RESULTS: The length of T-E shunt patient's vocal tract is 17-18.5 cm. T-E shunt patients phonated strained voice. The length of resonant chamber of T-E shunt patients are shorter than that of the normal subject. The vocal tract is shortened during the phonation by T-E shunt patients. In cases of /e/ and /i/, front cavities are constricted while back cavities are shortened. The pseudoglottis of the T-E shunt patients is located at the region 14-15 cm from lip. CONCLUSION: Acoustic characteristics and vocal tract shapes of the T-E shunt patients are relatively similar to those of the normal subject. To achieve normal voice, reconstruction of pharyngeal and superior glottal resonant chamber will be desirable.
Acoustics ; Humans ; Laryngectomy* ; Larynx ; Lip ; Magnetic Resonance Imaging ; Phonation* ; Rehabilitation ; Voice

Theca cell tumors of the ovary have been generally regarded as almost invariably benign neoplasms. Even though several case reports of the malignant variant of this tumor have appeared in the world literature, but the term "malignant thecoma" is controversial and doubtful. If a thecoma ever becomes malignant, the tumor cells dedifferentiate so that they can not be recognized any longer as theca cells: instead, they proliferate as a stromal sarcoma or fibrosarcoma. We have experienced a rare case of ovarian low-grade stromal sarcoma with thecomat ous features in a 66-year-old postmenopausal woman. The clinicopathologic finding and a review of literature on ovarian stromal sarcoma and malignant thecoma were described brie fly.
Aged ; Diptera ; Female ; Fibrosarcoma ; Humans ; Ovary ; Sarcoma* ; Theca Cells ; Thecoma