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: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

BACKGROUND: As a leading cause of death in Korea, cancer is known to be related to lifestyle including diet. In 2007, the World Cancer Research Fund announced 10 evidence-based guidelines for reducing the number of cancers. The purpose of this paper was to produce guidelines specific to and relevant to the people of Korea. METHODS: Ranging over 6 categories, 15 dietary factors known to be associated with cancers were selected after reviewing the results of relevant researches including Korean subjects and evidence-based research documents regarding the relationships between cancer and diet. The levels of intake of these selected dietary factors by Koreans were compared to the established dietary guidelines and detailed practices for cancer prevention. RESULTS: The Korean dietary guidelines for cancer prevention consists of 8 detailed recommendations along with multiple specific practices based on the analyses of data and documents on weight and intake of cereals, fruits, vegetables, meat, salt, dairy products, alcohol, and nutrient supplements. CONCLUSIONS: The Korean dietary guidelines for cancer prevention were established based on valid scientific approach by analyzing the most recent available data. For some dietary factors, however, sufficient analysis for intake levels in Koreans was not possible. Therefore, fundamental data for the establishment of national strategy and for guideline amendments for preventing cancers need to be gathered through the analyses of relationships between cause and deaths due to cancer, database reinforcement, additional research including Korean subjects, and assessment of usual intake.
Cause of Death ; Edible Grain ; Dairy Products ; Diet ; Financial Management ; Fruit ; Korea ; Life Style ; Meat ; Nutrition Policy ; Reinforcement (Psychology) ; Vegetables

PURPOSE: To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). METHODS: The study compared clinical features taken from 112 patients who tried VBAC at our institute from January 2001 through December 2006. There were divided into two GROUPS: 92 patients for the success (82.1%) and 20 patients for the failure group (17.9%). Excluding 36 patients with no BMI data, we constructed Receive-operating characteristics (ROC) curve to make the optimum BMI value for the prediction of success of VBAC. Based on the BMI 26 or more, two groups of patient were surveyed the interrelation between weight gain and success of VBAC. RESULTS: Between success and failure group, the weight gain during pregnancy showed significant differences which are 11.2+/-4 kg of the success group and 13.2+/-5 kg of the other one (p<0.05) A survey on the availability of the BMI date to estimate success of VBAC, the criteria with the standard BMI 26 is not statistically valuable (p=0.837). By comparing normal weight and overweight based on BMI 26, some factors showed statistically significant discrepancies: number of prenatal visit, maternal weight gain, maternal weight at the time of delivery, use of oxytocin and birth weight. CONCLUSION: BMI value of 26 has limitations in using as an estimate criteria on success of VBAC. Patients, however, who had relatively small scale of weight gain, showed significant clinical factors to increased success rate of VBAC.
Body Mass Index ; Humans ; Overweight ; Oxytocin ; Parturition ; Pregnancy ; Vaginal Birth after Cesarean ; Weight Gain

PURPOSE: A restorative proctocolectomy has been accepted as the operation of choice for ulcerative colitis and familial adenomatous polyposis. The purpose of this study was to assess the postoperative complications and functional outcomes following a total proctocolectomy with a J ileal pouch-anal anastomosis. METHODS: The medical records of 12 patients who had undergone a total proctocolectomy, with a J ileal pouch-anal anastomosis, between January 1997 and June 2002, were retrospectively reviewed according to sex, age, underlying disease and postoperative complications. We evaluated the functional outcomes using medical record reviews and patients and telephone interviews. RESULTS: Total proctocolectomy, with a J ileal pouch-anal anastomosis, were done for ulcerative colitis (n=2) and familial adenomatous polyposis (n=10). A diverting ileostomy was performed in 8 patients. Postoperative complications occurred in 7 patients (58%), intestinal obstructions in 4 and complications related with anastomosis in 3, i.e. J ileal pouch leakage (n=2) and ileal pouch-vaginal fistula (n=1). Re-operations, due to postoperative complications, were performed in 4 patients, i.e. small bowel segmental resection (n=1), adhesiolysis (n=1), diverting ileostomy (n=1) and ileal pouch resection & reconstruction (n=1). The daily median defecation frequencies were 7.7 (range 4~20) a month after the operation, 5.4 (3~12) at 2~3 months, 4.5 (3~7) at 6 months and 4.1 (3~5) at 12 months, following the operation. Two patients had gas incontinence, 1 had fluid incontinence, 4 had night soiling and 3 needed pads, but these incontinences, the need for anti-diarrhea medication and the use of pads, all improved within 6 months of the operation. Fluid incontinence and the use of pads improved within 3 months of the operation, gas incontinence and night soiling improved within 6 months of the operation. The mean length of follow-up was 30.6 months. CONCLUSIONS: The postoperative complication rate was 58%. Thirty-three percent of patients had fecal incontinence, but all these improved within 6 months. The long- term functional outcomes, after a total proctocolectomy with J ileal pouch-anal anastomosis, were satisfactory, and the postoperative complications acceptable. The postoperative complication rates were no different between the protective diverting ileostomy and non-ileostomy .
Adenomatous Polyposis Coli ; Colitis, Ulcerative ; Defecation ; Fecal Incontinence ; Fistula ; Follow-Up Studies ; Humans ; Ileostomy ; Interviews as Topic ; Intestinal Obstruction ; Medical Records ; Postoperative Complications ; Proctocolectomy, Restorative ; Retrospective Studies ; Soil

OBJECTIVE: The birth weight distributions are obtained to be classified according to the duration of pregnancy, and then compared with other results already published in literature to verify the difference. METHODS: A total of 17,291 deliveries in Gachon medical center hospital from January 1996 to December 1999 is retrospectively reviewed. The data of 28~42th week of gestation are analysed, and the 10th, 25th, 50th, 75th and 90th percentiles of birth weight are determined for each week and also according to sex and parity. Furthermore the 10th, 50th, 90th percentiles are compared with those from other reports. RESULTS: 1. The 10th, 50th, 90th percentiles of birth weight classifed according to gestational age are as follow : in 28th week of pregnancy, 1,068, 1,240 and 1,812 g; in 32th week, 1,470, 1,890 and 2,266 g; in 36th week, 2,170, 2,720 and 3,240 g; in 40th week, 2,910, 3,370 and 3,870 g; in 42th week, 2,977, 3,475 and 4,023 g.2. The mean birth weight of the male neonates is greater than that of the female ones from 37th week to 41th week (p<0.01).3. Comparisons of 10th, 50th, 90th percentiles of birth weight with Park groups show that there is an increase of birth weight by 100~144 g. CONCLUSION: Comparison of the birth weight-gestational age table with ones published by other groups shows that infants tend to be heavier.
Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Parity ; Parturition* ; Pregnancy ; Retrospective Studies

OBJECTIVES: The purpose of this study was to determine whether women with PCOS have greater subclinical atherosclerosis and evaluate the relationship to risk factors for atherosclerosis. METHODS: Women with PCOS(n=24) and age and body mass index(BMI)-matched cycling women(n=16) as control group underwent carotid scanning for the measurement of the IMT. We compared IMT and plaque between cases and controls, assessed some risk factors for atherosclerosis, and analyzed factors affecting IMT. RESULTS: There was no difference between the groups in waist-hip ratio(WHR) and in the levels of total cholesterol, triglyceride(TG), LDL, Lp(a), fibrinogen, homocystein, plasminogen activator inhibitor 1. However, HDL was significantly lower, and systolic and diastolic blood pressure, fasting blood sugar or insulin concentration and IMT was significantly higher in PCOS group than control group (51.1+/-11.6 vs 60.4+/- 10.0mg/dl, 119.4+/-12.5 vs 109.0+/-11.6mmHg, 79.1+/-11.1 vs 68.9+/-7.8mmHg, 93.6+/-11.1 vs 85.0+/-5.9 mg/dl, 8.9+/-5.2 vs 5.0+/-3.3milliunit/ml, 0.57+/-0.12 vs 0.49+/-0.11mm respectively, all p<.05). In the analysis of correlation between the IMT and clinical characteristics, PCOS status, BMI, systolic and diastolic blood pressure, fasting blood sugar or insulin concentration, TG, HDL, fibrinogen were significantly independent variables (Coefficients of correlation were 0.358, 0.461, 0.452, 0.349, 0.405, 0.466, 0.478, -0.433, 0.349 respectively, all p<.05). The factors affecting IMT by multivariate regression were PCOS status and fasting insulin concentration. CONCLUSIONS: We concluded that women with PCOS might have an increased risk of subclinical atherosclerosis and insulin resistance was assumed to be the main risk factor of atherosclerosis.
Atherosclerosis* ; Blood Glucose ; Blood Pressure ; Cholesterol ; Fasting ; Female ; Fibrinogen ; Humans ; Insulin Resistance* ; Insulin* ; Ovary* ; Plasminogen Activator Inhibitor 1 ; Polycystic Ovary Syndrome ; Risk Factors

The Purpose of this article is to present a clinical case report for palateless complete denture. Despite the contravacy of palatal uncoverage in upper complete denture, palateless complete denture has some merits for upper edentulous patient. Following the uncovering of the palatal portion, the patient became easy to talk and restored the lost good tastes. He is happy despite of the decrease of the retention of the upper complete denture. Palateless complete denture is a compatible alternative for upper edentulous patients in cases of gagging, large palatal torus and restoring the lost good tastes. The clinical points are as follows : 1. The remaning alveolar ridge should be ovoid and have enough width and height for the support and retention. 2. The patient must have strong wish to the palateless complete denture. 3. Palatal beading made on the palatal peripheral border give good border sealing of the palatal flange and minimaized the prominence of the denture flange. 4. The peripheral border of the palatal flange should be reduced as thin as possible for more comfort. 5. Upper artificial posterior teeth should be arranged over the alveolar ridge crest and inner incline of the buccal cusp relieved for denture stability while chewing. 6. For stability of palateless complete denture, bilateral balanced occlusion should be sttained. Palateless complete denture will restore the lost good tastes and more comfortable and physiologic to upper edentulous patients and a good alternative to full palatal coverage complete denture in the properly selected cases.
Alveolar Process ; Denture Retention ; Denture, Complete* ; Dentures ; Gagging ; Humans ; Mastication ; Tooth

The purpose of this article is to present the clinical and laboratory procedures for single tooth restoration using "Combination Implant Crown". It is cemented on implant abutment and that abutment is screw-retained over implant body. This type of implant restorations has the advantages of cement-retained restoration while being antirotational and retrievable. And, more esthetic and functional result can be achieved by minimizing the size of access hole. The results were as follow : 1. Preparation of abutment below the cuffline should be avoided 2. Axial reduction of implant abutment should not be excessive because it may weaken the abutment 3. More esthetical and functional occlusal surface was achieved with a minimal access hole which is slightly larger than the diameter of hex driver to enable future total retrievability. 4. Combination Implant Crown has the advantages of both the cement-retained and screw-retained type implant restoration. 5. Cementation between implant crown and abutment reduces screw loosening through even force distribution.
Cementation ; Crowns* ; Tooth*

Submerged implants require secondary surgical uncovering of implants after healing period of 3 - 6 months. In surgical methods, there are surgical scalpel, tissue punch, electro-surgical, and laser-used uncovering, and laser-used uncovering, and so forth. The objectives of this study are investigation and assessment of 1) thermal change in clinical application for uncovering of HA-coated implant and pure titanium implant irradiated by pulsed Nd-YAG. CO2, and Er-YAG laser. 2) surface change of cover screws after irradiation using laser energy. The temperature of apex & side wall of implants were recorded at 10sec, 20sec, 30sec after 30sec irradiation to implant healing screw; 1) pulsed Nd-YAG laser; 2W, 20pps, contact mode 2) CO2 laser; water-infused & non-water infused state, 2.5-3.5W, contibuous mode, noncontact mode 3) CO2 laser; non-water-infused state, 3W, superpulse, noncontact mode 4) Er-YAG laser; (1) non-water infused state, 10pps, 60mj, contact mode (2) water-infused state, 10pps, 60mj, 80mj, 101mj, contact mode According to the results of this study, pulsed Nd-YAG laser is not indicated because of increase thermal change and pitting of metal surface of implant cover screw. By contrast, CO2 laser & Er-YAG laser are presumed to indicate because of narrow range of thermal change & near abscence of thermal damage of metal surface. Dental laser is thought to be much helpful to surgical procedure when it is used as optimal power and time condition considering characteristics and indications of each laser. Further research is needed to verify that these techniques are safe and beneficial to implant success.
Lasers, Gas ; Lasers, Solid-State ; Titanium