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: and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry. Methods: Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers. Results: This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6± 10.9 years (mean±standard deviation), p=0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p= 0.038) and triptan responsiveness (100% vs. 85.1%, p=0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1). Conclusions Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.

Background: and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry. Methods: Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers. Results: This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6± 10.9 years (mean±standard deviation), p=0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p= 0.038) and triptan responsiveness (100% vs. 85.1%, p=0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1). Conclusions Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.

BACKGROUND: Gastrointestinal (GI) symptoms are believed to be common in the general population, and constipation is one of the most representative GI symptoms. However, the prevalence and risk factors of functional constipation are not well known in Korea. We aimed to study the prevalence of, and risk factors for, constipation in the elderly. METHODS: We randomly selected 852 among 854 (excluded by cancer and dementia) subjects, ages 65 yr and older, in three different geriatric welfare facilities in December, 2003. The prevalence of functional constipation was based on the Rome II criteria and the survey on risk factors for constipation was performed. RESULTS: Functional constipation had a prevalence of 26.6% and there was no difference between men and women. Exercise, fluid, fruit, vegetable intake, anal diseases and age related risk factors were associated with constipation. CONCLUSION: In the elderly, constipation is a common complaint. Further studies are now required for risk factors of constipation.
Aged* ; Constipation* ; Female ; Fruit ; Humans ; Korea ; Male ; Prevalence* ; Risk Factors* ; Vegetables

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

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

OBJECTIVES: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. METHODS: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox' model were used for potentially diseased group, other members, and total subjects, respectively. RESULTS: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk, while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. CONCLUSIONS: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.
Bias (Epidemiology) ; Coffee ; Cohort Studies* ; Surveys and Questionnaires ; Death Certificates ; Drinking ; Epidemiology ; Hepatitis B Surface Antigens ; Incidence ; Insurance ; Life Style ; Liver Diseases* ; Liver* ; Medical Records ; Obesity ; Odds Ratio ; Risk Factors* ; Smoke ; Smoking ; Soybeans

BACKGROUND: We have demonstrated recently that citrus red mite(Panonychus citri) is the most important allergen in citrus-cultivating farmers with asthma and/or rhinitis. OBJECTIVE: A cross-sectional survey was performed to evaluate the sensitizat,ion to the citrus red mite and the effect of environmental exposure on the specific sensitization among primary school children living in rural areas of Cheju Island. Material and METHODS: A total of 4,490 children (from ages 7 to 12 years) living in rural are- as were enrolled in this study. Each subject was evaluated by a questionnaire developed by International Study of Allergy and Asthma in Childhood (ISAAC), and a skin prick test with 11 common inhalant allergens including citrus red mite. RESULTS: On skin prick tests, the most common sensitizing allergen was Dermatophagoides pteronyssinus(7-9 years : 22.7%, 10-12 years : 25.5%), followed by D. farinae(20.4%, 21.8%), cockroach(9.6%, 12.8%), and citrus red mite(8.8%, 12.6%). The sensitization rate to citrus
Allergens ; Asthma ; Child* ; Citrus* ; Cross-Sectional Studies ; Environmental Exposure ; Humans ; Hypersensitivity ; Jeju-do* ; Mites* ; Pyroglyphidae ; Rhinitis ; Skin ; Surveys and Questionnaires

PURPOSE: To evaluate the usefulness of prone pad study in upper gastrointestinal series(UGIS) for thedetection of early gastric cancer(EGC). MATERIALS AND METHODS: During an eight-month period, 88 of 170 patientswho underwent gastrectomy due to EGC were also the subjects of prone pad study as well as double contrast(n=92),mucosal relief(n=76), or compression(n=91) studies. The EGCs were single in 84 patients and double in four. Wecompared prone pad study with the three other techniques for detecting a tumor and depicting the surroundingmucosal changes. Lesional conspicuity was rated 'complete', 'incomplete','suspicious'. or 'undetected'. Thedepiction of surrounding mucosal change was rated 'excellent', 'good', 'fair', or 'poor'. RESULTS: Mean tumorsize was 3.2cm, with a range of 0.3-9cm. Tumors were located in the antrum(n=55), angle(n=13), lower or midbody(n=16), or the sign body and cardia(n=5). Among the 92 EGCs evaluated, UGIS missed the lesion in threecases(sensitivity, 97%). The rates of 'complete' lesional conspicuity were 49% inn prone pad, 29% in compression,20% in double contrast, and 9% in mucosal relief. The rates of excellent' in depicting surrounding mucosal changewere 45% in prone pad, 11% in double contrast, 9% in mucosal relief, and 9% in compression. The tumor wasdemonstrated only in prone pad study in five(5%) of the 92 EGCs. CONCLUSION: prone pad study during UGIS improvesboth the detection rate of EGC and the depiction of mucosal change around the tumor.
Gastrectomy ; Humans

BACKGROUND AND PURPOSE: The authors conducted the study to evaluate the incompleteness of follow-up as well as the validity of the diagnostic code in the medical insurance databases in a cohort study. They also suggested several useful regression models for the analysis of such incomplete data. METHODS: The subjects of Seoul Cohort(n=14,533) were followed up for three and a half years. Based on the chart reviews of the subjects who had the diagnostic code of gastric cancer in the medical insurance databases, forty-four cases of gastric cancer were idenfified, using cancer registry databases and death certificates as the secondary source. Regression coefficients and the associated p-values were estimated using the following six methods and the results were compared with each other. Method 1: The subjects with the diagnostic code in the medical insurance databases were considered as the cases of gastric cancer. Method 2: The confirmed cases were considered as the cases of gastric cancer. Method 3: The cases were the subjects with the diagnositc code whose diagnosis was confirmed by medical chart reriew. Method 4: Ordinal logistic regression. Method 5: Weighted logistic regression. Method 6: Polytomous logistic regression RESULTS: A total of 12,541 subjects were followed up excluding censored cases. One hundred and nine subjects were diagnosed with gastric cancer in the medical utilization databases: forty-three were probable cases whose dianosis was not confrimed by chart review, twenty-six were ruled out and 26 were confirmed cases. Another 14 cases were confirmed using the cancer registry and death certificates. Using the secondary sources, four another cases were confirmed and 44 cases were confirmed during follow-up. In method 1, past history of gastritis and gastric ulcer was significant risk factor whereas intake frequency of fresh vegetable, ice cream and coffee was associated with significantly decreased risk. In the second and the sixth method, green tea was a significant protective factor, whereas in methods 3-5, no significant variables were found. CONCLUSIONS: Polytomous logistic regression was the preferred method in the cohort study using secondary sources of information for the follow-up, and it provided additional information for the risk factor identification, especially for the specificity of the risk factors.
Bias (Epidemiology) ; Coffee ; Cohort Studies* ; Death Certificates ; Diagnosis ; Follow-Up Studies ; Gastritis ; Ice Cream ; Insurance ; Logistic Models ; Risk Factors* ; Sensitivity and Specificity ; Seoul ; Stomach Neoplasms* ; Stomach Ulcer ; Stomach* ; Tea ; Vegetables