• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3799-3804
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• 2013

Background: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. Materials and Methods: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Results: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. Conclusions: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.

• 대한의용생체공학회:의공학회지
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• 제30권6호
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• pp.482-488
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• 2009

Conventional devices for transanal endoscopic microsurgery that are currently used clinically for intestine or rectal cancer patients have 40 mm external diameter of rectoscope tube - induces anal damage and long-term postoperative pain for small-sized patients. In this paper, we designed rectum and rectoscope models and calculated the changing trends of operation area of the surgical tools in accordance with the step-by-step variation of design parameters of the rectoscope tube - external diameter, axial length, and distal angle. Using the results of computer simulation, we suggested an optimal set of design parameters that minimizes external diameter of the rectoscope tube and at the same time, maintains similar operation area of the surgical tools compared with commercialized devices (${\geq}\;4274.7mm^2$). The results of the simulation showed that the optimal design parameters were 35 mm external diameter, 100 mm axial length, and $45^{\circ}$ distal angle of the rectoscope tube. This result can be applied to the development of endoscopic microsurgery device that can minimize side effects to the intestine or rectal cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5427-5431
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• 2014

Aim: To evaluate the outcome of stapled versus sutured colo-rectal anastomosis after low anterior resection of mid-rectal carcinoma. Patients and Methods: A prospective study of fifty patients who underwent colo-rectal anastomosis following low anterior resection (LAR) of T2 mid-rectal cancers at the Egyptian National Cancer Institute during the time period from June 2010 to June 2013 was conducted. Classification was into two groups; a stapled anastomosis group I (25 patients) and a hand-sewn anastomosis group II (25 patients). All operations are evaluated regarding intra-operative complications such as anastomotic line bleeding, visceral injuries or major blood loss. The anastomotic time and operative time are documented for each operation. All patients are evaluated post-operatively for anastomotic leakage (AL), wound infection and ileus. Results: The distance of the tumor from the anal verge was $9.6{\pm}2.0cm$ in group I and $9.9{pm}2.4cm$ in group II. The mean operative time was $191.5{\pm}16.2min$ in the stapled group and $208{\pm}18.6min$ in the sutured group (p=0.002). The mean anastomotic times were $9.0{\pm}1.9min$ and $19.7{pm}12.2min$ (p=0.001). Anastomotic leakage developed in three (12.0%) patients in the stapled group and in four (16.0%) patients in the sutured group (p=1.000). Post-operative ileus was observed in 3 patients in group I and one patient in group II. Wound infection developed in three (12.0%) patients in the stapled group and four (16.0%) patients in the sutured group (p=1.000). Conclusion: Colo-rectal anastomosis after low anterior resection for mid rectal carcinoma can be conducted safely either by stapling or hand-sewn techniques; however the stapling technique showed shorter anastomotic and operative times with no significant advantages regarding intra- or post-operative complications or hospital stay.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2993-2998
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• 2015

Background: Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Materials and Methods: Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Results: Patients in the IC group presented with advanced stage (Stage 3=89.2% versus 75.4%) (P=0.02) but a high rate of total mesorectal excision (TME) (100% versus 93.4%) (P=0.01) and sphincter preservation surgery (54.9 % versus 22.9%) (P=0.001). Patients with low rectal cancer who received IC had a significantly low positive CRM rate (9.2% versus 34%) (P=0.002). Actuarial 5 year DFS in IC and no IC groups were 39% and 43% (P=0.9) and 5 year OS were 70% and 47% (P=0.003). Pathological tumor size [HR: 2.2, CI: 1.1-4.5, P=0.01] and nodal involvement [HR: 2, CI: 1.08-4, P=0.02] were independent predictors of relapse while pathological nodal involvement [HR: 2.6, CI: 1.3-4.9, P=0.003] and IC [HR: 0.7, CI: 0.5-0.9, P=0.02] were independent predictors of death. Conclusions: In low rectal cancer, induction chemotherapy before CRT may significantly decrease CRM positivity and improve 5 year overall survival.

• 대한한방종양학회지
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• 제5권1호
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• pp.1-17
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• 1999

Large bowel cancer shows the 4-5th frequency in cancers that occurs in Korea. The western medicine cures the Large bowel cancer by radiation, surgery and chemotherapy. While, Oriental medicine cures the Large bowel cancer by Herb-drugs, acupuncture, moxa and et al. With just one way of treating Large bowel cancer can't be effective remedy. Because each medicine has a strength and weakness, it is effective treatment when two medicine combines and supplement each other. We got the following result about a trend of oriental and western combination treatment for Large bowel cancer through studding records. 1. In Large bowel cancer, colon cancer is referred hematochezia(腸風下血), rectal cancer is refereed enterotoxin(腸毒), and anal cancer is accumulation of pathogens in yin(結陰). 2. The western medicine treats Large bowel cancer patient with surgery first. They need on assembly treatment such as chemical, radiation and immune treatment. In oriental medicine, they treats Large bowel cancer patients with differentiation of symptom and signs and treatment(辨證施治) for example, insufficiency of spleen and stomach(脾胃虛弱), collapse of the spleen-ql(脾氣下陷), stagnation of blood stasis and toxic agent(瘀毒內結), reinforcing both qi and blood(脾血下陷), stagnation of damp-phlegm(痰濕凝結) and cure for them by acupuncture and moxa too. 3. In combination with oriental and western medical treatment princple of Large bowel cancer by each stage is as follows. First stage is cured with radical surgery and herb-drugs without chemotherapy. The intermediate and terminal stage patients is used radiation before surgery, or after palliative surgery cour with chemotherapy, radiation and Herb-drugs. In terminal stage patients, unable for surgery, is used combination between chemotherapy, palliative radiation and Herb-drugs. 4. After radiation surgery, the terminal stage patients who have extensively lymph node metastasis or local contraindication is able to undergo combination of Herb-durgs and chemotherapy. 5. The cure-effect with oriental and western medicine combination treatment was better than that just with oriental or western medical treatment. 6. The merits of oriental and western medicine combination treatment lengthen one's life and diminish the bad effect of chemotherapy and complete radiation treatment, prevent from relapsing, maintain the balance in their environment of body and improve immunity.

• Journal of Digestive Cancer Research
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• 제12권1호
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• pp.44-47
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• 2024

Malignant melanomas, which are rarely found in the Asian population, are malignant tumors or melanocytes that manifest in the skin mucosa. Malignant melanomas of the anorectum are very rare and account for approximately 1% of all malignant melanomas in the Asian population. Here, we present a rare case presenting a malignant melanoma of the anorectum. An 85-year-old woman visited the hospital with bloody stools and an anal mass. Sigmoidoscopy revealed a black mass protruding from the anus, and the scope was able to penetrate the anorectal mass. Close-up endoscopy revealed black moles of different sizes scattered across the rectal mucosa. PET-CT indicated multiple FDG uptakes in the liver, indicating multiple metastases. Pathologic examination led to the detection of malignant melanocytes with dark brown deposits. The patient's immunohistochemical markers were positive for melanin-A antibodies and HMB-45, indicating a malignant melanoma. As there was no evidence of malignant melanomas on the skin, the patient was diagnosed with primary malignant anorectal melanoma with liver metastases.

• The Korean Journal of Pain
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• 제18권2호
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• pp.263-266
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• 2005

The ganglion impar is a solitary retroperitoneal structure at the caudal end of the paravertebral sympathetic chain. Block of this ganglion has been advocated as a means of managing intractable perineal pain. In 1990, Plancarte et al performed a neurolytic block of the ganglion impar using 4-6 ml of 10% phenol through the intergluteal skin over the anococcygeal ligament. However, technical difficulties are encountered with the placement of the needle while performing this technique, with complications from the injection of phenol also being a possibility. In 1995, a modified approach for blocking the ganglion impar through the sacrococcygeal ligament was introduced by Wemm and Saberski. We used a radiofrequency (RF) lesion generator to create a controlled and localized lesion with a lower incidence of neural damages compared to chemical neurolysis. RF thermocoagulation of the ganglion impar through the sacrococcygeal ligament was performed on a 70-year-old male patient with constant anal pain using a curved TEW electrode. The patient has been relieved of his pain, without serious complication. Therefore, this technique may be an easier and safer approach, which is associated with fewer chances of complications.

• Bulletin of the Korean Chemical Society
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• 제20권9호
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• pp.1073-1077
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• 1999

CRAMP, a 37-amino acid cationic antimicrobial peptide was recently deduced from the cDNA cloned from mouse femoral marrow RNA. In order to investigate the structure-activity relationship and functional region of CRAMP, CRAMP and its 18-mer overlapping peptides were synthesized by the solid phase method. CRAMP showed broad spectrum antibacterial activity against both Gram-positive and Gram-negative bacterial strains (MIC: 3.125-6.25 μM) but had no hemolytic activity until 50 μM. CRAMP was found to have a potent anticancer activity (IC50: 12-23 μM) against two human small cell lung cancer cell lines. Furthermore, CRAMP was found to display faster bactericidal rate in B. subtilis rather than E. coli in the kinetics of bacterial killing. Among 18-meric overlapping fragment peptides, only CRAMP (16-33) displayed potent antibacterial activity (MIC: 12.5-50 μM) against several bacteria with no hemolytic activity. Circular dichroism (CD) spectra anal-ysis indicated that CRAMP and its analogues will form the amphipathic α-helical conformation in the cell membranes similar to other antimicrobial peptides, such as cecropins and magainins.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.565-570
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• 2009

Purpose: Numerous techniques have been introduced to reconstruct the perineal area in order to preserve function of both the recipient and the donor site while satisfying aesthetic results. There are several advantages of using the pudendal aretery perforator based flap in that it provides thin coverage of defect area and a relatively excellent circulation through perforators. The perineal region can be divided into two areas : the urogenital triangle and the anal triangle. Since each area differs in structure and function so does its reconstructive plan. The authors of this article report clinical results obtained from pudendal artery perforator based reconstructed cases according to each differrent triangles. Methods: A total of 15 patients who underwent perineal reconstruction were enrolled in our study between the year 2002 and 2006. There were 4 cases of vaginal cancer, 4 cases of extramammary Paget's disease, 1 case of rectovaginal fistula in females and 2 cases of Paget's disease and 4 cases of Fournier's gangrene in male cases. The follow up period was on average 6 month. In female, superfical pudendal artery perforator based local flap were used to reconstruct the urogenital triangle defects, while internal pudendal artery perfoator based local flaps were used to reconstruct the anal traingle defects. In males the gracilis myocutaneous flap and internal pudendal artery perforator based local flaps were used in reconstruction of the scrotum and perineal defect. Result: In females, there was 1 case of partial flap necorsis that employed the superficial pudendal artery perforator but secondary repair through the internal pudendal artery perforator based local flap was done. In addition, there were 4 wound dehiscence cases in females and 2 cases in males. Conclusion: We believe that a better aesthetic and functional outcome can be achieved in perineal reconstruction if discrete surgical planning is carried out systematically categorizing the choice of flap employed acccording to distinct anatomical regions : the urogenital and the anal triangle.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7693-7702
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• 2014

Background: Human papilloma virus (HPV) occurs in women of all age groups, and causes cervical, anal, vaginal, vulvar, penile and oropharyngeal cancers. The aim of the study was to discover what nurses know about HPV infection, testing and vaccination and to determine vaccine practice of their daughters and perceived barriers. Materials and Methods: This cross-sectional and prospective study was carried out nurses who have worked in a hospital between January and June 2014. Pre-test and post-test were used to evaluate the nurses' knowledge about HPV infection, testing and vaccination. This study was performed with nurses who had girls between 9 and 26 years of age for evaluating the behavior of vaccination after three months of education. Results: The mean of pre-test and post-test scores about HPV infection, which included 22 items, were $8.2{\pm}5.6$ and $19.2{\pm}1.5$, respectively. Before education the HPV testing knowledge score was remarkably poor ($1.9{\pm}1.7$ over 5), after education it increased to $4.8{\pm}0.5$. The mean HPV vaccine knowledge score were $3.7{\pm}2.7$ (pre-test) $7.3{\pm}0.8$ (post-test) on a 0-8 scale. The difference between mean total pre-test ($13.9{\pm}9.1$) and post-test ($31.3{\pm}1.9$) scores was statistically significant (p<0.001). After three months of education, only two of the nurses' daughters were vaccinated. The main reason was noted by nurses were not willing to be vaccinated was cost, doubts about safety and efficacy related to the vaccine. About one-third of nurses declared that they would receive the vaccine for their daughter later. Conclusions: Nurses have a crucial role in the prevention, treatment, increasing public awareness and care for population. The education of the nurses about HPV infection, test and vaccination will play an important part decreasing cancer mortality and morbidity.