• 대한암한의학회지
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• 제28권1호
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• pp.1-9
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• 2023

Objectives: To demonstrate an improvement of neuropathic pain after surgical site infection in a patient with anorectal cancer by administration of Soshihotang (SSHT). Methods: A 65-year-old female patient diagnosed with anorectal cancer was administered SSHT to relieve her neuropathic pain induced by surgical site infection. SSHT was administered from 4/22 to 5/2. Clinical outcomes were assessed using a numeric rating scale (NRS), and opioids administered to relieve her pain was calculated. Results: During 10 days of treatment, the NRS scale of neuropathic pain was improved and the dosage of opioids administered reduced to less than half. Conclusions: This case suggests that SSHT could be effective for the management of neuropathic pain induced by surgical site infection.

• 대한한방부인과학회지
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• 제29권3호
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• pp.68-77
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• 2016

Objectives: This paper is to report a spontaneous pregnancy with low AMH level and thin endometrium infertility after Korean medical treatments.Methods: A 38-year old patient who had low AMH level, thin endometrium, sleep disturbance and anxiety happened after anorectal cancer surgery was treated by korean medicine such as herb medications per day for 6 months. And we observed the effects of treatments by improvement of symptoms checking endometrium ultrasonography.Results: After treatments, Symptoms of anxiety and sleep disturbance were improved. The number of ovarian follicle and endometrium thickness were upgraded during artificial pregnancy trials. Finally the patient was a spontaneous pregnancy after failures of one intrauterine insemination and one in vitro fertilization trial.Conclusions: This case shows that the korean medicine has effective option for a patient with low AMH level and thin endometrium infertility. Further ultrasonography would be valid measurements to check the effectiveness of oriental treatments as well as symptoms.

• 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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• 제11권2호
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• pp.214-219
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• 1998

Pain is one of the most frequent and disturbing symptom of cancer patients. And almost of cancer patients are afraid of a attacks of pain related to cancer. Caring for the cancer patient can be divided into two phases. The phase of "active treatment" involves various interventions-surgical, chemical or radiological- that are designed to prolong the patient's life. "Terminal care" is the period from the end of active treatment until the patient's death. But in the majority of clinical settings, cancer pain is not being managed adequately results from a lack of education about how to treat the cancer pain management in the safest and most effective way during terminal phase. Althought organic factors represent the most important cause of their pain, it is also important to deal with the patient's psychological reactions and to take account of his or her social and family environment if treatment for chronic cancer pain is to prove adequate. Thus we try to evaluate a kinds of cancer related to pain, degree of pain, effectiveness of drugs, and patient's responses to management. In regard to the satisfaction for pain relief in pain clinics at Pusan National University Hospital(PNUH) are about 70% in patients and 90% in family. Average life expectancy in cancer patients are about 140 days (3 days- 5.7 years). Cancer patients are complained of several discomfortness (above 30 kinds) such as, pain associated with cancer (75%), nausea and vomitting (38%), sleeping disorder (38%), anorexia (38%), dyspnea (32%), constipation (31%), etc. Distributions of cancer associated with pain are stomach cancer (21%), lung cancer (16%), cervix cancer (10%), anorectal and colon cancer (8.6%), hepatoma (8%), pancreatic cancer (3%). About 1/3 of patients are suffer from incident pain in 3~5 times in a day especially in moving, coughing, and exercise. Methods for drug delivering system before death are transdermal fentanyl patch (42%), intravenous PCA (21%), oral intake of opioid (17%), epidural PCA (14%), etc.

• 대한영상의학회지
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• 제84권6호
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• pp.1290-1308
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• 2023

목적 직장암 병기결정에서 직장 CT의 진단능을 고해상도 직장 MRI 및 병리결과와 비교분석 하였다. 대상과 방법 초음파 젤을 이용하여 직장을 팽창시킨 후 얻은 직장 CT와 고해상도 직장 MRI를 촬영한 66명의 직장암 환자가 포함되었다. 두 명의 위장관 영상의학과 의사가 직장 CT와 MRI에서 항문피부선/항문직장경계까지의 거리, 직장간막근막까지의 거리, 벽외침범 깊이, 직장간막외 림프절 침범, 벽외정맥침범, 및 T/N 병기를 평가하였다. 동시화학방사선요법을 시행 받지 않고 근치적 수술을 시행한 20명의 환자의 CT 소견을 병리결과와 비교하였다. 급내상관분석 및 카파 분석을 이용하여 통계 분석하였다. 결과 항문피부선/항문직장경계까지의 거리 측정에서 두 명의 영상의학과 의사 모두 CT와 MRI 간에 높은 상관관계를 보였다. 벽외침범 깊이, 직장간막근막까지의 거리, 림프절의 유무, 직장간막외 림프절 침범, 벽외정맥침범, T 병기 결정에서 CT와 MRI 간의 높은 일치도를 보였다. 수술을 시행받은 20명의 환자에서 T 병기, 측방절제연 침범, 벽외정맥침범, 림프절 전이 결정에서 CT는 병리결과와 만족할만한 일치율을 보였다. 결론 직장암 전용 CT는 직장암 환자의 병기 결정에 중요한 정보를 제공하며, 진단능은 고해상도 직장 MRI와 유사하다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1067-1072
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• 2013

Hiwi, a human homologue of the Piwi family, plays an important role in stem cell self-renewal and is overexpressed in various human tumors. This study aimed to determine whether an RNA interference-based strategy to suppress Hiwi expression could inhibit tumor growth in a xenograft mouse model. A rare population of $SSC^{lo}\;Alde^{br}$ cells was isolated and identified as lung cancer stem cells in our previous study. Plasmids containing U6 promoter-driven shRNAs against Hiwi or control plasmids were successfully established. The xenograft tumor model was generated by subcutaneously inoculating with lung cancer stem cell $SSC^{lo}\;Alde^{br}$ cells. After the tumor size reached about 8 mm in diameter, shRNA plasmids were injected into the mice via the tail vein three times a week for two weeks, then xenograft tumor growth was assessed. In nude mice, intravenously delivery of Hiwi shRNA plasmids significantly inhibited tumor growth compared to treatment with control scrambled shRNA plasmids or the vehicle PBS. No mice died during the experiment and no adverse events were observed in mice administered the plasmids. Moreover, delivery of Hiwi shRNA plasmids resulted in a significant suppressed expression of Hiwi and ALDH-1 in xenograft tumor samples, based on immunohistochemical analysis. Thus, shRNA-mediated Hiwi gene silencing in lung cancer stem cells by an effective in vivo gene delivery strategy appeared to be an effective therapeutic approach for lung cancer, and may provide some useful clues for RNAi gene therapy in solid cancers.

• Advances in pediatric surgery
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• 제4권2호
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• pp.93-99
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• 1998

Anal endosonography has recently been popularized in adult patients in order to access staging of rectal cancer and other lesions of the anorectum. This study is not familiar to pediatric surgeons. We performed anal endosonography in 30 children without anorectal disease in order to determine the standard morphology of the anorectum. The internal anal sphincter(IAS) was clearly identified as a homogeneous hypoechoic circular band, extending caudally to a level just proximal to the anal verge. The external anal sphincter(EAS) showed mixed echogenicity and different architecture along the anal canal; the EAS was U-shape in the upper canal and it had a circular pattern in the lower canal. In the upper canal of girls, the perineal body and the vagina were found just anterior of the anal canal, which made the U shape of the EAS. In the male, the sphincter tapered anteriorly into two arcs that met in the midline. The perineal body was prominent in the female. Posteriorly, the anococcygeal ligament was represented by a triangular shadow in both sex. The thickness of the IAS was measured in 3 directions, left, right and posterior, at 3 levels, upper, middle and lower areas of the anal canal. The average thickness was 0.86-2.40 mm between 6 and 18 months of age(Group 1), 0.88-3.20 mm between 19 and 36(Group 2), 1.07-2.20 mm between 37 and 54(Group 3) and 1.18-2.42 mm more than 54-month-old(Group 4). The thickness was correlated with the age of the children only in the right upper(p=0.008) and the left middle portion(p=0.015). We were able to obtain standard morphologic features of the normal anal canal in children with anal endosonography. We believe that this technique is a safe and an effective procedure to evaluate anorectal lesions in children.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3811-3815
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• 2014

Background: Colorectal cancer (CRC) is the worldwide disease which causes enormous losses every year. Recent studies suggested that environmental and gene factors might be the etiologies in increasing the risk of morbidity. Nitric oxide synthase 3 (NOS3) gene polymorphisms are said to be associated with CRC risk but the conclusion is still controversial. Materials and Methods: Pubmed and HuGENet databases up to December 2013 were used in this meta-analysis. Three different certain genotypic models were applied, namely dominant (AA+AC versus CC), recessive (AA versus AC+CC), per-allele analysis (A vs C). In addition, information on tumor sites and pathologic stages was collected. The strength of associations was assessed through combining odds ratio (OR) and 95% confidence interval (CI). Results: Finally, five and three studies about the rs1799983 and rs2070744 were covered in the analysis with 2,745 cases and 2,478 controls. Three models were applied, but no significant association was found for NOS3 G894T/rs1799983 (dominant: OR=0.999, 95%CI=0.797-1.253, $I^2$=63.8%; recessive: OR=0.924, 95%CI=0.589-1.450, $I^2$=59.3%; allele analysis: OR=0.979, 95%CI=0.788-1.216, $I^2$=74.9%) and T-786C/rs2070744 (dominant: OR=1.138, 95%CI=0.846-1.530, $I^2$=67.9%; recessive: OR=0.956, 95%CI=0.708-1.291, $I^2$=0.0%; allele analysis: OR=1.110, 95%CI=0.865-1.425, $I^2$=69.4%). The same results were also obtained for tumor sites and pathologic stage subgroups. After further analyzing the NOS3 gene, rs1799983 as the tag- and functional SNP was presented. Conclusions: On the basis of this meta-analysis and the characteristics of the NOS3 gene, we suggested rs1799983 might be a key locus associated with CRC risk. Further prospective studies were needed to make more comprehensive explanation of the associations.