• 대한방사선기술학회지:방사선기술과학
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• 제38권2호
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• pp.127-134
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• 2015

인구 고령화에 따른 암에 대한 관심 증가로 건강 검진을 받는 수검자가 늘고 있으며, 담낭용종의 유병률과 체질량 지수, 성별, 나이, 대사증후군 등의 위험인자에 대한 몇몇 연구가 있으나 본 연구는 최근 3년간의 담낭용종의 유병률과 대장용종 유무, 지방간 등의 다른 위험인자를 알아보고자 하였다. 2011년 1월에서 2013년 12월까지 대구지역 종합검진전문병원에서 건강검진을 받은 4,877명을 대상으로 성별과 나이를 조사하고, 키, 몸무게, 공복혈당, 간기능 및 기본 지질검사를 하였다. 복부초음파검사를 통해 담낭용종을 진단하고 지방간, 대장 내시경 결과 용종의 유무를 분석하였다. 분석결과 담낭용종이 발견된 경우는 383명(7.9%)으로 남자 256명(9.8%), 여자 127명(5.6%)으로 남자에서 담낭용종 유병률이 의미 있게 높았다(p<0.001). 연령별 담낭용종 유병률은 40대에서 3.50%로 가장 높게 나타났고 유의하게 나타나지 않았다. 담낭용종 크기는 평균 4.92 mm (1.6-17 mm)로 10 mm 이하가 73.6% 나타났다. 383명 중 261명(68.2%)이 단발성 용종, 122명(31.28%)이 2개 이상의 다발성 용종으로 타나났다. 남성 (OR 0.551, p<0.001), 과체중 (OR 0 .713, p=0.002), 중성지방 (OR 0 .571, p<0.001), 대사증후군 (OR 0 .049, p=0.033), 대장 용종 유무 양성 (OR 1.409, p=0.002)등이 담낭용종 발생에 영향을 미치는 독립인자로 선정되었다. HBsAg 양성은 담낭용종 발생에 관련 있는 위험인자가 아니었다. 결론적으로 본 연구는 담낭용종이 유병률은 과거보다 높은 7.9%로 나타났다. 남성, 과체중, 중성지방, 대사증후군, 대장용종이 담낭용종의 위험인자였다. 향후 건강검진 수검자 대상뿐만 아니라 일반국민을 대상으로 추가적인 검사가 필요하다고 사료되고, 담낭 절제술을 받아서 조직학적으로 확인된 경우를 조사 할 필요가 있겠다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제10권2호
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• pp.206-210
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• 2007

저자들은 수모세포종이 있는 24세 여자 환자에서 가족성 선종성 용종증이 동반된 Tucot 증후군 1예를 경험하였으며 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.246-249
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• 2020

Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

• 대한산업공학회지
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• 제42권2호
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• pp.129-137
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• 2016

A colonoscopy is important because it detects the presence of polyps in the colon that can lead to colon cancer. How often one needs to repeat a colonoscopy may depend on various factors. The main purpose of this study is to determine personalized surveillance interval of colonoscopy based on characteristics of patients including their clinical information. The clustering analysis using a partitioning around medoids algorithm was conducted on 625 patients who had a medical examination at Korea University Anam Hospital and found several subgroups of patients. For each cluster, we then performed survival analysis that provides the probability of having polyps according to the number of days until next visit. The results of survival analysis indicated that different survival distributions exist among different patients' groups. We believe that the procedure proposed in this study can provide the patients with personalized medical information about how often they need to repeat a colonoscopy.

• 농촌의학ㆍ지역보건
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• 제39권3호
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• pp.137-145
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• 2014

대장내시경을 이용한 대장암 선별검사가 증가하면서 발견된 용종의 절제와 추적검사가 점차 많아지고 있다. 하지만 국내에 대장용종절제 후 추적검사에 대한 연구가 부족한 실정이다. 이에 본 연구에서는 대장용종절제술 후 용종의 재발률을 알아보고 재발 위험 인자를 알아보고자 하였다. 이를 위하여 2000년 1월부터 2008년 3월까지 기간 동안에 용종절제술을 시행 받고 이후 추적검사를 시행 받은 147명의 환자를 대상으로 의무기록을 통한 후향적 분석을 시행하였다. 대장내시경검사를 통해 발견된 용종은 Kudo의 분류법으로 기술하였다. 추적 조사기간은 용종절제술과 이후 시행한 추적 대장내시경 검사와의 간격으로 정의하였다. 대상자 중 남자가 76.2%이었고, 환자의 평균연령은 $56.5{\pm}8.1$세이었다. 대상자의 용종절제 후 평균 추적기간은 $24.9{\pm}13.7$(6 - 65)개월이었다. 1년 누적재발률은 11.6%, 2년 누적재발률은 36.7%이고, 3년 누적재발률은 55.8%이었다. 용종의 개수에 따라 재발율이 유의한 차이를 보였다. 용종의 재발여부에 독립적인 영향을 미치는 인자로는 조직학적 형태가 의미있는 인자로 조사되었다. 본 연구 결과 대장의 선종성 용종의 3년 누적재발률이 55%를 넘는 것으로 관찰되므로 대장용종절제 후 추적 대장 내시경의 중요성이 강조되며 향후 대장용종절제술 후 재발에 대한 국내의 대규모 연구가 이루어져야 할 것으로 보인다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5111-5116
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• 2014

Computed Tomography Colonography (CTC) is a medical imaging technology used in identifying polyps and colon cancer masses in the large intestine. The technique has evolved a great deal since its invention and has become a routine diagnostic procedure in Western countries due to its non invasiveness and ease of use. The objective of our study was to explore the possibility of CTC application in Indian hospitals. This paper gives an overview of the procedure and its commercial viability. The explanation begins with the domain aspects from gastroenterologist perspective, the new way of thinking in polyp classification, the technical components of CTC procedure, and how engineering solutions have helped clinicians in solving the complexities involved in colon diagnosis. The colon cancer statistics in India and the results of single institution study we carried out with retrospective data is explained. By considering the increasing number of patients developing colon malignancies, the practicality of CTC in Indian hospitals is discussed. This paper does not reveal any technical aspects (algorithms) of engineering solutions implemented in CTC.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.753-756
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• 2015

Background: Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Much previous research has indicated that it increases in cases of systemic inflammation or cardiametabolic incident. However, information on the relation of RDW with solid tumors causing systemic inflammation is limited. In the present research, we examined the relation of RDW with malignant and benign lesions of the colon. Materials and Methods: 115 patients with colon polyps (group 1), and 30 with colon cancer (group 2) who were diagnosed histopathologically in our clinic between January 2010-January 2013 were scanned retrospectively. Patients with anemia, hematologic diseases and active inflammation were excluded. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relations with the malignant and benign lesions of the colon were examined. Results: Both groups were similar in age and gender distribution. RDW values of patients with colon cancer were significantly higher than the patients with colon polyp (p=0,01). No significant differences were detected between the two groups in terms of MCV and Plt values (p>0,05). Conclusions: RDW can be used as an early warning biomarker for solid colon tumors. Further prospective research is required on the relations of cheap and easily measured RDW parameters with colon malignancies.

• Journal of Nutrition and Health
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• 제37권7호
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• pp.550-556
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• 2004

Dietary pattern analysis is important complementary approach for identifying associations between diet and chronic disease. A case-control study was conducted in order to examine dietary patterns and the risk of colon cancer in Korea. Data were collected from both 137 cases with either colorectal cancer or large bowl adenomatous polyps and 134 controls regarding social-demographic characteristics and food intake using a semi-quantitative food frequency questionnaire. We conducted factor analysis and identified 6 major dietary patterns: 'Well-being diet' characterized by higher intakes of potatoes, yogurt, soybean paste and vegetables, 'Meat & fish', 'Milk & juice', 'Pork & alcohol', 'Rice & kimchi', and 'Coffee & cake'. We calculated factor scores for each participant and examined the associations between dietary patterns and colon cancer risk. After adjusting for potential confounders, there was a relative risk for colon cancer of 0.16 (95% confidence interval, 0.07 - 0.34) when comparing the highest with the lowest tertile of the 'Well-being' pattern. Significant trends of decreasing risk of colon cancer also emerged with the 'Milk & juice' (OR = 0.40, 95% CI = 0.20 - 0.79). In contrast, inverse associations of the risk were found for 'Pork & alcohol' (OR = 1.92, 95% CI = 0.93 - 3.97), 'Coffee & cake' (OR = 2.18, 95% CI = 1.07 - 4.46). For the 'Meat & fish' pattern, the decreased risk of colon cancer was observed in the second tertile, but not in the highest tertile when comparing to the lowest. The 'Rice & kimchi' pattern had a nonsignificant association with the risk. These data suggest that major dietary patterns derived from the FFQ associated with the risk of colon cancer in Korea. Since foods are not consumed in isolation, dietary pattern research in natural eating behavior may be useful for understanding dietary causes of colon cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9773-9779
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• 2014

Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was $56.5{\pm}9.59$ and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms. The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2401-2405
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• 2016

Background: Both colorectal cancer (CRC) and diverticular disease (DD) are common in the affluent West, and their prevalence is also increasing in the rest of the world with economic development. Both diseases have common epidemiologic characteristics; increasing incidence, more common with advancing age and related to specific dietary changes. However, studies of associations between the two have generated mixed results with some showing positive correlations, whilst others have shown no or negative links. Most of these studies have been from the West with study populations that were predominantly Caucasians. Here the focus was on DD and colorectal neoplasms, including CRC, in Brunei. Materials and Methods: All patients who had undergone complete colonoscopy between 2011 and 2014 were identified and retrospectively reviewed. Patients under the age of 18 years old or had previous colonic surgeries (including previous CRC resection) were excluded. Results: The total number of colonoscopies included in the study was 2,766 (mean age $53.2{\pm}14.8$ years old, male 51.8%), of which DD, CRC and colonic polyps were detected in 17.3%, 4.7% and 28.2% respectively. The proportions of DD, polyps and CRC increased proportionally with age (<30 years, 30-49, 50-69 and ${\geq}70$). Overall, there was no association between the presence of DD and CRC (3.6% vs. 5.0%, p=0.179) but there was a significant association between CRC and left sided DD (p=0.034 by trend). There were also a significant association between presence of DD and polyps (36.1% vs. 28.2%, p=0.001), in particular with right-sided and pan-DD (p=0.001 for trend). Conclusions: Our study showed that the prevalence of DD, CRC and polyps increases with age. There were significant associations between presence of left-sided DD with CRC and right-sided or pan-DD with colonic polyps. This suggests shared risk factors. Further studies are required to assess links in other countries of the Asian Pacific region.