• Title/Summary/Keyword: Colorectal surgery

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Effects of Mobile Navigation Program in Colorectal Cancer Patients based on Uncertainty Theory (대장암 환자를 위한 불확실성 이론 기반 모바일 내비게이션 프로그램의 효과)

  • Kim, Kyengjin;Park, Wanju
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.274-285
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    • 2019
  • Purpose: This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients. Methods: To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale. Results: Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22, p=.009) and resilience (F=4.31, p=.042), but not for growth through uncertainty (F=2.76, p=.102). Conclusion: These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.

Tanshinone II-A Inhibits Angiogenesis through Down Regulation of COX-2 in Human Colorectal Cancer

  • Zhou, Li-Hong;Hu, Qiang;Sui, Hua;Ci, Shu-Jun;Wang, Yan;Liu, Xuan;Liu, Ning-Ning;Yin, Pei-Hao;Qin, Jian-Min;Li, Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4453-4458
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    • 2012
  • Angiogenesis plays a significant role in colorectal cancer (CRC) and cyclooxygenase-2 (COX-2) appears to be involved with multiple aspects of CRC angiogenesis. Our aim was to investigate the inhibitory effects of Tan II-A (Tanshinone II-A, Tan II-A) on tumor growth in mice, as well as alteration of expression of COX-2 and VEGF in CRC. We established the mice xenograft model of C26 CRC cell line, and injected 0.5, 1, 2mg/kg of Tan II-A and 1mg/kg of 5-FU in respectively in vivo. Then, we assayed tumor weight and volume, and evaluated microvascular density and expression of VEGF. COX-2 promoter and COX-2 plasmids were transfected into HCT-116 cells, followed by detection of COX-2 promoter activity by chemiluminescence, and detection of COX-2 mRNA expression by fluorescence quantitative PCR. Taken together, the results showed Tan II-A could inhibit tumor growth and suppress the VEGF level in vivo. HCT-116 cell experiments showed marked inhibitory effects of Tan II-A on COX-2 and VEGF in a dose-dependent manner. The results indicate that Tan II-A can effectively inhibit tumor growth and angiogenesis of human colorectal cancer via inhibiting the expression level of COX-2 and VEGF.

ROLE OF DCC(DELETED IN COLORECTAL CANCER) GENE IN ORAL SQUAMOUS CELL CARCINOMA (구강편평상피암종에서 DCC 유전자의 역할)

  • Ko, Seong-Kyu;Han, Se-Jin;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.5
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    • pp.518-524
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    • 2008
  • Chromosome 18q alteration plays a key role in colorectal tumorigenesis, and loss of heterozygosity at 18q is associated with a poor prognosis in colon cancer. DCC(Deleted in Colorectal Cancer) is a putative tumor- suppressor gene at 18q21 that encodes a transmembrane protein with structural similarity to neural cell adhesion molecule that is involved in both epithelial and neuronal cell differentiation. DCC is implicated in regulation of cell growth, survival and proliferation. Thus, tumor progression in squamous cell carcinoma, stomach cancer, colorectal cancer correlates with downregulation of DCC expression. The mechanism for DCC suppression is associated with hypermethylation of the DCC gene promoter region. Hence, the goal of this study is to identify the promoter methylation responsible for the down-regulation of DCC expression in oral squamous cell carcinoma. 12 of tissue specimens for the study are excised and gathered from 12 patients who are diagnosed as SCC in department of OMS, dental hospital, dankook university. To find expression of DCC in each tissue samples, immunohistochemical staining, RT-PCR gene analysis and methylation specific PCR are processed. The results are as follows. 1. In the DCC gene RT-PCR analysis, 5(41.6%) of 12 specimens of oral squamous cell carcinoma did not expressed DCC gene. 2. In the promoter methylation specific PCR analysis, 5(41.6%) of 12 specimens showed promoter methylation of DCC gene. 3. In the immunohistochemical staining of poor differentiated and invasive oral squamous cell carcinoma, loss of DCC expression was observed. These findings suggest that methylation of the DCC gene may play a role in loss of gene expression in invasive oral squamous cell carcinoma.

Correlation of Bevacizumab-induced Proteinuria with Therapeutic Effects in Patients with Colorectal Cancer (직결장암 환자에서 Bevacizumab에 의한 단백뇨 발현과 치료효과와의 상관관계 분석)

  • Sa, Yea-Ji;Kim, Kyung-Duck;Ahn, Hye-Lim
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.4
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    • pp.234-242
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    • 2020
  • Background: Bevacizumab-induced proteinuria is known to occur when vascular endothelial cell receptors are blocked, which leads to decreased protein filtration. Although several studies have analyzed the correlation between therapeutic effect of bevacizumab and proteinuria, no conclusion has been established. Methods: In this retrospective study, colorectal cancer patients who received bevacizumab and urinary protein check from January 2015 to December 2016, were included. The incidence of proteinuria and the grade according to Common Terminology Criteria for Adverse Events (CTCAE) 4.0 were evaluated after bevacizumab administration. The primary objective was to correlate proteinuria with overall response rate (ORR) and time to progression (TTP). Primary lesion, metastasized organs, surgery or radiation therapy, chemotherapy were investigated for analysis of risk factors for proteinuria development. Results: A total of 149 patients included in the analysis. Proteinuria occurred 19.5% (n=29) in the study patients; 20 in grade 1, 7 in grade 2, and 2 in grade 3. ORR was 55.2% in the proteinuria group and 51.7% in the non-proteinuria group. There was no difference between two groups (p=0.89). The TTP through the survival curve was similar in both groups (10 months, p=0.97). The risk of proteinuria was high in patients who had liver metastasis (p=0.02) and no surgery (p=0.01). Conclusions: These result indicates that bevacizumab-induced proteinuria expression was not correlated with the therapeutic effect on patients with colorectal cancer. Further analysis is required to find out the correlation between proteinuria and therapeutic effects. The risk of proteinuria was increased from patients who had liver metastasis, and no surgery.

Serum 25-hydroxy Vitamin D Status is Not Related to Osteopenia/Osteoporosis Risk in Colorectal Cancer Survivors

  • Akinci, Muhammed Bulent;Sendur, Mehmet Ali Nahit;Aksoy, Sercan;Yazici, Ozan;Ozdemir, Nuriye Yildirim;Kos, Tugba;Yaman, Sebnem;Altundag, Kadri;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3377-3381
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    • 2014
  • Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recently published studies. In addition, prospective investigations have indicated that low vitamin D levels may be associated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exact incidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis is still not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors of osteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancer survivors treated with surgery and/or chemotherapy ${\pm}$ radiotherapy were recruited from medical oncology outpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed, and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients was divided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: The median age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male. The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); mild deficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency (<10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17 (15.0%). Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma, chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis. Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). In female patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients (p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5% and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopenia and osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first to evaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.

Colorectal Foreign Bodies: Six Cases Report and Review of the Literature (직장을 통해 들어간 대장과 직장의 이물: 증례보고)

  • Kim, Hyoungran;Choi, Seokho;Yun, Jeongseok
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.51-54
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    • 2015
  • The incidence of foreign body insertion in the anorectum is rare, however, it is increasing, especially in urban populations. Foreign objects in the anorectum can be of different sizes, shapes and materials. Frangible objects like glass or beakers, and sharp foreign bodies that may easily injure the bowel mucosa are particularly dangerous. Physicians have to consider more innovative options on how to extract these foreign bodies without inciting injury; and, if injury would occur, consider different techniques to repair it, whether transanally or transabdominally, and opt for primary repair, or resection with either anastomosis or stoma creation. Here, I introduce our cases with colorectal foreign bodies and present several literatures to help physicians decide when presented with cases like these.

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Use of artificial intelligence in the management of T1 colorectal cancer: a new tool in the arsenal or is deep learning out of its depth?

  • James Weiquan Li;Lai Mun Wang;Katsuro Ichimasa;Kenneth Weicong Lin;James Chi-Yong Ngu;Tiing Leong Ang
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.24-35
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    • 2024
  • The field of artificial intelligence is rapidly evolving, and there has been an interest in its use to predict the risk of lymph node metastasis in T1 colorectal cancer. Accurately predicting lymph node invasion may result in fewer patients undergoing unnecessary surgeries; conversely, inadequate assessments will result in suboptimal oncological outcomes. This narrative review aims to summarize the current literature on deep learning for predicting the probability of lymph node metastasis in T1 colorectal cancer, highlighting areas of potential application and barriers that may limit its generalizability and clinical utility.

Effects of the Enhanced Recovery After Surgery (ERAS) Program for Colorectal Cancer Patients Undergoing Laparoscopic Surgery

  • Jeongwon Yeom;Hee-Sook Lim
    • Clinical Nutrition Research
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    • v.11 no.2
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    • pp.75-83
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    • 2022
  • This study sought to investigate the effects of the enhanced recovery after surgery (ERAS) program on postoperative recovery and nutritional status in patients with colorectal cancer undergoing laparoscopic surgery. A total of 37 patients were included: 19 in the experimental group and 18 in the control group. The experimental group was supplemented with carbohydrate drinks before and after surgery, and the control group was maintained with fasting and water intake in the traditional method. Both care management and nutrition education were implemented for both groups. Patients were evaluated for physical condition, clinical indicators, blood tests, pain, length of stay, nutritional status, and nutrient intake. Use of the ERAS program for the experimental group resulted in shorter length of stay (p = 0.006), less pain (p < 0.001), and a lower rate of malnutrition (p = 0.014) compared with controls. In conclusion, carbohydrate drinks provide great advantages by reducing discomfort, such as pain or thirst, during fasting in patients after colon cancer surgery, helping patients to eat comfortably and actively, minimizing insulin resistance, maintaining nitrogen balance, and reducing infection and anastomosis leakage. For use of ERAS as a standardized program, repeated and expanded research is needed, and a Korean-style ERAS should be prepared by using this approach for various diseases.

Elevated Mean Platelet Volume is Associated with Presence of Colon Cancer

  • Li, Jia-Ying;Li, Ying;Jiang, Zheng;Wang, Rui-Tao;Wang, Xi-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10501-10504
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    • 2015
  • Background: Colon cancer is the second most common cancer in developed countries. Activated platelets play a key role in inflammation and atherothrombosis, with mean platelet volume (MPV) is an early marker of platelet activation. The aim of the study was to clarify the relevance of MPV in patients with colon cancer. Materials and Methods: We measured MPV levels in 128 patients with colon cancer before and after surgery, and 128 controls matched for age, gender, body mass index (BMI) and smoking status. The odds ratios (ORs) and 95% confidence intervals (CIs) for colon cancer were calculated using multivariate logistic regression analyses across MPV quartiles. Results: Patients with colon cancer had higher MPV compared with controls. Surgical tumor resection resulted in a significant decrease in MPV levels (11.4 fL vs 10.7 fL; p<0.001). A positive correlation between MPV and tumor-nodule-metastases (TNM) stage was found. Furthermore, after adjusting for other risk factors, the ORs (95%CIs) for colon cancer according to MPV quartiles were 1.000, 2.238 (1.014-4.943), 3.410 (1.528-7.613), and 5.379 (2.372-12.198), respectively. Conclusions: The findings show that patients with colon cancer have higher MPV levels compared with controls, and these are reduced after surgery. In addition, MPV was found to be independently associated with the presence of colon cancer. Further studies are warranted to assess the utility of MPV as a novel diagnostic screening tool for colon cancer.

Clinicopathologic characteristics and survival rate in patients with synchronous or metachronous double primary colorectal and gastric cancer

  • Park, Ji-Hyeon;Baek, Jeong-Heum;Yang, Jun-Young;Lee, Won-Suk;Lee, Woon-Kee
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.83-88
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    • 2018
  • Purpose: Double primary colorectal cancer (CRC) and gastric cancer (GC) represent the most common multiple primary malignant tumors (MPMT) in Korea. The recognition and screening of hidden malignancies other than the primary cancer are critical. This study aimed to investigate the clinicopathologic characteristics and survival rates in patients with synchronous or metachronous double primary CRC and GC. Methods: Between January 1994 and May 2018, 11,050 patients were diagnosed with CRC (n=5,454) or GC (n=5,596) at Gil Medical Center. MPMT and metastatic malignant tumors were excluded from this study. A total of 103 patients with double primary CRC and GC were divided into two groups: the synchronous group (n=40) and the metachronous group (n=63). The incidence, clinicopathologic characteristics, and survival rate of the two groups were analyzed. Results: The incidence of synchronous and metachronous double primary CRC and GC was 0.93%. Double primary CRC and GC commonly occurred in male patients aged over 60 years with low comorbidities and minimal previous cancer history. There were significant differences between the synchronous and metachronous groups in terms of age, morbidity, and overall survival. Metachronous group patients were 6 years younger on average (P=0.009), had low comorbidities (P=0.008), and showed a higher 5-year overall survival rate (94.8% and 61.3%, P<0.001) in contrast to synchronous group. Conclusion: When primary cancer (CRC or GC) is detected, it is important to be aware of the possibility of the second primary cancer (GC or CRC) development at that time or during follow-up to achieve early detection and better prognosis.