• 제목/요약/키워드: Large bowel

검색결과 101건 처리시간 0.028초

Increasing Incidence of Colorectal Cancer, Starting at a Younger Age for Rectal Compared to Colon Cancer in Brunei Darussalam

  • Chong, Vui Heng;Telisinghe, Pemasari Upali;Bickle, Ian;Abdullah, Muhamad Syafiq;Lim, Ediwn;Chong, Chee Fui
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5063-5067
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    • 2015
  • Background: Colorectal cancer (CRC) is the most common gastrointestinal malignancy and is a significant cause of mortality. Its incidence is generally increasing in Asia. Reports from the West have indicated that the incidence of rectal cancer is increasing in the younger population. This study assessed the time trend of CRC in Brunei Darussalam specifically assessing the different age groups at which the incidences start to increase. Materials and Methods: The National Cancer registry was reviewed (1991 to 2014). The age standardized rate (ASR) and the age specific incidence rates (ASIRs) for three time periods (1991-1998), (1999-2006) and (2007-2014) were calculated. Results: The mean age of diagnosis was $59.3{\pm}14.6$ years old, incidences being slightly higher amongst men (57.6%) and Malays (67.1%). The most common tumor type was adenocarcinoma (96.4%). Rectal cancers accounted for 35.2% (n=372/1,056) of all cancers of the large bowel; more men were affected than women. The proportion of rectal cancer was also high among the indigenous group. In the three time periods, the ASR for CRC increased from 16 per 100,000 (1991-1998) to 19.6 per 100,000 (1999-2006) and 24.3 per 100,000 (2007-2014). The ASIRs for CRC increased markedly between the time periods 1998-2006 and 2007-2014, beginning in the 40-44 years age group. For rectal cancers, the ASIRs started to increase in the 25-29 age group onward whereas for colon cancers, the increase was observed at a later age, starting from the 45-49 age group. Conclusions: Our study showed an increase in the incidence of CRC including in the younger age groups. The increase was seen earlier in rectal cancer compared to colon cancer. These data mirror the trends reported from the West.

Epithelial-mesenchymal Transition and Its Role in the Pathogenesis of Colorectal Cancer

  • Zhu, Qing-Chao;Gao, Ren-Yuan;Wu, Wen;Qin, Huan-Long
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2689-2698
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    • 2013
  • Epithelial-to-mesenchymal transition (EMT) is a collection of events that allows the conversion of adherent epithelial cells, tightly bound to each other within an organized tissue, into independent fibroblastic cells possessing migratory properties and the ability to invade the extracellular matrix. EMT contributes to the complex architecture of the embryo by permitting the progression of embryogenesis from a simple single-cell layer epithelium to a complex three-dimensional organism composed of both epithelial and mesenchymal cells. However, in most tissues EMT is a developmentally restricted process and fully differentiated epithelia typically maintain their epithelial phenotype. Recently, elements of EMT, specially the loss of epithelial markers and the gain of mesenchymal markers, have been observed in pathological states, including epithelial cancers. Increasing evidence has confirmed its presence in human colon during colorectal carcinogenesis. In general, chronic inflammation is considered to be one of the causes of many human cancers including colorectal cancer(CRC). Accordingly, epidemiologic and clinical studies indicate that patients affected by ulcerative colitis and Crohn's disease, the two major forms of inflammatory bowel disease, have an increased risk of developing CRC. A large body of evidence supports roles for the SMAD/STAT3 signaling pathway, the NF-kB pathway, the Ras-mitogenactivated protein kinase/Snail/Slug and microRNAs in the development of colorectal cancers via epithelial-tomesenchymal transition. Thus, EMT appears to be closely involved in the pathogenesis of colorectal cancer, and analysis refered to it can yield novel targets for therapy.

복강내 종양으로 오인된 외상성 혈종: 증례보고 (Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor : A Case Report)

  • 박종민;김성엽;정일용;김우식;신용철;김영철;박세혁
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.300-303
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    • 2013
  • Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

In vitro Evaluation of Dextran-5-aminosalicylic Acid Conjugate as a Polymeric Colon-specific Prodrug of 5-aminosalicylic Acid

  • Jung, Yun-Jin;Jeon, Hyun-Chu;Choi, Dea-Kyu;Kim, Young-Mi
    • Journal of Pharmaceutical Investigation
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    • 제37권1호
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    • pp.45-49
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    • 2007
  • Dextran-5-aminosalicylic acid conjugate (dextran-5-ASA) was in vitro-evaluated as a polymeric colon-spe-cific prodrug of 5-aminosalicylic acid (5-ASA). Chemical stability of dextran-5-ASA in the pH 1.2 or 6.8 buffer solutions was investigated at 37 for 6 hrs. The dextran backbone was not degraded and no 5-ASA release was detected. Moreover, dextran-5-ASA neither liberated 5-ASA in the homogenates of the small intestine of rats nor was transported across Caco-2 cell monolayers, suggesting no significant loss of dextran-5-ASA during transit through the upper intestine. Furthermore, incubation of dextran-5-ASA in 10% cecal contents of rats released about 37% and 55% of 5-ASA bound to dextran in 8 hr and 24 hr, respectively. While that with either esterase or dextranase failed to liberate 5-ASA from the polymeric prodrug, incubation of dextran-5-ASA with both esterases and dextranse released 5-ASA up to about 24% of 5-ASA bound to dextran. These results suggest that, after oral administration of dextran-5-ASA, the polymeric prodrug is delivered specifically to and releases 5-ASA in the large intestine, and reveal that the 5-ASA release by cleavage of the ester bond requires precedent depolymerization of the dextran backbone.

유리 소장이식을 이용한 구강내 결손부위의 수복 증례보고 및 문헌 고찰 (FREE JEJUNAL FLAP FOR INTRAORAL RECONSTRUCTION CASES REPORT & LITERATURE REVIEW)

  • 강보원;김성문;임재석;권종진;최성원;이동근;민승기
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권2호
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    • pp.113-121
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    • 1994
  • Large oral defects following tumor resection pose formidable challenge for the reconstructive surgeon. Ideally, wound closure should utilize like tissue in providing expedient, single-stage closure, returning maximum function while minimizing deformity. Recent methods have reported and utilize variable mucocutaneous flaps. However, the ideal reconstruction has yet to defined. The small bowel serves as a readily available donor site for satisfying reconstructive needs in oropharyngeoesophageal defects. Segments of jejunum may be opened along the antimesenteric border and transferred to oral defect as free tissue transfers. Some of the benefits of this technique have included a one-stage procedure, abundant donor tissue with characteristics similar to oral mucosa, near normal facial appearance, preservation of maximum tongue function and relief of annoying xerostomia by jejunal mucous secretion. Three cases re presented in which two cases show successful use of this flap. The other one patient developed total necrosis of this flap. We report cases of reconstruction using free jejunal flap transfer in oral reconstruction.

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Effects of Rice Bran and Wheat Bran on Intestinal Physiology and Small-bowel Morphology in Rats

  • Park, Young-Sun;Jang, Jae-Hee;Bae, Bok-Sun;Seo, Jung-Sook
    • Nutritional Sciences
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    • 제3권1호
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    • pp.3-10
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    • 2000
  • The present study was aimed at investigating the nutritional and physiological significance of rice bran as a source of dietary fiber as compared to pectin and wheat bran. The parameters for comparison included hypertrophy and morphology of intestines, stool weights and villus marker enzyme activity. For 6 weeks, 10 Sprague Dawley male rats were given one of six experimental diets: 1% cellulose control (CC), 5% pectin (P5), 5% rice bran(RB5), 10% rice bran(RB10), 5% wheat bran (WB5) or 10% wheat bran (WB10) based on the level of dietary fiber. Among experimental groups, food efficiency ratio and body weight gain was comparable. RB10 increased cecal and colonic tissue weights and content weights of cecum and colon as much as P5 did. Stool weight was positiviely correlated with colonic tissue weight (r=0.727, P<0.001), with colonic content weight(r=0.647, P<0.001). Small intestine length increased most in the P5 group, followed by the RB10 group. The scanning electron micrograph of jejunal villi from rice bran groups showed a leaf-shaped, smooth and regular pattern, whereas that of CC group produced a rather long shape. The wheat bran groups showed an irregular leafshaped pattern, and the pectin group typically produced leaf-shaped villi with surface damage. The activities of villus marker enzymes (maltase and sucrase) were higher in the bran-fed rats than in the control or pectin-fed rats. The results indicate than not only dietary fiber amounts but also fiber sources are closely related to the physiology and morphology of the large and small intestines in rats. Rice bran exerted effects on fecal output and trophic effects on the intestines similar to those of pectin.

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엘러스-단로스 제4형 증후군 환자에서 발생한 대동맥 파열 ([Secondary publication] Sudden Aortic Rupture in Ehlers-Danlos Syndrome Type IV)

  • 백태화;김민정;기창석;박성환;이헌;김경열;최병하
    • The Korean Journal of Legal Medicine
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    • 제40권2호
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    • pp.61-64
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    • 2016
  • Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.

소아 기능성 위장 장애의 한약 치료에 대한 임상연구 동향 - 중의학 무작위 대조군 임상시험을 중심으로 (Trends in Clinical Research of Herbal Medicine Treatment for Functional Gastrointestinal Disorders in Children - Focused on Randomized Controlled Trials in traditional Chinese medicine)

  • 이지홍;이선행;장규태
    • 대한한방소아과학회지
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    • 제35권3호
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    • pp.67-88
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    • 2021
  • Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

간호기기 개발수요 조사연구 (A Study on the Demand for Equipent Development in Nursing)

  • 장순복;김의숙;황애란;강규숙;서미혜
    • 대한간호
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    • 제35권2호
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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$^{18}F-FDG$ PET/CT에서 저용량 경구용 조영제의 유용성 (Usefulness of Low Dose Oral Contrast Media in $^{18}F-FDG$ PET/CT)

  • 안영실;윤준기;홍선표;조철우;윤석남
    • Nuclear Medicine and Molecular Imaging
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    • 제40권5호
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    • pp.257-262
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    • 2006
  • 목적: 기존의 CT 영상 촬영에서 이용되고 있는 고용량의 경구용 조영제는 복용과정에서 위장계통의 불편함이 나타나고 또한 PET/CT에 이용할 경우에는 이로 인해 인공물(artifact)이 생길 우려가 있다. 본 연구의 목적은 $^{18}F-FDG$ PET/CT에서 저용량의 경구용 조영제 사용의 유용성에 대해 알아보고자 한다. 대상 및 방법: 총 435명의 전신 PET/CT 영상을 후향적으로 분석하였다. 모든 환자들은 $^{18}F-FDG$. 주사 직전에 200 ml의 경구용 조영제(bariumsulfate)를 복용하였다. 장에서의 FDG 섭취 양상을 가로단면, 관상면, 시상면에서 시각적으로 판독하였고, 섭취양상을 반정량화하였다. 결과: 435명의 영상 중 70명(16%, 113부위) 에서 높은 FDG 섭취(peak SUV > 4)를 보였으며, 이 중 미만성 섭취를 보인 경우가 50명(74%, 84부위), 국소적 섭취를 보인 것은 20명(26%, 29부위)이였다. 경구용 조영제가 가장 흔하게 분포된 부위는 소장(n=27, 39%)이었다. PET/CT 영상에서 FDG섭취부위와 조영제 분포 부위가 일치하는 경우 중에서 미만성 섭취를 보인 것은 26명(54%, 38부위), 국소적 섭취를 보인 것은 9명(45%, 9부위)이였다. 이들을 부위별로 보면 미만성 섭취를 보인 것은 38개(45%), 국소적 섭취를 보인 것이 9개(31%)였다. FDG 섭취와 조영제의 분포가 일치하는 부위는 소장에서 61% (29/47부위)로 가장 많이 관찰되었다. 감쇠 보정을 하지 않은 PET 영상을 본 결과, 검토가 가능했던 27개의 섭취 일치 부위에서 조영제로 인한 인공물(artifact) 영향은 관찰되지 않았다. 결론 저용량 경구용 조영제는 FDG PET/CT 영상에서 인공물 영향 없이 복부의 FDG 섭취를 판별하는데 도움을 줄 수 있다.T은 민감도 85.7%(6/7), 특이도 92.3%(12/13), MR은 민감도 100%(7/7), 특이도 76.9%(10/13)를 보였다. 그 외에도 간전이 병변의 평균 maxSUV는 $6.7{\pm}3.8$로 간전이와 양성병변을 최적으로 감별할 수 있는 maxSUV의 cutoff value는 3.1 이었다. (AUC=0.897, p<0.001, 민감도 83.3%, 특이도 94.1%) 결론: FDG PET은 간전이를 진단하는데 MR과 대등한 민감도와 특이도를 보였다. 통계적으로 유의한 차이를 보이지는 않았지만 간전이에 대한 FDG PET의 음성예측도는 MR보다 높았으며, 직경 10 mm 미만의 작은 병변에 대해서도 FDG PET은 우수한 성적을 보였다. 향후 대장암의 간전이 진단에 FDG PET이 유용하게 이용될 것이다.CA-tk 에서 확연한 집적의 차이를 보여주었다. 결론: 간암세포주에서 HSV1-tk 유전자의 발현 정도와 지속성 그리고 위치를 확인하기 위한 비침습적 PET 영상을 위한 기질로서 $[^{18}F]FHBG$는 매우 유용할 것으로 기대된다.EX>의 수용체 결합능의 감소율과 혈중 니코틴의 축적 농도와의 상관관계를 스피어만 상관분석법(Spearman's correlation)에 의하여 알아보았다. 결과: 흡연에 의한 선조체에서의 평균 $[^{11}C]raclopride$의 수용체 결합능의 변화는 미상핵에서 4.7%, 전피각에서 4.0%, 복측 선조체에서 7.8% 의 감소를 보여 흡연에 의한 선조체내 도파민 유리를 정량화 하였다. 특히 선조체에서의 도파민 유리에 의한 수용체 결합능의 감소는 흡연에 의한 혈중 니코틴의 축적 농도와 양의 상관관계를 보였다(rho=0.9, p=0.04). 결론: $[^{11}C]raclopride$ PET을 이용하여 비흡연 정상인에서 흡연에 의한