• The Korean Journal of Pain
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• v.9 no.2
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• pp.419-422
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• 1996

Pain arising from pelvic viscera and perineum is frequently associated with discomfort and disability and caused by local trauma, inflammation and malignancy within the pelvis. Although various interventions have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. The ganglion impar is a solitary retroperitoneal structure located at the level of the sacrococcygeal junction that marks the terminations of sympathetic chains. We propose that blockade of the ganglion impar is an effective method in the management of patient suffered from perianal pain due to advanced rectal cancer.

• The Journal of Korean Medicine
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• v.28 no.3 s.71
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• pp.108-115
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• 2007

Objectives : The purpose of this study was to investigate the effect of Sojukjeongwon-san (이하 SJJWS) on a rectal cancer patient. Methods : This clinical case was analyzed on a patient who was admitted on August 11th and discharged on September 7th, 2006. We recordedhis abdominal pain, urine, anal pain, bleeding, mucous stools, frequency and hardness and amount of the stools, weight, lab follow-ups and so on. Results : After the treatment, the chief complaints of the patient, such as rectal pain, bloody excrement, loss of weight, etc., had improved. Conclusion : In this study we suggest that SJJWS reduced symptoms for a rectal cancer patient and improved the patient's quality of life.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.71-77
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• 2017

Purpose: Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Materials and Methods: Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0-3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Results: Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (${\geq}75Gy_{10}$) than for the lower BED group (<$75Gy_{10}$). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. Conclusion: For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than $75Gy_{10}$, if the dose to the organ at risk is within acceptable levels.

• Journal of Sasang Constitutional Medicine
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• v.25 no.1
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• pp.62-70
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• 2013

Objectives This study reports a case of rectal cancer patient treated with Dokhwaljihwang-tang. Methods The patient's subjective symptoms such as pain, sleeping difficulty, frequent defecation and dysuria were observed and the change of the quality of life(QOL) was evaluated using Functional Assessment of Cancer-Colon (FACT-C). Results After the treatment, symptoms such as pain, sleep disorder, defecation, and urination difficulty ameliorated and the score of the FACT-C improved. Conclusions A rectal cancer patient suffering from adverse consequences from the low anterior resection and the pain induced by the metastases showed the improvement of general condition and the quality of life after treated with Dokhwaljihwang-tang.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6115-6120
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• 2014

Background: To compare the KKU-model rectal tube (KKU-tube) and the conventional rectal tube (CRT) for checking rectal doses during high-dose-rate intracavitary brachytherapy (HDR-ICBT) of cervical cancer. Materials and Methods: Between February 2010 and January 2011, thirty -two patients with cervical cancer were enrolled and treated with external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). The KKU-tube and CRT were applied intrarectally in the same patients at alternate sessions as references for calculation of rectal doses during ICBT. The gold standard references of rectum anatomical markers which are most proximal to radiation sources were anterior rectal walls (ARW) adjacent to the uterine cervix demonstrated by barium sulfate suspension enema. The calculated rectal doses derived from actual anterior rectal walls, CRT and the anterior surfaces of the KKU-tubes were compared by using the paired t-test. The pain caused by insertion of each type of rectal tube was assessed by the visual analogue scale (VAS). Results: The mean dose of CRT was lower than the mean dose of ARW ($Dmean_0-Dmean_1$) by $80.55{\pm}47.33cGy$ (p-value <0.05). The mean dose of the KKU-tube was lower than the mean dose of ARW ($Dmean_0-Dmean_2$) by $30.82{\pm}24.20cGy$ (p-value <0.05). The mean dose difference [($Dmean_0-Dmean_1$)-($Dmean_0-Dmean_2$)] was $49.72{\pm}51.60cGy$, which was statistically significant between 42.32 cGy -57.13 cGy with the t-value of 13.24 (p-value <0.05). The maximum rectal dose by using CRT was higher than the KKU-tube as much as 75.26 cGy and statistically significant with the t-score of 7.55 (p-value <0.05). The mean doses at the anterior rectal wall while using the CRTs and the KKU-tubes were not significantly different (p-value=0.09). The mean pain score during insertion of the CRT was significantly higher than the KKU-tube by a t-score of 6.15 (p-value <0.05) Conclusions: The KKU-model rectal tube was found to be an easily producible, applicable and reliable instrument as a reference for evaluating the rectal dose during ICBT of cervical cancer without negative effects on the patients.

• Journal of Sasang Constitutional Medicine
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• v.23 no.4
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• pp.533-540
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• 2011

In this case, we report a case of Soeumin rectal cancer patient who was mistreated with herb medication. This patient was 72 years old female diagnosed rectal cancer stage IV with multiple liver, lung, and LN metastases. She administered our cancer center in Sep. 2011 for cancer treatment, we diagnosed this patient as Taeyangin at first, and treated with Mihuedungsikjang-tang. After 1 week, she complained upper abdominal discomfort, severe abdominal pain, nausea and sweating. Considering several symptoms and conditions, the change of symptoms seemed to a adverse events caused by mistreatment. We re-diagnosed this patient as Soeumin, and treated with Soeumin herbal medication, Baekhaoleejung-tang(白何烏理中湯) and Hyangsayangyi-tang(香砂養胃湯). Several symptoms including abdominal pain were improved 2 weeks later. Therefore, we report this case as a reference that Soeumin misdiagnosed as Taeyangin and the improvement of adverse symptoms.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.165-168
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• 1998

Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at $L_5$ dermatome. Laminectomy was performed, and abscess and necrotic fat material was removed from left $L_5$ nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.238-241
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• 1999

Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6293-6299
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• 2013

Background: A number of clinicopathologic factors have been found to be associated with pathological lymph node metastasis (pLNM) in rectal cancer; however, most of them can only be identified by expensive high resolution imaging or obtained after surgical treatment. Just like the Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) scores which have been widely used in clinical practice, our study was designed to assess the pre-operative factors which could be obtained easily to predict intra-operative pLNM in rectal cancer. Methods: A cohort of 469 patients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal cancer, were included. Clinical, laboratory and pathologic parameters were analyzed. A multivariate unconditional logistic regression model, areas under the curve (AUC), the Kaplan-Meier method (log-rank test) and the Cox regression model were used. Results: Of the 469 patients, 231 were diagnosed with pLNM (49.3%). Four variables were associated with pLNM by multivariate logistic analysis, age<60 yr (OR=1.819; 95% CI, 1.231-2.687; P=0.003), presence of abdominal pain or discomfort (OR=1.637; 95% CI, 1.052-2.547; P=0.029), absence of allergic history (OR=1.879; 95% CI, 1.041-3.392; P=0.036), and direct $bilirubin{\geq}2.60{\mu}mol/L$ (OR=1.540; 95% CI, 1.054-2.250; P=0.026). The combination of all 4 variables had the highest sensitivity (98.7%) for diagnostic performance. In addition, age<60 yr and direct $bilirubin{\geq}2.60{\mu}mol/L$ were found to be associated with prognosis. Conclusion: Age, abdominal pain or discomfort, allergic history and direct bilirubin were associated with pLNM, which may be helpful for preoperative selection.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.212-227
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• 2000

The purpose of this study was to investigate the patterns of alternative therapy and to describe the characteristics of cancer patients used alternative therapy. The sample of this study were 232 consisted of cancer patients who visited at Pusan National University Hospital, Dong-a, Kosin University Hospital. The data were gathered from August, 1 to October, 30 1999 and analyzed by using SPSSWIN program for frequency, percentile and $X^2$-test. The important results of this study are as follows. 1. In population-sociological characteristics, sexual distribution showed female 52.6%, and the male 47.4%, age distribution showed that more than 60year old group are most as 31.5%. 2. In the disease characteristics, colon and rectal cancer patients were most as 19.0%. In the type of pain, the most of subjects were "dully pain" as 25.4%. In the pain level, 134 subjects complained pain, mean maximal pain score was $7.3{\pm}2.29$ in 10 points rating scale. 3. 132 patients (56.9%) among 232 cancer patients had used alternative therapy. The most common type of alternative therapy was dietary and nutritional therapy 44%, the place of use. home 43.2%, duration, less than 3 months, 56.8%. The most common motive was a recommendation by friends or family. The degree of satisfaction after the use of alternative therapy was high for 22.0%. 4. In the relation between general characteristic and utilization of alternative therapy, the only living area was showed a significant statistical differance($X^2$ = 4.070, P= .044). also in the relation between disease characteristic and utilization of alternative therapy, morbidity periods, the size of higher pain, the type of treatment were showed a significant statistical differance($X^2$= 7.964, 7.303, 3.565, P=.044, .026, .042). In conclusions, these findings indicate that cancer patients use various complementary and in alternative therapy. therefore, suggested that medical doctors or nurses verify the true effects or side-effects from the most common complementary or alternative therapies through experiments.