• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7241-7244
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• 2014

Background: To determine the accuracy of preoperative urinary symptoms, urinalysis, computed tomography (CT) and cystoscopic findings for the diagnosis of urinary bladder invasion in patients with colorectal cancer. Materials and Methods: Records of patients with colorectal cancer and a suspicion of bladder invasion, who underwent tumor resection with partial or total cystectomy between 2002 and 2013 at the Faculty of Medicine Siriraj Hospital, were reviewed. Correlations between preoperative urinary symptoms, urinalysis, cystoscopic finding, CT imaging and final pathological reports were analyzed. Results: This study included 90 eligible cases (71% male). The most common site of primary colorectal cancer was the sigmoid colon (44%), followed by the rectum (33%). Final pathological reports showed definite bladder invasion in 53 cases (59%). Significant features for predicting definite tumor invasion were gross hematuria (OR 13.6, sensitivity 39%, specificity 73%), and visible tumor during cystoscopy (OR 5.33, sensitivity 50%, specificity 84%). Predictive signs in CT imaging were gross tumor invasion (OR 7.07, sensitivity 89%, specificity 46%), abnormal enhancing mass at bladder wall (OR 4.09, sensitivity 68%, specificity 66%), irregular bladder mucosa (OR 3.53, sensitivity 70%, specificity 60% ), and loss of perivesical fat plane (OR 3.17, sensitivity 81%, specificity 43%). However, urinary analysis and other urinary tract symptoms were poor predictors of bladder involvement. Conclusions: The present study demonstrated that the most relevant preoperative predictors of definite bladder invasion in patients with colorectal cancer are gross hematuria, a visible tumor during cystoscopy, and abnormal CT findings.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.707-712
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• 2014

Purpose: Anastomotic leakage (AL) is associated with high morbidity and mortality, high reoperation rates, and increased hospital length of stay. Here we investigated the risk factors for AL after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Data for 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2003 to 2007 were prospectively collected. All patients experienced a total mesorectal excision (TME) operation. Clinical AL was defined as the presence of leakage signs and confirmed by diagnostic work-up according to ICD-9 codes 997.4, 567.22 (abdominopelvic abscess), and 569.81 (fistula of the intestine). Univariate and logistic regression analyses of 20 variables were undertaken to determine risk factors for AL. Survival was analysed using the Cox regression method. Results: AL was noted in 35 (7.6%) of 460 patients with rectal cancer. :Median age of the patients was 65 (50-74) and 161 (35%) were male. The diagnosis of AL was made between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate and multivariate analysis, age (p=0.004), gender (p=0.007), tumor site (p<0.001), preoperative body mass index (EMI) (p<0.001), the reduction of TSGF on 5th POD less than 10U/ml (p=0.044) and the pH value of pelvic dranage less than or equal to 6.978 on 3rd POD (p<0.001) were selected as 6 independent risk factors for AL. It was shown that significant differences in survival of the patients were AL-related (p<0.001), high ASA score related (p=0.036), high-level EMI related (p=0.007) and advanced TNM stage related

• Advances in Traditional Medicine
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• v.5 no.1
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• pp.62-68
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• 2005

Doxorubicin is a powerful anticancer antibiotic extensively used in the treatment of several types of cancers. Long-term administration of this drug results in cumulative dose related cardiotoxicity due to enhanced production of free radicals leading to oxidative stress. Our earlier investigations have demonstrated significant antioxidant, anti-inflammatory and antitumour properties of Ganoderma lucidum extracts. We extended our investigations to evaluate the protective effect of Ganoderma lucidum extract against doxorubicin-induced cardiotoxicity. Administration of 3 doses of doxorubicin, 6 mg/kg body weights, i.p. per each dose, alternative days, showed dear signs of cardiotoxicity in rats. The drug enhanced serum creatine kinase (CK) activity and lipid peroxidation in tissue drastically. The drug also induced significant decrease in GSH level and activities of CAT, SOD and GPx. Administration of methanolic extract of G.lucidum (500 and 1,000 mg/kg body weight) significantly increased the level of GSH and activities of CAT, SOD and GPx. Activity of CK was significantly lowered in a dose dependent manner. The treatment also caused significant decrease in lipid peroxidation (MDA). The results thus indicated that methanolic extract of G.lucidum prevented oxidative stress caused by doxorubicin administration and the increase in serum CK activity and lipid peroxidation in the tissue. The experimental findings suggest the therapeutic potential of G.lucidum as adjuvant in cancer chemotherapy.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.204-207
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• 2015

We are reporting an unusual case of dural arteriovenous fistula (AVF) of the superior sagittal sinus (SSS) after tamoxifen treatment for breast cancer. A 30-year-old female arrived at the emergency room with a sudden headache and left sided weakness and sensory loss. In her past medical history, she was diagnosed with breast cancer 1 year prior, and subsequently underwent a breast conserving mastectomy with whole breast radiation and adjuvant chemotherapy with tamoxifen. At the time of admission, computed tomography showed a small acute intracerebral hemorrhage at the right parietal cortex, and magnetic resonance imaging showed that a dural AVF at the SSS with a prominent and tortuous venous enhancement along the centrum semiovale was present. Cerebral angiography showed that the dural AVF at the mid-portion of the SSS with meningeal arterial feeding vessels entering the wall of the SSS, then draining through the dilated cortical veins. Our patient had no signs of active malignancy or any abnormalities in her coagulation profile, so it can be concluded that the tamoxifen was the likely cause of the SSS thrombosis and dural AVF. The dural AVF was treated by an endovascular coil embolization for the arterialized segment of the SSS. The patient dramatically recovered favorably from left side motor and sensory deficit. The best clinical approach is to screen potential patients of tamoxifen hormonal therapy and educate them on the sign and symptoms of life threatening thromboembolic events while taking tamoxifen.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.239-243
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• 1996

MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.524-527
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• 2010

Temporary disruption of the blood-brain barrier (BBB) after cerebral angiography is presumably caused by nonionic radiographic contrast medium (CM). We hereby report a case of 58-year-old woman who developed decreased mentality, global aphasia and aggravated right hemiparesis after cerebral angiography. Brain CT examination demonstrated gyriform enhancement throughout the left cerebral cortex and thalamus. MR diffusion did not reveal acute infarction. MR angiography did not show any stenosis, spasm or occlusion at the major cerebral vessels. Follow-up CT scan after 1 day did not show any gyriform enhancement. Worsened neurologic signs and symptoms were improved completely after 7 days. In the present study, disruption of the BBB with contrast medium after angiography seems to be the causative factor of transient neurologic deterioration.

• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.125-129
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• 2023

Appropriate sedation and analgesia are crucial for successful endoscopic procedures, patient safety, and satisfaction. Endoscopic resection for upper gastrointestinal tumors requires a deep sedation level because the procedure is lengthy and induces moderate to severe pain. Continuous patient consciousness assessment and vigilant vital signs monitoring are required for deep sedation. General anesthesia may unintentionally occur even during deep sedation for endoscopic tumor resection, which may cause unexpected complications, especially in high-risk patients. Previous studies have revealed that general anesthesia increases the en bloc resection rate and decreases the procedure time. Complications, such as perforation, aspiration pneumonia, and cardiopulmonary instability, including hypoxemia, hypotension, and arrhythmia, occurred more frequently in patients with sedation compared to those with general anesthesia. Therefore, general anesthesia demonstrated potential benefits in endoscopic treatment results and patient safety. General anesthesia should be considered a useful alternative for sedation in patients undergoing endoscopic gastrointestinal tumor resection. However, more high-quality prospective studies are required to determine the safety and effectiveness of general anesthesia in endoscopic upper gastrointestinal tumor resection because most studies comparing general anesthesia and sedation in these procedures have been retrospectively conducted and the results were inconsistent.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1194-1203
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• 2020

Purpose To evaluate the diagnostic utility of the stalk and the inchworm sign on preoperative MRI for detecting superficial bladder cancers, and to compare the diagnostic performance between the stalk and the inchworm sign. Materials and Methods We retrospectively reviewed 240 patients (505 tumors) who had undergone radical cystectomy. The tumors were classified as follows: superficial or invasive tumors indicated by the stalk or inchworm sign on 3.0 Tesla MRI. We evaluated the diagnostic accuracy of the stalk and inchworm signs, by comparing each finding with the postoperative pathologic T stage. We compared diagnostic performance between them statistically. Results The stalk and inchworm signs showed high specificity (93% and 91%, respectively), positive predictive values (89% and 90%, respectively), and acceptable accuracy (70% and 74%, respectively), but low sensitivity (54% and 61%, respectively) and negative predictive values (60% and 63%, respectively). There was no statistically significant difference between the two signs (p > 0.05). Conclusion Superficial bladder cancers could be differentiated from invasive tumors using the stalk or inchworm sign on MRI.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3799-3804
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• 2013

Background: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. Materials and Methods: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Results: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. Conclusions: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2781-2789
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• 2012

Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.