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1.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1041963

RESUMEN

Purpose@#Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery. @*Methods@#We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3. @*Results@#The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection. @*Conclusion@#In our experience, the learning curve for SPR colectomy was achieved after the 18th case.

2.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-1044125

RESUMEN

Objectives@#This study aimed to investigate the effectiveness and safety of combining psychostimulants and nonstimulants for patients under treatment for attention deficit hyperactivity disorder (ADHD). @*Methods@#The study included 96 patients aged 6–12 years who were diagnosed with ADHD, among whom 34 received combination pharmacotherapy, 32 received methylphenidate monotherapy, and 30 received atomoxetine monotherapy. Statistical analysis was conducted to compare treatment and adverse effects among groups and to analyze changes before and after combination pharmacotherapy.The difference between combination pharmacotherapy and monotherapy was investigated. Logistic regression analysis was used to identify the predictors of combination pharmacotherapy. @*Results@#No significant differences were observed between the groups in terms of age or pretreatment scores. The most common adverse effect experienced by 32% of patients in the combination pharmacotherapy group was decreased appetite. Clinical global impression-severity score decreased significantly after combination pharmacotherapy. All three groups showed significant clinical global impression-severity score improvements over time, with no significant differences among them. The predictive factors for combination pharmacotherapy included the Child Behavior Checklist total score internalizing subscale. @*Conclusion@#Combination pharmacotherapy with methylphenidate and atomoxetine is a relatively effective and safe option for patients with ADHD who do not respond to monotherapy.

3.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-966477

RESUMEN

Purpose@#The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC). @*Materials and Methods@#Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity. @*Results@#Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin. @*Conclusion@#The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

4.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-938471

RESUMEN

Purpose@#Various clinical practice guidelines recommend at least 12 regional lymph nodes should be removed for resected colon cancer. According to a recent study, the lymph node yield (LNY) in colon cancer surgery in the last 20 years has tended to increase from 14.91 to 21.30. However, it is unclear whether these guidelines adequately reflect recent findings on the number of harvested lymph nodes in colon cancer surgery. The aim of this study is to assess the impact of an LNY of more than 25 on survival in right-sided colon cancer. @*Methods@#We included 285 patients who underwent a right hemicolectomy during the period from January 2010 through December 2015. Patients were divided into two groups (<25 nodes and ≥25 nodes). Primary endpoints included 5-year and 10-year survival including disease-free and overall. @*Results@#We found that survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with a <25 group. Large tumor size (5 cm) is significantly associated with poor 5-year and 10-year overall survival. @*Conclusion@#Survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with the <25 group in stage II colon cancer with no risk.

5.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-914493

RESUMEN

Objectives@#A primary brain tumor starts to grow from brain cells, and it occurs as a result of errors in the DNA of normal cells. Therefore, this study was carried out to analyze the two-dimensional (2D) texture, morphology, and statistical features of brain tumors and to perform a classification using artificial intelligence (AI) techniques. @*Methods@#AI techniques can help radiologists to diagnose primary brain tumors without using any invasive measurement techniques. In this paper, we focused on deep learning (DL) and machine learning (ML) techniques for texture, morphological, and statistical feature classification of three tumor types (namely, glioma, meningioma, and pituitary). T1-weighted magnetic resonance imaging (MRI) 2D scans were used for analysis and classification (multiclass and binary). A total of 102 features were calculated for each tumor, and the 20 most significant features were selected using the three-step feature selection method, which included removing duplicate features, Pearson correlations, and recursive feature elimination. @*Results@#From the predicted results of multiclass and binary classification, a long short-term memory binary classification (glioma vs. meningioma) showed the best performance, with an average accuracy, recall, precision, F1-score, and kappa coefficient of 97.7%, 97.2%, 97.5%, 97.0%, and 94.7%, respectively. @*Conclusions@#The early diagnosis of primary brain tumors is very important because it can be the key to effective treatment. Therefore, this research presents a method for early diagnoses by effectively classifying three types of primary brain tumors.

6.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-968231

RESUMEN

Objectives@#:A growing body of evidence links type 2 diabetes (T2D) with a neurodegenerative disease (ND) such as Alzheimer’s disease and Parkinson’s disease. The purpose of this study is to investigate the relationship between NDs and the development of T2D by comparing the incidence of T2D in a group of various NDs (ND group) and control group. @*Methods@#:A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002-2015. We used a retrospective cohort study design to investigate the association of ND with T2D occurrence. The study population included ND (n=8,814) and control (n=37,970) groups, all aged 60 years or over. The Kaplan-Meier method was used to estimate the risk of developing T2D as a function of time. Cox proportional hazards regression models were used to evaluate the relationship between ND and T2D. @*Results@#:T2D was developed in a significantly higher percentage of patients in the ND group (53.6%) than in the control group (44.7%). The ND group increased the risk of T2D (HR, 1.43; 95% CI, 1.38-1.47). About onethird of patients in both groups were additionally diagnosed with another ND before the occurrence of T2D during a 10-year follow-up period. When compared to those who did not have another ND during the follow-up period, the incidence of T2D in those who were additionally diagnosed with another ND was higher in both the ND and control groups. @*Conclusions@#:The ND group had about 1.4 times higher risk of developing T2D than the control group. Our results showed a positive association between ND and T2D.

7.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-925429

RESUMEN

Purpose@#Identification of type I protein arginine methyltransferase (PRMT) substrates and their functional significance during tumorigenesis is becoming more important. The present study aimed to identify target substrates for type I PRMT using 2-dimensional (2D) gel electrophoresis (GE) and 2D Western blotting (WB). @*Methods@#Using immunoblot analysis, we compared the expression of type I PRMTs and endogenous levels of arginine methylation between the primary colorectal cancer (CRC) and adjacent noncancerous tissues paired from the same patient. To identify arginine-methylated proteins in HCT116 cells, we carried out 2D-GE and 2D-WB with a type I PRMT product-specific antibody (anti-dimethyl-arginine antibody, asymmetric [ASYM24]). Arginine-methylated protein spots were identified by mass spectrometry, and messenger RNA (mRNA) levels corresponding to the identified proteins were analyzed using National Center for Biotechnology Information (NCBI) microarray datasets between the primary CRC and noncancerous tissues. @*Results@#Type I PRMTs and methylarginine-containing proteins were highly maintained in CRC tissues compared to noncancerous tissues. We matched 142 spots using spot analysis software between a Coomassie blue (CBB)-stained 2D gel and 2D-WB, and we successfully identified 7 proteins that reacted with the ASYM24 antibody: CACYBP, GLOD4, MAPRE1, CCT7, TKT, CK8, and HSPA8. Among these proteins, the levels of 4 mRNAs including MAPRE1, CCT7, TKT, and HSPA8 in CRC tissues showed a statistically significant increase compared to noncancerous tissues from patients using the NCBI microarray datasets. @*Conclusion@#Our results indicate that the method shown here is useful in identifying arginine-methylated proteins, and significance of arginine modification in the proteins identified here should be further identified during CRC development.

8.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-925434

RESUMEN

Recently, abdominoperineal resection (APR) using a robot has been demonstrated in other studies. However, there has been no report on APR for rectal cancer using the single-port robot (SPR) platform. In response to this research gap, we described the clinical experience of APR using a SPR. From April 2019 to March 2020, APR using a SPR platform was performed in a total of 4 patients. Three patients had a transumbilical approach, and 1 patient had a transstoma site approach. The average operation time was 307 minutes, and the patient docking time to the SPR platform was 133.5 minutes. There were no complications during the operation, and no laparoscopy or open conversion. No reoperation occurred within 30 days. Mild postoperative complications occurred in 2 patients. We found that APR has safety and feasibility in surgery using an SPR platform. There was no intraoperative event and severe postoperative complications.

9.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-925512

RESUMEN

Purpose@#We analyzed the learning curve of single-port robotic (SPR)-assisted rectal cancer surgery. @*Methods@#Fifty-seven consecutive SPR-assisted rectal cancer surgery cases performed by the same surgeon were considered in surgical interventions for rectal cancer. Total operation time (OT), docking time (DT), and surgeon console time (SCT) measured during surgery were used to parametrize the learning curve. The parameters representing the learning curve were evaluated using the cumulative sum (CUSUM). @*Results@#The mean value of total OT was 241.8 ± 91.7 minutes, the mean value of DT was 20.6 ± 19.1 minutes, and the mean value of SCT was 135.9 ± 66.7 minutes. The learning curve was divided into phase 1 (initial 16 cases), phase 2 (second 16 cases), and phase 3 (subsequent 25 cases). The peak on the CUSUM graph occurred in the 21st case. The longest OT among phases was in phase 2. Complications were most frequent in phase 2. However, complications of Clavien-Dindo (CD) grade IIIb were most frequent in phase 3 with 2 patients. The most common complications were fluid collection and urinary retention (7 patients each). Complications of CD grade IIIb required one stomal revision due to stoma obstruction and one irrigation and loop ileostomy due to anastomosis leakage. @*Conclusion@#Improvement in surgical performance of SPR assisted rectal cancer operation was achieved after 21 cases.The three phases identified in the cumulative sum analysis showed a significant decrease in operative time after the middle stage of the learning curve without an increase in the complication rate.

10.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-899688

RESUMEN

Objective@#We evaluated the association between cancer and various neurodegenerative diseases (NDs), including Alzheimer’s disease (AD), Parkinson’s disease (PD), and circumscribed brain atrophy (CBA) and to evaluate the impact of ND on the development of cancer. @*Methods@#A population-based longitudinal study was conducted using the National Health Information Database for 2002-2015.A total of 9,365 ND patients (3,157 AD, 5,866 PD, 342 CBA) were included in the study, as were 46,818 matched controls. @*Results@#Various NDs were newly developed in control and ND groups during the 10-year follow-up periods. Newly developed ND cases were as follows: 33.0% in control, 35.3% in AD, 19.9% in PD, and 45.3% in CBA. Cancer developed in 22.6% of ND groups (20.5% AD, 23.6% PD, 24.3% CBA) and in 18.5% of control group. Cancer development was significantly higher in AD pa-tients with new ND cases (especially PD cases), compared to patients without new ND cases (22.8% vs. 19.3%, p=0.019). There were no differences in the frequencies of cancer development between patients with and without new ND cases in PD, CBA, and control groups. The adjusted hazard ratios for cancer in AD, PD, and CBA groups were 1.43, 1.55, and 1.58, respectively. @*Conclusion@#This study showed that various NDs are positively associated with development of cancer and suggests that newly developed PD in AD group during the follow-up period may influence the development of cancer that follows.

11.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-900088

RESUMEN

Objectives@#This study examined the satisfaction of patients who had undergone electroconvulsive therapy to provide important information for improving the social misunderstanding about electroconvulsive therapy, to increase the effectiveness of treatment, and make a decision of effective treatment. @*Methods@#A questionnaire survey was conducted to determine the satisfaction, adverse effects, attitudes, and experiences toward electroconvulsive therapy in patients at 2 to 4 weeks after finishing an acute course of electroconvulsive therapy in three psychiatric hospitals. @*Results@#There were 85 respondents (38 males), whose average age was 42.0±13.6 years and average illness duration was 12.8±8.9 years. Fifty-two patients (61.2%), 19 (22.4%), 8 (9.4%), and 6 (7.1%) were diagnosed with schizophrenia, major depressive disorder, bipolar disorder, and other mental disorders, respectively. The average session number for acute electroconvulsive therapy was 12.6±6.0 sessions, and 61 patients (71.8%) had received maintenance electroconvulsive therapy. Among the respondents, 60.0% reported that they were satisfied with the electroconvulsive therapy. Satisfaction was similar according to sex, age, diagnosis, electrode placement, and use of anesthetic agents. Forty-three (53.8%) patients experienced memory impairment during acute electroconvulsive therapy. @*Conclusion@#This study showed that patients who received electroconvulsive therapy were generally satisfied with the treatment and that memory impairment should be detected early and managed promptly. Follow-up studies with a large number of subjects and variables will be needed to determine the predictive factors affecting satisfaction toward electroconvulsive therapy.

12.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-891984

RESUMEN

Objective@#We evaluated the association between cancer and various neurodegenerative diseases (NDs), including Alzheimer’s disease (AD), Parkinson’s disease (PD), and circumscribed brain atrophy (CBA) and to evaluate the impact of ND on the development of cancer. @*Methods@#A population-based longitudinal study was conducted using the National Health Information Database for 2002-2015.A total of 9,365 ND patients (3,157 AD, 5,866 PD, 342 CBA) were included in the study, as were 46,818 matched controls. @*Results@#Various NDs were newly developed in control and ND groups during the 10-year follow-up periods. Newly developed ND cases were as follows: 33.0% in control, 35.3% in AD, 19.9% in PD, and 45.3% in CBA. Cancer developed in 22.6% of ND groups (20.5% AD, 23.6% PD, 24.3% CBA) and in 18.5% of control group. Cancer development was significantly higher in AD pa-tients with new ND cases (especially PD cases), compared to patients without new ND cases (22.8% vs. 19.3%, p=0.019). There were no differences in the frequencies of cancer development between patients with and without new ND cases in PD, CBA, and control groups. The adjusted hazard ratios for cancer in AD, PD, and CBA groups were 1.43, 1.55, and 1.58, respectively. @*Conclusion@#This study showed that various NDs are positively associated with development of cancer and suggests that newly developed PD in AD group during the follow-up period may influence the development of cancer that follows.

13.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-892384

RESUMEN

Objectives@#This study examined the satisfaction of patients who had undergone electroconvulsive therapy to provide important information for improving the social misunderstanding about electroconvulsive therapy, to increase the effectiveness of treatment, and make a decision of effective treatment. @*Methods@#A questionnaire survey was conducted to determine the satisfaction, adverse effects, attitudes, and experiences toward electroconvulsive therapy in patients at 2 to 4 weeks after finishing an acute course of electroconvulsive therapy in three psychiatric hospitals. @*Results@#There were 85 respondents (38 males), whose average age was 42.0±13.6 years and average illness duration was 12.8±8.9 years. Fifty-two patients (61.2%), 19 (22.4%), 8 (9.4%), and 6 (7.1%) were diagnosed with schizophrenia, major depressive disorder, bipolar disorder, and other mental disorders, respectively. The average session number for acute electroconvulsive therapy was 12.6±6.0 sessions, and 61 patients (71.8%) had received maintenance electroconvulsive therapy. Among the respondents, 60.0% reported that they were satisfied with the electroconvulsive therapy. Satisfaction was similar according to sex, age, diagnosis, electrode placement, and use of anesthetic agents. Forty-three (53.8%) patients experienced memory impairment during acute electroconvulsive therapy. @*Conclusion@#This study showed that patients who received electroconvulsive therapy were generally satisfied with the treatment and that memory impairment should be detected early and managed promptly. Follow-up studies with a large number of subjects and variables will be needed to determine the predictive factors affecting satisfaction toward electroconvulsive therapy.

14.
Annals of Coloproctology ; : 253-258, 2021.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-896738

RESUMEN

Purpose@#Coronavirus disease 2019 (COVID-19) has affected many parts of daily life and healthcare, including cancer screening and diagnosis. The purpose of this study was to determine whether there was an upshift in the colorectal cancer stage at diagnosis due to delays related to the COVID-19 outbreak. @*Methods@#From January to June of each year from 2017 to 2020, a total of 3,229 patients who were first diagnosed with colorectal cancer were retrospectively reviewed. Those enrolled from 2017 to 2019 were classified as the ‘pre-COVID’ group, and those enrolled in 2020 were classified as the ‘COVID’ group. The primary outcome was the rate of stage IV disease at the time of diagnosis. @*Results@#There was no statistically significant difference in the proportion of stage IV patients between the pre-COVID and COVID groups (P=0.19). The median preoperative carcinoembryonic antigen level in the COVID group was higher than in the pre-COVID group in all stages (all P<0.05). In stage I, II patients who underwent radical surgery, the lymphatic invasion was more presented in COVID patients (P=0.009). @*Conclusion@#We did not find significant stage upshifting in colorectal cancer during the COVID-19 outbreak. However, there were more initially unresectable stage IV colorectal cancer patients with a low conversion rate to resectable status, and more patients had factors related to poor prognosis. These results may become more apparent over time, so it is vital not to neglect cancer screening to not delay the diagnosis during the COVID-19 epidemic.

15.
Annals of Coloproctology ; : 244-252, 2021.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-896741

RESUMEN

Purpose@#The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first. @*Methods@#We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared. @*Results@#Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups. @*Conclusion@#NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

16.
Annals of Coloproctology ; : 253-258, 2021.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-889034

RESUMEN

Purpose@#Coronavirus disease 2019 (COVID-19) has affected many parts of daily life and healthcare, including cancer screening and diagnosis. The purpose of this study was to determine whether there was an upshift in the colorectal cancer stage at diagnosis due to delays related to the COVID-19 outbreak. @*Methods@#From January to June of each year from 2017 to 2020, a total of 3,229 patients who were first diagnosed with colorectal cancer were retrospectively reviewed. Those enrolled from 2017 to 2019 were classified as the ‘pre-COVID’ group, and those enrolled in 2020 were classified as the ‘COVID’ group. The primary outcome was the rate of stage IV disease at the time of diagnosis. @*Results@#There was no statistically significant difference in the proportion of stage IV patients between the pre-COVID and COVID groups (P=0.19). The median preoperative carcinoembryonic antigen level in the COVID group was higher than in the pre-COVID group in all stages (all P<0.05). In stage I, II patients who underwent radical surgery, the lymphatic invasion was more presented in COVID patients (P=0.009). @*Conclusion@#We did not find significant stage upshifting in colorectal cancer during the COVID-19 outbreak. However, there were more initially unresectable stage IV colorectal cancer patients with a low conversion rate to resectable status, and more patients had factors related to poor prognosis. These results may become more apparent over time, so it is vital not to neglect cancer screening to not delay the diagnosis during the COVID-19 epidemic.

17.
Annals of Coloproctology ; : 244-252, 2021.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-889037

RESUMEN

Purpose@#The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first. @*Methods@#We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared. @*Results@#Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups. @*Conclusion@#NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

18.
Yonsei Medical Journal ; : 1107-1116, 2021.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-919591

RESUMEN

Purpose@#Indications for local excision in patients with rectal cancer remain controversial. We reviewed factors affecting survival rate and treatment effectiveness in cancer recurrence after local excision among patients with rectal cancer. @*Materials and Methods@#A total of 831 patients was enrolled. Of these, 391 patients were diagnosed with primary rectal cancer and underwent local excision. A retrospective observational study was performed on patients who underwent full-thickness local excision for rectal cancer. @*Results@#The median duration of follow-up was 61 months. The overall recurrence rate was 11.5%. The rate of local recurrence was 5.1%. Five-year overall survival rate among recurrent patients was 66.8%; the rate among patients who underwent salvage operation due to recurrence was 84.7%, compared with 44.2% among patients treated with non-operative management (p<0.001).Multivariate analysis of disease-free survival identified distance from the anal verge (p=0.038) and histologic grade (p=0.047) as factors predicting poor prognosis. Multivariate analysis of overall survival showed that age (p<0.001), serum carcinoembryonic antigen (CEA) levels (p=0.001), and histologic grade (p=0.013) also affected poor prognosis. In subgroup analysis of patients with recurrence, 25 patients underwent reoperation, while 20 patients did not. For 5-year overall survival rate, there was a significant difference between 84.7% of the reoperation group and 44.2% of the non-operation group (p<0.001). @*Conclusion@#The risk factors affecting overall survival rate after local excision were age 65 years or older, preoperative CEA level 5 or higher, and high histologic grade. In cases of recurrence after local excision of rectal cancer, salvage operation might improve overall survival.

19.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-915563

RESUMEN

Objectives@#According to previous studies, cancer risk has decreased among patients with neurodegenerative disease (ND). However, some types of cancer are positively associated with ND.ND and cancer share common mechanisms of genetic and molecular abnormalities. The objective of this study was to evaluate the association between cancer and ND by comparing the incidence of cancer in the ND and control groups. @*Methods@#A population-based 10-year follow-up study was conducted using the Korean National Health Information Database for 2002–2015. The participants were 60-year-old or more, and they were divided into two groups, including ND (n=9324) and control (n=46683) groups. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio and 95% confidence interval for determining cancer risk. @*Results@#About one-third of patients in both groups were diagnosed with ND before the occurrence of cancer during the 10-year follow-up. Cancer was developed in a significantly higher percentage of patients with ND (22.0%) than in the control group (18.4%). Compared to the control group, patients with ND had about 1.5-times higher risk of developing cancer. In the ND group, the incidence of cancer was increased when another ND was diagnosed during the 10-year follow-up. @*Conclusion@#Our results showed a positive association between ND and cancer. Thus, further replication study is needed to address the positive association between NDs and cancer, and it is also necessary to study the association between NDs and various types of cancer.

20.
Psychiatry Investigation ; : 417-423, 2020.
Artículo | WPRIM (Pacífico Occidental) | ID: wpr-832576

RESUMEN

Objective@#Since the risk of suicide cannot be predicted by clinical symptoms alone, and suicide is known to have a genetic component, the discovery of genetic markers that can predict the lethality of suicide attempts is a clinically important topic. There have been many studies aiming to determine whether the rs6265 polymorphism of the BDNF gene is associated with suicidality; however, the results have been mixed, and there have been few studies investigating the relationship between this polymorphism and suicide attempt lethality. @*Methods@#We assessed suicide lethality in 258 individuals who had attempted suicide using the relative risk ratio (RRR) scale and by genotyping the rs6265 polymorphism of the BDNF gene. @*Results@#The RRR score for suicide attempts was higher in subjects with Met/Val and Val/Val genotypes than in that with a Met/Met genotype (p=0.015). The RRR score for suicide attempts was also higher in Val allele carriers (Met/Val+Val/Val) than in Met/Met homozygotes (p=0.006). @*Conclusion@#This study demonstrates the possibility that the rs6265 polymorphism of the BDNF gene could be used as a genetic marker to predict the lethality of suicide attempts, but more replication studies are needed for the application of this result in clinical practice.

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