Showing papers by "Byung Chang Kim published in 2011"

Clinicopathological differences of laterally spreading tumors of the colorectum according to gross appearance

Abstract: Background and study aims: Laterally spreading tumors (LST) are classified into two subtypes, with the nongranular type harboring a higher risk of (pre)malignant changes than the granular type. Further subdifferentiation into two subgroups each has been suggested, but the clinical significance of such a subdifferentiation has not previously been studied in detail in larger numbers. Patients and methods: Out of 6499 patients diagnosed with colorectal adenomas between January 2006 and November 2008, 153 patients (2.35 %) had 158 LSTs, 96 with a granular and 62 with a nongranular pattern. The former group was subdivided into homogeneous and nodular mixed, the latter group into flat elevated and pseudodepressed. Clinical and histopathological parameters were compared among the four subtypes. Results: Parameters were variably distributed between the four groups, with nodular mixed tumors being larger than the other three types (P < 0.0001). As in other studies, malignant transformation and premalignant lesion (HGIN/CIS) were more frequent in nodular mixed than in homogeneous tumors (45.0 % vs. 5.6 %, P < 0.001), and also more common in pseudodepressed than in flat elevated tumors (41.7 % vs. 13.2 %, P = 0.011). Submucosal invasive cancer was present in 8.3 % of nodular mixed tumors, 7.9 % of flat elevated, and 12.5 % of pseudodepressed, while it was absent in homogeneous tumors. Serrated adenoma was identified in 10.8 % of all LSTs, and sessile serrated adenoma tended to be more common in flat elevated tumors. Conclusions: Further subdifferentiation of the LST lesions to identify lesions at risk of malignant transformation makes most sense in the granular type. Among nongranular LSTs, both subtypes carry a significant risk.

Associations of Cigarette Smoking and Alcohol Consumption With Advanced or Multiple Colorectal Adenoma Risks: A Colonoscopy-based Case-Control Study in Korea

Abstract: The associations between alcohol consumption and cigarette smoking habits and the risk for colorectal adenomatous polyps according to the detailed clinical information about polyps were assessed in a large colonoscopy-based study. The study enrolled participants who visited the National Cancer Center of the Republic of Korea for cancer screening between April 2007 and April 2009. In 1,242 newly diagnosed colorectal adenoma patients and 3,019 polyp-free controls, past smokers (odds ratio (OR) = 1.31, 95% confidence interval (CI): 1.04, 1.65) and current smokers (OR = 1.70, 95% CI: 1.37, 2.11) had increased risks for adenomas compared with nonsmokers. Cigarette smoking conferred an even higher risk for advanced adenomas and 3 or more adenomas than for low-risk adenomas or a single adenoma. Dose-response relations were observed among the daily number of cigarettes smoked, the duration of smoking, the pack-years of smoking, and the risk for adenomas. A longer duration of alcohol consumption was associated with a higher risk for advanced adenomas (for >28 years of consumption: OR = 2.0, 95% CI: 1.10, 3.64) and 3 or more adenomas (OR = 2.19, 95% CI: 1.27, 3.76). In conclusion, cigarette smoking and alcohol consumption play roles in colorectal carcinogenesis, and the association differs by the clinical features of the adenomas.

Anti-alpha-enolase antibody as a serologic marker and its correlation with disease severity in intestinal Behçet's disease.

Abstract: Intestinal Behcet’s disease (BD) is a chronic inflammatory bowel disease, as are Crohn’s disease (CD) and ulcerative colitis (UC). But unlike CD and UC, serologic markers for intestinal BD are not well known. Recently, anti-α-enolase antibody (AAEA) has been detected in sera from BD patients. The aim of this study was to evaluate the prevalence of AAEA in intestinal BD and its clinical correlations. The study sample included 80 patients with intestinal BD and 23 healthy controls. IgM AAEA was detected by ELISA. The positivity of IgM AAEA was defined as an optical density greater than three standard deviations above the mean of the control sera. Other parameters, such as demographic information, subtype of BD, colonoscopic findings, disease severity and treatment modality, were analyzed retrospectively. The prevalence of IgM AAEA was 67.5% in intestinal BD and 0% in the control group. The positivity rate of IgM AAEA was higher in complete or incomplete BD than in suspected BD (77.5% vs. 51.6%, P = 0.016). The mean HBI score was higher in antibody positive patients than in antibody negative patients (5.60 vs. 4.61, P = 0.003). The cumulative probability of steroid use for aggravation of intestinal and extra-intestinal symptoms was higher in antibody positive patients than in antibody negative patients (P = 0.012). The number of patients with systemic involvement was higher in the AAEA positive group than in the negative group. Monitoring IgM AAEA may be helpful for diagnosis of intestinal BD and could be used to predict clinical course and disease severity.

Clinical Classification of Colorectal Epithelial Tumors and Proposal for Diagnostic Coding

Abstract: The Korean Standard Classification of Diseases (KCD), which reflects the International Classification of Diseases (ICD), is a fundamental coding system for the diagnosis of colorectal epithelial tumors. The KCD coding of colorectal lesions is entirely up to the clinician and is based on pathologic reports. However, coding discrepancies have arisen among physicians using the KCD and pathologists using the ICD for Oncology-3 (ICD-O-3). The Korean Society of Pathologists recently proposed a standardized pathology-reporting format and guidelines for the coding of colorectal cancer to decrease these discrepancies among pathologists. However, ICD and ICD-O are simple classification codes based on pathologic reports, and are neither intended nor suitable for indexing of distinct clinical entities. For appropriate diagnostic coding using the KCD, a corrected coding principle based upon pathologic reports is required, and unified coding between KCD and ICD-O is necessary. A standardized pathologic report format and communication with understanding between physicians and pathologists should be established. Additionally, the private medical insurance system for colorectal cancer should be revised to reduce conflicts among patients, clinicians, and insurance companies over the medical coding system.

Method for crystallizing low mass ions for diagnosing colorectal cancer and method for diagnosing colorectal cancer using same

Abstract: The present invention provides a method for crystallizing low mass ions for diagnosing colorectal cancer by using a MALDI-TOF mass spectrometer to biostatistically analyze low mass ions, which are extracted from a biological sample, and a method for providing information for diagnosing colorectal cancer using same. The present inventions can provide a diagnostic method, which requires low cost and a short time for analysis, can analyze large areas, and which can provide superior and credible discriminations.

Comparison of Long-term Outcome after Palliative Treatment for Unresctable Stage IV Colorectal Cancer Patients with Obstructive Symptoms: Self Expandable Metal Stents versus Surgery

Abstract: 목적(Purpose) : 본 연구의 목적은 장폐쇄 증상이 있는 완전 절제가 불가능한 4기 대장암 환자에서 완화 목적의 자가팽창금속스텐트를 시술한 경우와 완화 목적으로 수술을 시행한 경우의 장기 임상 성적을 분석하는 것이다. 대상 및 방법(Methods) : 2002년 1월부터 2010년 5월까지, 완화 스텐트 삽입(n = 88)과 완화 수술을 시행한(n = 96)환자들을 대상으로 스텐트 삽입 및 수술의 성공률, 합병증, 재원기간, 합병증 발생까지의 기간, 항암치료까지의 기간, 전체 생존률을 분석하고, 생존률과 관련한 예후인자를 평가하였다. 결과(Results) : 스텐트군의 초기 합병증은 수술군보다 낮았으나(26.1% vs 47.9%, P = 0.002), 후기 합병증과 주요 합병증 발생률이 더 많았다(P ＜ 0.05). 또한, 스텐트 시술 후 발생하는 장관련 합병증의 비율은 수술군보다 더 많았다(P = 0.037). 수술군에서의 전체 생존기간 중앙값은 스텐트군보다 더 높았고(15.7개월 vs. 9.1개월), 시술 또는 수술 후 합병증으로 인해 추가로 치료를 받아야 하는 경우도 스텐트군에서 많았다(P＜0.001). 결론 (Conclusions) : 스텐트 삽입은 상대적으로 덜 침습적이며 빠른 증상 호전을 기대할 수 있다. 그러나, 완화 목적의 스텐트 삽입은 완화 수술 보다 후기 합병증 발생 빈도가 높아 환자의 원발 병소, 증상 정도, 등의 환자 상태를 고려하여 적절한 완화치료를 고려할 필요가 있다.