• 건강소식
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• v.35 no.11
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• pp.18-20
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• 2011

대장암은 결장과 직장에 생기는 약성의 종양을 말하며, 암이 발생하는 위치에 따라 결장에 생기는 암을 결장암, 직장에 생기는 암을 직장암이라고 하고, 이를 통칭하여 대장암 혹은 결장직장암이라고 한다. 대장암의 대부분은 대장의 점막에서 발생하는 선암이다. 선암의 대부분은 선종이라는 양성 종양(폴립, 용종)이 진행되어 발생하며 선암 이외에도 림프종, 육종, 편평상피암, 유암종 등이 발견된다.

• Journal of Hospice and Palliative Care
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• v.10 no.1
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• pp.35-42
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• 2007

Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

• Radiation Oncology Journal
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• v.18 no.3
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• pp.187-193
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• 2000

Purpose : DNA ploidy pattern was shown to correlate with several clinicohistologic findings in several tumors. Aim of this study was to evaluate the correlation of the clinicohistologic findings in colorectal cancer and the failure pattern in rectosigmoid cancer with DNA ploidy. Materials and Methods DNA flow cytometry using the Hedley methods on paraffin embedded specimen from 117 patients with colorectal cancers after curative resection was peformed. We tried to find the correlation between DNA ploidy and various clinicohistologic findings. And then the correlation DNA ploidy and the failure pattern in 75 patients of rectosigmoid cancer was analized. Results : Forty samples (34.2%) from tumors gave aneuploidy histogram. There was no significant difference in the frequency of DNA aneuploidy in terms of age, sex, depth of invasion, location and Dukes stage. But there was a significant correlation between DNA ploidy and the failure rates in Dukes stage B rectosigmoid cancer (P=0.048). Conclusions : These findings suggest that DNA ploidy pattern shows the correlation with the treatment failure rates in Dukes stage B rectosigmoid, but not with many other clinicohistologic findings. However,more patients will be needed to disclose these findings.

• Journal of Yeungnam Medical Science
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• v.12 no.2
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• pp.210-225
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• 1995

The expression of $p62^{c-myc}$ and $p21^{ras}$ can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the $p62^{c-myc}$ and $p21^{ras}$ expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of $p62^{c-myc}$ and $p21^{ras}$ was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The expression of $p21^{ras}$ was increased in female(p<0.05). Abdominal pain(43.7%) was the most frequent chief complaint. The most frequent tumor location was rectum(44.8%). The expression of $p62^{c-myc}$ was increased in the rectum(p<0.05). The 65 cases(97.0%) out of 67 cases showed positive reaction of $p62^{c-myc}$ in the nucleus, cytoplasmic membrane, and cytoplasm. The 62 cases(92.5%) out of 67 cases showed positive reaction of $p21^{ras}$ in the cytoplasmic membrane and cytoplasm. The positive rate of $p62^{c-myc}$ and $p21^{ras}$ was 97.0% and 91.4% in well differentiated adenocarcinoma, 100.0% and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated adenocarcinoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of $p62^{c-myc}$ and $p21^{ras}$ was 94.1% and 88.2% in Dukes stage $B_1$, 96.0% and 96.0% in Dukes stage $B_2$, 100.0% and 100.0% in Dukes stage $C_1$, 100.0% and 88.9% in Dukes stage $C_2$, and 100.0% and 100.0% in Dukes stage D. The expression of $p62^{c-myc}$ in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of $p21^{ras}$ in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.

• The Journal of the Korean life insurance medical association
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• v.19
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• pp.109-117
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• 2000

연구배경 : 3대 특정질병 진단보험금지급의 양상과 경향을 평가하고자 하였다. 방법 : 1997년 7월${\sim}$1999년 3월까지 당사의 한 건강보험가입자 중 1998년 1월${\sim}$1999년 9월 기간동안 당사 약관상의 정의에 의한 악성종양, 급성심근경색증, 뇌졸중으로 진단보험금이 지불된 총 411건에 대해 조사하였다. 결과 : 3대 특정질병 진단보험금 지급건 총 411건의 구성을 보면 악성종양이 290건(70.6%), 급성심근경색이 25건(6.1%) 그리고 뇌졸중이 96건(23.3%)이었다. 남녀비율은 남자 280건(68.1%), 여자 131건(31.9%)이었다. 3대 특정질병 진단급여금 지급건의 평균연령은 $3.88{\pm}5.9$이었다. 3대 특정질병 진단보험금 지불건은 $30{\sim}39$세 연령대에서 187건(45.4%)으로 가장 많았고, 그 다음으로 $40{\sim}49$세 연령대 178건(43.2%)의 순이었다. 계약시점에서 3대 특정질병 진단보험금 지급 시까지 평균진단확정 기간은 325.2일${\pm}$184.9일 이었다. 계약 후 12개월 내에 진단지급보험금 발생건은 총 193건(55.3%)이었고, 12개월 이후에 지급된 건은 156건(44.7%)이었다. 계약 후 12개월 내에 진단지금보험금 발생건 193건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)로 가장 많았다. 악성종양의 신체계통별로 보면 소화기관>유방>여자생식기>호흡기계 순이었다. 악성종양을 장기별로 보면 위암>유방암>간암 및 담도계암>결장암과 직장암, 자궁경부암의 순이었다. 남자의 경우 위암>간암 및 담도계암>결장암과 직장암의 순이었고 여자의 경우 유방암>자궁경부암(상피내암 제외)>결장암, 직장암의 순이었다. 뇌졸중의 종류별 빈도를 보면 뇌경색증(47.9%)>뇌내출혈(34.4%)>거미막하출혈(9.4%)의 순이었다. 결론 : 3대 특정질병 중 악성종양이 다수를 차지하고 있었고, 남자가 여자보다 훨씬 많았고 주로 $30{\sim}39$세 연령대, $40{\sim}49$세 연령대였다. 계약 후 12개월 내에 진단지급보험금 발생건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)으로 가장 많았다는 것은 역선택의 가능성 그리고 제척기간 중 발생한 3대 특정질환이 3개월 이후 특히 3개월 이상${\sim}$4개월 미만 사이에 지급청구되었을 가능성을 시사하는 것으로 사료된다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.566-573
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• 2016

The age-adjusted incidence rate (AAR) of colorectal cancer in Korea peaked in 2011 and then began to decline. However, the AAR of colorectal cancer in Jeju increased continually from 1999 to 2013. Compared with the 16 major cities in Korea, the inhabitants of Jeju-do have a low cancer screening program participation rate, high alcohol consumption rate and high BMI. The present study aimed to provide a statistical basis for the lowering of the incidence of colorectal cancer in Jeju-do. The Jeju regional cancer institute data from 1999 to 2013 was used to analyze the between Jeju-do and Korea using the Joinpoint Regression program (Statistical Methodology and Applications Branch, Surveillance Research Program, National Cancer Institute) Version 4.2.0 - April 2015. The AAR of colorectal cancer in Jeju-do has being increasing because of the increase in the rates of male colon cancer (average annual percent change 8.422%, p-value<0.000), female colon cancer (AAPC 6.136%, p-value<0.000), male rectal cancer (AAPC 4.221%, p-value 0.003) and colon cancer in people aged over 50 years (AAPC 7.986% p-value<0.000). The results of this study suggest that the treatment of precancerous lesions of the male rectum and lowering of the incidence of colon cancer in people aged over 50 years are necessary to reduce the colorectal cancer incidence rate in Jeju-do.

• Journal of Digestive Cancer Research
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• v.6 no.2
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• pp.69-72
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• 2018

Mucinous adenocarcinoma occurs in 1.6-25.4% of patients with colorectal cancer. We report a case of a 27-year-old man with negative findings on initial colonoscopic biopsy, but finally diagnosed with mucinous adenocarcinoma of the colon. After undergoing an abdominal CT due to persistent abdominal pain, he was transferred to our hospital. The abdominal CT showed a diffuse and irregular wall thickening in the distal transverse colon. Due to the edema and stenosis of colonic wall, it was difficult to insert the colonoscope into the proximal region; a biopsy revealed chronic colitis with lymphofollicular hyperplasia. Transverse colectomy and lymph node dissection were performed. The diagnosis was mucinous adenocarcinoma of approximately 20×4.5 cm. Compared to adenocarcinoma, mucinous adenocarcinoma is found in a younger population with an advanced stage and is less responsive to palliative chemotherapy. Therefore, recalcitrant abdominal pain even in young people warrants early detection through appropriate examinations such as abdominal CT and colonoscopy.

• Journal of Haehwa Medicine
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• v.24 no.2
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• pp.65-83
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• 2016

Objectives : The purpose of this study is to present the clinical practice guidelines for colorectal cancer through the analysis of existing clinical practice guidelines and randomised clinical trials (RCTs) in Western and Chinese medicine. Methods : The data related to Western and Oriental medical treatment of colorectal cancer were collected using various search engines such as Google Scholar, KIOM OASIS, PUBMED and Jisan library of Daejeon university. Results & Discussion : Colorectal cancer is the third most common cancer in Korea. In recent studies, applying combined oriental and western medicine can improve the survival, quality of life, immune function, and suppress of tumor growth in colorectal cancer. However there isn't still an objective and systemic clinical guideline for colorectal cancer, so we have difficulty in clinical application. This study will be a preliminary study to establish clinical practice guidelines of Korean Medicine for colorectal cancer. Conclusions : Further objective and systemic clinical studies related to Korean Medicine are needed to develop more advanced clinical practice guidelines of colorectal cancer.

• Journal of agricultural medicine and community health
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• v.40 no.3
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• pp.115-125
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• 2015

Objectives: Colorectal cancer is one of the major cancers in South Korea. We described the time trends in colorectal cancer incidence in Daejeon, a metropolitan city, and Chungcheongnam-do (Chungnam), a rural province, South Korea. Methods: Using the databases from the Daejeon Cancer Registry (DCR) and the Chungnam Cancer Registry (CCR), age-standardized (to world standard population) rates for incidence (ASRW) were calculated. Average annual percent change (AAPC) was assessed as a trend indicator. The completeness (such as the mortality/incidence ratio) and validity (such as the death certificate only %, microscopic verification %, primary site uncertain %, and age unknown %) were analyzed to examine the data quality of DCR and CCR. Results: Incidence of colorectal cancer showed increasing trend in both sexes. Over the years 2000-2012 in Daejeon, ASRW was increased significantly from 37.2 to 51.7 per 100,000 person-years (AAPC, 3.9%) among men and from 17.1 to 28.4 (AAPC, 3.9%) among women, respectively. In Chungnam, ASRW was also increased from 29.8 to 50.1 per 100,000 person-years (AAPC, 5.1%) among men and from 15.9 to 26.6 (AAPC, 3.2%) among women, respectively. The AAPC for colon cancer was greater than rectal cancer in both Daejeon and Chungnam. The trend of rectal cancer incidence was differ by sex (AAPC in men vs women, 2.7% vs 1.7% in Daejeon; 3.5% vs 0.8% in Chungnam). Indices of completeness and validity showed that the quality control of DCR and CCR was adequate to describe the trends of ASRW. Conclusions: Both Daejeon and Chungnam have had a rapid increase in colorectal cancer incidence. Monitoring and intervention are required on the risk factors which may contribute to this trend.

• Journal of radiological science and technology
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• v.27 no.1
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• pp.13-16
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• 2004

대장내시경검사는 역사적으로 돌아보면 원래 히포크라테스의 치루치료과정에서 직장경 사용으로부터 유래되며 그 후 Kelly의 25 cm 표준 S상 결장경의 발견으로 진전되었고 조명 및 각종 부속기구들이 많이 개선되면서 직장암의 발견에 기여해 왔다. 1911년에 독일 뮌헨의 Michael Hoffman이라는 광학 기술자가 프리즘을 여러 개를 연결하면 직선이 아닌 곡선에서도 빛을 그대로 전달할 수 있다는 사실을 발견하였고 이를 기초로 하여 1958년에 미국에서 Hirschowitz가 처음으로 섬유경(fiberscope)을 선보였고 그 이후 이용한 상부소화관에 대한 내시경 기술이 급속히 발전하기 시작하였고, 이를 기초로 1969년부터 ACMI, Olympus, Fujinon, Pentax 등 세계 유수의 내시경 회사들이 대장내시경을 제작하기 시작하였다. 1983년에 미국의 Welch-Allyn사가 CCD(Charge Coupled Device)라는 집광 장치를 만들어서 마치 내시경의 눈과 같은 작용을 해서 이것을 내시경 선단에 장치하고 전파를 이용하여 영상을 전달하여 이 상이 TV 모니터에 비치는 것을 보게 되는 전자내시경을 개발하여 현재는 상부내시경 뿐 아니라 대장내시경도 대부분이 전자 내시경으로 대체되어서 오늘에 이르고 있다.