• Title/Summary/Keyword: Colorectal

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"I'm healthy, I don't have pain"- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population

  • Wee, Liang En;Sin, David;Cher, Wen Qi;Li, Zong Chen;Tsang, Tammy;Shibli, Sabina;Koh, Gerald
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.34-43
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    • 2017
  • Background: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ${\geq}85%$ own homes; public rental flats are reserved for those with low-income. Methods: Chronic pain was defined as pain ${\geq}3$ months. From 2009-2014, residents aged 40-60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. Results: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36-3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25-3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18-4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34-5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94-6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of "major illness"; screening as a search for answers to pain; and labelling pain as an end in itself. Conclusions: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

Development of Bone Metastasis Detection Algorithm on Abdominal Computed Tomography Image using Pixel Wise Fully Convolutional Network (픽셀 단위 컨볼루션 네트워크를 이용한 복부 컴퓨터 단층촬영 영상 기반 골전이암 병변 검출 알고리즘 개발)

  • Kim, Jooyoung;Lee, Siyoung;Kim, Kyuri;Cho, Kyeongwon;You, Sungmin;So, Soonwon;Park, Eunkyoung;Cho, Baek Hwan;Choi, Dongil;Park, Hoon Ki;Kim, In Young
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.321-329
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    • 2017
  • This paper presents a bone metastasis Detection algorithm on abdominal computed tomography images for early detection using fully convolutional neural networks. The images were taken from patients with various cancers (such as lung cancer, breast cancer, colorectal cancer, etc), and thus the locations of those lesions were varied. To overcome the lack of data, we augmented the data by adjusting the brightness of the images or flipping the images. Before the augmentation, when 70% of the whole data were used in the pre-test, we could obtain the pixel-wise sensitivity of 18.75%, the specificity of 99.97% on the average of test dataset. With the augmentation, we could obtain the sensitivity of 30.65%, the specificity of 99.96%. The increase in sensitivity shows that the augmentation was effective. In the result obtained by using the whole data, the sensitivity of 38.62%, the specificity of 99.94% and the accuracy of 99.81% in the pixel-wise. lesion-wise sensitivity is 88.89% while the false alarm per case is 0.5. The results of this study did not reach the level that could substitute for the clinician. However, it may be helpful for radiologists when it can be used as a screening tool.

A novel herbal formulation consisting of red ginseng extract and Epimedium koreanum Nakai-attenuated dextran sulfate sodium-induced colitis in mice

  • Saba, Evelyn;Lee, Yuan Yee;Kim, Minki;Hyun, Sun-Hee;Park, Chae-Kyu;Son, Eunjung;Kim, Dong-Seon;Kim, Sung-Dae;Rhee, Man Hee
    • Journal of Ginseng Research
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    • v.44 no.6
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    • pp.833-842
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    • 2020
  • Background: Ulcerative colitis (UC) is a commonly encountered large intestine disease in the contemporary world that terminates into colorectal cancer; therefore, the timely treatment of UC is of major concern. Panax ginseng Meyer is an extensively consumed herbal commodity in South East Asian countries, especially Korea. It exhibits a wide range of biologically beneficial qualities for almost head-to-toe ailments in the body. Epimedium koreanum Nakai (EKN) is also a widely used traditional Korean herbal medicine used for treating infertility, rheumatism, and cardiovascular diseases. Materials and methods: Separately the anti-inflammatory activities of both red ginseng extracts (RGEs) and EKNs had been demonstrated in the past in various inflammatory models; however, we sought to unravel the anti-inflammatory activities of the combination of these two extracts in dextran sulfate sodium (DSS)-induced ulcerative colitis in mice model because the allopathic remedies for UC involve more side effects than benefits. Results: Our results have shown that the combination of RGE + EKN synergistically alleviated the macroscopic lesions in DSS-induced colitic mice such as colon shortening, hematochezia, and weight loss. Moreover, it restored the histopathological lesions in mice and decreased the levels of proinflammatory mediators and cytokines through the repression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP-3) expression. In vitro, this combination also reduced the magnitude of nitric acid (NO), proinflammatory mediators and cytokine through NF-κB and mitogen-activated protein kinase (MAPK) pathways in RAW 264.7 mouse macrophage cells. Conclusion: In the light of these findings, we can endorse this combination extract as a functional food for the prophylactic as well as therapeutic treatment of UC in humans together with allopathic remedies.

MICROSATELLITE INSTABILITY AND p53 GENE MUTATION IN ORAL SQUAMOUS CELL CARCINOMA (구강편평상피세포암 조직에서의 Microsatellite 불안정성 및 p53 유전자 돌연변이 분석)

  • Choi, Tae-Ho;Chung, Woon-Bok;Hong, Su-Hyung;Kim, Jin-A;Na, Sun-Oung;Jang, Hyun-Jung;Sohn, Yoon-Kyung;Kim, Chin-Soo;Kim, Jung-Wan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.337-344
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    • 2000
  • Germ-line mutations at DNA repair loci confer susceptibility to colon cancer in hereditary non-polypopsis colorectal cancer. Somatic loss of DNA mismatch repair gene has been reported in a large variety of other tumor types. Replication errors(RERs) judged by microsatellite instability(MSI) and its associated mutations have been recognized as an important mechanism in various tumor types. To investigate associations between MSI and oral squamous cell carcinoma, the frequency of MSI using 12 microsatellite markers were analyzed for the series of oral tumors. Of 17 tumors, 8 cases(47%) did not show instability at any of the 12 loci; 5(29%) showed instability at $2{\sim}3$ loci; and 4(24%) showed instability above 4 loci. The 4 cases showing widespread MSI did not differ from those without evidence of instability in terms of age at diagnosis, degree of differentiation, metastasis to lymph node, tumor location or the presence of mutations in the p53 tumor suppressor gene. DCC and D17S 796 were the most frequently detected in MSI analysis. There were no correlation between smoking and MSI frequency, instead, smoking was suggested to increase the mutation rate of p53 and development of oral carcinomas.

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Meta-Analysis of the Association between H63D and C282Y Polymorphisms in HFE and Cancer Risk

  • Zhang, Meng;Xiong, Hu;Fang, Lu;Lu, Wei;Wu, Xun;Wang, Yong-Qiang;Cai, Zhi-Ming;Wu, Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4633-4639
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    • 2015
  • Background: Previous studies suggested that the H63D and C282Y polymorphisms in the HFE genes were susceptible to many cancer types, nevertheless, the present results were inconclusive. Thus, the present study was aimed to evaluate the association between the HFE polymorphisms (H63D and C282Y) and cancer risk via meta-analysis. Materials and Methods: We retrieved PubMed, Google Scholar, Embase and Web of Science databases for all eligible studies up to April 1, 2015. All the statistical analysis was conducted by STATA 12.0. Results: Finally, a total of 20 publications including 24 case-control studies, comprising 6,524 cases and 31,080 controls for HFE-C282Y polymorphism and 19 publications including 21 case control studies, comprising 5,648 cases and 14,257 controls for HFE-H63D polymorphism were enrolled in our analysis. An increased risk for overall cancer risk was identified in HFE-H63D polymorphism under allele contrast (D vs H: OR=1.153; 95%CI=1.031-1.289, Pheterogeneity=0.002), homozygotes vs wide type (DD vs HH: OR=1.449; 95%CI=1.182-1.777, Pheterogeneity=0.391), dominant model (DD+HD vs HH: OR=1.145; 95%CI=1.007-1.301, Pheterogeneity=0.002) and recessive model (DD vs HD+HH: OR=1.416 ; 95%CI=1.156-1.735, Pheterogeneity=0.549), as well as HFE-C282Y under homozygotes vs wide type (YY vs CC: OR=1.428, 95%CI=1.017-2.006, Pheterogeneity=0.220). In addition, in the stratified analysis by cancer type, an increased risk was identified in hepatocellular carcinoma and breast cancer in C282Y polymorphism, as well as pancreatic cancer in H63D polymorphism, whereas a decreased risk of colorectal cancer was identified in C282Y polymorphism. Conclusions: Present study suggested that H63D and C282Y polymorphisms associated with an increased risk of overall cancer. Nevertheless, well-designed study with large sample size will be continued on this issue of interest.

Effects of Allogeneic Blood Transfusion in Patients with Stage II Colon Cancer

  • Meng, Jin;Lu, Xiao-Bo;Tang, Yuan-Xin;Sun, Gong-Ping;Li, Xin;Yan, Yi-Fei;Liang, Gao-Feng;Ma, Si-Ping;Li, Xiao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.347-350
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    • 2013
  • The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank=0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.

Efficacy of Ginger in Control of Chemotherapy Induced Nausea and Vomiting in Breast Cancer Patients Receiving Doxorubicin-Based Chemotherapy

  • Ansari, Mansour;Porouhan, Pezhman;Mohammadianpanah, Mohammad;Omidvari, Shapour;Mosalaei, Ahmad;Ahmadloo, Niloofar;Nasrollahi, Hamid;Hamedi, Seyed Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3877-3880
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    • 2016
  • Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the first 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (${\pm}1.31$) and 1.46 (${\pm}1.28$) with no statistically significant difference. After the $2^{nd}$ chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After $3^{rd}$ chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (${\pm}1.14$), versus 1.42 (${\pm}1.30$)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (${\pm}0.96$) and in control arm it was 1.40 (${\pm}0.92$). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (${\pm}1.03$), 0.68 (${\pm}1.00$) and 0.77 (${\pm}1.18$). In control arm, mean vomiting was 0.983 (${\pm}1.23$), 1.03 (${\pm}1.22$) and 1.15 (${\pm}1.27$). In all sessions, ginger decreased vomiting severity from 1.4 (${\pm}1.04$) to 0.71 (${\pm}0.86$). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe ($0.64{\pm}0.87$) comparing to those who received placebo ($1.13{\pm}1.12$), which was statistically significant (p-Value <0.05). Further and larger studies are needed to draw conclusions.

Microsatellite Instability and Promoter Methylation of hMLH1 in Sporadic Gastric Carcinoma (산발성 위암에서 Microsatellite Instability 빈도와 hMLH1 촉진자부위 메칠화)

  • Kim Hee Cheol;Roh Sun Ae;Yook Jeong Hwan;Oh Sung Tae;Kim Byung Sik;Yu Chang Sik;Kim Jin Cheon
    • Journal of Gastric Cancer
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    • v.3 no.1
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    • pp.50-55
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    • 2003
  • Background: An aberrant function of the mismatch repair system has been reported to underlie carcinogenesis in several tumors, including colorectal and gastric carcinomas, and to induce the typical genotype of microsatellite instability (MSI). Purpose: We aimed to determine the frequency of MSI in early-onset sporadic gastric carcinoma and elucidate the role of promoter methylation in hMLH1 as the mechanism of MSI. Materials and Methods: Thirty-six early-onset sporadic gastric carcinomas were analyzed to determine the status of MSI and the frequency of methylation of the promoter region in hMLH1. MSI was determined using five markers recommended by NCI: MSI-H (high), MSI-L (low), and MSS (Microsatellite stable). Methylation specific PCR (MSP) and direct automated genomic sequencing analysis with DNA modified by sodium bisulfite have been performed to confirm promoter region methylation. All the data were analyzed regarding characteristics of molecular changes, and clinicopathologic variables. Results: The microsatellite status was determined as MSI-H in five cases ($13.8\%$), MSI-L in 13 cases ($36.1\%$), and MSS in 18 cases ($50.0\%$). hMLH1 was methylated in seven cases ($19.4\%$). In all cases of MSI-H, promoter of hMLH1 was methylated, and in two of the 13 cases of MSI-L, hMLH1 promoter methylation was identified. Methylation was not found in any cases of MSS. Promoter methylation in hMLH1 was significantly correlated with MSI status (P<0.001). We could not find any relationship between MSI and clinicopathologic parameters. Conclusion: These results suggest that an abnormal function of the mismatch repair system may be associated with gastric carcinogenesis in more than $10\%$ of early-onset gastric carcinomas and MSI appeared to be closely related to the promoter methylation in hMLH1.

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The Clinicopathologic Features of Synchronous and Metachronous Cancer in Patients with Gastric Cancer (위암 환자에 발생한 동시성과 이시성암의 임상병리학적 특성)

  • Yoo, Young-Sun;Choi, Eun-Seo;Kim, Sung-Soo;Min, Young-Don
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.256-261
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    • 2009
  • Purpose: With the development of diagnostic techniques, second primary neoplasms such as synchronous or metachronous cancers in gastric cancer patients are being increasingly found. In this study, we investigated the clinicopathological features and clinical significance of gastric neoplasms combined with synchronous and metachronous cancers. Materials and Methods: 1,048 patients who were diagnosed with gastric cancer in Chosun University Hospital from January 1998 to March 2008 were retrospectively reviewed. Results: 38 of the 1,048 patients with gastric cancer (3.6%) had synchronous and metachronous cancers. Of the 38 patients, 16 patients (42.1%) had synchronous cancer and 22 patients (57.9%) had metachronous cancer. The average time interval between gastric cancer and the secondary primary cancer was $27.08{\pm}31.25$ months. The most common second primary neoplasm was lung cancer (8/38, 21.1%), followed by colorectal cancer (8/38, 21.1%). Among the 27 patients who underwent surgical resection for gastric cancer, 5 patients (18.5%) were in the synchronous group and 22 patients (81.5%) were in the metachronous group. The mean survival time of the 38 patients was 49.8 months. The mean survival time was 24.6 months for the synchronous cancer patients and 68.1 month for the metachronous cancer patients. The 3 year survival rate of the synchronous group and the metachronous group was 33.3% and 81.1%, respectively. Conclusion: We must pay attention on the preoperative workup for synchronous cancer and on the postoperative follow-up for metachronous cancer in gastric cancer patients.

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Multiple Primary Malignant Tumors in Patients with Gastric Cancer (위암 환자에서의 다발성 원발성 악성종양)

  • Ryu Dong Do;Um Jun Won;Son Gil Soo;Cho Min young;Song Tae Jin;Kim Chong Suk;Mok Young Jae;Kim Seung Joo
    • Journal of Gastric Cancer
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    • v.3 no.3
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    • pp.139-144
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    • 2003
  • Purpose: Because of an improving gastric cancer detection program and treatment methods, we can expect improved survival of patients with gastric cancer. Given the longer survival times, the chance of an occurrence of multiple primary malignant tumors other than stomach is increased in the same patients. The purpose of this study is to analyze the clinical characteristrics and the survival of patients with gastric cancer and other malignancies. Materials and Methods: A retrospective study of 3669 patients with gastric cancer observed at our department between January 1994 to December 2002 was conducted. Associated tumors were diagnosed using the Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of the gastric cancer. Results: Of all 3669 patients, $2.07\%$ (n=76) had primary tumors other than gastric cancer, $63\%$ of which were synchronous (n=48) and $37\%$ metachronous (n=28). The mean age of the study group was 64.9 (65.5 in males, 61.8 in females), and the male-to-female ratio was 4.8 : 1. The most common cancer associated with gastric cancer was a hepatocellular carcinoma ($23.7\%$), followed by colorectal cancer ($17.1\%$), esophageal cancer ($10.5\%$), breast cancer ($6.6\%$). Of the 45 patients who had undergone a resection, 14 were in stage I, 12 in stage II, 13 in stage III, and 6 in stage IV. No statistically significant differences were found between the synchronous and the metachronous groups with regard to age, sex ratio, differentiation, and stage. The 5-year survival rates of the metachronous and the resected patients were significantly higher than those of the synchronous and the non resected patients, respectively. Conclusion: Due to increasing length of the follow-up period for patients with gastric cancer, another malignancy may develop in other organs. Therefore, physicians should pay attention to detect other cancers early in these patients, and a surgical resection is recommended as the treatment of choice in the management of multiple primary cancer associated with gastric cancer.

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