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Kim, Hung Dai 4 Articles
Preliminary Study of the Clinical Features of the Chemosensitivity Test in Colorectal Cancer.
Park, Chan Sup , Choi, Sung Ho , Kim, Hung Dai
J Korean Soc Coloproctol. 2007;23(5):358-364.
DOI: https://doi.org/10.3393/jksc.2007.23.5.358
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AbstractAbstract PDF
PURPOSE
Colorectal cancers have been known to be refractory to chemotherapy in the past decades. Recently, novel agents have been developed and various data have shown an improved response rate and a survival benefit. However, considerable heterogeneity exists between cancers of the same tissue type, including colorectal cancer. Thus, Individualized chemotherapy that is tailored specifically to the characteristics of the tumor is necessary for an improved clinical outcome.
RESULTS
We evaluate the chemosensitivity of colorectal cancer to standard drugs (5-FU, oxaliplatin, and irinotecan) and to drugs used for other cancers (mitomycin, paclitaxel, and gemcitabine) by using Adenosine-triphosphate-based chemotherapy response assay (ATP-CRA).
RESULTS
The degree of in-vitro response to a single anticancer medication was highest for 5-FU. According to stages, 5-FU is the most sensitive chemotherapeutic agent in Duke's B, irinotecan in Duke's C, and 5-FU in Duke's D patients. With tumor location, irinotecan is most sensitive in colon cancers and 5-FU in rectal cancers. The effect of treatment is superior in the test-guided therapy group in Duke's D colorectal cancer patients.
CONCLUSIONS
Chemosensitivity tests may be useful in selecting optimum drugs for patient who require chemotherapy. However, the results of this study do not strongly support the usefulness of this assay; further studies with a sufficient number of cases and an extended observation period are ongoing.
New Trend in Chemotherapy for Colorectal Cancer.
Kim, Young Jin , Kim, Hung Dai
J Korean Soc Coloproctol. 2004;20(2):118-123.
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AbstractAbstract PDF
5-Fluorouracil (5-FU) has been the main chemotherapeutic agent for the treatment of colorectal cancer for four decades with modest efficacy. Modulation of 5-FU by leucovorin or continuous infusion improves the response rate, but overall survival duration remains approximately 12 months. Many oral fluoropyrimidines have been studied, including capecitabine, UFT, S-1, and Eniluracil. Capecitabine has demonstrated equivalent efficacy with 5-FU and has been approved as first line treatment. CPT-11 demonstrated non-crossover resistance with 5-FU and was proven to be effective treatment for patients who received prior 5-FU. CPT-11 in combination with 5-FU has demonstrated improved response rate and overall survival duration over 5-FU or CPT-11. Oxaliplatin plus 5-FU has offered another effective treatment option for colorectal cancer. Both 5-FU plus leucovorin in combination with CPT-11 or oxaliplatin are widely used first-line chemotherapies for advanced colorectal cancer. The combinations of capecitabine with CPT-11 or oxaliplatin are being developed. Several molecular targeting agents such as EGFR inhibitors and antiangiogenic agents have developed. Cetuximab induces a broad range of cellular responses in tumors expressing EGFR, enhancing sensitivity to radiotherapy and chemotherapeutic agents. A key angiogenic pathway in the stimulation of tumour growth is the vascular endothelial growth factor (VEGF) pathway, inhibited by the monoclonal antibody bevacizumab. Phase II first line and phase III second line studies of oxaliplatin in combination with bevacizumab are now in progress. Optimal combinations and sequences of treatment are being studied, since several effective regimens have become available.
The Usefulness of Colonoscopy in the Management of Right Side Colonic Diverticulitis.
Lee, Eun Kyu , Kim, Hung Dai , Son, Beong Ho , Han, Won Kon
J Korean Soc Coloproctol. 2001;17(6):283-288.
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AbstractAbstract PDF
PURPOSE
Most patients who finally diagnosed as the cecal and ascending colonic diverticulitis would complain pain on right low quadrant of abdomen. So many of them unfortunately would be performed emergency operation for presumed appendicitis. We are purposed to verify the usefulness of colonoscopy for the diagnosis and aimed to treat many patients with this disease conservatively.
METHODS
We reviewed retrospectively the medical records of the 46 patients who diagnosed as the cecal and ascending colonic diverticulitis under admission at general surgery department during 4 years from January, 1997 to December, 2000.
RESULTS
The mean age was 40.1 years and the male to female ratio was 1.2:1. Most common clinical manifestation was abdominal pain (46 cases) and nausea/vomiting (13 cases), fever/chill (4 cases) followed. On physical examination on abdomen, 26 patients had tenderness with rebound tenderness on right low quadrant and 18 patients showed only tenderness on right low quadrant. The mean peripheral WBC count was 10,600.9/mm2. Diagnostic tools were abdominal ultrasonography (34 cases), abdominal CT (13 cases), barium enema (8 cases) and colonoscopy (22 cases). The sensitivities of each modalities were 52.6%, 46.2%, 33.3% and 81.8% respectively. The respective mean hospital days depending on the treatment arms were as follows: 6.0 days of the conservatively treated group, 8.0 days of whom were operated as exploratory laparotomy with incidental appendectomy and 16.9 days of whom were operated as Right-hemicolectomy. 17 patients of 24 colonoscopy-done patients were recovered with conservative treatment, compared with only 7 patients of 22 colonoscopy-undone patients (P=0.0005). 2 cases of the conservatively managed groups were operated later due to recurrences (mean follow up periods=20 months). 2 operated patients had complications of postoperative ileus.
CONCLUSIONS
Based on our study, the indications of colonoscopy are that in whom impressed clinically as acute appendicitis, on physical examination there be obvious tenderness on right low quadrant but obscure rebound tenderness, on peripheral blood smear the WBC counts range from normal to mild increased (<15,000/mm2), and on ultrasonography, appendix couldn't be detected or colonic wall show thickening. In patients who selected fit for indications, colonoscopy is safe and highly sensitive. We would manage these patients more conservatively, and may reduce their hospital stay.
Surgical Review of the Rectal Villous Adenoma.
Lee, Jong Ho , Kim, Hung Dai , Son, Byung Ho , Yoo, Chang Hak , Park, Yong Lai , Shin, Jun ho , Kim, Yong Shin , Han, Won Kon , Pae, Won Gil
J Korean Soc Coloproctol. 1999;15(4):301-306.
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AbstractAbstract PDF
PURPOSE
This study was undertaken to evaluate retrospectively the clinical results of surgery for the rectal villous adenoma.
METHODS
The study took place from the period of Mar. of 1988 to Feb. 1998 at the Dept. of Surgery, Sungkyunkwan Univ., Medical college. The study consisted of : Among the 97 cases diagnosed with colon & rectal villous adenoma, and 59 were rectal villous adenoma, and 42 cases underwent resection. We focused on these 42 cases, especially on the position of tumor, its size, surgical technique, histologic results & keeping close follow up post-surgically.
RESULTS
The sex ratio was 2:1 with male predominence, 18 cases were in their fifties with the average age of 55. In 30 cases, the lesion was situated within the 8 cm of anal verge. The average size of tumor was 3.64 cm. The applied methods were; rectotomy 19 cases, anterior resection 13 cases (including low anterior resection), endoscopic excision and transanal excision were 7 cases, and 2 cases, respectively. And in one case where the tumor size was 14.5 cm and which was situated within 3 cm of anal verge, Miles' operation was conducted. Death due to post-operative complication was not observed. 2 cases of wound infection in postoperation, one case of transient urinary incontinence & hematoma were found. And in the case of explo-laparotomy, anastomosis site leakage, in one case, anastomosis site stricture in 2 cases were noted. malignant cells were observed in total of 73.8%, among these, 80% were from villous adenoma, 70% from tubullovillous adenoma. In the case of tumor size less 1 cm, and tumor size greater than 1 cm, the probability of finding malignant lesion were 33.3% and 76.9%, respectively.
CONCLUSIONS
We suggest that wideexcision through York-Mason approach is a safe and effective technique for huge villous adenomas of the rectum.

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