Nam Kyu Kim

Wonju Severance Christian Hospital, Genshū, Gangwon-do, South Korea

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Publications (202)454.87 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Surgical treatment of intestinal Behcet's disease (BD) is not well established. Specifically, it is still difficult to assess the clinical value of laparoscopic surgery to address this condition. We aimed to evaluate the clinical course and the characteristics of laparoscopic surgery for intestinal BD compared with open surgery. We reviewed charts of 91 patients who underwent surgical treatment for intestinal BD between January 1995 and December 2012. We retrospectively compared the laparoscopic group (LG, n = 30) and the open group (OG, n = 61) in terms of patient demographics, clinical features, operative data, postoperative course, complications within 30 days after operation, and long-term follow-up data. There were more females in the LG than in the OG (63.3 vs. 36.1 %, p = 0.014), and oral/genital ulcers were more frequent in the LG (76.7 vs. 54.1 %, p = 0.038; 60 vs. 36.1 %, p = 0.031). Intractability with medical treatment was dominant in the LG (76.7 vs. 45.9 %, p = 0.02), while intestinal perforation or fistula were more prevalent in the OG (10 vs. 44.3 %, p = 0.001). Most patients received an ileocecectomy or a right hemicolectomy as their first surgery. In the LG, the patients had a shorter operation time (162.0 vs. 228.5 min, p < 0.001) and had less blood loss (61.7 vs. 232.3 ml, p = 0.003). There were no significant differences in postoperative complications, reoperation, mortality, and hospital stay between the groups. During the follow-up period, the mean number of operations was less in the LG than in the OG (1.3 vs. 2.1, p = 0.011). Analysis indicated that 20 % of patients in the LG and 50.8 % in the OG underwent more than two operations (p = 0.005). Laparoscopic surgery is feasible and safe for selected intestinal BD patients. However, there were no better short-term outcomes in LG compared with OG.
    Surgical Endoscopy 03/2015; DOI:10.1007/s00464-015-4166-1 · 3.31 Impact Factor
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    ABSTRACT: The true benefits of robotic surgery are controversial, and whether robotic total mesorectal excision (R-TME) can be justified as a standard treatment for rectal cancer patients needs to be clarified. This case-matched study aimed to compare the postoperative complications and short- and long-term outcomes of R-TME and laparoscopic TME (L-TME) for rectal cancer.Among 1029 patients, we identified 278 rectal cancer patients who underwent R-TME. Propensity score matching was used to match this group with 278 patients who underwent L-TME.The mean follow-up period was similar between both groups (L-TME vs R-TME: 52.5 ± 17.1 vs 51.0 ± 13.1 months, P = 0.253), as were patient characteristics. The operation time was significantly longer in the R-TME group than in the L-TME group (361.6 ± 91.9 vs 272.4 ± 83.8 min; P < 0.001), whereas the conversion rate, length of hospital stay, and recovery of pain and bowel motility were similar between both groups. The rates of circumferential resection margin involvement and early complications were similar between both groups (L-TME vs R-TME: 4.7% vs 5.0%, P = 1.000; and 23.7% vs 25.9%, P = 0.624, respectively), as were the 5-year overall survival, disease-free survival, and local recurrence rates (93.1% vs 92.2%, P = 0.422; 79.6% vs 81.8%, P = 0.538; 3.9% vs 5.9%, P = 0.313, respectively).The oncologic quality, short- and long-term outcomes, and postoperative morbidity in the R-TME group were comparable with those in the L-TME group.
    Medicine 03/2015; 94(11):e522. DOI:10.1097/MD.0000000000000522 · 4.35 Impact Factor
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    ABSTRACT: This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications. Copyright © 2015 Elsevier Inc. All rights reserved.
    Surgery 02/2015; DOI:10.1016/j.surg.2015.01.010 · 3.37 Impact Factor
  • Journal of the American College of Surgeons 02/2015; DOI:10.1016/j.jamcollsurg.2015.02.016 · 4.45 Impact Factor
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    ABSTRACT: The impact of cancer on quality of life and depression is an important issue. The purpose of this study was to identify the impact of physical fitness on quality of life and depression in stage II-III colorectal cancer survivors. Participants in the current study included 122 stage II-III colorectal cancer survivors (57 females; 56.67 ± 9.16 years of age and 55 males; 54.69 ± 9.78 years of age). Fitness was assessed using the 6-min walk test, chair stand test, and push-up test. Quality of life and depression were measured using the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale and a 9-item patient health questionnaire interview, respectively. There was a significant association between physical fitness and quality of life and depression in colorectal cancer survivors. The 6-min walk test results were associated with FACT-C total (r = 0.298, p < 0.05), physical well-being (r = 0.230, p < 0.05), functional well-being (r = 0.234, p < 0.05), colorectal cancer concern (r = 0.229, p < 0.05), and depression (r = -0.228, p < 0.05), and the chair stand test results were associated with functional well-being (r = 0.231, p < 0.05), colorectal cancer concern (r = 0.242, p < 0.05), and depression (r = -0.227, p < 0.05) even after controlling for all potentially confounding variables. A multiple regression analysis indicated that the 6-min walk was a significant predictor of health-related quality of life, and participants in the lowest tertile of the 6-min walk test results had lower quality of life and greater depression than those in the highest tertile. Improving and maintaining physical fitness are important for quality of life and depression in stage II-III colorectal cancer survivors.
    Supportive Care Cancer 02/2015; DOI:10.1007/s00520-015-2615-y · 2.50 Impact Factor
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    ABSTRACT: To review and compare clinical manifestations of and risk factors for anastomotic leakage (AL) after low anterior resection for rectal cancer between minimally invasive surgery (MIS) and open surgery (OS). MIS for rectal cancer has become popular, and its clinical course is different from OS. Many studies have reported on the risk factors and oncologic influence of AL. However, few have directly compared clinical manifestations and risk factors for AL between MIS and OS. From January 2004 to December 2012, a total of 1704 consecutive patients who underwent elective low anterior resection with colorectal anastomosis for rectal cancer were eligible. The variables associated with short-term outcomes and risk factors were analyzed. The overall AL incidence was 6.4%. In the MIS-AL group, the time to diagnosis of AL and the time to second operation were shorter. A majority of the patients (77.8%) in the MIS-AL group underwent second MIS operation, whereas none in the OS-AL group. The hospital stays after second MIS were shorter than those after second open operation. Multivariate analyses revealed that male sex, smoking and alcohol intake history, previous abdominal surgery, longer operation times, low-lying tumor, and using 2 or more staplers for distal rectal resection were independent risk factors in the MIS-AL group, whereas smoking and alcohol intake history, operation times, and blood loss were significant in the OS-AL group. The clinical manifestations of and risk factors for AL were different between MIS and OS. AL after MIS may be more influenced by factors related to technical difficulties. Close attention should be given to patients undergoing surgery with risk factors for AL.
    Annals of Surgery 02/2015; DOI:10.1097/SLA.0000000000001157 · 7.19 Impact Factor
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    ABSTRACT: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.
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    ABSTRACT: The development of new medical electronic devices and equipment has increased the use of electrical apparatuses in surgery. Many studies have reported the association of long-term exposure to extremely low-frequency magnetic fields (ELF-MFs) with diseases or cancer. Robotic surgery has emerged as an alternative tool to overcome the disadvantages of conventional laparoscopic surgery. However, there has been no report regarding how much ELF-MF surgeons are exposed to during laparoscopic and robotic surgeries. In this observational study, we aimed to measure and compare the ELF-MFs that surgeons are exposed to during laparoscopic and robotic surgery.The intensities of the ELF-MFs surgeons are exposed to were measured every 4 seconds for 20 cases of laparoscopic surgery and 20 cases of robotic surgery using portable ELF-MF measuring devices with logging capability.The mean ELF-MF exposures were 0.6 ± 0.1 mG for laparoscopic surgeries and 0.3 ± 0.0 mG for robotic surgeries (significantly lower with P < 0.001 by Mann-Whitney U test).Our results show that the ELF-MF exposure levels of surgeons in both robotic and conventional laparoscopic surgery were lower than 2 mG, which is the most stringent level considered safe in many studies. However, we should not overlook the effects of long-term ELF-MF exposure during many surgeries in the course of a surgeon's career.
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    ABSTRACT: This article was designed to study the clinical outcomes and prognostic factors following radiotherapy (RT) in the multidisciplinary management of isolated retroperitoneal lymph node (RPLN) recurrence of colorectal cancer. We identified 52 patients treated consecutively with tumor-directed RT for isolated RPLN recurrence. Twenty-five patients received upfront RT (Group 1). Twenty-seven patients received RT after systemic therapy. The deferred RT was administered either to locally controlled tumors (Group 2, n = 17) or to locally progressive tumors in RPLNs (Group 3, n = 10). The median overall survival and progression-free survival were 41 and 13 months, respectively, with a median follow-up time of 34 months. Survival was not significantly different among three groups. Local recurrence (32/52) was predominant and occurred earlier than distant metastasis (31/52). Two-thirds of the local recurrences (21/32) involved outfield recurrence, which was mostly in the cranial direction (15/21) from the upper margin of the RT volume. Repeated RT successfully salvaged a substantial number of patients. A shorter disease-free interval, low-dose radiation, and a tumor location above the renal vein were independent risk factors for local recurrence (all P < 0.05). A large gross tumor volume was an independent risk factor for distant metastasis (P = 0.037). No acute or late RT-related toxicity ≥ grade 3 occurred. Our analysis suggests that both upfront RT and deferred RT incorporated into multidisciplinary management are potentially effective treatment strategies. We found that gross tumor volume, tumor location, and disease-free interval are important prognostic factors and should be taken into consideration to decide the timing of RT.
    Annals of Surgical Oncology 01/2015; DOI:10.1245/s10434-014-4363-5 · 3.94 Impact Factor
  • Sami Alasari, Daero Lim, Nam Kyu Kim
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    ABSTRACT: Rectal cancer classification is important to determine the preoperative chemoradiation therapy and to select appropriate surgical technique. We reviewed the Western and Japanese rectal cancer classification and we propose our new classification based of Magnetic resonance imaging (MRI). We determine the relation of the tumor to fixed parameters in MRI, which are peritoneal reflection and levator ani muscle. Then, we classify the rectal cancer into four levels based on tumor distal margin and invasion to MRI parameters. We applied all three classifications to 60 retrospectively collected patients of different rectal cancer distance and we compared our classifications to the others. Based on each level we standardize our surgical approach. For stages I-III, We found that level I where tumor distal margin is located above the peritoneal reflection and all of them were received low anterior resection (LAR) without chemoradiation. Level II where tumor distal margin is located from the peritoneal reflection and above the levator ani insertion on the rectum. 90% of them were received LAR ± chemoradiation. Level III where tumor distal margin is located at the level of levator ani insertion or invading any part of the levator ani. 60% of them had ULAR + coloanal anastomosis ± chemoradiation. Level IV where the tumor distal margin is located below the levator ani insertion; 77% were received APR ± chemoradiation. The overall kappa for all levels between surgeons and radiologist was 0.93 (95%CI: 0.87-0.99), which is indicating almost perfect agreement. We concluded that the management of rectal tumors differed among each tumor level and our new MRI based classification might facilitate the prediction of surgical and chemoradiation management with better communication among a multidisciplinary team comparing to other classifications.
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    ABSTRACT: The estimation of regional lymph node metastasis (LNM) risk in T1 colorectal cancer is based on histologic examination and imaging of the primary tumor. High-frequency microsatellite instability (MSI-H) is likely to decrease the possibility of metastasis to either regional lymph nodes or distant organs in colorectal cancers. This study evaluated the clinical implications of MSI in T1 colorectal cancer with emphasis on the usefulness of MSI as a predictive factor for regional LNM. A total of 133 patients who underwent radical resection for T1 colorectal cancer were included. Genomic DNA was extracted from normal and tumor tissues and amplified by polymerase chain reaction (PCR). Five microsatellite markers, BAT-25, BAT-26, D2S123, D5S346, and D17S250, were used. MSI and clinicopathological parameters were evaluated as potential predictors of LNM using univariate and multivariate analyses. Among 133 T1 colorectal cancer patients, MSI-H, low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS) colorectal cancers accounted for 7.5%, 6%, and 86.5%, respectively. MSI-H tumors showed a female predominance, a proximal location and more retrieved lymph nodes. Twenty-two patients (16.5%) had regional LNM. Lymphovascular invasion and depth of invasion were significantly associated with LNM. There was no LNM in 10 MSI-H patients; however, MSI status was not significantly correlated with LNM. Disease-free survival did not differ between patients with MSI-H and those with MSI-L/MSS. MSI status could serve as a negative predictive factor in estimating LNM in T1 colorectal cancer, given that LNM was not detected in MSI-H patients. However, validation of our result in a different cohort is necessary.
    Yonsei Medical Journal 01/2015; 56(1):175-81. DOI:10.3349/ymj.2015.56.1.175 · 1.26 Impact Factor
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    ABSTRACT: Objectives To determine whether magnetic resonance imaging (MRI)-detected extramural vascular invasion (EMVI) could predict synchronous distant metastases in rectal cancer. Methods Patients who underwent rectal MRI between July 2011 and December 2012 were screened. This study included 447 patients with pathologically confirmed rectal adenocarcinoma who had undergone MRI without previous treatment. Distant metastases were recorded at the initial work-up and over a 6-month follow-up. Univariate/multivariate logistic regression models were used to determine the risk of metastasis. The diagnostic performance was calculated using pathologic lymphovascular invasion (LVI) as a gold standard. Results Among 447 patients, 79 patients (17.7 %) were confirmed to have distant metastases. Three MRI features are significantly associated with a high risk of distant metastasis: positive EMVI (odds ratio 3.02), high T stage (odds ratio 2.10) and positive regional lymph node metastasis (odds ratio 6.01). EMVI in a large vessel (≥3 mm) had a higher risk for metastasis than EMVI in a small vessel ( Conclusions MRI-detected EMVI is an independent risk factor for synchronous metastasis in rectal cancer. EMVI in large vessels is a stronger risk factor for distant metastasis than EMVI in small vessels. Key points • EMVI, LN metastasis and T staging on MRI are risk factors for metastasis. • EMVI in large vessels has greater risk for metastasis than in small vessels. • Regional LN metastasis on MRI has highest risk for predicting metastasis. • MR findings could be helpful for selecting patients at high risk for metastasis.
    European Radiology 12/2014; DOI:10.1007/s00330-014-3527-9 · 4.34 Impact Factor
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    ABSTRACT: Background: With the increasing burden of organ transplant recipients and improvements in allograft outcome, the incidence of neoplasms rising from these patients is an important issue. Objective: In this study, we investigated transplant recipients with colorectal cancer to determine its incidence, clinicopathological characteristics, and prognosis. Methods: The database of Severance Hospital was queried for all cases of colorectal adenocarcinoma among transplant recipients from August 2005 to January 2013. Results: A total of 29 patients were diagnosed with colorectal adenocarcinoma after transplantation, and the median age at diagnosis was 58.6 years. As for primary tumor stage, 17 (58.6%) patients had stage ≥3, and distant metastasis was found in 10 (34.4%) patients. The mean time from transplantation to tumor detection was 13.7 years. The median disease-free survival was 11.0 months and the median overall survival (OS) was 18.1 months. In multivariate analysis of prognostic factors for OS, surgical resection was a positive prognostic factor (HR 1.357, p = 0.010) and the presence of distant metastasis at diagnosis was a negative prognostic factor (HR 1.047, p = 0.006). Conclusion: The behavior of colorectal cancer in posttransplant patients is more aggressive and refractory to treatment. A separate guideline for the colorectal screening program for the posttransplant patients needs to be established. © 2014 S. Karger AG, Basel.
    Oncology 12/2014; 88(4):195-200. DOI:10.1159/000369254 · 2.61 Impact Factor
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    ABSTRACT: To evaluate immunohistochemical expression of nuclear factor-kappa B (NFκB), cyclo-oxygenase (COX)-2, and vascular endothelial growth factor (VEGF) and the impacts thereof on clinicopathological tumor features and survival in patients with colorectal cancer.
    Anticancer research 11/2014; 34(11):6451-7. · 1.87 Impact Factor
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    ABSTRACT: As robotic surgery was developed with ergonomic designs, there are expectations that the technical advantages of robotic surgery can shorten the learning curve. However, there is no comparative study, so far, to evaluate the learning curve between robotic and laparoscopic rectal cancer surgeries. Therefore, the aim of this study is to compare the learning curve of robotic low anterior resection (LAR) with laparoscopic LAR for rectal cancer.Patients who underwent robotic or laparoscopic LAR by a single surgeon were compared retrospectively (robot n = 89 vs laparoscopy n = 89). Cumulative sum (CUSUM) was used to evaluate the learning curve. The patients were divided into phase 1 (initial learning curve period) and phase 2 (post-learning curve period). The perioperative clinicopathologic characteristics were compared by phases and surgical procedures.According to CUSUM, the learning curve of robotic LAR was the 44th case and laparoscopic LAR was the 41st case. The learning phases were divided as follows: phase 1 (cases 1-41) versus phase 2 (cases 42-89) in the laparoscopic group, and phase 1 (cases 1-44) versus phase 2 (cases 45-89) in the robotic group. Comparison between phase 1 and phase 2 in each type of surgery showed no significant difference for the perioperative outcomes. Comparison between robotic and laparoscopic surgeries in each phase showed similar perioperative results. Pathologic outcomes were not significantly different in both procedures and phases.The learning curve of robotic LAR for rectal cancer was similar to laparoscopic LAR, and the clinicopathologic outcomes were similar in both the procedures.
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    ABSTRACT: Abstract Background: Actinomycosis is a chronic granulomatous infection characterized by variable presentations, including disease states that can mimic neoplastic disease. A case is presented of actinomycosis that resembled metastatic carcinoma of the ovary. Methods: Case report and review of pertinent English-language literature. Case Report: A 52-year-old female presented with a four-month history of abdominal discomfort and general weakness, and a two-month history of weight loss (8 kg). She had no history of medical disease. She had undergone exploratory laparotomy in the past because of ectopic pregnancy and she had used an intra-uterine contraceptive device for many years. Abdominal-pelvic computed tomography (CT) and pelvic magnetic resonance imaging (MRI) revealed a 5.9 × 6.4 cm heterogeneous enhancing pelvic soft tissue mass with central necrosis, probably arising from the left adnexa, and was consistent with ovarian cancer. She also had multiple peripheral enhancing cystic lesions in the pelvis, abdominal wall, both paracolic gutters, the root of the small bowel mesentery, the omentum, and Morison pouch. She had a moderate amount of ascites with diffuse peritoneal thickening consistent with carcinomatosis. An exploratory laparotomy was performed, showing multiple large abscesses with adhesions and a large soft tissue mass in the left pelvic cavity. After resection and drainage, final pathology was reported as actinomycosis. After her operation, she was given intravenous penicillin for six weeks and discharged. Conclusion: Surgeons and clinicians should be aware of this infectious disease because of its atypical symptoms and potential to mimic soft tissue tumors or malignant neoplasms.
    Surgical Infections 10/2014; DOI:10.1089/sur.2013.005 · 1.72 Impact Factor
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    ABSTRACT: Background: It has been proved that participating in exercise improves colorectal cancer patients' prognosis. This study is to identify barriers to exercise in Korean colorectal cancer patients and survivors. Materials and Methods: A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. Results: The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Conclusions: Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.
    Asian Pacific journal of cancer prevention: APJCP 10/2014; 15(18):7539-45. DOI:10.7314/APJCP.2014.15.18.7539 · 1.50 Impact Factor
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    ABSTRACT: Associated with reduced trauma, laparoscopic colon surgery is an alternative to open surgery. Furthermore, complete mesocolic excision (CME) has been shown to provide superior nodal yield and offers the prospect of better oncological outcomes.
    Canadian journal of surgery. Journal canadien de chirurgie 10/2014; 57(5):331-336. DOI:10.1503/cjs.002114 · 1.27 Impact Factor
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    ABSTRACT: In recent years, characterization of cancer and its environment has become necessary. However, studies of the cancer microenvironment remain insufficient. Copy number variations (CNVs) occur in 40% of cancer-related genes, but few studies have reported the correlation between CNVs in morphologically normal tissues adjacent to cancer and cancer progression. In this study, we evaluated cancer cell migration and invasion according to the genetic differences between cancer tissues and their surrounding normal tissues. To study the field cancerization effect, we screened 89 systemic metastasis-related CNVs from morphologically normal tissues adjacent to colon cancers. Among these CNVs, LIM and senescent cell antigen-like domain 2 (PINCH-2) showed copy number amplification and up-regulation of mRNA in the non-relapsed group compared to the systemic relapse group. PINCH-2 expression in colon cancer cells was lower than that in normal epithelial colon cells at both the protein and mRNA levels. Suppression of PINCH-2 resulted in decreased formation of the PINCH-2-IPP (PINCH-2, ILK, and PARVA) complex and reciprocally increased formation of the PINCH-1-IPP complex. Although PINCH-2 expression of survival pathway-related proteins (Akt and phospho-Akt) did not change upon suppression of PINCH-2 expression, cell migration-related proteins (MMP-9 and -11) were up-regulated through autocrine and paracrine activation. Thus, PINCH-2 participates in decreased systemic recurrence by competitively regulating IPP complex formation with PINCH-1, thereby suppressing autocrine and paracrine effects on motility in colon cancer. This genetic change in morphologically normal tissue suggests a field cancerization effect of the tumor microenvironment in cancer progression. © 2014 Wiley Periodicals, Inc.
    International Journal of Cancer 10/2014; 136(10). DOI:10.1002/ijc.29273 · 6.20 Impact Factor
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    ABSTRACT: The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around the lesion. For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed. The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.
    10/2014; 30(5):241-4. DOI:10.3393/ac.2014.30.5.241

Publication Stats

2k Citations
454.87 Total Impact Points


  • 2008–2015
    • Wonju Severance Christian Hospital
      Genshū, Gangwon-do, South Korea
  • 1998–2015
    • Yonsei University Hospital
      • • Surgery
      • • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2002–2014
    • Yonsei University
      • • Department of Surgery
      • • Division of Medical Oncology
      • • College of Medicine
      Sŏul, Seoul, South Korea
  • 2013
    • Kosin University
      Tsau-liang-hai, Busan, South Korea
  • 2010
    • Korea Institute of Radiological & Medical Sciences
      Sŏul, Seoul, South Korea
  • 2004
    • National Cancer Center Korea
      • Colorectal Cancer Branch
      Goyang, Gyeonggi, South Korea
  • 1999
    • Hanyang University
      • Department of Medicine
      Sŏul, Seoul, South Korea