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Background: The aim of this study was to identify subgroups that benefit from preoperative or postoperative chemoradiotherapy (CRT) for rectal cancer of intermediate stage., Patients and Methods: Between 1999 and 2004, 118 and 177 patients matched with respect to clinical T stage, circumferential tumor extent (= 60% / > 60%), lymph node metastasis, and lymph node size (< 1 cm / ≥ 1 cm), were allocated to preoperative CRT and postoperative CRT, respectively. In preoperative CRT, a total of 45 Gy was delivered with chemotherapy, and then surgery followed. In postoperative CRT, 45-51 Gy was delivered with chemotherapy following primary surgery., Results: Local recurrence, distant metastasis, disease-free survival, and disease-specific survival were not different between the two schemes. For a circumferential tumor extent of = 60%, local recurrence in preoperative CRT (3.6%) was lower than in postoperative CRT (11.9%) (p = 0.084, hazard ratio (HR) = 0.274, 95% confidence interval (CI) = 0.058-1.032). For a tumor located < 5cm from the anal verge, distant metastasis in preoperative CRT (18.9%) was lower than in postoperative CRT (34.4%) (p = 0.061, HR = 0.444, 95% CI = 0.188- 1.047), and 5-year disease-free survival rates in preoperative and postoperative CRT were 72.0 and 59.0%, respectively (p = 0.078)., Conclusions: Our findings suggest that preoperative CRT might be appropriate in rectal cancer involving the limited circumferential lumen and located in the low rectum. However, further prospective studies are required., (Copyright © 2011 S. Karger AG, Basel.)

Yellow rot, caused by an ascomycetous fungus having a distinctive arthroconidial anamorph, is the most destructive disease of cultivated Ganoderma lucidum in Korea, but the identity of the yellow rot pathogen (YRP) remains uncertain. Isolates have been identified as Xylogone sphaerospora (with putative anamorph Sporendonema purpurascens) or as Arthrographis cuboidea. Therefore we used morphological features, pathogenicity tests and phylogenetic analyses of DNA sequences from the nuclear ribosomal genes, including partial small subunit and internal transcribed spacer regions, and from the gene encoding RNA polymerase second largest subunit to evaluate the relationship between YRP isolates and these species. YRP isolates formed a distinct subgroup within a clade that included X. sphaerospora, A. cuboidea and Scytalidium lignicola, the type species of Scytalidium, but the disposition of the clade within the Leotiomycetes was uncertain. We describe Xylogone ganodermophthora sp. nov. and Scytalidium ganodermophthorum sp. nov. for the teleomorph and anamorph of YRP respectively. Arthrographis cuboidea is reclassified as Scytalidium cuboideum comb. nov., and the anamorph of X. sphaerospora is named Scytalidium sphaerosporum sp. nov. In pathogenicity tests only X. ganodermophthora caused disease in Ganoderma lucidum. Amplified fragment length polymorphism analyses showed that X. ganodermophthora populations from diseased fruiting bodies or from oak wood in Korea consisted of two clonal groups.

Background/aims: A panel of five markers (two mononuclotide markers and three dinucleotide markers; the so-called Bethesda markers) has been proposed to define MSI status. However reducing these 5 markers into one or two markers have been suggested to be sufficient for detection of the MLH1- or MSH2-mutated Lynch syndrome. We attempted to examine the effectiveness of each Bethesda marker for the determination of MSI status clinically relevant to Lynch syndrome., Methodology: We compared the MSI status obtained using each or a combination of two Bethesda markers to those obtained using all five Bethesda markers in 1,531 non-selected colorectal cancer patients., Results: At least one mononucleotide marker was unstable in 94% of the MSI-H tumors defined by the Bethesda markers (126 of 134). After sequencing MLH1 and MSH2 genes from 31 of 86 patients eligible for the genetic test, 18 germline mutations were detected. Seventeen of these mutations were from high MSI tumors, and 1 was from a MSS tumor defined by 5 Bethesda markers. A combination of two mononucleotide markers was able to identify all 17 mutation-positive individuals with MSI-H tumors defined by the five Bethesda markers., Conclusions: Instability in two mononucleotide markers, BAT26 and BAT25, was most effective markers at defining MSI status. Sensitivity is only slightly impaired by using two mononucleotide markers instead of five markers.

Purposes: This study is a prospective randomized clinical trial to evaluate the clinical safety and the effect of a sodium hyaluronate-based bioresorbable membrane (Seprafilm; Genzyme, Cambridge, MA, USA) for reducing adhesive intestinal obstruction after colorectal cancer surgery., Materials and Methods: Between November 2002 and December 2003, 504 patients underwent radical resection for sigmoid or rectal cancer. Among these patients, 427 patients were enrolled in this study. The patients were randomized into the Seprafilm group (N = 185) and the control group (N = 242). All the patients in the Seprafilm) group received one sheet of Seprafilm over the pelvic inlet where the peritoneum was denuded due to pelvic dissection. Intestinal obstruction was defined when there were symptoms of nausea, vomiting, and abdominal distension combined with an obstructive bowel pattern on the radiologic evaluation., Results: The median follow-up period was 25.0 months. There were no significant differences between the Seprafilm and the control groups for the clinicopathologic parameters. There were no differences in the incidence of complications between the two groups; however, the incidence of early postoperative intestinal obstruction was significantly less in the Seprafilm group than in the control group (2.7% vs 7.0%, respectively, p = 0.045). Five patients in the Seprafilm group experienced postoperative intestinal obstruction (2.7%) compared with 11 patients in the control group (4.6%) during the follow-up period; however, there was no statistical difference., Conclusions: Seprafilm appears to be effective in preventing early postoperative intestinal obstruction and there was a trend for reduced intestinal obstruction after lower abdominal surgery for colorectal cancer.

The lengths of the surgical rectum and peritoneal reflection were important factors in treatment modality of rectal tumor. To evaluate the surgical length of rectum, we measured the length of the peritoneal reflections, sacral promontory and termination of the taenia coli from the anal verge by rigid sigmoidoscope in 23 male and 23 females during operation. The mean lengths of the sacral promontory were 16.5+/- 2.2 cm and 16.1+/-2.2 cm in the males and females, respectively. As for the peritoneal reflection, the results were anterior (8.8+/-2.2 cm, 8.1+/-1.7 cm), lateral (10.8+/-2.7 cm, 11.4+/-1.9 cm) and posterior (13.8+/-2.5 cm, 14.0+/-1.9 cm), respectively. There were no statistically significant differences between male and female. And only height had a correlation with the length of sacral promontory both in male and female (p=0.015 and p=0.018, respectively). For all the estimated lengths, the length of the sacral promontory had a correlation with the lengths of the anterior (p<0.001 and p=0.001) and posterior (p<0.001 and p<0.001) peritoneal reflections in males and females, respectively. We suggest that the intra-operative lengths of the rectum and peritoneal reflection will be useful information for treatment modality of rectal tumor clinically in Korean.

Little is known about the chromosomal variability and polymorphism existing in mitotic chromosomes of Citrus, mainly due to lack of reliable chromosomal markers and small chromosome size. To test the hypothesis of chromosomal polymorphism and provide the foundation of the genome organization in the Citrus cultivars, we have developed molecular cytogenetic markers for 13 Citrus species collected from Jeju island, Korea. In this study, we demonstrated that the chromosomal locations of cytogenetic markers are quite variable and extremely polymorphic, in contrast to the previous studies. The data obtained in this study will be of utmost importance in cytological systematics and karyotyping of the Citrus species.

Purpose: The clinical features, treatment modality approaches in clinical practice, and prognostic factors for anal canal carcinoma patients were retrospectively analyzed., Materials and Methods: Between October 1994 and December 2005, 50 patients with anal canal cancer were treated at Samsung Medical Center, Seoul, Korea., Results: After a median follow up of 37.8 months (range, 6.6-136.1 months), the 5-year and 10-year survival rates for the 38 patients with early and locally advanced squamous and cloacogenic carcinoma (squamous cell carcinoma and cloacogenic carcinoma) were 74.8% and 66.5%, respectively. The 5-year survival and disease-free survival rates (DFS) of the 31 patients who received chemoradiation therapy (CRT) were 83.6% and 74.3%, respectively. The overall and DFS could not be determined for the adenocarcinoma group due to the small number of cases (n=8). Univariate analysis showed that tumor size (p=0.04) and inguinal node status (p=0.04) significantly influenced patient survival in patients with squamous cell and cloacogenic carcinomas. Furthermore, univariate analysis also showed that, inguinal node status influenced patient survival in the adenocarcinoma group. Multivariate analysis showed that inguinal node metastasis is a single independent prognostic variable for survival (p=0.04) in patients with squamous cell and cloacogenic carcinomas., Conclusion: Combined CRT has been adopted as standard treatment with outcomes that are comparable to those reported in randomized clinical trials. Due to the rarity and complexity of anal canal carcinoma, interdepartmental cooperation is required for disease treatment. Thus, proper treatment of patients should incorporate a team-approach and should be available to as many patients as possible.

Head-out water immersion (HOI) increases cardiac output (CO) for a given oxygen consumption. To investigate whether professional breath-hold divers show a similar response, cardiovascular responses to HOI were compared between six Korean women breath-hold divers, six non-diving housewives and six non-diving young women at rest and while performing leg cycle exercise of moderate intensity (Deltametabolic rate = approximately 100 W m(-2)) in water at a thermoneutral temperature (34.5 degrees C). In all three groups, HOI increased CO markedly due to a rise in stroke volume, with no significant change in heart rate (HR) and arterial blood pressure (BP). Thus, total peripheral resistance (TPR) and arterio-venous oxygen content difference fell significantly. During dynamic exercise in water CO increased mainly due to a rise in HR. The arterial systolic BP rose slightly with no significant change in diastolic BP, and the TPR fell 20-40% with similar responses among the three groups of subjects. This study showed that both at rest and during exercise, cardiovascular responses to immersion do not vary significantly with age and water immersion experience.