• Title/Summary/Keyword: Barrett

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Epidemiology of early esophageal adenocarcinoma

  • Thuy-Van P. Hang;Zachary Spiritos;Anthony M. Gamboa;Zhengjia Chen;Seth Force;Vaishali Patel;Saurabh Chawla;Steven Keilin;Nabil F. Saba;Bassel El-Rayes;Qiang Cai;Field F. Willingham
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.372-380
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    • 2022
  • Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%-5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

The Clinicopathological Characteristics of Adenocarcinoma of the Gastro-esophageal Junction (위식도접합부선암의 임상병리학적 특성)

  • Kim, Han-Su;Jeong, Oh;Park, Young-Kyu;Kim, Dong-Yi;Ryu, Seong-Yeop;Kim, Young-Jin
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.210-216
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    • 2008
  • Purpose: Siewert's classification of adenocarcinoma of the esophagogastric junction (AEG) has been widely adopted, but there is a wide discrepancy of the clinicopathological features of AEG of the Asian patients as compared to that of the Western patients. The aim of this study was to investigate the clinicopathological characteristics of AEG according to the Siewert classification. Materials and Methods: Among the patients who underwent surgery for gastric carcinoma in our institution between May 2004 and February 2008, the AEG patients were selected based on their operation records and the photographs according to Siewert's classification. Results: There were 70 AEG patients (3.9%) among the total of 1,778 patients. There were 3 patients (4.3%) with type I, 30 patients (42.8%) with type II and 37 patients (52.8%) with type III. Curative resection (R0) was achieved in 68 cases (97.1%). No significant differences in gender, stage, Barrett's esophagus and the proximal margin were found between the patients with type II and type III AEG. The patients with type III were younger than the patients with type II (59 vs 64 years, respectively, P=0.049). Well differentiated histology (P=0.045) and the intestinal type (P=0.055) were significantly more frequent in the patients with type II as compared with that in the patients with type III. Conclusion: There was a striking difference of the Asian patients from the Western patients for the incidence of AEG (and especially type I). Some of the differences between type II and type III patients were similar to those of the previous Western studies. A large study is needed to investigate whether these features are typical in the Korean population.

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Investigation on CO Adsorption and Catalytic Oxidation of Commercial Impregnated Activated Carbons (상용 첨착활성탄의 일산화탄소 흡착성능 및 촉매산화반응 연구)

  • Ko, Sangwon;Kim, Dae Han;Kim, Young Dok;Park, Duckshin;Jeong, Wootae;Lee, Duck Hee;Lee, Jae-Young;Kwon, Soon-Bark
    • Applied Chemistry for Engineering
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    • v.24 no.5
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    • pp.513-517
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    • 2013
  • We investigated the properties of impregnated activated carbons, a commercial adsorbent for the individual protection equipment, and examined CO adsorption and oxidation to $CO_2$. The surface area, pore volume and pore size were measured for four commercial samples using Brunauer-Emmett-Teller/Barrett-Joyner-Halenda (BET/BJH), and atomic compositions of the sample surface were analyzed based on SEM/EDS and XPS. Impregnated activated carbons containing Mn and Cu for fire showed the catalytic CO oxidation to $CO_2$ with a high catalytic activity (up to 99% $CO_2$ yield), followed by the CO adsorption at an initial reaction time. On the other hand, C: for chemical biologial and radiological (CBR) samples, not including Mn, showed a lower CO conversion to $CO_2$ (up to 60% yield) compared to that of fire samples. It was also found that a heat-treated activated carbon has a higher removal capacity both for CO and $CO_2$ at room temperature than that of untreated carbon, which was probably due to the impurity removal in pores resulted in a detection-delay about 30 min.

Treatment of Stomach Cancer Involving Esophagogastric Junction (식도-위 경계부위를 침범한 위암의 치료)

  • 이종목;백희종;박종호;임수빈;조재일
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.930-936
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    • 2001
  • Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1%(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

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Association between Impulsivity and Medical Lethality of Suicide Attempts among Suicide Attempters (자살시도자들에서 충동성과 자살시도의 의학적 치명도와의 관계)

  • Park, Ji Won;Suh, Kyung Hoon;Son, Kyung Hoon;Han, Jae Hyun;Jeon, Yeong Ju;Jung, Yu Jin;Lee, Won Joon;Seong, Su Jeong;Han, Chang Hwan;Cho, Gyu Chong;Hwang, Jae Yeon
    • Korean Journal of Biological Psychiatry
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    • v.25 no.4
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    • pp.118-124
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    • 2018
  • Objectives Although impulsivity has long been thought as an important factor influencing suicidal behaviors, it is unknown whether impulsivity increases the risk of dying from suicidal behaviors and what specific component among constructs of impulsivity contributes to the risk of dying among suicide attempters. Methods To elucidate the association between impulsivity and medical lethality of suicide attempt among suicide attempters, we consecutively recruited 46 suicide attempters who visited an emergency room of a general hospital located in a metropolitan area, Seoul, Republic of Korea, due to suicide attempts and consented to participate in this study. Then we assessed medical lethality with the Beck Lethality Scale (LS) and impulsivity with the Korean version of the Barratt Impulsiveness Scale-11-Revised (BIS). Demographic variables were obtained from medical records and structured social work reports for suicide attempters. Results Although total scores of the BIS did not correlate with LS scores, only the scores of self-control, that is one of the Barrett's six theoretical constructs of impulsivity in which the higher score indicates less self-control and more impulsivity, had a significant positive correlation with scores of LS (p = 0.003). The association remained significant after adjusting for variables known to affect suicide lethality such as job status, recent alcohol consumption, diagnosis of depressive disorders, and having a plan for suicide (${\beta}=0.429$, p = 0.009). Conclusions Not impulsivity in general, but poor self-control, in particular, predicts lethal suicidal behaviors among suicide attempters. The degree of self-control should be evaluated when assessing patients with elevated suicide risk, and proper measures should be installed to prevent possible future lethal suicide attempts.

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Affective Representations of Basic Tastes and Intensity using Multivariate Analyses (다변량분석방법을 이용한 미각 자극의 기본 맛과 강도에 따른 정서표상 )

  • Chaery Park;Inik Kim;Jongwan Kim
    • Science of Emotion and Sensibility
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    • v.26 no.2
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    • pp.39-52
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    • 2023
  • According to the core affect theory, affect consists of two independent dimensions of valence and arousal. Previous studies have found that various types of stimuli, such as pictures, videos, and music, are mapped onto the core affect space. However, the research on affect using gustatory stimuli has not been explored sufficiently. This study investigated whether the affects elicited by tastes could be mapped onto the core affect space. Stimuli were selected based on two factors (taste types and intensity). Participants were presented with each stimulus, evaluated the tastes, and rated their affective responses on taste and emotion scales. The data were analyzed using repeated-measures ANOVAs and multivariate analyses (multidimensional scaling and classification). The results of univariate analyses indicated that participants felt positive for sweet stimuli but negative for bitter and salty. Furthermore, participants reported high arousal with high intensity. Multidimensional scaling revealed that taste stimuli are also represented on the core affect dimensions. Specifically, it was confirmed that in the first dimension, sweetness was represented as a positive affect, while bitter and salty tastes were represented as a negative affect. In the second dimension, bitterness was represented as low arousal and sourness as high arousal. Classification analyses confirmed that the taste was identified consistently based on the affective responses within and across participants. This study showed that the taste stimuli in daily life are also located on core affect dimensions of valence and arousal.

Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.