• Journal of Gastric Cancer
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• 제11권3호
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• pp.155-161
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• 2011

Purpose: To determine the diagnostic utility of a frozen section biopsy in patients undergoing endoscopic submucosal dissection (ESD) for early gastric neoplasms with obscure margins even with chromoendoscopy using acetic acid and indigo carmine (AI chromoendoscopy). Materials and Methods: The lateral spread of early gastric neoplasms was unclear even following AI chromoendoscopy in 38 patients who underwent ESD between June 2007 and May 2011. Frozen section biopsies were obtained by agreement of the degree of lateral spread between two endoscopists. Thus, frozen section biopsies were obtained from 23 patients (FBx group) and not in the other 15 patients (AI group). Results: No significant differences were observed for size, histology, invasive depth, and location of lesions between the AI and FBx groups. No false positive or false negative results were observed in the frozen section diagnoses. Adenocarcinoma was revealed in three patients and tubular adenoma in one, thereby changing the delineation of lesion extent and achieving free lateral margins. The rates of free lateral resection margins and curative resection were significantly higher in the FBx group than those in the AI group. Conclusions: Frozen section biopsy can help endoscopists perform more safe and accurate ESD in patients with early gastric neoplasm.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9801-9804
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• 2014

Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - the most accepted mode of screening to date - is not done routinely and national data are still lacking. Objective: To determine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopy for various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta, Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed. New patients referred for colonoscopy were included. Data collected were patient demographic and significant colonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation, and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations between categorical variables were analyzed using chi-square test, while mean differences were tested using the t-test. Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses were found in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass were significantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with male gender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age >50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%), comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polyps or masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not represent the nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major health problem with colorectal cancer in Indonesia.

• Journal of Digestive Cancer Research
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• 제3권2호
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• pp.95-100
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• 2015

Currently, inappropriate information regarding cancer is being disseminated indiscreetly via the media and Internet. Many people are confused due to the mixed presence of facts and misinformation concerning cancer. Owing to the flood of information, especially that concerning gastrointestinal cancer (the most common cancer in Korea), patients with gastrointestinal cancers, their family members, and medical staff, as well as the general public, are faced with a number of problems in understanding, treating, and overcoming this type of cancer. Therefore, investigating the level of recognition for and understanding of gastrointestinal cancers among these populations is very important for the prevention, diagnosis, and management of this disease. This review article investigated the differences in the recognition levels of the general understanding, prevention, quality of life, pain control, and the ethical issues of gastrointestinal cancer treatment among the general public, patients with gastrointestinal cancers, their family members, and medical staff via surveys.

• Journal of Digestive Cancer Research
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• 제3권1호
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• pp.35-38
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• 2015

2008년 9월 조기 위암으로 내시경점막하박리술을 시행받은 과거력이 있는 62세 남자가 2010년 10월 시행한 상부위장관내시경 검사상 중부식도에 병변이 관찰되었다. 루골 색소 내시경상 염색이 잘 되지 않고, 확대내시경상에서 신생혈관이 관찰되며, 파괴된 혈관들이 연결되는 상피유두내혈관 루프상점막근층을 침범한 양상(IPCL-V3)이 관찰되었다. 초음파내시경 검사상 점막에 국한된 소견으로 보여, 조기 식도암으로 진단하에 내시경점막하박리술을 시행받았다. 이후 최종 조직 검사상 침범깊이는 점막층 M2 부위까지 침범한 소견이 관찰되고 D2-40 양성으로 림프절 전이 위험성이 높아 추가로 항암방사선 동시요법을 시행하였고, 이후 재발없이 지내다가 2013년 3월 중부식도에 이소성 병변으로 고분화 이형성이 발견되어 내시경점막절제술 및 광역동 치료를 시행받았다. 이 환자에서와 같이 조기 식도암에서 내시경점 막하박리술 시행 후 항암방사선 동시요법을 시행하는 것도 효과적인 치료 방법이 될 수 있다. 추후 전향적 연구가 필요할 것으로 생각된다.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.82-84
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• 2014

We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

• Journal of Ginseng Research
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• 제45권3호
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• pp.380-389
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• 2021

Metabolic syndrome (MS) refers to a clustering of at least three of the following medical conditions: high blood pressure, abdominal obesity, hyperglycemia, low high-density lipoprotein level, and high serum triglycerides. MS is related to a wide range of diseases which includes obesity, diabetes, insulin resistance, cardiovascular disease, dyslipidemia, or non-alcoholic fatty liver disease. There remains an ongoing need for improved treatment strategies for MS. The most important risk factors are dietary pattern, genetics, old age, lack of exercise, disrupted biology, medication usage, and excessive alcohol consumption, but pathophysiology of MS has not been completely identified. Korean Red Ginseng (KRG) refers to steamed/dried ginseng, traditionally associated with beneficial effects such as anti-inflammation, anti-fatigue, anti-obesity, anti-oxidant, and anti-cancer effects. KRG has been often used in traditional medicine to treat multiple metabolic conditions. This paper summarizes the effects of KRG in MS and related diseases such as obesity, cardiovascular disease, insulin resistance, diabetes, dyslipidemia, or non-alcoholic fatty liver disease based on experimental research and clinical studies.

• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.8-10
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• 2014

Patients with uncontrolled pain may become tired, depressed, angry, worried, lonely, and stressed. In contrast, proper management of cancer pain allows patients to be more active, sleep better, enjoy family and friends, improve their appetite, enjoy sexual intimacy, and prevent depression. Pain control is strongly influence to quality of life of cancer patients. This review discusses the importance of quality of life in pain management for cancer patients.

• Journal of Gastric Cancer
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• 제10권2호
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• pp.49-54
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• 2010

Endoscopic resection is now accepted as curative treatment modalities for early gastric cancer without lymph node metastasis. However, based on large-scaled data about the risk of lymph node metastasis in early gastric cancer and as a result of the technical development of endoscopic devices, it was suggested that the criteria for endoscopic resection should be extended. According to the treatment guidelines for gastric cancer in Japan, the extended indications include the following: differentiated-type mucosal cancer without ulceration and greater than 2 cm in diameter, differentiated-type mucosal cancer with ulceration and up to 3 cm in diameter, undifferentiated-type mucosal cancer without ulceration and up to 2 cm in diameter, and, in the absence of lymphovascular invasion, a tumor not deeper than submucosal level 1 (less than $500\;{\mu}m$). In this review, we discuss the evidence of the application of expanded endoscopic indication based on analysis of biologic behavior and data of endoscopic resection.

• Journal of Gastric Cancer
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• 제19권2호
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• pp.225-233
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• 2019

Purpose: Gastric adenocarcinoma of the fundic gland type (chief cell predominant type) (GA-FG-CCP) was first reported as a rare adenocarcinoma found in the normal fundic mucosa. Recent studies have proposed the possibility that GA-FG-CCPs were also generated in the atrophic mucosa after Helicobacter pylori (HP) eradication therapy. However, little is known on the endoscopic findings of GA-FG-CCP generated in the atrophic mucosa due to its extreme rarity. Materials and Methods: A total of 8 patients who underwent endoscopic submucosal resection and were diagnosed with GA-FG-CCP generated in the HP-uninfected mucosa (4 cases, HP-uninfected group) or HP-eradicated atrophic mucosa (4 cases, HP-eradicated group) were retrospectively analyzed, and their endoscopic findings, including magnifying endoscopy with narrow band imaging (M-NBI), and pathological features were compared. Results: While GA-FG-CCPs in the 2 groups displayed similar macroscopic appearance, M-NBI demonstrated that characteristic microvessels (tapered microvessels like withered branches) were specifically identified in the HP-eradicated group. Pathological investigation revealed that a decreasing number of fundic glands and thinned foveolar epithelium covering tumor ducts were thought to lower the thickness of the covering layer over tumor ducts in the HP-eradicated group. Moreover, dilation of vessels just under the surface of the lesions contributed to the visualization of microvessels by M-NBI. Conclusions: The change in background mucosa due to HP infection influenced the thickness of the covering layer over the tumor ducts and M-NBI finding of GA-FG-CCP.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.126-128
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• 2013

Pyogenic liver abscess in patients with malignant disease is a fatal state and is easily diagnosed. We presented a rare case of sudden fatal septicemia following anticancer treatment for recurred gastric cancer due to multiple liver abscesses which could not be diagnosed. A 72-year-old male with recurred gastric cancer received anticancer agents. He had a history of distal gastrectomy with right hepatic lobectomy for hepatic metastasis. He received anticancer treatment in the outpatient's service center periodically, and his performance status was preserved with nothing in particular. After administrating docetaxel, he suddenly developed septicemia and multiple organ failure and died 5 days after strong medical supports. Pathological autopsy revealed that multiple minute abscesses of the liver which could not be detected macroscopically were the causes of fatal septicemia. The etiology, therapies and prognosis of rare entity are being discussed.