• Korean Journal of Head & Neck Oncology
• /
• v.34 no.2
• /
• pp.89-92
• /
• 2018

Malignant salivary gland tumors only represent 0.08% of all childhood tumors. Especially, nasopharyngeal mucoepidermoid carcinoma(MEC) in pediatric age is an extremely rare malignancy. We hereby report a case of nasopharyngeal MEC in 5 year-old female patient. The patient underwent the complete removal of the tumor by endonasal endoscopic approach. Adjuvant postoperative radiotherapy was not considered. After 3.5 years of follow-up, there are no sign of recurrence and metastasis. Minor salivary gland tumor must be considered as a differential diagnosis of angiofibroma in nasopharynx in pediatric age. To our knowledge, the case we describe is the third case of nasopharyngeal MEC in pediatric age reported in literature.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.32 no.1
• /
• pp.1-8
• /
• 2021

Human vocal cords vibrate as quickly as 100-250 times per second, so it is impossible to observe them with normal endoscopic diagnostic equipment. High-speed videolaryngoscopy (HSV) allows the visualization of non-periodic vibratory motion of vocal fold beyond the limitation of videostroboscopy. New developed post-processing methods that converts HSV to two-dimensional videokymography (2D VKG) using U-medical image-processing software can provide quantitative information on vocal fold mucosa vibration. Multifunctional laryngeal examination system is composed of 3 kinds of examinations such as HSV, 2D scanning digital kymography (2D DKG) and line scanning digital kymography (DKG). Evaluation of entire vocal cord vibratory pattern in each cord is possible using 2D DKG and a faster and more reliable quantitative information can be obtained. As this system is used in clinical and research, it is expected to bring much advances to the diagnosis of voice disorders. In this review, I will introduce the principles and advantages on examination of the vocal fold vibration, which is in the spotlight recently, and proceed with the literature review.

• Journal of Digestive Cancer Research
• /
• v.2 no.2
• /
• pp.45-51
• /
• 2014

Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.

• Clinical and Experimental Pediatrics
• /
• v.45 no.4
• /
• pp.482-488
• /
• 2002

Purpose : We performed this study to evaluate the diagnostic usefulness of endoscopic finding of nodular gastritis, CLO and HpKit test for H. pylori infection in children. Methods : Gastroduodenal endoscopy and mucosal biopsy were performed on 212 children who visited our hospital between Jul. 1999 and May 2000 due to abdominal pain. We performed CLO and HpKit test for H. pylori with the time interval of 15, 30 minutes, 1, 2, 3, 24, 48, 72, 96, 120 and 144 hours. Histological examination of H. pylori was made by H-E or Alcian yellow stain with biopsy specimens. Sensitivity, specificity, positive predictive and negative predictive value of nodular gastritis, CLO and HpKit test were calculated from the analysis of above data. Results : Sensitivity and specificity of 3 hour-CLO test was 68.4% and 100% respectively. Sensitivity and specificity of 3 hour-HpKit test was 65.8% and 100% respectively. No significant difference in sensitivity and specificity was found between in 3 hour-CLO and HpKit test(P>0.05). Sensitivity of CLO test increased as time lapsed, but corresponding specificity did not decrease as time lapsed(sensitivity and specificity at 144 hours : 89.5% and 94.8% respectively). However, sensitivity of HpKit test increased as time lapsed, but specificity markedly decreased. Sensitivity and specificity of the nodular gastritis was 78.9% and 93.7% respectively. Conclusion : Both CLO and HpKit test have relatively low sensitivity and specificity for the detection of H. pylori in 3 hours of testing in children. The endoscopic finding of nodular gastritis is another good standard in the diagnosis of H. pylori infection in children.

• Clinical and Experimental Pediatrics
• /
• v.46 no.6
• /
• pp.576-584
• /
• 2003

Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

• Journal of Gastric Cancer
• /
• v.5 no.2
• /
• pp.120-126
• /
• 2005

Purpose: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors(GISTs) and assessed differences between the two groups. Materials and Methods: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echoheterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. Results: Tumor sizes over 40 mm were observed in $85.7\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.000). Intralesional cystic spaces were noted in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.003). The outer margin was irregular in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.014). $85.7\%$ of the malignant and $13.0\%$ of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. Conclusion: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1347-1350
• /
• 2016

Background: Breast cancer prognosis is influenced by several histopathology and clinical factors including expression of Ki67 which may have a predictive role in lymph node negative breast cancer patients. The aim of this study was to assess Ki67 expression in breast cancers without axillary lymph node involvement and to evaluate its prognostic value with regard to disease-free survival. Materials and Methods: Subjects were selected from non-metastatic invasive breast cancer patients who were referred to the oncology department of Ghaem hospital during 1 April 2001 to 1 April 2008. Ki67 levels were measured using immunohistochemistry (IHC) and compared with clinicopathological features. The relation of Ki67 expression with disease-free survival was also analysed. Results: A total of 106 women with a mean age of 49 were examined. Some 94.3% were classified as having invasive ductal carcinomas and the mean tumour diameter at the time of diagnosis was 2.8 cm. Some 50.9% of cases were ER positive and 47.2% were PR positive. P53 expression was positive in 48.1% of the cases. According to the IHC results, only 8.5% of the patients were Her2/neu positive. Ki67 was positive in 66 (62.3%) with a significant relation to lower age (p=0.0229) and P53 positivity (p=0.005). After an average of 40-months follow up, 13 (12.3%) demonstrated recurrence, most commonly systemic. Of 13 cases with relapse, 10 patients (77%) were Ki67 positive. Conclusions: In our population Ki67 appeared to be an independent prognostic factor for three-year survival. However, we stress that a survival study with a bigger sample size would help to support this conclusion.

• Journal of Gastric Cancer
• /
• v.7 no.2
• /
• pp.102-106
• /
• 2007

Gastric carcinoid tumor is a neoplasm that arises from enterochromaffine-like (ECL) cells in the gastric fundus. It is a rare disease that comprises less than 2% of all gastric neoplasms; however its incidence has been recently increasing. We experienced one case of gastric carcinoid tumor that was revealed to be multiple polypoid lesions. A 29-year-old female patient visited a hospital three years ago due to syncope. The blood hemoglobin was measured as 6.0 g/dl. Gastroscopy revealed multiple polypoid lesions with bleeding; therefore endoscopic clipping was performed. The polyps were diagnosed as carcinoid tumor via endoscopic biopsy. She was transferred to our hospital because of persistent iron deficiency anemia that was caused by bleeding at the gastric polyps. Gastroscopy revealed more than twenty various-sized polypoid lesions from the mid-body to the antrum. The blood hemoglobin level was 9.0g/dl. Total gastrectomy was performed under the diagnosis of gastric carcinoid tumor with bleeding. All of the gastric polyps were diagnosed as carcinoid tumors, and any metastasis to the regional lymph nodes was not found. Eighteen months after operation, the blood hemoglobin was increased to 12.8g/dl with no evidence of recurrence. Surgical resection should be considered for treating gastric carcinoid tumor with continuous bleeding.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.20
• /
• pp.9005-9008
• /
• 2014

Background: Gastric cancer is the second leading course of cancer death worldwide and H. pylori infection is an important risk factor for gastric cancer development. This study was design to evaluate the clinical, pathological features, survival rate and prevalence of H. pylori infection in gastric cancer in Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and H. pylori status were collected from gastric cancer patients from Thammasat university hospital during June 1996-December 2011. H. pylori infection was assessed by histological evaluation, rapid urease test and serological test. Clinical information, endoscopic findings and histopathology of all patients were recorded and compared between patients with active or non-active H. pylori infection. Results: A total of 100 gastric cancer patients (55 men and 45 women with mean age of $55{\pm}16.8years$) were enrolled in this study. Common presenting symptoms were dyspepsia (74%), weight loss (66%), anemia (63%) and anorexia (38%). Mean duration of symptoms prior to diagnosis was 98 days. Overall prevalence of H. pylori infection was 83% and active H. pylori infection was 40%. 1-year and 5-year survival rates were 43% and 0%. There was no significant difference between active H. pylori infection in different locations (proximal vs non-proximal: 47.1% vs 48.5%; P-value = 0.9, OR=0.9; 95%CI=0.3-3.1) and histology of gastric cancer (diffuse type vs intestinal type: 47.4% vs 50%; P-value = 0.8, OR=0.9, 95%CI=0.3-2.7). However, linitis plastica was significantly more common in non-active than active H. pylori infection (27.9% vs 0%; P-value<0.0001, OR=13.3, 95%CI=3.2-64.5). Moreover, gastric cancer stage 4 was higher in non-active than active H. pylori infection (93% vs 50%, P-value<0.001). Conclusions: Prevalence of H. pylori infection in Thai gastric cancer patients was high but active infection was low. Most gastric cancer patients presented in advance stage and had a grave prognosis. Screening for gastric cancer in high risk individuals might be an appropriate tool for early detection and improve the treatment outcome for this particular disease in Thailand.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.20 no.4
• /
• pp.227-235
• /
• 2017

Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.