• Journal of Gastric Cancer
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• 제17권4호
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• pp.374-383
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• 2017

Purpose: Bleeding is one of the most serious complications of advanced gastric cancer (AGC) and is associated with a poor prognosis. This study aimed to evaluate the clinical outcomes of endoscopic hemostasis for bleeding in patients with unresectable AGC. Materials and Methods: This study included 106 patients with bleeding associated with gastric cancer who had undergone endoscopic hemostasis between January 2010 and December 2013. Clinical characteristics, treatment outcomes, including rates of successful endoscopic hemostasis and rebleeding, risk factors for rebleeding, and overall survival (OS) were investigated. Results: Successful initial hemostasis was achieved in 83% of patients. Rebleeding occurred in 28.3% of patients within 30 days. The median OS after initial hemostasis was lower in patients with rebleeding than in those without rebleeding (2.7 and 3.9 months, respectively, P=0.02). There were no significant differences in disease status and rebleeding rates among patients with partial response or stable disease (n=4), progressive disease (n=64), and first diagnosis of disease (n=38). Univariate and multivariate analyses (P=0.038 and 0.034, respectively) revealed that transfusion of ${\geq}5$ units of RBCs was a significant risk factor for rebleeding. Conclusions: Despite favorable success rates of endoscopic hemostasis for bleeding associated with gastric cancer, the 30-day rebleeding rate was 28.3% and the median OS was significantly lower in patients with rebleeding than in those without rebleeding. Massive transfusion (${\geq}5$ units of RBCs) was the only significant risk factor for rebleeding. Patients with bleeding associated with AGC who have undergone massive transfusion should be observed closely following endoscopic hemostasis. Further research on approaches to reduce rebleeding rate and prevent death is needed.

• Biomolecules & Therapeutics
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• 제5권3호
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• pp.228-232
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• 1997

AU-164 was synthesized as a reversible gastric $H^+/K^+$ ATPase inhibitor, and its effects were tested in various systems. AU-164 inhibited rabbit gastric $H^+/K^+$ ATPase with an $IC_{50}$/ of 9 $\mu$M. On the other hand, AU-164 was a weak inhibitor for dog kidney $Na^+/K^+$ ATPasc, indicating the selectivity for gastric $H^+/K^+$ ATPase. The reversible property of the AU-164-induced inhibition of $H^+/K^+$ ATPase was confirmed by filtering the inhibition mixture through Sephadex G-25M column. In vivo basal acid secretion was also inhibited by AU-164 under the pylorus ligation of Sprague-Dawley rats. In addition, AU-164 protected dose dependently gastric lesion induced by ethanol in rats. The $ED_{50}$ value of 62 mg/kg p.o was estimated. These results suggest that AU-164 is a potent, selective and reversible gastric $H^+/K^+$ ATPase inhibitor, and that AU-164 has a potential use for the clinical therapeutics of peptic ulcer disease.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.17-24
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• 2014

Gastric cancer is highly invasive, aggressively malignant, and amongst the most prevalent of all forms of cancer. Despite improved management strategies, early stage diagnosis of gastric cancer and accurate prognostic assessment is still lacking. Several recent reports have indicated that the pathogenesis of gastric cancer involves complex molecular mechanisms and multiple genetic and epigenetic alterations in oncogenes and tumor suppressor genes. Functional inactivation of the tumor suppressor protein PTEN (Phosphatase and Tensin Homolog) has been detected in multiple cases of gastric cancer, and already shown to be closely linked to the development, progression and prognosis of the disease. Inactivation of PTEN can be attributed to gene mutation, loss of heterozygosity, promoter hypermethylation, microRNA- mediated regulation of gene expression, and post-translational phosphorylation. PTEN is also involved in mechanisms regulating tumor resistance to chemotherapy. This review provides a comprehensive analysis of PTEN and its roles in gastric cancer, and emphasizes its potential benefits in early diagnosis and gene therapy-based treatment strategies.

• Journal of Gastric Cancer
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• 제18권2호
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• pp.152-160
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• 2018

Purpose: Totally laparoscopic gastrectomy (TLG) for advanced gastric cancer (AGC) is a technically and oncologically challenging procedure for surgeons. This study aimed to compare the oncologic feasibility and technical safety of TLG for AGC versus early gastric cancer (EGC). Materials and Methods: Between 2011 and 2016, 535 patients (EGC, 375; AGC, 160) underwent curative TLG for gastric cancer. Clinicopathologic characteristics and surgical outcomes of both patient groups were analyzed and compared. Results: Patients with AGC required a longer operation time and experienced more intraoperative blood loss than those with EGC did. However, patients from both the AGC and EGC groups demonstrated similar short-term surgical outcomes such as postoperative morbidity (14.4% vs. 13.3%, P=0.626), mortality (0% vs. 0.5%, P=0.879), time-to-first oral intake (2.7 days for both groups, P=0.830), and postoperative hospital stay (10.2 days vs. 10.1 days, P=0.886). D2 lymph node dissection could be achieved in the AGC group (95%), with an adequate number of lymph nodes being dissected ($36.0{\pm}14.9$). In the AGC group, the 3-year overall and disease-free survival rates were 80.5% and 73.7%, respectively. Conclusions: TLG is as safe and effective for AGC as it is for EGC.

• Journal of Gastric Cancer
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• 제17권3호
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• pp.246-254
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• 2017

Purpose: The significance of hospital volume remains inconsistent and controversial. In particular, few studies have examined whether hospital volume is associated with the outcome of gastrectomy for gastric cancer in East Asia. This study examined the effect of hospital volume on the short-term surgical and long-term oncological outcomes of patients undergoing curative gastrectomy for gastric cancer. Materials and Methods: Between 2009 and 2011, 1,561 patients underwent curative gastrectomy for gastric cancer at Seoul St. Mary's Hospital (n=1,322) and Bucheon St. Mary's Hospital (n=239). We defined Seoul St. Mary's Hospital as a high-volume center and Bucheon St. Mary's Hospital as a low-volume center. Results: The extent of resection, rate of combined resection, tumor stage, operating time, and hospital stay did not differ significantly between the 2 hospitals. In addition, the hospital volume was not significantly associated with the 30-day morbidity and mortality. When the overall and disease-free survival rates of the patients were stratified according to stage, hospital volume was not significantly associated with prognosis at any stage. Conclusions: Hospital volume might not be a decisive factor with respect to the surgical and oncological outcomes of patients if well-trained surgeons perform gastrectomy for gastric cancer.

• Journal of Gastric Cancer
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• 제21권3호
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• pp.319-324
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• 2021

The abscopal effect refers to the phenomenon in which local radiotherapy is associated with the regression of metastatic cancer that is distantly located from the irradiated site. Here, we present a case of a patient with advanced gastric cancer and brain metastases who was successfully treated with brain radiotherapy and anti-programmed death-1 (PD-1) therapy-induced abscopal effect. Although anti-PD-1 therapy alone could not prevent disease progression, the metastatic lesions in the brain and also in the abdominal lymph node showed a drastic response after brain radiotherapy and anti-PD-1 therapy. To our knowledge, this is the first reported case of successful treatment of advanced gastric cancer with multiple brain and abdominal lymph node metastases, possibly through anti-PD-1 therapy combined with brain radiotherapy-induced abscopal effect. We suggest that the combination of brain radiotherapy and anti-PD-1 therapy may be considered as a therapeutic option for advanced gastric cancer, especially when there is brain metastasis.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.45-51
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• 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.

• Journal of Gastric Cancer
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• 제12권1호
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• pp.18-25
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• 2012

Purpose: Recently, laparoscopy-assisted gastrectomy (LAG) has been widely accepted modality for early gastric cancer in Korea. The indication of LAG may be extended in an experienced institution. In our institution, the first case of laparoscopy-assisted gastrectomy (LAG) for gastric cancer was performed in May 1998. We retrospectively reviewed the long-term oncologic outcomes over 12 years to clarify the feasibility of LAG for gastric cancer. Materials and Methods: The authors retrospectively analyzed 753 patients who underwent LAG for gastric cancer, from May 1998 to August 2010. We reviewed clinicopathological features, postoperative outcomes, mortality and morbidity, recurrence, and survival of LAG for gastric cancer. Results: During the time period, 3,039 operations for gastric cancer were performed. Among them, 753 cases were done by LAG (24.8%). There were 69 cases of total gastrectomy, 682 subtotal gastrectomies, and 2 proximal gastrectomies. According to TNM stage, 8 patients were in stage 0, 619 in stage I, 88 in stage II, and 38 in stage III. The operation-related complications occurred in 77 cases (10.2%). Median follow-up period was 56.2 months (range 0.7~165.6 months). Twenty-five patients (3.3%) developed recurrence, during the follow-up period. The overall 5-year and disease free survival rates were 97.1% and 96.3%, respectively. Conclusions: The number of postoperative complications and survival rates of our series were comparable to the results from that of other reports. The authors consider LAG to be a feasible alternative for the treatment of early gastric cancer. However, rationale for laparoscopic surgery in advanced gastric cancer has yet to be determined.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2003년도 추계학술대회초록집
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• pp.39-39
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• 2003

Balantidiasis is an infectious disease worldwide which is produced by a protozoan Balantidium coli. This single-celled organism is characterized by their large size ranging from 50 $\mu\textrm{m}$ to more than 500 $\mu\textrm{m}$ [1] which indicated by the presence of cilia on its cell surface. The parasite occurs in the lumen of cecum and colon of swine, humans and nonhuman primates as commensal, but can turn opportunist and invade injury tissues by other diseases [2]. It is difficult to diagnose the disease clinically since they are asymptomatic [3]; and can be complicated with other disease or parasitism. Here we report the incidental findings of Balantidiasis in the lymphatic ducts of gastric lymph node of Barbary sheep (Ammotragus lervia). (omitted)

• 한국동물위생학회지
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• 제27권2호
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• pp.121-131
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• 2004

This experiment was executed to control effectively endemic disease of swine farms in Incheon metropolitan city. Mainly using PigMon program which had been developed by the College of Veterinary Medicine in the University of Minnesota(USA), we examined lesions of gastric ulcer and interstitial nephritis additionally. 446 heads of pigs shipped from 5 farms in Incheon to a slaughterhouse from June in 2003 to May in 2004 were examined. Infection rates by farms were obtained as follows; 1. Pneumonia was varied from 34.6% to 74.1% and pneumonic score was 1.47∼7.06. As for atrophic rhinitis, four farms were 100% and one farm was 89.5% and rhinitis score was 1.3∼3.2. 2. The infection rate of pericarditis and peritonitis was 1.0∼3.9% and liver white spots, papular dermatitis were observed in pigs of 9.8∼29.7%, 16.7∼51.4% respectively. 3. The outbreak rates of interstitial nephritis, lesions of ileal thickening and gastric ulcer were 15.4∼24.1%, 7.7∼13.5%, and 62.7%∼86.2% respectively.