• Journal of Gastric Cancer
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• 제15권2호
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• pp.113-120
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• 2015

Purpose: Although several clinical trials have proven the efficacy of adjuvant S-1 treatment in gastric cancers, it is still unclear which patients receive the most benefit. In this study, we prospectively recruited patients with locally advanced gastric cancer who had undergone curative resection followed by adjuvant S-1 administration to investigate which factors affect the outcomes. Materials and Methods: Between July 2010 and October 2011, we enrolled 49 patients who underwent curative resection for stage II or III gastric cancer and who subsequently received adjuvant S-1 treatment for 1 year. Results: Twenty-nine patients (59.2%) continued S-1 treatment for 1 year, and 12 patients (24.5%) experienced recurrent disease during the follow-up period. Patients with continuation of S-1 for 1 year had significantly increased rates of disease-free survival (P<0.001) and overall survival (P=0.001) relative to the patients who discontinued S-1 during year 1. Multivariate analysis indicated poor outcomes for patients with stage III disease and those who discontinued S-1 treatment. Excluding patients who discontinued S-1 due to cancer progression (n=7), adjuvant treatment with S-1 still demonstrated a significant difference in the disease-free survival rate between the patients who continued treatment and those who discontinued it (P=0.020). Conclusions: S-1 is tolerated as adjuvant treatment in gastric cancer patients. However, discontinuing S-1 treatment may be an unfavorable factor in the prevention of recurrence. S-1 adjuvant treatment should be continued for 1 year if possible through the proper management of toxicities.

• 한방안이비인후피부과학회지
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• 제29권3호
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• pp.208-216
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• 2016

Objectives : The purpose of this study is to report the effectiveness of Soshiho-tang on the patients who suffered from atopic dermatitis with gastrointestinal disorders.Methods : We diagnosed the symptoms and the signs of the patients who suffered from atopic dermatitis with gastrointestinal disorders as Soshiho-tang syndrome(嘔而發熱) according to 'Treatise on Cold Damage Disease(傷寒論)'. Patients are treated only with Soshiho-tang. The severity of Atopic dermatitis was evaluated by SCORAD index, visual analogue scale(VAS) and pictures. Gastrointestinal disorders(mainly food allergy, indigestion) were evaluated by patients' subjective complaint.Results : After the treatment, not only the severity of atopic dermatitis but gastrointestinal disorders were also improved.Conclusions : Soshiho-tang has improved the symptoms of Atopic dermatitis with gastrointestinal disorders in this study.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• Journal of Gastric Cancer
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• 제23권4호
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• pp.609-621
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• 2023

Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.

• Parasites, Hosts and Diseases
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• 제55권4호
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• pp.391-398
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• 2017

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

• 대한한방내과학회지
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• 제40권4호
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• pp.629-636
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• 2019

Objective: This study was designed to assess the correlation between gastrointestinal symptoms, depression, and anxiety in patients with irritable bowel syndrome (IBS). Method: New patients who visited the ${\bigcirc}{\bigcirc}$ Oriental Hospital completed standardized questionnaires. These consisted of questionnaires for IBS based on Rome III criteria, the Gastrointestinal Symptom Rating Scale (GSRS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: A total of 103 patients participated. Among them, IBS was observed in 42 patients. There was a weak correlation between GSRS and BDI, but it was not statistically significant. There was a statistically significant weak correlation between GSRS and BAI. The main symptom factors affecting BAI were borborygmus, increased flatus, sucking sensations in the epigastrium, and abdominal distension. Conclusion: There was a statistically significant correlation between gastrointestinal symptoms and anxiety in patients with irritable bowel syndrome.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1779-1782
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• 2012

Background & Objectives: In patients with gastric cancer, the most frequently reported family history of cancer also involves the stomach. The aim of this study was to assess the presence of gastric precancerous lesions in first-degree relatives of patients with gastric cancer and to compare the obtained results with those of individuals with no such family history. Methods: Between 2007 and 2009, 503 consecutive persons more than 30 years old were enrolled in the study covering siblings, parents or children of patients with confirmed adenocarcinoma of stomach. The control group was made up of 592 patients who were synchronously undergoing upper gastrointestinal endoscopy for evaluation of dyspepsia without gastric cancer or any family history. All subjects were endoscopically examined. Results: The overall prevalence of Helicobacter pylori was 77.7% in the cancer relatives and in 75.7% in the control group. Chronic gastritis was found in 90.4% vs. 81.1% (P<0.001). Regarding histological findings, 37(7.4%) of the study group had atrophy vs. 12(1.7%) in the control group (P<0.001), while no difference was observed for intestinal metaplasia (20.3%vs. 21.6%, P=0.58). Dysplasia were shown in 4% of cancer relatives but only 0.4% of the control group (P<0.001). There was no gender specificity. Conclusions: Findings of our study point to great importance of screening in relatives of gastric cancer patients in Iran.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.817-823
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• 2010

Gastrointestinal and colonic endoscopic examinations have been performed in pediatric patients in Korea for 3 decades. Endoscopic procedures are complex and may be unsafe if special concerns are not considered. Many things have to be kept in mind before, during, and after the procedure. Gastrointestinal endoscopy is one of the most frequently performed procedure in children nowadays, Since the dimension size of the endoscopy was modified for pediatric patients 15 years ago, endoscopic procedures are almost performed routinely in pediatric gastrointestinal patients. The smaller size of the scope let the physicians approach the diagnostic and therapeutic endoscopic procedures. But this is an invasive procedure, so the procedure itself may provoke an emergence state. The procedure-related complications can more easily occur in pediatric patients. Sedation-related or procedure-related respiratory, cardiovascular complications are mostly important and critical in the care. The endoscopists are required to consider diverse aspects of the procedure - patient preparation, indications and contraindications, infection controls, sedation methods, sedative medicines and the side effects of each medicine, monitoring during and after the procedure, and complications related with the procedure and medicines - to perform the procedure successfully and safely. This article presents some important guidelines and recommendations for gastrointestinal endoscopy through literature review.

• 임상간호연구
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• 제29권1호
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• pp.85-94
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• 2023

Purpose: The purpose of this study was to investigate the influencing factors of post-traumatic growth in patients with gastrointestinal cancer. Methods: A cross-sectional study was conducted, enrolling 120 patients with gastrointestinal cancer. Their general characteristics, disease-related characteristics, perceived illness intrusiveness, levels of optimism, social support, and post-traumatic growth were assessed through self-administered questionnaires. The collected data were analyzed using descriptive statistics, independent t-test, oneway ANOVA, Pearson's correlation, and multiple regression analysis. Results: The mean score of post-traumatic growth was 52.74 points(total score of 92 points). Among the subscales of post-traumatic growth, levels of the preciousness of life were the highest, and relating with others was the lowest. The post-traumatic growth was found to be significantly correlated with optimism (r=.48, p<.001), social support (r=.47, p<.001), and depression (r=-.37 p<.001). Factors associated with post-traumatic growth were optimism (β=.36, p<.001), social support (β=.31, p<.001), and depression (β=-.27, p<.001). Conclusion: Given that prevalence of gastrointestinal cancer is increasing in Korea, identifying general, psychological, and social factors affecting post-traumatic growth among this population will be helpful in clinical practice. Integrated strategies to increase optimism and social support and lower depression should be considered to improve the post-traumatic growth of patients with gastrointestinal cancer.