• Journal of Medicine and Life Science
• /
• 제16권1호
• /
• pp.27-30
• /
• 2019

We describe a case of a 48-year-old Korean woman who had a subepithelial mass incidentally discovered by endoscopic examination. Endoscopic mucosal resection revealed a well-circumscribed whitish solid mass within the submucosal space. Microscopically, the tumor was comprised of sparse spindle cells in the dense collagenous stroma with several calcifications and lymphoid aggregates. Immunohistochemical analysis showed that the tumor cells are negative for c-kit, smooth muscle actin, desmin, S-100 and CD34. Based on these findings, the tumor was diagnosed with calcifying fibrous tumor.

• 대한영상의학회지
• /
• 제83권3호
• /
• pp.608-619
• /
• 2022

목적 이 연구의 목적은 CT에서 확인된 소장의 작은 상피하종양의 임상 경과를 밝히는 것이다. 대상과 방법 2005년 1월부터 2020년 12월까지 전산화단층촬영에서 소장의 상피하종양이 의심되는 환자들을 분석했다. 최소 2개월 간격을 두고 시행한 2차례 이상 전산화단층촬영에서 30 mm 미만의 소장 상피하종양이 보인 환자를 연구에 포함시켰다. 저자들은 환자의 임상정보, 병변의 소견 및 추적 관찰 영상에서의 변화를 기록하였다. 결과 총 64명의 환자에서 64개의 소장 상피하종양이 분석에 포함되었다. 추적관찰 기간의 중앙값인 15.8개월 동안 병변의 길이 변화와 부피 변화는 각각 0.02 mm/월, 1.5 mm³/월이었다. 소장 상피하종양의 초기 병변의 크기와 크기 변화속도는 통계적으로 유의한 연관성을 보였다. 추가적으로 10 mm 이상의 그룹은 10 mm 미만의 그룹보다 lobulated contour, 불균질한 조영증강, 괴사를 보이는 경우가 더 많았다. 결론 10 mm 미만의 소장 상피하종양이 10 mm 이상 30 mm 미만의 종괴보다 천천히 자란다.

• Animal cells and systems
• /
• 제3권3호
• /
• pp.253-258
• /
• 1999

The present study describes histochemical properties of the mucosubstances in the pedal sole of abalone, in relation to two main additional functions known to date. Only neutral mucosubstances were demonstrated in the lateral epithelium of the pedal sole of the abalone, however, two distinct types of cells, one containing neutral and the other containing acidic mucosubstances, were identified in the ventral epithelium. The epithelial mucocytes distributed throughout both epithelial and subepithelial glands located in the ventral subepithelial region showed a mixture of neutral and acidic mucosubstances. However, acidic mucosubstances were found in larger amounts than neutral ones in epithelial mucocytes, and vice versa in subepithelial glands. Among these acidic mucosubstances, sulphated substances were dominant. Lesser amounts of carboxylated substances also occurred together with low levels of neuramic and sialic acid. Collectively, the notable morphological differences between abalone and other gastropoda were observed in the ventral surface of the foot, which showed a tall columnar epithelium, peripherally concentrated mucocytes, and subepithelial glands. Mucosubstances are presumably produced by these cells and may also play a role in clinging to some substances to support abalones in addition to the main functions of lubrication and protection.

• 대한소화기학회지
• /
• 제72권6호
• /
• pp.304-307
• /
• 2018

Gastric tuberculosis accounts for approximately 2% of all cases of gastrointestinal tuberculosis. Diagnosis of gastric tuberculosis is challenging because it can present with various clinical, endoscopic, and radiologic features. Tuberculosis manifesting as a gastric subepithelial tumor is exceedingly rare; only several dozen cases have been reported. A 30-year-old male visited emergency room of our hospital with hematemesis and melena. Abdominal CT revealed a 2.5 cm mass in the gastric antrum, and endoscopy revealed a subepithelial mass with a visible vessel at its center on gastric antrum. Primary gastric tuberculosis was diagnosed by surgical wedge resection. We report a rare case of gastric tuberculosis mimicking a subepithelial tumor with acute gastric ulcer bleeding.

• Journal of Digestive Cancer Research
• /
• 제10권1호
• /
• pp.16-21
• /
• 2022

Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.

• Journal of Gastric Cancer
• /
• 제24권1호
• /
• pp.122-134
• /
• 2024

Most gastric subepithelial tumors (SETs) are asymptomatic and are often incidentally discovered during endoscopic procedures conducted for unrelated reasons. Although surveillance is sufficient for the majority of gastric SETs, certain cases necessitate proactive management. Laparoscopic wedge resection, although a viable treatment option, has its limitations, particularly in cases where SETs (especially those with intraluminal growth) are not visualized on the peritoneal side. Recent advances in endoscopic instruments and technology have paved the way for the feasibility of endoscopic resection of SETs. Several promising endoscopic techniques have emerged for gastric SET resection, including submucosal tunneling endoscopic resection, endoscopic full-thickness resection (EFTR), laparoscopic and endoscopic cooperative surgery (LECS), and non-exposure EFTR (non-exposed endoscopic wall-inversion surgery and non-exposure simple suturing EFTR). This study aimed to discuss the indications, methods, and outcomes of endoscopic therapy for gastric SETs. In addition, a simplified diagram of the category of SETs according to the therapeutic indications and an algorithm for the endoscopic management of SET is suggested.

• Journal of Periodontal and Implant Science
• /
• 제32권3호
• /
• pp.555-584
• /
• 2002

Exposed root surfaces can cause esthetic problems, hypersensitivity, and root caries. Numerous efforts have been tried to cover the recessed root surfaces, and various techniques have been developed and introduced. Among these, subepithelial connective tissue graft which shows high coverage rate in various researches, has the advantage of good color match, less discomfort to the donor site, rich vascularity, and high predictability. Following results were obtained after investigating 6 and 18 months post operatively, 98 cases of subepithelial connective tissue graft from 48 patients who underwent subepithelial connective tissue graft procedure in the department of periodontology, college of dentistry, Yonsei university. 1. The total average root coverage of Miller class I, II & III were 76.2?24% at 6 months follow-up and 75?25.2% at 18 months follow-up with no statistically significant difference between the follow-up periods.(p<0.05) 2. The percentage of teeth showing complete coverage were 41.9% at 6 months follow-up and 39.2% at 18 months follow-up. 3. At 6 months follow-up, Miller classification I showed 84.9?20.7%, class II showed 82.5?17.7%, and class III showed 62.3?24.5% of coverage. In class III recession, statistically significantly less root coverage was observed compared to class I & II. (p(0.05) 4. At 18 months follow-up, Miller classification I showed 92.2?13.5%, class II showed 84.3?17.4%, and class III showed 59.5?24.5% of coverage. In class III recession, statistically significantly less root coverage was observed compared to class I & II. (p<0.05) In conclusion, subepithelial connective tissue graft for class I and II recession can be used as a clinically predictable treatment modality for root coverage.

• Journal of Periodontal and Implant Science
• /
• 제37권3호
• /
• pp.625-636
• /
• 2007

Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.

• 구강회복응용과학지
• /
• 제32권4호
• /
• pp.330-337
• /
• 2016

치은퇴축의 원인 중 하나인 의원성 치은퇴축은 교정치료 또는 근관치료에 의하여 발생할 수 있다. 이는 기능적, 심미적 문제뿐만 아니라 치료에 대한 만족도도 낮출 수 있다. 이를 위한 치료 방법으로 다양한 술식이 존재하나, 상피하결합조직 이식을 동반한 측방변위판막술은 각화치은량의 증대, 치유된 치은의 수여부 연조직과의 조화로운 형태 및 색을 얻을 수 있는 장점이 있다. 술 전 임상적 및 방사선학적 검사를 통한 예지성 있는 적절한 증례 선택을 필요로 하며 술식에 있어 적합한 양의 상피하결합조직 획득과 판막의 피개량을 고려해야 한다. 본 증례보고의 두 가지 다른 원인의 의원성 치은퇴축의 치료 결과를 살펴보았을 때, 상피하결합조직 이식을 동반한 측방변위판막술은 의원성 치은퇴축의 치료법으로 우수한 결과를 나타내었으며, 1년 이상의 추적관찰시 높은 예지성을 보였다.

• Journal of Periodontal and Implant Science
• /
• 제48권6호
• /
• pp.395-404
• /
• 2018

Purpose: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. Methods: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1-3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1-3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. Results: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1-3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. Conclusions: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.