• 대한세포병리학회지
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• 제19권2호
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• pp.178-182
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• 2008

We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1 cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.

• 동의생리병리학회지
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• 제19권2호
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• pp.429-433
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• 2005

We investigated the effects of aqueous extract from talc for suppression in the process of cyclophosphamide-induced cystitis in the rat. The weight of urinary bladder was increased in the cyclophosphamide-injected rat compared with normal, but the increase of weight was arrested by intake of talc. More similar results showed in the uric test involving nitrate content and blood cell number and serum analysis involving the content of blood urea nitrogen and uric acid in the talc challenged rat compared with control one. More severe histological changes of urinary bladder such as edema, wall thickness, bleeding, vacuolation in mucosal epithelium were demonstrated in the rat injected with cyclophosphamide compared with normal. Fewer scores of these changes such as edema and bleeding were observed in rats treated with talc. In the immunohistochemical analysis, the expression of inflammatory-related protein examined tended to increase in the urinary bladder of cyclophosphamide-injected rat, especially COX-2 and $TNF-{\alpha}$ in mucosal epithelium and iNOS and $IL-1{\beta}$ in mucosal and muscular layer. The decline of these immunoreation were observed in the talc treated rat, significant decrease of COX-2 was detected in mucosal epithelium and iNOS in submucosal layer. These results suggest that talc may use as a useful therapeutic agent for noninfectious cystitis.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.189-193
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• 2018

Background: This study aimed to reveal the clinicopathologic features and causes of bleeding in older patients with postmenopausal bleeding (PMB) and to investigate the correlation between the ultrasonographic findings and etiology of PMB. Methods: We retrospectively analyzed the causes and clinical characteristics of PMB in 498 patients who were diagnosed between January 2007 and December 2017. The population with PMB was divided into 2 groups according to age: Group A (n=204) included individuals more than 65 years of age and group B (n=294) included those less than 65 years of age. Clinical characteristics such as age, parity, underlying conditions, previous surgical history, and previous menopausal hormone therapy were compared between the groups. Cervical cytology testing and transvaginal ultrasonography were performed in all patients with PMB. Endometrial biopsy was performed in all cases of endometrial thickness ${\geq}5mm$. Results: We examined 498 patients with PMB. In group A, atrophic endometrium (n=125, 61.27%) was the most common cause of PMB. Twenty-three patients had gynecological malignancy (cervical cancer: n=12, 5.88%; endometrial cancer: n=8, 3.42%; ovarian cancer: n=3, 1.46%), and 30 patients had benign gynecological disease (endometrial polyp: n=10, 4.90%; submucosal myoma: n=6, 2.94%; uterine prolapse: n=7, 3.42%; cervical dysplasia; n=5, 2.45%; cervical polyp: n=2, 0.98%). Forty patients had endometrial thickness ${\geq}5mm$. Eight patients were diagnosed with endometrial cancer. All cases of endometrial cancer were diagnosed with endometrial thickness >10 mm. Conclusion: Atrophic endometrium was the most common cause of PMB in both groups, and approximately 12% of cases were associated with gynecological malignancy in older patients.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.409-416
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• 2018

A 55-year-old man visited our hospital for a detailed examination of a gastric submucosal tumor that was first detected 10 years prior. The tumor continued to grow and had developed a depressed area in its center. A histopathological examination of biopsy specimens revealed gastric adenocarcinoma of the fundic gland type (GA-FG). It was diagnosed as T2 based on the invasion depth as determined by white-light endoscopy and endoscopic ultrasonography. A total gastrectomy with lymphadenectomy was performed and a GA-FG in the mucosa and submucosa was confirmed histopathologically. However, there was a gradual transition to an infiltrative tubular adenocarcinoma with poorly differentiated components in the muscular and subserosal layers. Metastasis was identified in a dissected lymph node (LN). This is the first report of a GA-FG progressing to an aggressive cancer with LN metastasis. These findings modify our understanding of the pathophysiology of GA-FG.

• 대한수의학회지
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• 제59권3호
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• pp.141-149
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• 2019

From 1996 to 2014, 14 foals from nine farms in Jeju were diagnosed with a Rhodococcus equi infection. Clinically, most foals showed characteristic respiratory signs, including hyperthermia and dyspnea. The seasonal occurrence of R. equi infection in foals was higher in summer, such as June (eight foals; 57.1%) and July (four foals; 28.6%), than in the other seasons. The major cases of R. equi infections were observed among two-month-old (eight foals; 57.1%) and three-month-old (three foals; 21.4%) foals. Histopathologically, bronchopneumonia, abscess, and granulomatous pneumonia were the most prevalent lesions in the lungs of foals. Colonic ulcers and submucosal abscesses were found in a foal. Some foals showed granulomatous lymphadenitis and abscesses in the mesenteric and other lymph nodes. According to the polymerase chain reaction using 10 tissue samples of foals and nine R. equi isolates, the vapA gene was detected in 11/11 (100%) foals. Immunohistochemical staining using the anti-VapA monoclonal antibody was applied to detect the R. equi VapA antigen in the organs of foals. R. equi VapA antigens were demonstrated in most lungs and some mesenteric and hilar lymph nodes of 13 foals. Isolated virulent R. equi VapA bacteria showed high sensitivity to gentamicin, quinolones, rifampin, and vancomycin.

• 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.

• 대한의용생체공학회:의공학회지
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• 제44권1호
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• pp.85-91
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• 2023

Stress urinary incontinence (SUI) occurs when abdominal pressure increases, such as sneezing, exercising, and laughing. Surgical and non-surgical treatments are the common methods of SUI treatment; however, the conventional treatments still require continuous and invasive treatment. Laser have been used to treat SUI, but excessive temperature increase often causes thermal burn on urethra tissue. Therefore, the optimal conditions must be considered to minimize the thermal damage for the laser treatment. The current study investigated the feasibility of the laser irradiation condition for SUI treatment using non-ablative 980 nm laser from a safety perspective through numerical simulations. COMSOL Multiphysics was used to analyze the numerical simulation model. The Pennes bioheat equation with the Beer's law was used to confirm spatio-temporal temperature distributions, and Arrhenius equation defined the thermal damage caused by the laser-induced heat. Ex vivo porcine urethral tissue was tested to validate the extent of both temperature distribution and thermal damage. The temperature distribution was symmetrical and uniformly observed in the urethra tissue. A muscle layer had a higher temperature (28.3 ℃) than mucosal (23.4 ℃) and submucosal layers (25.5 ℃). MT staining revealed no heat-induced collagen and muscle damage. Both control and treated groups showed the equivalent thickness and area of the urethral mucosal layer. Therefore, the proposed numerical simulation can predict the appropriate irradiation condition (20 W for 15 s) for the SUI treatment with minimal temperature-induced tissue.

• Clinical Endoscopy
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• 제56권1호
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• pp.38-49
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• 2023

Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I²=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I²=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I²=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

• Clinical Endoscopy
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• 제56권5호
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• pp.623-632
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• 2023

Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. Conclusions: NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

• BMB Reports
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• 제57권3호
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• pp.149-154
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• 2024

The stomach has emerged as a crucial endocrine organ in the regulation of feeding since the discovery of ghrelin. Gut-derived hormones, such as ghrelin and cholecystokinin, can act through the vagus nerve. We previously reported the satiety effect of hypothalamic clusterin, but the impact of peripheral clusterin remains unknown. In this study, we administered clusterin intraperitoneally to mice and observed its ability to suppress fasting-driven food intake. Interestingly, we found its synergism with cholecystokinin and antagonism with ghrelin. These effects were accompanied by increased c-fos immunoreactivity in nucleus tractus solitarius, area postrema, and hypothalamic paraventricular nucleus. Notably, truncal vagotomy abolished this response. The stomach expressed clusterin at high levels among the organs, and gastric clusterin was detected in specific enteroendocrine cells and the submucosal plexus. Gastric clusterin expression decreased after fasting but recovered after 2 hours of refeeding. Furthermore, we confirmed that stomachspecific overexpression of clusterin reduced food intake after overnight fasting. These results suggest that gastric clusterin may function as a gut-derived peptide involved in the regulation of feeding through the gut-brain axis.