• Journal of Gastric Cancer
• /
• v.16 no.4
• /
• pp.266-270
• /
• 2016

We report a unique case of synchronous double primary gastric cancer consisting of adenocarcinoma components with micropapillary features and composite glandular-endocrine cell carcinoma components. The patient was a 53-year-old man presenting with a 6-month history of epigastric pain and diarrhea. A subtotal gastrectomy was performed. Histologically, one tumor was composed of micropapillary carcinoma components (50%) with tight clusters of micropapillary aggregates lying in the empty spaces, admixed with moderately differentiated adenocarcinoma components. MUC-1 was expressed at the stromal edge of the micropapillary component. The other tumor was composed of atypical carcinoid-like neuroendocrine carcinoma (50%), adenocarcinoid (30%), and adenocarcinoma components (20%). The neuroendocrine components were positive for CD56, synaptophysin, chromogranin, and creatine kinase. The adenocarcinoid components were positive for both carcinoembryonic antigen and neuroendocrine markers (amphicrine differentiation). This case is unique, due to the peculiar histologic micropapillary pattern and the histologic spectrum of adenocarcinoma adenocarcinoid-neuroendocrine carcinoma of the synchronous composite tumor.

• Journal of Gastric Cancer
• /
• v.18 no.1
• /
• pp.99-107
• /
• 2018

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40-50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.

• Journal of Gastric Cancer
• /
• v.7 no.1
• /
• pp.16-22
• /
• 2007

Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.

• Journal of Gastric Cancer
• /
• v.5 no.4 s.20
• /
• pp.238-245
• /
• 2005

Purpose: Ghrelin, produced primarily in the gastrointestinal tract, including the stomach, has been reported to reflect nutritional status and to control homeostasis by influencing food intake and adiposity. The purpose of this study is to evaluate nutritional status, as well as plasma and gastric tissue ghrelin levels, in patients with gastric cancer who underwent a gastrectomy. Materials and Methods: Eighty patients were analyzed by the degree of weight loss $(weight\;loss{\geq}5%\;or\;<5%)$ and the extent of gastrectomy (subtotal or total gastrectomy). Blood samples were collected from all patients preoperatively and postoperatively especially at seven days. Gastric tissues, including tumor and normal tissues, were obtained from the resected stomach. levels of plasma and tissue ghrelin were measured with a commercial ELISA kit. Results: There were no significant differences in the clinical characteristics and ghrelin levels of plasma, gastric tumor tissue and normal tissue by the degree of weight loss. The ghrelin levels in plasma and tumor tissue showed no correlations with each other while the ghrelin level in tumor tissue was significantly lower than that in normal tissue. The degree of cellular differentiation also had an association with ghrelin production. A gastrectomy proved to decrease significantly plasma ghrelin levels, body mass index, and biochemical markers, regardless of the extent of gastric resection. Conclusion: These results show that gastric cancer affects the production of ghrelin in the gastric mucosa and that ghrelin is mainly produced in stomach even though it could be partially covered by endogenous ghrelin from other organs following a gastrectomy. However, we should further investigate which other factors have an impact on energy consumption, ghrelin secretion, and changes in ghrelin levels after a gastrectomy.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.1 no.1
• /
• pp.19-35
• /
• 1994

To test the effectiveness of the preparatory audiovisual information with videotape, 34 patients with gastric cancer and who have scheduled for subtotal gastrectomy were studied with quasiexperimental research design. The subjects were selected from the 4 general surgical wards of one university hospital in Seoul, and assigned to experimental and control group conveniently. The videotaped information on the preparation and recovery for surgery was showed to the experimental subjects once before having operation. Data on the sleep and the state anxiety level before and after treatment day was collected with VSH sleep scale and STAI. The data was analyzed with t-test to test the effect of preparatory information and the Pearson's correlation to identify the correlation between anxiety and sleep. The results were summerized as follows : 1. After receiving the preparatory information, the level of anxiety of the experimental group was the same level as the initial, whereas that of the control group showed markedly increase. However no significant difference in anxiety between the two groups was found. 2. There was significant difference in sleep score between the experimental and the control group. 3. There was significant negative correlation between the state anxiety score and the sleep score. Based upon the above findings, this study concludes that preparatory information is effective to enhance sleep just prior to the surgery.

• Journal of Gastric Cancer
• /
• v.13 no.1
• /
• pp.65-68
• /
• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

• Journal of Gastric Cancer
• /
• v.13 no.1
• /
• pp.69-72
• /
• 2013

Carcinosarcoma is a rare malignant, biphasic tumor comprised of carcinoma and sarcoma components. In the gastrointestinal tract, carcinosarcoma is most frequently seen in the esophagus and rarely in the stomach. We report a 51-year-old female patient with 2-month-history of epigastric pain and dyspepsia. Endoscopic finding revealed a huge ulcerative lesion that infiltrated from the antrum to the mid-body. An endoscopically taken biopsy revealed poorly differentiated malignant round cell neoplasm. After the palliative subtotal gastrectomy, immunohistochemical studies showed two positive reactions for the epithelial marker and mesenchymal marker. Based on the above findings, the patient was diagnosed with gastric carcinosarcoma. The immunohistochemical analysis is a critical method in making an accurate diagnosis of carcinosarcoma.

• The Korean Nurse
• /
• v.12 no.5 s.67
• /
• pp.83-92
• /
• 1973

1972년 1월부터 1972년 12월말까지 충남대학교 의과대학 부속병원에서 위 수술을 받은 환자 66명을 대상으로 여러 가지 통계 결과 1. 성별 분포에선 남자가 51명 여자가 15명으로 약 3.4:1의 비율을 나타냈다. 2. 연령별 분포에선 $69.7\%$가 40세 이상에서 나타났다. 3. Chief complain은 Indigestion이었다. 4. 증상의 평균 연한은 1년 전후의 Chronic symptom을 경험했다. 5. Vital sign의 변화는 대부분이 별로 나타나지 않았다. 6. 수술 전 수혈은 1000cc 이내로 환자의 $78\%$에 필요했었다. 7. 수술 전의 Hb은 정상보다 낮은 율은 $45.4\%$였고 정상은 $54.6\%$였다. 8. 수술 전의 W.B.C는 정상보다 낮은 율은 $10.6\%$, 정상이 $42.4\%$, 정상보다 높은 율이 $47\%$였다. 9. 수술 전의 Ht치는 정상보다 낮은 율은 $60.6\%$, 정상은 $36.4\%$ 정상보다 높은 율은 $3\%$였다. 10. 수술 전 위액검사 결과는 Cancer인 경우는 Free acid와 Total acid가 모두 거의 정상보다 낮았고 Ulcer인 경우 대부분 높았다. 11. Liver function test에서는 표에서 나타난 대로 많은 변화는 없었다. 12. 병소 부위는 Cancer의 경우 $51.8\%$에서 Pylorus부위에 왔었고 Ulcer의 경우 $62.4\%$에서 Lesser curvature (ciratricial region포함)에 왔었다. 13. 수술방법은 $77.7\%$가 Subtotal gastrectomy였었다. 14. 위 수술을 위한 입원 일자는 $60\%$ 이상에서 $11\~15$일간의 평균을 보였었다.

• Journal of Gastric Cancer
• /
• v.16 no.3
• /
• pp.195-199
• /
• 2016

Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the stomach wall, with a high mortality rate. Antibiotics with or without surgical treatment are required for treatment. We present a case in which phlegmonous gastritis occurred during the diagnostic evaluation of early gastric cancer. The patient showed improvement after antibiotic treatment, but attempted endoscopic submucosal dissection failed because of submucosal pus. We immediately applied argon plasma coagulation since surgical resection was also considered a high-risk procedure because of the submucosal pus and multiple comorbidities. However, there was local recurrence two years later, and the patient underwent subtotal gastrectomy with lymph node dissection. Considering the risk of incomplete treatment immediately after recovery from phlegmonous gastritis and that recurrent disease can be more difficult to manage, delaying treatment and evaluation until after complete recovery of PG might be a better option in this particular clinical situation.

• Proceedings of the Ginseng society Conference
• /
• 1993.09a
• /
• pp.61-65
• /
• 1993

To find out the mechanisms of anticancer effect of ginseng, we performed prospective randomized study for the 39 patients with stomach cancer who had undergone radical subtotal or total gastrectomy and postoperative immunochemotherapy with PMF from July 1991 to November 1991 at Department of Surgery, Seoul National University Hospital. The patients were randomly divided into study and control group: the study group was administered with powdered red ginseng of 5400mg daily dose for 12 months postoperatively, the control group was simply followed-up. There were no significant differences between study and control group in twelve months postoperative body weights, triceps skin fold, hemoglobin. albumin, total protein, PNI, total WEC and lymphocyte count, and T-cell percentage (p>0.05). The results of preoperative DNCB skin test of study group was (0) for 8 patients and (+) for 12 patiens. but after operation, it showed the tendency of decreasing (0) and (+) ratio and increasing tendency of (++) ratio (p<0.05), but those of control group showed no increasing tendency of the degree of positive DNCB skin test. From the above results, we could conclude that ginseng had anti - cancer effect by the way of immune mechanism and could be an adjunct to the patients with stomach cancer postoperatively.