• Journal of Gastric Cancer
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• v.20 no.3
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• pp.277-289
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• 2020

Purpose: To evaluate the feasibility and safety of intracorporeal overlapping gastrogastrostomy between the proximal anterior wall and antrum posterior wall (PAAP; PAAP anastomosis) of the stomach in minimally invasive pylorus-preserving gastrectomy (PPG) for early gastric cancer (EGC). Materials and Methods: From December 2016 to December 2019, 17 patients underwent minimally invasive PPG with PAAP anastomosis for EGC in the high body and posterior wall of the stomach. Intraoperative gastroscopy was performed with the rotation maneuver during proximal transection. A longer antral cuff (>4-5 cm) was created for PAAP than for conventional PPG (≤3 cm) at the point where a safe distal margin and good vascular perfusion were secured. Because the posterior wall of the proximal remnant stomach was insufficient for intracorporeal anastomosis, the anterior wall was used to create an overlapping anastomosis with the posterior wall of the remnant antrum. The surgical and oncological outcomes were analyzed, and the stomach volume was measured in patients who completed the 6-month follow-up. The results were compared to those after conventional PPG (n=11 each). Results: PAAP anastomosis was successfully performed in 17 patients. The proximal and distal resection margins were 2.4±1.9 cm and 4.0±2.6 cm, respectively. No postoperative complications were observed during the 1-year follow-up esophagogastroduodenoscopy (n=10). The postoperative remnant stomach (n=11) was significantly larger with PAAP than with conventional PPG (225.6±118.3 vs. 99.1±63.2 mL; P=0.001). The stomach length from the anastomosis to the pylorus was 4.9±2.4 cm after PAAP. Conclusions: PAAP anastomosis is a feasible alternative for intracorporeal anastomosis in minimally invasive PPG for highly posteriorly located EGC.

• The Korean Journal of Physiology and Pharmacology
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• v.3 no.2
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• pp.165-174
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• 1999

We explore the question of whether adenosine 5'-triphosphate (ATP) acts as an excitatory neurotransmitter in guinea-pig gastric smooth muscle. In an organ bath system, isometric force of the circular smooth muscle of guinea-pig gastric antrum was measured in the presence of atropine and guanethidine. Under electrical field stimulation (EFS) at high frequencies (＞20 Hz), NO-mediated relaxation during EFS was followed by a strong contraction after the cessation of EFS (a 'rebound-contraction'). Exogenous ATP mimicked the rebound-contraction. A known $P_{2Y}-purinoceptor$ antagonist, reactive blue 2 (RB-2), blocked the rebound-contraction while selective desensitization of $P_{2Y}-purinoceptor$ with ${\alpha},{\beta}-MeATP$ did not affect it. ATP and 2-MeSATP induced smooth muscle contraction, which was effectively blocked by RB-2 and suramin, a nonselective $P_2-purinoceptor$ antagonist. Particularly, in the presence of RB-2, exogenous ATP and 2-MeSATP inhibited spontaneous phasic contractions, suggesting the existence of different populations of purinoceptors. Both the rebound-contraction and the agonist-induced contraction were not inhibited by indomethacin. The rank orders of agonists' potency were 2-MeSATP > ATP ${ge}$ UTP for contraction and ${\alpha},{\beta}-MeATP\;{\ge}\;{\beta},{\gamma}-MeATP$ for inhibition of the phasic contraction, that accord with the commonly accepted rank order of the classical $P_{2Y}-purinoceptor$ subtypes. Electrical activities of smooth muscles were only slightly influenced by ATP and 2-MeSATP, whereas ${\alpha},{\beta}-MeATP$ attenuated slow waves with membrane hyperpolarization. From the above results, it is suggested that ATP acts as an excitatory neurotransmitter, which mediates the rebound-contraction via $P_{2Y}-purinoceptor$ in guinea-pig gastric antrum.

• Journal of Gastric Cancer
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• v.17 no.1
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• pp.88-92
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• 2017

Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.132-135
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• 2013

Gastric lipoma is a typical benign submucosal tumor that is usually asymptomatic and is generally detected incidentally when performing gastroscopy. However, depending on its size and location, an atypical gastrointestinal lipoma can cause abdominal pain, diarrhea, constipation, intestinal obstruction, intussuception and life-threatening gastrointestinal bleeding. We report herein a case of gastric lipoma with bleeding in a 43-year-old man. The gastroscopy showed a $4{\times}4$ cm ulcero-fungating submucosal mass at the anterior wall of the gastric antrum. Laparoscopic gastric wedge resection was performed and the lesion was diagnosed as gastric lipoma.

• Clinical Endoscopy
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• v.57 no.4
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• pp.486-494
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• 2024

Background/Aims: Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC. Methods: This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021. Only patients diagnosed with HPNGC were enrolled, and their clinicopathological and endoscopic features were analyzed in detail. Results: The prevalence of HPNGC in the present study was 2.6% (54/2,112). The types of HPNGC observed in each gastric region were as follows: advanced gastric cancer was observed in the cardia; gastric adenocarcinoma of fundic-gland differentiation, gastric adenocarcinoma of foveolar-type presenting with whitish elevation and raspberry-like foveolar-type gastric adenocarcinoma, gastric adenocarcinoma arising in polyposis, and gastric adenocarcinoma with autoimmune gastritis were observed in the fundic gland region ranging from the gastric fornix to the gastric body; signet-ring cell carcinoma was observed in the gastric-pyloric transition region ranging from the lower gastric body to the gastric angle; and well-differentiated tubular adenocarcinoma with low-grade atypia was observed in the antrum. Conclusions: This study revealed that tumors from each gastric region exhibited distinct macroscopic and histological types in HPNGC.

• Journal of Veterinary Clinics
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• v.11 no.1
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• pp.383-387
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• 1994

The purpose of this report is to describe the radiographic patterns of canine gastric dilatation-volvulus syndrome derived from a case. Radiographs showed the presence of a large amount of gas, fluid and ingesta within the stomach. The gas-filled pyloric antrum was present in the left cranial abdomen in the ventrodorsal view, and located dorsal and slightly cranial to the gas-filled fundus of the stomach in the right lateral recumbent and standing lateral view. On the right lateral recumbent view, the gas-filled stomach was compartmentalized by a soft-tissue dense band caused by the pyloric antral wall folding back and contacting the fundic wall. It was thought that the gastric volvulus in this case occurred In a clock. wise direction by radiographic findings.

• Korean Journal of Veterinary Research
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• v.40 no.4
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• pp.691-699
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• 2000

We investigated the effects of nitric oxide (NO) donors, S-nitroso-L-cysteine (Cys-NO) and 3-morpholinosydnonimine hydrochloride (SIN-1), on the contractile and electrical activity of the circular muscle of guinea pig gastric antrum by using intracellular microelectrode technique. The gastric antral circular muscle showed spontaneous phasic contraction and slow wave of membrane potential. Cys-NO ($0.001{\sim}10{\mu}M$) and SIN-1 ($0.001{\sim}100{\mu}M$) reduced not only the tonic and phasic contraction but also the amplitude of slow wave in a concentration dependent manner. NO donors were more potent to inhibit phasic contraction than to do slow wave. These inhibitory effects of NO donors were mimicked by the membrane permeable guanosine-3',5'-cyclic monophosphate (cGMP) analogue, 8-bromo-cyclic GMP (8-br-cGMP, $10{\sim}300{\mu}M$). The inhibitory effects of SIN-1 and Cys-NO were antagonized by the guanylate cyclase inhibitor, 1H[ [1,2,4]oxadiazolo[4,3,-a]quinoxalin-1-one (ODQ, $10{\mu}M$). These results suggest that the inhibitory effects of NO donors on the mechanical and electrical activity is mainly mediated by cGMP pathway.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.110-114
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• 2020

Gastric xanthoma is frequently an incidental finding on upper endoscopy in adults. Gastric xanthomas (GX) can be mistaken for malignancies and warrant prompt histologic diagnosis. The underlying etiology is not fully understood; however, it has been linked to Helicobacter pylori gastritis and gastric cancer. GX in the pediatric population is largely unreported in the literature. Because of the relative rarity, documentation with case reports are essential to provide as much data as possible to see if there is a correlation between GX and malignant potential in the pediatric population. Our group is reporting two cases, a 10-year-old male and a 7-year-old male, both who presented with chronic dysphagia, upper abdominal pain, nausea, vomiting, and loss of appetite. Upper endoscopies for both patients revealed small polypoid lesions located in the antrum with foamy histiocytes on histology, leading to the diagnosis of gastric xanthoma.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.356-359
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• 2012

An eight-year-old, spayed female Shih-tzu, weighing 3.2 kg with a history of chronic intermittent vomiting and unknown pain for four months was referred. In ultrasonography, a small round hypoechoic mass was identified in the gastric wall. Gastric endoscopy showed a solitary raised mass with smooth surface in the pyloric antrum. Surgical resection was performed. Histopathologic findings with immunohistochemical studies showed extramedullary plasmacytoma in the gastric submucosal and muscle wall layer. The patient recovered normally without any complications. The tumor has not been re-occurred after surgical removal, to date.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1407-1412
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• 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.