• Journal of Gastric Cancer
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• v.10 no.4
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• pp.175-181
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• 2010

Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.108-112
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• 2015

A 54-year-old male patient who was diagnosed with advanced gastric cancer underwent a distal gastrectomy, D2 lymph node dissection, and adjuvant chemoradiotherapy. After a year, in a follow-up PET-CT, lymph node metastases were observed in the neck and abdomen, and therefore, the patient underwent chemotherapy. After treatment, the follow-up PET-CT revealed a growth of the posterior neck lymph node. Thus, an excisional biopsy was performed, and the growth was diagnosed as metastatic adenocarcinoma. Therefore, the patient received chemotherapy with FOLFIRI. Another follow-up PET-CT after chemotherapy revealed a growth in the right inguinal lymph node, and the patient underwent salvage radiotherapy for this lesion. The PET-CT taken for the response evaluation showed no evidence of further metastasis of the lymph node. We hereby report a case of advanced gastric cancer with neck and inguinal lymph node recurrence showing complete remission after palliative chemotherapy and salvage radiotherapy.

• Clinical Endoscopy
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• v.55 no.1
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• pp.86-94
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• 2022

Background/Aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site. Methods: We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at the anastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and nonBillroth II groups. Results: The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm; p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation time was longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth II group. Conclusions: Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with a background of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involved longer operative times and more frequent bleeding episodes than that in patients without Billroth II.

• Journal of Gastric Cancer
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• v.2 no.2
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• pp.73-80
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• 2002

In spite the fact that H. pylori infection might be the causative organisms of acute and chronic gastritis, peptic ulcer diseases and the definition as the class I carcinogen by WHO IARC, still debates exist about the relationship between H. pylori and gastric carcinogenesis. Epidemiological and animal studies demonstrated a link between gastric cancer and chronic infection with H, pylori, but the exact mechanism responsible for the development of gastric cancer in H. pylori-infected patients still remain obscure. In order to declare the clear association, definate evidences like that decrement in the incidence of gastric cancer after the eradication of H. pylori in designated area compared to noneradicated region or the blockade of specific mechanism acting on the carcinogenesis by H. pylori infection. The other way is to identify the upregulating oncogenes or downregulating tumor suppressor genes specifically invovled in H. pylori-associated carcinogenesis. For that, we established the animal models using C57BL/6 mice strain. Already gastric carcinogenesis was developed in Mongolian gerbils infected with H. pylori, but there has been no development of gastric cancer in mice model infected with H. pylori after long-term evaluation. Significant changes such as atrophic gastritis were observed in mice model. However, we could observe the development of mucosal carcinoma in the stomach of transgenic mice featuring the loss of TGF-beta sig naling by the expressions of dominant negative forms of type II receptor specifically in the stomach. Moreover, the incidence of gastric adenocarcinoma was significantly increased in group administered with both MNU and H. pylori infection than MNU alone, signifying that H. pylori promoted the gastric carcinogenesis and there might be host susceptibility genes in H. pylori-associated gastric carcinogenesis. Based on the assumption that chronic, uncontrolled inflammation might predispose to carcinogenesis, there have been several evidences showing chronic atrophic gastritis predisposed to gastric carcinogenesis in H. pylori infection. Although definite outcome of chemoprevention was not drawn after the longterm administration of anti-inflammatory drug in H. pylori infection, the actual incidence of atrophic gastritis and molecular evidence of chemoprevention could be obtained. Selective COX-2 inhibitor was effective in decreasing the development of gastric carcinogenesis provoked by H. pylori infection and carcinogen like in chemoprevention of colon carcinogenesis.

• Journal of Oral Medicine and Pain
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• v.35 no.4
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• pp.237-243
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• 2010

Acanthosis nigricans usually has the characteristics that involve the development of darker pigmented patches and thickened skin with velvety texture on the body folds, and papillomatosis on lip and intraoral regions including tongue, gingiva, mucosa, palate. Malignant acanthosis nigricans, a type of acanthosis nigricans, occurs most commonly in association with underlying malignancy and characterically appears with three characteristic mucocutaneous lesion : especially of the lips and eyelids, hyperkeratosis of the palms and soles, the sign of Leser-Trelat. In the present report, the patient had typical clinical and histological findings of oral acanthosis nigricans, as well as past medical history associated with malignant gastric adenocarcinoma.

• Archives of Pharmacal Research
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• v.26 no.11
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• pp.906-911
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• 2003

We previously reported that the butanol (BuOH) fraction of the head of Panax ginseng exhibited gastroprotective activity in peptic and chronic ulcer models. In order to identify the active constituent, an activity-guided isolation of the BuOH faction was conducted with a HCI$.$ethanol-induced gastric lesion model. The BuOH fraction was passed through a silica-gel column using a chloroform-methanol gradient solvent system, and six fractions (frs. 1-6) were obtained. The active fr. 5 was further separated by silica-gel column, to yield 6 subfractions (subfrs. a-f). Subfr. d was composed of ginsenosides Re, Rc and $Rb_1$. The most active constituent was ginsenoside $Rb_1$ ($GRb_1$), a protopanaxadiol glycoside, which was investigated for its anti-ulcer effect. Gastric injury induced by HCI$.$ethanol, indomethacin and pyloric ligation (Shay ulcer) was apparently reduced with oral $GRb_1$ doses of 150 and 300 mg/kg. $GRb_1$ at these dosage significantly increased the amount of mucus secretion in an ethanol-induced model. The anti-ulcer effects were consistent with the result of histological examination. These results suggest that the major active constituent in the head of Panax ginseng is $GRb_1$ and that anti-ulcer effect is produced through an increase in mucus secretion.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.192-196
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• 2003

Angiodysplasia is the most common vascular abnormality of the gastrointestinal tract and probably the most frequent cause of recurrent lower intestinal bleeding in otherwise healthy elderly patients. Also, it is an important cause of hemorrhage in chronic renal failure observed in up to 19~32% of patients. Bleeding due to gastric angiodysplasia is treated by various endoscopic approaches, including argon and Nd : YAG laser photocoagulation, monopolar or bipolar electrocoagulation, heater probe, injection sclerotherapy, band ligation or hemoclipping. A 15-year-old boy, who had undergone hemodialysis for chronic renal failure for about 10 years, was admitted due to melena and progressive anemia. A gastroduodenoscopy revealed a cherry red and fern-like lesion with oozing on the posterior wall at junction of gastric body and fundus. Endoscopic hemoclipping therapy was performed. However, melena recurred four days later. Argon plasma coagulation and hemoclipping therapy were performed again. Since then, no recurrence of bleeding has been observed.

• YAKHAK HOEJI
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• v.45 no.3
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• pp.258-268
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• 2001

Garlic has been known to be effective against the gastrointestinal diseases which can be induced by production of oxygen-derived free radical. It has been shown that bamboo salt is effective on the treatment and prevention of various gastrointestinal disorders. Bamboo salt is a processed salt invented by a Korean, ll-Hoon Kim. It has been reported that garlic and bamboo-salt are useful to the treatment of gastric disorders in Korea. To clarify the protective mechanism of the garlic-bamboo salt mixture, the gas-tropathy was induced in rats with alcohol-salicylate and the activities of the free radical scavenging enzymes were examined. In this study, we found that the garlic-bamboo salt mixture reduced the severity of hemorrhagic lesion in gastric mucosa in the rats. In addition, the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) were significnatly increased and the total content of GSH was recovered. From those results, we concluded that the protective effect of the garlic-bamboo salt mixture on gastropathy in rats is its ability to recover the level of GSH and to increase the activities of the free radical scavenging enzymes (SOD, GPx, GR).

• The Korea Journal of Herbology
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• v.24 no.1
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• pp.41-47
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• 2009

Objectives : The objective of this study was to examine the effects of P. oleracea into the HCl-ethanol induced gastritis in rats, and to isolate and determine the chemical compounds from P. oleracea. Methods : The rats were orally administered with crude extract or fractions or isolated compounds of P. oleracea 30 mins before the induction of gastric lesion by oral administration of HCl-ethanol. The gastric lesional area was measured using pixel counting software. Then the chemical compounds from P. oleracea was isolated and determined by LC-MS and NMR. Results : The inhibition effect of oral administration of crude extract of P. oleracea at a dose of 500 mg/kg in HCl-ethanol induced gastritis was similar to cimetidine. Then, aqueous fraction at a dose of 240 mg/kg exhibited the effects similar to cimetidine. Then, the aqueous fraction was further separated by MPLC and yielded four sub fractions. Among those sub fractions, agent II at a dose of 40 mg/kg possessed the strongest effect in the HCl-ethanol induced gastritis. The water fraction yielded-Uridine, Adenosine, Guanosine, which were characterized by Mass, 1H-NMR, 13C-NMR. Conclusions : This study suggest that a P. oleracea and its compounds showed potent efficacy on the development of HCl-ethanol induced gastritis. Thus, P. olaracea can be a potential natural resource for the management of gastritis although the mechanism of action involved in the treatment remains to be explored.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.45-51
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• 2015

Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention and treatment. Materials and Methods: Patients with different stages of esophageal/gastric cardia lesions completed two QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1, 6 and 12 months after treatment. Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer, and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancer reported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores before treatment and at 1 month after treatment were $71{\pm}9$ versus $69{\pm}9$ (p>0.01), $71{\pm}8$ versus $61{\pm}11$ (p<0.01), $67{\pm}11$ versus $62{\pm}9$ (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recovered gradually in precursor lesion and early cancer patients, while some continuously deteriorated in advanced cancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions (p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior to corresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patients with early stage cancer, those with advanced cancer showed worse QoL with all function and most symptom measures (p<0.01). Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancer show better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatment may improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling should be given by health care providers during treatment and follow-up to facilitate QoL improvement.