• Journal of Gastric Cancer
• /
• v.14 no.4
• /
• pp.279-283
• /
• 2014

We report a case of primary gastric malignant melanoma that was diagnosed after curative resection but initially misdiagnosed as adenocarcinoma. A 68-year-old woman was referred to our department for surgery for gastric adenocarcinoma presenting as a polypoid lesion with central ulceration located in the upper body of the stomach. The preoperative diagnosis was confirmed by endoscopic biopsy. We performed laparoscopic total gastrectomy, and the final pathologic evaluation led to the diagnosis of primary gastric malignant melanoma without a primary lesion detected in the body. To the best of our knowledge, primary gastric malignant melanoma is extremely rare, and this is the first case reported in our country. According to the literature, it has aggressive biologic activity compared with adenocarcinoma, and curative resection is the only promising treatment strategy. In our case, the patient received an early diagnosis and underwent curative gastrectomy with radical lymphadenectomy, and no recurrence was noted for about two years.

• Biomolecules & Therapeutics
• /
• v.14 no.3
• /
• pp.171-177
• /
• 2006

Gastritis and gastric ulcer were known to be induced by gastic acid, stress, ethanol, Helicobacter pylori and free radical, etc. This study was performed for the development of a new drug or nutraceutical from medicinal plants or natural products with anti-gastritis, anti-ulcerative and gastroprotective activities. The water extract of Scutellaria baicalensis was exhibited potent inhibition in HCl ethanol-induced gastric lesion, acetic acid-induced and Shay ulcers, indicating the effects on gastric lesion and ulcer in rats. The water extract of Scutellaria baicalensis significantly inhibited HCl ethanol-induced gastric lesions at the oral dose of 300, 500 mg/kg. In pylorus ligated rats, the treatments of the water extract from Scutellaria baicalensis showed decrease in the volume of gastric secretion and acid output and increase pH at oral dose of 300, 500 mg/kg. And significantly reduced acetic acid-induced ulcer at the oral dose of 500 mg/kg for 12 days. In this study, we have found that the water extract from Scutellaria baicalensis had significant improvement in acute gastritis and ulcer at the dose of 300, 500 mg/kg and in chronic gastritis and ulcer at the dose of 500 mg/kg. Also we evaluated the antibacterial activity against Helicobacter pylori treated with Scutellaria baicalensis. Scutellaria baicalensis had a equivalent antibacterial activity with ampicilin against H. pylori at the dose of $100\;{\mu}/ml$. In histological examination, the water extract of Scutellaria baicalensis drastically restored gastric damages induced by HCl ethanol solution, pylorus- ligature and acetic acid. Therefore, we may use the water extract from Scutellaria baicalensis as antigastritic and antiulcerative agent for the purpose of the improvement or treatment of gastritis and gastric ulcer.

• Journal of Gastric Cancer
• /
• v.23 no.3
• /
• pp.375-387
• /
• 2023

Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions. Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.6 no.2
• /
• pp.187-191
• /
• 2003

The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

• Journal of Gastric Cancer
• /
• v.1 no.1
• /
• pp.24-31
• /
• 2001

Purpose: Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation. Materials and Methods: Seven hundred fifteen gastric cancer patients who were operated on at our hospital from 1992 to 1998 were included in this analysis. Various clinicopathological factors, including resection-line involvement, were ascertained from the surgical and histopathological records. Results: Of the 715 evaluable patients, 27 patients ($3.8\%$) had involvement of one or both resection lines; in 10 patients the proximal resection line only, in 16 the distal resection line only, and 1 both resection lines were involved. Presence of resection-line involvement was significantly associated with T3 and T4 stage, N (+) stage, M (+) stage, type of operation (total gastrectomy), tumor location (entire stomach), size$\geq$11 cm), and gross type of tumor (Borrmann 4 type). When performing a distal subtotal gastrectomy, no involvement was found when the cranial and caudal distances between the lesion and the line of transection was equal to or greater than 2 cm and 3 cm, respectively, for early cancer and 7 cm and 3 cm, respectively, for advanced cancer. When performing a total gastrectomy for upper 1/3 or middle 1/3 gastric cancer, no involvement was found when the cranial distances between the lesion and the line of transection were equal to or greater than 3 cm and 4 cm, respectively, without distinction of the presence of serosal invasion. Conclusions: The difference in survival between positive and negative margin patients is limited to the group of patients with curative surgery. An important principle of treatment is that the entire tumor must be removed with a 3 cm distal margin and a 2- to 7 cm margin depending on the location and the depth of wall invasion of the tumor, to provide histologically negative margins.

• The Journal of Internal Korean Medicine
• /
• v.35 no.2
• /
• pp.208-221
• /
• 2014

Purpose : Banhasasim-tang (BHSST) has been applied for treating the symptom of gastric stuffiness, which is similar to dyspepsia. The object of this study was to observe the healing effect of BHSST on the indomethacin (IND)-induced gastric ulcer in rats. Methods : Three different dosages of BHSST (400, 200 and 100 mg/kg) were orally administered 30 min before IND treatment; 6 hrs after IND treatment, the changes on the gross lesion scores, fundic histopathology, myeloperoxidase (MPO) activity, lipid peroxidation and antioxidant defense system (glutathione contents, catalase (CAT) and superoxide dismutase (SOD) activities) were observed, and compared with the activity of the synthetic anti-ulcer drug, a representative proton pump inhibitor omeprazole (OME) 10 mg/kg. Results : All three different dosages of BHSST treatment in the IND-induced gastric ulcer rats, significant and dose dependent decreased gastric damages - hemorrhagic gross lesions, gastric mucosa MPO levels and histopathological gastric ulcerative lesions - were detected as compared with the IND treated control rats. BHSST also strengthened the antioxidant defense systems - decreased the level of lipid peroxidation and CAT activity but increased the level of GSH and SOD activity, and BHSST 200 mg/kg showed similar anti-ulcerative effect as compared with OME 10 mg/kg. Conclusions : The results obtained in this study suggest that BHSST has favorable effects against IND-induced gastric damages, through significant and dose-dependent decreasing gastric damages and the strengthening of the body's antioxidant defense systems with direct anti-inflammatory effects.

• Journal of Food Hygiene and Safety
• /
• v.31 no.4
• /
• pp.286-293
• /
• 2016

This study is an experiment for gastric protective effects of ursolic acid. In order to identify the effects of ursolic acid on gastrointestinal disorder, acute and chronic gastritis were also observed using HCl ethanol and indomethacin-induced gastric lesion models, respectively. As for gastric acid, it was also identified through proton pump ($H^+/K^+-ATPase$) inhibiting activity. In regards to protective factor for gastric damage, prostaglandin $E_2$ ($PGE_2$) was quantitatively analyzed. Antibacterial activity experiment was done on Helicobacter pylori (H.pylori), which is known to be the causing factor of chronic gastritis, gastric ulcer and gastric cancer. By making use of AGS cell, it was confirmed that ursolic acid was involved in apoptosis of gastric cancer cell through 4',6-diamidino-2-phenylindol (DAPI) staining and flow cytometry analysis. As a result, ursolic acid reduced gastric lesions caused by HCl ethanol and indomethacin. Ursolic acid inhibited acid secretion by inhibiting proton pump ($H^+/K^+-ATPase$), which is the gastric acid secreting enzyme involved at the final phase of gastric acid secretion. And ursolic acid was identified with gastric mucosa protection effects by increasing the concentration of $PGE_2$, a protective factor of gastric mucosa preservation. The antibacterial activity on H. pylori, which is aggressive factor in gastrointestinal disorder, ursolic acid showed inhibitory effects on H. pylori colonization. In the DAPI nuclear staining, unlike the control group, shape of the nucleus has deformed, and has been observed either shrinked cell or chromatin condensation phenomenon. In the Flow cytometry assay, confirmed the growth rate of apoptosis in a concentration-dependent manner.

• Journal of Gastric Cancer
• /
• v.1 no.1
• /
• pp.55-59
• /
• 2001

Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

• Biomolecules & Therapeutics
• /
• v.4 no.2
• /
• pp.111-121
• /
• 1996

Antiulcer effects of Artemisia herba extract (DA-9601) were evaluated in various types of experimental gastric ulcer induced in rats. And the effects of DA-9601 on mucus, basal and stimulated gastric acid secretion were also investigated in rats. DA-9601 (12.5∼400 mg/kg, p.o.) prevented the formation of gastric ulcers induced by 60% EtOH in 150 mM HC1, restraint water immersion stress, platelet activating factor (PAF), aspirin in 150 mM HCI with Pylorus-ligation and indomethacin. DA-9601 (4∼400 mg/kg, p.o.) significantly accelerated the healing rate of acetic acid-induced gastric ulcer and significantly stimulated mucus secretion in a dose-dependent manner. DA-9601 (20∼200 mg/kg, i.d.), however, did not inhibit basal gastric acid secretion in pylorus ligated rats and DA-9601 (200 mg/kg, i.d.) failed to influence histamine-, pentagastrin- and carbachol- stimulated gastric acid secretion. These results suggest that DA-9601 has inhibitory action on gastric lesion and ulceration through increasing mucus secretion in the stomach of rats without influencing basal and stimulated gastric acid secretion.

• Journal of Biomedical Engineering Research
• /
• v.41 no.2
• /
• pp.101-106
• /
• 2020

Although benign gastric ulcers do not develop into gastric cancer, they are similar to early gastric cancer and difficult to distinguish. This may lead to misconsider early gastric cancer as gastric ulcer while diagnosing. Since gastric cancer does not have any special symptoms until discovered, it is important to detect gastric ulcers by early gastroscopy to prevent the gastric cancer. Therefore, we developed a Convolution Neural Network (CNN) model that can be helpful for endoscopy. 3,015 images of gastroscopy of patients undergoing endoscopy at Gachon University Gil Hospital were used in this study. Using ResNet-50, three models were developed to classify normal and gastric ulcers, normal and gastric cancer, and gastric ulcer and gastric cancer. We applied the data augmentation technique to increase the number of training data and examined the effect on accuracy by varying the multiples. The accuracy of each model with the highest performance are as follows. The accuracy of normal and gastric ulcer classification model was 95.11% when the data were increased 15 times, the accuracy of normal and gastric cancer classification model was 98.28% when 15 times increased likewise, and 5 times increased data in gastric ulcer and gastric cancer classification model yielded 87.89%. We will collect additional specific shape of gastric ulcer and cancer data and will apply various image processing techniques for visual enhancement. Models that classify normal and lesion, which showed relatively high accuracy, will be re-learned through optimal parameter search.