• Journal of Gastric Cancer
• /
• v.7 no.4
• /
• pp.206-212
• /
• 2007

Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

• Journal of Yeungnam Medical Science
• /
• v.6 no.1
• /
• pp.197-204
• /
• 1989

A case of multiple myeloma combined with stomach cancer and related literatures were reviewed. A 67 year-old male patient entered the hospital with dysphagia and weight loss for 3 months. Peripheral blood examination revealed anemia with rouleaux formation. Total protein of the serum was 9.9g/$d{\ell}$ with hyperglobulinemia(albumin 2.7g/$d{\ell}$, globulin 7.2g/$d{\ell}$, A/G ratio 0.375). On the electrophoresis and immunoelectrophoresis of the serum, the abnormal protein with the pattern of monoclonal gammopathy(IgG-K type) was shown. There were multiple variable sized osteolytic lesions on skull X-ray and abnormal hot uptakes of ribs on bone scan and result of rib biopsy was plasmacytoma. Gastrofiberscopy was performed to search for the cause of upper gastrointestinal bleeding, revealed stomach cancer, and the result of the gastric mucosal biopsy proved to be well-differentiated adenocarcinoma.

• BMB Reports
• /
• v.36 no.1
• /
• pp.82-94
• /
• 2003

Although debates still exist whether Helicobacter pylori infection is really class I carcinogen or not, H. pylori has been known to provoke precancerous lesions like gastric adenoma and chronic atrophic gastritis with intestinal metaplasia as well as gastric cancer. Chronic persistent, uncontrolled gastric inflammations are possible basis for ensuing gastric carcinogenesis and H. pylori infection increased COX-2 expressions, which might be the one of the mechanisms leading to gastric cancer. To know the implication of long-term treatment of antiinflammatory drugs, rebamipide or nimesulide, on H. pylori-associated gastric carcinogenesis, we infected C57BL/6 mice with H. pylori, especially after MNU administration to promote carcinogenesis and the effects of the long-term administration of rebamipide or nimesulide were evaluated. C57BL/6 mice were sacrificed 50 weeks after H. pylori infection. Colonization rates of H. pylori, degree of gastric inflammation and other pathological changes including atrophic gastritis and metaplasia, serum levels and mRNA transcripts of various mouse cytokines and chemokines, and NF-${\kappa}B$ binding activities, and finally the presence of gastric adenocarcinoma were compared between H. pylori infected group (HP), and H. pylori infected group administered with long-term rebamipide containing pellet diets (HPR) or nimesulide mixed pellets (HPN). Gastric mucosal expressions of ICAM-1, HCAM, MMP, and transcriptional regulations of NF-${\kappa}B$ binding were all significantly decreased in HPR group than in HP group. Multi-probe RNase protection assay showed the significantly decreased mRNA levels of apoptosis related genes and various cytokines genes like IFN-$\gamma$, RANTES, TNF-$\alpha$, TNFR p75, IL-$1{\beta}$ in HPR group. In the experiment designed to provoke gastric cancer through MNU treatment with H. pylori infection, the incidence of gastric carcinoma was not changed between HP and HPR group, but significantly decreased in HPN group, suggesting the chemoprevention of H. pylori-associated gastric carcinogenesis by COX-2 inhibition. Long-term administration of antiinflammatory drugs should be considered in the treatment of H. pylori since they showed the molecular and biologic advantages with possible chemopreventive effect against H. pylori-associated gastric carcinogenesis. If the final concrete proof showing the causal relationship between H. pylori infection and gastric carcinogenesis could be obtained, that will shed new light on chemoprevention of gastric cancer, that is, that gastric/cancer could be prevented through either the eradication of H. pylori or lessening the inflammation provoked by H. pylori infection in high risk group.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.8 no.2
• /
• pp.164-171
• /
• 2005

Purpose: The aim of this study was to evaluate the clinical characteristics, endoscopic findings and risk factors related to the upper gastrointestinal bleeding (UGIB) seen in full-term infants. Methods: A clinical analysis for 9 cases with UGIB confirmed by endoscopy was carried out retrospectively. Patients were admitted to the Department of Pediatrics, Eulji Hospital, from January to December 2003. Results: UGIB from gastric or duodenal mucosal lesions has been seen in 0.13% in newborns infants. All patients were full-term AGA neonates without asphyxic findings at birth. Hematemesis, melena or recurrent vomiting developed within $4.4{\pm}3.8days$ after birth. Vital sign and laboratory test was normal on admission. Endoscopic findings showed hemorrhagic gastritis in 6 cases and peptic ulcers in 3 cases. All patients were successfully managed by medical treatment for $18.6{\pm}5.0days$. On treatment, clinical symptoms improved within $0.9{\pm}0.3days$. Follow-up endoscopy was not performed because there was no recurrence of symptoms in all patients. Case mothers had no history of gastritis, ulcer or anti-ulcer medications before and during pregnancy. Conclusion: If the healthy full-term infants express UGIB within a few days after birth, it is necessary to take careful history of family, mother and delivery process and to practice endoscopy for mucosal lesions of the patients. A follow-up endoscopy dose not seem to be necessary if the infant is clinically well.

• Journal of Gastric Cancer
• /
• v.13 no.2
• /
• pp.93-97
• /
• 2013

Purpose: Endoscopic submucosal dissection has recently been practiced on a differentiated type of early gastric cancer. However, there is no clear evidence for endoscopic treatments of signet ring cell carcinoma. The aim of this study is to identify the predictive clinicopathological factors for lymph node metastasis in signet ring cell carcinoma for assisting endoscopic submucosal dissection trials. Materials and Methods: A total of 186 patients with early signet ring cell carcinoma who underwent radical curative gastrectomy between January 2001 and September 2009 were enrolled in this study. Retrospective reviews of their medical records are being conducted. Several clinicopathologic factors were being investigated in order to identify predictive factors for lymph nodes metastasis: age, gender, tumor size, type of operation, tumor location, gross type, ulceration, Lauren's classification, depth of invasion, and lymphatic invasion. Results: The lymph node metastasis rate for signet ring cell carcinoma was 4.3% (n=8). Of the 186 lesions with early signet ring cell carcinoma, 91 (48.9%) tumors were larger than 15 mm in size and 40 (21.5%) showed submucosal invasions in the resection specimens. In multivariate analysis, only the lymphatic invasion (P<0.0001) showed an association with lymph node metastasis. To evaluate cutoff values for tumor sizes in the presence of lymph node metastasis, early signet ring cell carcinomas with lymphatic invasions were excluded. In the absence of lymphatic invasion, mucosal cancer with tumor sizes <15 mm had no lymph node metastasis. Conclusions: Endoscopic submucosal dissection can be performed on patients with early signet ring cell carcinoma limited to the mucosa and less than 15 mm.

• Food Science and Preservation
• /
• v.24 no.7
• /
• pp.1017-1024
• /
• 2017

The objective of this study was to investigate the inhibitory effects of Litsea japonica fruit flesh extract (LJF-HE) on gastritis in an indomethacin-induced SD rat model. Rats were randomly divided into six groups: G1 (normal group), G2 (control group, indomethacin-induced gastritis), G3 (positive group, indomethacin-induced gastritis and ranitidine 50 mg/kg), G4 (LJF-HE-L group, indomethacin-induced gastritis and L. japonica fruit flesh extract at 30 mg/kg), G5 (LJF-HE-M group, indomethacin-induced gastritis and L. japonica fruit flesh extract at 60 mg/kg), G6 (LJF-HE-H group, indomethacin-induced gastritis and L. japonica fruit flesh extract at 120 mg/kg). In the group treated with LJF-HE (G4, G5, and G6), gastric mucosal damage, gastric juice secretion and pepsin activity were significantly decreased compared to the control group. Additionally, there were decreases in the expression of cholecystokinin 2 receptor (CCK-2r), histamine receptor H2 (H2r) and H+/K+ ATPase in the gastric lesions. The plasma levels of TNF-${\alpha}$ and IL-$1{\beta}$ significantly decreased in LJF-HE (G4, G5, and G6) treated groups compared with control. The plasma level of PGE2 was also significantly increased by LJF-HE (G5 and G6). These results suggest that LJF-HE (G4, G5, and G6) has the ability to inhibit on indomethacin-induced gastritis.

• Journal of Food Hygiene and Safety
• /
• v.32 no.6
• /
• pp.536-541
• /
• 2017

The object of this study was to investigate the inhibitory effects of Litsea japonica fruit flesh extract (LJF-HE) on gastritis of an stress-induced SD rat model. Rats were randomly divided into six groups: Normal (normal group), Control (stress-induced gastritis), Ranitidine (stress-induced gastritis and ranitidine 50 mg/kg), LJF-HE-L (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 30 mg/kg), LJF-HE-M (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 60 mg/kg), LJF-HE-H (stress-induced gastritis pretreated with L. japonica fruit flesh extract at 120 mg/kg). In groups treated with LJF-HE, gastric mucosal damage and pepsin activity were reduced. Additionally, there were decreases in the expression of cholecystokinin 2 receptor (CCK-2r) in the gastric lesions. The plasma levels of IL-$1{\beta}$ slightly but significantly decreased in LJF-HE treated groups compared to control. The plasma level of PGE2 was also significantly increased in LJF-HE treated groups. These results suggest that LJF-HE has the ability to reduce of the severity stress-induced gastritis.