• Journal of Digestive Cancer Research
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• 제10권2호
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• pp.56-64
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• 2022

Narrow-band imaging (NBI) is the most widely used image-enhanced endoscopic technique. The superficial microanatomy of gastric mucosa can be visualized when used with a magnifying endoscopy with narrow-band imaging (ME-NBI). The diagnostic criteria for early gastric cancer (EGC), using the classification system for microvascular and microsurface pattern of ME-NBI, have been developed, and their usefulness has been proven in the differential diagnosis of small depressed cancer from focal gastritis and in lateral extent delineation of EGC. Some studies reported on the prediction of histologic differentiation and invasion depth of gastric cancer using ME-NBI; however, its application is limited in clinical practice, and further well-designed studies are necessary. Clinicians should understand the ME-NBI classification system and acquire appropriate diagnostic skills through various experiences and training to improve the quality of endoscopy for EGC diagnosis.

• Journal of Digestive Cancer Research
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• 제12권1호
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• pp.6-14
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• 2024

Gastric cancer is the 4th leading cause of death worldwide. The primary cause of gastric cancer is known to be Helicobacter pylori (H. pylori). The advancement of molecular biology has enabled the identification of microbiomes that could not be confirmed through cultivation, and it has been revealed that the microbial communities vary among normal mucosa, atrophic gastritis, intestinal metaplasia, and gastric cancer. It has also been confirmed that the composition of the microbial community differs depending on the presence or absence of H. pylori. Whether changes in the microbiome are causative factors in the carcinogenesis process is not yet clear. Experiments using animal models and in vitro studies on the role of microbes other than H. pylori in the carcinogenic process are underway, but the data is still insufficient.

• Korean Journal of Radiology
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• 제1권4호
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• pp.226-228
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• 2000

Gastric teratomas are extremely rare neoplasms and almost exclusively benign. They occur predominantly in males and generally present as a palpable abdominal mass. To our knowledge, only one adult case has been described in the Korean literature. We report a case in which an immature gastric teratoma in a 3-month-old boy was revealed by CT and US.

• Journal of Digestive Cancer Research
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• 제11권3호
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• pp.130-140
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• 2023

Gastric cancer (GC) is one of the most common malignant tumors worldwide, with a 5-year survival rate of < 40%. The diagnosis and treatment decisions of GC rely on human experts' judgments on medical images; therefore, the accuracy can be hindered by image condition, objective criterion, limited experience, and interobserver discrepancy. In recent years, several applications of artificial intelligence (AI) have emerged in the GC field based on improvement of computational power and deep learning algorithms. AI can support various clinical practices in endoscopic examination, pathologic confirmation, radiologic staging, and prognosis prediction. This review has systematically summarized the current status of AI applications after a comprehensive literature search. Although the current approaches are challenged by data scarcity and poor interpretability, future directions of this field are likely to overcome the risk and enhance their accuracy and applicability in clinical practice.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.256-261
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• 2009

목적: 진단 기술의 발전과 함께 위암 환자에서 동시성과 이시성암이 발견되는 빈도가 증가하고 있다. 본 연구에서는 위암에서 발견된 동시성과 이시성암의 임상병리학적 특성과 임상적 의의에 대하여 알아보고자 하였다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 조선대학교병원에서 위암으로 진단된 환자들의 의무기록을 후향적으로 분석하였다. 결과: 1,048명 위암 환자 중 38명(3.6%)에서 동시성과 이시성암이 있었다. 38명 중 16명(42.1%)은 동시성암이었고 22명(57.9%)은 이시성암이었다. 위암과 이차성 원발암 간의 평균 시간간격은 $27.08{\pm}31.25$개월이었다. 가장 흔한 중복암은 폐암(8/38, 21.1%)과 대장암(8/38, 21.1%)이었다. 27명의 환자가 위암에 대하여 수술적 치료를 하였으며 이 중 5명(18.5%)은 동시성암, 22명(81.5%)은 이시성암이었다. 평균 생존 기간은 49.8개월이었으며 동시성암의 경우는 24.6개월 이시성암의 경우는 68.1개월이었고 이들의 3년 생존율은 동시성암, 이시성암 각각 33.3%, 81.1%였다. 결론: 위암에서의 이차성 원발암 진단에 대한 진단에 있어 충분한 수술 전 검사를 통한 동시성암의 발견과 지속적인 추적검사를 통한 이시성암의 발견을 위해 주의를 기울여야 한다.

• Journal of Gastric Cancer
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• 제15권4호
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• pp.246-255
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• 2015

Purpose: The importance of Helicobacter pylori eradication after endoscopic resection (ER) of gastric neoplasms remains controversial. In this study, we clarified the importance of H. pylori eradication for metachronous lesions after ER. Materials and Methods: This study included 3,882 patients with gastric neoplasms who underwent ER. We included patients infected with H. pylori who received eradication therapy. Among them, 34 patients with metachronous lesions after ER and 102 age- and sex-matched patients (nonmetachronous group) were enrolled. Background mucosal pathologies such as atrophy and intestinal metaplasia (IM) were evaluated endoscopically. The expression levels of CDX1, CDX2, Sonic hedgehog (SHH), and SOX2 were evaluated based on H. pylori eradication and the development of metachronous lesions. Results: The eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.036). Open-type atrophy (P=0.003) and moderate-to-severe IM (P=0.001) occurred more frequently in the metachronous group. In patients with an initial diagnosis of dysplasia, the eradication failure rate was higher in the metachronous group than in the nonmetachronous group (P=0.002). In addition, open-type atrophy was more frequent in the metachronous group (P=0.047). In patients with an initial diagnosis of carcinoma, moderate-to-severe IM occurred more frequently in the metachronous group (P=0.003); however, the eradication failure rate was not significantly different between the two groups. SHH and SOX2 expression was increased, and CDX2 expression was decreased in the nonmetachronous group after eradication (P<0.05). Conclusions: Open-type atrophy, moderate-to-severe IM, and H. pylori eradication failure were significantly associated with metachronous lesions. However, eradication failure was significantly associated with dysplasia, but not carcinoma, in the metachronous group. Thus, H. pylori eradication may play an important role in preventing metachronous lesions after ER for precancerous lesions before carcinomatous transformation.

• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.24-27
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• 2014

본 증례에서는 우연히 한 환자에서 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종을 동시에 발견하였고, 이를 내시경적 절제술로 치료한 사례이다. 현재 환자는 절제술 후 2년 동안 질병의 진행 없이 외래에서 경과 관찰 중이다. 아직 MALT 림프종과 위장관 간질종양에서 내시경적 점막하 절제술은 정립된 치료 방법이 아니지만, 본 증례처럼 성공적으로 치료될 수 있음을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 아직은 내시경적 절제술로 치료한 사례가 적지만, 향후 내시경적 절제술 후 긴 기간 동안 추적 관찰된 증례들이 모인다면 조기위암처럼 표준화된 치료법으로 시행될 수 있기를 기대한다.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.283-293
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• 2017

Objectives: The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. Methods: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. Results: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. Conclusions: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.

• 임상간호연구
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• 제18권1호
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• pp.111-125
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• 2012

Purpose: The purposes of this study were to develop a navigation program for newly diagnosed cancer patients and to evaluate its effects. Methods: The navigation program was based upon Professional Navigation Framework. Patients were asked to complete self-administered questionnaires on satisfaction, distress, anxiety and depression for evaluating the program. Results: The navigation program consisted of facilitating two concepts: continuity of care and empowerment of patients. Information-education package, telephone counseling and navigator's phone number were provided to the newly diagnosed cancer patients for care continuity. Self-care diary and emotional support by telephone counseling were provided to the patients for empowerment of patients. A total of 163 patients - 78 control and 85 experimental participants - were included in the study. The mean scores of satisfaction, distress, anxiety and depression had no statistical differences between the two groups after program implementation. In patients with longer waiting days, the experimental group with the navigation program showed higher relational continuity than the control group after program implementation(p=.023). In patients with longer waiting days or with higher distress, satisfaction of relational continuity was improved after program implementation in the experimental group. Conclusion: The navigation program in this study has applied the concept of patient navigation into oncology clinical setting in Korea. Navigation program can play a significant role in assisting patients navigating across the care continuum.

• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.142-149
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• 1977

To use basic data for health planning and evaluation of Kangwha community health project of Yonsei University, a study on death rates and causes of death were investigated in two townships (Naega and Sunwon Myuns) in Kangwha County from April 1, 1975 to March 31, 1977 All death was identified and reported by family health workers who are living in each village and 2 trained public health nurses confirmed the death. The causes of death were investigated by 2 public physicians. Total number of deaths for 2 years was 230 and the followings are brief summary of the study. 1. Age-adjusted crude death rates of study area were 8.69 per 1,000 population in 1975 and 7.18 per 1,000 population in 1976. Age-adjusted crude death rates for male were 9.18 in 1975 and 6.38 in 1976 and for female were 8.33 and 7.80 per 1,000 population 2. Age specific death rate curves by year and sex showed 'U' shapes. 3. Infant and neonatal death rates were 30.08 and 22.56 per 1,000 live births in 1975, and the rates in 1976 were 18.18 and 13.64. 4. The most common cause of death was cerebrovascular disease and average cause specific death rate for the disease was 215.5 per 100,000 population. 5. Four leading causes of death were non-infectious origin; cerebrovascular disease, malignant neoplasms, senility and suicide. Pulmonary tubeculosis and pneumonia occupied 5th and 9th causes of death. 6. Stomach cancer and hepatoma occupied 61.3% of total death due to malignant neoplasms. 7. Most frequent cause of neonatal death was birth injury. Two deaths due to tetanus were found in 1975, but no death due to this disease was found in 1976. 8. About half of deceased received care from physician before death.