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Is endoscopic submucosal dissection safe for papillary adenocarcinoma of the stomach?

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World Journal of Gastroenterology 2015年第13期21卷 3944-3952页

作者： Hyun Jeong lee Gwang Ha Kim Do Youn Park bong eun lee Hye Kyung Jeon Joon Hyung Jhi Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research Institute Pusan National University Hospital Busan 602-739South Korea Department of Pathology Pusan National University School of MedicineBusan 602-739South Korea

AIM: To identify the clinicopathological predictors of lymph node(LN) metastasis and evaluate the outcomes of endoscopic submucosal dissection(ESD) in papillary adenocarcinoma-type early gastric cancers(EGCs).METHODS: From January 2005 to May 2013, 49 patients who underwent surgical operation and 24 patients who underwent ESD for papillary adenocarcinomatype EGC were enrolled to identify clinicopathological characteristics and predictive factors of LN metastasis and to evaluate the outcomes of ESD for papillary adenocarcinoma-type ***: Most papillary adenocarcinoma-type EGCs were located in the lower third of the stomach and had an elevated macroscopic shape. The overall prevalence of LN metastasis was 18.3%(9/49). The presence of lymphovascular invasion was found to be a predictor of LN metastasis(P = 0.016). According to current indication criteria of ESD, 6 and 11 of the 49 patients had absolute and expanded indications for ESD, respectively. Two patients(11.8%) with expanded indication for ESD had LN metastasis. Of the 24 patients who underwent ESD, 13(54%) achieved out-of-ESD indication, with 9 of those 13 patients undergoing surgical operation due to non-curative resection. CONCLUSION: The use of ESD should be carefully considered for papillary adenocarcinoma-type EGC with suspected ESD indication after pre-treatment work-up because of the higher frequency of LN metastasis and additional surgeries.

关键词： Gastric cancer Papillary adenocarcinoma Endoscopic

New magnifying endoscopic classification for superficial esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2017年第24期23卷 4416-4421页

作者： Su Jin Kim Gwang Ha Kim Moon Won lee Hye Kyung Jeon Dong Hoon Baek bong eun lee Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan Hospital Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University Hospital

To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed. RESULTSOverall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95). CONCLUSIONThe recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.

关键词： Narrow-band imaging Esophageal cancer Squamous cell carcinoma Magnifying endoscopy

Endoscopic resection of sparganosis presenting as colon submucosal tumor: A case report

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World Journal of Gastroenterology 2016年第19期22卷 4776-4780页

作者： Joong Keun Kim Dong Hoon Baek bong eun lee Gwang Ha Kim Geun Am Song Do Youn Park Division of Gastroenterology Departments of Internal Medicine Pusan National University School of Medicine and Biomedical Research Institute Pusan National University Hospital Department of Pathology Pusan National University School of Medicine and Biomedical Research Institute Pusan National University Hospital

Human sparganosis is a rare parasitic disease caused by infection with the tapeworm Sparganum, the migrating plerocercoid(second stage) larva of Spirometra species. Sparganosis usually involves subcutaneous tissues and/or muscles of various parts of the body, but involvement of other sites such as the brain, eye, peritoneopleural cavity, urinary track, scrotum, and abdominal viscera has also been documented. Infections caused by sparganum have a worldwide distribution but are most common in Southeast Asia such as China, Japan, and South Korea. Rectal sparganosis is an uncommon disease but should be considered in the differential diagnosis of unusual and suspicious rectal submucosal tumors. We report a case of rectal sparganosis presenting as rectal submucosal tumor. We performed endoscopic submucosal dissection of the rectal submucosal tumor. The sparganosis was confirmed based on the presence of calcospherules in the submucosal layer on histological examination. Moreover, the result of the immunoglobulin G antibody test for sparganosis was positive but became negative after endoscopic submucosal dissection. Though rare, rectal sparganosis should be considered in the differential diagnosis of rectal submucosal tumor-like lesions. This case suggests that physicians should make effort to exclude sparganosis through careful diagnostic approaches, including detailed history taking and serological tests for parasites. In this report, we aimed to highlight the clinical presentation of Sparganum infection as a rectal submucosal tumor.

关键词： Rectum Submucosal tumor Sparganosis Sparganum Parasite disease

Magnifying endoscopy of gastric epithelial dysplasia based on the morphologic characteristics

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World Journal of Gastroenterology 2014年第42期20卷 15771-15779页

作者： Hwa Mi Kang Gwang Ha Kim Do Youn Park Hong Ryeol Cheong Dong Hoon Baek bong eun lee Geun Am Song Department of Internal Medicine Busan Adeventist Hospital Department of Internal Medicine Pusan National University School of Medicine Department of Pathology Pusan National University School of Medicine

AIM: To investigate the difference in magnifying endoscopic findings of gastric epithelial dysplasias (GEDs) according to the morphologic characteristics.

关键词： Stomach Dysplasia Narrow band imaging Magnifying endoscopy Mucin

Endoscopic removal of gastric ectopic pancreas:An initial experience with endoscopic submucosal dissection

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World Journal of Gastroenterology 2010年第36期16卷 4589-4593页

作者： Dong Yup Ryu Gwang Ha Kim Do Youn Park bong eun lee Jae Hoon Cheong Dong Uk Kim Hyun Young Woo Jeong Heo Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Medical Research InstitutePusan National University HospitalBusan 602-739South Korea Department of Pathology Pusan National University School of MedicineBusan 602-739South Korea

AIM:To evaluate the therapeutic usefulness and safety of endoscopic resection in patients with gastric ectopic ***:A total of eight patients with ectopic pancreas were *** of them underwent endoscopic ultrasonography before endoscopic ***-scopic resection was performed by two methods:endo-scopic mucosal resection(EMR)by the injection-and-cut technique or endoscopic mucosal dissection(ESD).RESULTS:We planned to perform EMR in all eight cases but EMR was successful in only four *** the other four cases,saline spread into surrounding normal tissues and the lesions becameattened,which made it impossible to remove them by *** four cases,we performed ESD and removed the lesions without any ***:If conventional EMR is difficult to remove gastric ectopic pancreas,ESD is a feasible alternative method for successful removal.

关键词： Ectopic pancreas Endoscopic resection Endoscopic ultrasonography

Risk of lymph node metastasis in mixed-type early gastric cancer determined by the extent of the poorly differentiated component

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World Journal of Gastroenterology 2016年第15期22卷 4020-4026页

作者： Chung-Su Hwang Sangjeong Ahn bong-eun lee So-Jeong lee Ahrong Kim Chang In Choi Dae Hwan Kim Tae-Yong Jeon Gwang Ha Kim Geum Am Song Do Youn Park Department of Pathology Pusan National University Hospital and Pusan National University School of Medicine Biomedical Research Institute Pusan National University Hospital Internal medicine Pusan National University Hospital and Pusan National University School of Medicine Surgery Pusan National University Hospital

AIM: To predict the rate of lymph node(LN) metastasis in diffuse- and mixed-type early gastric cancers(EGC) for guidelines of the ***: We reviewed 550 cases of EGC withdiffuse- and mixed-type histology. We investigated the clinicopathological factors and histopathological components that influence the probability of LN metastasis, including sex, age, site, gross type, presence of ulceration, tumour size, depth of invasion, perineural invasion, lymphovascular invasion, and LN metastasis status. We reviewed all slides and estimated the proportions of each tumour component; pure diffuse type, mixed-predominantly diffuse type(diffuse > intestinal type), mixed-predominantly intestinal type(intestinal > diffuse type), and mixed diffuse = intestinal type. We calculated the extents of the respective ***: LN metastasis was observed in 12.9%(71/550) of early gastric cancers cases [15/288 mucosal EGCs(5.2%) and 56/262 submucosal EGCs(21.4%)]. Of 550 cases, 302 were diffuse-type and 248 were mixed-type EGCs. Of 248 mixed-type EGCs, 163 were mixed-predominantly diffuse type, 82 were mixed-predominantly intestinal type, and 3 were mixed diffuse = intestinal type. Mixed-type cases with predominantly diffuse type histology showed a higher frequency of LN metastasis(20.2%) than cases of pure diffuse type(9.3%) and predominantly intestinal type(12.2%) histology. We measured the dimensions of each component(intestinal and diffuse type) to determine the association of the extent of each component with LN metastasis in mixed-type gastric carcinoma. The total tumour size and the extent of poorly differentiated components was associated with LN metastasis, while that of signet ring cell components was ***: We recommend careful identification and quantitative evaluation of mixed-type early gastric cancer components after endoscopic resection to determine the intensity of the treatment.

关键词： Lymph nodes Metastasis Gastric cancer Histology Endoscopic gastrointestinal surgery

Clinicopathologic factors influencing the accuracy of EUS for superficial esophageal carcinoma

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World Journal of Gastroenterology 2014年第20期20卷 6322-6328页

作者： Jung Im Jung Gwang Ha Kim Hoseok I Do Youn Park Tae Kyun Kim Young Hwa Cho Yong Wan Sung Mun Ki Choi bong eun lee Geun Am Song Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research Institute Pusan National University Hospital Busan 602-739 South Korea Department of Chest Surgery Pusan National University School of Medicine Busan 602-739 South Korea Department of Pathology Pusan National University School of Medicine Busan 602-739 South Korea

AIM: To identify clinicopathologic factors influencing the accuracy of a high-frequency catheter probe endoscopic ultrasonography (EUS) for superficial esophageal carcinomas (SECs).

关键词： Esophageal cancer Endoscopic ultrasonography Accuracy

Galectin-3 expression level was correlated with histological activity index,anti-dsDNA antibody titer,and complement levels in lupus nephritis

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Galectin-3 expression level was correlated with histological...

Cardiac mucosa at the gastroesophageal junction:An Eastern perspective

The 8th International Congress on SLE

作者： eun Ha Kang Hee Jung Ryu Jung Hwa lee Kyung Chul Moon eun Young lee Yun Jong lee eun bong lee Curie Ahn Yeong Wook Song Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Department of Pathology Seoui National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital Division of Nephrology Department of Internal Medicine Seoul National University Hospital Division of Rheumatology Department of Internal Medicine Seoul National University Hospital

＜正＞Purpose:Galectin-3 is one of carbohydrate-binding proteins that has been implicated in modulation of immune or inflammatory responses by regulating cell survival and signaling,influencing cell growth and chemota...

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World Journal of Gastroenterology 2015年第30期21卷 9126-9133页

作者： Ahrong Kim Won-Young Park Nari Shin Hyun Jung lee Young Keum Kim So Jeong lee Cheong-Soo Hwang Do Youn Park Gwang Ha Kim bong eun lee Hong-Jae Jo Department of Pathology Bio Medical Research InstitutePusan National University Hospital Pusan National University School of Medicine Department of Internal Medicine Bio Medical Research InstitutePusan National University Hospital Department of Surgery Pusan National University Hospital

AIM:To investigate the nature and origin of cardiac mucosa(CM).METHODS:Biopsy samples from sixty-one individuals were included in this study. The specimens were taken "at","just below",or "just above" the gastroesophageal junction,including the histologic squamocolumnar junction. Clinical data were obtained by reviewing electronic medical records for each patient. Patients with a history of stomach adenoma or carcinoma and esophageal carcinoma were excluded,and cases that were endoscopically suspicious of Barrett's esophagus or a polyp were also ruled out. Histologic and endoscopic reviews were performed blinded to the patient's clinical data. Histologic evaluation wasconducted by two pathologists,and endoscopic review was performed by a endoscopist with wide experience in the field. Histologically,the columnar epithelium of squamocolumnar junction,presence and severity of acute and chronic inflammation,atrophy,intestinal metaplasia,and presence of carditis were evaluated. Endoscopically,reflux esophagitis was evaluated by Los Angeles(LA) classification,hiatal hernias were classified by Hill grade,and gastroesophageal flap valves were assessed. RESULTS:Fifty-nine of the 61(96.7%) patients were Korean; 65.6%(40/61) of the patients underwent endoscopy according to the schedule of the National Health Insurance Program as a screening inspection. Of these,only 20.0%(8/40) of cases had reflux s y m p t o m s. C M w a s p r e s e n t i n 4 1 / 6 1( 6 7. 2 %) individuals,and its presence was associated with older age compared to oxyntocardiac mucosa/oxyntic mucosa(60.59 ± 2.02 years vs 51.55 ± 3.35 years; P = 0.018). The presence of CM was associated with endoscopic diagnosis of esophagitis according to the LA classification(P = 0.022). CM was associated with mononuclear cell infiltration and neutrophilic infiltration,which were statistically significant(P = 0.001,and P = 0.004,respectively). The inflammation of CM,"carditis",showed a statistically significant association w

关键词： Cardiac mucosa Carditis Gastroesophagealjunction Gastroesophageal reflux disease Histopathology