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Early gastric cancer presenting as a typical submucosal tumor cured by endoscopic submucosal dissection:A case report

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World Journal of Gastroenterology 2022年第25期28卷 2994-3000页

作者： Joon Hyun Cho si hyung lee Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND Submucosal tumor(SMT)-like gastric cancer is rare,and almost all cases undergo curative surgical treatment because the submucosal layer is usually deeply invaded by tumor cells or because histopathologic types of SMT-like gastric cancer are undifferentiated or poorly *** report has been issued on an SMT-like gastric cancer cured by endoscopic resection alone or on changes in the endoscopic features of this type of tumor over several *** SUMMARY We describe an exceptional case of a 53-year-old male with a 1.5 cm-sized SMTlike lesion covered by normal-appearing mucosa discovered by esophagogastroduodenoscopy(EGD)at the gastric *** ultrasound(EUS)visualized a homogeneous,well-circumscribed hypoechogenic lesion arising from the second sonographic layer with associated subtle obliteration of the third sonographic *** endoscopic biopsy was negative for *** patient refused to undergo an invasive procedure and was subsequently lost to *** years after initial detection,EGD revealed the lesion had become markedly erythematous,and at 4 years after initial EGD it had increased in size to 1.8 cm and developed a central ulcer and a heterogeneous EUS ***,endoscopic submucosal dissection(ESD)was performed,and histopathologic examination revealed a moderately differentiated adenocarcinoma had minutely invaded the submucosal layer(invasion depth 169μm)but without lymphovascular invasion and with negative resection ***,no additional surgical treatment was *** has been followed for 4 years after ESD without any evidence of local or distant *** This report describes an extremely rare case of early gastric cancer presenting as SMT that was cured by ESD after a treatment delay of 4 years and the endoscopic changes that occurred during this *** report highlights the importance of considering the possibility of gastric cancer when SMT is encountered in clini

关键词： Subepithelial lesion Submucosal tumor Early gastric cancer Adenocarcinoma Endoscopic mucosal dissection Case report

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Influences of etiology and endoscopic appearance on the long-term outcomes of gastric antral vascular ectasia

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World Journal of Clinical Cases 2022年第18期10卷 6050-6059页

作者： Hyo Jin Kwon si hyung lee Joon Hyun Cho Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND Gastric antral vascular ectasia(GAVE)has diverse associations and presumed causes,which include liver cirrhosis,chronic kidney disease,and autoimmune *** heterogeneity of underlying disorders suggests that the pathogenesis of GAVE may be *** To compare the clinical features and long-term outcomes of GAVE according to endoscopic patterns and *** The medical records and endoscopic images of 23 consecutive patients diagnosed with GAVE by endoscopy at Yeungnam University Hospital from January 2006 to December 2020 were retrospectively *** were allocated to cirrhosis(16 patients)and non-cirrhosis groups(7 patients).GAVE subtypes,as determined by endoscopy,were categorized as punctate(a diffuse,honeycomb-like appearance,17 patients)or striped(a linear,watermelon-like appearance,6 patients).RESULTS All GAVE patients with cirrhosis(16/16,100%)had a punctate pattern by endoscopy,whereas the majority of patients(6/7,85.7%)without cirrhosis had a striped pattern(Pleeding(10/23,43%)was significantly more common in the non-cirrhosis group than in the cirrhosis group(6/7,85.7%vs 4/16,25.0%;P=0.019),and more common in the striped group than in the punctate group(5/6,83.3%vs 5/17,29.4%;P=0.052).However,mean numbers of admissions due to GAVE bleeding and argon plasma coagulation(APC)sessions to address overt bleeding were similar in the cirrhosis and non-cirrhosis groups and in the punctate and striped *** patients with GAVE bleeding were successfully treated by APC,and no patient died from GAVE-related blood loss during a median follow-up of 24 *** Punctate-type GAVE is strongly associated with liver cirrhosis,and GAVE patients without cirrhosis tend to be more prone to overt ***,the presence of cirrhosis and endoscopic patterns did not influence long-term clinical courses or outcomes in cases of overt bleeding.

关键词： Gastric antral vascular ectasia Cirrhosis Endoscopy Gastrointestinal bleeding Argon plasma coagulation

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Primary gastric dedifferentiated liposarcoma resected endoscopically:A case report

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World Journal of Gastroenterology 2022年第23期28卷 2625-2632页

作者： Joon Hyun Cho Jun Hyeon Byeon si hyung lee Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND Liposarcoma is one of the most common adult mesenchymal tumors but is uncommon in the gastrointestinal tract and extremely rare in the ***,the histological subtypes of liposarcoma usually reported in the stomach are well-differentiated or myxoid,and few reports have been issued on small-sized gastric liposarcomas resected endoscopically and followed ***,we report a case of primary gastric dedifferentiated liposarcoma(DL)that was resected *** SUMMARY A 67-year-old female Korean patient was referred to our institution for further evaluation of a gastric submucosal tumor(SMT)located in the lesser curvature of the gastric body by *** ultrasound revealed a well-circumscribed,slightly heterogeneous,isoechoic,17 mm×10 mm sized mass originating from the third sonographic *** tomography showed no evidence of significant lymph node enlargement or distant *** resection was undertaken using the snare resection technique after mucosal precutting to provide a definitive histopathologic diagnosis,which proved to be consistent with DL,based on its morphology and the immunoexpressions of MDM2 and *** patient was planned for surgery because the deep resection margin was positive for *** declining any invasive procedure or adjuvant treatment,the patient was placed under close follow-up,and at one year after endoscopic resection,remained disease *** This is the first reported case of a small primary gastric DL resected endoscopically and followed *** report demonstrates that when diagnosis of a SMT is uncertain,the use of invasive techniques,including endoscopic resection,should be considered.

关键词： Gastric liposarcoma Dedifferentiated liposarcoma Submucosal tumor Endoscopic resection Case report

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Esophageal subepithelial lesion diagnosed as malignant gastrointestinal neuroectodermal tumor

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World Journal of Gastroenterology 2015年第18期21卷 5739-5743页

作者： Sung Bum Kim si hyung lee Mi Jin Gu Department of Internal Medicine Yeungnam University Hospital Department of Pathology Yeungnam University Hospital

A 21-year-old male visited our hospital with a complaint of aggravating dysphagia and odynophagia for a few *** showed huge bulging mucosa with an intact surface causing luminal narrowing at 35 cm from the incisor *** ultrasonography showed an about 35 mm sized irregular margined in-homogenous hypoechoic lesion with an obscure layer of *** ultrasonography fine needle aspiration revealed spindle cell proliferation without immunoreactivity for CD117,SMA,and *** patient underwent excision of the subepithelial lesion at the distal *** pathologic examination of the specimen,the tumor was composed of short fascicles of oval to spindle cells with eosinophilic and clear cytoplasm and vesicular *** tumor cells were positive for S-100 and SOX10and negative for CD117,SMA,HMB-45,melan-A,cytokeratin,and *** split-apart signal was detected in EWSR1 on FISH,suggesting a malignant gastrointestinal neuroectodermal *** the time of writing,the patient is on radiation therapy at the operated site of esophagus and doing well,with no recurrence for three *** gastrointestinal neuroectodermal tumor is a rare gastrointestinal tumor with features of clear cell sarcoma,without melanocytic differentiation,and shows a poor *** is the first reported case of malignant gastrointestinal neuroectodermal tumor arising as subepithelial lesion in the esophagus.

关键词： Subepithelial lesion Esophagus Malignant gastrointestinal neuroectodermal tumor Ewing sarcoma break point region 1 gene Fluorescence in situ hybridization

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Clinical outcomes of endoscopic resection of superficial nonampullary duodenal epithelial tumors: A 10-year retrospective, single-center study

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World Journal of Gastrointestinal Surgery 2022年第4期14卷 329-340页

作者： Joon Hyun Cho Ki Young Lim Eun Jung lee si hyung lee Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND Although premalignant duodenal lesions such as adenomas are uncommon,the incidences of these lesions have increased in recent times,and thus,the demand for minimally invasive treatments such as endoscopic resection(ER)has also ***,ER in the duodenum is more challenging than ER in other locations of the gastrointestinal *** To evaluate the safety and efficacy of ER for superficial nonampullary duodenal epithelial tumors(SNADETs)METHODS We performed a retrospective observational study on 56 consecutive patients(58 lesions)diagnosed with SNADETs that underwent ER from January 2011 to December 2020 at Yeungnam University *** demographics,lesion characteristics,and procedural and technical data were collected,and clinical outcomes,including procedure-related complications,completeness of resection,and recurrence were *** Median patient age was 57 years[range,26–77,30(53.6%)men].Endoscopic mucosal resection(EMR)was performed on 57 lesions(98.3%)and snare polypectomy on one(1.7%).Lesions consisted of 52 adenomas with low-grade dysplasia(89.7%),3 adenomas with high-grade dysplasia(5.2%),and 3 intramucosal adenocarcinomas(5.2%).There were 16 cases of intraprocedural bleeding(27.6%)and 1 case of delayed bleeding(1.7%),and all these 17 cases were successfully managed *** perforation or procedure-related death *** lesion size was associated with an increased risk of EMR-related bleeding(P=0.033).During a median follow-up period of 23 mo(range 6–100 mo),no local recurrence occurred,despite the fact one-third of the patients(19 lesions,32.8%)underwent piecemeal resection and 3 patients(3 lesions,5.2%)that underwent en bloc resection had a pathologically determined positive lateral *** patient died from a primary duodenal *** The majority of SNADETs can be safely and curatively resected by EMR,and thus,based on consideration of the high incidence of fatal complications attribut

关键词： Duodenum Adenoma Endoscopic mucosal resection Endoscopic resection Superficial nonampullary duodenal epithelial tumor

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Efficacy of 0.5-L vs 1-L polyethylene glycol containing ascorbic acid as additional colon cleansing methods for inadequate bowel preparation as expected by last stool examination before colonoscopy

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World Journal of Clinical Cases 2019年第1期7卷 39-48页

作者： Joon Hyun Cho Eun Joo Goo Kyeong Ok Kim si hyung lee Byung Ik Jang Tae Nyeun Kim Division of Gastroenterology and Hepatology Department of Internal Medicine Yeungnam University College of Medicine

BACKGROUND No consensus has been reached in patients suspected of having inadequate bowel preparation regarding optimal salvage methods, which negatively affects the efficacy and quality of colonoscopy. The most ideal and reasonable rescue option involves early suspicion and identification of patients with inadequate preparation before sedation, additional oral ingestion of a suitable preparation formulation, and same-day *** To compare 0.5-L and 1-L polyethylene glycol containing ascorbic acid(PEG +Asc) as additional bowel cleansing methods after a 2-L split-dose PEG + Asc regimen in patients with expected inadequate bowel preparation before *** Individuals with expected inadequate bowel preparation based on last stool form, such as turbid liquid, particulate liquid, or liquid with small amounts of feces, were randomized to either a 0.5-L PEG + Asc group or a 1-L PEG + Asc group. The primary endpoint was bowel preparation as assessed using the Aronchick bowel preparation scale(ABPS) and Boston bowel preparation scale(BBPS) scores. The secondary endpoints were cecal intubation time, withdrawal time, polyp detection rate(PDR), adenoma detection rate(ADR), individual compliance with additional PEG + Asc, and patient *** Initially, 98 patients were included, but 8 were later excluded due to withdrawal of consent to participate in the study. Adequate bowel preparation(as assessed by ABPS) was observed in 80.9%(38/47) of subjects in the 0.5-L group and in88.4%(38/43) of subjects in the 1-L group(P = 0.617). Mean total BBPS was 6.7 points in the 0.5-L group and 7.0 points in the 1-L group(P = 0.458). ADRs and PDRs were similar in the two groups, and cecal intubation and withdrawal times were not significantly different. However, mean patient satisfaction score was significantly higher in the 0.5-L group(P = 0.041).CONCLUsiON The bowel cleaning efficacy of additional 0.5-L PEG + Asc was not inferior to that of 1-L PEG + Asc. Add

关键词： Inadequate bowel preparation Additional colon cleansing Colonoscopy Polyethylene glycol

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Prediction of the indication criteria for endoscopic resection of early gastric cancer

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World Journal of Gastroenterology 2015年第39期21卷 11160-11167页

作者： Jae Hyun Park si hyung lee Joon Mo Park Chan Seo Park Kyung sik Park Eun Soo Kim Kwang Bum Cho Department of Internal Medicine Yeungnam University College of Medicine Department of Internal Medicine Keimyung University College of Medicine

AIM: To find risk factors of lymph node metastasis(LNM) in early gastric cancer(EGC) and to find proper endoscopic therapy indication in ***: We retrospectively reviewed the 2270 patients who underwent curative operation for EGC from January 2001 to December 2008. EGC was defined as malignant lesions that do not invade beyond the submucosal layer of the stomach wall irrespective of presence of lymph node ***: Among 2270 enrolled patients, LNM was observed in 217(9%) patients. LNM in intramucosal(M) cancer and submucosal(SM) cancer was detectedin 3 8( 2. 8 %, 3 8 / 1 3 4 0) patients and 1 7 9(19%, 179/930) patients, respectively. In univariate analysis, the risk factors for LNM in EGC were size of tumor, Lauren classification, ulcer, lymphatic invasion, vascular invasion, and depth of invasion. However, in multivariate analysis, size of tumor, lymphatic invasion, vascular invasion, and depth of invasion were risk factors for LNM in EGC. size of tumor, lymphatic invasion, vascular invasion, and depth of invasion were risk factors for LNM in cases of intramucosal cancer and submucosal cancer. In particular, there was no lymph node metastasis in cases of well differentiated early gastric cancer below 1 cm in size without ulcer regardless of lymphovascular ***: Tumor size, perilymphatic-vascular invasion, and depth of invasion were risk factors for LNM in EGC. There was no LNM in EGC below 1 cmregardless risk factors.

关键词： Early gastric cancer Lymph node metastasis Endosco

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Gastric subepithelial lesion complicated with abscess: Case report and literature review

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World Journal of Gastroenterology 2015年第20期21卷 6398-6403页

作者： Sung Bum Kim Myung Jin Oh si hyung lee Department of Internal Medicine Yeungnam University College of Medicine

Gastric abscess is a localized pyogenic inflammation of the gastric wall, which is a rare form of suppurative gastritis. The rarity of gastric abscess may be associated with the difficulty of early diagnosis and high mortality as a result. In general, subepithelial lesions (SELs) of the stomach are incidentally detected during the course of upper endoscopy without specific clinical symptoms and signs. However, some gastric SELs present rarely as a form of hemorrhage, obstruction, perforation, and abscess. Here we report a 45-year-old man with gastric SEL presenting as a gastric abscess, which was diagnosed as an ectopic pancreas of the stomach, along with a review of the literature. Although gastric SEL presenting as an abscess is known as a serious and life-threatening lesion, the patient made a complete recovery through surgical resection as well as medical treatment.

关键词： Suppurative gastritis Gastric abscess Subepithelial lesion Ectopic pancreas Endoscopicultrasound

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Association between Helicobacter pylori status and metachronous gastric cancer after endoscopic resection

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World Journal of Gastroenterology 2016年第44期22卷 9794-9802页

作者： Sung Bum Kim si hyung lee Seung Il Bae Yo Han Jeong Se Hoon Sohn Kyeong Ok Kim Byung Ik Jang Tae Nyeun Kim Department of Internal Medicine Yeungnam University College of Medicine

AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed the medical records of 433 patients(441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group(n = 257) and the H. pylori non-tested group(n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup(n = 120), the H. pylori-persistent subgroup(n = 42), and the H. pylori-negative subgroup(n = 95). Incidences of MGC and risk factors of MGC were *** Median follow-up duration after ESD was 30.00 mo(range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group(7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group(P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients. CONCLUsiON H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.

关键词： Metachronous gastric cancer Endoscopic submucosal dissection Helicobacter pylori

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Analysis of Hydrogen Reforming Process With Water Gas Shift Reaction

Analysis of Hydrogen Reforming Process With Water Gas Shift ...

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第五届国际炼铁科技大会

作者： Ki Hyun Kim si hyung lee Sung Man Kim Min Oh Iron making Research Group of Technical Research Laboratories POSCO1Goedong-dongNam-guPohangGyeongbuk Department of Chemical Engineering Hanbat national universitySan 16-1Dukmyung-dongYuseong-guDaejeon

Hydrogen is receiving considerable interest as clean and high efficiency energy. During the past decades, hydrogen was mainly produced by petroleum resources（i.e. Naphtha, CH4）. However, because of the recent increasing of the oil cost and the lack of the resources, alternative technologies are required for mass production hydrogen. In the present work, we consider iron making exhausted gases as hydrogen resources because they contain much carbon monoxide and hydrogen. To increase hydrogen content in the exhausted gases, hydrogen reforming process such as a water gas shift reactor is needed. In the present work, considerations are focused on the performance analysis of the water gas shift reaction with the iron making exhausted gases in various operation conditions. And, we discuss the reactor design concepts to achieve better reactor performance.

关键词： Hydrogen carbon monoxide water gas shift reactor

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