• Journal of Gastric Cancer
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• v.10 no.1
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• pp.1-4
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• 2010

Purpose: Gastric epithelial dysplasia (GED) was defined as "unequivocally neoplastic epithelium that may be associated with or give rise to invasive adenocarcinoma" and GED also represents a direct precursor of intestinal type adenocarcinoma of the stomach. The recommended treatment guidelines for GED in the medical literature are endoscopic mucosal resection (EMR) or surgery for high grade dysplasia (HGD) and annual endoscopic surveillance with biopsy for low grade dysplasia (LGD) The aim of this study was to determine the treatment plan for GED that is diagnosed by endoscopic biopsy. Materials and Methods: We enrolled 148 patients who were treated by endoscopic mucosal resection (EMR) or endoscopiccsubmucosal dissection (ESD) for GED: there were 63 patients with HGD and 85 patients with LGD and all of them were diagnosed by endoscopic biopsy from January 2006 to December 2008. The results of the final histopathologic reports after EMR or ESD were compared with the results of the endoscopic biopsies. Results: The final histopathologic results of the 148 patients with GED showed 49 (33.1%) patients with adenocarcinoma, 40 (27.0%) patients with HGD and 59 (39.9%) patients with LGD. Among the 63 patients with HGD, 34 (54.0%) patients had adenocarcinoma, 20 (31.7%) patients had HGD and 9 (14.3%) patients had LGD. For the 85 patients with LGD, 15 (17.6%) patients had adenocarcinoma, 20 (23.5%) patients had HGD and 50 (58.8%) patients had LGD Conclusion: Complete resection, including EMR or ESD, is needed for patients with GED diagnosed by endoscopic biopsy and they have HGD. For patients with LGD, EMR or ESD may be needed in addition to endoscopic surveillance with biopsy for making the correct diagnosis and proper treatment because of the possibility of adenocarcinoma.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.875-878
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• 2006

A 39-year-old man presented with a esophageal submucosal tumor on regular check up examination. Preoperative exams showed the typical submucosal tumor as leiomyoma and operative procedure was enucleation for complete resection. Postoperative pathologic diagnosis including histologic and immunohistochemical study was compatible with plexiform schwannoma. Plexiform schwannoma is one of the least common variant of schwannoma that typically shows a plexiform or multinodular pattern. To our knowledge, there is rare case report of plexiform schwannoma originating in the esophagus and we report ore case with related literature.

• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.390-397
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• 2009

Endoscopic ultrasonography is a medical procedure in endoscopy combined with ultrasound to obtain images of the internal organs. It is useful to have a predictive pathological manifestation since a doctor can observe tumors under mucosa. However, it is often subjective to judge the degree of malignant degeneration of tumors. Thus, in this paper, we propose a feature analysis procedure to make the pathological manifestation more objective so as to improve the accuracy and recall of the diagnosis. In the process, we extract the ultrasound region from the image obtained by endoscopic ultrasonography. It is necessary to standardize the intensity of this region with the intensity of water region as a base since frequently found small intensity difference is only to be inefficient in the analysis. Then, we analyze the spot region with high echo and calcium deposited region by applying LVQ algorithm and bit plane partitioning procedure to tumor regions selected by medical expert. For detailed analysis, features such as intensity value, intensity information included within two random points chosen by medical expert in tumor region, and the slant of outline of tumor region in order to decide the degree of malignant degeneration. Such procedure is proven to be helpful for medical experts in tumor analysis.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.665-671
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• 2004

Background: Lymph node metastasis is commonly reported in thoracic esophageal cancer, even in the early esophageal cancer which may be localized only in the mucosa or within the submucosal layer. Although lymph node metastasis greatly influence long-term outcome and cure of the disease, endoscopic mucosal resection or photodynamic therapy without lymph node dissection is widely attempted. The investigation of the pattern of lymph node metastasis and results of surgical resection of superficial esophageal cancer is needed. Material and Method: Pattern of lymph node metastsis and depth of tumor invasion were studied retrospectively from 44 patients with early esophageal cancer who underwent radical resection of the tumor from December, 1995 to August, 2001. Result: Lymph node metastasis was found in 10 patients (22.7%) out of total of 44 patients. Lymph node metastasis was found in 0% (0 of 3), 0% (0 of 4), 50% (2 of 4), and 24.24% (8 of 33) of tumors that invaded the intraepitherium, lamina propria, muscularis mucosa, and submucosa respectively. Anatomically distant lymph node metastases were found more frequently in recurrent laryngeal nerve node(5 cases of 10 patients) and in intraperitoneal node (8 cases of 10). than intrathoracic node (3 cases of 10). There was no operative mortality, however, there were 1 hospital death in patient with lamina propria cancer, 1 late death in patient with submucosal cancer. Three-year survival rates (except hospital death) were 100% in mucosal cancer and 97.0% in submucosal cancer (p>0.05), and 100% in the node negative group and 90.0% in the node positive group (p>0.05). Conclusion: The survival rate of superficial esophageal cancer patient who was recieved operative resection was excellent. But, lymph node metastasis were found in superficial esophageal cancer, even in esophageal cancer limited to the muscularis mucosa. Systemic lymph node dissection which includes recurrent laryngeal nerve nodes and intraperitoneal nodes was recommended for favorable outcome in superficial esophageal cancer.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.31-40
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• 2005

Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

• Korean Journal of Head & Neck Oncology
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• v.25 no.2
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• pp.128-131
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• 2009

Objectives : Mucosa-associated lymphoid tissue(MALT) lymphoma of the head and neck region is relatively rare, but it has variable clinical and biological characteristics. Although there were few studies on this topic, there is still controversy regarding the best treatment. The authors retrospectively investigated the clinical courses and treatment results in 10 patients presenting with MALT-lymphoma in head and neck region except ocular adnexa. Material and Methods : Ten patients with a histologically verified diagnosis of the extranodal marginal zone B cell lymphoma arising in thyroid glands(3), larynx(3), oral cavity(2), oropharynx(1), salivary glands(1) were analyzed. Results : Four patients were allocated to stage IE and another six patients to stage IIE according to the Ann Arbor staging system. Treatment consisted of local therapy(surgical resection and/or radiotherapy) in four patients and systemic chemotherapy with/without local therapy in six patients. Complete remission and partial remission were achieved in seven patients(70%) and two patients(20%), respectively. No recurrence or mortality was observed with a mean follow-up of 40.5 months. Conclusion : Patients with MALT-lymphomas of the head and neck region were potentially treated by local modality in localized disease state. However systemic chemotherapy was also effective even in localized disease state and was well tolerated by patients. And strict staging and close long-term monitoring were recommended considering its indolent progression.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.120-126
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• 2005

Purpose: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors(GISTs) and assessed differences between the two groups. Materials and Methods: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echoheterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. Results: Tumor sizes over 40 mm were observed in $85.7\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.000). Intralesional cystic spaces were noted in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.003). The outer margin was irregular in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.014). $85.7\%$ of the malignant and $13.0\%$ of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. Conclusion: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.

• Radiation Oncology Journal
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• v.15 no.2
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• pp.79-95
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• 1997

Purpose : Phospholipase C(PLC) isozymes play significant roles in signal transduction mechanism. $PLC-\gamma$ 1 is one of the key regulatory enzymes in signal transduction for cellular proliferation and differentiation. Ras oncoprotein, EGFR, and PKC are also known to be involved in cell growth. The exact mechanisms of these signal transduction following irradiation, however, were not clearly documented Thus, this study was Planned to determine the biological significance of PLC, ras oncoprotein, EGFR, and PKC in damage and regeneration of rat intestinal mucosa following irradiation. Material and Method : Sixty Sprague-Dawley rats were irradiated to entire body with a single dose of 8Gy. The rats were divided into S groups according to the sacrifice days after irradiation. The expression of PLC, ras oncoprotein, EGFR and PKC in each group were examined by the immunoblotting and immunohistochemistry. The histopathologic findings were observed using H&I stain, and the mitoses for the evidence of regeneration were counted using the light microscopy & PCNA kit. The Phosphoinositide(PI) hydrolyzing activity assay was also done for the indirect evaluation of $PLC-\gamma$ 1 activity. Results: In the immunohistochemistry , the expression of $PLC-{\beta}$ was negative for all grøups. The expression of $PLC-{\gamma}1$ was highest in the group III followed by group II in the proliferative zone of mucosa. The expression of $PKC-{\delta}1$ was strongly positive in group 1 followed by group II in the damaged surface epithelium. The above findings were also confirttled in the immunoblotting study. In the immunoblotting study, the expressions of $PLC-{\beta}$, $PLC-{\gamma}1$, and $PKC-{\delta}1$ were the same as the results of immunohis-tochemistry. The expression of ras oncoprctein was weakly positive in groups II, III and IV. The of EGFR was the highest in the group II, III, follwed by group IV and the expression of PKC was weakly positive in the group II and III. Conclusion: $PLC-{\gamma}1$ mediated signal transduction including ras oncoprotein, EGFR, and PKC play a significant role in mucosal regeneration after irradiation. $PLC-{\delta}1$ mediated signal transduction might have an important role in mucosal damage after irradiation. Further studies will be necessary to confirm the signal transduction mediating the $PKC-{\delta}1$.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.715-720
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• 2021

Transurethral resection (TUR) is the gold standard treatment of non-muscle invasive bladder cancers. Recurrence occurs in approximately half of the patients with bladder cancer after initial TUR. Most recurrent bladder cancers present as polypoid masses with intraluminal growth originating from the mucosa. To the best of our knowledge, there has been no report on imaging findings of recurrent bladder cancers located within the subepithelial and intramural layers. Recurrent cancers within the intramural layer are difficult to detect with cystoscopy; they are also difficult to remove surgically. Imaging studies reveal the most important indicators for diagnosing subepithelial recurrent cancers. Here, we present a rare case of a recurrent bladder cancer within the subepithelial layer detected on imaging.

• Radiation Oncology Journal
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• v.4 no.2
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• pp.99-105
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• 1986

Optimal balance between control probability and risk of complication is emphasized even in present time, Although certain incidence of intestinal injury is accepted as an inevitable consequence after abdominopelvic irradiation, these complications still remain as problems. 60 mice were irradiated with 250 kVp orthovoltage x-ray machine and $200rad{\times}5/wk$ regimen. Histpathologic findings of colorectum and the relationship with occult blood test were analyzed and possible tolerable dose which would be safe from permanent complication was also estimated. Followings are the results: Mild mucosal and submucosal edema were observed in 1,000 rad irradiated group. Congestion of small vessels was prominent in 2,000 rad irradiated group and infiltration of inflammatory cells was observed in 3,000 rad irradiated group. Denuded mucosa was observed in 3,000 rad irradiated group. Occult blood test is not a proper indicator for rectal denuding or rectal ulcer, but our results suggest the possibility of using this as a relative scale of intestinal damage. Mitotic figures of crypt cells were observed even in 5,000 rad irradiated group, these suggest that the repair capacity of crypt cells are still functioning.