• 대한수의학회지
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• 제48권1호
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• pp.111-117
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• 2008

Gastrointestinal stromal tumor (GIST) is one of the mesenchymal tumors originated from gastrointestinal submucosa. A 10 year-old, male, mixed breed dog with persistent diarrhea, anorexia and lethargy was referred to Haemaru Animal Referral Hospital. Large mass originated from the transverse colon was observed and large amount of ascites and free gas were found on abdominal radiography and ultrasonography. The ascites was septic exudate mixed with bacteria that consisted with intestinal perforation. There was no metastatic lesion. This mass was tentatively diagnosed as adenocarcinoma, leiomyosarcoma (LMS) and lymphosarcoma and surgical resection and histilogical examination were planned. However, according to owner's request, the patient was euthanized and then the necropsy was performed. About 10 cm sized mass originated from the cecum, ascending colon and transverse colon was adhered to surrounding mesentery and the perforation and large amount of ascites were observed. GIST was suspected on histopathologic examination and confirmed according to CD 117 expression in immunohistochemistry. GIST, derived from interstitial cells of Cajal, can be distinguished from LMS and leiomyoma (LM) on the basis of expression of CD117 (KIT) immunohistochemically. GIST has a different biological behavior and clinical course compared with LMS and LM, therefore definite diagnosis for GIST using immunohistochemistry is clinically important to predict the precise prognosis of the patient.

• Radiation Oncology Journal
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• 제29권4호
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• pp.219-227
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• 2011

Purpose: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. Materials and Methods: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). Results: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, ${\alpha}/{\beta}$ = 10 Gy) was 52 $Gy_{10}$ (range, 37.5 to 76.8 $Gy_{10}$) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 $Gy_{10}$ and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, P = 0.041). Conclusion: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (${\alpha}/{\beta}$ = 10 Gy) higher than 57 $Gy_{10}$ could improve local control.

• 대한한의학회지
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• 제40권1호
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• pp.99-113
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• 2019

Objectives: This study is designed to identify the responses of autonomic nervous system and gastrointestinal function which are induced by acupuncture at abdominal anterior cutaneous nerve. Methods: This study is one group before and after pilot study. Subjects were treated once, after having been fasting six hours. They had before tests, labeling points for acupuncture, acupuncture, and after tests in order. The points of acupuncture were motor points of rectus abdominis where the abdominal anterior cutaneous nerve came to the skin from abdominal wall. Before and after tests were consisted of three things: Digital Infrared Thermographic Imaging(D.I.T.I.), Heart Rate Variability(HRV), and Recording of bowel sounds. Results: There were significant differences on the skin temperature of upper body and the frequency of bowel sounds(p<0.001, p<0.001). The HRV parameters and volume of bowel sounds had no significant differences(p>0.05, p>0.05). Conclusion: Even though no significant differences in HRV parameters, the significant differences of skin temperature of upper body and frequency of bowel sounds could mean acupuncture at abdominal anterior cutaneous nerve could affect the autonomic nervous system and gastrointestinal function. However, this study had no group to compare with. Future randomized project should address this issue.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제14권2호
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• pp.130-136
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• 2011

Plain X-ray radiographs are the first line of investigation taken in the diagnosis of abdominal pathology and are considered an important diagnostic tool to provide guidelines for further imaging studies and comprehensive therapeutic management. Although most abdominal pathology demonstrates non-specific radiologic findings, the plain abdominal radiography is very useful in specific diseases, including certain gastrointestinal anomalies. This review provides image findings of normal plain abdominal radiography and some common abdominal pathology in infants and children.

• 대한소화기학회지
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• 제72권6호
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• pp.277-280
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• 2018

Although small bowel the mainly occupies the most part of the gastrointestinal tract, small intestine tumors are rare, insidious in clinical presentation, and frequently represent a diagnostic and management challenge. Small bowel tumors are generally classified as epithelial, mesenchymal, lymphoproliferative, or metastatic. Familial adenomatous polyposis and Peutz-Jeghers syndrome are the most common inherited intestinal polyposis syndromes. Until the advent of capsule endoscopy (CE) and device-assisted enteroscopy (DAE) coupled with the advances in radiology, physicians had limited diagnostic examination for small bowel examination. CE and new radiologic imaging techniques have made it easier to detect small bowel tumors. DAE allows more diagnosis and deeper reach in small intestine. CT enteroclysis/CT enterography (CTE) provides information about adjacent organs as well as pictures of the intestinal lumen side. Compared to CTE, Magnetic resonance enteroclysis/enterography provides the advantage of soft tissue contrast and multiplane imaging without radiation exposure. Treatment and prognosis are tailored to each histological subtype of tumors.

• Journal of Digestive Cancer Research
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• 제10권1호
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• pp.16-21
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• 2022

Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.

• Clinical Endoscopy
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• 제56권2호
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• pp.164-168
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• 2023

When diagnosing the nature of biliary strictures, it is sometimes difficult to perform non-invasive methods such as ultrasound, spiral computed imaging, magnetic resonance imaging, or endoscopic ultrasonography. Thus, treatment decisions are usually based on biopsy results. However, brush cytology or biopsy, which is widely used for biliary stenosis, has limitations owing to its low sensitivity and negative predictive value for malignancy. Currently, the most accurate method is bile duct tissue biopsy under direct cholangioscopy. On the other hand, intraductal ultrasonography administered under the guidance of a guidewire has the advantages of easy administration and being less invasive, allowing for adequate examination of the biliary tract and surrounding organs. This review discusses the usefulness and drawbacks of intraductal ultrasonography for biliary strictures.

• Journal of Gastric Cancer
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• 제11권3호
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• pp.173-179
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• 2011

Purpose: It is difficult to obtain biopsies from gastrointestinal stromal tumors (GISTs) prior to surgery because GISTs are submucoal tumors, despite being the most common nonepithelial neoplasms of the gastrointestinal tract. Unlike anatomic imaging techniques, PET-CT, which is a molecular imaging tool, can be a useful technique for assessing tumor activity and predicting the malignant potential of certain tumors. Thus, we aimed to evaluate the usefulness of PET-CT as a pre-operative prognostic factor for GISTs by analyzing the correlation between the existing post-operative prognostic factors and the maximum SUV uptake (SUVmax) of pre-operative 18F-fluoro-2-deoxyglucose (FDG) PET-CT. Materials and Methods: The study was conducted on 26 patients who were diagnosed with gastric GISTs and underwent surgery after being examined with pre-operative FDG PET-CT. An analysis of the correlation bewteen (i) NIH risk classification and the Ki-67 proliferation index, which are post-operative prognostic factors, and (ii) the SUVmax of PET-CT, which is a pre-operative prognostic factor, was performed. Results: There were significant correlations between (i) SUVmax and (ii) Ki-67 index, tumor size, mitotic count, and NIH risk group (r=0.854, 0.888, 0.791, and 0.756, respectively). The optimal cut-off value for SUVmax was 3.94 between "low-risk malignancy" and "high-risk malignancy" groups. The sensitivity and specificity of SUVmax for predicting the risk of malignancy were 85.7% and 94.7%, respectively. Conclusions: The SUVmax of PET-CT is associated with Ki-67 index, tumor size, mitotic count, and NIH classification. Therefore, it is believed that PET-CT is a relatively safe, non-invasive diagnostic tool for assessing malignant potential pre-operatively.

• Clinical Endoscopy
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• 제51권6호
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• pp.558-562
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• 2018

Background/Aims: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studies on MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings and clinicopathological features of MWFL. Methods: Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening between April 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL. Results: The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes, mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa, and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclear microvascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusions and oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug use was significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001). Conclusions: The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acid-reducing drug use.

• 대한영상의학회지
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• 제85권1호
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• pp.124-137
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• 2024

장회전이상과 이로 인한 중장염전은 생후 1개월 이내에 호발하는 외과적 응급 질환이다. 전형적인 증상은 급성 담즙성 구토이며, 유아기 이후에는 반복적인 복통과 같은 비특이적인 증상을 호소할 수 있다. 장간막 띠로 인한 십이지장 폐쇄나 고리췌장, 십이지장 전방 문맥과 같은 기형을 동반하기도 한다. 중장염전은 장의 괴사를 일으켜 생명을 위협할 수 있으므로 정확하고 빠른 진단이 중요하다. 상부 위장관 조영술, 초음파 및 CT로 진단할 수 있으며, 초음파는 소아에서 방사선 피폭 없이 빠르고 정확하게 진단할 수 있어 선별검사로 대두되고 있다. 본 임상화보에서는 장회전이상과 중장염전의 핵심적인 영상 소견 및 진단적 접근법에 대해 알아보고, 실제 증례에서 경험한 진단적 오류와 주의할 점에 대하여 살펴보고자 한다.