• Journal of Gastric Cancer
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• v.15 no.1
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• pp.68-73
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• 2015

Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.252-259
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• 2005

To clarify the clinicopathologic features of small-cell carcinomas (SCC) of the stomach, we reviewed three cases of surgically treated SCC. The first case was a pure SCC, with severe pancreatic invasion and peritoneal seeding. A gastro-jejunostomy was performed. Postoperative chemotherapy was performed with CDDP and VP-16 (8 cycles) but showed disease progression (PD); a consecutive chemotherapy with CDDP and irinotencan (2 cycles) also showed PD. A third line with CDDP, VP16, ifosfamide, and mesna was followed by a 4th line (CDDP and Taxol). The male patient died with liver metastasis and peritoneal seeding 14 months after the operation. The second case was a SCC mixed with a poorly differentiated adenocarcinoma. Profound lymphadenopathy and liver metastasis were found. Two cycles of preoperative chemotherapy with TS-1 and CDDP were performed, which showed nearly complete remission for lymphadenopathy and partial response for the primary tumor site and liver metastatic lesion. A total gastrectomy and extended lymphadenectomy was performed. There were no viable cancer cells in 35 retrieved lymph nodes. Postoperative chemotherapy using the same regimen was performed for 4 cycles. Enlarged liver metastasis was found at the follow-up CT scan, so a posterior segmentectomy of liver was performed. After liver surgery, the chemotherapy regimen was changed to irinotecan and cisplatin. This male patient has been in good health for the f4 months since gastric surgery. The third case was a pure SCC, and a subtotal gastrectomy was performed curatively. That male patient received 5 cycles of TS-1 and is still in good health 14 months after operation.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.156-164
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• 1995

Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.176-181
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• 2008

Purpose: The adipocyte-derived cytokine leptin plays a major role in the control of stable body weight by suppressing food intake and increasing energy metabolism. Leptin regulates the cell proliferation of various epithelial cells and it may be involved in the promotion of cancer. Leptin and its receptor are highly expressed in gastric adenocarcinoma, but the association between the serum leptin level and the tissue expression of leptin is uncertain. We evaluated the serum leptin level and the expressions of leptin and leptin receptor in gastric cancer, and we explore the possible mechanism and role of leptin in the carcinogenesis of gastric cancer. Materials and Methods: 72 carcinomas that were curatively resected at our hospital from October 2005 to March 2007 were included in this study. By immunoassay and immunohistochemical staining, we evaluated the serum leptin level and the expressions of leptin and its receptor, and we analyzed their relationship together with the clinicopathological variables. Results: The serum leptin level was increased as the patient's BMI increased and it was decreased in H. pylori infected patients. The expression of leptin was increased as the TNM stage increased (P=0.014), and the expression of leptin receptor in the intestinal type gastric adenocarcinoma was higher than that in the diffuse type gastric adenocarcinoma (71.4% vs 28.6%, respectively, P=0.033). Conclusion: There was no significant correlation between the serum leptin level and expression of leptin in gastric cancer patients. The expression of leptin was associated with the TNM stage, but its role in the pathogenesis of gastric cancer has to be elucidated.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.9
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• pp.1243-1252
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• 2009

We investigated a method to improve anticancer activities of Acer mono by ultra high pressure extraction process. The extract yields by ultra high pressure were 9.49% and 9.87% for 5 min and 15 min processing time, respectively, which were relatively higher than 3$\sim$4% of conventional extraction processes due to their resid bark structure. The extract for 15 minutes extraction (HPE15) showed higher potent scavenging effect as 94.56% than the control, BHA as 93.24%. On SOD-like test, HPE15 also showed the highest activity as 38.6% at 1.0 mg/mL concentration. The cytotoxicity of HPE15 on normal human lung and kidney cell were below 23.54% in adding 1.0 mg/mL. Generally, human cancer cell growth stomach adenocarcinoma (AGS), lung adenocarcinoma (A549), breast adenocarcinoma (MCF-7), colon adenocarcinoma (Caco-2) and liver adenocarcinoma (Hep3B) were inhibited up to 75% with higher selectivity of above 4.0. High antioxidant activity of HPE15 resulted in high anticancer activity, and its activity was also due to higher yields of Acer mono by ultra high pressure extraction process. It was also proved by HPLC comparison analysis.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.31-35
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• 2006

Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.565-573
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• 1998

Malignant pleural effusions are most commonly associated with lung cancers, however, it also can be resulted from breast cancers, ovarian cancers, stomach cancers and so on. According to the their histologic types, adenocarcinoma have been known as the most common cell type of malignant pleural effusions and squamous cell carcinoma is rare. We herein present incidences, clinical characteristics and survivals of malignant pleural effusions according to their cell types and primary diseases. The objects are 84 malignant pleural effusion patients diagnosed by pleural fluid cytologic examination or pleural biopsy from Jan. 1992 to May. 1997 in Seoul National University Hospital. A retrospective chart review on their histologic types, biochemical parameters and survivals is described. Among 84 patients, 52 were males and the other 32 were females with 1.6:1 of male and female ratio and their mean age was 57.6 years old. Common symptoms of them wele dyspnea, cough, sputum and pleuritic chest pain. The proportions of bloody nature of effusion, lymphocyte dominant pleural effusion, exudative effusions were 66%, 39% and 93%, respectively. They consisted of 54 cases of adenocarcinoma(33 cases of them were lung cancers), and 10 cases of squamous cell carcinoma (8 cases of them were lung cancers), 10 cases of malignant lymphoma, 8 cases of small cell lung cancer and a case of mesothelioma and leukemia. There was no differences in characteristics of effusions, clinical features and survivals between each histologic cell types. Analyzing them according to primary diseases, no difference except longer survivals in malignant pleural effusions from breast cancer than from other cancers was observed. In conclusion, considering the incidences of histologic types of lung cancers during same period (squamous cell carcinoma; 47%, adenocarcinoma; 33%, small cell lung cancer; 12% and large cell carcinoma; 2%), malignant pleural effusions more likely occurred in adenocarcinoma than other cell types of lung cancers and there was no significant difference of clinical characteristics between histologic types.

• Korean Journal of Medicinal Crop Science
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• v.15 no.6
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• pp.405-410
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• 2007

This study was performed to investigate anticancer activities and immuno modulatory activities in the several parts of the A. mono and A. okamotoanum. The cytotoxicity of 1 $mg/m{\ell}$ of the water extracts on normal human lung cell(HEL299) was < 19.5%. The anticancer activity of all extracts were increased in over 55% against AGS (stomach adenocarcinoma), A549 (lung adenocarcinoma), Hep3B (liver adenocarcinoma, and MCF-7 (breast adenocarcinoma) cells. The growth of human immune B and T cells was improved of A. mono and A. okamotoanum in adding 1.0 $mg/m{\ell}$ concentration. The secretion of the IL-6 and $TNF-{\alpha}$ of human immune B and T cells was increased with all extracts of A. mono and A. okamotoanum. All extracts of. A. mono and A. okamotoanum increased NK cell growth. The results showed that the barks and woods extracts of A. mono and A. okamotoanum had useful biological activities. In addition, bark of A. okamotoanuim showed the highest anticancer and immune activities.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.150-154
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• 2001

Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.

• Journal of Ginseng Research
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• v.28 no.2
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• pp.104-110
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• 2004

The aim of this study was to evaluate prospectively the impact of the red ginseng extract on circulating interleukin (IL) 2 and 10 in advanced gastric cancer during chemotherapy after operative treatment. Analysis of circulating IL-2 and 10 was performed in 50 patients with advanced gastric adenocarcinoma who underwent a curative surgery or with an unresectable gastric adenocarcinoma by using ELISA and monoclonal antibodies at preoperative day 1, postoperative months 1, and 3. Twenty-five patients as the control group, twenty-six patients as the non-ginseng (NG) group, and twenty-four patients as the ginseng (G) group were eligible in this study. All plasma IL-2 of the NG and G groups was significantly lower an that of the control group on preoperative 1 day. These values of the G group were more increase than these of the NG group during the postoperative chemotherapy. The mean value of serum IL-10 of the control group (0.608pg/ml) was significantly lower than that of the advanced gastric cancer patients including the NG (12.015 pg/ml) and G group (9.409 pg/ml) (p＜0.001). These values of the G group were reduced progressively during the postoperative chemotherapy. The mesh value of the G group were only close to that of the control group on postoperative months 3 (p=0.003). The number of patients who were enrolled in this study was relatively small to fully evaluate the immunologic effects of the red ginseng extract on circulating IL-2 and 10. Despite this limitation, these results suggest that the post-operative intake of the red ginseng extract have potential to improve earlier anti-cancer immunity with recovering IL-2 and reducing IL-10 from the depressed IL-2 and elevated IL-10 by gastric cancer during the postoperative chemotherapy. This study will be based on the future study to evaluate the anti-immunity of the red ginseng extract.