• Journal of Digestive Cancer Research
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• v.6 no.1
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• pp.25-31
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• 2018

Background: In Korea, stomach cancer is the second most common malignancy and the third leading cause of cancer-related deaths. the time of diagnosis is very important for treatment so early detection and surgery are currently considered the mainstay of treatment, when diagnosed advanced with tumor extension through the gastric wall and direct extension into other organs, with metastatic involvement. Recently, new drugs, drug combinations, and multimodal approaches have been used to treat this disease and In cancers over expressing or amplifying HER2, the combination of cisplatin-fluoropyrimidine-trastuzumab is considered to be the treatment of reference. but At present, the choice of treatment schedule for HER2-negative tumors is based on the medical institution's preferences and adverse effects profile. The aim of this study was to evaluate the effectiveness and safety of using FOLFOX regimen as a first-line therapy or a salvage therapy in the patients with HER2-negative advanced or metastatic gastric cancer. Methods: We retrospective reviewed the patient medical record from March 2012 to July 2017. This study evaluated 113 patients. Sixty-eight patients were treated with the FOLFOX regimen for the first time (first-line group) and 45 patients were treated with the FOLFOX regimen as a second (35 patients) or third (10 patients) chemotherapy (salvage group). Results: In the first-line group, the response rate was 54.9%. In the salvage therapy group, the response rate was 24.4% and The difference was statistically significant (p=0.205). The median TTP of the first-line group was 10.7 months (95% confidence interval [95% CI], 7.8-13.7 months) and that of salvage line group was 6.1 months (95% CI, 3.8-8.4 months). The median OS of the first-line group was 15.8 months (95% CI, 12.7-18.9 months) and that of the salvage therapy group was 10.2 months (95% CI, 8.2-11.9 months). drug toxicity was similar andtolerable between two groups. Conclusion: In patients with unresctable metastatic gastric cancer, after failing to respond to first-line therapy, most patients have no alternative other than second-line therapy because the disease is highly progressive. if the performance status of the patient is good enough to be eligible to treatments beyond best supportive care. FOLFOX regimen can be a considerable therapeutic option for salvage treatment.

• Korean Journal of Veterinary Service
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• v.38 no.3
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• pp.199-203
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• 2015

An 8-year old intact female poodle was presented to clinics due to abdominal distension, anorexia, and labored breath associated with pleural effusion. Intra-operative findings revealed multiple neoplasm of the greater omentum, involving anterolateral abdominal wall, sterna surface in the pleural cavity and diaphragm. These masses were 0.1~0.5 cm in diameter and extended to ovaries, pancreas, and serosal surface of stomach. Microscopically, most neoplastic cells had oval nuclei with prominent nucleoli and abundant eosinophilic cytoplasm. In deeper area, neoplastic acinus or glandular structures showed invaginated growth resembling adenocarcinoma. High mitotic figures were observed. By immunohistochemistry, the neoplastic cells were strong positive both cytokeratin and vimentin. The present case described for malignant mesothelioma in a dog. Our findings might be helpful for diagnosis and information and helped the clinics choose the treatment including chemotherapy such as cisplatin.

• The Korean Journal of Physiology and Pharmacology
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• v.24 no.1
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• pp.89-99
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• 2020

Although microscopic analysis of tissue slides has been the basis for disease diagnosis for decades, intra- and inter-observer variabilities remain issues to be resolved. The recent introduction of digital scanners has allowed for using deep learning in the analysis of tissue images because many whole slide images (WSIs) are accessible to researchers. In the present study, we investigated the possibility of a deep learning-based, fully automated, computer-aided diagnosis system with WSIs from a stomach adenocarcinoma dataset. Three different convolutional neural network architectures were tested to determine the better architecture for tissue classifier. Each network was trained to classify small tissue patches into normal or tumor. Based on the patch-level classification, tumor probability heatmaps can be overlaid on tissue images. We observed three different tissue patterns, including clear normal, clear tumor and ambiguous cases. We suggest that longer inspection time can be assigned to ambiguous cases compared to clear normal cases, increasing the accuracy and efficiency of histopathologic diagnosis by pre-evaluating the status of the WSIs. When the classifier was tested with completely different WSI dataset, the performance was not optimal because of the different tissue preparation quality. By including a small amount of data from the new dataset for training, the performance for the new dataset was much enhanced. These results indicated that WSI dataset should include tissues prepared from many different preparation conditions to construct a generalized tissue classifier. Thus, multi-national/multi-center dataset should be built for the application of deep learning in the real world medical practice.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2695-2697
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• 2016

Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (p<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4631-4635
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• 2016

Background: The plant Ecballium elaterium (L.) A. Rich, belongs to the Cucurbitaceae family which occupies an important position in traditional medicine prescriptions. It has been reported that a freeze-dried aqueous extract of E. elaterium fruits has cytotoxic effects on the AGS human stomach adenocarcinoma cell line. We here focused on anticancer effects of the main chemicals purified from E. elaterium fruits. Materials and Methods: We isolated cucurbitacins D, E, and I from chloroform, and ethyl acetate fractions of a methanolic extract of E. elaterium fruits and assessed their cytotoxic effects on the AGS cell line by MTT assay. The methanolic extract was fractionated to petroleum ether, chloroform, and ethyl acetate fractions. The compounds isolated by column chromatography were identified by NMR spectroscopy. Results: After 24 h of incubation with AGS cells, the IC50 values were 0.3, 0.1, and $0.5{\mu}g/ml$ for cucurbitacins D, E, and I respectively. Conclusions: This finding suggests that because of its cucurbitacins, E. elaterium fruit may have some cytotoxic effects on gastric cancer cells. Also, compared with D and I, cucurbitacin E showed greater potency in this regard.

• Korean Journal of Medicinal Crop Science
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• v.12 no.2
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• pp.141-148
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• 2004

Two compounds from Gomisin N and Gomisin A were isolated from the fruits of Schizandra chinensis Baillon. The highest extraction yield as 21.36% was observed in the ethanol extract, compared to the yield obtained form the water extract. The extraction yields of the single compounds were measured to be 0.13 and 0.014 Gomisin A and Gomisin N, respectively. Approximately, 90% of the growth of human stomach adenocarcinoma cancer cells was inhibited after adding 1.0 g/l of the ethanol extract. The growth of the human normal lung cell was limited to 24% after adding the ethanol extract. The water extract lowered the specific secretion of $TNF-\acute{a}$ and IL-6 from T cells, $10.3{\times}10^{-4}\;pg/cell\;and\;12.1{\times}10^{-4}\;pg/cell$, respectively, compared to the ethanol extracts. On the other hand, a treatment with the ethanol extract increased the specific secretion of $TNF-\acute{a}$ and IL-6 from human T cells, to $11{\times}10^{-4}\;pg/cell\;and\;14.3{\times}10^{-4}\;pg/cell$, respectively. The crude ethanol extract had the highest effect on the differentiation of human promyelocytic leukemia cells compared to the other extracts and Gomisin A and N. In general, the biological activities of the extracts gradually decreased as the purification process proceeded, which suggests that higher immunostimulatory activities can be maintained by adding the crude extracts of the fruits rather than by adding a single compound.

• Tuberculosis and Respiratory Diseases
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• v.61 no.4
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• pp.398-402
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• 2006

Trousseau's syndrome comsists of migratory thrombophlebitis and thromboembolic disorders of the venous and arterial systems in a malignancy or occult cancer. The overall incidence has been reported to vary from 1 to 11%. Pancreatic, lung, prostate, and stomach cancer is associated with the greatest risk of thromboembolic events. We encountered a 49-year-old man who presented with painful swelling of his lower legs. The chest radiograph showed increased opacity of the Left middle lung fields and Doppler sonography showed a thrombus in the left superficial femoral vein. Chest Computed Tomography showed a 5cm sized left hilar mass invading the pericardium with lymphadenopathy. The bronchoscope biopsy demonstrated an adenocarcinoma of the lung. Platinum based chemotherapy and anticoagulant therapy with warfarin was carried out. The patient was later discharged with an improvement in the painful swelling of his lower legs.

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.21-28
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• 1998

Cytologic evaluation of cerebrospinal fluid(CSF) is an effective tool in diagnosing many disorders involving the central nervous system(CNS). CSF examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous or leukemic involvement of CNS and certain primary CNS tumors. As a survey of metastatic tumors to CSF and an evaluation of the preparation techniques increasing cellular yield in our laboratory, 713 CSF specimens examined between July 1995 and April 1997(1 year 10 months), were reviewed. There were 75 positive and 5 suspicious cases, the latter have had no evidence of tumors clinically. Primary tumors of 75 positive cases were classified as follows; 4(5.3%) as primary brain tumors, 40(53.3%) as secondary carcinomas, 13(17.3%) as leukemias, and 18 (24.0%) as lymphomas. The most common primary site of metastatic carcinomas was the lung in 17 cases(42.5%) followed by the stomach in 13(32.5%), breast in 8 (20.0%), and unknown primary in 2(5.0%). Four primary brain tumors were 3 cerebellar medulloblastomas and a supratentorial primitive neuroectodermal tumor (PNET). All 40 metastatic carcinomas were adenocarcinoma presented as single cells or cell clusters. Although signet ring cells were frequent in the cases of gastric primary cancers, no significant cytologic differences according to the primary site were observed. The cytologic features of leukemia and lymphoma were characterized by hypercellular smears presenting as individual atypical cells with increased N/C ratio, presence of nucleoli, and nuclear protrusions. In medulloblastomas and PNET, the principal cytologic findings were small undifferentiated cells arranged singly or in loose clusters with occasional rosettoid features. This study suggests that the CSF cytology is useful in the diagnosis of malignancy, especially metastatic extracranial tumors and the diagnostic accuracy can be improved by increasing cellular yield using cytocentrifuge.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.373-379
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• 1993

Primary lung cancer has increased markedly in its incidence and prevalence rate recently in Korea. In frequency, it occupies the second rank cancer preceded by stomach cancer in korean male. From February 1986 to December 1992, we have operated on 55 cases of primary lung cancer in Korea Veterans Hospital and followed them. The results are as follows; 1. The peak incidence of age of primary lung cancer was 6th decade and 5th decade and those were 87.3% of study group, mainly in male. 2. Symptoms were cough [63.6%], dyspnea [41.8%], chest pain and discomfort [38.2%], blood tinged sputum and hemoptysis [21.8%]. Symptoms were frequently encountered before hospitalization and asymptomatic cases were 9.1% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy [52.7%], percutaneous needle aspiration[PCNA][21.8%], sputum cytolgy [12.7%], open biopsy [12.7%]. 4. Histopathologically, squamous cell carcinoma [76.4%] was the most frequent cancer and adenocarcinoma [10.9%], giant cell cancer [7.3%], and the others in order. 5. Methods of operation were pneumonectomy [32.7%], bilobectomy [18.2%], lobectomy [27.3%], lobectomy and segmenectomy [1.8%], exploration [20%], and overall resectability was 80%. 6. Operative mortality was 5.5% [3 cases] and there were 5 cases of complication. 7. Postoperative long-term follow up reveals that the cumulative survival rates in 6 months, 12 months, 26 months, 34 months, 43 months, 64 months were 89.5%, 71.7%, 66.7%, 57.2%, 50.8%, 42.3% respecively.

• Journal of Chest Surgery
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• v.45 no.1
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• pp.35-39
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• 2012

Background: The aims of the study were to determine the accuracy of fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting pulmonary metastasis through video-assisted thoracoscopic surgery (VATS), a technique that allows the excisional biopsy of small pulmonary nodules in patients with known malignancies. Materials and Methods: Between October 2007 and April 2010, 28 patients with known malignancies and small pulmonary nodules underwent VATS excisional biopsies. All patients were in follow-up for a previously treated malignancy. The malignancies included the following: colorectum (9), breast (6), head and neck (5), stomach (3), lymph (1), ovary (1), uterus (1), bladder (1), and liver (1). Results: There were 16 men and 12 women whose mean age was 56.7 years old (range, 38 to 77 years). The sizes of the mean nodules removed were 11.3 mm (range, 7 to 21 mm). Diagnoses included metastatic (11), bronchioloalveolar carcinoma (1), primary adenocarcinoma (1), pulmonary tuberculosis (6), fibrosis (5), organizing pneumonia (3), lymphoid hyperplasia (1). Among these lesions, 46.4% were malignant. Conclusion: True positive FDG-PET was 39.2%. FDG-PET is not a sensitive test in the evaluation of patients with a history of an extrathoracic malignancy and newly diagnosed small pulmonary nodules. VATS excision allows the early diagnosis of small pulmonary nodules, with low morbidity, in patients with known malignancies.