• Journal of Gastric Cancer
• /
• 제21권4호
• /
• pp.439-456
• /
• 2021

Purpose: Gastric cancer (GC) has high morbidity and mortality and is a serious threat to public health. The flavonoid compound vitexin is known to exhibit anti-tumor activity. In this study, we explored the therapeutic potential of vitexin in GC and its underlying mechanism. Materials and Methods: The viability, migration, and invasion of GC cells were determined using MTT, scratch wound healing, and transwell assays, respectively. Target molecule expression was determined by western blotting. Tumor growth and liver metastasis were evaluated in vivo using nude mice. Protein expression in the tumor tissues was examined by immunohistochemistry. Results: Vitexin inhibited GC cell viability, migration, invasion, and epithelial-mesenchymal transition (EMT) in a dose-dependent manner. Vitexin treatment led to the inactivation of phosphatidylinositol-3-kinase (PI3K)/AKT/hypoxia-inducible factor-1α (HIF-1α) pathway by repressing HMGB1 expression. Vitexin-mediated inhibition in proliferation, migration, invasion and EMT of GC cells were counteracted by hyper-activation of PI3K/AKT/HIF-1α pathway or HMGB1 overexpression. Finally, vitexin inhibited the xenograft tumor growth and liver metastasis in vivo by suppressing HMGB1 expression. Conclusions: Vitexin inhibited the malignant progression of GC in vitro and in vivo by suppressing HMGB1-mediated activation of PI3K/Akt/HIF-1α signaling pathway. Thus, vitexin may serve as a promising therapeutic agent for the treatment of GC.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권1호
• /
• pp.73-76
• /
• 2011

Gastrointestinal cyst found within the oral cavity has been reported as a rare occurrence with less than 40 cases. The tongue is the preferred site with almost 60% of cysts occurring within oral cavity. The cyst usually shows an asymptomatic swelling in the floor of the mouth, about 30% of affected individuals have symptoms related to difficulties with feeding, swallowing and respiration. The histopathologic features of the cyst vary with respect to the type of epithelium lining; gastric, squamous, intestinal and respiratory epithelium. The pathogenesis is not known, but it may be related to entrapment of undifferentiated endoderm within oral cavity during early fetal development. In this article, we report a case of a gastrointestinal cyst of the tongue in a 16-month-old girl.

• Radiation Oncology Journal
• /
• 제2권1호
• /
• pp.93-100
• /
• 1984

Among 238 patients with Non-Hodgkin's lymphoma received radiotherapy at Yonsei Cancer center, Yonsei University Medical College, from 1970 to 1981, 30 patients presented with localized(Stage I&II ) gastrointestinal lymphomas. Retrospective analysis of these 30 cases in an attempt to evaluate the influence of various prognostic factors and the effectiveness of therapy is presented. Overall 5 year survival rate of 30 cases of primary gastrointestinal lymphoma was $48\%$. Bulk of residual disease after initial surgery and stage were significant prognostic factors. Stage I with small residual disease treated with post-op irradiation achieved $100\%$ 5 year survival rate. So above group is considered curable with surgery and post-op irradiation. $80\%$ of Stage II with large residual disease were died with intra-abdominal local tumor control failure. Stage II with small residual disease showed $31.5\%$ 5 year survival rate. Non of them died with local failure. So, we suggest that complete surgical resection of tumor mass should be attempted initially in the management of localized gastrointestinal lypmhomas and systemic chemotherapy is needed in addition to post-op irradiation in the cases of Stage II and large residual disease after initial surgery.

• Journal of Gastric Cancer
• /
• 제16권1호
• /
• pp.58-62
• /
• 2016

Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract and usually appear as a well-circumscribed mass. However, it may be difficult to confirm the extent of the disease for some GISTs. A 70-year-old asymptomatic female presented for a regular physical exam. An esophagogastroduodenoscopy showed a 2.0 cm protruding mass on the gastric fundus. Endoscopic ultrasound revealed an ill-defined heterogenous hypoechoic lesion ($3.0{\times}1.5cm$). A computed tomography (CT) scan demonstrated a 4.5 cm multifocal calcified mass at the gastric body as well as at the gastric fundus. Laparoscopic gastric wedge resection was performed according to the extent of multifocal calcifications that are shown on the CT. Intraoperative specimen mammography and intraoperative biopsy might be helpful to obtain a tumor-free margin. Final pathologic diagnosis was an intermediate risk GIST in multilobular form. In patients with diffuse multifocal calcifications in the stomach, the possibility of GIST should be considered.

• Journal of Yeungnam Medical Science
• /
• 제23권1호
• /
• pp.131-137
• /
• 2006

Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

• Clinical Endoscopy
• /
• 제57권3호
• /
• pp.309-316
• /
• 2024

The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariatric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article comprehensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern exists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongoing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to support its routine use in clinical practice.

• 한국간담췌외과학회지
• /
• 제28권1호
• /
• pp.99-103
• /
• 2024

Pancreatic resections, depending on the location of the tumor, usually require division of the vasculature of either the distal or proximal part of the stomach. In certain situations, such as total pancreatectomy and/or with splenic vein occlusion, viability of the stomach may be threatened due to inadequate venous drainage. We discuss three cases of complex pancreatic surgeries performed for carcinoma of the pancreas at a tertiary care center in India, wherein the stomach was salvaged by reimplanting the veins in two patients and preserving the only draining collateral in one case after the gastric venous drainage was compromised. The perioperative and postoperative course in these patients and the complications were analyzed. None of these 3 patients developed any complication related to gastric venous congestion, and additional gastrectomy was avoided in all these patients. Re-establishment of the Gastric venous outflow after extensive pancreatic resections helps to avoid additional gastric resection secondary to venous congestive changes.

• Journal of Chest Surgery
• /
• 제38권7호
• /
• pp.514-517
• /
• 2005

위장관 간질 종양은 위장관 전역에서 발생하며 그 중 위와 소장 등에 많이 생기며 식도에서도 발생한다. 44세 남성이 연하곤란과 체중감소를 주소로 내원하여 시행한 상부 위장관 내시경 검사 및 흉부 전산화 단층 촬영에서 식도 하부의 완전폐쇄, 위의 전방 편위 소견과 중앙부 괴사를 동반하는 최대 직경 15cm 정도의 저음영의 거대 종괴를 보여 흉복부 절개를 이용하여 하부 식도 및 위전적출술을 시행하였다 종양은 CDl17 (c-kit)와 CD34에서 양성을 보여 악성 위장관 간질 종양으로 확진되었으며 현재 외래 추적관찰 중이다.

• Journal of Gastric Cancer
• /
• 제4권1호
• /
• pp.32-35
• /
• 2004

Purpose: The most important prognostic factors in gastric cancer is the depth of invasion of the primary tumor and lymph node metastasis. The nodal staging of the 5th edition of the Union Internationale Contrala Cancrums (UICC) TNM classification in 1997 was changed based on the number of metastatic lymph node. We attempted to evaluate the prognostic significance of N2 group metastasis in pT3pN1 gastric cancer patients by comparing two different nodal staging systems. Materials and Methods: A retrospective analysis was made for 352 gastric cancer patients who underwent curative resection, including D2 dissection, from 1991 to 1997 at Asan Medical Center. A clinicopathologic comparison between two groups by using a nodal staging systems was summarized into a table. Cumulative survival rates were calculated by using the Kaplan-Meier method. The difference between the two groups was evaluated by using the log rank test with SPSS 11.5 for Windows Results: There were no statistical differences in clinicopathologic factors. However, there was a significant difference in survival rate between the two groups (P=0.0009). This suggests that N2 group metastasis in pT3pN1 gastric cancer patients has a clinical significance for predicting prognosis. Conclusion: Our results suggest a possibility of prognostic significance of N2 group metastasis. Therefore, anatomical location of the lymph node should be described.

• Journal of Gastric Cancer
• /
• 제3권4호
• /
• pp.191-194
• /
• 2003

Purpose: Neuroendocrine carcinomas of the stomach account for only about $0.3\%$ of all gastric tumors. The prognosis of this disease is very poor compared with the common type of gastric adenocarcinoma. The purpose of this retrospective study was to review the clinicopathologic features of 18 cases of this unusual gastric tumor and to establish a treatment strategy for this tumor. Materials and Methods: Excluding 2 cases of non-curative resection and 1 case of operative mortality, 18 cases of typical neuroendocrine carcinoma who had curative resection from January 1991 to December 2000 at Asan Medical Center were analyzed; 6841 gastric cancer patient were treated surgically during the same period. Results: The mean age at the time of diagnosis was 58.6 years (range: $35\∼75$ yr). Sixteen patients were male, and two were female. Eleven tumors ($61.1\%$) developed in the lower part of the stomach, three ($16.7\%$) in the middle part, and three ($16.7\%$) in the upper part. One tumor involved the entire stomach. Eight cases ($44.4\%$) were Borrmann type 2, and six case ($33.3\%$) were Borrmann type 3. The mean tumor size was 6.94 cm (range: $0.6\∼15$ cm). Nine cases ($50\%$) showed recurrence of the disease, and eight of them died within 20 months. Of the nine recurred cases, 7 cases ($77.8\%$) showed liver metastasis. The mean disease-free interval was 6.8 months (range: $2.5\∼11$ months) after surgical resection, and the mean survival was 17.9 months (range: $8\∼40$ months) for recurrence cases. One patient with liver metastasis was treated with a liver-wedge resection just after diagnosis and was still alive for 37.5 months postoperatively. There were 9 deaths after the median follow- up period of 40 months (range: $8\∼72$ months). Conclusion: Gastric neuroendocrine carcinomas frequently recur at the liver, even in early stage cancer, and have a poor prognosis. We experienced a case of successful control of hepatic metastasis by surgical resection and a case of a small cell carcinoma which was successfully controlled with systemic chemotherapy.