Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer

Haruo Takahashi,Yoshimasa Miura,Hiroyuki Osawa,Takahito Takezawa,Yuji Ino,Masahiro Okada,Alan Kawarai Lefor,Hironori Yamamoto 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3

Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished frominflamed mucosa. We treated a patient with a small early gastric cancer that was diffcult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, bluelaser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from thesurrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even withsmall-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosaldissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinomalocalized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. Thissmall early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.

Potential Applicability of Local Resection With Prophylactic Left Gastric Artery Basin Dissection for Early-Stage Gastric Cancer in the Upper Third of the Stomach

Akashi Yoshimasa,Ogawa Koichi,Hisakura Katsuji,Enomoto Tsuyoshi,Ohara Yusuke,Owada Yohei,Hashimoto Shinji,Takahashi Kazuhiro,Shimomura Osamu,Doi Manami,Miyazaki Yoshihiro,Furuya Kinji,Moue Shoko,Oda T 대한위암학회 2022 Journal of gastric cancer Vol.22 No.3

Purpose Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD. This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature Purpose Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD. This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature

The Study of the Self-Compatibility Mechanism of Apple Autotetraploid Cultivars

Yoshiteru Adachi,Sadao Komori,Yoshimasa Hoshikawa,Kazuyuki Abe,Hideo Bessho,Sae Takahashi,Akira Suzuki 한국원예학회 2006 한국원예학회 기타간행물 Vol.- No.-

Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast

Hiraoka, Yuji,Miura, Yoshimasa,Osawa, Hiroyuki,Nomoto, Yoshie,Takahashi, Haruo,Tsunoda, Masato,Nagayama, Manabu,Ueno, Takashi,Lefor, Alan Kawarai,Yamamoto, Hironori The Korean Gastric Cancer Association 2021 Journal of gastric cancer Vol.21 No.2

Purpose: Screening image-enhanced endoscopy for gastrointestinal malignant lesions has progressed. However, the influence of the color enhancement settings for the laser endoscopic system on the visibility of lesions with higher color contrast than their surrounding mucosa has not been established. Materials and Methods: Forty early gastric cancers were retrospectively evaluated using color enhancement settings C1 and C2 for laser endoscopic systems with blue laser imaging (BLI), BLI-bright, and linked color imaging (LCI). The visibilities of the malignant lesions in the stomach with the C1 and C2 color enhancements were scored by expert and non-expert endoscopists and compared, and the color differences between the malignant lesions and the surrounding mucosa were assessed. Results: Early gastric cancers mainly appeared orange-red on LCI and brown on BLI-bright or BLI. The surrounding mucosae were purple on LCI regardless of the color enhancement but brown or pale green with C1 enhancement and dark green with C2 enhancement on BLI-bright or BLI. The mean visibility scores for BLI-bright, BLI, and LCI with C2 enhancement were significantly higher than those with C1 enhancement. The superiority of the C2 enhancement was not demonstrated in the assessments by non-experts, but it was significant for experts using all modes. The C2 color enhancement produced a significantly greater color difference between the malignant lesions and the surrounding mucosa, especially with the use of BLI-bright (P=0.033) and BLI (P<0.001). C2 enhancement tended to be superior regardless of the morphological type, Helicobacter pylori status, or the extension of intestinal metaplasia around the cancer. Conclusions: Appropriate color enhancement settings improve the visibility of malignant lesions in the stomach and color contrast between the malignant lesions and the surrounding mucosa.

Standardization of the first Korean national reference standard for snake (Gloydius brevicaudus) antivenom

Han Kiwon,Song Hojin,Choi Chan Woong,Park Sangmi,Kang Yong Seok,Jung Kikyung,Lee Byung-Hwa,Takahashi Yoshimasa,Matsumura Takayuki,Yamamoto Akihiko,Kim Yang Jin,Jee Seung-wan,Kim Jaeok 한국독성학회 2020 Toxicological Research Vol.36 No.4

In 2017, the second national reference standard (NRS) for Gloydius snake venom was established to replace the first NRS for Gloydius snake venom. In connection with the second venom NRS, a candidate for the first NRS for Gloydius snake antivenom was produced in 2017. In this study, the qualification of the candidate was estimated and the potency was determined by a collaborative study. The potency (anti-lethal titer and anti-hemorrhagic titer) of the candidate was determined by measuring the capability of the antivenom to neutralize the lethal and hemorrhagic effects of the second NRS for Gloydius snake venom, which was calibrated against the regional reference standard for Gloydius snake antivenom established in 2006. Two Korean facilities contributed data from 20 independent assays. Subsequently, one foreign national control research laboratories participated in this collaborative study. The general common potency of the anti-lethal and anti-hemorrhagic titers was obtained from the results of a total of 25 tests performed at three facilities. According to the results of the present study, the candidate preparation showed good quality and is judged to be suitable to serve as the first NRS for Gloydius snake antivenom with the following potency: an anti-lethal titer of 3100 unit (U) (95% confidence interval 2991–3276 U) and anti-hemorrhagic titer of 3000 U (95% confidence interval 2849–3159 U). In conclusion, the first NRS for Gloydius snake antivenom was established in this study. This reference standard will be used routinely for quality control of a snake antivenom product by manufacturer in Korea, which also can be used for national quality control, including a national lotrelease test of the snake antivenom product.