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Pathologic outcomes of endoscopic submucosal dissection for gastric epithelial neoplasia
Ryu, Dae Gon,Choi, Cheol Woong,Kang, Dae Hwan,Kim, Hyung Wook,Park, Su Bum,Kim, Su Jin,Nam, Hyeong Seok Wolters Kluwer Health 2018 Medicine Vol.97 No.33
<P><B>Abstract</B></P><P>Endoscopic submucosal dissection (ESD) has been widely implemented for the treatment of gastric superficial neoplasia. However, the final pathologic diagnosis after ESD may be different from that indicated by the results of endoscopic forceps biopsy. This study identified risk factors for gastric epithelial lesions so that early gastric cancer (EGC) could be diagnosed after ESD.</P><P>From December 2008 to January 2017, 1541 lesions (1410 patients) diagnosed as initial adenoma or indefinite for neoplasia by endoscopic forceps biopsy were enrolled. The EGC rate and factors predicting upstaged diagnoses were analyzed retrospectively.</P><P>The diagnostic discrepancy rate was 31.1%. Upstaged and downstaged diagnostic rates after ESD were 23.8% and 7.3%, respectively. The upstaged diagnosis rate for EGC was 18.8%. Gross depression (OR, 16.017) and surface redness (OR, 22.136) were significantly associated with EGC and lesions indefinite for neoplasia during the initial endoscopic forceps biopsy. Central depression (OR, 2.959), nodular surface (OR, 6.581), and surface redness (OR, 6.399) were significantly associated with EGC and lesions with low-grade dysplasia during the initial endoscopic forceps biopsy. Central depression (OR, 1.999), nodular surface (OR, 1.733), surface redness (OR 2.283), lesion location (upper third of the stomach) (OR, 3.989), and tumor size ≥10 mm (OR, 2.200) were significantly associated with EGC and lesions with high-grade dysplasia during the initial endoscopic forceps biopsy.</P><P>Central depression, nodular surface, surface redness, lesion location, and tumors >10 mm were associated with EGC. Gastric epithelial lesions with these characteristics require attention before ESD.</P>
류대곤 ( Dae Gon Ryu ),김은정 ( Eun Jung Kim ),안은영 ( Eun Young Ahn ),송병준 ( Byeong Jun Song ),강대환 ( Dae Hwan Kang ) 대한내과학회 2014 대한내과학회지 Vol.86 No.6
이 증례는 특별한 병력이 없던 건강검진 상부위장관 내시경에서 십이지장 종괴가 발견된 환자에서 내시경 역행 췌담관 조영술로 총담관류의 소견을 보여 내시경 유두괄약근 절개술을 시행하였고 조직 검사에서 고이형성증을 동반한 총담 관류를 진단하여 광범위 수술까지 진행한 경우이다. 총담관류는 빈도가 매우 드물고 다른 담관 낭종에 비해 악성화 가능성이 낮아서 내시경 유두괄약근 절개술로 치료를 종결하는 것이 대부분이지만 이번 증례처럼 고이형성증이 동반될 수 있으므로 총담관류를 발견하였을 때 유두괄약근 절개술 후 절개면을 주의 깊게 관찰하고 철저한 조직 검사와 추적관찰이 필요할 것으로 생각한다. A type III choledochal cyst, known as a choledochocele, is rare. It is defined as cystic dilatation of the distal common bile duct, protruding into the duodenal lumen. Surgical treatment of a choledochocele remains controversial because it has a low incidence for malignancy compared with other choledochal cysts. While there have been few reported cases of choledochocele with malignancy, here we report our experience of a choledochocele with high-grade dysplasia and provide a literature review of the field. (Korean J Med 2014;86:728-732)
급성 관상 동맥 증후군으로 오인된 식도 벽내 혈종 1예
유대곤 ( Dae Gon Ryu ),최철웅 ( Cheol Woong Choi ),강대환 ( Dae Hwan Kang ),김형욱 ( Hyung Wook Kim ),정동일 ( Dong Il Jeong ),김완철 ( Wan Chul Kim ),신재규 ( Jae Gyu Shin ),임태원 ( Tae Won Lim ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.4
Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents. Coronary angiography was performed immediately under the suspicion of acute coronary syndrome, and we found that there was no obvious clogging of the coronary arteries. Next, chest computed tomography was performed due to suspected aortic dissection, and the result was also negative. Four days later, endoscopy was performed and intramural hematoma covered with large ulcers was diagnosed. (Korean J Gastroenterol 2017;69:239-242)
The Role of Chitosan Nanoparticles in Delivery of Photosensitizer to Cholangiocarcinoma Cells
( Dae Hwan Kang ),( Hyung Wook Kim ),( Dae Gon Ryu ),( Tae Sung Kim ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Purpose: Chitosan is a natural, biocompatible, and biodegradable polymer with immuno-positive features and anticancer activities. Due to its cationic properties, Chitosan is used to incorporate anionic drugs e.g. Ce6 via transmucosal or oral delivery. In the study, Ce6-incorporated nanoparticles were created using water-soluble chitosan and its physicochemical properties and photodynamic potentials were studied against cholangiocarcinoma cells in vitro and in vivo settings. Methods: Water-soluble chitosan were obtained from Kittolife Co. Korea and Ce6 from Frontier Sci. Co. Ltd. USA. Ce6-incorporated nanoparticles using chitosan was prepared by thawing 100 mg of chitosan in 10 mL of deionized water. After the sonication of chitosan solution using bar-type ultrasonicator, 5-20 mg of Ce6 in 0.5 mL DMSO was added.The solution was dialyzed against water to remove any organic solvents and free drugs. Results: The higher Ce6 contents in the nanoparticles induced increased particle size and decreased zetapotential. When Ce6-incorporated nanoparticles were treated in HuCC-T1 cholangiocarcinoma cells with irradiation, it enhanced delivery of Ce6 to HuCC-T1 cells and raised ROS levels in tumor cells compared to Ce6 alone. Moreover, Photo-induced toxicity against cholangiocarcinoma cells were increased compared to Ce6 alone as well. In the in and ex vivo studies using cholangiocarcinoma-bearing mice and porcine bile duct slice, significantly better delivery was demonstrated with Ce6 comprising nanoparticles. Conclusions: ChitoCe6 nanoparticles can enhance cellular uptake of Ce6, phototoxicity, and ROS generation in HuCC-T1 cholangiocarcinoma cells compared to Ce6 alone. It has also shown improved delivery performance in both in and ex vivo settings
Type 316L(N) 스테인리스 강의 최적질소함량 평가
金大煥,金雨坤,柳禹錫 대한금속재료학회 2002 대한금속·재료학회지 Vol.40 No.6
Tensile, fatigue, creep-fatigue, creep tests were conducted at R.T.∼600℃ to evaluate the effect of nitrogen on mechanical properties and the optimum nitrogen content for type 316L(N) stainless steel containing the different nitrogen content from 0.04% to 0.15%. Tensile strength decreased with temperature and increased with the addition of nitrogen but elongation was not decreased with the addition of nitrogen. Fatigue life was almost same up to 300℃ and decreased drastically at 600℃. Fatigue life increased with the addition of nitrogen but decreased at above 0.10% nitrogen content. Fatigue crack propagation increased with temperature, decreased with the addition of nitrogen, and increased at above 0.10% nitrogen content. The time to rupture for creep increased with the addition of nitrogen and saturated at above 0.10% nitrogen content. Minimum creep rate of creep decreased with the addition of nitrogen. Creep-fatigue life increased with the addition of nitrogen but decreased at above 0.10% nitrogen content. Mechanical properties were improved up to 0.10% nitrogen content but saturated or decreased at above 0.10% nitrogen content. The optimum nitrogen content for the high temperature mechanical properties of type 316L(N) stainless steel was evaluated as 0.10% in the 0.02% carbon content.
Hyung-Gon Ryu,Dae Won Shin,Beom Su Han,Sang-Min Kim 대한고관절학회 2023 Hip and Pelvis Vol.35 No.3
Purpose: Cephalomedullary (CM) nailing is widely performed in treatment of elderly patients with femoral intertrochanteric fractures. However, in cases of fixation failure, re-operation is usually necessary, thus determining factors that may contribute to fixation failure is important. In this study, we examined factors affecting the occurrence of fixation failure, such as age or fracture stability, after CM nailing in elderly patients. Materials and Methods: This study was conducted retrospectively using registered data. From April 2011 to December 2018, CM nailing was performed in 378 cases diagnosed with femoral intertrochanteric fractures, and 201 cases were finally registered. Cases involving patients who were bed-ridden before injury, who died from causes unrelated to surgery, and those with a follow-up period less than six months were excluded. Results: Fixation failure occurred in eight cases. Comparison of the surgical success and fixation failure group showed that the mean age was significantly higher in the fixation failure group compared with the control group (81.3±6.4 vs. 86.4±6.8; P=0.034). A significantly high proportion of unstable fractures was also observed (139/54 vs. 3/5; P=0.040), with a significantly high ratio of intramedullary reduction (176/17 vs. 5/3; P=0.034). A significantly higher ratio of unstable fractures compared with that of stable fractures was observed in the intramedullary reduction group (132/49 vs. 10/10; P=0.033). Conclusion: Fixation failure of CM nailing is likely to occur in patients who are elderly or have unstable fracture patterns. Thus, care should be taken in order to avoid intramedullary reduction.