The incidence rate of gastric cancer in Korean Americans is over five times higher than that in non-Hispanic whites, and is similar to the incidence of colorectal cancer in the overall United States population. In Korea, the National Cancer Screening Program recommends endoscopy or upper gastrointestinal series for people aged 40 years and older every 2 years. However, the benefit of gastric cancer screening in Korean Americans has not been evaluated. Based on epidemiologic studies, Korean Americans appear to have more similar gastric cancer risk factors to Koreans as opposed to Americans of European descent, though the risk of gastric cancer appears to decrease for subsequent generations. Therefore, in accordance with recent recommendations regarding screening for gastric cancer in Korea, endoscopic screening for gastric cancer in Korean Americans should be considered, especially in those with known atrophic gastritis/intestinal metaplasia or a family history of gastric cancer. In the future, additional studies will needed to assess whether a screening program for gastric cancer in Korean Americans will result in a survival benefit.
*Asian Americans ; Early Detection of Cancer/*methods ; *Endoscopy, Gastrointestinal ; Humans ; Incidence ; Predictive Value of Tests ; Prognosis ; Program Development ; Republic of Korea/ethnology ; Risk Assessment ; Risk Factors ; Stomach Neoplasms/*diagnosis/*ethnology ; United States/epidemiology

Acer mono is known to contain bioactive substances that exhibit beneficial effects in osteoporosis, gastric ulcers, hepatic damage, and pathologic angiogenesis. The current study aimed to investigate the effects of Acer mono extract on the invasive activities and cell-cycle progression of human fibrosarcoma cells. Cytotoxicity of Acer mono extract was assessed by MTT assay, in-vitro invasiveness of HT1080 fibrosarcoma cells was measured using matrigel assay, expression of invasion- and cell-cycle-related proteins was analyzed by western blot analysis, and that of E2F target genes was quantified using qRT-PCR. Acer mono extract did not show distinct cytotoxicity in the experimental concentrations used. Invasiveness of HT1080 fibrosarcoma cells and expression of cyclin D1 and CDK4 in them were significantly reduced in a dose-dependent manner after treatment with Acer mono extract. Acer mono extract showed inhibitory effects on the G1/S transition during cell-cycle progression; the active phosphorylated Rb protein level was decreased, and expression of E2F target genes was downregulated by the Acer mono extract. Our data collectively demonstrated that Acer mono extract exerts inhibitory effects on the invasiveness and cell-cycle progression of HT1080 human fibrosarcoma cells.

Acer mono is known to contain bioactive substances that exhibit beneficial effects in osteoporosis, gastric ulcers, hepatic damage, and pathologic angiogenesis. The current study aimed to investigate the effects of Acer mono extract on the invasive activities and cell-cycle progression of human fibrosarcoma cells. Cytotoxicity of Acer mono extract was assessed by MTT assay, in-vitro invasiveness of HT1080 fibrosarcoma cells was measured using matrigel assay, expression of invasion- and cell-cycle-related proteins was analyzed by western blot analysis, and that of E2F target genes was quantified using qRT-PCR. Acer mono extract did not show distinct cytotoxicity in the experimental concentrations used. Invasiveness of HT1080 fibrosarcoma cells and expression of cyclin D1 and CDK4 in them were significantly reduced in a dose-dependent manner after treatment with Acer mono extract. Acer mono extract showed inhibitory effects on the G1/S transition during cell-cycle progression; the active phosphorylated Rb protein level was decreased, and expression of E2F target genes was downregulated by the Acer mono extract. Our data collectively demonstrated that Acer mono extract exerts inhibitory effects on the invasiveness and cell-cycle progression of HT1080 human fibrosarcoma cells.

PURPOSE: Laparoscopic gastric wedge resection is a standard treatment for removing gastric submucosal tumors (SMTs). So far, however, there have been few reports of single-incision laparoscopic intragastric wedge resection. Our aim was to describe this procedure and our experience with it. METHODS: From January 2010 to December 2013, a total of 21 consecutive patients with gastric SMTs underwent single-incision intragastric resection at our institution. Their clinicopathologic data were analyzed retrospectively. RESULTS: The patients consisted of nine men and 12 women with a mean age of 51.9 +/- 12.9 years (22-69 years). Their mean body mass index was 22.6 +/- 2.0 kg/m2. Mean tumor size was 2.4 +/- 0.7 cm, with the following anatomic distribution: esophagogastric junction in three patients, fundus in twelve, upper body in three, and lower body in two. Mean operating time was 68.6 +/- 12.0 minutes. There were no conversions to open surgery and no major intraoperative complications. Time to resumption of water intake was 1.4 +/- 0.5 days. Mean hospital stay was 4.9 +/- 1.7 days. There were no recurrences or deaths during the mean 19-month follow-up. CONCLUSION: Single-incision intragastric wedge resection is a feasible and safe procedure. It is especially efficient for treating small endophytic gastric SMTs located on the upper and mid portion of the stomach.
Body Mass Index ; Drinking ; Esophagogastric Junction ; Female ; Follow-Up Studies ; Gastrectomy ; Gastric Mucosa ; Gastrointestinal Stromal Tumors ; Humans ; Intraoperative Complications ; Laparoscopy ; Length of Stay ; Male ; Recurrence ; Retrospective Studies ; Stomach ; Stomach Neoplasms

BACKGROUND/AIMS: Endoscopic resection (ER) is a well-established treatment modality for gastric epithelial neoplasm. However, there is a discrepancy between forceps biopsy and ER specimen pathology, including a negative pathologic diagnosis (NPD) after ER. It has been suggested that pit dysplasia (PD) is a subtype of gastric dysplasia, and the aim of this study was to assess the significance of PD in cases with NPD after ER for early gastric neoplasms. METHODS: After ER, 29 NPD lesions that had an associated pretreatment forceps biopsy specimen, were correctly targeted during ER, and had no cautery artifact on the resected specimen were included in this study. RESULTS: Sixteen lesions showed PD and 13 had no neoplastic pathology. The initial pretreatment forceps biopsy diagnoses of 29 NPD lesions were low-grade dysplasia (LGD) in 17 lesions, high-grade dysplasia (HGD) in seven lesions, and adenocarcinoma in five lesions, which after review were revised to PD in 19 lesions, LGD in four lesions, adenocarcinoma in two lesions, and no neoplastic pathology in four lesions. Overall, nine lesions (31%) were small enough to be removed by forceps biopsy, four NPD lesions (14%) were initially misinterpreted as neoplastic lesions, and 16 PD lesions (55%) were misinterpreted as NPD lesions on ER slides. CONCLUSIONS: Approximately half of the lesions initially diagnosed as LGD or HGD were subsequently classified as PD. Therefore, including PD as a subtype of gastric dysplasia could reduce the diagnostic discrepancy between initial forceps biopsy and ER specimens.
Adenocarcinoma ; Artifacts ; Biopsy ; Cautery ; Diagnosis ; Neoplasms, Glandular and Epithelial* ; Pathology* ; Stomach ; Stomach Neoplasms ; Surgical Instruments

Dieulafoy's lesion is an uncommon but important cause of massive upper gastrointestinal bleeding. The lesion usually occurs in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction but extragastric locations of Dieulafoy's lesion are rare. In this study, diagnosis of Dieulafoy's lesion was frequently made by endoscopy instead of surgery. Hemostasis was achieved by endoscopic treatment in more than 90% of patients. We report the successful application of endoscopic hemoclipping for treatment of active bleeding from Dieulafoy's lesion in the ampulla of Vater of the duodenum.
Ampulla of Vater* ; Diagnosis ; Duodenum ; Endoscopy ; Esophagogastric Junction ; Hemorrhage ; Hemostasis ; Humans ; Stomach

BACKGROUND: The term 'portal biliopathy' has been used to describe abnormalities of the extrahepatic and intrahepatic bile ducts in patients with portal hypertension, especially those with extrahepatic portal vein obstruction. The aim of this study was to delineate the clinical features and imaging findings of portal biliopathy. METHODS: Clinical and imaging data of 15 patients who had portal biliopathy from April 2001 to March 2005 were reviewed. Two radiologists working in concensus analyzed the imaging finings and each radiologist and gastroenterologist made a comparison between MRCP and ERCP. RESULTS: Of the 15 patients with portal biliopathy, there were 7 men and 8 women and their mean age was 56.4 years (range, 24 to 78 years). Most of them were unknown origin (11/15, 73%) and 4 patients combined with recurrent pyogenic cholangitis. 4 patients presented with obscure right abdominal pain, 3 had mild fever with chilling and others had no symptoms. Extrahepatic portal vein obstruction was replaced by cavernous transformation in all patients. 3 different types of biliary abnormalities were 3 pseudocholangiocarcinoma type, 8 varicoid type and 4 mixed type. Choledocholithiasis occuring 4 patients (2 CBD stone, 1 GB stone and 1 CBD with IHD stone). Correlation betwen MRCP and ERCP (or PTC) was identical and exact diagnosis was possible. During EST or cholecystectomy, no significant bleeding was found. CONCLUSIONS: On portal hypertension combined with biliary obstruction, portal biliopathy should be suspected as a possible diagnosis. Knowledge of these clinical features and imaging findings should facilitate accurate diagnosis of portal biliopathy.
Abdominal Pain ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Choledocholithiasis ; Diagnosis ; Female ; Fever ; Hemorrhage ; Humans ; Hypertension, Portal ; Male ; Portal Vein

Angiosarcoma is a rare malignant tumor which occurs frequently in the skin and soft subcutis. Moreover, primary gastrointestinal angiosarcomas are very rare. This tumor manifests as non-specific symptoms such as gastrointestinal bleeding, abdominal pain and nausea. The diagnosis is often made at an advanced stage. Surgery, chemotherapy and radiotherapy are the mainstay of treatment. However, the prognosis is very poor. We report a case of primary angiosarcoma of the small intestine presenting as recurrent gastrointestinal bleeding. A 54-year-old man was admitted with recurrent gastrointestinal bleeding. An abdominal CT scan revealed an ileo-ileal intussusception. Segmental resection was performed with ileo-ileal anastomosis. The ileal mass was diagnosed as angiosarcoma on immunohistochemical stain. He received 3 cycles of chemotherapy, but died 5 months after the diagnosis.
English Abstract ; Gastrointestinal Hemorrhage/*etiology ; Hemangiosarcoma/complications/*diagnosis/pathology ; Humans ; Intestinal Neoplasms/complications/*diagnosis/pathology ; *Intestine, Small/pathology ; Male ; Middle Aged ; Recurrence

Endoscopic retrograde biliary drainage (ERBD) is useful for the palliative decompression of biliary obstruction. However, the complications of ERBD include cholangitis, hemorrhage, acute pancreatitis, obstruction of the stent, and duodenal perforation. Pressure necrosis on the duodenal mucosa by the stent may contribute to perforation. Although duodenal perforation following ERBD is very rare compared to other complications, it can result in a fatal outcome. Recent reports describe nonsurgical treatment for small gastrointestinal perforation with localized peritonitis and suggest that endoclipping may be appropriate in the management of a well selected group of patients with iatrogenic perforation. We describe a case of duodenal perforation secondary to ERBD that was successfully treated with approximating using endoclip and detachable snare.
Bile Ducts, Extrahepatic ; Biliary Tract Diseases/complications/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Duodenal Diseases/*diagnosis/etiology/therapy ; Female ; Gallbladder Neoplasms/diagnosis ; Humans ; Intestinal Perforation/*diagnosis/etiology/therapy ; Middle Aged ; Plastics ; Stents/*adverse effects ; Tomography, X-Ray Computed

Menetrier's disease is a rare entity characterized by large, tortuous gastric mucosal folds. The mucosal folds in Menetrier's disease are often most prominent in the body and fundus. Histologically, massive foveolar hyperplasia (hyperplasia of surface and glandular mucous cells) is noted, which replaces most of the chief and parietal cells. Profuse mucus is usually observed during the endoscopy but there have been few cases that show interesting endoscopic findings such as mucus bridge or water pearl. Herein, we report a case of Menetrier's disease showing mucus bridge by excessive mucus observed during the endoscopy.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Clarithromycin/therapeutic use ; Drug Therapy, Combination ; Gastric Mucosa/*pathology/secretion ; Gastritis, Hypertrophic/*diagnosis/pathology ; Gastroscopy ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Mucus/secretion ; Proton Pump Inhibitors/therapeutic use ; Tomography, X-Ray Computed