The incidence of colorectal cancer has been increased gradually and it was about 6.9% of all malignancies in Korea. Early diagnosis was recognized as the most important factor influencing the prognosis of colorectal cancer and the incidence of early colorectal cancer was increasing. Thus great change was observed in the treatment of early colorectal cancer, endoscopic therapy as well as curative surgical resection is being accepted. We report a case of effective and safe endoscopic therapy for early rectal cancer in 5S-year-old male patient. He presented with rectal prolapse and bleeding of a year's duration. A large polypoid mass with fine nodular surface and thick, short stalk was seen in the rectum at 4cm above the anal verge during flexible sigmoidoscopy. After the histologic examination of specimen obtained by bite biopsy, CT scan of pelvic cavity and ultrasonogram of abdomen, the tumor was removed safe and completely by 2 sessions of piecemeal polypectomies and strip biopsy. He has been well without symptoms and signs of recurrence of rectal cancer for 20 months.
Abdomen ; Biopsy* ; Colorectal Neoplasms ; Early Diagnosis ; Hemorrhage ; Humans ; Incidence ; Korea ; Male ; Prognosis ; Rectal Neoplasms* ; Rectal Prolapse ; Rectum ; Recurrence ; Sigmoidoscopy ; Tomography, X-Ray Computed ; Ultrasonography

The incidence of heterotopic gastric mucosa located in the submucosa in resected stomach specimens has been reported to be 3.0 to 20.1%. Heterotopic gastric mucosa is thought to be a benign disease, which rarely becomes malignant. Heterotopic gastric mucosa exists in the gastric submucosa, and gastric cancer rarely occurs in heterotopic gastric mucosa. Since tumors are located in the normal submucosa, they appear as submucosal tumors during endoscopy, and are diagnosed through endoscopic biopsies with some difficulty. For such reasons, heterotopic gastric mucosa is mistaken as gastric submucosal tumor. Recently, two cases of early gastric cancer arising from heterotopic gastric mucosa in the gastric submucosa were treated. Both cases were diagnosed as submucosal tumors based on upper gastrointestinal endoscopy, endoscopic ultrasound, and computed tomography findings, and in both cases, laparoscopic wedge resections were performed, the surgical findings of which also suggested submucosal tumors. However, pathologic assessment of the surgical specimens led to the diagnosis of well-differentiated intramucosal adenocarcinoma arising from heterotopic gastric mucosa in the gastric submucosa.
Adenocarcinoma ; Biopsy ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastric Mucosa ; Incidence ; Stomach ; Stomach Neoplasms

Seven hundred forty seven cases of gastrointestinal stromal tumors (GISTs) in Koreans who were diagnosed between 2001 and 2002 were analyzed to evaluate their occurrence and their clinical, pathologic and immunohistochemical findings. The most frequent location of tumor was in the stomach (63%), followed by the small intestine (30%), the colorectum (5%), and the esophagus (2%). c-kit expression was found in 93.6% of the cases, while CD34, SMA and S-100 protein was positive in 80.1%, 28.2%, and 20.2%, respectively. c-kit positivity was high in the stomach (94.2%) and small intestine (94.6%), while it was relatively low in the colorectum (85.0%), and esophagus (81.2%). The positivity for CD34 was correlated with the higher risk of GISTs (p=0.04). Follow up of the patients showed that 58 primary GISTs patients died and 20 of these patients were recurrent or metastatic at the time of diagnosis. The pathologic diagnosis to predict the risk of aggressive behavior of GISTs was correlated with the numbers of tumor, clinical stage, epithelioid histologic type, cellularity, cellular atypia, necrosis, and mucosal invasion (p= 0.00). GISTs with a poor prognosis were closely related to the clinical stage at presentation, the locations of the tumor, and the ages of the patients.
Actins/metabolism ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD34/metabolism ; Child ; Female ; Gastrointestinal Stromal Tumors/*epidemiology/metabolism/pathology ; Humans ; Immunohistochemistry ; Korea/epidemiology ; Male ; Middle Aged ; Prognosis ; Proto-Oncogene Proteins c-kit/metabolism ; Research Support, Non-U.S. Gov't ; S100 Proteins/metabolism

BACKGROUND: As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents. METHODS: The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age. RESULTS: The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] > or = 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to <95th percentile) and 2.5% of those with a BMI below the 85th percentile (P<0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI. CONCLUSION: Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.
Adolescent* ; Adult ; Cardiovascular Diseases ; Child* ; Cholesterol ; Education ; Humans ; Korea ; Logistic Models ; Nutrition Surveys* ; Obesity ; Overweight ; Pediatric Obesity ; Physical Examination ; Prevalence* ; Public Health ; Surveys and Questionnaires

Until 1972, many carcinoid tumors of the thymus were not recognized as distinct lesions and were mistakenly labeled as variants of thymomas. Thymic carcinoid tumors are unusual neoplasms that show different morphological, functional, and behavioral characteristics than those of thymomas. We report a case of a 65-year-old woman with thymic carcinoid tumor. The cinicopathological findings are discussed with a review of the literature.
Aged ; Carcinoid Tumor* ; Female ; Humans ; Thymoma ; Thymus Gland

Applying proper coding is important for doctors practicing gastroenterology. The coding systems established by various organizations define tumors differently. As a result of changing concepts of tumor classification, there are coding and reimbursement issues following the confirmation of malignant lesions by nationwide cancer screening in patients with intramucosal carcinoma and neuroendocrine tumors of the colorectum. In addition, there have been discrepancies between the views of endoscopists and pathologists regarding tumor coding. The Korean Society of Gastrointestinal Endoscopy held an expert meeting and established a consensus for the coding of intramucosal carcinoma and neuroendocrine tumor of the colorectum.
Classification ; Clinical Coding* ; Consensus ; Early Detection of Cancer ; Endoscopy, Gastrointestinal ; Gastroenterology ; Humans ; Korea ; Neuroendocrine Tumors*

Applying proper coding is important for doctors practicing gastroenterology. The coding systems established by various organizations define tumors differently. As a result of changing concepts of tumor classification, there are coding and reimbursement issues following the confirmation of malignant lesions by nationwide cancer screening in patients with intramucosal carcinoma and neuroendocrine tumors of the colorectum. In addition, there have been discrepancies between the views of endoscopists and pathologists regarding tumor coding. The Korean Society of Gastrointestinal Endoscopy held an expert meeting and established a consensus for the coding of intramucosal carcinoma and neuroendocrine tumor of the colorectum.
Classification ; Clinical Coding* ; Consensus ; Early Detection of Cancer ; Endoscopy, Gastrointestinal ; Gastroenterology ; Humans ; Korea ; Neuroendocrine Tumors*

BACKGROUND: The aim of the present study was to prepare hydroxyapatite (HA) and then characterize its effect on bone integration in a rabbit tibial defect model. The bone formation with different designs of HA was compared and the bony integration of several graft materials was investigated qualitatively by radiologic and histologic study. METHODS: Ten rabbits were included in this study; two holes were drilled bilaterally across the near cortex and the four holes in each rabbit were divided into four treatment groups (HAP, hydroxyapatite powder; HAC, hydroxyapatite cylinder; HA/TCP, hydroxyapatite/tri-calcium phosphate cylinder, and titanium cylinder). The volume of bone ingrowth and the change of bone mineral density were statistically calculated by computed tomography five times for each treatment group at 0, 2, 4, 6, and 8 weeks after grafting. Histologic analysis was performed at 8 weeks after grafting. RESULTS: The HAP group showed the most pronounced effect on the bone ingrowth surface area, which seen at 4, 6, and 8 weeks after graft (p < 0.05). On comparing the change of bone mineral density the bone ingrowth surface area among the 4 groups, there were no statistically significant differences among the groups found for any period (p > 0.05). On histological examination, the HAP group revealed well-recovered cortical bone, but the bone was irregularly thickened and haphazardly admixed with powder. The HAC group showed similar histological features to those of the HA/TCP group; the cortical surface of the newly developed bone was smooth and the bone matrix on the surface of the cylinder was regularly arranged. CONCLUSIONS: We concluded that both the hydroxyapatite powder and cylinder models investigated in our study may be suitable as a bone substitute in the rabbit tibial defect model, but their characteristic properties are quite different. In contrast to hydroxyapatite powder, which showed better results for the bone ingrowth surface, the hydroxyapatite cylinder showed better results for the sustained morphology.
Animals ; *Bone Substitutes ; *Durapatite ; *Osseointegration ; Rabbits ; Tibia/pathology/radiography/*surgery

The first edition of the ‘Standardized Pathology Report for Colorectal Cancer,’ which was developed by the Gastrointestinal Pathology Study Group (GIP) of the Korean Society of Pathologists, was published 13 years ago. Meanwhile, there have been many changes in the pathologic diagnosis of colorectal cancer (CRC), pathologic findings included in the pathology report, and immunohistochemical and molecular pathology required for the diagnosis and treatment of colorectal cancer. In order to reflect these changes, we (GIP) decided to make the second edition of the report. The purpose of this standardized pathology report is to provide a practical protocol for Korean pathologists, which could help diagnose and treat CRC patients. This report consists of “standard data elements” and “conditional data elements.” Basic pathologic findings and parts necessary for prognostication of CRC patients are classified as “standard data elements,” while other prognostic factors and factors related to adjuvant therapy are classified as “conditional data elements” so that each institution could select the contents according to the characteristics of the institution. The Korean version is also provided separately so that Korean pathologists can easily understand and use this report. We hope that this report will be helpful in the daily practice of CRC diagnosis.

BACKGROUND: The histomorphologic criteria for the pathological features of liver tissue from patients with non-alcoholic fatty liver disease (NAFLD) remain subjective, causing confusion among pathologists and clinicians. In this report, we studied interobserver agreement of NAFLD pathologic features and analyzed causes of disagreement. METHODS: Thirty-one cases of clinicopathologically diagnosed NAFLD from 10 hospitals were selected. One hematoxylin and eosin and one Masson's trichrome-stained virtual slide from each case were blindly reviewed with regard to 12 histological parameters by 13 pathologists in a gastrointestinal study group of the Korean Society of Pathologists. After the first review, we analyzed the causes of disagreement and defined detailed morphological criteria. The glass slides from each case were reviewed a second time after a consensus meeting. The degree of interobserver agreement was determined by multi-rater kappa statistics. RESULTS: Kappa values of the first review ranged from 0.0091-0.7618. Acidophilic bodies (k = 0.7618) and portal inflammation (k = 0.5914) showed high levels of agreement, whereas microgranuloma (k = 0.0984) and microvesicular fatty change (k = 0.0091) showed low levels of agreement. After the second review, the kappa values of the four major pathological features increased from 0.3830 to 0.5638 for steatosis grade, from 0.1398 to 0.2815 for lobular inflammation, from 0.1923 to 0.3362 for ballooning degeneration, and from 0.3303 to 0.4664 for fibrosis. CONCLUSIONS: More detailed histomorphological criteria must be defined for correct diagnosis and high interobserver agreement of NAFLD.
Biopsy* ; Consensus ; Diagnosis ; Eosine Yellowish-(YS) ; Fibrosis ; Glass ; Hematoxylin ; Humans ; Inflammation ; Liver* ; Non-alcoholic Fatty Liver Disease*