Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Objectives: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes. Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5460 ESD cases from 5250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Objectives: To involve institutions without the ability to perform susceptibility testing, long-term storage of tissue sample is critical to isolate the bacteria in a central laboratory. The aim of the study was to investigate the feasibility of H. pylori isolation and antibiotic susceptibility testing using rapidly frozen biopsy specimens collected from various institutions. Methods: Eight institutions located in various regions of Korea participated in the study. Patients requiring upper endoscopy and H. pylori testing were screened. Two biopsy samples were taken from the stomach. One was placed in a sterile Eppendorf tube and then immediately placed in a vacuum bottle containing dry ice, which was stored at -80°C. The other was used in a rapid urease test. Collected samples were delivered to a central laboratory. The bacteria were isolated from the frozen samples under microaerophilic conditions. The agar dilution method was used to determine the minimum inhibitory concentration (MIC) of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: Patients with a positive rapid urease test result (n=113) were enrolled. The mean age was 56.6±12.3 years. The male:female ratio was 64:49. The overall culture success rate was 77.0% (87/113). MIC values were determined using isolated 87 H. pylori strains. Rates of resistance to amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and ciprofloxacin were 23.0%, 25.3%, 28.7%, 1.1%, 33.3%, and 34.5%, respectively. Conclusions It is feasible to perform H. pylori isolation and antimicrobial susceptibility testing using rapidly frozen and transported biopsy specimens.

BACKGROUND: Current polymer-based drug-eluting stents (DESs) have fundamental issues about inflammation and delayed re-endothelializaton of the vessel wall. Substance-P (SP), which plays an important role in inflammation and endothelial cells, has not yet been applied to coronary stents. Therefore, this study compares poly lactic-co-glycolic acid (PLGA)-based everolimus-eluting stents (PLGA-EESs) versus 2-methacryloyloxyethyl phosphorylcholine (MPC)-based SP-eluting stents (MPC-SPs) in in-vitro and in-vivo models. METHODS: The morphology of the stent surface and peptide/drug release kinetics from stents were evaluated. The invitro proliferative effect of SP released from MPC-SP is evaluated using human umbilical vein endothelial cell. Finally, the safety and efficacy of the stent are evaluated after inserting it into a pig’s coronary artery. RESULTS: Similar to PLGA-EES, MPC-SP had a uniform surface morphology with very thin coating layer thickness (2.074 lm). MPC-SP showed sustained drug release of SP for over 2 weeks. Endothelial cell proliferation was significantly increased in groups treated with SP (n = 3) compared with the control (n = 3) and those with everolimus (n = 3) (SP:118.9 ± 7.61% vs. everolimus: 64.3 ± 12.37% vs. the control: 100 ± 6.64%, p < 0.05). In the animal study, the percent stenosis was higher in MPC-SP group (n = 7) compared to PLGA-EES group (n = 7) (MPC-SP: 28.6 ± 10.7% vs. PLGAEES: 16.7 ± 6.3%, p < 0.05). MPC-SP group showed, however, lower inflammation (MPC-SP: 0.3 ± 0.26 vs. PLGAEES: 1.2 ± 0.48, p < 0.05) and fibrin deposition (MPC-SP: 1.0 ± 0.73 vs. PLGA-EES: 1.5 ± 0.59, p < 0.05) around the stent strut. MPC-SP showed more increased expression of cluster of differentiation 31, suggesting enhanced reendothelialization. CONCLUSION Compared to PLGA-EES, MPC-SP demonstrated more decreased inflammation of the vascular wall and enhanced re-endothelialization and stent coverage. Hence, MPC-SP has the potential therapeutic benefits for the treatment of coronary artery disease by solving limitations of currently available DESs.

Objectives: To involve institutions without the ability to perform susceptibility testing, long-term storage of tissue sample is critical to isolate the bacteria in a central laboratory. The aim of the study was to investigate the feasibility of H. pylori isolation and antibiotic susceptibility testing using rapidly frozen biopsy specimens collected from various institutions. Methods: Eight institutions located in various regions of Korea participated in the study. Patients requiring upper endoscopy and H. pylori testing were screened. Two biopsy samples were taken from the stomach. One was placed in a sterile Eppendorf tube and then immediately placed in a vacuum bottle containing dry ice, which was stored at -80°C. The other was used in a rapid urease test. Collected samples were delivered to a central laboratory. The bacteria were isolated from the frozen samples under microaerophilic conditions. The agar dilution method was used to determine the minimum inhibitory concentration (MIC) of amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, and levofloxacin for each H. pylori isolate. Results: Patients with a positive rapid urease test result (n=113) were enrolled. The mean age was 56.6±12.3 years. The male:female ratio was 64:49. The overall culture success rate was 77.0% (87/113). MIC values were determined using isolated 87 H. pylori strains. Rates of resistance to amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and ciprofloxacin were 23.0%, 25.3%, 28.7%, 1.1%, 33.3%, and 34.5%, respectively. Conclusions It is feasible to perform H. pylori isolation and antimicrobial susceptibility testing using rapidly frozen and transported biopsy specimens.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.