65 research outputs found

    Regression of Advanced Gastric MALT Lymphoma after the Eradication of Helicobacter pylori

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    A 66-year-old female presented with a 1-month history of dyspepsia. An initial upper gastrointestinal endoscopy with biopsy revealed a low-grade mucosa-associated lymphoid tissue (MALT) lymphoma. A rapid urease test was positive for Helicobacter pylori. Endoscopic ultrasound (EUS) and computed tomography (CT) revealed a 30Ă—15-mm lymph node (LN) in the subcarinal area. Histopathologic and phenotypic analyses of the biopsy specimens obtained by EUS-guided fine-needle aspiration revealed a MALT lymphoma, and the patient was diagnosed with a stage 4E gastric MALT lymphoma. One year after H. pylori eradication, the lesion had disappeared, as demonstrated by endoscopy with biopsy, CT, fusion whole-body positron emission tomography, and EUS. Here, we describe a patient with gastric MALT lymphoma that metastasized to the mediastinal LN and regressed following H. pylori eradication

    Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis

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    Background/Aims The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis. Methods The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed. Results ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85). Conclusions ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit

    Endoscopic Submucosal Dissection for Treatment of Localized Gastric Mucosa-associated Lymphoid Tissue Lymphoma: A Case Series

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    Background/Aims The treatment for gastric mucosa-associated lymphoid tissue lymphoma (MALToma) generally involves eradication of Helicobacter pylori. However, MALToma lesions may recur even without H. pylori re-infection. Furthermore, the remission rate of H. pylori-negative MALToma after eradication is low. Therefore, herein, we report on endoscopic submucosal dissection (ESD) as a treatment strategy for gastric MALToma. Methods We retrospectively reviewed the data of all patients of gastric MALToma who underwent endoscopic resection at our institution between January 2000 and December 2021. Clinical remission was defined as complete histological remission or probable minimal residual disease according to the GELA grading system for post-treatment evaluation of gastric MALToma. Results Six patients with gastric MALToma underwent ESD. Two patients were diagnosed with gastric MALToma, which improved after eradication treatment and relapsed approximately 36 and 41 months later, respectively. These patients had singular lesions localized to the mucosa and did not experience H. pylori re-infection. The lesions were successfully removed via ESD. The remaining four patients had H. pylori-negative gastric MALToma. These patients also had single, localized lesions that were removed via ESD. All the patients remained in clinical remission until the final follow-up. Conclusions ESD is a safe and effective intervention for H. pylori-negative gastric MALToma when the lesion is single and confined to the mucosal layer

    Is Ex Vivo Training before In Vivo Training Effective in Learning Gastric Endoscopic Submucosal Dissection?

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    Background/Aims The learning curve is essential in endoscopic submucosal dissection (ESD) training to improve outcomes and reduce the risk of procedure-related complications. We compared the outcomes of gastric ESD in live pigs performed by inexperienced endoscopists with or without ex vivo training. Materials and Methods At the Olympus Medical Training and Education Center, nine endoscopists inexperienced in ESD were randomly divided into two groups (group A: ex vivo training followed by in vivo training; group B: in vivo training only), and they performed gastric ESDs. Results A total of 18 ESDs were performed. The en bloc resection rate was 88.9% (16/18), and the complete resection rate was 94.4% (17/18). The median specimen size was 2.5 cm in group A and 2.1 cm in group B (P=0.227). There was no significant difference in the procedure time between the two groups, except for the marking time (0′58″ vs. 2′58″, P=0.027). However, group A took a shorter time in dissecting the same area than group B (109 vs. 246 sec/cm2, P=0.083). Complication rates were not significantly different between both groups. Conclusions The procedure time during in vivo ESD training in pigs may be shortened by prior ex vivo training. However, the ex vivo model presented poor air inflation, unstable fixation, and excessive mucosal hardness for cutting. An advanced simulator or sufficient ex vivo training may be effective in training for the ESD procedure

    Understanding conference attendee's experience quality and value perception: the case of academic association conferences

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    Doctor of PhilosophyDepartment of Hospitality and DieteticsChihyung Ok and Betsy BarrettThe meeting industry has seen significant growth over the last few decades and has now become truly global. As the number of conferences increases and attendees have so many conferences to choose from, understanding how they evaluate the conference experience is more important than ever. Previous studies have focused on site selection factors, destination perception and image, economic impact, and meeting planner issues, not on the conference experience itself. Annual association conferences are lucrative because of the large number of attendees they bring to the host destination. In marketing and managing association conferences, host destinations and meeting convention organizers are increasingly interested in how attendees evaluate the conference experience. With the first conceptual model, this study sought to reveal the effect of perceived conference quality dimensions on conference experience quality dimensions. Academic association conference was taken as the context, and data were collected to validate the proposed models. A self-reported questionnaire was distributed to faculty members from twenty randomly selected universities in the United States who attended an academic association conference at least once within the past year. The hypotheses included in the conceptual model were examined based on responses from 370 faculty members in the United States. The proposed relationships were analyzed by using PLS-SEM analysis which involves evaluation of measurement model and structural model. The results indicated significant relationships among all conference specific dimensions (i.e., professional education and professional & social networking) and all conference experience quality dimensions (i.e., learning, self-esteem, and excitement). Moreover, all destination specific dimensions (i.e., site attractiveness, travelability, and site environment) had a significant relationship with excitement, but site attractiveness did not have a significant relationship with learning. With the second conceptual model, this study sought to verify the relationships among perceived conference value dimensions, satisfaction, and behavioral intentions. This study found that utilitarian value, hedonic value, and social value had significant effects on satisfaction and behavioral intentions. Given that understanding attendee behavior is critical in the meeting industry, this study benefits meeting planners and host destinations with information that allows them to maximize the conference experience for attendees, and attracting and retaining repeat attendees. The results indicated significant relationships among all conference specific dimensions (i.e., professional education and professional & social networking) and all conference experience quality dimensions (i.e., learning, self-esteem, and excitement). Moreover, all destination specific dimensions (i.e., site attractiveness, travelability, and site environment) had a significant interrelationship with excitement, but site attractiveness did not have a significant relationship with learning. With the second conceptual model, this study sought to verify the relationships among perceived conference value dimensions, satisfaction, and behavioral intentions. This study found that utilitarian value, hedonic value, and social value had significant effects on satisfaction and behavioral intentions. Given that understanding attendee behavior is critical in the meeting industry, this study benefits meeting planners and host destinations with information that allows them to maximize the conference experience for attendees, and attracting and retaining repeat attendees
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