Sentinel Node Mapping Using a Fluorescent Dye and Visible Light During Laparoscopic Gastrectomy for Early Gastric Cancer

Recently, fluorescent imaging technology using indocyanin green (ICG) and infra-red light offers improved the visibility with the possibility of better sensitivity or accuracy in sentinel node mapping. In our institute, a new fluorescent imaging technique using fluorescein and blue light has been introduced. 

Twenty patients with early gastric cancer, for whom laparoscopic distal gastrectomy with standard lymphadenectomy had been planned, were enrolled in this study. Before lymphadenectomy, the patients received a gastrofiberoscopic peritumoral injection of fluorescein solution. The sentinel basin was investigated via laparoscopic fluorescent imaging under blue light (wavelength of 440-490 nm) emitted from an LED curing light. The detection rate and lymph node status were analyzed in the enrolled patients. In addition, short-term clinical outcomes were also investigated.

No hypersensitivity to the dye was identified in any enrolled patients. Sentinel nodes were detected in 19 of 20 enrolled patients (95.0%), and metastatic lymph nodes were found in 2 patients. The latter lymph nodes belonged to the sentinel basin of each patient. Meanwhile, 1patient (5.0%) experienced a postoperative complication that was unrelated to sentinel node mapping. No mortality was recorded among enrolled cases.

Sentinel node mapping with visible light fluorescence was a feasible method for visualizing sentinel nodes in patients with early gastric cancer. In addition, this method is advantageous in terms of visualizing the concrete relationship between the sentinel nodes and surrounding structures.

The study has been published in <ANNALS OF SURGERY>, under the title “Sentinel Node Mapping Using a Fluorescent Dye and Visible Light During Laparoscopic Gastrectomy for Early Gastric Cancer.”

Student Research Group, ‘1st Hoeui Academic Seminar’

On October 30, 2017, the Korea University College of Medicine (KUCM) successfully hosted the 1st Hoeui Academic Seminar.

In an effort to prepare its medical students to become active drivers in the age of the 4th industrial revolution and the rapidly changing medical environment, KUCM has begun preparing a wide variety of programs. One such program focuses on exposing students to medical science research during their undergraduate studies, so that they will be capable of conducting voluntary research. To help develop young medical scientists, since 2011, KUCM has operated a Student Research Group.

The 8th Student Research Group, which initiated its activities in December 2017, is comprised of 17 research teams and 59 students, ranging from 2nd year pre-med students to those in the 4th year of medical school. The teams have been working hard for the past year, with assistance from their academic advisors. Beginning this year, the association meetings were upgraded to allow students to share the finding of their research in an academic seminar setting.

The proceedings of the seminar began with approximately 150 students and professors in attendance. Professor Ho-Sung Son, Associate Dean for Research & Global Outreach, kicked off the seminar with his opening remarks, followed by a special lecture on ‘The Role of Undergraduate Medical School Students in a Research-centered Environment.’ Then, research teams were invited to deliver their findings, for which evaluations were given, before awards were handed out and closing remarks wrapped up the agenda.

Anatomy Professor Hyun-Soo Kim delivered the special lecture. He provided various examples and offered knowhow, while emphasizing the appropriate attitude of medical students as student researchers and effective ways to write an academic paper. Then, 17 research teams took their turns presenting their research findings, which invited a remarkably active student Q&A session, as well as faculty commentaries.

One student who had presented at the seminar expressed satisfaction by reflecting, “for the past year, I was occasionally overwhelmed with both school work and this research activity. But today, I feel happy and proud that all my efforts culminated in this academic seminar.” The student researcher also thanked the faculty advisor for the assistance that was integral to the successful completion of the student research activity, and expressed a new resolve to continue participation in the program, and to expand the research scope in the coming year.

Associate Dean Son expressed his pleasant surprise “to find that students who participated in today’s seminar demonstrated significant caliber in their research as well as in their presentation skills.” He added, “while the 8th Student Research activities may have concluded, they should not stop here. Instead, by identifying their own areas of research interest, I look forward to witnessing their continued growth into young medical scientists.”

Left Ventricular Wall Motion Abnormalities (LVWMA) are Associated with

Increased Risk of Stroke Recurrence

In his study of the correlation between left ventricular wall motion abnormalities (LVWMA) and stroke recurrence among ischemic stroke patients, Neurology Professor Sungwook Yu (Neurology Department, Anam Hospital) discovered that LVWMA can serve as an independent predictor of stroke recurrence.

Many risk factors play into the possibility of stroke recurrence; among them, blood clots resulting from atherosclerotic plaque or embolism originating from the heart have been well recognized as typical pathogens. However, the precise cause of stroke remains unknown in 20 to 40% of the cases. Hence, identifying yet unknown risk factors and pathogens is an essential means to seeking proper treatment for stroke patients.

LVWMA increases the risk of embolic stroke, and it can generally be detected through echocardiography. Cardiovascular conditions, such as myocardial infarction, unstable angina and/or cardiomyopathy, are usually accompanied by LVWMA; these heart diseases have been traditionally associated with high risk factors of embolic cerebral infarction. However, it is often difficult to identify cardiac diseases that cause LVWMA. In fact, LVWMA, in and of itself, can cause ventricular thrombostasis and chronic inflammation, creating blood clots, and thus stroke. However, due to the lack of research regarding the causality of LVWMA and stroke, these conditions have not been considered as high risk factors for stroke. Consequently, their significance in the equation was overlooked.

GAME founded with 9 medical schools around the world

The Korea University College of Medicine (KUCM) is carving out its position in the world’s academia, by establishing a consultative body with 8 other global medical schools, with the goal of defining the world’s education standards in medicine.

Global Alliance of Medical Excellence, a.k.a. GAME, has been launched to foster mutual cooperation and joint development among global colleges of medicine. With the aim of harnessing medical advancement through joint research and mutual medical education exchange, GAME will be dedicated to advancing education and research in medicine. KUCM is the only Korean founding member, joining hands with 8 other countries: Chinese University of Hong Kong; Monash University of Australia; University of Alberta in Canada; Ludwig Maximilian University of Munich in Germany; Nagoya University of Japan; Erasmus University Rotterdam of the Netherlands; University of Bologna in Italy; University of Nottingham in England.

On November 9, 2017, Professor Hong Sik Lee, Dean of KUCM, and Ho Sung Son, Associate Dean for Research & Global Outreach, attended the inaugural conference venued at the Chinese University of Hong Kong. Dean Lee delivered a keynote address introducing the state of the art KUCM facility, and outlining the academic curriculum, currently under revision, as well as its programs.

As the goal of GAME, Professor Son offered multifaceted innovations in medical education, focused on developing students and faculty of the future, equipped with international perspectives that transcend national boundaries. New and specific student activities were proposed: medical education digital archive; student exchange program; clinical trials program; study tours; medical students’ research conference; and work study programs.  

A particularly well-received proposal by Korea University was the ‘GAME Diamond Project,’ a digital archive that allows the 9-member universities to share their medical education content. Currently, KUCM supports its faculty in creating quality education content through ‘Studio M,’ equipped with sophisticated video recording devices. In addition, the College also operates the ‘Diamond Project,’ an online medical education platform that allows students and other program enrollees to participate in learning, regardless of time and location. By expanding these programs to the 9-member universities, medical students will be exposed to a greater variety of theories and clinical samples. There is also anticipation that these efforts will further boost new and diverse learning modes of the future, such as Flipped Learning, problem-focused learning and self-directed learning.  

Thanks to GAME, KUCM has been chosen as the sponsor college of the transnational medical education program. In addition to the GAME Diamond Project, for clinical trial student exchange programs, and by recruiting researchers from each university on 8 study topics, KUCM will embark on a medical student research program that will provide funds for travel and initial research investment.

Dean Lee expressed delight in that “KUCM has been chosen to represent Korea to found GAME with other remarkable global medical schools,” and expressed his hope that “GAME will serve as an exemplary model of international cooperation among the world’s medical colleges.” Moreover, he pledged that “by forging strong transnational ties with renowned medical schools around the world, the standard of medical education will be upgraded, thereby helping the University to achieve further development.”