• 제목/요약/키워드: 대장 용종

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Sacroiliac Joint MRI Segmentation to Generate RoI of Ilium (장골의 관심영역 생성을 위한 천장관절 MRI 세그멘테이션)

  • Lee, Go-Eun;Min, Jae-Eun;Choi, Changhwan;Cho, Jungchan;Choi, Sang Tae;Choi, Sang-Il
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2022.07a
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    • pp.223-224
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    • 2022
  • 본 논문에서는 축형 척추관절염으로 발전할 수 있는 천장관절염 환자들을 진단하기 위해 장골의 관심영역을 자동 생성할 수 있는 세그멘테이션 방법을 제안한다. 다양한 MRI 기기로부터 얻은 천장관절염 환자의 영상에서 장골의 GT(Ground Truth)를 생성하였으며, 대장 용종 검출을 위한 세그멘테이션 모델인 PraNet과 지역 특징 간의 표현 능력을 활용할 수 있는 Position Attention Module을 사용하여 유의미한 성능 향상을 보여주었다.

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Characteristics and Risk Factors on Colorectal Polyps by the gender in Health Screen Examinees (건강검진 수진자의 대장용종의 특성과 성별에 따른 위험요인)

  • Choe, So-Eun;Lee, So-Young
    • Journal of Korean Biological Nursing Science
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    • v.13 no.2
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    • pp.164-173
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    • 2011
  • Purpose: The colorectal polyps has been regarded as a precursor of colon cancer, and the prevalence and mortality of colon cancer in Korea has increased due to westernized lifestyle and environmental factors. The purpose of this study was to investigate the characteristics and the risk factors on colorectal polyps in adults. Methods: The participants were 956 adults enrolled from health screen examinees underwent colonoscopy at the health promotion center in Seoul. Results: 49.5 percent of examinees has colorectal polyps and the most common sites were ascending colon (27.6%) and sigmoid colon (23.2%). The colorectal polyps showed a significant difference according to gender, age, and health behavior related characteristics including alcohol intake, exercise, and BMI. In male, the relative odds of having an colorectal polyps decreased as exercise (OR=1.74; 95% CI=1.01-1.04), and increased as BMI (OR=1.57; 95% CI=1.07-2.50) and age (OR=1.02; 95% CI=1.02-1.04). In female, it decreased as exercise (OR=2.49; 95% CI=1.52-4.10), and increased as age (OR=1.05; 95% CI=1.02-1.08). Conclusion: Based on the findings of this study, age and exercise were the influencing factors of colorectal polyps in health screen examinees. Therefore, effective exercise and appropriate health education program about colorectal polyps need to be developed and applied in nursing interventions to prevent colorectal polyps in the community dwelling adults.

The Role of Colonoscopy in Children with Hematochezia (소아 선혈변에서 대장 내시경 검사의 역할)

  • We, Ju-Hee;Park, Hyun-Suk;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.155-160
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    • 2011
  • Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

Eine vergleichende Betrachtung der Haftungszurechnung im Arztrecht (의료판례에서의 인과성과 책임귀속의 판단 - 독일법원 판결례와의 비교 고찰 -)

  • Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.147-208
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    • 2013
  • In der vorliegenden Arbeit geht es um die vergleichende Betrachtung von deutschen Urteilen OLG Munchen, Urt. v. 21. 4. 2011 - Az. 1 U 2363/10; BGH, Urt. v. 22. 5. 2012 - VI ZR 157/11) und einer Reihe von koreanischen Urteilen im Bereich des Arzthaftungsrechts. Sie behandelt die Kausalitat von Tatbestand und Rechtswidrigkeitszusammenhang in der normativen Haftungszurechung. In Korea gilt die sog. Adaquanztheorie noch entscheidend als bewertendes Zurechnungskriterium - sogar manchmal als umgangssprachliches Homonym im Sinne der Verh$\ddot{a}$ltnism$\ddot{a}{\ss}$igkeit angewendet -, die dogmengeschichtlich von Deutschland $\ddot{o}$bernommen wurde. Doch wie aus den deutschen Urteilen ersichtlich, ist sie dort schon $\ddot{u}$berwunden. Die Ergebnisse der betrffenden koreanischen Urteile sind zwar nicht unbillig, deren Urteilsbegrundungen aber theoretisch bzw. praktisch nicht $\ddot{u}$berzeugend. Nach allgemeiner Ansicht kommt es vielmehr auf den Schutzzweck an, der auch bei der Anwendung des ${\S}$ 393 KBGB gelten kann. Schlie${\ss}$lich wurde die $\ddot{U}$bertragung des praxisgerechten L$\ddot{o}$sungsansatzes in deutschen Urteilen auf rechtsvergleichende Weise dazu beitragen, die Zivilrechtspraxis in der koreanischen Justiz nachvollziehbarer machen.

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Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

The Association of Obesity and Left Colonic Adenomatous Polyps in Korean Adult Men (성인 남자에서 대장경 검사로 확인된 하부대장 선종성 용종과 비만의 관련성)

  • Kim, Chang-Sup;Cheong, Hae-Kwan;Jeong, Tae-Heum;Kim, Moon-Chan
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.4
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    • pp.415-419
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    • 2005
  • Objectives : We wanted to evaluate the relationship between obesity and left colonic adenomatous polyps in Korean adult men. Methods : This study was conducted among 575 adults men (aged between 40 and 69), who had colonoscopy done from January to December 2002 during a routine health examination at Health Promotion Center, Ulsan University Hospital. The patients' colons were examined up to splenic flexure by using fiberoptic colonoscopy. A questionnaire survey on behavioral factors and physical measurements were also done. The body mass index (BMI) and waist-hip ratio (WHR) were used as the indices of obesity. The BMI was categorized into three levels: normal ($BMI{\leq}22.9$), overweight ($23{\leq}BMI{\leq}24.9$), and obese ($BMI{\geq}25.0$). The WHR was categorized into four levels with cutoff points at the 30th, 60th, and 90th percentile of the control group. Age, education, smoking, alcohol use and exercise were controlled for by performing multiple logistic regression analysis. Results : There were 99 cases of colonic adenomatous polyps. Four hundred seventy six subjects with normal colonoscopy findings served as the control. The BMI and WHR were associated with the adenomatous polyps (odds ratio, 1.81 [95% CI=1.02-3.19] for a $BMI{\geq}25.0$ as compared with a $BMI{\leq}22.9$, odds ratio, 3.94 [95% CI=1.77-8.77] for a $WHR{\geq}0.95$ as compared with a $WHR{\leq}0.86$). The BMI was not associated with the risk of adenomatous polyps after additional adjustment was made for the WHR, but the association between the WHR and adenomatous polyps was still positive and independent of the BMI (odds ratio, 4.15 [95% CI=1.63-10.59]). Conclusions : The results support that obesity, and particularly abdominal obesity, can be associated with an increased risk of incurring colonic adenomatous polyps.

Changes in Pediatric Gastrointestinal Endoscopy: Review of a Recent Hospital Experience (일개 대학병원에서의 소아 위장관 내시경 시술의 최근 경험)

  • Park, Kyung-Heui;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.20-27
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    • 2007
  • Purpose: This study was performed to review the recent experiences of pediatric gastrointestinal (GI) endoscopy done in one university hospital. Methods: A retrospective review of medical records was conducted of 1,040 pediatric cases who underwent GI endoscopy at the Pusan National University Hospital between January 2001 to June 2005. Results: A total of 1,040 endoscopies (upper 840 and lower 200) were performed. The male/female ratio was 1.25:1. Neonates and infants accounted for 6.0% and 16.5% respectively. Half of the children were below 5 years (mean age $8.5{\pm}2.1$ years). Upper and lower GI diagnostic endoscopies were performed in 634 and 163 children respectively. Abdominal pain (38.8%), vomiting (19.4%), foreign body (17.7%), and hematemesis (10.3%) were the main reasons for esophagogastroduodenoscopy. Hematochezia (56.0%), abdominal pain (27.5%) and diarrhea (3.0%) were the main reasons for colonoscopy. Upper GI therapeutic procedures included retrieval of foreign bodies, balloon dilatations of esophageal stricture, PEG, and variceal ligation in 148, 27, 15, and 3 children, respectively. Therapeutic lower GI endoscopies were performed in 37 children (polypectomy in 92%, argon lazer cauterization for angiodysplasia in 4%). Conclusion: GI endoscopy played an important role in the diagnosis and treatment of GI diseases in children. Procedures in younger aged children, cases evaluated by colonoscopy and therapeutic endoscopies are increasing in pediatric practice.

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A Case of Eosinophilic Gastritis Mimicking Borrmann Type-4 Advanced Gastric Cancer (Borrmann 4형 진행위암과 같은 형태를 보인 호산구성 위염(Eosinophilic Gastritis) 1예)

  • Shin Hyun-Wook;Suh Byoung-Jo;Yu Hang-Jong;Lee Hye-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.47-51
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    • 2005
  • Eosinophilic gastroenteritis is a rare clinicopathologic entity of unknown etiology with a variety of digestive symptoms. The pathogenesis is poorly understood. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence of extraintestinal disease, and exclusion of various disorders that could mimic similar conditions. The disease might involve any area of the gastrointestinal tract from the esophagus to the rectum, but the stomach and the proximal small bowel are most commonly affected. The clinical features depend on which layer and site are involved. We report the case of a 59-year-old male patient with a 3-week history of post-prandial vomiting with malnutrition and weight loss. An abdominopelvic CT showed a gastric outlet obstruction with diffuse wall thickening, as with linitis plastica. Three gastrofiberscopic biopsies showed chronic gastritis. We carried out a radical total gastrectomy with D2 lymph node dissection. The pathologic report revealed a mural type eosinophilic gastritis with a marked hypertrophic scar formation at the proper muscle layer. We report this case with a brief review of the literature. (J Korean Gastric Cancer Assoc 2005;5:47-51)

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The Clinical Utility of Rectal Gas Distension F-18 FDG PET/CT (공기주입 직장 확장 F-18 FDG PET/CT의 임상적 유용성)

  • Kim, Jin-Suk;Lim, Seok-Tae;Jeong, Young-Jin;Kim, Dong-Wook;Jeong, Hwan-Jeong;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.565-571
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    • 2009
  • Purpose: The aim of this study was to evaluate the clinical value of rectal gas distension F-18 FDG PET/CT imaging for the differentiation of the rectal focal uptake lesions. Materials and Methods: Twenty four patients (M:F=11:13, Age $62.8{\pm}12.4$ years) underwent rectal gas distension F-18 FDG PET/CT, prospectively: initial image at 50-60 min after the intravenous injection of F-18 FDG and rectal distension image after the infusion of air through the anus. Focally increased uptake lesions on initial images but disappeared on rectal distension images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on rectal distension images, colonoscopy and histopathologic examination were performed. Results: Among the 24 patients, 27 lesions of focal rectal uptake were detected on initial images of F-18 FDG PET/CT. Of these, 7 lesions were able to judge with physiological uptake because the focal increased uptake disappeared from rectal distension image. Remaining 3 lesions were non-rectal lesions (2 lesions: rectovesical space, 1 lesion: uterine myoma). Among 17 lesions which was showed persistent increased uptake in rectal distension image, 15 lesions were confirmed as the malignant tumor (SUVmax=$15.9{\pm}6.8$) and 2 lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Conclusion: The rectal distension F-18 FDG PET/CT imaging could be an important noninvasive method for the differentiation of malignant and benign focal rectal uptake lesions including physiologic uptake.

Gastrointestinal Mucosal Lesions in Children with Short-Term Abdominal Pain (급성 복통을 호소하는 환아에서 위장관 점막병변에 관한 연구)

  • Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.176-182
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    • 2006
  • Purpose: The aim of this study was to investigate the spectrum of gastrointestinal mucosal lesions in the children presenting with short-term abdominal pain. Methods: Thirty one children with short term abdominal pain for less than 1 month from January 1995 to May 2004 who were examined using gastrointestinal (GI) endoscopy were reviewed retrospectively. Children presenting with acute abdominal pain unrelated to proper GI were excluded from this study. Results: Male patients were 16 and female were 15. Three patients were 1~5 years old, 15 were 6~10 years old, and 13 were 11~15 years old. The duration of the abdominal pain was less than 7 days in 23 patients, 10 days in 1, 20 days in 2, and 30 days in 4. The major accompanying symptoms were vomiting (15), diarrhea (4), melena (1), hematemesis (1), and fever (2). Using endoscopy, 6 patients were found to have hemorrhagic gastritis, 5 nodular gastritis, 4 duodenal ulcer, 3 gastric ulcer, 3 reflux esophagitis, 2 nodular duodenitis, 2 superficial gastritis, 2 erosive hemorrhagic duodenitis, 2 ulcerative colitis, 1 duodenogastric reflux, and 1 esophageal polyp. Helicobacter pylori (H. pylori) infection was positive in 10 patients. The age and sex ratio, duration of abdominal pain, site of abdominal pain, and duration of abdominal pain between H. pylori- positive and negative children were different. However, only the site of abdominal pain (epigastric) showed statistical significance. All symptoms improved with medication for the GI mucosal lesions noted by the endoscopic findings. Conclusion: The author suggests that GI endoscopy be one of the important first steps in examinations to find out diverse GI mucosal lesions in the patients with short-term abdominal pain. Additionally, the examinations for H. pylori infection are important for these patients, also.

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