• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.7.1-7
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• 1983

Esophageal perforation occurred rarely, but it leads to a high mortality and morbidity. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of esophagus during diagnostic endoscopy or therapeutic bouginage. A case of 25-year-old male patient entered to outpatient clinic. Chief complaints were mild pain at swallowing, mild fever elevation and chest tightness with radiating pain to shoulder and interscapular region for 1 day. On the X-ray film with barium soaked cotton piece in esophagus, it was revealed that foreign body (fish bone) had been located on the level of 2nd vertebra with leakage of barium to mediastinum. The foreign body was removed with endoscopy in Dept. of otolaryngology, and cervical mediastinostomy was performed in Dept. of thoracic surgery.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.4
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• pp.29-40
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• 2019

Objectives : Hwanglyeonhaedok-tang(黃連解毒湯) is a representative herbal formula with "clear heat(淸熱)" effects. The aim of this study was to evaluate the effects of Hwanglyeonhaedok-tang-based intranasal herbal ointment Biyeom-go based on the cold and heat pattern identification questionnaire(CHPIQ). Methods : We performed a subgroup analysis of the previously published prospective observational study. A total of 58 patients with rhinitis were administered Biyeom-go for 4 weeks, and its effects on the Total Nasal Symptom Score(TNSS), Mini Rhinoconjunctivitis Quality of Life Questionnaire(Mini-RQLQ) score, and nasal endoscopy index score were analyzed based on CHPIQ. Results : Among the 58 patients, the heat and non-heat patterns were shown by 39 and 19 patients, respectively, while the cold and non-cold patterns were shown by 46 and 12 patients, respectively. The change in TNSS from baseline negatively correlated with the heat pattern score(p=0.011). Improvement in TNSS was greater in the heat pattern group than in the non-heat pattern group, with a borderline significant difference(p=0.07). Mini-RQLQ and nasal endoscopy index scores tended to be lower in the heat pattern group than in the non-heat pattern group, but without a statistically significant difference. Conclusion : The findings indicate that CHPIQ is a useful tool for the diagnostic and prognostic evaluation of patients with rhinitis. This study provides fundamental evidence of the close association between the cold-heat pattern in patients with rhinitis and the treatment effects of Biyeom-go.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.10a
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• pp.2-5
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• 2022

Human organs in the body have a complex structure, and in particular, the small intestine is about 7m long, so endoscopy is not easy and the risk of endoscopy is high. Currently, the test is performed with a capsule endoscope, and the test time is very long. The doctor connects the removed storage device to the computer to store the patient's capsule endoscope image and reads it using a program, but the capsule endoscope test results in a long image length, which takes a lot of time to read. In addition, in the case of the small intestine, there are many curves due to villi, so the occlusion area or light and shade of the image are clearly visible during the examination, and there may be cases where lesions and abnormal signs are missed during the examination. In this paper, we provide a method of assisting small intestine capsule endoscopic lesion examination using artificial neural networks to shorten the doctor's image reading time and improve diagnostic reliability.

• Clinical Endoscopy
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• v.56 no.1
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• pp.100-106
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• 2023

Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

• Clinical Endoscopy
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• v.57 no.1
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• pp.105-111
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• 2024

Background/Aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage. This study aimed to assess trends in the utilization of different drainage modalities for treating PP from 2016 to 2020. The trends in mortality, mean length of hospital stay, and mean hospitalization costs were also assessed. Methods: The National Inpatient Sample database was used to obtain data. The variables were generated using International Classification of Diseases-10 diagnostic and procedural codes. Results: Endoscopic drainage was the most commonly used drainage modality in 2018-2020, with an increasing trend over time (385 procedures in 2018 to 515 in 2020; p=0.003). This is associated with a decrease in the use of other drainage modalities. A decrease in the hospitalization cost for PP requiring drainage was also noted (29,318 United States dollar [USD] in 2016 to 18,087 USD in 2020, p<0.001). Conclusions: Endoscopic drainage is becoming the most commonly used modality for the treatment of PP in hospitals located in the US. This new trend is associated with decreasing hospitalization costs.

• Clinical Endoscopy
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• v.57 no.3
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• pp.384-392
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• 2024

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is a standard diagnostic method for biliary tract cancer (BTC), and samples obtained in this manner may be used for comprehensive genomic profiling (CGP). This study evaluated the utility of EUS-TA for CGP in a clinical setting and determined the factors associated with the adequacy of CGP in patients with BTC. Methods: CGP was attempted for 105 samples from 94 patients with BTC at the Aichi Cancer Center, Japan, from October 2019 to April 2022. Results: Overall, 77.1% (81/105) of the samples were adequate for CGP. For 22-G or 19-G fine-needle biopsy (FNB), the sample adequacy was 85.7% (36/42), which was similar to that of surgical specimens (94%, p=0.45). Univariate analysis revealed that 22-G or larger FNB needle usage (86%, p=0.003), the target primary lesions (88%, p=0.015), a target size ≥30 mm (100%, p=0.0013), and number of punctures (90%, p=0.016) were significantly positively associated with CGP sample adequacy. Conclusions: EUS-TA is useful for CGP tissue sampling in patients with BTC. In particular, the use of 22-G or larger FNB needles may allow for specimen adequacy comparable to that of surgical specimens.

• KIPS Transactions on Software and Data Engineering
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• v.8 no.6
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• pp.251-256
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• 2019

A capsule endoscopy is a medical device that can capture an entire digestive organ from the esophagus to the anus at one time. It produces a vast amount of images consisted of about 8~12 hours in length and more than 50,000 frames on a single examination. However, since the analysis of endoscopic images is performed manually by a medical imaging specialist, the automation requirements of the analysis are increasing to assist diagnosis of the disease in the image. Among them, this study focused on automatic detection of polyp images. A polyp is a protruding lesion that can be found in the gastrointestinal tract. In this paper, we propose a weighted-image generation method to enhance the polyp image learning by multi-scale analysis. It is a way to extract the suspicious region of the polyp through the multi-scale analysis and combine it with the original image to generate a weighted image, that can enhance the polyp image learning. We experimented with SVM and RF which is one of the machine learning methods for 452 pieces of collected data. The F1-score of detecting the polyp with only original images was 89.3%, but when combined with the weighted images generated by the proposed method, the F1-score was improved to about 93.1%.

• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.28-34
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• 2004

Background : Esophageal perforation due to a traumatic endoscopy or intubation is exceedingly rare. If riot noticed immediately or treated promptly, however, the morbidity and mortality is significant. We performed a retrospective review of patients with iatrogenic hypopharyngo-esophageal perforation to assess the outcome of current management techniques. Material and Methods : We retrospectively analyzed all cases iatrogenic hypopharyngo-esophageal perforation diagnosed at our hospital from January, 1999, through April, 2004. The study group consisted of 11 patients (4 men) with a mean age of 47.6 years (range, 21-83 yr). We reviewed the 11 patients with perforated injuries of the hypopharynx or esophagus during the diagnostic or therapeutic procedures. Result: Perforations were due to diagnostic gastroscopy ($54.5\%$, 6/11), esophageal dilation ($27.3\%$, 3/11), endoscopic port insertion ($9.1\%$, l/11), and tracheal intrathoracic ($9.1\%$, 1/11). Seven patients had intrathoracic and 4 had cervical perforations. Treatment included incision and drainage (5), resection and reconstruction (4), drainage only (1), and observation (2). Nonfatal complications included transient pneumonia (1), and wound infection (1). They occurred in advanced mediastinal abscess ]patients. Mortality was $9.1\%$ (1/11) in old patient who managed medically in cervical esophageal perforation. Conclusions : Current mortality rates in iatrogenic esophageal perforation were improved compared to previous published rates of $19\%\;to\;66\%$ for all patients with this condition. We concluded that aggressive and definitive surgery for thoracic esophageal perforations improving the survival rate, whether diagnosed early or late.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1667-1670
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• 2014

Background: Calprotectin in feces seems to be a more sensitive marker for gastrointestinal (GI) cancers than fecal occult blood, but its specificity may be too low for screening average risk populations. This study aims at evaluating the diagnostic value of fecal calprotectin as a screening biomarker for GI malignancies. Materials and Methods: In a case-control study, 100 patients with GI malignancies (50 patients with colorectal cancer and 50 patients with gastric cancer) and 50 controls were recruited in Tabriz Imam Reza and Sina hospitals during a 24-month period. One to two weeks after the last endoscopy/colonoscopy, fecal specimens were collected by the patients and examined by ELISA method for quantitative measurement of calprotectin content. The results were compared between the three groups. Results: The mean fecal calprotectin level was $109.1{\pm}105.3$ (2.3-454.3, median:74), $241.1{\pm}205.2$ (3.4-610.0, median:19.3) and $45.9{\pm}55.1{\mu}g/g$ (1.3-257.1, median:19.3) in gastric cancer, colorectal cancer and control group, respectively, the differences being significant (p<0.001) and remaining after adjustment for age. The optimal cut-off point for fecal calprotectin was ${\geq}75.8{\mu}g/g$ for distinguishing colorectal cancer from normal cases (sensitivity and specificity of 80% and 84%, respectively). This value was ${\geq}41.9{\mu}g/g$ for distinguishing gastric cancer from normal cases (sensitivity and specificity of 62%). Conclusions: Our results revealed that fecal calprotectin might be a useful and non-invasive biomarker for distinguishing colorectal cancer from non-malignant GI conditions. However, due to low sensitivity and specificity, this biomarker may not help physicians distinguishing gastric cancer cases from healthy subjects.

• Journal of Digestive Cancer Research
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• v.11 no.3
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• pp.165-170
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• 2023

Gastric cancer is histologically classified into two types. One is the intestinal and diffuse type according to Lauren's classification, and the other is the differentiated and undifferentiated type based on Nakamura's classification. In 2007, Japanese groups proposed a new type of well-differentiated gastric adenocarcinoma in the gastric fundic glands with distinct endoscopic and clinicopathologic features. This is gastric adenocarcinoma of the fundic-gland type (GA-FG), a rare variant of gastric cancer. In a 2012 Korean study, of 6,000 cases of gastric cancer tissues, only three cases of GA-FG were identified. GA-FG is usually located in the upper third of the stomach and not known to be associated with the Helicobacter pylori infection. We herein report a case of GA-FG diagnosed in a 63-year-old man. A gastric polyp was incidentally detected during an upper endoscopy screening while conducting a health check-up, and he was diagnosed with GA-FG after an endoscopic mucosal resection (EMR) was conducted for diagnostic and therapeutic purposes. Our case suggests that for both diagnostic and therapeutic purposes, EMR may be beneficial in case of gastric polyps with suspected GA-FG.