• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.93-98
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• 2023

Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.134-137
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• 2016

A Killian-Jamieson diverticulum (KJD) is an unfamillar and unusual cervical esophageal diverticulum. This diverticulum originates on the anterolateral aspect of the esophagus through the Killian-Jamieson's area that is formed between cricopharyngeal muscle and the lateral to longitudinal esophageal muscle. Recently, we experienced a patient who was found outpouching lesion on lateral side of left esophagus on the duodenoscopy. Then, a barium esophagography performed and in left lateral position demonstrated a left-sided diverticulum with a frontal projection, highly suggestive of a KJD. There are two ways of surgical approach to manage the KJD. First is external approach, another one is endoscopic approach. In common, external approach has been recommended for the treatment of KJD because of concern of nerve injury. We present a case of KJD that underwent external approach and sternocleidomastoid muscle flap in the management of KJD.

• Parasites, Hosts and Diseases
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• 제30권3호
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• pp.231-234
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• 1992

조경사업 인부로 일하던 58세 만성 알폴성 환자가 2년 전부터 심와부 불쾌감, 오심, 무른변을 자주 보는 등의 증상을 느꺼오던 중 3개일 전부터 증상이 심해지면서 4 kg의 체중 감소가 있어 내원하였다. 입원 후 시행한 내시 경정사상 십이지 장궤양이 관찰되었고, 대 변검사에서는 분선충(Strongyloides stertoralis)의 rhabditoid 유충이 발견되어, 십이지장궤양 및 분선충증으로 진단되었다. 대변 배양검사에서는 분선충의 filari(orts 유충이 화인되었다. 환자는 분선충증에 대하여 albendazole을 14일간 투여받은 후 하루 4∼5회씩 있던 무른 대변이 정상 대변으로 돌아왔고, 대변 검사 및 대변 배양검사에서 분선충이 더 이상 관찰되지 않았다. 십이지장궤양에 대해서는 colloidal bismuth sulfate로 6주간 치료받은 후, 역시 내시경상 완치되었음이 확인되었고, 건강한 상태로 퇴원하였다. 이 증례는 분선충증이 십이지장궤양과 인과관계가 있을 것임을 시사하는 흥미있는 1례로 생각되었다.

• Journal of Gastric Cancer
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• 제12권1호
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• pp.43-45
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• 2012

Mesenteric pseudocyst is rare. This term is used to describe the abdominal cystic mass, without the origin of abdominal organ. We presented a case of mesenteric pseudocyst of the small bowel in a 70-year-old man. Esophago-gastro-duodenoscopy showed a 3.5 cm sized excavated lesion on the posterior wall of angle. Endocopic biopsy confirmed a histologic diagnosis of the poorly differentiated adenocarcinoma, which includes the signet ring cell component. Abdominal computed tomography scan showed a focal mucosal enhancement in the posterior wall of angle of the stomach, a 2.4 cm sized enhancing mass on the distal small bowel loop, without distant metastases or ascites in rectal shelf, and multiple gallbladder stones. The patient underwent subtotal gastrectomy with gastroduodenostomy, segmental resection of the small bowel, and cholecystectomy. The final pathological diagnosis was mesenteric pseudocyst. This is the first case report describing incidentally detected mesenteric pseudocyst of the small bowel in gastric cancer patients.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1084-1092
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• 2018

Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

• 한국컴퓨터정보학회논문지
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• 제26권3호
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• pp.19-28
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• 2021

위내시경 촬영은 조기에 위 병변을 진단하기 위해서 주로 사용한다. 하지만 위내시경을 했음에도 불구하고 위 내부를 자세히 관찰하지 못해서 10~20% 위 병변을 놓치는 경우가 생기는 것으로 보고되고 있다. 미국, 영국, 일본 등의 일부 국가와 세계내시경협회(Wold Endoscopy Organization)에서는 위내시경 시에 맹점 없는 관찰을 위해서 반드시 촬영해야 할 부위에 대한 촬영지침을 제안한 바 있다. 이에 본 논문에서는 수련의가 내시경을 하는 데 있어 위 내부를 자동으로 맹점 없이 관찰하는데 필요한 딥러닝 기술인 해부학적 분류모델을 제안한다. 제안한 모델은 위내시경 이미지에 적합한 전처리 모듈과 데이터 증강 기술들을 사용한다. 실험결과를 통해 최대 F1 점수 99.6% 분류 성능을 확인하였다. 또한, 실제 데이터를 통한 실험결과에서도 에러율이 4% 미만을 보였다. 이러한 성능을 바탕으로 설명 가능한 모델임을 보여 임상에서의 사용 가능성을 확인하였다.