• Clinical Endoscopy
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• v.55 no.3
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• pp.339-346
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• 2022

Since the earliest reports, advanced clipping systems have been developed, and it is possible to choose among many models with different structural and technical features. The main drawback of through-the-scope clips is their small size, which allows the compression of limited amounts of tissue needed for large-size vessel treatment. Therefore, the over-the-scope clip system was realized, allowing a larger and stronger mechanical compression of large tissue areas, with excellent results in achieving a definitive hemostasis in difficult cases. Many studies have analyzed the indications and efficacy of two-pronged endoclips and have shown good results for initial and permanent hemostasis. The aim of this review was to provide updated information on indications, positioning techniques, and results of clip application for endoscopic treatment of upper gastrointestinal non-variceal bleeding lesions.

• Clinical Endoscopy
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• v.51 no.6
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• pp.541-546
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• 2018

Recent advances in cholangiopancreatoscopy technology permit image-enhanced endoscopy (IEE) for pancreatobiliary diseases. There are limitations in endoscopy performance and in the study of the clinical role of IEE in bile duct or pancreatic duct diseases. However, currently available IEEs during cholangiopancreatoscopy including traditional dye-aided chromoendoscopy, autofluorescence imaging, narrow-band imaging, and i-Scan have been evaluated and reported previously. Although the clinical role of IEE in pancreatobiliary diseases should be verified in future studies, IEE is a useful promising tool in the evaluation of bile duct or pancreatic duct mucosal lesions.

• Clinical Endoscopy
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• v.55 no.6
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• pp.775-783
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• 2022

Background/Aims: Colorectal endoscopic submucosal dissection (ESD) is burdened by its associated high risk of adverse events and long procedure time. Recently, a waterjet-assisted knife was introduced to simplify and speed up the procedure. The aim of this study was to evaluate the efficacy and safety of waterjet-assisted ESD (WESD) compared to that of the conventional ESD (CESD) technique. Methods: The charts of 254 consecutive patients who underwent colorectal ESD between January 2014 and February 2021 for colorectal neoplasms were analyzed. The primary outcome was the en-bloc resection rate. Secondary outcomes were complete and curative resection rates, the need to switch to a hybrid ESD, procedure speed, the adverse event rates, and the recurrence rates. Results: Approximately 174 neoplasias were considered, of which, 123 were removed by WESD and 51 by CESD. The en-bloc resection rate was higher in the WESD group (94.3% vs. 84.3%). Complete resection rates and curative resection rates were similar. The need to switch to a hybrid ESD was greater during CESD (39.2% vs. 13.8%). Procedure speed and adverse event rates were similar. During follow-up, one recurrence occurred after a WESD. Conclusions: WESD allows a high rate of en-bloc resections and less frequently requires a rescue switch to the hybrid ESD compared to CESD.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.987-992
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• 2008

This study was carried out to understand the macroscopic aspects of the digestive system symptoms occurring after taking oriental herb complex decoction as observing morphological changes in esophagus, stomach and duodenal bulb by endoscopy of upper gastrointestinal tract when these symptoms developed. The subjects of this study were 46 patients (male 22, female 24, mean age : $54.72{\pm}14.26$ years) who were chosen among ones who took oriental herb complex decoction for medical care and developed symptoms related to the gastrointestinal tract while taking an oriental herb decoction, which were assumed that the digestive symptoms were newly developed because of administration. The subjects were given morphological examination by endoscopy of the upper gastrointestinal tract. As a result of the endoscopy operated due to the digestive symptoms developed during the administration of oriental herb decoction, there were 2 cases of esophagitis, 5 cases of acute gastritis, 1 case of chronic gastritis A type, 15 cases of chronic gastritis B type, 1 case of duodenitis, 1 case of gastric ulcer, 1 case of gastric polyp, 2 cases of intestinal metaplasia, 1 case of gastric ptosis and 17 cases of normal findings which didn't have any abnormality macroscopically with endoscopy. With regards to the patients who complained of the digestive symptoms after taking oriental herb decoction, it has been found that the symptoms occurred as the oriental herbal medicine taken by the patients who had the digestive symptoms at ordinary times influenced on the gastrointestinal tract. Especially, many of them were had chronic gastritis and functional dyspepsia in the past. The disease accompanying macroscopic lesions at endoscopy which occurred due to the oriental herb decoction as direct cause, was acute gastritis, and it was the prescription to cure the pains and inflammations of skeletomuscular disease.

• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.56-64
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• 2022

Narrow-band imaging (NBI) is the most widely used image-enhanced endoscopic technique. The superficial microanatomy of gastric mucosa can be visualized when used with a magnifying endoscopy with narrow-band imaging (ME-NBI). The diagnostic criteria for early gastric cancer (EGC), using the classification system for microvascular and microsurface pattern of ME-NBI, have been developed, and their usefulness has been proven in the differential diagnosis of small depressed cancer from focal gastritis and in lateral extent delineation of EGC. Some studies reported on the prediction of histologic differentiation and invasion depth of gastric cancer using ME-NBI; however, its application is limited in clinical practice, and further well-designed studies are necessary. Clinicians should understand the ME-NBI classification system and acquire appropriate diagnostic skills through various experiences and training to improve the quality of endoscopy for EGC diagnosis.

• Clinical Endoscopy
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• v.55 no.1
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• pp.33-40
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• 2022

Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I²]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I²=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

• Clinical Endoscopy
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• v.57 no.2
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• pp.196-202
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• 2024

Background/Aims: Hypoxemia is a common side effect of propofol sedation during endoscopy. Applying mild positive airway pressure (PAP) using a nasal mask may offer a simple way to reduce such events and optimize the conditions for diagnostic and therapeutic upper gastrointestinal endoscopies. Methods: We compared overweight patients (body mass index >25 kg/m²) with a nasal PAP mask or standard nasal cannula undergoing upper gastrointestinal endoscopies by non-anesthesiologists who provided propofol sedation. Outcome parameters included the frequency and severity of hypoxemic episodes. Results: We analyzed 102 procedures in 51 patients with nasal PAP masks and 51 controls. Episodes of hypoxemia (oxygen saturation [SpO₂] <90% at any time during sedation) occurred in 25 (49.0%) controls compared to 8 (15.7%) patients with nasal PAP masks (p<0.001). Severe hypoxemia (SpO₂ <80%) occurred in three individuals (5.9%) in both groups. The mean delta between baseline SpO₂ and the lowest SpO₂ recorded was significantly decreased among patients with nasal PAP mask compared to controls (3.7 and 8.2 percentage points difference, respectively). There were significantly fewer airway interventions performed in the nasal PAP mask group (15.7% vs. 41.2%, p=0.008). Conclusions: Using a nasal PAP mask may be a simple means of increasing patient safety and ease of examination.

• Clinical Endoscopy
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• v.57 no.2
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• pp.141-157
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• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

• Journal of information and communication convergence engineering
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• v.16 no.2
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• pp.130-134
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• 2018

Wireless capsule endoscopy (WCE) is considered as recent technology for the detection cancer cells in the human digestive system. WCE sends the captured information from inside the body to a sensor on the skin surface through a wireless medium. In WCE, the design of low-power consumption devices is a challenging topic. In the Shannon-Nyquist sampling theorem, the number of samples should be at least twice the highest transmission frequency to reconstruct precise signals. The number of samples is proportional to the power consumption in wireless communication. This paper proposes compressive sensing as a method to reduce power consumption in WCE, by means of a trade-off between samples and reconstruction accuracy. The proposed scheme is validated under channel constraints, expressed as the realistic human body path loss. The results show that the proposed scheme achieves a significant reduction in WCE power consumption and achieves a faster computation time with low signal error reconstruction.

• Journal of Intelligence and Information Systems
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• v.15 no.2
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• pp.33-48
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• 2009

Capsule endoscopy is one of the most remarkable inventions in last ten years. Causing less pain for patients, diagnosis for entire digestive system has been considered as a most convenience method over a normal endoscope. However, it is known that the diagnosis process typically requires very long inspection time for clinical experts because of considerably many duplicate images of same areas in human digestive system due to uncontrollable movement of a capsule endoscope. In this paper, we propose a method for clinical diagnosticians to get highly valuable information from capsule-endoscopy video. Our software system consists of three global maps, such as movement map, characteristic map, and brightness map, in temporal domain for entire sequence of the input video. The movement map can be used for effectively removing duplicated adjacent images. The characteristic and brightness maps provide frame content analyses that can be quickly used for segmenting regions or locating some features(such as blood) in the stream. Our experiments show the results of four patients having different health conditions. The result maps clearly capture the movements and characteristics from the image frames. Our method may help the diagnosticians quickly search the locations of lesion, bleeding, or some other interesting areas.