• Title/Summary/Keyword: Endoscopy Unit

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TLR1 Polymorphism Associations with Gastric Mucosa Morphologic Patterns on Magnifying NBI Endoscopy: a Prospective Cross-Sectional Study

  • Tongtawee, Taweesak;Bartpho, Theeraya;Kaewpitoon, Soraya;Kaewpitoon, Natthawut;Dechsukhum, Chavaboon;Leeanansaksiri, Wilairat;Loyd, Ryan A;Matrakool, Likit;Panpimanmas, Sukij
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3391-3394
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    • 2016
  • Background: Helicobacter pylori is now recognized as a causative factor of chronic gastritis, gastroduodenal ulcers, gastric cancer and mucosa-associated lymphatic tissue lymphoma. Toll-like receptors are important bacterial receptors in gastric epithelial cell signaling transduction and play critical roles in gastric carcinogenesis. Materials and Methods: A total of 400 patients undergoing esophagogastroduodenoscopy for investigation of chronic abdominal pain were genotyped for single-nucleotide polymorphisms (SNPs) in TLR1 (rs4833095) using TagMan SNPs genotyping assay by real-time PCR hybridization. Relationships with susceptibility to H. pylori infection and pre-malignant gastric mucosa morphological patterns, classified by magnifying NBI endoscopy, were investigated. Results: The percentages of TLR1 rs4833095, CC homozygous, CT heterozygous and TT homozygous cases were 34, 46.5 and 19%, respectively. CC showed statistical differences between H. pylori positive and negative cases (P<0.001). CT and TT correlated with type 1 and type 2 gastric mucosal morphological patterns (P <0.01) whereas CC correlated with types 3 and 4 (P<0.01). Conclusions: This study demonstrated good correlation of TLR1 rs4833095 genotype with severity of inflammation in H. pylori infected gastric mucosa according to gastric mucosal morphologic patterns with magnifying NBI endoscopy.

Airway Management for Initial PEG Insertion in the Pediatric Endoscopy Unit: A Retrospective Evaluation of 168 Patients

  • Peck, Jacquelin;Nguyen, Anh Thy H.;Dey, Aditi;Amankwah, Ernest K.;Rehman, Mohamed;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.100-108
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    • 2021
  • Purpose: Percutaneous endoscopic gastrostomy (PEG) tube placements are commonly performed pediatric endoscopic procedures. Because of underlying disease, these patients are at increased risk for airway-related complications. This study compares patient characteristics and complications following initial PEG insertion with general endotracheal anesthesia (GETA) vs. anesthesia-directed deep sedation with a natural airway (ADDS). Methods: All patients 6 months to 18 years undergoing initial PEG insertion within the endoscopy suite were considered for inclusion in this retrospective cohort study. Selection of GETA vs. ADDS was made by the anesthesia attending after discussion with the gastroenterologist. Results: This study included 168 patients (GETA n=38, ADDS n=130). Cohorts had similar characteristics with respect to sex, race, and weight. Compared to ADDS, GETA patients were younger (1.5 years vs. 2.9 years, p=0.04), had higher rates of severe American Society of Anesthesiologists (ASA) disease severity scores (ASA 4-5) (21% vs. 3%, p<0.001), and higher rates of cardiac comorbidities (39.5% vs. 18.5%, p=0.02). Significant associations were not observed between GETA/ADDS status and airway support, 30-day readmission, fever, or pain medication in unadjusted or adjusted models. GETA patients had significantly increased length of stay (eβ=1.55, 95% confidence interval [CI]=1.11-2.18) after adjusting for ASA class, room time, anesthesia time, fever, and cardiac diagnosis. GETA patients also had increased room time (eβ=1.20, 95% CI=1.08-1.33) and anesthesia time (eβ=1.50, 95% CI=1.30-1.74) in adjusted models. Conclusion: Study results indicate that younger and higher risk patients are more likely to undergo GETA. Children selected for GETA experienced longer room times, anesthesia times, and hospital length of stay.

A Clinical study of Paranasal Sinusitis (副鼻洞炎에 關한 臨床的 硏究)

  • Choi, In-hwa;Chae, Byung-yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.269-283
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    • 1998
  • Paranasal sinusitis, especially chronic is one of the most common diseases in the field of otolaryngology. It is similar to Bee Yeun(鼻淵) in oriental medicine. Most cases of sinusitis are due to anatomical abnormalities within ostiomeatal unit or disturbed mucocilliary flow. The ostiomeatal unit is the first place of contact with bacteria and allergens during aspiration, and it can be obstructed easily by minute mucosal swelling due to anatomical narrowness. Therefore the treatment of paranasal sinusitis is not easy and often leads to recurrences in spite of long term treatment or surgical therapy. We studied 83 patients who had visited our hospital with complaints of nasal symptoms; they had been diagnosed as having paranasal sinusitis through an endoscopy or CT scan in another hospital and were diagnosed as the paranasal sinusitis through a PNS series. The results were as follows: 1. Age and sex distribution: The most common occurence was found between 6-10 and 1-5 years old. The Males Were 52($62.7\%$) and Females were 31($37.3\%$). 2. By residence 58 cases lived in apts: 25 lived in houses. 3. The longest duration of disease varied from a lower of 13 to a higher of 36 months in 22 cases and from 7 to 12 months in 21 cases. 4. The most common complication & past history with otolaryngologic or allergic disease were adenoid or tonsil hypertrophy & tonsillectomy and adenoidectomy (21 cases). In decreasing order the others were atopic dematitis, otitis media with effusion and allergic rhinitis. 5. Distribution of paranasal sinus disease was most common in both maxillary sinuses in 52 cases. 12 cases showed a normal PNS X-ray series but these had been diagnosed as paranasal sinusitis with an endoscopy or CT scan in another hospital. 6. Common sinusitis - related symptoms were from highest incidence to lowest nasal obstruction, postnasal drip rhinorrhea, frontal headache, cough with sputum. 7. The most administered of prescription was Gamibangpoongtongsungsan and Sunbangpaedoksan extract. 8. In 26 cases the subjects showed significant improvement symptoms in PNS X-ray series : In 21 case showed partial improvement symptoms.

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Epidemic Trends of Upper Gastrointestinal Tract Abnormalities: Hospital-based study on Endoscopic Data Evaluation

  • Mohiuddin, Mohammed Khaliq;Chowdavaram, Suman;Bogadi, Varun;Prabhakar, Boddu;Rao, Kondadasula Pandu Ranga;Devi, Suneetha;Mohan, Vasavi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5741-5747
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    • 2015
  • Purpose: To understand the epidemiology of different upper gastrointestinal (UGI) tract related abnormalities through endoscopic data analysis. Materials and Methods: A retrospective study of three years from January 2009 to December 2011 was conducted with data from endoscopic surveillance of upper GI tract problems, collected from the Gastroenterology Unit, Osmania General Hospital, Hyderabad. MS excel and Medcalc software (comparison of proportions) were used for data analysis. Results: A total of 10,029 (6,468 in males and 3,561 in females) endoscopies were performed during this three-year period. The male to female ratio was 1.8:1. Overall, ~30% of endoscopies evaluated showed patients with acid peptic disorders, 13.6% with vascular-related abnormalities, 10.6% showed structural abnormalities, followed by 6.3% with malignancies. Burden of malignancies was mostly observed in the older age group (60-69 years). Esophageal cancer cases decreased (p=0.0001) whereas stomach cancers increased over this period (p=0.0345). We also observed an increased incidence of acid peptic disease (APD) (p=0.0036) and gastroesophageal reflux disease (GERD) (p=0.0002) cases during this period. Conclusions: Endoscopic diagnosis is useful for early detection of UGI anomalies and helpful for physicians to manage and treat varied kinds of UGI disorders. Analysis of data revealed changing trends in the incidence of various pathologies of the UGI tract. Functional dyspepsia and GERD definitely reduce the quality of life of the individual. The role of our diverse dietary habits and lifestyle associated with these problems have not yet been established, though there have been reports on the effect of coffee, spicy food, wheat-based diet, screening of UGI pathologies along with collection of complete personal and medical history details, can h elp in correlating the patients' condition with various aspects of lifestyle and diet.

Role of the Mdm2 SNIP 309 Polymorphism in Gastric Mucosal Morphologic Patterns of Patients with Helicobacter pylori Associated Gastritis

  • Tongtawee, Taweesak;Dechsukhum, Chavaboon;Leeanansaksiri, Wilairat;Kaewpitoon, Soraya;Kaewpitoon, Natthawut;Loyd, Ryan A;Matrakool, Likit;Panpimanmas, Sukij
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1057-1060
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    • 2016
  • Background: The tumor suppressor p53 is as a regulator of cell proliferation, apoptosis and many other biological processes as well as external and internal stress responses. Mdm2 SNIP309 is a negative regulator of 53. Therefore, this study aimed to determine the role of the Mdm2 SNIP 309 polymorphism in the gastric mucosal morphological patterns in patients with Helicobacter pylori associated gastritis. Materials and Methods: A prospective cross-sectional study was carried out from November 2014 through November 2015. Biopsy specimens were obtained from patients and infection was proven by positive histology. Gastric mucosa specimens were sent to the Molecular Genetics Unit, Institute of Medicine, Suranaree University of Technology where they were tested by molecular methods to detect the patterns of Mdm2 SNIP 309 polymorphism using the real-time PCR hybridization probe method. The results were analyzed and correlated with gastric mucosal morphological patterns by using C-NBI endoscopy. Results: A total of 300 infected patients were enrolled and gastric mucosa specimens were collected. In this study the percentage of Mdm2 SNIP 309 T/T homozygous and Mdm2 SNIP309 G/T heterozygous was 78% and 19 % respectively whereas Mdm2 SNIP309 G/G homozygous was 3%. Mdm2 SNIP 309 T/T homozygous and Mdm2 SNIP309 G/T heterozygosity correlated with type 1 to type 3 gastric mucosal morphological patterns (P<0.01) whereas Mdm2 SNIP309 G/G homozygous correlated with type 4 and type 5 (P<0.01). Conclusions: Our study finds the frequency of Mdm2 SNIP309 G/G in a Thai population is very low, and suggests that this can explain ae Thailand enigma. Types 1 to type 3 are the most common gastric mucosal morphological patterns according to the unique genetic polymorphism of MDM2 SNIP 309 in the Thai population.

Design of Miniaturized Telemetry Module for Bi-Directional Wireless Endoscopy

  • Park, H. J.;H. W. Nam;B. S. Song;J. H. Cho
    • Proceedings of the IEEK Conference
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    • 2002.07a
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    • pp.494-496
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    • 2002
  • A bi-directional and multi-channel wireless telemetry capsule, 11mm in diameter, is presented that can transmit video images from inside the human body and receive a control signal from an external control unit. The proposed telemetry capsule includes transmitting and receiving antennas, a demodulator, decoder, four LEDs, and CMOS image sensor, along with their driving circuits. The receiver demodulates the received signal radiated from the external control unit. Next, the decoder receives the stream of control signals and interprets five of the binary digits as an address code. Thereafter, the remaining signal is interpreted as four bits of binary data. Consequently, the proposed telemetry module can demodulate external signals so as to control the behavior of the camera and four LEDs during the transmission of video images. The proposed telemetry capsule can simultaneously transmit a video signal and receive a control signal determining the behavior of the capsule itself. As a result, the total power consumption of the telemetry capsule can be reduced by turning off the camera power during dead time and separately controlling the LEDs for proper illumination of the intestine.

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Diagnosis of Helicobacter pylori Infection

  • Tongtawee, Taweesak;Kaewpitoon, Soraya;Kaewpitoon, Natthawut;Dechsukhum, Chavaboon;Leeanansaksiri, Wilairat;Loyd, Ryan A;Matrakool, Likit;Panpimanmas, Sukij
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1631-1635
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    • 2016
  • Helicobacter pylori infection plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease and gastric malignancy. A diagnosis of infection is thus an important part of a treatment strategy of many gastrointestinal tract diseases. Many diagnostic tests are available but all have some limitations in different clinical situations and laboratory settings. A single gold standard cannot available, but be used for diagnosis of Helicobacter pylori infection in daily clinical practice in all areas, so several techniques have been developed to give reliable results, especially focusing on real time endoscopic features. The narrow band imaging system (NBI) and high resolution endoscopy are imaging techniques for enhanced visualization of infected mucosa and premalignant gastric lesions. The aim of this article is to review the current diagnostic options and possible future developments detection of Helicobacter pylori infection.

Upper Gastrointestinal Tract Polyps: What Do We Know About Them?

  • Buyukasik, Kenan;Sevinc, Mert Mahsuni;Gunduz, Umut Riza;Ari, Aziz;Gurbulak, Bunyamin;Toros, Ahmet Burak;Bektas, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2999-3001
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    • 2015
  • Background: This study aimed to evaluate upper gastrointestinal polyps detected during esophago-gastroduodenoscopy tests. Materials and Methods: We conducted a retrospective analysis on data regarding 55,987 upper gastrointestinal endoscopy tests performed at the endoscopy unit of Istanbul Education and Research Hospital between January 2006 and June 2012. Results: A total of 66 upper gastrointestinal polyps from 59 patients were analyzed. The most common clinical symptom was dyspepsia, observed in 41 cases (69.5%). The localizations of the polyps were as follows: 29 in the antrum (43.9%), 15 in the corpus (22.7%), 11 in the cardia (16.7%), 3 in the fundus (4.54%), 3 in the second portion of the duodenum (4.54%), 2 in the bulbus (3.03%) and 3 in the lower end of the esophagus (4.54%). Histopathological types of polyps included hyperplastic polyps (44) (66.7%), faveolar hyperplasia (8) (12.1%), fundic gland polyps (4) (6.06%), squamous cell polyps (4) (6.06%), hamartomatous polyps (3) (4.54%), and pyloric gland adenoma (3) (4.54%). Histopathological analysis of the gastric mucosa showed chronic atrophic gastritis in 30 cases (50.84%), HP infection in 33 cases (55.9%) and intestinal metaplasia in 19 cases (32.20%). In 3 cases with multiple polyps, adenocarcinoma was detected in hyperplastic polyps. Conclusions: Among polypoid lesions of the upper gastrointestinal tract, the most common histological type is hyperplastic polyps. Generally, HP infection is associated with chronic atrophic gastritis and intestinal metaplasia. The incidence of adenocarcinoma tends to be higher in patients with multiple hyperplastic polyps.

Prevalence of Esophageal Cancer in the Northern Part of Afghanistan

  • Hamrah, Mohammad Shoaib;Hamrah, Mohammad Hashem;Rabi, Mirwais;Wu, Hong Xian;Hao, Chang-Ning;Harun-Or-Rashid, Mohammad;Sakamoto, Junichi;Ishii, Hideki
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10981-10984
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    • 2015
  • Background: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patients presenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancer in the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophageal cancer among patients in this region. Materials and Methods: We identified 364 consecutive patients that received EGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospital from March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years or more. We evaluated the results retrospectively. Results: The cases consisted of 184 (51%) males and 180 (49%) females. The mean age was $47.3{\pm}17.8$ and the age range 17-88 years. Ninety two cases had esophageal cancer, out of which 58 (63.0%) were male. The mean age at time of diagnosis was $57.8{\pm}13.2years$. Uzbek-Turkmen peoples were more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptom among patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. Conclusions: Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in the Uzbek-Turkmen ethnic group.