• 동서간호학연구지
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• 제23권1호
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• pp.75-85
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• 2017

Purpose: This study was conducted to examine the effects of Pericardium Kimek (K9) and Nei-Guan (P6) acupressure on relief of the anxiety, nausea, retching and physiologic changes (oxygen saturation, blood pressure, heart rate, temperature and respiration) in the patients undergoing unsedated esophagogastroduodenoscopy. Methods: A quasi-experimental research design was used. The participants were assigned into the listed three groups, i.e., the control group, the first experimental group (E1: K9 acupressure group) and the second experimental group (E2: P6 acupressure group). A total of 60 participants were included for analysis. Results: The severity of nausea (F=3.503, p=.037), the oxygen saturation (F=5.417, p=.007). and the respiration rate (F=7.270, p=.002) showed statistically significant differences in three groups. Conclusion: Based on the results of the present study, K9 acupressure with moxa pellets and P6 acupressure with wristbands (Sea-Band) are considered to be safe and an easy-to-apply intervention to relieve nausea and maintain the level of oxygen saturation and respiration rate in patients undergone unsedated esophagogastroduodenoscopy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.87-93
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• 2017

Purpose: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. Methods: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion. Results: Sedation was not applied in 24.1% of the cases in topical lidocaine spray group (LS group) and in 5.7% of the cases in distilled water spray group (DS group). Gag reflex was observed in 6.5% of cases in LS group and 33.3% of cases in DS group (p=0.024), increased oral secretion was observed in 9.3% of cases in LS group and 51.7% of cases in DS group (p=0.038), sore throat was observed in 3.7% of cases in LS group and 35.6% of cases in DS group (p=0.019) and the difference was statistically significant. Conclusion: The study showed that topical pharyngeal lidocaine reduces both requirement and amount of IV sedation before EGD in children and sore throat, gag reflex and decreased oral secretion increase.

• Clinical Endoscopy
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• 제56권4호
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• pp.453-454
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• 2023

• Journal of Digestive Cancer Research
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• 제3권1호
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• pp.26-29
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• 2015

A 73-year-old male visited our hospital with a complaint of general weakness. He underwent pyloric preserving pancreas-toduodenectomy due to ampullary cancer three years ago. Abdominal computed tomography scan at initial visit revealed multiple hepatic masses. A PET-CT scan showed multiple FDG uptakes at whole liver. He underwent hepatic artery infusion chemotherapy (HAIC) for five cycles. During the first cycle of HAIC, he developed gastric ulcer bleeding and endoscopic hemostasis was done successfully. Esophagogastroduodenoscopy after the 5^th cycle of HAIC revealed ulcer scar at gastric angle. PET-CT scan at 12 months showed no FDG uptake at liver, but a focal FDG uptakes at stomach and peri-gastric lymph nodes were newly developed. Esophagogastroduodenoscopy revealed about 3 cm sized mass at gastric angle. He underwent surgery and pathologic examination revealed large cell neuroendocrine carcinoma. We report a case of gastric large cell neuroendocrine carcinoma with liver metastasis treated with HAIC followed by surgery.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.271-274
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• 2014

Prostate cancer is the second most common cause of cancer death in men in the United States. The most common sites of metastasis include the bone, lymph nodes, lung, liver, pleura, and adrenal glands, whereas metastatic prostate cancer involving the gastrointestinal tract has been rarely reported. A 64-year-old African-American man with a history of prostate cancer presented with anemia. He reported the passing of dark colored stools but denied hematemesis or hematochezia. Colonoscopy revealed circumferential nodularity, and histology demonstrated metastatic carcinoma of the prostate. Esophagogastroduodenoscopy showed hypertrophic folds in the gastric fundus, and microscopic examination revealed tumor cells positive for prostate-specific antigen. Bone scanning and computed tomography of the abdomen and pelvis did not show metastasis. It is crucial to distinguish primary gastrointestinal cancer from metastatic lesions, especially in patients with a history of cancer at another site, for appropriate management.

• Journal of Gastric Cancer
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• 제11권4호
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• pp.234-238
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• 2011

A 67 year old male at a regular checkup underwent esophagogastroduodenoscopy. On performing esophagogastroduodenoscopy, a lesion about 1.2 cm depressed was noted at the gastric angle. The pathology of the biopsy specimen revealed a well-differentiated adenocarcinoma. On performing an abdominal computed tomography (CT) scan & positron emission tomography-computed tomography (PET-CT) scan, no definite evidence of gastric wall thickening or mass lesion was found. However, lymph node enlargement was found in the left gastric and prepancreatic spaces. This patient underwent laparoscopic assisted distal gastrectomy and D2 lymph node dissection. On final examination, it was found out that the tumor had invaded the mucosal layer. The lymph node was a metastasized large cell neuroendocrine carcinoma with an unknown primary site. The patient refused chemotherapy. He opted to undergo a close followup. At the postoperative month 27, he had a focal hypermetabolic lesion in the left lobe of the liver that suggested metastasis on PET-CT scan. He refused to undergo an operation. He underwent a radiofrequency ablation.

• Clinical Endoscopy
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• 제56권6호
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• pp.812-816
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• 2023

We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

• Perspectives in Nursing Science
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• 제17권2호
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• pp.61-71
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• 2020

Purpose: This mixed method study aimed to investigate patients' level of anxiety and their experience of this before undergoing esophagogastroduodenoscopy (EGD). Methods: A total of 125 patients answered a questionnaire assessing their pre-EGD level of anxiety, and a total of 17 patients participated in individual interviews regarding their experience of EGD-related anxiety. The SPSS Software program was used for survey data analysis and content analysis was used for qualitative data. Results: The mean anxiety score was 40.00±9.86 and the factors related to anxiety levels were being female (p<.001) and being a relatively young age (20-30 years old, p=.004). There were no significant differences shown in level of anxiety according to the purpose EGD was performed for: screening, diagnosis, or disease follow-up. In the qualitative analysis, however, patients who underwent a follow-up procedure as a result of stomach cancer exhibited more complicated feelings of anxiety and helplessness than others. For those who underwent EGD for diagnostic reasons, they worried about the test results and were concerned about possible life changes after diagnosis. Those for whom EGD was performed for screening purposes expressed concern only in the event of EGD complications. Conclusion: This study explored the nature of pre-EGD anxiety according to the purpose of the procedure. Nurses and doctors should be aware that patients undergoing EGD may have different levels and experiences of pre-procedure anxiety.

• 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.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.137-144
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• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.