• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.4 no.2
• /
• pp.142-147
• /
• 2001

Purpose: We are going to establish the efficacy of endoscopic examinations in diagnosing and treating upper GI bleeding in full term neonates. Methods: We retrospectively reviewed newborns who underwent endoscopic examination because of hematemesis from July 1998 to April 2001. Results: Gestational ages were between 38 and 41weeks, and birth weights were between 2,730 and 3,400 gm. Total of 9 patients were reviewed. Endoscopic examination revealed gastric ulcer in 6 cases, multiple erosions in 2 cases and negative finding in 1 case. All 6 gastric ulcers were multiple and among them 2 patients endoscopic hemostatic therapy. No complication due to the procedure was noticed. Five patients recieved transfusions. All 9 cases were cured through conservative and endoscopic therapy without recurrence. Conclusion: The common cause of upper GI hemorrhage in newborns with no preceding disease turns out to be multiple gastric ulcers and the prognosis is good. The endoscopic approach is useful in diagnosing and treating upper GI bleeding in newborns.

• Journal of Hospice and Palliative Care
• /
• v.12 no.2
• /
• pp.49-55
• /
• 2009

Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

• Journal of Digestive Cancer Research
• /
• v.2 no.1
• /
• pp.24-27
• /
• 2014

A 42-year-old female was referred to our department after find out submucosal tumor type lesion on cardia at local clinics. She experienced no specific symptom. On gastroscopy, two distinct neoplasms were detected. One of which was located in the cardia anterior wall of the stomach with the size of 2.0×1.1 cm, and the other one was localized in the cardia posterior wall of the stomach and its size was 1.5×1.2 cm. We performed endoscopic submucosal dissection. Pathological evaluation revealed the diagnosis of gastrointestinal stromal tumor (GIST) at the cardia anterior wall and malignant lymphoma from the mass localized cardia posterior wall of the stomach. We would like to report these rare synchronous tumors which were successfully treated by endoscopic resection in the same patient

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.10 no.2
• /
• pp.157-165
• /
• 2007

Purpose: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. Methods: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. Results: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. Conclusion: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.

• Journal of Yeungnam Medical Science
• /
• v.18 no.1
• /
• pp.75-84
• /
• 2001

Background: The accidental swallowing of foreign body is a common problem in the children. Ingested foreign bodies may be managed by endoscopy, observation, or surgery. So we analyzed the methods of removal, type, location and complications of foreign bodies. Materials and Methods: This report reviewed 37 cases of ingested foreign body in the gastrointestinal tract at the Department of Pediatrics, Yeungnam University Hospital between January 1997 and April 2001. Results: The age ranged from 8 months to 8 years. The most prevalent age group was between 1 year and 2 years of age(19%). The male to female ratio was 2.1:1 with 25 male and 12 female patients. The type of foreign bodies were coins in 20 cases(54%), nail in 4 cases(11%), key in 4 cases(11%), pin in 2 cases(5.5%), necklace in 2 cases(5.5%) and others. The locations of foreign bodies were upper esophagus in 12 cases(32.5%), lower esophagus in 4 cases(10.8%), stomach in 16 cases(43.2%), small bowel in 5 cases(13.5%). 4. Presenting symptoms were variable with asymptomatic(59.4%), vomiting(19.0%), epigastric pain(8.1%), dysphagia(5.4%) and others. The methods for removal of foreign bodies included 20 cases of endoscopic removal(54.0%). 3 cases of spontaneous removal(8.1%) and there was no surgical removal. 14 cases(37.9%) did not confirmed removal of foreign body because of no revisit of our hospital. Endoscopic finding of patients were normal(15 cases), ulceration(2 cases), erosion(1 case), inflammation(1 case), mucosal scratch(1 case). Conclusion: It appears that the endoscopic approach is the preferable method for the removal of upper gastrointestinal foreign bodies in the children.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.13 no.1
• /
• pp.23-29
• /
• 2010

Purpose: The aim of this study was to assess the benefits of routine pre-endoscopy coagulation screening tests and platelet counts in Korean children. Methods: Between March 2004 and December 2009, children who underwent gastrointestinal endoscopy for the evaluation of various gastrointestinal symptoms were included. All of the subjects included in the study also underwent routine coagulation screening and platelet count determinations prior to endoscopy and biopsy. The clinical records and laboratory tests were retrospectively reviewed in all patients. Results: One hundred sixty-two of 1,476 (11%) patients who underwent endoscopy had abnormal results on pre-screening coagulation tests. Fourteen patients underwent coagulation factor assays due to abnormal clotting results in consecutive tests or due to clinical evidence of a bleeding tendency. Seven patients were diagnosed with factor XII deficiency, one patient was diagnosed with von Willebrand disease, one patient had von Willebrand disease and factor XII deficiency, and one patient was presumed to have mild hemophilia. The remaining 4 patients had normal results with the factor assays. The results of platelet counts were normal with the exception of 1 patient. No patient had significant bleeding during the endoscopic procedures, despite abnormal pre-endoscopic coagulation tests. Conclusion: Routine coagulation screening tests and platelet counts revealed abnormal results in some patients. Most of the patients with abnormal clotting were shown to have a factor XII deficiency, which had no significant associated bleeding tendencies; the other patients were diagnosed with hemophilia or von Willebrand disease. Therefore, although abnormal pre-endoscopic coagulation is not always related to significant bleeding complications, pre-endoscopic coagulation screening may be useful in some children in predicting the risk of bleeding tendency during endoscopic procedures.

• Journal of Gastric Cancer
• /
• v.9 no.4
• /
• pp.238-245
• /
• 2009

Purpose: Treatment strategies for early gastric carcinoma (EGC) should be based on achieving a complete cure, but clear indications for limited surgery have not been established. We investigated surgical outcomes for early gastric cancer to determine the optimal? treatment strategy for EGC. Materials and Methods: Subjects included 881 patients who underwent curative surgery for EGC between 1986 and 2003. Retrospective uni & multi-variate analysis for prognostic factors, factors affecting lymph node metastasis, and risk factors for cancer recurrence were analyzed. Results: In multivariate survival analyses, age, operation method, macroscopic appearance and lymph node stage proved to be independent prognostic factors. Lymph node metastasis, depth of tumor invasion, tumor size, lymphatic and venous invasion were also significant risk factors in multivariate analyses. In multivariate analyses for cancer recurrence, depth of tumor invasion and lymph node metastasis proved to be significant risk factors. Conclusion: Appropriate surgical treatment with lymph node dissection is necessary for EGC patients with risk factors for lymph node metastasis.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.2
• /
• pp.103-109
• /
• 2008

Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p<0.05). H. pylori infection was documented in 41.5% of patients with histologic esophagitis, compared with 58.5% of patients not infected with H. pylori (p<0.05). The possibility of histologic esophagitis was higher in patients with H. pylori infection (OR 2.5, 95% CI 1.2544 to 4.8286) and in those who visited in the spring (OR 2.5, 95% CI 1.2544 to 4.8286). Conclusion: We believe esophageal tissue biopsy should be performed in pediatric patients with upper gastrointestinal symptoms who are undergoing GFS and stomach tissue biopsy, especially preschoolers and H. pylori-infected children in the spring.

• Korean Journal of Optics and Photonics
• /
• v.26 no.1
• /
• pp.1-8
• /
• 2015

The most common cause of a heart attack is known as coronary artery disease, which narrows the arteries and reduces the blood flow to the heart. To treat coronary artery stenosis, percutaneous coronary intervention (PCI) (a nonsurgical procedure to install a stent, which holds the artery wall open) is performed. Intracoronary optical coherence tomography (OCT) is a catheter-based, invasive optical imaging system. To determine whether PCI is appropriate, and to perform stent evaluation in a catheterization laboratory, OCT examinations are carried out. This review details the fundamental principles and technological status of intracoronary OCT imaging, and discusses the ongoing clinical applications to determine the benefits of OCT-guided PCI.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.7 no.1
• /
• pp.29-32
• /
• 2011

There are a lot of dental emergency situations and accidental aspiration or ingestion of a dental instrument is one of the common accidents in dental practice especially on disabied or pediatric patient with negative behavior. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. This is a case of an accident during the treatment of a 18 months male patient with caries of anterior deciduous teeth. During the treatment, the gauze was used by waterproofing instead of a rubber dam. #4 round bur (approximately 2.2cm long) which was put on the tray was cling to the gauze and the bur was fell into the patient's throat. The bur was 2.2cm long and very sharp so it could not be passed spontaneously through the pylorus, so we tried to remove the bur by esophagogastroduodenoscopy. Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure.