• Title/Summary/Keyword: Endoscopic diagnosis

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A Case of Childhood Biliary Stricture after Blunt Trauma Managed by Endoscopic Therapy (소아에서 둔상 후에 발생한 담도협착의 내시경적 치료 경험 1례)

  • Kim, Kyung-Mo;Kim, Seong-Chul;Seo, Dong-Wan;Yoon, Chong-Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.144-147
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    • 1998
  • Isolated injury to the extrahepatic biliary tract following blunt abdominal trauma is rare, and there is little information especially in children regarding the endoscopic diagnosis and management of occult injury to the biliary tract. We experienced a 5-year-old boy who presented with jaundice 16 days after blunt abdominal trauma and was diagnosed as isolated distal common bile duct stricture by ultrasonography of abdomen. We could get more detailed information about the injury by endoscopic retrograde cholangiopancreatography. We could also manage this isolated common bile duct stricture successfully with endoscopic nasobiliary drainage and plastic stent insertion instead of surgical correction. There appeared to be no recurrence of stricture as evidenced by biochemical test and ultrasonography during 2 years of follow up.

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Two Portal Approach(Endoscopic Transnasal and Subciliary) in Medial Orbital Wall Fracture (내시경을 이용한 비강내 접근법과 속눈썹밑 절개를 동시에 이용한 안와내벽 재건술)

  • Chang, Hyun;Dhong, Eun-Sang;Won, Chang-Hoon;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.552-556
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    • 2006
  • Purpose: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. Methods: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with $Medpor^{(R)}$ insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture. Results: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. Conclusion: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach

  • Kim, Jung-Wook
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.527-533
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    • 2018
  • There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopy with narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations with invasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imaging offers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitations of narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness in undifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use of endoscopic submucosal dissection for the treatment of gastric tumors.

A Single-Center Experience of Endoscopic Resection for Early Gastric Cancer with Lymphoid Stroma

  • Lim, Hyun;Lee, Jeong Hoon;Park, Young Soo;Na, Hee Kyong;Ahn, Ji Yong;Kim, Do Hoon;Choi, Kee Don;Song, Ho June;Lee, Gin Hyug;Jung, Hwoon-Yong
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.400-408
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    • 2018
  • Purpose: This study aimed to evaluate immediate outcomes and clinical courses of patients with early gastric carcinoma with lymphoid stroma (GCLS) who underwent endoscopic resection. Materials and Methods: We retrospectively reviewed the medical records of 40 patients (mean age, 56.9 years; 90.0% male) who underwent endoscopic resection and were pathologically diagnosed with GCLS confined to the mucosa or to the submucosa between March 1998 and December 2017. Results: Forty GCLS lesions in 40 patients were treated using endoscopic resection. Only 4 (10%) patients received diagnosis of GCLS before endoscopic resection. Fourteen (35.0%) lesions were intramucosal cancers and 26 (65.0%) exhibited submucosal invasion. En bloc resection (97.5%) was achieved for all lesions except one, with no significant complications. The complete resection rate was 85.0% (34 of 40 lesions). After endoscopic resection, 17 patients were referred for surgery and underwent gastrectomy with lymph node (LN) dissection because of deep submucosal invasion (n=16) and misclassification as undifferentiated cancer (n=1). No LN metastasis was determined in the specimens obtained during surgery. During a mean follow-up period of 49.7 months for 23 patients without surgical treatment, no regional LN enlargements, distant metastases, or gastric cancer-related deaths were found, although 1 metachronous lesion (undifferentiated adenocarcinoma, follow-up duration: 7 months) was observed. Conclusions: In patients with early GCLS, endoscopic resection is technically feasible and has favorable clinical outcomes. Therefore, endoscopic resection might represent an alternative treatment modality in patients with early GCLS with a low likelihood of LN metastasis.

Design and Fabrication of a Multi-modal Confocal Endo-Microscope for Biomedical Imaging

  • Kim, Young-Duk;Ahn, Myoung-Ki;Gweon, Dae-Gab
    • Journal of the Optical Society of Korea
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    • v.15 no.3
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    • pp.300-304
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    • 2011
  • Optical microscopes are widely used for medical imaging these days, but biopsy is a lengthy process that causes many problems during the ex-vivo imaging procedure. The endo-microscope has been studied to increase accessibility to the human body and to get in-vivo images to use for medical diagnosis. This research proposes a multi-modal confocal endo-microscope for bio-medical imaging. We introduce the design process for a small endoscopic probe and a coupling mechanism for the probe to make the multi-modal confocal endo-microscope. The endoscopic probe was designed to decrease chromatic and spherical aberrations, which deteriorate the images obtained with the conventional GRIN lens. Fluorescence and reflectance images of various samples were obtained with the proposed endo-microscope. We evaluated the performance of the proposed endo-microscope by analyzing the acquired images, and demonstrate the possibilities of in-vivo medical imaging for early diagnosis.

Endoscopic Diagnosis and Management of Esophageal Extramedullary Plasmacytoma in a Dog

  • Tae-Hyung Kwon;Guk-Il Jung;Kun-Ho Song;Joong-Hyun Song
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.18-23
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    • 2024
  • A 13-year-old spayed female Golden Retriever with clinical signs of weight loss and lethargy presented with two esophageal masses and one sessile polyp on computed tomography and esophagoscopy. Endoscopic snare resection was performed, and histopathological examination was requested. Based on histopathology and immunohistochemistry of multiple myeloma oncogene 1 staining, the patient was diagnosed with esophageal extramedullary plasmacytoma. The patient remained clinically well without any clinical signs during a follow-up period of 12 months. Herein, we report the successful diagnosis and management of esophageal extramedullary plasmacytoma in a dog using endoscopy.

Upper Endoscopy up to 3 Years Prior to a Diagnosis of Gastric Cancer Is Associated With Lower Stage of Disease in a USA Multiethnic Urban Population, a Retrospective Study

  • Shah, Shailja C.;Nakata, Chiaki;Polydorides, Alexandros D.;Peek, Richard M. Jr;Itzkowitz, Steven H.
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.3
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    • pp.179-187
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    • 2019
  • Objectives: In the USA, certain races and ethnicities have a disproportionately higher gastric cancer burden. Selective screening might allow for earlier detection and curative resection. Among a USA-based multiracial and ethnic cohort diagnosed with non-cardia gastric cancer (NCGC), we aimed to identify factors associated with curable stage disease at diagnosis. Methods: We retrospectively identified endoscopically diagnosed and histologically confirmed cases of NCGC at Mount Sinai Hospital in New York City. Demographic, clinical, endoscopic and histologic factors, as well as grade/stage of NCGC at diagnosis were documented. The primary outcome was the frequency of curable-stage NCGC (stage 0-1a) at diagnosis in patients with versus without an endoscopy negative for malignancy prior to their index exam diagnosing NCGC. Additional factors associated with curable-stage disease at diagnosis were determined. Results: A total of 103 racially and ethnically diverse patients were included. Nearly 38% of NCGC were stage 0-Ia, 34% stage Ib-III, and 20.3% stage IV at diagnosis. A significantly higher frequency of NCGC was diagnosed in curable stages among patients who had undergone an endoscopy that was negative for malignancy prior to their index endoscopy that diagnosed NCGC, compared to patients without a negative endoscopy prior to their index exam (69.6% vs. 28.6%, p=0.003). A prior negative endoscopy was associated with 94.0% higher likelihood of diagnosing curable-stage NCGC (p=0.003). No other factors analyzed were associated with curablestage NCGC at diagnosis. Conclusions: Endoscopic screening and surveillance in select high-risk populations might increase diagnoses of curable-stage NCGC. These findings warrant confirmation in larger, prospective studies.

Direction Sensor Design for Reducing Perforation Risk in Endoscopy (천공부작용 해소용 내시경 Direction Sensor 설계)

  • Kang, Sang-man;Park, Dea-woo
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.4
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    • pp.836-845
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    • 2017
  • Due to the development of endoscopic technology, endoscopic diagnosis and procedures have been actively performed. However, due to the increase in colorectal cancer and the effect of government's early cancer screening project, the number of endoscopic diagnosis and procedures has increased, thus medical accidents such as perforation and bleeding are increasing. Therefore, efforts to reduce such medical accidents are needed. In this paper, we propose a method to provide the direction information of the endoscope and the force applied to the probe in real time. We also propose and evaluate an interpolated complementary filter considering the very slow movement of the endoscope probe. The proposed interpolated complementary filter showed 34.6% and 27.6% performance improvement. The expected user interface for applying the proposed method to the endoscopic system is also presented. This shows that the proposed method is applicable to endoscopy system.

Metachronous Liver Metastasis Resulting from Early Gastric Carcinoma after Subtotal Gastrectomy Following Endoscopic Resection: A Case Report

  • Oh, Sung Jin;Suh, Byoung Jo
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.139-142
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    • 2015
  • Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

Pathological Interpretation of Gastric Tumors in Endoscopic Submucosal Dissection (위암 및 위선종에서 내시경절제술 조직의 병리 판독)

  • Jung Yeon Kim
    • Journal of Digestive Cancer Research
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    • v.11 no.1
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    • pp.15-20
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    • 2023
  • Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for early gastric cancer. The criteria for determining the suitability and success of ESD have expanded, with changes in the histopathological classification of gastric carcinoma, including results from molecular research. Treatment methods have also diversified to include targeted therapies and immuno-oncology agents. To improve communication between clinicians and pathologists, it is crucial to understand the standardized diagnostic forms of gastric cancer. This study aims to examine the handling method of ESD specimens and describe the pathological findings of gastric tumors.