• Journal of Korean Clinical Nursing Research
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• v.26 no.3
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• pp.305-313
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• 2020

Purpose: The purpose of this study was to identify factors influencing the Radiation Protection(RP) behaviors of endoscopy nurses during endoscopic interventional radiology. Methods: A total of 188 endoscopy nurses working at 30 tertiary or general hospitals participated in this questionnaire-based study. The questionnaire included items on general and job related characteristics, RP knowledge, RP attitude, RP behavior, self-efficacy, and safety climate. Data were collected through online surveys from March 22 to April 10, 2019. Results: Multivariate analysis revealed that RP attitude (β=.65, p<.001), safety climate (β=.12, p=.035), self-efficacy (β=.14, p=.009), and existence of RP protocols (β=.11, p=.038) were significant predictors of better RP behavior. Conclusion: The findings showed that the RP behavior of endoscopy nurses was at high levels and the continuing education for endoscopy nurses and development of a radiation safety management education program were important to improve RP behavior.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.281-288
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• 2023

While the standard management for posthemorrhagic hydrocephalus (PHH) has not been determined, many patients initially receive temporary treatment such as a ventricular drainage, a ventricular reservoir, or a ventriculosubgaleal shunt. Subsequently, approximately 15% of patients with PHH will require permanent cerebrospinal fluid diversion. Shunt placement is most commonly performed for PHH as permanent treatment. However, shunting still has high complication rates. Since the development of the neuroendoscopic technique has progressed, and indication has been expanded, endoscopic third ventriculostomy with or without choroid plexus cauterization has performed more frequently in recent years in patients with PHH. In this paper, the permanent treatment for PHH will be reviewed based on the latest evidence.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.30-34
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• 2023

Since the 1990s, serrated polyps have been established to contribute to intermediate cancer development, and their importance has begun to be recognized. Serrated polyps are morphologically difficult to detect through endoscopy, and an effective resection method has not been established. Among serrated polyps, studies on sessile serrated lesions, with a relatively high risk of colorectal cancer transformation and detected with difficulty, are in progress. Studies to date describe the endoscopic features as mucus cap, surface debris or stool, attenuation of underlying vasculature, cloud-like surface, dark spots in crypts, and ill-defined irregular border. Additionally, it is expected that relatively large serrated polyps can be safely removed through cold snare resection. A plan for an effective management of serrated polyps through continuous research in the future is warranted.

• Korean Journal of Bronchoesophagology
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• v.15 no.2
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• pp.87-91
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• 2009

Esophageal diverticulum is a rare entity, the true incidence of which is unknown, mainly because there are usually no clinical symptoms. Most esophageal diverticulum are found incidentally during an endoscopic or radiologic examination. Their classification is based on anatomical location; namely, upper third(Zenker or pharyngoesophageal), middle third(thoracic), or lower third(epiphrenic). Here we report a 52-years-old female presenting with dysphagia and regurgitation. Esophagogram showed esophageal diveticulum at lower cervical esophagus. Its positional aspect, it is different from Zenker's diveticulum. Treatment is surgical via an endoscopic or external approach. In view of the patient's age and anatomical location, various surgical approaches were considered as a therapeutic option for the management. This paper presents our experience in the management of esophageal diverticulum which was unusual location and stapled open resection without sternotomy.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.224-229
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• 2022

Biliary cast syndrome is an unusual complication in patients who have previously undergone liver transplantation. It occurs in approximately 5%-18% of such patients. Rare cases of biliary cast syndrome in patients without liver transplants have also been reported. The pathogenesis of biliary cast has not been clearly identified, although etiologic factors including post-transplant bile duct damage, ischemia, biliary infection, and presence of a post-operative biliary drainage tube have been proposed. Here we present a case of biliary cast that developed in a 49-year-old male who underwent a non-liver surgery after endoscopic and percutaneous management of common bile duct stone.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.137-142
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• 2005

Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

• Journal of Digestive Cancer Research
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• v.8 no.1
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• pp.1-50
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• 2020

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

• Journal of Veterinary Clinics
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• v.34 no.3
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• pp.193-196
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• 2017

A 14-year-old, castrated male, domestic shorthair cat was referred for gastrointestinal (GI) signs, including nausea, regurgitation, anorexia, and weight loss. Abdominal ultrasonography revealed thickening of the wall of the gastric and proximal duodenum, moderately enlarged mesenteric lymph nodes, and coarse echotexture of the splenic parenchyma. The results of the feline leukemia virus test were positive. Based on gastrointestinal endoscopic characteristics and histopathological examinations, low-grade alimentary lymphoma was identified in multiple regions of the gastrointestinal tract. The patient was treated with oral prednisolone and chlorambucil chemotherapy, and the clinical signs resolved gradually. During serial follow-up, ultrasonographic findings demonstrated decreases in the duodenal wall thickness and size of the abdominal lymph nodes over a period of 550 days. Survival time was 886 days with prednisolone and chlorambucil chemotherapy. This report describes clinical features, imaging findings, endoscopic characteristics, histopathological features, and long-term management with chlorambucil chemotherapy in a case of feline low-grade alimentary lymphoma.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.217-221
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• 2011

Objective : This paper presents data from a retrospective study of endoscopic third ventriculostomy (ETV) in patients with shunt malfunction and proposes a simple and reasonable post-operative protocol that can detect ETV failure. Methods : We enrolled 19 consecutive hydrocephalus patients (11 male and 8 female) who were treated with ETV between April 2001 and July 2010 after failure of previously placed shunts. We evaluated for correlations between the success rate of ETV and the following parameters : age at the time of surgery, etiology of hydrocephalus, number of shunt revisions, interval between the initial diagnosis of hydrocephalus or the last shunt placement and ETV, and the indwelling time of external ventricular drainage. Results : At the time of ETV after shunt failure, 14 of the 19 patients were in the pediatric age group and 5 were adults, with ages ranging from 14 months to 42 years (median age, 12 years). The patients had initially been diagnosed with hydrocephalus between the ages of 1 month 24 days and 32 years (median age, 6 years 3 months). The etiology of hydrocephalus was neoplasm in 7 patients; infection in 5; malformation, such as aqueductal stenosis or megacisterna magna in 3; trauma in 1; and unknown in 3. The overall success rate during the median follow-up duration of 1.4 years (9 days to 8.7 years) after secondary ETV was 68.4%. None of the possible contributing factors for successful ETV, including age (p=0.97) and the etiology of hydrocephalus (p=0.79), were statistically correlated with outcomes in our series. Conclusion: The use of ETV in patients with shunt malfunction resulted in shunt independence in 68.4% of cases. Age, etiology of hydrocephalus, and other contributing factors were not statistically correlated with ETV success. External ventricular drainage management during the immediate post-ETV period is a good means of detecting ETV failure.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.35-42
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• 2011

Purpose: Blow-out fractures can be reduced using various methods. The orbital reconstruction technique using a balloon under endoscopic control has advantages over other methods. However, this method has some problems too, such as postoperative follow-up, management of the balloon catheter, and reduction of the posterior orbital floor. Thus, we developed a simple, effective method for orbital floor reduction that involves molding and shaping the antral balloon catheter. Methods: A 0, 30, or $70^{\circ}$, 4-mm endoscope was placed though a two-point, 5-mm maxillary antrostomy. The balloon catheter is placed directly at the orbital apex to reconstruct the anterior shelf (spherical shape), while it is turned in a U-shape towards the anterior maxilla for the posterior shelf (elliptical shape). Orbital floor defects, compound or comminuted fractures are reconstructed with alloplastic materials through an open lid incision under the endoscopic control. Results: This technique was applied to ten patients with orbital floor fractures: five anterior shelf and five posterior shelf fracture, respectively. Four of the patients had zygomatico-orbital fractures, while the rest had isolated orbital floor fractures. Two patients were given porous polyethylene implants Synpor$^{(R)}$) and three underwent reconstruction with a resorbable mesh plate. No complication associated with this technique was identified. Conclusion: The freestyle placement and selection of a urinary balloon catheter under endoscopic control and the preoperative estimation of the volume enhanced the stabilization of the orbital contour. This method improves the adaptation of the orbital floor without the risk of injuring the surrounding orbital contents, dissecting blindly, or using sharp traction. One drawback of this method is the patient's discomfort from the catheter during treatment.