• Clinical Endoscopy
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• 제56권2호
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• pp.194-202
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• 2023

Background/Aims: Endoscopic therapy for neoplastic Barrett's esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing. Methods: Retrospective analysis of endoscopically treated neoplastic BE in a single referral center. Results: In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy. Conclusions: In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

• Clinical Endoscopy
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• 제57권3호
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• pp.350-363
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• 2024

Background/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs. Methods: Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed. Results: Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group. Conclusions: cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.155-159
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• 2020

Chronic maxillary atelectasis (CMA) is a progressive alteration in the volume of the maxillary sinuses that may result in facial asymmetry. CMA in asymptomatic patients is known as silent sinus syndrome (SSS) and is a rare entity, especially in pediatric patients. This study reports a case of SSS in a pediatric patient who received an early diagnosis through cone-beam computed tomography (CBCT). An asymptomatic 12-year-old female patient in orthodontic treatment presented with opacification of the left maxillary sinus on a panoramic radiograph. Clinically, the patient had discrete hypoglobus and enophthalmos. CBCT and nasal video-endoscopy revealed ostiomeatal obstruction with bone deformity, leading to diagnosis of SSS. Endonasal endoscopic maxillary sinusotomy was performed. Two years later, the patient remained asymptomatic, and a second CBCT exam confirmed a stable condition. This case highlights the role of optimal radiographic interpretation for early diagnosis of maxillofacial alterations in pediatric patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.529-532
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• 2013

Cholangiocarcinoma, though very rare in Western countries, is one of the commonest liver malignancies in Southeast Asia, especially in Thailand. More than half of the patients present with advanced stage disease. Given the poor treatment outcomes of adjuvant therapeutic options, many patients undergo only biliary drainage for palliative treatment. Clinical characteristics and treatment outcomes after biliary stenting were here analyzed for a total of 224 uresectable cholangiocarcinoma cases, 58.9% in men. The mean age was 61.5 years. Hilar involvement was the most common location. The patients underwent biliary drainage using plastic and metallic stents equally, early stent occlusion being encountered in 21.4% and 10.7%, respectively. The median survival time was 4.93 months for patients who received plastic and 5.87 months for patients who received metallic stents.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.275-278
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• 2014

Gastric cancer is rare during pregnancy, and often advanced upon presentation. A Krukenberg tumor presents a diagnostic and therapeutic challenge in the pregnant patient. We present a case of a 38-year-old woman at 22 weeks' gestation who presented with worsening epigastric pain, and was found to have a left pelvic mass on ultrasound, which was confirmed by magnetic resonance imaging. She went into active labor and delivered a viable infant via vaginal delivery. An exploratory laparotomy revealed a large mass originating from her left ovary and diffuse thickening of the lesser curvature of the stomach. Frozen section investigation revealed the presence of signet cell adenocarcinoma. Subsequent upper endoscopy showed linitis plastica, while biopsy confirmed the presence of adenocarcinoma. In conclusion, the occurrence of gastric cancer in pregnancy is rare despite extremely common symptoms. The management poses a challenge because of the need for early treatment, and the continuation of the pregnancy.

• 대한한의학회지
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• 제22권4호
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• pp.171-176
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• 2001

The Stagnation Syndrome of Qi is the depressed and suppressed mental state caused by anxiety, unaccomplished desire, maintained thought, and emotional problems, resulting in a concomitant physiological somatic dysfunction. Although blood test, urine test, EKG, and gastric endoscopy showed normal finding. a patient complained of a group of symptoms, so we considered it as an unidentified clinical syndrome. This syndrome could be interpreted as the disconnection of Fire (Heart) and Water (Kidney) in Oriental medicine, and treated with the therapeutic method of 'Ascending Water-Descending Fire'. After the application of Gyogam-dan and Ganggi-tang for 18 days, symptoms and signs improved.

• 대한후두음성언어의학회지
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• 제22권2호
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• pp.156-158
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• 2011

Organophosphates are used as herbicides. Glyphosate is one of the acidic organophosphate solution of pH4.8-6. We experienced a case of laryngeal injury after glyphosate caustic ingestion. He had a mild respiratory distress, and a laryngeal granuloma was observed in endoscopy. He received treatment with oral steroid and PPI for two weeks, the laryngeal granuloma and respiratory distress were nearly disappeared. Therefore, we expect this case report to be helpful the therapeutic formulations in the damage of larynx due to glyphosate.

• 대한의용생체공학회:의공학회지
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• 제18권2호
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• pp.121-126
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• 1997

Endoscopy has become a crucial diagnostic and therapeutic procedure in clinical areas. Over the past three years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholecystectomy, pelviscopic endometriosis, and surgical arthroscopy. In this study, we developed a computer system, which is composed of a frame yabber, a sound board, a VCR control board, a LAN card and EDMS(endoscopic data management software. Also, computer system has controled peripheral instruments such as a color video printer, a video cassette recorder, and endoscopic input/output signals(image and doctor's comment). Digital endoscopic data management system is based on open architecture and a set of widely available industry standards, namely: windows 3.1 as a operating system, TCP/IP as a network protocol and a time sequence based database that handles both images and doctor's cotnments. For the purpose of data storage, we used MOD and CD-R. Digital endoscopic system was designed to be able to store, recreate, change, and compress signals and medical images.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.3.1-3
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• 1978

진단이나 치료 목적으로 내시경술이 빈번하게 사용됨으로써 오늘날 식도천공의 위험은 증가하는 경향을 보인다. 식도벽에 경미한 상처를 주더라도 치명적인 경우까지 야기시킬 수 있으며 조기진단과 신속한 치료를 하지 않으면 늪은 사망률 병3변(病變)을 일으킨다. 본 연자들은 식도 이물 제거시 식도경술로 인한 식도천공 및 식도주위농양을 동반한 2례에 대한 치료를 하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고 하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.571-575
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• 2019

We report a case of a 13-year-old girl who presented with a 2-month history of intermittent abdominal pain. Laboratory examination showed hepatitis and pancreatitis. Because of persistent vomiting, computed tomography (CT) was performed, which revealed a circumferential soft tissue density in the duodenal wall, causing partial obstruction. Supportive therapy failed. Repeat CT showed no significant change from the initial study. The patient underwent upper endoscopy, which revealed a mass in the second portion of the duodenum, which occluded most parts of the lumen. The histopathological finding was consistent with an anaplastic large cell lymphoma, a rare form of small bowel neoplasm. After the third course of chemotherapy, complete resolution of the mass was noted, and her symptoms were relieved.