• 한국컴퓨터정보학회논문지
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• 제21권3호
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• pp.47-56
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• 2016

Recently many small and mid-sized hospitals are closing down or experiencing financial difficulties. As a result, in order to provide exceptional service that would increase their competitiveness, they implemented telemedicine service for the prescription of medicine necessary before a colonoscopy. This study is an analysis of how telemedicine service affects patient satisfaction. Through the focus group interview (FGI) of medical service providers, regarding telemedicine service and face-to-face service, it was appraised that telemedicine service was more effective than face-to-face service. Afterward, a second survey aimed at endoscopy patients was conducted in order to find out the value of telemedicine service. First, through the analysis of the three main factors of telemedicine service, conclusions were drawn(safety/reliability, convenience/rapidity, and economics). A follow-up analysis showed that convenience/rapidity had the greatest effect on telemedicine service satisfaction. Next the factors of the quality of medical service were analyzed and 3 main factors were deduced (the superiority of the external and internal environments/appropriateness, superiority of the medical team, telemedicine service). A follow-up analysis found that telemedicine service had the greatest effect on patient satisfaction. This study found that providing exceptional medical service that utilizes telemedicine service would improve patient satisfaction. Therefore, we would be able to form a strategic plan that would strengthen the competitiveness of small and mid-sized hospitals.

• Journal of Korean Biological Nursing Science
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• 제16권1호
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• pp.33-40
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• 2014

Purpose: The purpose of this study was to identify the prevalence and risk factors of colon polyps. Methods: The subjects were 180 adults enrolled from examinees who underwent colonoscopy at the health promotion center and OPD in Ulsan University Hospital. The risk factors were collected by a self-reporting standardized questionnaire and medical records. Data analysis involved chi-square test, and multiple logistic regression. Results: The prevalence of colon polyps was 41.6%. The risk factors for colon polyps were significantly increased by the cases of subjects more than 50 years old (OR, 9.213; CI, 3.291-25.789), subjects who didn't have any regular high-intensity exercise (OR, 4.762; CI, 1.387-16.351), subjects whose intake of fruits was less than once per a week (OR, 5.938; CI, 1.069-32.985) and subjects who showed irregular defecation (OR, 3.066; CI, 1.178-7.980). Conclusion: This study suggests that eating habits and proper exercise, which promote a normal habit of defecation so as to be helpful in preventing colon polyps.

• Journal of Yeungnam Medical Science
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• 제37권3호
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• pp.246-249
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• 2020

Synchronous gastric cancer and adenomatous colorectal polyp in patients with Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) and bacteremia is a rare presentation. A 58-year-old man with a 6-month history of diabetes mellitus (DM) presented with febrile sensation and dull abdominal pain in the right upper quadrant of the abdomen. Subsequent to laboratory test results and abdominal computed tomography findings, KP-PLA with bacteremia was diagnosed. After intravenous antibiotic administration, his symptoms improved, and upper endoscopy and colonoscopy were performed to evaluate the cause of KP-PLA. Biopsy specimens of the prepyloric anterior wall revealed a moderately differentiated adenocarcinoma. Endoscopic mucosal resection of the colon revealed high-grade dysplasia. Early gastric cancer (EGC) and adenomatous colorectal polyps with high-grade dysplasia concomitant with KP-PLA and bacteremia were diagnosed in our patient who had DM. Intravenous antibiotic treatment for KP-PLA, subtotal gastrectomy for EGC, and colonoscopic mucosal resection for the colon polyp were performed. After 25 days of hospitalization, subtotal gastrectomy with adjacent lymph node dissection was performed. Follow-up ultrasound imaging showed resolution of the abscess 5 weeks post-antibiotic treatment, as well as no tumor metastasis. Upper gastrointestinal endoscopy and colonoscopy should be performed to evaluate gastric cancer in patients with PLA or bacteremia, accompanied with DM or an immunocompromised condition.

• 한국임상수의학회지
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• 제27권1호
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• pp.113-116
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• 2010

A 6-years-old 30 kg male Germen Shepherd dog was presented with the history of abdominal pain, intermittent vomiting and anorexia. Abdominal survey radiography and ultrasonography revealed marked colonic distention. Positive contrast radiography revealed a colonic obstruction between the transverse colon and descending colon. Foreign bodies were identfied during colonoscopy. The descending colon was inflated by the air of endocope then foreign bodies were moved to the descending colon. Foreign bodies were removed by the enema. The dog's clinical signs resolved following foreign body removal.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.613-618
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• 2019

Juvenile polyps are the most common types of polyps in children, and patients usually present with lower gastrointestinal (GI) bleeding as the predominant symptom. These lesions, which are referred to as hamartomas, usually measure approximately 2 cm in size and are benign tumors located mainly in the rectum and sigmoid colon. The most common symptom of a juvenile polyp is mild intermittent rectal bleeding. It is rare for anemic patients because the amount of blood loss is small and often not diagnosed immediately. We present the case of a 6-year-old girl with a juvenile polyp in the distal transverse colon, who developed hypovolemic shock due to massive lower GI bleeding. Pediatricians must perform colonoscopy for thorough evaluation of polyps, because their location and size can vary and they can cause massive bleeding.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.415-421
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• 2018

Cases showing complications such as esophageal injury, deep neck infection, and mediastinitis caused by accidental ingestion of fish bone are common. But ingestion of fish bone rarely causes perforation of the gastrointestinal tract or an intra-abdominal abscess. We report herein a case of a 78-year-old man with a periumbilical mesenteric abscess caused by fish bone which was ingested unconsciously. The fish bone was found in the terminal ileum and it was removed by colonoscopy. The patient improved and he was discharged after systemic antibiotic therapy. Occasionally, when patients swallow fish bone without a foreign body sensation, clinicians should suspect perforation caused by fish bone in case of an intra-abdominal abscess of unknown cause.

• Journal of Digestive Cancer Research
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• 제11권1호
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• pp.49-54
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• 2023

Colorectal cancers often invade adjacent organs; however, direct duodenal invasion is rare. Adenocarcinoma is the most common type of colorectal cancer, but an undifferentiated carcinoma type is unusual. Herein, we present a case of undifferentiated carcinoma of the colon that directly invaded the duodenum and metastasized to distant lymph nodes. An 85-year-old female patient was admitted with a 7-cm-sized colonic mass invading the duodenum, detected by computed tomography. Positron emission tomography revealed fluorodeoxyglucose uptake in the colon, duodenum, and aortocaval lymph nodes. A large encircling mass in the ascending colon and an ulcerated mass in the duodenum were revealed by colonoscopy and esophagogastroduodenoscopy, respectively. Pathologic examinations of the colon and the duodenum revealed nonglandular, diffusely infiltrating atypical round cells, confirming undifferentiated carcinoma of the colon. The histologic type of this tumor was distinguished using immunohistochemical (IHC) markers. Finally, microscopic characteristics and IHC markers aided in identifying the histologic type of colorectal cancer.

• Clinical Endoscopy
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• 제56권5호
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• pp.563-577
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• 2023

In inflammatory bowel disease (IBD), chronic inflammation leads to unfavorable clinical outcomes and increases the risk of developing colorectal neoplasm (CRN); thereby highlighting the importance of endoscopically evaluating disease activity as well as detecting and characterizing CRN in patients with IBD. With recent advances in image-enhanced endoscopic (IEE) technologies, especially virtual chromoendoscopy (VCE) platforms, this review discusses state-of-the-art IEE techniques and their applicability in assessing disease activity and surveillance colonoscopy in patients with IBD. Among various IEE, VCE demonstrated the capacity to identify quiescent disease activity. And endoscopic remission defined by the new scoring system using VCE platform better predicted clinical outcomes, which may benefit the tailoring of therapeutic strategies in patients with IBD. High-definition dye-chromoendoscopy (HD-DCE) is numerically superior to high-definition white light endoscopy (HD-WLE) in detecting CRN in IBD; however, discrepancy is observed in the statistical significance. VCE showed comparable performance in detecting dysplasia to HD-WLE or DCE and potential for optical diagnosis to differentiate neoplastic from nonneoplastic lesions during surveillance colonoscopy. Applying these novel advanced IEE technologies would provide opportunities for personalized medicine in IBD and optimal treatment of CRN in patients with IBD.

• Clinical Endoscopy
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• 제55권2호
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• pp.292-296
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• 2022

Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computed tomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverse event is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, to consider a conservative approach and avoid surgical treatment.

• 대한의용생체공학회:의공학회지
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• 제24권2호
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• pp.77-82
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• 2003

삼차원 CT 영상을 이용하여 대장 내부의 병변을 관찰하고 진단하기 위한 비침습적 검사 방법인 가상 대장 내시경을 위하여 가상 카메라의 관찰점과 관찰 방향을 제공하기 위한 적절한 경로가 필요하다. 특히. 인간의 대장은 매우 길고 복잡하므로 사용자가 직접 경로를 생성하려면 많은 시간이 걸리고 정확한 결과를 기대하기 어렵다. 또한 경로를 자동으로 생성하는 기존의 방법들은 계산량이 많아 약 수 분에서 수 십분 이상의 수행 시간이 걸리고. 사람의 대장이 가지는 대표적인 구조인 두께가 급격히 변하거나 곡률이 큰 영역에서 적절한 중앙선을 얻기 어려우며. 끊김이 있는 부적절한 경로를 생성하고, 평활화된 경로가 대상체의 표면과 충돌할 가능성을 배제할 수 없다. 이 논문에서는 계산량이 적은 거리 지도 및 제안된 순서 지도를 이용하여 끊김이 없고 적절한 중앙선을 얻는 고속의 알고리즘을 제안한다 순서 지도는 대상체 내부의 각 복셀에서의 가능한 경로의 방향을 나타내며 거리 지도는 대상체 내부의 각 복셀과 가장 가까운 배경 복셀까지의 거리를 나타낸다. 제안한 방법에서는 두 지도들을 이용하여 끝점에서 출발하여 시작점을 향하는 동시에 더욱 넓은 영역으로 진행하는 경로를 얻으므로, 대상체의 두께와 곡률의 크기에 관계없이 적절한 중앙선을 얻을 수 있다. 이와 함께 경로의 충돌 가능성을 완전히 제거할 수 있는 간단한 평활화 방법을 제안한다 알고리즘의 적절성을 검증하기 위해 사람의 대장의 특징을 가진 팬텀(phantom) 데이터를 이용하여 실험하였다. 사람의 대장 CT 데이터를 이용하여 800MHz PC에서 1분 이내에 적절한 경로를 얻었으며 이를 따라 이동하는 가상의 카메라로부터 만족할만한 가상 대장 내시경 영상을 얻을 수 있음을 보였다.