• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5163-5167
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• 2015

Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited low-grade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.2
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• pp.155-160
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• 2011

Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.27 no.6
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• pp.954-959
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• 2003

Colonoscopy is an important medical procedure for the diagnosis of various diseases like cancers in the colon and rectum. But it requires a lot of time for a doctor to acquire dexterous skills necessary to perform successful colonoscopy. Moreover, to many patients, conventional colonoscopy simply takes too long time. Therefore, some studies on the development of autonomous and more convenient colonoscope are carried out. In this Paper, we Propose a functional colonoscope robot system that has a locomotive function with a hollow body, a steering system, and other basic functions of typical conventional colonoscope systems. The concept and each component of the functional colonoscope system are described in this paper. In order to evaluate the functional performance of the colonoscope robot, we carried out in -vitro and in-vivo tests.

• Parasites, Hosts and Diseases
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• v.52 no.1
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• pp.85-87
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• 2014

We encountered a patient with heavy Hymenolepis nana infection. The patient was a 44-year-old Korean man who had suffered from chronic hepatitis (type B) for 15 years. A large number of H. nana adult worms were found during colonoscopy that was performed as a part of routine health screening. The parasites were scattered throughout the colon, as well as in the terminal ileum, although the patient was immunocompetent. Based on this study, colonoscopy may be helpful for diagnosis of asymptomatic H. nana infections.

• Journal of Biomedical Engineering Research
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• v.32 no.3
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• pp.251-256
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• 2011

Virtual colonoscopy is favored over conventional colonoscopy because its non-invasive procedure can avoid complications that may happen in a conventional approach and because it can cleanse colon electronically instead of uncomfortable conventional colon cleansing. Electronic Colon Cleansing(ECC) has to deal with not only removing tagged fecal material but also recovering Partial Volume Effect(PVE) due to tagging material. This paper proposes an ECC method restoring inherent natural PVE while previous approaches focused only on reducing PVE due to tagged fecal material. The proposed method reduces PVE using 3-dimensional adaptive density correction and then replaces tagged fecal material into air. Next, it generates natural PVE for the replaced air adjacent to soft tissue and finally makes smooth transition of gray values for soft tissue adjacent to the replaced air. The proposed method applied to eleven patient data, and showed promising results.

• Clinical Endoscopy
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• v.51 no.6
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• pp.534-540
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• 2018

From dye-assisted conventional chromoendoscopy to novel virtual chromoendoscopy, image-enhanced endoscopy (IEE) is continuously evolving to meet clinical needs and improve the quality of colonoscopy. Dye-assisted chromoendoscopy using indigo carmine or crystal violet, although slightly old-fashioned, is still useful to emphasize the pit patterns of the colonic mucosa and predict the histological structures of relevant lesions. Equipment-based virtual chromoendoscopy has the advantage of being relatively easy to use. There are several types of virtual chromoendoscopy that vary depending on the manufacturer and operating principle. IEE plays distinctive roles with respect to histologic characterization of colorectal polyps and prediction of the invasion depth of colorectal cancers. In addition, the newest models of IEE have the potential to increase adenoma and polyp detection rates in screening colonoscopy.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7657-7661
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• 2013

Background: This study concerns uptake and results of colorectal cancer (CRC) screening of government servant as part of the Health Screening Program that was conducted in Brunei Darussalam in 2009. Materials and Methods: Government servants above the age of 40 or with family history of CRC were screened with a single fecal occult blood test (FIT, immunohistochemistry). Among 11,576 eligible subjects, 7,360 (66.9%) returned their specimen. Subjects with positive family history of CRC (n=329) or polyps (n=135) were advised to attend clinics to arrange screening. All the subjects with positive FIT (n=142, 1.9%) were referred to the endoscopy unit for counselling for screening colonoscopy. Results: Overall only 17.7% of eligible subjects attended for screening; 54.9% (n=79/142) of positive FIT, 8.8% (n=29/329) of positive family history of CRC and none with history of polyps (n=0/135). Of these, only 54 patients (50.5%) agreed for colonoscopy, 52 (48.6%) declined as they were asymptomatic, and one was not offered (0.9%) due to his very young age. On screening colonoscopy, 12.9% (n=7) had advanced lesions including a sigmoid carcinoma in situ and six advanced polyps. The other findings included non advanced polyps (n=21), diverticular (n=11) and hemorrhoids (n=26). One patient who missed his screening colonoscopy appointment re-presented two years later and was diagnosed with advanced right sided CRC. All the advanced lesions were detected in patients with positive FIT, giving a yield of 20.5% for advanced lesions including cancers in the 5.1% FIT positive subjects. Conclusions: Our study showed screening for CRC even with a single FIT was effective. However, the uptake rate was poor with just over half of the patients agreeing to screening colonoscopy. Measures to increase public awareness are important. Since one limitation of our study was the relatively small sample size, larger studies should be conduced in future.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4143-4147
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• 2016

Purpose: We evaluated all PET/CTs acquired for patients without a primary diagnosis of colorectal cancer, and compared results for those who had subsequent colonoscopy within 6 months, to assess the accuracy of FDG PET/CT for detection of incidental pre-malignant polyps and malignant colon cancers. Materials and Methods: Medical records of 9,545 patients who underwent F-18 FDG PET/CT studies over 3.5 years were retrospectively reviewed. Due to pre-existing diagnosis of colorectal cancer, 818 patients were excluded. Of the remainder, 157 patients had colonoscopy within 6 months (79 males; mean age 61). We divided the colon into 4 regions and compared PET/CT results for each region with colonoscopy and histopathologic findings. True positive lesions included colorectal cancer, villous adenoma, tubulovillous adenoma, tubular adenoma and serrated hyperplastic polyp/hyperplastic polyposis. Results: Of 157 patients, 44 had incidental colonic uptake on PET/CT (28%). Of those, 25 had true positive (TP) uptake, yielding a 48% positive predictive value (PPV); 9% (4/44) were adenocarcinoma. There were 23 false positive (FP) lesions of which 4 were hyperplastic polyp, one was juvenile polyp and 7 were explained by diverticulitis. Fifty eight patients had false negative PET scans but colonoscopy revealed true pre-malignant and malignant pathology, yielding 23% sensitivity. The specificity, negiative predictive value (NPV) and accuracy were 96%, 90% and 87%, respectively. The average SUVmax values of TP, FP and FN lesions were 7.25, 6.11 and 2.76, respectively. There were no significant difference between SUVmax of TP lesions and FP lesions (p>0.95) but significantly higher than in FN lesions (p<0.001). The average size (by histopathology and colonoscopy) of TP lesions was 18.1 mm, statistically different from that of FN lesions which was 5.9 mm (p<0.001). Fifty-one percent of FN lesions were smaller than 5 mm (29/57) and 88% smaller than 10 mm (50/57). Conclusions: The high positive predictive value of incidental focal colonic FDG uptake of 48% for colonic neoplasia suggests that colonoscopy follow-up is warranted with this finding. We observed a low sensitivity of standardly acquired FDG-PET/CT for detecting small polyps, especially those less than 5 mm. Clinician and radiologists should be aware of the high PPV of focal colonic uptake reflecting pre-malignant and malignant lesions, and the need for appropriate follow up.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.49-59
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• 2006

"본 논문은 대한영상의학회지 2005년 제52권 제1호에 실렸던 논문으로 대한영상의학회의 승인을 득하고 본 협회지에 게재함. Purpose: We wished to compare CT colonography with conventional colonoscopy for the detection of colorectal poiypoid lesions, and we wanted to evaluate the role of IV contrast-enhanced CT colonography for the differentiation between benign polypoid lesions and malignant polypoid lesions. Materials and Methods: Thirty-four consecutive patients underwent CT colonography prior to conventional colonoscopy, Precontrast prone-position CT images and post contrast supine position CT images were obtained and the virtual colonoscopic images were reconstructed, Axial, sagittal and presence, size and morphologic features of colorectal polypoid lesions, and thor these findings were compared with the colonoscopic findings. The degree of enhancement of colorecralpolypoid lesions was measured by subtracting the attenuation valves obtained with precontrastand postcontrast CT images for the differentiation of benignity and malignancy of the colorectal polypoid lesions. Results. Among 75 colorectal polypoid lesions identified on conventional colonoscopy, 49neoplasms were found on CT coloaographv, and the overall detection rate was 65,3%.Detection rate of lesions smaller than l0mm was 52.1%(24/46), and the detection rate for lesions equal to or larger than 10mm was 86.2%(25/29), Morphologic features of the sessile type lesions on CT colonography were well correlated with those noted on colonoscopy, but the stalks were not identified in 6 of 13 polyps on CT colonography. There was no statistical correlation between benignity and malignancy and the degree of contrast enhancement on CT colonography, Conclusion CT colonography is a useful modality for the detection of colorectal polypoid lesionsequal to or polyps. However, CT colonography cannot differentiate benignity from malignancy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8951-8955
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• 2014

Background: Studies have shown the existence of gender- and age-related differences in the incidence and anatomic distribution of colorectal cancers. The purposes of this study were to analyze the distribution characteristics of colorectal cancer patients regarding gender, age, location and tumor size in the course of colonoscopy. Materials and Methods: All colorectal cancer patients who underwent colonoscopy in the First Affiliated Hospital of Guangxi Medical University from 2003 to 2012 were included in our retrospective study. Demographic information (age and gender) and colonoscopy report information (tumor size and location) were collected and analyzed. To compare the gender differences in tumor location and tumor size, as well as the size differences in tumor location, the chi-square test was used. Results: A total of 3, 369 colorectal cancer patients (2, 007 men vs 1, 362 women) were included in our study. Statistical analysis showed there was no gender difference in the anatomic distribution of the tumors (p>0.05). However, there was a gender difference in tumor size (p<0.05). In addition, our study found there was a significant difference in tumor size between rectal and colon tumors (p<0.001). Conclusions: There was no gender difference in the anatomic distribution of colorectal tumors. In addition, tumors observed in men were larger than in women.