• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.1
• /
• pp.49-55
• /
• 2023

Backgrounds/Aims: Data regarding outcomes of endoscopic retrograde cholangiography (ERC) in liver transplant (LT) recipients with biliary-enteric (BE) anastomosis are limited. We report outcomes of ERC and percutaneous transhepatic biliary drainage (PTBD) as first-line therapies in LT recipients with BE anastomosis. Methods: All LT recipients with Roux-BE anastomosis from 2001 to 2020 were divided into ERC and PTBD subgroups. Technical success was defined as the ability to cannulate the bile duct. Clinical success was defined as the ability to perform cholangiography and therapeutic interventions. Results: A total of 36 LT recipients (25 males, age 53.5 ± 13 years) with Roux-BE anastomosis who underwent biliary intervention were identified. The most common indications for a BE anastomosis were primary sclerosing cholangitis (n = 14) and duct size mismatch (n = 10). Among the 29 patients who initially underwent ERC, technical success and clinical success were achieved in 24 (82.8%) and 22 (75.9%) patients, respectively. The initial endoscope used for the ERC was a single balloon enteroscope in 16 patients, a double balloon enteroscope in 7 patients, a pediatric colonoscope in 5 patients, and a conventional reusable duodenoscope in 1 patient. Among the 7 patients who underwent PTBD as the initial therapy, six (85.7%) achieved technical and clinical success (p = 0.57). Conclusions: In LT patients with Roux-BE anastomosis requiring biliary intervention, ERC with a balloon-assisted enteroscope is safe with a success rate comparable to PTBD. Both ERC and PTBD can be considered as first-line therapies for LT recipients with a BE anastomosis.

• Clinical Endoscopy
• /
• v.57 no.3
• /
• pp.335-341
• /
• 2024

Background/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy. Methods: Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 ㎛). Differences in particle counts between time points were recorded. Results: During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54-385] vs. 579 [213-1,379]×10³/m³; p=0.056). However, the intervention group had a significant decrease in 0.3-㎛ particles (68 [-25 to 185] vs. 242 [72-588] ×10³/m³; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients. Conclusions: This modified N95 respirator reduced the number of particles, especially 0.3-㎛ particles, generated during upper gastrointestinal endoscopy.

• Clinical and Experimental Pediatrics
• /
• v.45 no.4
• /
• pp.459-465
• /
• 2002

Purpose : The aim of this study was to evaluate the latest tendency of esophageal foreign body's extraction and to obtain a consensus from recent trends of indications and techniques of flexible endoscopy of esophageal FB in children. Methods : We retrospectively reviewed medical records of 127 cases with foreign bodies in esophagus at Dept. of Pediatrics and Otorhinolaryngology, Gyeongsang National University Hospital (GNUH) from Jun, 1987 to July, 2001. They were divided into two groups by the kinds of endoscopy : flexible endoscope(66 cases) or rigid endoscope(61 cases). Rigid endoscopy was performed under general anesthesia at Dept. of Otorhinolaryngology but flexible endoscopy was performed without general anesthesia or sedative drugs(midazolam or diazepam). Results : An annual number of cases of two groups were similar from 1991 to 1998. But from 1999, flexible endoscopy was performed actively. Asymptomatic cases were frequently observed in flexible endoscopy(28 cases/66 cases) but swallowing difficulties were frequently observed in the rigid endoscopy group(25 cases/61 cases). Other symptoms were vomiting, irritability, chest discomfort and abdominal pain. The total number of cases with underlying disease(esophageal stenosis, cerebral palsy) was 8. The total number of cases with complications (erosion, ulcer, bleeding, perforation) was 11. The above cases were not correlated between the two groups. In 55 cases(83.3%) of the flexible endoscopic group and 53 cases(86.8%) of the rigid endoscopic group, foreign bodies in the esophagus were removed within 24 hours. Conclusion : We could not find any benefit in rigid endoscopic technique. Flexible endoscopic FB removal can be performed safely and effectively in children by an experienced endoscopist.

• Journal of Chest Surgery
• /
• v.38 no.5 s.250
• /
• pp.366-370
• /
• 2005

Background: In general, cardiac surgery has been performed via median sternotomy. During the past decade, improvements in endoscopic equipment and operative techniques have resulted in development of minimally invasive cardiac operation using small incisions. With the advent of a voice controlled camera-holding robotic arm (AESOP 3000, Automated Endoscope System for Optimal Positioning), cardiac surgery entered the robotic age. Material and Method: Between April 2004 and December 2004, a total of seventy eight patients underwent robotic cardiac surgery, of whom sixty four patients underwent robot-assisted minimally invasive cardiac surgery via 5cm right lateral minithoracotomy using voice controlled robotic arm, femoral vessels cannulation, percutaneous internal jugular cannulation, transthoracic aortic cross clamp. Other fourteen patients underwent MIDCAB via internal mammary artery harvesting using AESOP. Result: Robotic cardiac surgery were mitral valve repair in 37 cases, mitral valve replacement in 10 cases, aortic valve replacement in 1 case, MIDCAB in 14 cases, ASD operation in 9 cases, and isolated Maze procedure in 1 case. In mitral operation, mean CPB time was $165.3\pm43.1$ minutes and mean ACC time was $110.4\pm48.2$ minutes. Median length of hospital stay was 6 days (range 3 to 30) in mitral operation, 4 days (range 2 to 7) in MIDCAB, and 4 days (range 2 to 6) in ASD operation. For complications, 3 patients were required by reoperation for bleeding. There was no hospital mortality. Conclusion: Our experience of robot cardiac surgery suggests that many cardiovascular surgeons will be able to perform minimally invasive cardiac operations through small incisions with robot-assisted video-direction. Well-designed studies and close long-term follow-up will be required to analyze the benefits of robot-assisted operation.

• KIPS Transactions on Software and Data Engineering
• /
• v.9 no.3
• /
• pp.101-108
• /
• 2020

Since the performance of deep learning techniques has recently been proven in the field of image processing, there are many attempts to perform classification, analysis, and detection of images using such techniques in various fields. Among them, the expectation of medical image analysis software, which can serve as a medical diagnostic assistant, is increasing. In this study, we are attention to the capsule endoscope image, which has a large data set and takes a long time to judge. The purpose of this paper is to distinguish the gastrointestinal landmarks and to estimate the gastrointestinal transition location that are common to all patients in the judging of capsule endoscopy and take a lot of time. To do this, we designed CNN-based Classifier that can identify gastrointestinal landmarks, and used it to estimate the gastrointestinal transition location by filtering the results. Then, we estimate gastrointestinal transition location about seven of eight patients entered the suspected gastrointestinal transition area. In the case of change from the stomach to the small intestine(pylorus), and change from the small intestine to the large intestine(ileocecal valve), we can check all eight patients were found to be in the suspected gastrointestinal transition area. we can found suspected gastrointestinal transition area in the range of 100 frames, and if the reader plays images at 10 frames per second, the gastrointestinal transition could be found in 10 seconds.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.17 no.1
• /
• pp.28-37
• /
• 2006

Purpose: Evaluation of vocal cord vibration is very important in cases of voice disorders. There are several equipments for examining the vocal fold vibration such as laryngeal stroboscope, ultra high-speed digital imaging system, and videokymograph. Among these, laryngeal stroboscope is the most popular equipment because of easy to examine the laryngeal pathology. However, current laryngo-stroboscopes are too bulky to move and relatively expensive. The purpose of this research is to develope a portable laryngeal stroboscope of equivalent performance with the current equipments. Methods and Materials: Recently developed high luminescent white LEDs(light emitting diodes) are placed at the head of the endoscope as light sources for the CCD image sensor which is also placed at the head with imaging lens. This arrangement eliminates the bulky light source like expensive halogen or xenon lamps as well as the optical light guiding cables. The LEDs are controlled to flash in phase with the voice frequency of the examinee. The CCD captures these strobo images and converts them into video signals for examinations. Results: There was no functional differences between preexisting stroboscope and the newly developed stroboscope of this study. LED light sources and microprocessor based control circuits of the stroboscope enabled the development of flicker-less, hand-held, portable and battery-operating stroboscope. Conclusion: The developed stroboscope is cost-effective, small-sized, easy to use and very easy desirable to bring and to use in any place.

• Journal of Veterinary Clinics
• /
• v.28 no.4
• /
• pp.452-456
• /
• 2011

5 year-old female Siberian husky which was 27 kg had presented with a recurrent rhinitis with chronic discharge and cough. A nasal foreign material had been suggested by a finding of a bone density ($0.3{\times}0.3$ cm) in the left nasal cavity on X-ray and CT-scanning. Soft tissue opacity in frontal sinus and nasal cavity was increased and foreign material was located beside turbinate bone in the left nasal. We found that there was the increase in the number of eosinophil and mast cell by the nasal cytology test. These results mentioned above indicated that the rhinitis by nasal foreign body was suspicious. We decided that the transfrontal rhinotomy could be the proper procedure to approach the material in this case. After rhinotomy, the foreign body and severe sticky discharge were removed. Drain was placed through the hole and into the frontal sinus and nasal cavity which were flushed two times a day for 7 days. The clinical signs such as cough and nasal discharge were shown to be improved in the every visiting for the re-check. On the $40^{th}$ day after surgery, we could confirm that the most of soft tissue density in the frontal sinus and nasal cavity was decreased by CT-scanning. However, foreign body was not identified by histological examination. For the treatment of chronic rhinitis caused by foreign body, the surgical method such as rhinotomy can be applied, when it is difficult to remove it in the guide of the nasal endoscope.

• Journal of radiological science and technology
• /
• v.34 no.2
• /
• pp.149-156
• /
• 2011

This study is to identify perceptions and response degrees of anxiety for each factor, targeting patients for CT test and analyze the relations between factors. It is to provide scientific fundamental data to reduce anxiety by improving awareness of patients about CT test by analyzing relations between variables. The subjects of this study were surveyed in self-writing type, targeting 263 patients for CT test in the department of radiology at three University hospitals from July to September, 2010. This survey was executed once by a structured self-administered survey type. The targeting patients for CT test of anxiety will investigate for affect. Anxiety by each CT test variables depending on CT test-related features showed independent variable is Expense Responsibility, Economic burden, Sufficient explain, Explain agent, Endoscope, Biopsy, Pre treatment, Previous experience, CT side effect experience, Side effect of contrast medium and dependent variable is physical, Hospital staff, Hospital environment, Socioeconomic These used statistics program SPSS (ver. 13.0). Summarizing the above results of this study, awareness of anxiety and response to it in each variable under CT test appeared significant differences in economic burdens, state anxiety, pre-treatment anxiety, exposure anxiety to radiation, and anxiety of side effect. Therefore, pre-treatment before test and pre-training programs on chemical poison of contrast medium and side effect seem to be able to release patients' anxiety level for CT test. Ways to meditate these anxiety variables and reduce degree of anxiety are needed to be researched more and updated. In addition, impact of patients' economic burdens on CT test anxiety is required to be recognized and solved in society level.

• International Journal of Highway Engineering
• /
• v.18 no.5
• /
• pp.57-62
• /
• 2016

PURPOSES : The objective of this study is to evaluate the effect of size and depth of cavities on the pavement failure using the full-scale accelerated pavement testing. METHODS : A full-scale testbed was constructed by installing the artificial cavities at a depth of 0.3 m and 0.7 m from the pavement surface for accelerated pavement testing. The cavities were made of ice with a dimension of 0.5 m*0.5m*0.3m, and the thickness of asphalt and base layer were 0.2 m and 0.3 m, respectively. The ground penetrating radar and endoscope testing were conducted to determine the shape and location of cavities. The falling weight deflectometer testing was also performed on the cavity and intact sections to estimate the difference of structural capacity between the two sections. A wheel loading of 80 kN was applied on the pavement section with a speed of 10 km/h in accelerated pavement testing. The permanent deformation was measured periodically at a given number of repetitions. The correlation between the depth and size of cavities and pavement failure was investigated using the accelerated pavement testing results. RESULTS : It is found from FWD testing that the center deflection of cavity section is 10% greater than that of the intact section, indicating the 25% reduction of modulus in subbase layer due to the occurrence of the cavity. The measured permanent deformation of the intact section is approximately 10 mm at 90,000 load repetitions. However, for a cavity section of 0.7 m depth, a permanent deformation of 30 mm was measured at 90,000 load repetitions, which is three times greater than that of the intact section. At cavity section of 0.3 m, the permanent deformation reached up to approximately 90 mm and an elliptical hole occurred at pavement surface after testing. CONCLUSIONS : This study is aimed at determining the pavement failure mechanism due to the occurrence of cavities under the pavement using accelerated pavement testing. In the future, the accelerated pavement testing will be conducted at a pavement section with different depths and sizes of cavities. Test results will be utilized to establish the criteria of risk in road collapse based on the various conditions.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7121-7126
• /
• 2013

Aim: To examine lymph nodes obtained after lipolysis and liposuction of subcutaneous fat of the inguinal region of female vulvar cancer patients to explore the feasibility of clinical application. Methods: The field of operation was on the basis of the range of the conventional resection of inguinal lymph nodes. We injected lipolysis liquid fanwise, started liposuction after 15-20 minutes; then the subcutaneous fatty tissue was sucked out clearly by suction tube. We selected the first puncture holes located on 2-3 cm part below anterior superior spine, the others respectively being located 3cm and 6cm below the first for puncturing into the skin, imbedding a trocar to intorduce $CO_2$ gas and the specular body, and excise the lymph nodes by ultrasonic scalpel. The surgical field chamber was set with negative pressure drainage and was pressured with a soft saline bag after surgery. Results: A lacuna emerged from subcutaneous of the inguinal region after lipolysis and liposuction, with a wide fascia easily exposed at the bottom where lymph nodes could be readily excised. The number of lymph nodes of ten patients excised within the inguinal region on each side was 4-18. The excised average number of lymph nodes was 11 when we had mature technology. Conclusion: Most of adipose tissue was removed after lipolysis and liposuction of subcutaneous tissue of inguinal region, so that the included lymph nodes were exposed and easy to excise by endoscope. This surgery avoided the large incision of regular surgery of inguinal region, the results indicating that this approach is feasible and safe for used as an alternative technology.