• Korean Journal of Veterinary Research
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• v.49 no.1
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• pp.79-83
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• 2009

A 6-year-old, spayed female Miniature Pinscher dog with chronic vomiting lasted for 7 weeks was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Physical examination, complete blood counts, serum chemistry, gastroscopy, upper gastrointestinal series, endoscopic biopsy and histopathological examination were performed for the diagnosis. The complete blood counts and serum biochemistry revealed no remarkable effect to the patient's general condition. Gastroscopy revealed erosion, erythema in mucosal surface of gastric lesions and endoscopic biopsy performed. No significant findings in upper gastrointestinal series were observed, and histopathologic examination revealed infiltration of lymphocyte in the gastric mucosa. Based on these findings, the dog was diagnosed with lymphocytic gastritis. The dog were treated by metronidazole and ranitidine with hypoallergenic diet, and then the patient showed no vomiting or other complications.

• Journal of Gastric Cancer
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• v.24 no.3
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• pp.327-340
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• 2024

Purpose: Results of initial endoscopic biopsy of gastric lesions often differ from those of the final pathological diagnosis. We evaluated whether an artificial intelligence-based gastric lesion detection and diagnostic system, ENdoscopy as AI-powered Device Computer Aided Diagnosis for Gastroscopy (ENAD CAD-G), could reduce this discrepancy. Materials and Methods: We retrospectively collected 24,948 endoscopic images of early gastric cancers (EGCs), dysplasia, and benign lesions from 9,892 patients who underwent esophagogastroduodenoscopy between 2011 and 2021. The diagnostic performance of ENAD CAD-G was evaluated using the following real-world datasets: patients referred from community clinics with initial biopsy results of atypia (n=154), participants who underwent endoscopic resection for neoplasms (Internal video set, n=140), and participants who underwent endoscopy for screening or suspicion of gastric neoplasm referred from community clinics (External video set, n=296). Results: ENAD CAD-G classified the referred gastric lesions of atypia into EGC (accuracy, 82.47%; 95% confidence interval [CI], 76.46%-88.47%), dysplasia (88.31%; 83.24%-93.39%), and benign lesions (83.12%; 77.20%-89.03%). In the Internal video set, ENAD CAD-G identified dysplasia and EGC with diagnostic accuracies of 88.57% (95% CI, 83.30%-93.84%) and 91.43% (86.79%-96.07%), respectively, compared with an accuracy of 60.71% (52.62%-68.80%) for the initial biopsy results (P<0.001). In the External video set, ENAD CAD-G classified EGC, dysplasia, and benign lesions with diagnostic accuracies of 87.50% (83.73%-91.27%), 90.54% (87.21%-93.87%), and 88.85% (85.27%-92.44%), respectively. Conclusions: ENAD CAD-G is superior to initial biopsy for the detection and diagnosis of gastric lesions that require endoscopic resection. ENAD CAD-G can assist community endoscopists in identifying gastric lesions that require endoscopic resection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8917-8921
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• 2014

Objective: To observe and compare the effects of multi-patch biopsy under conventional white light imaging endoscopy (C-WLI) and precise targeted biopsy under magnifying narrow-band imaging endoscopy (M-NBI) on the endoscopic submucosal dissection (ESD) of early gastric cancers and intraepithelial neoplasias. Methods: According to the way of selecting biopsy specimens, patients were divided into C-WLI and M-NBI groups, 20 cases. The ESD operations of the 2 groups were compared quantitively. Results: The mean frequency of biopsy in M-NBI group was ($1.00{\pm}0.00$), obviously lower than in the C-WLI group ($4.78{\pm}1.02$) (P<0.01).The average total number of selected biopsy specimens was also fewer ($1.45{\pm}0.12$ and $7.82{\pm}2.22$, respectively, P<0.01). There was no significant difference in the time of determining excision extension, marking time and the time of specimen excision of 2 groups during the ESD (P>0.05), whereas submucosal injection time, mucosal dissection time, stopping bleeding time, wound processing time in the M-NBI group were significantly shorter than in the C-WLI group (P<0.01). Conclusion: Precise targeted biopsy under M-NBI can obviously shorten the time of ESD operation, with small quantity of tissues but high pathological positive rate.

• Journal of Gastric Cancer
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• v.11 no.3
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• pp.155-161
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• 2011

Purpose: To determine the diagnostic utility of a frozen section biopsy in patients undergoing endoscopic submucosal dissection (ESD) for early gastric neoplasms with obscure margins even with chromoendoscopy using acetic acid and indigo carmine (AI chromoendoscopy). Materials and Methods: The lateral spread of early gastric neoplasms was unclear even following AI chromoendoscopy in 38 patients who underwent ESD between June 2007 and May 2011. Frozen section biopsies were obtained by agreement of the degree of lateral spread between two endoscopists. Thus, frozen section biopsies were obtained from 23 patients (FBx group) and not in the other 15 patients (AI group). Results: No significant differences were observed for size, histology, invasive depth, and location of lesions between the AI and FBx groups. No false positive or false negative results were observed in the frozen section diagnoses. Adenocarcinoma was revealed in three patients and tubular adenoma in one, thereby changing the delineation of lesion extent and achieving free lateral margins. The rates of free lateral resection margins and curative resection were significantly higher in the FBx group than those in the AI group. Conclusions: Frozen section biopsy can help endoscopists perform more safe and accurate ESD in patients with early gastric neoplasm.

• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.93-98
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• 2023

Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

• Journal of Gastric Cancer
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• v.11 no.1
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• pp.59-63
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• 2011

Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findings (such as an upper gastrointestinal series, abdominal computed tomography and positron emission tomography/computed tomography) or the macroscopic findings of a gastrofiberscopy examination imply a high suspicion of cancer, there can be difficulty in getting the definite pathologic results despite multiple biopsies. In these cases, we have performed endoscopic mucosal resection under gastrofiberscopy as an alternative to simple biopsies. Here we report on a case in which no cancer cells were found even in the endoscopic mucosal resection specimen, but the radiologic evidence and clinical findings were highly suspicious for gastric cancer. The patient finally underwent total gastrectomy with lymph node resection, and she was pathologically diagnosed as having stage IV gastric cancer postoperatively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.1
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• pp.29-37
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• 2016

Purpose: The aim of our study was to establish a safe and convenient diagnostic method for acute gastrointestinal (GI) graft-versus-host disease (GVHD) in children by determining the sensitivity and negative predictive values of upper and lower endoscopic biopsies for children suspected of GI GVHD. Methods: Patients suspected of GI GVHD who received endoscopic evaluation within 100 days after stem cell transplantation and endoscopies between January 2012 and March 2014 in Seoul National University Children's Hospital were included in our study. Results: Fifteen patients with a total of 20 endoscopic procedures were included in our study. Sensitivity at the esophagus, stomach, and duodenum were 22.2%, 30.0%, and 80.0%, respectively. Negative predictive values at the esophagus, stomach, and duodenum were 22.2%, 30.0%, and 60.0%, respectively. Overall sensitivity and negative predictive values of upper endoscopic biopsy for GVHD were 77.8% and 50.0%, respectively. Overall sensitivity and negative predictive values of lower endoscopic biopsy for GVHD were 88.9% and 66.7%, respectively. Conclusion: We recommend flexible sigmoidoscopy as a safe and accurate diagnostic tool for GVHD, similar to other studies reported previously. However, if there is no evidence of GVHD on sigmoidoscopy with high index of suspicion of GI bleeding, full colonoscopy and upper endoscopy should be considered.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.375-379
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• 2017

Midbrain gliomas are relatively rare neoplasms with a generally benign prognosis, with dissemination or metastasis not previously reported. We describe here a woman, in whom magnetic resonance imaging scans showed hydrocephalus and a tegmental lesion in the upper aqueduct. Endoscopic third ventriculostomy and biopsy were performed; during surgery, a second small lesion was observed in the infundibular recess. Histologically, the two lesions had the characteristics of low grade astrocytoma, suggesting that the midbrain astrocytoma may have been disseminated via the cerebral spinal fluid to the infundibular recess. Postoperatively this patient received radiotherapy for nearly one month. Although patients with these tumors are not usually administered adjunctive therapy, radiation and, combined modality therapy, including surgery, radiotherapy, and chemotherapy, may be beneficial in patients with midbrain gliomas with dissemination.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.537-541
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• 1990

Early esophageal carcinoma is defined as a lesion wherein invasion is confined to the mucosa and submucosa without metastasis to lymph node or other organs. Postoperative 5-year survival rate for early esophageal carcinoma is much superior than advanced carcinoma. Unfortunately, because of the anatomic characteristic of esophagus and absence of specific early symptoms, detection is frequently belated, and advanced disease is present at the time of the initial diagnosis. We experienced 2 cases of early esophageal carcinoma. They complained no specific symptoms. The diagnosis was made by barium esophagogram, esophagofiberscopy with dye staining and endoscopic biopsy. We performed esophagectomy with esophagogastrostomy. All had good postoperative course without any complication. We concluded that the combined use of double contrast radiography, esopagofiberscopy aided by intraluminal staining with Toluidine blue or Lugol`s solution, and endoscopic biopsy is very important in the diagnosis of early esophageal carcinoma in high risk patient group.

• Clinical Endoscopy
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• v.56 no.1
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• pp.107-113
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• 2023

Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018-2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions: EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.