• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.22 no.2
• /
• pp.132-141
• /
• 2019

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnetattached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).

• Parasites, Hosts and Diseases
• /
• v.57 no.2
• /
• pp.207-211
• /
• 2019

Anisakiasis is a zoonotic disease induced by anisakid nematodes, and endoscopic inspection is used for a diagnosis or remedy for it. Anisakis simplex, Anisakis physeteris, and Pseudoterranova decipiens had been reported to be the major species causing human infections, particularly, in Japan. However, in Korea, recent studies strongly suggested that Anisakis pegreffii is the major species of human infections. To support this suggestion, we collected anisakid larvae (n=20) from 20 human patients who were undergone gastrointestinal endoscopy at a health check-up center in Korea, and molecular identification was performed on the larvae using PCR-RFLP analysis and gene sequencing of rDNA ITS regions and mtDNA cox2. In addition, anisakid larvae (n=53) collected from the sea eel (Astroconger myriaster) were also examined for comparison with those extracted from humans. The results showed that all human samples (100%) were identified as A. pegreffii, whereas 90.7% of the samples from the sea eel were A. pegreffii with the remaining 9.3% being Hysterothylacium aduncum. Our study confirmed that A. pegreffii is the predominant species causing human anisakiasis in Korea, and this seems to be due to the predominance of this larval type in the fish (sea eels) popularly consumed by the Korean people. The possibility of human infection with H. aduncum in Korea is also suggested.

• Clinical Endoscopy
• /
• v.56 no.1
• /
• pp.75-82
• /
• 2023

Background/Aims: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy. Methods: This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions. Results: For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44-8.40; p<0.001). Conclusions: Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.

• Korean Journal of Head & Neck Oncology
• /
• v.15 no.2
• /
• pp.162-165
• /
• 1999

Background and Objectives: Multiple primary tumors of the upper aerodigestive tract are not unusual. We examined head and neck cancer patients to discover the presence of second primary cancer in their upper gastrointestinal tract, using esophagogastroscopy. Materials and Methods: Endoscopic examination of the upper gastrointestinal tract was performed on 51 patients whose head and neck cancers were treated at department of therapeutic radiology from August 1996 to April 1999. Two of all patients had been studied by barium swallowing study. In 51 patients, twenty-four had a primary tumor in the larynx, 8 in the oropharynx, 6 in the nasopharynx, 6 in the oral cavity, 6 in the hypopharynx, and 1 in the nasal cavity. Endoscopically pathologic lesions were biopsied. In control group, endoscopy was performed on 1097 patients who didn't complain any symptoms. Results: Endoscopy showed early malignant lesions in 4 cases(7.7%). Histology of esophageal cancers showed squamous cell carcinoma. Malignant lesions of stomach in 2 cases were histologically identified as adenocarcinoma. Two esophageal cancers occurred in patients whose primary lesions had oropharynx and hypopharynx. Two cases of gastric cancer were also accompanied by oropharynx and hypopharynx. The incidence of second primary cancer was 2 in oropharynx and 2 in hypopharynx. In all cases, second primary cancers were found simultaneously. In control group, 9(0.8%) of 1097 patients were confirmed as early esophageal and gastric cancers. Conclusion: The majority of esophageal and gastric cancer detected by endoscopy were early stage in both head and neck cancer and control group. The incidence of esophageal and gastric cancer of head and neck cancer patients was 10 times as high as that of control group. Although followup period was short, all second primary cancers were detected simultaneously. We would recommend that endoscopic evaluation be included in the workup and followup of all patients with newly diagnosed head and neck cancer.

• Clinical Endoscopy
• /
• v.56 no.3
• /
• pp.367-374
• /
• 2023

Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using oblique-view EUS in patients with a surgically altered anatomy (SAA) of the upper gastrointestinal tract is limited because of difficult scope insertion due to the disturbed anatomy. This study aimed to investigate the efficiency of forward-view (FV)-EUS in performing FNA in patients with a SAA. Methods: We retrospectively investigated 32 patients with a SAA of the upper gastrointestinal tract who visited Aichi Cancer Center Hospital in Nagoya, Japan, between January 2014 and December 2020. We performed upper gastrointestinal EUS-FNA using FV-EUS combined with fluoroscopic imaging to confirm tumor recurrence or to make a decision before chemotherapy or after a failure of diagnosis by radiology. Results: We successfully performed EUS-FNA in all studied patients (100% technical success), with the specificity, sensitivity, and accuracy of 100%, 87.5%, and 87.8%, respectively, with no complications. Conclusions: EUS-FNA using FV-EUS combined with fluoroscopic imaging is an effective and safe technique for tissue acquisition in patients with a SAA.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.10 no.1
• /
• pp.20-27
• /
• 2007

Purpose: This study was performed to review the recent experiences of pediatric gastrointestinal (GI) endoscopy done in one university hospital. Methods: A retrospective review of medical records was conducted of 1,040 pediatric cases who underwent GI endoscopy at the Pusan National University Hospital between January 2001 to June 2005. Results: A total of 1,040 endoscopies (upper 840 and lower 200) were performed. The male/female ratio was 1.25:1. Neonates and infants accounted for 6.0% and 16.5% respectively. Half of the children were below 5 years (mean age $8.5{\pm}2.1$ years). Upper and lower GI diagnostic endoscopies were performed in 634 and 163 children respectively. Abdominal pain (38.8%), vomiting (19.4%), foreign body (17.7%), and hematemesis (10.3%) were the main reasons for esophagogastroduodenoscopy. Hematochezia (56.0%), abdominal pain (27.5%) and diarrhea (3.0%) were the main reasons for colonoscopy. Upper GI therapeutic procedures included retrieval of foreign bodies, balloon dilatations of esophageal stricture, PEG, and variceal ligation in 148, 27, 15, and 3 children, respectively. Therapeutic lower GI endoscopies were performed in 37 children (polypectomy in 92%, argon lazer cauterization for angiodysplasia in 4%). Conclusion: GI endoscopy played an important role in the diagnosis and treatment of GI diseases in children. Procedures in younger aged children, cases evaluated by colonoscopy and therapeutic endoscopies are increasing in pediatric practice.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.6
• /
• pp.2721-2728
• /
• 2012

Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.

• Clinical Endoscopy
• /
• v.56 no.5
• /
• pp.563-577
• /
• 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.

• Journal of Digestive Cancer Research
• /
• v.10 no.2
• /
• pp.56-64
• /
• 2022

Narrow-band imaging (NBI) is the most widely used image-enhanced endoscopic technique. The superficial microanatomy of gastric mucosa can be visualized when used with a magnifying endoscopy with narrow-band imaging (ME-NBI). The diagnostic criteria for early gastric cancer (EGC), using the classification system for microvascular and microsurface pattern of ME-NBI, have been developed, and their usefulness has been proven in the differential diagnosis of small depressed cancer from focal gastritis and in lateral extent delineation of EGC. Some studies reported on the prediction of histologic differentiation and invasion depth of gastric cancer using ME-NBI; however, its application is limited in clinical practice, and further well-designed studies are necessary. Clinicians should understand the ME-NBI classification system and acquire appropriate diagnostic skills through various experiences and training to improve the quality of endoscopy for EGC diagnosis.