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Costly Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in Korea

Lee, Sang-il
Fonte: Korean Society for Preventive Medicine Publicador: Korean Society for Preventive Medicine
Tipo: Text
Português
Since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (hereafter Korea) began on May 11, 2015, a total of 186 persons have been infected by the MERS coronavirus, 38 of whom have died. With this number, Korea becomes second only to the Kingdom of Saudi Arabia in the ranking of cumulative MERS cases. In this paper Korea’s unique experience of an outbreak of MERS will be summarized and discussed briefly.

Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy

Arao, Yoshihisa; Sato, Yuichi; Hashimoto, Satoru; Honda, Hiroki; Yoko, Kazumi; Takamura, Masaaki; Mizuno, Ken-ichi; Kobayashi, Masaaki
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.

Narrow Band Imaging as an Efficient and Economical Tool in Diagnosing Colorectal Polyps

Muguruma, Naoki; Takayama, Tetsuji
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Usefulness and Future Prospects of Confocal Laser Endomicroscopy for Gastric Premalignant and Malignant Lesions

Lee, Sang Kil
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Confocal laser endomicroscopy (CLE) is a new technology enabling endoscopists to visualize tissue at the cellular level. CLE has the fundamental potential to provide a histologic diagnosis, and may theoretically replace or reduce the need for performing biopsy for histology. The clinical benefits of CLE are more obvious in esophageal disease, including Barrett’s esophagus. Currently, this technology has been adapted to the diagnosis and surveillance of Barrett’s esophagus and related neoplasia. Standard white light endoscopy is the primary tool for gastric cancer screening. Currently, the only method available to precisely diagnose these lesions is upper endoscopy with an appropriate biopsy. A recent study showed that CLE could characterize dysplasia or cancer and identify the risk factors for gastric cancer, such as intestinal metaplasia and the presence of Helicobacter pylori in vivo, although fewer studies on CLE were performed on the stomach than on Barrett’s esophagus and other esophageal diseases. However, the application of CLE to routine clinical endoscopy continues to be refined. This review focused on the usefulness and future prospects of CLE for gastric premalignant and malignant lesions.

Polyp Detection, Characterization, and Management Using Narrow-Band Imaging with/without Magnification

Utsumi, Takahiro; Iwatate, Mineo; Sano, Wataru; Sunakawa, Hironori; Hattori, Santa; Hasuike, Noriaki; Sano, Yasushi
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Narrow-band imaging (NBI) is a new imaging technology that was developed in 2006 and has since spread worldwide. Because of its convenience, NBI has been replacing the role of chromoendoscopy. Here we review the efficacy of NBI with/without magnification for detection, characterization, and management of colorectal polyps, and future perspectives for the technology, including education. Recent studies have shown that the next-generation NBI system can detect significantly more colonic polyps than white light imaging, suggesting that NBI may become the modality of choice from the beginning of screening. The capillary pattern revealed by NBI, and the NBI International Colorectal Endoscopic classification are helpful for prediction of histology and for estimating the depth of invasion of colorectal cancer. However, NBI with magnifying colonoscopy is not superior to magnifying chromoendoscopy for estimation of invasion depth. Currently, therefore, chromoendoscopy should also be performed additionally if deep submucosal invasive cancer is suspected. If endoscopists become able to accurately estimate colorectal polyp pathology using NBI, this will allow adenomatous polyps to be resected and discarded; thus, reducing both the risk of polypectomy and costs. In order to achieve this goal...

A Randomized Controlled Clinical Study Comparing the Diagnostic Accuracy of the Histologic Prediction for Colorectal Polyps Depending on the Use of Either Magnified or Nonmagnified Narrow Band Imaging

Kim, Jin Joo; Hong, Kyoung Sup; Kim, Joo Sung; Jung, Hyun Chae
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Advanced Imaging Technology Other than Narrow Band Imaging

Cho, Jun-Hyung
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
To improve the detection rate of gastrointestinal tumors, image-enhanced endoscopy has been widely used during screening and surveillance endoscopy in Korea. In addition to narrow band imaging (NBI) with/without magnification, various types of electronic chromoendoscopies have been used, including autofluorescence imaging, I-scan, and flexible spectral imaging color enhancement. These technologies enable the accurate characterization of tumors because they enable visualization of microvascular and microsurface patterns. The present review focuses on understanding the principle and clinical applications of advanced imaging technologies other than NBI.

Narrow Band Imaging: Technology Basis and Research and Development History

Gono, Kazuhiro
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
The first launch of narrow band imaging (NBI) was in 2005. Since then, in most countries where gastrointestinal endoscopies are performed, NBI is the most commonly used optical digital method of performing image-enhanced endoscopy. Thanks to the outstanding efforts of many endoscopists, many clinical studies have been performed and clinical evidence has been gathered. In Japan, since 2010, NBI has been reimbursed under the Japanese national health insurance system. This is owing to the establishment of clinical evidence by physicians. However, even though endoscope systems with NBI function have been widely used outside of Japan, dissemination of knowledge on how to use NBI is insufficient. In this review paper, the technology basis of NBI and its research and development history are described. I hope this information will be helpful for updating physicians’ knowledge of NBI.

The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores

Park, Sun Wook; Song, Young Wook; Tak, Dae Hyun; Ahn, Byung Moo; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Successful Palliation of a Malignant Cologastric Fistula with a Covered Self-Expanding Metal Stent

Breitenbauch, Mathilde Therese Winther; Tøttrup, Anders
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
When patients present with malignant cologastric fistulas, the tumor stage is often advanced and management is only palliative. We report the case of a 75-year-old man with a symptomatic cologastric fistula arising from an advanced tumor in the transverse colon, previously stented owing to malignant obstruction. An 8-cm-long covered self-expanding metal stent (COMVI enteral colonic stent; Taewoong Medical) was placed inside the primary stent, which sealed the fistula and completely alleviated the symptoms. Considering the successful outcome, we propose that insertion of a covered stent be considered in the palliative management of patients with malignant cologastric fistulas.

An Ultrathin Endoscope with a 2.4-mm Working Channel Shortens the Esophagogastroduodenoscopy Time by Shortening the Suction Time

Shinozaki, Satoshi; Miura, Yoshimasa; Ino, Yuji; Shinozaki, Kenjiro; Lefor, Alan Kawarai; Yamamoto, Hironori
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

The Clinical Usefulness of Simultaneous Placement of Double Endoscopic Nasobiliary Biliary Drainage

Kim, Hong Jun; Lee, Sung Koo; Ryu, Choong Heon; Park, Do Hyun; Lee, Sang Soo; Seo, Dong Wan; Kim, Myung-Hwan
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Can AIMS65 Save the Endoscopists from Midnight Calls?

Kim, Joon Sung; Kim, Byung-Wook
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Clinical Application of Magnifying Endoscopy with Narrow-Band Imaging in the Stomach

Yao, Kenshi
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Magnifying endoscopy with narrow-band imaging (M-NBI) can visualize superficial microanatomies in the stomach. The normal morphology of the microanatomy visualized by M-NBI differs according to the part of the stomach. The gastric fundic glandular mucosa appears as a regular honeycomb-like subepithelial capillary network (SECN) pattern with a regular collecting venule pattern and regular oval crypt opening with circular marginal crypt epithelium (MCE) pattern. The gastric pyloric glandular mucosa displays a regular coil-shaped SECN pattern and regular polygonal or curved MCE pattern. For a diagnosis of early gastric cancer using M-NBI, the vessel plus surface classification system was developed. This system is clinically useful for the differential diagnosis of focal gastritis and small depressed cancer and for determining the horizontal extent of early gastric cancer for successful endoscopic resection. Advantages of M-NBI over conventional endoscopic imaging techniques with white light include accurate diagnosis and cost effectiveness. This technique is a breakthrough in the endoscopic diagnostic field.

Advanced Imaging Technology in Biliary Tract Diseases:Narrow-Band Imaging of the Bile Duct

Choi, Hyun Jong; Moon, Jong Ho; Lee, Yun Nah
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Newly introduced direct peroral cholangioscopy and the development of video choledochoscopes have enabled more defined observation of bile duct mucosal lesions with clearer images. Narrow-band imaging (NBI) is a unique endoscopic imaging technology that provides enhanced endoscopic images of surface mucosal structures and its superficial microvessels. Advanced cholangioscopy and NBI are expected to be useful for precise evaluation and correct diagnosis of biliary tract diseases. However, the diagnostic value of advanced bile duct imaging with cholangioscopy requires further evaluation.

Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor

Ko, Young Bo; Lee, Jeong-Mi; Kim, Wan Soo; Kwak, Min Seob; Lee, Ji Wan; Shin, Dong Yeol; Yang, Dong-Hoon; Byeon, Jeong-Sik
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Colonic perforation may occur as a complication of diagnostic and therapeutic colonoscopy. The risk factors for perforation after colorectal endoscopic submucosal dissection (ESD) include an inexperienced endoscopist, a large tumor size, and submucosal fibrosis. The mechanisms of perforation include unintended endoscopic resection/dissection and severe thermal injury. Here, we report a case of colon perforation that occurred after ESD with snaring of a laterally spreading tumor. The perforation was completely unexpected because there were no colorectal ESD-associated risk factors for perforation, deep dissection, or severe coagulation injury in our patient.

Endoluminal Closure of Colon Perforation with Endoscopic Band Ligation: Technical Feasibility and Safety in an In Vivo Canine Model

Han, Joung-Ho; Kim, Myounghwan; Lee, Tae Hoon; Kim, Hyun; Jung, Yunho; Park, Seon Mee; Chae, Heebok; Youn, Seijin; Shin, Ji Yun; Lee, In-Kwang; Lee, Tae Soo; Choi, Seok Hwa
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Endoscopic Extraction of Biliary Fascioliasis Diagnosed Using Intraductal Ultrasonography in a Patient with Acute Cholangitis

Ha, Ji Su; Choi, Hyun Jong; Moon, Jong Ho; Lee, Yun Nah; Tae, Jae Woong; Choi, Moon Han; Lee, Tae Hoon; Cha, Sang-Woo
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Fasciola hepatica infection may result in biliary obstruction with or without cholangitis in the chronic biliary phase. Because clinical symptoms and signs of F. hepatica are similar to other biliary diseases that cause bile duct obstruction, such as stones or bile duct malignancies, that are, in fact, more common, this condition may not be suspected and diagnosis may be overlooked and delayed. Patients undergoing endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the evaluation of bile duct obstruction may be incidentally detected with the worm, and diagnosis can be confirmed by extraction of the leaf-like trematode from the bile duct. Intraductal ultrasonography (IDUS) can provide high-resolution cross-sectional images of the bile duct, and is useful in evaluating indeterminate biliary diseases. We present a case of biliary fascioliasis that was diagnosed using IDUS and managed endoscopically in a patient with acute cholangitis.

Can Endoscopic Nasobiliary Drainage Involving Two Catheters Be Used to Treat Various Conditions?

Lee, Dong Wook; Kim, Ho Gak
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português

Eosinophilic Gastritis Presenting as Tissue Necrosis

Jo, Yong Min; Jang, Jin Seok; Han, Seung Hee; Kang, Sang Hyun; Kim, Woo Jae; Jeong, Jin Sook
Fonte: The Korean Society of Gastrointestinal Endoscopy Publicador: The Korean Society of Gastrointestinal Endoscopy
Tipo: Text
Português
Eosinophilic gastroenteritis is very rare disorder that is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of any definite causes of eosinophilia. It is associated with various clinical gastrointestinal manifestations, and depends on the involved layer and site. We report a case of eosinophilic gastritis presenting with severe necrosis. The symptoms disappeared immediately after beginning steroid treatment, and the eosinophil count decreased to the reference range. The patient showed eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis. It is a unique presentation of eosinophilic gastritis. To the best of our knowledge, no case of eosinophilic gastritis characterized by necrotic change such as necrotizing gastritis has been previously reported in Korea.