1.A Psychiatric Approach to a Patient with Excessive Belching.
Hee Yun KIM ; Byoung Wook BANG ; Chul Eung KIM
Journal of Korean Neuropsychiatric Association 2014;53(5):327-331
Belching is the audible escape of air from the esophagus into the pharynx. It is considered a disorder when the symptom is very frequent and causes significant distress to the patients. Excessive belching can be divided according to excessive supragastric and gastric belching. Gastric belching is usually physiological. In contrast, supragastric belching can be considered learned behavior. In addition, many psychiatric conditions, including anxiety, have been described in patients with supragastric belching and some patients have reported that their symptoms increased during stressful events. We report on a case of supragastric belching in a depressive patient and discuss its management through psychiatric approaches.
Anxiety
;
Cognitive Therapy
;
Depressive Disorder, Major
;
Eructation*
;
Esophagus
;
Humans
;
Life Change Events
;
Pharynx
;
United Nations
2.A Psychiatric Approach to a Patient with Excessive Belching.
Hee Yun KIM ; Byoung Wook BANG ; Chul Eung KIM
Journal of Korean Neuropsychiatric Association 2014;53(5):327-331
Belching is the audible escape of air from the esophagus into the pharynx. It is considered a disorder when the symptom is very frequent and causes significant distress to the patients. Excessive belching can be divided according to excessive supragastric and gastric belching. Gastric belching is usually physiological. In contrast, supragastric belching can be considered learned behavior. In addition, many psychiatric conditions, including anxiety, have been described in patients with supragastric belching and some patients have reported that their symptoms increased during stressful events. We report on a case of supragastric belching in a depressive patient and discuss its management through psychiatric approaches.
Anxiety
;
Cognitive Therapy
;
Depressive Disorder, Major
;
Eructation*
;
Esophagus
;
Humans
;
Life Change Events
;
Pharynx
;
United Nations
3.Endoscopic Classification of Intestinal Metaplasia.
Byoung Wook BANG ; Hyung Gil KIM
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(2):78-83
Intestinal metaplasia (IM) is recognized as a precancerous condition for intestinal type gastric cancer. Therefore, endoscopic diagnosis of IM is valuable for patients undergoing surveillance endoscopy. However, there are no standard endoscopic findings that distinguish it from the normal mucosa. Thus, biopsy is normally required to confirm the diagnosis of IM. Recently, the development of high-resolution image technique and some advanced endoscopic technologies such as chromoendoscopy, magnifying endoscopy with narrow band image and confocal laser endomicroscopy has significantly improved the ability to observe mucosal surface and identify IM. Although chromoendoscopy is time consuming, it is a useful method for diagnosis of IM. Narrow band imaging may enhance the accuracy of endoscopic surveillance of IM and dysplasia. Confocal laser endomicroscopy could provide in the real-time identification and classification of IM. Herein, we reviewed the clinical usefulness of white light endoscopy and several new endoscopic methods for the diagnosis of gastric intestinal metaplasia. Also, we will discuss appropriate follow-up period according to IM type and extension.
Biopsy
;
Endoscopy
;
Follow-Up Studies
;
Humans
;
Light
;
Metaplasia
;
Methylene Blue
;
Microscopy, Confocal
;
Mucous Membrane
;
Narrow Band Imaging
;
Precancerous Conditions
;
Stomach Neoplasms
4.Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision.
Jee Young HAN ; Byoung Wook BANG ; Hyung Gil KIM ; Kye Sook KWON ; Yong Woon SHIN
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(4):276-279
Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles
;
Early Diagnosis
;
Endoscopy
;
Female
;
Foreign Bodies
;
Hand Strength
;
Humans
;
Jaw
;
Middle Aged
;
Mucous Membrane
;
Stomach
;
Surgical Instruments
5.Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision.
Jee Young HAN ; Byoung Wook BANG ; Hyung Gil KIM ; Kye Sook KWON ; Yong Woon SHIN
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(4):276-279
Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles
;
Early Diagnosis
;
Endoscopy
;
Female
;
Foreign Bodies
;
Hand Strength
;
Humans
;
Jaw
;
Middle Aged
;
Mucous Membrane
;
Stomach
;
Surgical Instruments
6.A Case of Esophageal Squamous Papillomatosis.
Sang Hyun PARK ; Byoung Wook BANG ; Hyung Gil KIM ; Yong Woon SHIN ; Lucia KIM
The Korean Journal of Internal Medicine 2012;27(2):243-243
No abstract available.
Aged
;
Biopsy
;
Esophageal Neoplasms/*diagnosis/pathology
;
Esophagoscopy
;
Esophagus/*pathology
;
Humans
;
Male
;
Mucous Membrane/pathology
;
Papilloma/*diagnosis/pathology
7.A Surgical Clip Stone in Common Bile Duct.
Sang Hyun PARK ; Seok JEONG ; Byoung Wook BANG ; Don Haeng LEE
Korean Journal of Medicine 2011;81(4):453-454
No abstract available.
Common Bile Duct
;
Surgical Instruments
8.An adenosquamous carcinoma of the liver that developed metachronously in a patient with a colon adenocarcinoma.
Byoung Wook BANG ; Mie Jin LIM ; Joo Han LIM ; Eun Joo KIM ; Seok JEONG ; Suk Jin CHOI ; In Suh PARK
Korean Journal of Medicine 2007;72(1):74-78
A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine.
Adenocarcinoma*
;
Aged
;
Carcinoma, Adenosquamous*
;
Carcinoma, Squamous Cell
;
Cholangiocarcinoma
;
Colon*
;
Colon, Ascending
;
Colonic Neoplasms
;
Humans
;
Immunohistochemistry
;
Liver*
;
Magnetic Resonance Imaging
;
Mastectomy, Segmental
;
Neoplasm Metastasis
;
Outpatients
;
Prognosis
;
Ultrasonography
;
Capecitabine
9.Percutanous Ultrathin Flexible Peritoneoscopy for Detecting Peritoneal Metastasis: A Feasibility Study.
Min Su KIM ; Hea Yoon KWON ; Byoung Wook BANG ; Hyung Gil KIM ; Kye Sook KWON ; Yong Woon SHIN ; Seok JEONG ; Don Haeng LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(3):167-172
BACKGROUND/AIMS: Preoperative diagnosis of peritoneal metastasis is extremely important to select the appropriate treatment strategy and predict the prognosis for patients with gastrointestinal cancer. However, imaging techniques have a limited capacity for detecting peritoneal metastasis. We therefore evaluated the feasibility of percutaneous ultrathin flexible peritoneoscopy in an animal model. MATERIALS AND METHODS: Percutanous ultrathin flexible peritoneoscopy was performed on two mini-pigs under general anesthesia. We punctured the abdominal wall at the anti-Mcburney and umbilical regions using a 16-gauge angiocatheter. Guidewire was inserted through the angiocatheter and we then enlarged the puncture using a biliary dilation catheter and a 6- to 8-mm balloon dilator catheter. After track formation, we inserted a 4.9-mm ultrathin endoscope into the abdominal cavity. The peritoneal cavity was examined, and peritoneal and liver biopsy was performed. The puncture was closed with a single suture. After the procedure, we monitored the general condition of the pigs for 2 weeks. RESULTS: Percutaneous ultrathin flexible peritoneoscopy was successfully performed regardless of the puncture site location. Peritoneal and liver biopsy was also successfully executed. The mean procedure time was 20 minutes. Formation of the abdominal track was not easily accomplished with standard endoscopic equipment. Nevertheless, none of the abdominal organs were injured. The post-procedure course was uneventful. Minor scarring was observed at the incision site 2 weeks after the procedure. CONCLUSIONS: Percutanous ultrathin flexible peritoneoscopy is a relatively simple and technically feasible method. However, dedicated accessories for fascial dilation should be developed to ensure the safety of human patients undergoing this procedure.
Abdominal Cavity
;
Abdominal Wall
;
Anesthesia, General
;
Animals
;
Biopsy
;
Catheters
;
Cicatrix
;
Endoscopes
;
Feasibility Studies
;
Gastrointestinal Neoplasms
;
Laparoscopy
;
Liver
;
Neoplasm Metastasis
;
Peritoneal Cavity
;
Peritoneum
;
Prognosis
;
Punctures
;
Sutures
;
Swine
10.Twenty-Second versus Sixty-Second Dilation Duration in Endoscopic Papillary Balloon Dilation for the Treatment of Small Common Bile Duct Stones: A Prospective Randomized Controlled Multicenter Trial.
Byoung Wook BANG ; Tae Hoon LEE ; Tae Jun SONG ; Joung Ho HAN ; Hyun Jong CHOI ; Jong Ho MOON ; Chang Il KWON ; Seok JEONG
Clinical Endoscopy 2015;48(1):59-65
BACKGROUND/AIMS: Endoscopic papillary balloon dilation (EPBD) has been advocated as an alternative therapy to endoscopic sphincterotomy for the treatment of common bile duct (CBD) stones. However, there is no established consensus on the optimal balloon dilation duration (BDD). We prospectively evaluated the efficacy and post-endoscopic retrograde cholangiopancreatography (ERCP) complications between the 20- and 60-second EPBD groups. METHODS: A total of 228 patients with small CBD stones (< or =12 mm) were randomly assigned to undergo EPBD with a 20- or 60-second duration at six institutions. We evaluated baseline patient characteristics, endoscopic data, clinical outcomes, and procedure-related complications. In addition, we analyzed risk factors for postprocedural pancreatitis. RESULTS: CBD stones were removed successfully in 107 of 109 patients (98.1%) in the 20-second group and in 112 of 119 patients (94.1%) in the 60-second group (p=0.146). Post-ERCP pancreatitis developed in seven patients (6.4%) in the 20-second group and nine patients (7.5%) in the 60-second group (p=0.408). In multivariate analysis, contrast dye injection into the pancreatic duct is a significant risk factor for post-EPBD pancreatitis. CONCLUSIONS: Based on the data showing that there were no significant differences in safety and efficacy between the two BDD groups, 20 seconds of BDD may be adequate for treatment of small CBD stones with EPBD.
Choledocholithiasis
;
Common Bile Duct*
;
Consensus
;
Humans
;
Multivariate Analysis
;
Pancreatic Ducts
;
Pancreatitis
;
Prospective Studies*
;
Risk Factors
;
Sphincterotomy, Endoscopic