BACKGROUND: Some patients present transient swelling on lower lateral neck during swallowing; this condition is known as "omohyoid syndrome" or "omohyoid sling syndrome". The purpose of this case report is to evaluate the proper mechanism as well as to give the reader an appreciation for the proper diagnosis and treatment to this not-uncommon condition. METHODS: There were three cases between May, 2000 and January, 2001. The photography, real-time sonography, and computed tomography (CT) were used. RESULTS: There was a brief report on omohyoid syndrome. The sternocleidomastoid muscle is passively tented up by an underlying omohyoid muscle, and the omohyoid muscle is paradoxically thickened during swallowing. The former appears to have lost its restriction to bowstring by the retaining deep cervical fascia. And the latter seems to result from lack of its relaxation during laryngeal elevation. CONCLUSION: The described approaches allow for precise diagnosis and definite proof of the pathogenetic mechanism.
Deglutition ; Diagnosis ; Fascia ; Humans ; Neck ; Photography ; Relaxation

Life expectancy in Korea has increased, and the number of screening colonoscopies in the elderly has also dramatically increased. The net benefit of colonoscopy in the very elderly (> or =80 years of age as defined by the World Health Organization) may be reduced because of the competing risk of mortality due to other diseases. Therefore, the decision to perform screening colonoscopy may be more complex in this age group. As the potential increase in life expectancy due to screening colonoscopy is significantly reduced in the very elderly, this procedure should be limited to those among the very elderly who have substantial life expectancies. Furthermore, considering the common major complications associated with colonoscopy, poor bowel preparation, and the possibility of incomplete colonoscopies in the very elderly, the performance of screening colonoscopy in the very elderly may not be an ideal recommendation. In terms of providing the greatest benefit to the most number of people, patients with the highest potential gain in terms of life expectancy, relative to the diagnostic yield, should be targeted for colonoscopy screening. This review addresses the unique considerations regarding screening colonoscopy in the very elderly and the individualized approach, which involves the weighing of the risks and benefits for each individual with consideration of their overall health status.
Aged* ; Colonic Neoplasms ; Colonoscopy* ; Humans ; Korea ; Life Expectancy ; Mass Screening* ; Mortality ; Risk Assessment ; World Health ; World Health Organization

Colonoscopy is currently regarded as the gold standard and preferred screening method for colorectal cancer (CRC). Recently, however, a limitation of colonoscopy in the prevention of CRCs has been identified, particularly in the right-sided colon, and the problem of so-called interval cancers has emerged. The prevalence of interval cancer is estimated to be between 4% and 8% of CRCs detected. Although the exact etiology of interval cancer remains unknown, factors implicated in the development of interval cancers include missed lesions at the time of colonoscopy, incomplete resection of previous neoplastic lesions, different tumor biology, and serrated pathway of carcinogenesis. However, recent evidence suggests that interval cancers are related to the training of the endoscopist and quality of the colonoscopy rather than tumor biology. Therefore, the importance of adequate training and continuous monitoring of the colonoscopy quality, which are amenable to improvement, cannot be overstated in order to prevent the risk of interval cancers. In this study, the current literature regarding the prevalence and potential factors related to interval cancers and colonoscopy quality-related issues are reviewed.
Biology ; Carcinogenesis ; Colon ; Colonic Neoplasms ; Colonoscopy* ; Colorectal Neoplasms ; Education ; Mass Screening ; Prevalence

No abstract available.
Neuroendocrine Tumors*

No abstract available.
Neuroendocrine Tumors*

The motivation for improving quality of gastrointestinal endoscopy begins with the desire to provide patients with the best possible care. Gastrointestinal endoscopy is an excellent area for quality improvement because of its high volume, significant associated risk and expense, and variability in its performance affecting outcomes. Therefore, the assurance that high-quality endoscopic procedures are performed has taken increased importance. The 'Korean Gastrointestinal Endoscopy Research Foundation' and 'Korean Society of Gastrointestinal Endoscopy', as ladders in promoting the highest quality patient care, formed endoscopy quality evaluation in 'National Cancer Screening Program' and 'Endoscopy Unit Accreditation' in Korea. However, both new systems have not settled down despite efforts of many years and support by the government. In this article, the past and present of quality improvement of gastrointestinal endoscopy will be reviewed, and the future of quality improvement of gastrointestinal endoscopy will be illuminated.
Early Detection of Cancer ; Endoscopy, Gastrointestinal/*standards ; Humans ; Neoplasms/diagnosis ; Quality Improvement ; Quality Indicators, Health Care ; Republic of Korea

No abstract available.
Colonoscopy*

Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rate in population-based screening program. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis and socioeconomic burden. In addition, harmful effect of colonoscopy may increase with age and comorbidity. As the adverse event risk in population-based colonoscopy screening may offset benefit of the screening colonoscopy, the adverse events associated with screening colonoscopy should be well managed and monitored. To adopt population-based colonoscopy screening, consensus for the risk and benefits of screening colonoscopy should be formed for its potential harms, patient preference, socioeconomic considerations, quality improvement of colonoscopy as well as its efficacy for CRC prevention. As the suboptimal colonoscopy quality is a major pitfall of population-based colonoscopy screening, adequate training and provider regulation for screening colonoscopists should be the first step to minimize the variation of quality between colonoscopists. Gastroenterologists should lead quality improvement, auditing, and training associated with colonoscopy in a population-based colonoscopy screening program.
Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Comorbidity ; Consensus ; Mass Screening ; Methods ; Patient Harm ; Quality Improvement

No abstract available.
Epithelioid Cells* ; Granuloma, Pyogenic* ; Histiocytoma* ; Histiocytoma, Benign Fibrous

Dermatofibroma (DF) is one of the most common benign soft tissue tumors. Various histological variants of DF have been described, and it is important to discern the different variants to evaluate the prognosis. A 43-year-old female patient with no specific medical history presented with multiple brown-colored nodules on the right arm for 5 years. Biopsy specimens showed a predominance of collagen and fibroblasts in a whorled arrangement with moderate cellularity, findings that were consistent with fibrocollagenous DF. The patient underwent excision of the largest lesion and revisited our department 3 months after surgery with local recurrence at the excision site. We report a rare case of multiple fibrocollagenous DF with local recurrence at the excision site.