1.The comparative study of Stretta radiofrequency and anti-reflux mucosectomy in the management of intractable gastroesophageal reflux disease: a single-center retrospective study from Korea
Ah Young LEE ; Ji Woo CHOI ; Jeong Haeng HEO ; Jun Young CHUNG ; Seong Hwan KIM ; Joo Young CHO
Clinical Endoscopy 2025;58(3):409-417
Background/Aims:
Chronic gastroesophageal reflux disease (GERD) requires symptom relief and treatment of associated conditions. In this study, we aimed to compare anti-reflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) for treating patients with chronic GERD who are unresponsive to proton pump inhibitors (PPIs) and to identify the indications for each procedure.
Methods:
Data of patients who underwent ARMS or SRF between March 2021 and April 2023 were analyzed. Changes in GERD questionnaire (GERDQ) scores, endoscopic Los Angeles (LA) grade, flap valve grade (FVG) based on Hill’s type, EndoFLIP distensibility index (DI), endoscopic Barrett’s epithelium (BE) resolution rate, and PPI withdrawal rate were compared between the two groups.
Results:
Improvements in the GERDQ scores and PPI withdrawal rates were similar between the groups. The ARMS group showed significantly better changes in endoscopic LA grade, FVG, and EndoFLIP DI than the SRF group. The complications were more prevalent in the ARMS group than in the SRF group.
Conclusions
The change in endoscopic LA grade before and after the procedure was significantly higher in the ARMS group than in the SRF group. Significant improvements in endoscopic FVG, BE resolution, and EndoFLIP DI were observed only with the ARMS group.
2.The comparative study of Stretta radiofrequency and anti-reflux mucosectomy in the management of intractable gastroesophageal reflux disease: a single-center retrospective study from Korea
Ah Young LEE ; Ji Woo CHOI ; Jeong Haeng HEO ; Jun Young CHUNG ; Seong Hwan KIM ; Joo Young CHO
Clinical Endoscopy 2025;58(3):409-417
Background/Aims:
Chronic gastroesophageal reflux disease (GERD) requires symptom relief and treatment of associated conditions. In this study, we aimed to compare anti-reflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) for treating patients with chronic GERD who are unresponsive to proton pump inhibitors (PPIs) and to identify the indications for each procedure.
Methods:
Data of patients who underwent ARMS or SRF between March 2021 and April 2023 were analyzed. Changes in GERD questionnaire (GERDQ) scores, endoscopic Los Angeles (LA) grade, flap valve grade (FVG) based on Hill’s type, EndoFLIP distensibility index (DI), endoscopic Barrett’s epithelium (BE) resolution rate, and PPI withdrawal rate were compared between the two groups.
Results:
Improvements in the GERDQ scores and PPI withdrawal rates were similar between the groups. The ARMS group showed significantly better changes in endoscopic LA grade, FVG, and EndoFLIP DI than the SRF group. The complications were more prevalent in the ARMS group than in the SRF group.
Conclusions
The change in endoscopic LA grade before and after the procedure was significantly higher in the ARMS group than in the SRF group. Significant improvements in endoscopic FVG, BE resolution, and EndoFLIP DI were observed only with the ARMS group.
3.The comparative study of Stretta radiofrequency and anti-reflux mucosectomy in the management of intractable gastroesophageal reflux disease: a single-center retrospective study from Korea
Ah Young LEE ; Ji Woo CHOI ; Jeong Haeng HEO ; Jun Young CHUNG ; Seong Hwan KIM ; Joo Young CHO
Clinical Endoscopy 2025;58(3):409-417
Background/Aims:
Chronic gastroesophageal reflux disease (GERD) requires symptom relief and treatment of associated conditions. In this study, we aimed to compare anti-reflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) for treating patients with chronic GERD who are unresponsive to proton pump inhibitors (PPIs) and to identify the indications for each procedure.
Methods:
Data of patients who underwent ARMS or SRF between March 2021 and April 2023 were analyzed. Changes in GERD questionnaire (GERDQ) scores, endoscopic Los Angeles (LA) grade, flap valve grade (FVG) based on Hill’s type, EndoFLIP distensibility index (DI), endoscopic Barrett’s epithelium (BE) resolution rate, and PPI withdrawal rate were compared between the two groups.
Results:
Improvements in the GERDQ scores and PPI withdrawal rates were similar between the groups. The ARMS group showed significantly better changes in endoscopic LA grade, FVG, and EndoFLIP DI than the SRF group. The complications were more prevalent in the ARMS group than in the SRF group.
Conclusions
The change in endoscopic LA grade before and after the procedure was significantly higher in the ARMS group than in the SRF group. Significant improvements in endoscopic FVG, BE resolution, and EndoFLIP DI were observed only with the ARMS group.
4.Myositis Ossificans of the Thighs Due to Repeated Assault: A Case Report
Jin-Haeng HEO ; Jeong-hwa KWON ; Jang Gyu CHA ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):180-184
Myositis ossificans (MO) is defined as a lesion where abnormal ossification forms in soft tissues, such as muscle, fascia, and ligament, usually as a result of trauma. It commonly appears in areas such as the thigh, hip, and elbow, though it can affect any part of the body. In the forensic field, MO resulting from trauma is reported to be valuable evidence of repeated physical abuse. This case report describes a deceased adult male with an intellectual disability, whose cause of death was multiple injuries from assault. Postmortem computed tomography (PMCT) and autopsy findings revealed MO of both thighs associated with repeated physical abuse. This case also showed typical findings of MO on PMCT imaging, characterized by well-defined, high-density lesions within the quadriceps. Adults with intellectual disabilities are at high risk of abuse and assault. Therefore, autopsy findings of MO can serve as important evidence in forensic practice, considering the possibility of repeated abuse.
5.Statistical Analysis of Forensic Autopsies in Busan and Gyeongnam: Changes and Characteristics in the Past 10 Years
In-Gyu SON ; Joo-Young NA ; Jin-Haeng HEO ; Jeong-hwa KWON ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):165-174
The cause and manner of death in the Busan and Gyeongnam regions were analyzed using autopsy data performed by the National Forensic Service Busan Institute (NFS BI) for 10 years—from 2014 to 2023. In addition, changes in the number of autopsy cases of elderly individuals aged 65 and older, were analyzed in the Busan and Gyeongnam regions. A total of 6,374 cases were classified, excluding autopsies from the Ulsan area and the Coast Guard, from the NFS BI data. Analysis of the manner of death revealed that 3,203 cases (50.3%) were unnatural deaths; 2,031 cases (31.9%) were natural deaths; and 1,140 cases (17.9%) were deaths of unknown cause. Among the unnatural deaths, accidents were the most common at 1,149 cases (18.0%), followed by suicide at 979 cases (15.4%); and homicide at 583 cases (9.1%). Among natural deaths, heart disease was the most common with 764 cases (37.6%), followed by vascular disease with 351 cases (17.3%). The proportion of the population aged 65 or older in Busan and Gyeongnam has been steadily increasing from 13.7% in 2014 to 21.6% in 2023. Accordingly, the number of autopsies on people aged 65 or older has increased from 72 in 2014 to 174 in 2023, and the number of autopsies on people aged 65 or older accounted for one-quarter of the total number of forensic autopsies commissioned by Busan/Gyeongnam, and performed by NFS BI in 2023. Therefore, we plan to introduce emerging issues relating to population aging and geriatric forensic medicine.
6.Myositis Ossificans of the Thighs Due to Repeated Assault: A Case Report
Jin-Haeng HEO ; Jeong-hwa KWON ; Jang Gyu CHA ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):180-184
Myositis ossificans (MO) is defined as a lesion where abnormal ossification forms in soft tissues, such as muscle, fascia, and ligament, usually as a result of trauma. It commonly appears in areas such as the thigh, hip, and elbow, though it can affect any part of the body. In the forensic field, MO resulting from trauma is reported to be valuable evidence of repeated physical abuse. This case report describes a deceased adult male with an intellectual disability, whose cause of death was multiple injuries from assault. Postmortem computed tomography (PMCT) and autopsy findings revealed MO of both thighs associated with repeated physical abuse. This case also showed typical findings of MO on PMCT imaging, characterized by well-defined, high-density lesions within the quadriceps. Adults with intellectual disabilities are at high risk of abuse and assault. Therefore, autopsy findings of MO can serve as important evidence in forensic practice, considering the possibility of repeated abuse.
7.Statistical Analysis of Forensic Autopsies in Busan and Gyeongnam: Changes and Characteristics in the Past 10 Years
In-Gyu SON ; Joo-Young NA ; Jin-Haeng HEO ; Jeong-hwa KWON ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):165-174
The cause and manner of death in the Busan and Gyeongnam regions were analyzed using autopsy data performed by the National Forensic Service Busan Institute (NFS BI) for 10 years—from 2014 to 2023. In addition, changes in the number of autopsy cases of elderly individuals aged 65 and older, were analyzed in the Busan and Gyeongnam regions. A total of 6,374 cases were classified, excluding autopsies from the Ulsan area and the Coast Guard, from the NFS BI data. Analysis of the manner of death revealed that 3,203 cases (50.3%) were unnatural deaths; 2,031 cases (31.9%) were natural deaths; and 1,140 cases (17.9%) were deaths of unknown cause. Among the unnatural deaths, accidents were the most common at 1,149 cases (18.0%), followed by suicide at 979 cases (15.4%); and homicide at 583 cases (9.1%). Among natural deaths, heart disease was the most common with 764 cases (37.6%), followed by vascular disease with 351 cases (17.3%). The proportion of the population aged 65 or older in Busan and Gyeongnam has been steadily increasing from 13.7% in 2014 to 21.6% in 2023. Accordingly, the number of autopsies on people aged 65 or older has increased from 72 in 2014 to 174 in 2023, and the number of autopsies on people aged 65 or older accounted for one-quarter of the total number of forensic autopsies commissioned by Busan/Gyeongnam, and performed by NFS BI in 2023. Therefore, we plan to introduce emerging issues relating to population aging and geriatric forensic medicine.
8.Myositis Ossificans of the Thighs Due to Repeated Assault: A Case Report
Jin-Haeng HEO ; Jeong-hwa KWON ; Jang Gyu CHA ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):180-184
Myositis ossificans (MO) is defined as a lesion where abnormal ossification forms in soft tissues, such as muscle, fascia, and ligament, usually as a result of trauma. It commonly appears in areas such as the thigh, hip, and elbow, though it can affect any part of the body. In the forensic field, MO resulting from trauma is reported to be valuable evidence of repeated physical abuse. This case report describes a deceased adult male with an intellectual disability, whose cause of death was multiple injuries from assault. Postmortem computed tomography (PMCT) and autopsy findings revealed MO of both thighs associated with repeated physical abuse. This case also showed typical findings of MO on PMCT imaging, characterized by well-defined, high-density lesions within the quadriceps. Adults with intellectual disabilities are at high risk of abuse and assault. Therefore, autopsy findings of MO can serve as important evidence in forensic practice, considering the possibility of repeated abuse.
9.Statistical Analysis of Forensic Autopsies in Busan and Gyeongnam: Changes and Characteristics in the Past 10 Years
In-Gyu SON ; Joo-Young NA ; Jin-Haeng HEO ; Jeong-hwa KWON ; Seon Jung JANG
Korean Journal of Legal Medicine 2024;48(4):165-174
The cause and manner of death in the Busan and Gyeongnam regions were analyzed using autopsy data performed by the National Forensic Service Busan Institute (NFS BI) for 10 years—from 2014 to 2023. In addition, changes in the number of autopsy cases of elderly individuals aged 65 and older, were analyzed in the Busan and Gyeongnam regions. A total of 6,374 cases were classified, excluding autopsies from the Ulsan area and the Coast Guard, from the NFS BI data. Analysis of the manner of death revealed that 3,203 cases (50.3%) were unnatural deaths; 2,031 cases (31.9%) were natural deaths; and 1,140 cases (17.9%) were deaths of unknown cause. Among the unnatural deaths, accidents were the most common at 1,149 cases (18.0%), followed by suicide at 979 cases (15.4%); and homicide at 583 cases (9.1%). Among natural deaths, heart disease was the most common with 764 cases (37.6%), followed by vascular disease with 351 cases (17.3%). The proportion of the population aged 65 or older in Busan and Gyeongnam has been steadily increasing from 13.7% in 2014 to 21.6% in 2023. Accordingly, the number of autopsies on people aged 65 or older has increased from 72 in 2014 to 174 in 2023, and the number of autopsies on people aged 65 or older accounted for one-quarter of the total number of forensic autopsies commissioned by Busan/Gyeongnam, and performed by NFS BI in 2023. Therefore, we plan to introduce emerging issues relating to population aging and geriatric forensic medicine.
10.Postmortem Computed Tomography – Based Body Weight Estimation in Korean Infants Using Volume and Multiplication Factors
Jin-Haeng HEO ; Seon Jung JANG ; Jeong-hwa KWON ; Sang-Beom IM ; Joo-Young NA ; Yongsu YOON ; Young San KO ; Minju LEE ; Se-Min OH ; Sung Wook CHOI ; Sookyoung LEE
Korean Journal of Legal Medicine 2024;48(3):55-60
Postmortem computed tomography (PMCT) is used in forensic medicine worldwide due to its ability to non-invasively visualize injuries, hemorrhage, and estimate volume. In the autopsy of infants, assessing nutritional conditions such as weight is crucial for identifying neglect. This study aims to evaluate the usefulness of retrospectively estimating the weight of Korean infants using PMCT-based volume and multiplication factors, even when the body has been cremated. A total of 44 cases of infant death (under 12 months) were analyzed. PMCT images were obtained before autopsy. Autopsy records and documentation provided by the police at the time of autopsy were reviewed to determine the weight (g) of the infant. PMCT-based infant volumes (mL) were estimated using a three-dimensional semi-automatic segmentation method. Multiplication factors (g/mL) were calculated by dividing the weight recorded at autopsy by the PMCT-based volume, yielding a mean of 1.047 g/mL, ranging from 1.014 g/mL to 1.085 g/mL. The mean absolute error compared to weights recorded at autopsy was 95 g. Significant discrepancies were observed between weights recorded at the scene or medical center and those measured at autopsy. This study demonstrates that PMCT-based weight estimation for Korean infants is a reliable method and has the potential for retrospectively validating incorrect weight measurements and addressing inconsistencies in recorded weight data.

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