Endoscopic Treatment of Gastric Bezoars: A Report of Three Cases

Younghee Choe,Joon Sung Kim,Byung-Wook Kim 대한상부위장관ㆍ헬리코박터학회 2024 Korean Journal of Helicobacter Upper Gastrointesti Vol.24 No.3

Bezoars, including phytobezoars, trichobezoars, and pharmacobezoars, are accumulations of undigested substances in the gastrointestinal tract. We report three cases of gastric bezoars. Case 1: An 86-year-old woman presented with a one-month history of abdominal pain and vomiting. Esophagogastroduodenoscopy revealed gastric bezoars; consumption of 2 L of cola daily for 2 weeks resulted in complete disappearance of the bezoars. Case 2: An asymptomatic 63-year-old woman underwent esophagogastroduodenoscopy, which revealed a gastric bezoar. Cola spraying and endoscopic lithotomy were ineffective; therefore, the patient underwent laparoscopic removal of the bezoar for management of small bowel obstruction secondary to the bezoar fragments. Case 3: A 6-year-old girl with a history of pica underwent two laparoscopic surgeries 10 months apart for recurrent trichobezoars. We report our treatment approach in three patients who presented with gastric bezoars.

Eating Behavior in Functional Dyspepsia

Younghee Choe,Kyung Ho Song 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.3

비만 치료를 위한 위풍선 삽입술의 단기 치료 성적

Younghee Choe,김준성,김병욱 대한상부위장관ㆍ헬리코박터학회 2020 Korean Journal of Helicobacter Upper Gastrointesti Vol.20 No.4

Endoscopic treatment for obesity, especially intragastric balloon insertion, is on the rise in Korea. From 2016 to 2019, we performed intragastric balloon placement for the treatment of obesity in 12 patients at a single tertiary center. One balloon was removed on the next day due to nausea and severe abdominal pain, and the remaining 11 patients were followed up for 6 months. Body weight reduction of 8.9±5.4 kg was achieved, and the body mass index was reduced by 3.3±2.0 kg/m². Significant effects regarding total body weight loss and excess weight loss were noted. The effect of weight reduction was greatest within 1 month after the procedure. Low density lipoprotein cholesterol significantly decreased by 18.0±18.2 mg/dL, but there were no significant changes in blood pressure, fasting blood glucose, total cholesterol, triglyceride, and high density lipoprotein cholesterol. Common adverse events were nausea and epigastric pain, but no serious adverse events occurred. Further studies regarding the long-term effects of endoscopic treatment for obesity and the improvement of metabolic syndrome are needed.

Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study

Younghee Choe,Yu Kyung Cho,Gwang Ha Kim,Jun-Ho Choi,Eun Soo Kim,Ji Hyun Kim,Eun Kwang Choi,Tae Hyeon Kim,Seong-Hun Kim,Do Hoon Kim 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.6

Background/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the uppergastrointestinal (UGI) tract. Methods: The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals betweenJanuary and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. Results: UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions,1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequentlyfound in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients(28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The pro-portions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastricSELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. Conclusions: The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed byEUS and clinical decisions without initial pathological confirmation.

Antibiotic Resistance and Helicobacter pylori Eradication Therapy

Younghee Choe 대한상부위장관ㆍ헬리코박터학회 2023 Korean Journal of Helicobacter Upper Gastrointesti Vol.23 No.3

Factors influencing occurrence of metachronous gastric cancer after endoscopic resection: a systematic review and meta-analysis

Younghee Choe,Jae Myung Park,Joon Sung Kim,Yu Kyung Cho,Byung-Wook Kim,Myung-Gyu Choi 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.6

Background/Aims: Metachronous gastric cancer (MGC) can occur after endoscopic resection for gastric cancer. Further studies on factors other than Helicobacter pylori infection are needed. This systematic review and meta-analysis aimed to evaluate risk factors for metachronous recurrence of endoscopically resected gastric cancer. Methods: We searched medical literature published by February 2023 and identified patients with MGC after endoscopic resection for gastric cancer. The occurrence of MGC and the presence of intestinal metaplasia (IM), severe atrophic gastritis (AG), and H. pylori infection were quantitatively analyzed. Results: We identified 2,755 patients from nine cohort studies who underwent endoscopic resection for gastric cancer by 2018. Those with severe AG or presence of IM had a significantly higher incidence of MGC than those without (RR 2.00, 95% CI 1.35–2.98, I2 = 52% for severe atrophy on antrum; RR 7.08, 95% CI 3.63–13.80, I2 = 0% for antral IM). Absolute risk difference of MGC occurrence was 7.1% in those with severe AG and 9.2% in those with IM. The difference in incidence rate per 1,000 person-years was 17.5 person-years for those with severe AG and 24.7 person-years for those with IM. However, H. pylori eradication did not significantly affect the occurrence of MGC (RR 1.18, 95% CI 0.88–1.59, I2 = 10%). Conclusions: Gastric cancer patients with severe AG or presence of IM had a 2.0-fold or 7.0-fold higher risk of MGC occurrence after endoscopic resection than those without, respectively. They need more stringent follow-up to monitor MGC occurrences (CRD42023410940).

비만과 상부 위장관 질환

최영희 ( Younghee Choe ) 대한소화기학회 2024 대한소화기학회지 Vol.83 No.3

Obesity increases gastroesophageal reflux disease through several factors. As a result, Barrett's esophagus, esophageal adenocarcinoma, and gastroesophageal junctional gastric cancer are increasing. Existing studies usually defined obesity by body mass index and analyzed the correlation. Recently, more studies have shown that central obesity is a more important variable in upper gastrointestinal diseases related to gastroesophageal reflux. Studies have reported that weight loss is effective in reducing gastroesophageal reflux symptoms. Obesity also affects functional gastrointestinal diseases. A significant correlation was shown in upper abdominal pain, reflux, vomiting, and diarrhea rather than lower abdominal diseases. (Korean J Gastroenterol 2024;83:81-86)

학업중단 청소년의 심리사회적 적응과정

김영희(Kim, Younghee),최보영(Choe, Boyoung) 한국청소년정책연구원 2015 한국청소년연구 Vol.26 No.2

본 연구는 학업중단 청소년의 심리사회적 적응과정을 탐색하였다. 이를 위하여 정규 중ㆍ고등학교를 그만 둔 후 1년 이상 경과하였고 제도권 내로 복교하지 않은 청소년 42명으로부터 자료를 수집하여 근거이론접근 방법(Strauss & Corbin, 1998)으로 분석하였다. 그 결과를 요약하면 다음과 같다. 첫째, 개방코딩 결과 151개의 개념과 46개의 하위범주, 그리고 15개의 범주가 도출되었다. 둘째, 근거이론의 패러다임에 의거하여 개방코딩에서 도출된 범주들 간의 관련성을 분석한 결과 참여자들이 적응과정에서 겪는 중심현상은 ‘예지적 불안’과 ‘현상적 두려움’이었으며, 인과적 조건은 ‘동기화’와 ‘트라우마’, ‘비행’이었다. 중심현상에 대한 맥락적 조건은 ‘의지력’과 ‘관계 경험’이었고 중재적 조건은 ‘지원혜택 누림’과 ‘자극’, ‘개인 내적변인’이었으며, 중심현상을 조절하기 위한 작용/상호작용 전략은 ‘도전하기’와 ‘탈출하기’, ‘시도하지 않기’였다. 그 결과는 ‘성장’과 ‘미해결’로 나타났다. 셋째, 과정분석 결과 참여자들은 ‘방종단계’ ‘자각단계’ ‘변화시도 단계’ ‘재정립 단계’ ‘도약단계’를 거쳐 적응수준을 높여갔으며, 변화시도 단계에서 시행착오에 적절하게 대응을 못할 땐 안주단계에 머물렀다. 이들의 적응과정을 대변하는 핵심범주는 ‘불안조절을 통한 정체성 확립이었다. 본 연구결과는 학업중단 청소년에 대한 이해를 돕고 그들의 적응수준을 효과적으로 높일 수 있는 이론적 근거를 제공했다는 점에서 의의를 갖는다. This study explored the psycho-social adjustment process of adolescent dropouts. Qualitative data collected from 42 youths had spent more than one year since dropping out of a regular middle or high school were analyzed making use of a grounded theory approach. Open coding identified 151 concepts and 46 subcategories, and 15 categories. Adolescent dropouts experienced ‘precognitive anxiety’ and ‘fear for their current situation’ due to the causal conditions of ‘motivation’, ‘trauma’ and ‘delinquency’. The contextual factors were ‘willpower’ and ‘relationships’ and the intervening conditions were ‘receiving support’, ‘stimuli’ and ‘interindividual factors’. The action/interaction strategies to regulate the main phenomena were ‘presenting challenges’, ‘escaping’, or ‘not trying’. The consequence of using such strategies was either ‘growth’ or ‘being unsettled’. The participants were seen to experience growth through the stages of ‘self-indulgence’, ‘awakening’, ‘attempts to change’, ‘reestablishment’, and ‘taking-off’. On the other hand, at the stage of ‘attempts to change’, adolescent dropouts who failed to respond adequately remained in the ‘complacency stage’ with unsolved problems. The main category for the adjustment process was the ‘establishment of identity through anxiety control’. These findings could serve as a basis for developing intervention strategies to help adolescent dropouts and contribute to the expansion of the knowledge base on the phenomena of dropping out among adolescents.

Case 19: A 65-Year-Old Man With Melena and Hematochezia

Lee Hajin,Choe Younghee,Heo Jung,Park Gwkang Hui,Lee Su Young,Cho Young Wook,Kim Hyo Suk 대한의학회 2024 Journal of Korean medical science Vol.39 No.6

IMAGE OF INTEREST : Widespread intracranial calcifications in a patient with hypoparathyroidism

( Jeong Young Seo ),( Ju Hyun Seo ),( Younghee Choe ),( Hannah Seok ),( Tae Seo Sohn ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.2