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Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer 被引量:3
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作者 Ji Eun Na Yeong Chan lee +7 位作者 Tae Jun Kim hyuk lee Hong-Hee Won Yang Won Min Byung-Hoon Min Jun Haeng lee Poong-Lyul Rhee Jae J Kim 《World Journal of Gastroenterology》 SCIE CAS 2022年第24期2721-2732,共12页
BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection(ESD)in early gastric cancer(EGC)patients.There are limited studies on estimating the bleeding risk after ESD using an artifi... BACKGROUND Bleeding is one of the major complications after endoscopic submucosal dissection(ESD)in early gastric cancer(EGC)patients.There are limited studies on estimating the bleeding risk after ESD using an artificial intelligence system.AIM To derivate and verify the performance of the deep learning model and the clinical model for predicting bleeding risk after ESD in EGC patients.METHODS Patients with EGC who underwent ESD between January 2010 and June 2020 at the Samsung Medical Center were enrolled,and post-ESD bleeding(PEB)was investigated retrospectively.We split the entire cohort into a development set(80%)and a validation set(20%).The deep learning and clinical model were built on the development set and tested in the validation set.The performance of the deep learning model and the clinical model were compared using the area under the curve and the stratification of bleeding risk after ESD.RESULTS A total of 5629 patients were included,and PEB occurred in 325 patients.The area under the curve for predicting PEB was 0.71(95%confidence interval:0.63-0.78)in the deep learning model and 0.70(95%confidence interval:0.62-0.77)in the clinical model,without significant difference(P=0.730).The patients expected to the low-(<5%),intermediate-(≥5%,<9%),and high-risk(≥9%)categories were observed with actual bleeding rate of 2.2%,3.9%,and 11.6%,respectively,in the deep learning model;4.0%,8.8%,and 18.2%,respectively,in the clinical model.CONCLUSION A deep learning model can predict and stratify the bleeding risk after ESD in patients with EGC. 展开更多
关键词 Clinical model Deep learning model Post-endoscopic submucosal dissection bleeding Stratification of bleeding risk
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Superiority of split dose midazolam as conscious sedation for outpatient colonoscopy 被引量:12
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作者 hyuk lee Jeong Hwan Kim 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第30期3783-3787,共5页
AIM: To elucidate the efficacy and safety of a split dose of midazolam in combination with meperidine for colonoscopy. METHODS: Eighty subjects undergoing outpatient colonoscopy were randomly assigned to group A or B.... AIM: To elucidate the efficacy and safety of a split dose of midazolam in combination with meperidine for colonoscopy. METHODS: Eighty subjects undergoing outpatient colonoscopy were randomly assigned to group A or B. Group A (n = 40) received a split dose of midazolam in combination with meperidine. Group B (n = 40) received a single dose of midazolam in combination with meperidine. Outcome measurements were level of sedation, duration of sedation and recovery, degree of pain and satisfaction, procedure-related memory, controllability, and adverse events. RESULTS: Group A had a lower frequency of significant hypoxemia (P = 0.043) and a higher sedation score on withdrawal of the endoscope from the descending colon than group B (P = 0.043). Group B recovered from sedation slightly sooner than group A (P < 0.002). Scores for pain and memory, except insertion-related memory, were lower in group A one week after colonoscopic examination (P = 0.018 and P < 0.030, respectively). Poor patient controllability was noted by the endoscopist and nurse in group B (P = 0.038 and P = 0.032, respectively). CONCLUSION: Split dose midazolam in combination with meperidine resulted in a safer, more equable sedation status during colonoscopic examination and a reduction in procedure-related pain and memory, but resulted in longer recovery time. 展开更多
关键词 AMNESIA COLONOSCOPY Conscious sedation MIDAZOLAM
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Impact of tumor location on clinical outcomes of gastric endoscopic submucosal dissection 被引量:10
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作者 Ji Young Yoon Choong Nam Shim +7 位作者 Sook Hee Chung Wan Park Hyunsoo Chung hyuk lee Sung Kwan Shin Sang Kil lee Yong Chan lee Jun Chul Park 《World Journal of Gastroenterology》 SCIE CAS 2014年第26期8631-8637,共7页
AIM: To determine whether there is a correlation between the location of the lesion and endoscopic submucosal dissection (ESD) outcome.
关键词 Endoscopic submucosal dissection Gastric neoplasm LOCATION COMPLICATION OUTCOMES
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Low-dose amitriptyline combined with proton pump inhibitor for functional chest pain
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作者 Se Woo Park hyuk lee +5 位作者 Hyun Jik lee Jun Chul Park Sung Kwan Shin Sang Kil lee Yong Chan lee Ji Eun Kim 《World Journal of Gastroenterology》 SCIE CAS 2013年第30期4958-4965,共8页
AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose ami... AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose amitriptyline(10 mg at bedtime)to a conventional dose of rabeprazole(20 mg/d)(group A,n = 20)vs a double-dose of rabeprazole(20 mg twice daily)(group B,n = 20)for patients with FCP whose symptoms were refractory to PPI.The primary efficacy endpoints were assessed by global symptom score assessment and the total number of individuals with > 50% improvement in their symptom score.RESULTS:The between-group difference in global symptom scores was statistically significant during the last week of treatment(overall mean difference;3.75 ± 0.31 vs 4.35 ± 0.29,the between-group difference;P < 0.001).Furthermore,70.6% of patients in group A had their symptoms improve by > 50%,whereas only 26.3% of patients in group B had a similar treatment response(70.6% vs 26.3%,P = 0.008).Specifically,patients in group A had a significantly greater improvement in the domains of body pain and general health perception than did patients in group B(52.37 ± 17.00 vs 41.32 ± 12.34,P = 0.031 and 47.95 ± 18.58 vs 31.84 ± 16.84,P = 0.01,respectively).CONCLUSION:Adding amitriptyline to a PPI was more effective than a double-dose of PPI in patients with FCP refractory to a conventional dose of PPI. 展开更多
关键词 FUNCTIONAL CHEST PAIN PROTON pump inhibitor AMITRIPTYLINE
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Unexpected anterograde amnesia associated with Buscopan used as a predmedication for endocscopy
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作者 hyuk lee Hee Jung Son +2 位作者 Poong-Lyul Rhee Jae J Kim Jong Chul Rhee 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第28期3895-3896,共2页
It has been known that peripheral adverse event is caused by peripheral antimuscarinic action, from hyoscine butylbromide (Buscopan; Boehringer Ingelheim, Germany) used as a premedication for endoscopy. However, sympt... It has been known that peripheral adverse event is caused by peripheral antimuscarinic action, from hyoscine butylbromide (Buscopan; Boehringer Ingelheim, Germany) used as a premedication for endoscopy. However, symptoms or signs associated with the central nervous system are rarely reported in the field of anesthesiology and peripartum labor. This central anticholinergic syndrome is likely caused by blockade of muscarinic cholinergic receptors in the central nervous system. There is no report on Buscopan-induced central anticholinergic syndrome in endoscopy room so far. Three middle-aged females unexpectedly suffered from anterograde amnesia after intramuscular injection of hyoscine butylbromide as an antispasmodic premedication for endoscopy at our endoscopy unit in the Health Promotion Center. 展开更多
关键词 ENDOSCOPY Hyoscine butylbromide Central anticholinergic syndrome AMNESIA
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