• Title/Summary/Keyword: 내시경 검사

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Clinical Evaluation on Transbronchial Needle Aspiration (TBNA) of Subcarinal Lymph Node in Lung Cancer (폐암에서 기관 분기부하 림프절의 경기관지 침흡인 세포검사에 관한 연구)

  • Kang, Yu-Ho;Choi, In-Seon;Jung, Ik-Ju;Park, Jai-Hee;Lee, Shin-Seok;Lee, Min-Su;Kim, Young-Cheol;Park, Kyung-Ok;Jung, Sang-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.177-184
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    • 1993
  • Background: Accurate staging of bronchogenic carcinoma is important in determining resectability and metastasis of tumor to the subcarinal nodes is generally believed to indicate poor prognosis. The technique of Transbronchial needle aspiration (TBNA) has offered a safe & effective way to asscess mediastinal lymph node involvement in the staging of lung cancer. We performed TBNA in patients who were suspected lung cancer to evaluate the clinical usefulness of the TBNA. Method: TBNA of the subcarinal lymph node was performed at the time of initial diagnostic bronchoscopy in 60 patients with suspected lung cancer, and 42 cases of histologically proved bronchogenic cancer were analized. Results: The frequency of adequate samples by transbronchial needle aspiration (TBNA) was 81% and the positive rate of malignant cells by TBNA was 14.7%. There were no differences in positive rates by tumor cell types. In patients with thickened carina on bronchoscopy, the TBNA was positive in 33.3% as compared to 5.3% of normal carina on bronchoscopy, and the difference was statistically significant (p<0.05). In patients with enlarged subcarinal lymph node on chest CT, the positive rate of malignant cells (50.0%) was higher than that of normal sized subcarinal lymph node on chest CT (4.8%) (p<0.01). There were no specific complications in the TBNA procedure. Conclusion: TBNA is a relatively safe procedure and it offers the possibility of avoiding the cost and morbidity of surgical staging in patients especially whose carina is thickened on bronchoscopy and whose subcarinal LN was enlarged on chest CT.

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The Study on a Various Parameter for the CT Test and the Patients-Anxiety of Factor Related (CT검사 시 다양한 매개변수와 환자의 불안 요인에 관한 연구)

  • Baek, Cheol-Oh;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.34 no.2
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    • pp.149-156
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    • 2011
  • This study is to identify perceptions and response degrees of anxiety for each factor, targeting patients for CT test and analyze the relations between factors. It is to provide scientific fundamental data to reduce anxiety by improving awareness of patients about CT test by analyzing relations between variables. The subjects of this study were surveyed in self-writing type, targeting 263 patients for CT test in the department of radiology at three University hospitals from July to September, 2010. This survey was executed once by a structured self-administered survey type. The targeting patients for CT test of anxiety will investigate for affect. Anxiety by each CT test variables depending on CT test-related features showed independent variable is Expense Responsibility, Economic burden, Sufficient explain, Explain agent, Endoscope, Biopsy, Pre treatment, Previous experience, CT side effect experience, Side effect of contrast medium and dependent variable is physical, Hospital staff, Hospital environment, Socioeconomic These used statistics program SPSS (ver. 13.0). Summarizing the above results of this study, awareness of anxiety and response to it in each variable under CT test appeared significant differences in economic burdens, state anxiety, pre-treatment anxiety, exposure anxiety to radiation, and anxiety of side effect. Therefore, pre-treatment before test and pre-training programs on chemical poison of contrast medium and side effect seem to be able to release patients' anxiety level for CT test. Ways to meditate these anxiety variables and reduce degree of anxiety are needed to be researched more and updated. In addition, impact of patients' economic burdens on CT test anxiety is required to be recognized and solved in society level.

Colonic Uptake Patterns of F-18-FDG PET in Asymptomatic Adults: Comparison with Colonoscopic Findings (무증상 성인의 F-18-FDG PET 대장 섭취양상 : 대장내시경 소견과의 비교)

  • Pai, Moon-Sun;Cho, Yoo-Kyung;Jung, Sung-Ae;Shim, Ki-Nam;Lee, Hong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.15-20
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    • 2005
  • Purpose: Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. Materials and Methods: We reviewed retrospectively 64 subjects (age: 27-87, M:F=31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. Results: In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter=5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: $1.7{\pm}0.1\;vs.\;1.9{\pm}0.5$, Segmental: $4.8{\pm}3.6\;vs.\;4.2{\pm}1.2$, Focal: $6.5{\pm}4.7\;vs.\;3.5{\pm}1.3$). large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV ($6.3{\pm}4.8$) than small adenomas ($3.5{\pm}3.0$) (statistically insignificant). Conclusion: focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal.

A Case of Giant Gastric Schwannoma Accompanied with Bleeding (출혈을 동반한 거대 위 신경초종 1예)

  • Kim, Je-Yeon;An, Ji-Yeong;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.47-51
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    • 2006
  • The origin of a submucosal tumor is difficult to determine by endoscopic biopsy. One type of submucosal tumor, which originates in Schwann cell, a schwannoma represents 0.2% of all gastric tumors. We experienced the case of a 57-year-old female patient with a gastric schwannoma presenting with melena and anemia. Computed tomography and upper gastrointestinal endoscopy showed a protruded huge mass from 3 cm below the cardia to angle. Seven endoscopic biopsies indicated only necrotic debri and granulation tissue, chronic gastritis. Because we suspected an advanced gastric cancer, or lymphoma with bleeding, It was performed an operation for an exact diagnosis and a treatment for bleeding. A-post-operative histopathological, immunohistochemical examination led to the final diagnosis of a gastric schwannoma.

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The Guideline for Colorectal Cancer Screening (대장암 선별검사 권고안)

  • Dong Il Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.17-20
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    • 2016
  • Colorectal cancer is the 2nd most common cancer in men, and the 3rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

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Effect of One- or Two-Week Triple Therapy with Omeprazole, Amoxicillin, and Clarithromycin on Eradication of Helicobacter pylori Infection in Children (소아에서 Omeprazole, Amoxicillin, Clarithromycin 삼제 병합 요법의 치료기간별 Helicobacter pylori 제균율)

  • Choi, In-Kyoung;Lee, Seung-Yun;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.19-25
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    • 2002
  • Purpose: The triple therapy with proton pump inhibitor (PPI) has been recognized as the treatment of choice in Helicobacter pylori (H. pylori) infection in adults. However, the effect of triple therapy with omeprazole, amoxicillin and clarithromycin (OAC) on eradication of H. pylori infection in children has not been established yet. This study was performed to evaluate the efficacy of OAC triple therapy and to compare the effect of one-week with two-week therapy on H. pylori eradication. Methods: From July 1998 to July 2000, 34 children with upper gastrointestinal symptoms, who underwent upper gastrointestinal endoscopy with biopsy at entry and 4 or more weeks after therapy, were enrolled in this study. H. pylori infection was assessed by CLO test and histologic examination (Hematoxylin-Eosin stain or Alcian yellow stain) with biopsy specimens. The regimen consisted of omeprazole (0.7 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (25 mg/kg/day) for 1 week (n=21) or 2 weeks (n=13). Eradication of H. pylori was determined after the termination of treatment by the CLO test and histologic examination. Results: One-week treatment group consisted of 21 children (11 male, 10 female) with a mean age of $9.5{\pm}3.0$ years. Two-week group consisted of 13 children (4 male, 9 female) with a mean age of $9.9{\pm}4.0$ years. The endoscopic diagnoses included nodular gastritis in 19 cases, superficial gastritis in 7 cases, gastric ulcer in 4 cases, purpuric duodenitis in 2 cases, and normal in 2 cases. H. pylori was eradicated in 28 of total 34 children (82.4%). In 1-week group, H. pylori was eradicated in 17 of 21 children (81%). In 2-week group, H. pylori was eradicated in 11 of 13 children (84.6%). In remaining 6 cases in whom H. pylori had not been eradicated with OAC regimen, H. pylori infection persisted despite of the treatment with additional drugs such as colloidal bismuth subcitrate ($Denol^{(R)}$) and metronidazole. Conclusion: In this study, eradication rate of H. pylori with OAC regimen was 82.4%, and the triple therapy would be highly effective as primary treatment. However, there was no significant difference in the eradication rate between the 1-week and 2-week treatment group (P=0.785).

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Gastrointestinal Foreign Bodies: Review of 96 Cases (소아의 위장관 이물에 대한 고찰)

  • Lee, Min-Rye;Kang, Ki-Su;Jung, Hae-Sung;Seo, Ji-Hyoun;Lim, Jae-Young;Park, Chan-Hoo;Choi, Myoung-Bum;Woo, Hyang-Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.136-142
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    • 2002
  • Purpose: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. Methods: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. Results: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. Conclusion: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.

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The Effects of Aromatherapy Hand Massage on Anxiety before Gastroscopy (아로마테라피 손마사지가 위내시경 대상자의 검사 전 불안에 미치는 효과)

  • Lee, Hea-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.12 no.1
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    • pp.36-42
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    • 2006
  • Purpose: The purpose of this study was to verify the effect of aromatherapy hand massage on the anxiety of gastroscopy clients. Method: The data were collected during the period from March 10 to May 20, 2004 at S-Hospital in Kyungi-Do. There were sixty subjects, 30 for the experimental and 30 for the control group. The data were analyzed by descriptive statistics, t-test, $X^2$-test and paired t-test with SPSS program. Result: The pulse rate was reduced significantly, but there were no significant differences in the systolic and diastolic blood pressure between two groups. The status anxiety of experimental group was lower than the control group, but there was no significant difference statistically. Conclusion: Aromatherapy could be useful in the nursing practice, and be utilized as a way of nursing intervention to reduce anxiety of the client in specific clinical situations.

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MEASURING OF SOFT PALATE FOR EFFECTIVE PALATOPHARYNGOPLASTY (성공적 구개인두성형술을 위한 구인두궁 측정법)

  • 이준희;이상덕;남순열;박재훈
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.23-23
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    • 1991
  • 구개인두성형술이 코골음과 수면무호흡증에 유용한 수술적 방법으로 널리 이용되고 있으나 코골음과 수면무호흡증의 유발기전이 어리기지 복합적인 원인에 의하므로 구개인두성형술의 적응증을 결정하는데 많은 어려움이 있어, 수술전에 이 방법의 적응이 되는 환자를 보다 정확히 선택함이 중요하므로 많은 사람들에 의하여 주된 병변부위를 검시하는 방법들이 시행되어 왔다. 예를 들면 Mueller maneuver 중 내시경검사, Cephalometrics, polysomnogram, Multiple sleep latency test, CT scan 등의 방법이 환자선택에 이용되었다. 저자들은 비교적 쉽고 경비가 들지 않는 술전 검사법으로 양 후구치봉선(retromolar raphe)을 연결하는 선상에서 구인두궁 (soft palate arch)의 길이를 비교하는 방법을 총 89례에 적용 시행하여 그중 추적관찰이 가능한 46례에서 코골음은 86%, 수면무호흡증은 82%에서 자각적 증상의 개선이 있었기에 구개인두성형술을 시행함에 있어 양 후구치봉선거리와 구인두궁 거리를 비교하는 방법이 간단하고 경제적인 술전 진단방법으로 사료되어 문헌고찰과 함께 보고하는 바이다.

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Endobronchial Metastasis from Renal Cell Carcinoma -A case report- (신장세포암의 기관지내 전이 - 1예 보고 -)

  • Kim, Si-Wook;Shin, Yoon-Mi
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.386-389
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    • 2008
  • Lung parenchyma is a common organ for metastases of extrathoracic tumors, but endobronchial metastasis is very rare. In this report, we present a case of endobronchial metastases from renal cell carcinoma (RCC), and this was managed by performing operative resection. A 63-year-old man presented with frequent dry cough; he had previously undergone left nephrectomy and postoperative chemotherapy for grade 2 RCC eight years ago. Computed tomography and bronchoscopy showed an endobronchial tumor from the left lower lobe bronchus to the second carina, and this mass was diagnosed as a necrotic tissue with chronic inflammation at biopsy. During the operation, the mass was revealed to be a metastatic renal cell carcinoma on the frozen section diagnosis and there was no mucosal invasion on the resection margin of the left lower lobe bronchus. We performed lobectomy of the left lower lobe with systemic dissection of the mediastinal lymph nodes. The final histopathologic diagnosis of the endobrochial mass was metastatic RCC and any mediastinal lymph node metastasis was not found. The patient was discharged on postoperative day 10 without any postoperative complications.