• Title/Summary/Keyword: 내시경 검사

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Feature Analysis of Endoscopic Ultrasonography Images (내시경 초음파 영상의 특징 분석)

  • Kim, kwang-beak;Kang, hyo-joo;Kim, mi-jeong;Kim, gwang-ha
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.390-397
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    • 2009
  • Endoscopic ultrasonography is a medical procedure in endoscopy combined with ultrasound to obtain images of the internal organs. It is useful to have a predictive pathological manifestation since a doctor can observe tumors under mucosa. However, it is often subjective to judge the degree of malignant degeneration of tumors. Thus, in this paper, we propose a feature analysis procedure to make the pathological manifestation more objective so as to improve the accuracy and recall of the diagnosis. In the process, we extract the ultrasound region from the image obtained by endoscopic ultrasonography. It is necessary to standardize the intensity of this region with the intensity of water region as a base since frequently found small intensity difference is only to be inefficient in the analysis. Then, we analyze the spot region with high echo and calcium deposited region by applying LVQ algorithm and bit plane partitioning procedure to tumor regions selected by medical expert. For detailed analysis, features such as intensity value, intensity information included within two random points chosen by medical expert in tumor region, and the slant of outline of tumor region in order to decide the degree of malignant degeneration. Such procedure is proven to be helpful for medical experts in tumor analysis.

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Making Differential Diagnosis of Biliary Atresia Using Endoscopy (내시경을 이용한 영아 담즙울체 질환의 감별진단에 대한 연구)

  • Beck, Nam-Seon;Kang, I-Seok;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.71-76
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    • 2001
  • Purpose: Many diagnostic modalities for neonatal cholestasis have shown features that are helpful, however until recently none of them are not pathognomonic of biliary atresia (BA). We carried out a prospective study of infants with cholestatic jaundice with the aim of establishing an efficient method of diagnosing BA. Methods: Twenty-seven consecutive infants with cholestatic jaundice were enrolled in this study and ranged from 7 to 152 days in age (mean; $51.2{\pm}34.2$ days). Gastroduodenoscopy was carried out using a fiberscope (Olympus N30). All the babies were fasted for at least 4 hours before the procedure and 20 ml of 10% dextrose solution was given at the time of endoscopy. The endoscopic examination focused on the 5 minutes observation of the evidence of biliary secretion. If there was lack of the evidence of the biliary secretion, endoscopy was removed and repeated the examination with some pause. Results: There are lack of the evidence of biliary secretion in all infants with BA. In non-BA group, 8 out of the 10 infants showed biliary secretion on the first trial, however one (Alagille syndrome) of the two infants without evidence of biliary secretion, finally exhibited biliary secretion on the second trial. The above observations resulted in the diagnostic accuracy of 96.3% with 100.0% sensitivity and 90.0% specificity. Conclusion: In light of the results from our relatively small study, endoscopy is a convenient, and relative inexpensive procedure. we strongly support the use of endoscopy for the diagnosis of BA in the screening and evaluation of infantile cholestasis.

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Gastrointestinal Mucosal Lesions in Children with Short-Term Abdominal Pain (급성 복통을 호소하는 환아에서 위장관 점막병변에 관한 연구)

  • Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.176-182
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    • 2006
  • Purpose: The aim of this study was to investigate the spectrum of gastrointestinal mucosal lesions in the children presenting with short-term abdominal pain. Methods: Thirty one children with short term abdominal pain for less than 1 month from January 1995 to May 2004 who were examined using gastrointestinal (GI) endoscopy were reviewed retrospectively. Children presenting with acute abdominal pain unrelated to proper GI were excluded from this study. Results: Male patients were 16 and female were 15. Three patients were 1~5 years old, 15 were 6~10 years old, and 13 were 11~15 years old. The duration of the abdominal pain was less than 7 days in 23 patients, 10 days in 1, 20 days in 2, and 30 days in 4. The major accompanying symptoms were vomiting (15), diarrhea (4), melena (1), hematemesis (1), and fever (2). Using endoscopy, 6 patients were found to have hemorrhagic gastritis, 5 nodular gastritis, 4 duodenal ulcer, 3 gastric ulcer, 3 reflux esophagitis, 2 nodular duodenitis, 2 superficial gastritis, 2 erosive hemorrhagic duodenitis, 2 ulcerative colitis, 1 duodenogastric reflux, and 1 esophageal polyp. Helicobacter pylori (H. pylori) infection was positive in 10 patients. The age and sex ratio, duration of abdominal pain, site of abdominal pain, and duration of abdominal pain between H. pylori- positive and negative children were different. However, only the site of abdominal pain (epigastric) showed statistical significance. All symptoms improved with medication for the GI mucosal lesions noted by the endoscopic findings. Conclusion: The author suggests that GI endoscopy be one of the important first steps in examinations to find out diverse GI mucosal lesions in the patients with short-term abdominal pain. Additionally, the examinations for H. pylori infection are important for these patients, also.

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Clinical and Histopathologic Features and Their Correlations in Children with Nodular Duodenitis (소아 결절성 십이지장염의 임상적 및 조직병리학적 소견)

  • Tchah, Hann;Paeng, Sung-Suk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.151-159
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    • 2000
  • Purpose: Recently, a wide application of gastrofiberscopy in the pediatric group have revealed that nodular duodenitis is not an uncommon disease in children and is suspected to be associated with H. pylori infection. The aim of this retrospective study was to investigate the clinical and histopathologic features in children with nodular duodenitis, and to assess the correlations beween both. Methods: During a period of 5 years (Jan. 1995~Dec. 1999), we investigated clinical, endoscopic and histopathologic features of 39 consecutive patients diagnosed as having nodular duodenitis at Pediatric department of Seoul Red Cross Hospital. In 35 children with nodular duodenitis endoscopic biopsy specimens were stained with Hematoxylin & Eosin and Giemsa's stain, and were graded according to the criteria outlined by Triadafilopoulos, Whitehead et al., and Prieto et al.. Statistical analyses were performed with Graph PAD InStat. Results: The prevalence rate of nodular duodenitis was 17.1% and the most frequent chief complaint was abdominal pain (69.2%). Endoscopically grade 1 was the most common (45.7%) and nodular gastritis was coexistent in 28.3%. The most common histology of the duodenum was grade 2 (54.3%), and the most common histologic score of the stomach was 2 (42.9%). H. pylori was found in the duodenum in 37.1%, and in the stomach in 31.4%. The correlation coefficient between the endoscopic grade and the histologic grade of nodular duodenitis was 0.3983 (p=0.0178). And the correlation coefficient between the histologic grade and the grade of H. pylori colonization in the duodenum was 0.5154 (p=0.0018). Conclusion: There was significant correlation between the endoscopic grade and the histologic grade of nodular duodenitis, and was also significant correlation between the histologic grade and the grade of H. pylori colonization in the duodenum. Therfore H. pylori infection should be regarded as an etiologic factor of nodular duodenitis.

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The Clinical and Histopathologic Findings of Lymphonodular Hyperplasia of the Colon in Infancy and Childhood (소아에서 대장 림프결절증식의 임상적 및 병리조직학적 소견)

  • Nam, Yoo-Nee;Lee, Seung-Hyeon;Chung, Dong-Hae;Sim, So-Yeon;Eun, Byung-Wook;Choi, Deok-Young;Sun, Yong-Han;Cho, Kang-Ho;Ryoo, Eell;Son, Dong-Woo;Jeon, In-Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.1-9
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    • 2009
  • Purpose: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC. Methods: We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up. Results: The mean age of the patients was 12.5${\pm}$14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients. Conclusion: LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.

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Gastric Extramedullary Plasmacytoma in a Dog (개의 위에서 발생한 골수외 형질세포종)

  • Chae, Woong-Joo;Kwon, Do-Hyoung;Kwon, Jin-A;Kim, Jae-Hoon;Jung, Joo-Hyun
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.356-359
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    • 2012
  • An eight-year-old, spayed female Shih-tzu, weighing 3.2 kg with a history of chronic intermittent vomiting and unknown pain for four months was referred. In ultrasonography, a small round hypoechoic mass was identified in the gastric wall. Gastric endoscopy showed a solitary raised mass with smooth surface in the pyloric antrum. Surgical resection was performed. Histopathologic findings with immunohistochemical studies showed extramedullary plasmacytoma in the gastric submucosal and muscle wall layer. The patient recovered normally without any complications. The tumor has not been re-occurred after surgical removal, to date.

Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.576-584
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    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

Health Zone_4050 멋지게 - 가슴 답답한데 소화기내과로 가는 이유는? 역류성 식도염

  • Min, Yeong-Il
    • 건강소식
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    • v.36 no.5
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    • pp.20-22
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    • 2012
  • 중소기업에 다니는 40대 중반의 남성은 얼마 전부터 종종 가슴이 화끈거리는 불쾌한 통증과 함께, 목과 가슴 사이에 복숭아씨가 걸려있는 듯한 답답함을 느꼈다. 혹시나 심장에 이상이 있는 것이 아닌지 검사를 해보았지만, 결과는 정상이었다. 이리저리 알아보다 위액이 역류하는 경우에도 비슷한 증상이 있을 수 있다는 정보를 얻고 소화기내과를 찾았고, 내시경 검사 결과 역류성 식도염 진단을 받았다.

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Endoscopic Bio-Imaging Using Optical Coherence Tomography (마이크로 내시경 및 첨단 광 단층촬영기법을 이용한 생체 이미징)

  • Ahn, Yeh-Chan;Brenner, Matthew;Chen, Zhongping
    • Journal of the Korean Society for Nondestructive Testing
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    • v.31 no.5
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    • pp.466-471
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    • 2011
  • Optical coherence tomography(OCT) is an emerging medical diagnostic tool that draws great attention in medical and biological fields. It has a 10-100 times higher spatial resolution than that of the clinical ultrasound but lower imaging depth such as 1-2 mm. In order to image internal organs, OCT needs an endoscopic probe. In this paper, the principle of Fourier-domain optical coherence tomography with high-speed imaging capability was introduced. An OCT endoscope based on MEMS technology was developed. It was attached to the Fourier-domain OCT system to acquire three-dimensional tomographic images of gastrointestinal tract of New Zealand white rabbit. The endoscope had a two-axis scanning mirror that was driven by electrostatic force. The mirror stirred an incident light to sweep two-dimensional plane by scanning. The outer diameter of the endoscope was 6 mm and the mirror diameter was 1.2 mm. A three-dimensional image rendered by 200 two-dimensional tomographs with $200{\times}500$ pixels was displayed within 3.5 seconds. The spatial resolution of the OCT system was 8 ${\mu}m$ in air.