• Title/Summary/Keyword: 내시경 검사

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Injury of the Medial Rectus Muscle by Using a Microdebrider During Endoscopic Sinus Surgery: A Case Report

  • Choi, Yoon-Seok;Bai, Chang-Hoon;Song, Si-Youn;Kim, Yong-Dae
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.240-246
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    • 2006
  • A microdebrider is increasingly used in endoscopic sinus surgery. Although it has many advantages over conventional instruments, it has been associated with severe complications. We treated a case of rupture of the left medial rectus muscle after use of a microdebrider during endoscopic sinus surgery in a 50 year-old female patient who complained of binocular diplopia and exotropia. The patient showed marked limitation on adduction and about 40 prism diopters of left exodeviation. The orbital computed tomography showed a bony defect at the left medial orbital wall, and injury of the medial rectus muscle. The exodeviation was corrected after ophthalmologic surgery. We report a case of the rupture of the medial rectus muscle after use of a microdebrider during endoscopic sinus surgery and review the medical literature.

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Treatment Outcomes and Acoustic Rhinometric Results in Endoscopic Sinus Surgery of Adult Chronic Paranasal Sinusitis (성인 말성 부비동염에서 내시경적 부비동 수술 전.후의 증상 호전도와 음향비강통기도 검사 결과)

  • Kim, Yong-Dae;Kim, Jae-Yeul;Chang, Keun-Young;Lee, Hyung-Joong;Song, Si-Youn;Yoon, Seok-Keun
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.28-38
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    • 2002
  • Background: Chronic paranasal sinusitis is one of the most common disease in the otorhinolaryngologic field. Endoscopic sinus surgery is treatment of choice in chronic paranasal sinusitis. The aim of this study was to evaluate objective and subjective treatment outcomes of endoscopic sinus surgery in adult chronic paranasal sinusitis with or without polyp. Materials and Methods: We reviewed 84 adult patients underwent endoscopic sinus surgery by one surgeon from June 1999 to June 2000, prospectively. We analyzed preoperative and postoperative subjective symptom scores and acoustic rhinometric results. Results: Fifty cases were male and thirty four cases female. The average age was of 33 year-old (range: 17 to 66 years). There was significantly improvement of symptom scores in postoperative 3 months and 6 months compared with preoperative symptom scores. There was significantly increased postoperative total volume of nasal cavity. When we compared high score group with low score group, there was statistically significant improvement of symptom scores between preoperative stage and postoperative 3 months in radiologic grading group. Conclusions: Endoscopic sinus surgery is considered to be effective for the treatment of chronic paranasal sinusitis. It seems to be helpful to employ subjective symptom score system and objective total volume change of nasal cavity through acoustic rhinometric test to analyze effectiveness of endoscopic sinus surgery. In this study, the most important preoperative factor of sinus surgery outcomes is radiologic grading system.

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A Study on Recovery Time and Factors Related to Recovery after Sedative Gastroscopy (수면 위 내시경 검사 후 회복 시간과 회복 관련 요인에 관한 연구)

  • Choi, Seung-Hye;ChoiKwon, S-Mi
    • Journal of Korean Biological Nursing Science
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    • v.8 no.1
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    • pp.49-59
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    • 2006
  • Purpose: The purpose of this study was to investigate the recovery time and its related factors after sedative gastroscopy. Method: The subjects of this study consisted of 103 clients. The data were collected from clients who visited a health care system at S national university hospital in Seoul. The sedative gastroscopy was performed by gastrointestinal endoscopists. Patients' demographics and medical characteristics were assessed by reviewing the patients' charts. Degree of sedation and recovery were assessed by the Ramsay's sedation scale and the Aldrete score, respectively. Result: The mean recovery time was $37.8{\pm}16.9$ minutes(range, 5 to 90 minutes). Hypoxia was resent in four clients during recovery. Alcohol intake(p=0.02) and pulmonary function(p=0.003) were significant factors affecting recovery time, whereas midazolam dose and sedation level were not. Conclusion: Current alcohol intake, pulmonary function were predicting factors on recovery time.

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Unfolding of Virtual Endoscopy Using Ray Template (광선 템플릿을 이용한 가상 대장 내시경에서의 펼친 영상 생성)

  • Lee Hye-Jin;Shin Byeong-Seok
    • Proceedings of the Korean Information Science Society Conference
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    • 2005.07a
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    • pp.691-693
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    • 2005
  • 가상 내시경 기법 중 하나 펼친 영상 가시화(unfold rendering) 기법은 장기 내부를 펼쳐서 본 영상을 제공함으로써 장기의 내부 구조와 병변의 유무를 쉽게 판단할 수 있도록 해준다. 가장 일반적으로 사용하는 원형 광선 투사법은 곡률이 급격하게 변하는 경우에 광선들이 교차하여 병변이 두 개로 나타나는 문제가 발생할 수 있다. 본 논문에서는 경로의 제어점을 따라 광선 템플릿을 적용하여 적은 비용으로 펼친 영상을 생성하는 방법을 제안한다. 우선 중심 경로의 제어점들에서 곡률을 계산하여 곡률에 해당하는 광선 템플릿을 적용하여 광선 원뿔(ray Cone)을 구한다. 그리고 생성된 광선 원뿔간의 교차 검사와 보정을 통해 이들이 서로 교차하지 않도록 조정한다. 제어점들 사이의 샘플점들은 앞서 구한 제어점에서의 광선 투사 위치로부터 다음 제어점에서의 투사 위치를 잇는 선분을 보간하여 광선 투사 방향을 결정하게 된다. 마지막으로 계산된 방향에 따라 광선을 투사하여 영상을 생성한다.

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Relationship of Colorectal Polyps and Fatty Liver Disease Diagnosed by Ultrasonography (초음파로 진단된 지방간 질환과 대장 용종과의 연관성)

  • Lee, Hye-Nam;Lim, Cheong-Hwan;Jung, Hong-Ryang
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.345-352
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    • 2014
  • This study proposes a more comprehensive approach for FLD by analyzing the relationship of colorectal polyps, which are precursors of colorectal cancer. In Chi-Square tests of FLD and colorectal polyps, the prevalence of colorectal polyps was significantly high in cases of FLD. The polyps and correlation of each factor showed a positive relationship with all factors, and the correlation coefficient with FLD was highest (r = 0.39, p <.001). In multiple regression analysis, FLD(OR 3.80 95% CI 1.93.-7.50), FBS (OR 2.51; 95% CI 1.12-5.62), and older age (OR 2.12; 95% CI 1.27-3.54) were independent risk factors for colorectal polyps. FLD was associated with the prevalence of colorectal polyps. These results show a meaningful influenceof FLD by ultrasonography in the occurrence of colorectal polyps, and that positive consideration of colonoscopy is needed for diagnosed FLD.

Gastroduodenoscopic Findings and Effect of Therapy of Helicobacter pylori Infection in Children (소아 Helicobacter pylori 감염의 상부 위장관 내시경 소견 및 치료 효과)

  • Rhee, Kyung Shin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.12-20
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    • 2005
  • Purpose: Helicobacter pylori infection is known to be associated with acute or chronic abdominal pain and upper gastrointestinal bleeding in children. This study was performed to analyze the gastroduodenoscopic findings and the efficacy of triple therapy with omeprazole, amoxicillin and clarithromycin between one and two weeks of duration in children with H. pylori infection. Methods: We have assessed retrospectively 60 patients presented with acute or chronic abdominal pain or upper gastrointestinal bleeding. H. pylori infection was confirmed by endoscopic biopsy and rapid urease test. Out of 60 patients, 30 patients were treated with a combination of omeprazole, amoxicillin, and clarithromycin for one week, and the other 30 patients were treated for two weeks with the same medication. Efficacy of treatment was assessed 4 weeks after the termination of treatment by using the $^{13}C$ urea breath test. Results: The 60 patients with the complaint of diffuse abdominal pain, epigastric pain, vomiting or hematemesis were included in this study. One-week treatment group (group I) consisted of 30 patients (14 male, 16 female) with mean age of $11.6{\pm}2.67years$. Two-week treatment group (group II) consisted of 30 patients (11 male, 19 female) with mean age of $10.7{\pm}4.17years$. In group I, H pylori were eradicated in 26 out of 30 patients (86.7%). In group II, H. pylori were eradicated in 26 out of 30 children (86.7%). Both groups did $^{13}C$ urea breath test after 4 weeks after termination of the triple therapy. The eradication rates were same in both groups as 86.7%, 26 out of 30 patients in each group. The results of endoscopy were nodular gastritis 26 (43.3%), erosive gastritis 10 (16.7%), hemorrhagic gastritis 7 (11.7%), gastric ulcer 2 (3.3%) and normal finding 15 (25.0%). Conclusion: In this study, the nodular gastritis was most common endoscopic findings with H. pylori positive patients. The eradication rate of H. pylori with omeprazole, amoxicillin and clarithromycin was 86.7% and it would be highly effective as primary treatment with no significant differences in the eradication rate between one-week and two-week treatment groups. However, we should need more long-term follow-up data.

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Pediatric Endoscopic Sedation in Korea: A Survey of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (소아청소년 진정내시경: 대한소아소화기영양학회 학술위원회 조사 보고)

  • Ryoo, Eell;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.21-27
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    • 2008
  • Purpose: The aim of this survey was to analyze the choice of sedative drugs and their side effects during pediatric endoscopic sedation in Korea. We also evaluated doctors, caretakers and patient satisfaction with the procedures. Methods: Between June 2006 and July 2006, a 16-item survey regarding current sedation practices, during one month, was mailed to 28 hospitals in Korea. The results of the survey responses were then analyzed. Results: Endoscopy performed under conscious sedation was reported in 89.0% of the responders and endoscopy under general anesthesia in 0.9% of 465 endoscopic procedures. Endoscopy under conscious sedation was performed in 89.1% for upper gastrointestinal endoscopy (GFS) and 88.1% for lower GFS. Midazolam was used for conscious sedation during the endoscopy in 84.5% of cases and propofol was used in two cases (0.5%). In addition, a bezodiazepine/opioid combination was used iin 84.6% (44 cases) for lower GFS. Patients were monitored with pulse oxymetry, EKG (91.4%) as well as automatic BP (5.1%). Transient hypoxia was the only side effect noted and was treated with supplemental oxygen (4.6%). Flumazenil was used in 2.71% of cases. The choice of sedation was made by the endoscopist (84%). The satisfaction rate for endoscopists was 68%, and for the patients and caretakers was 84% (as reported by the endoscopists). Conclusion: Midazolam was used only for the upper GFS and benzodiazepine/opioid combination was used for the lower GFS in Korea. The rate of satisfaction was relatively high and there were no significant side effects noted during the endoscopy under conscious sedation.

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The Role of Bronchoscopy in Determining the Etiology of Pleural Effusion (흉막유출증의 원인규명에 기관지내시경의 역할)

  • Kim, Chang-Ho;Son, Ji-Woong;Kim, Gwan-Young;Kim, Jeong-Seok;Chae, Sang-Chull;Won, Jun-Hee;Kim, Yeon-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.397-403
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    • 1998
  • Background: Little information is available concerning the value of bronchoscopy in patients with a lymphocytic exudative pleural effusion in which percutaneous pleural biopsy have been regarded as cornerstone in investigating the etiology. Recently, a few reports suggest that bronchoscopy may be more effective diagnostic method in patients with unexplained pleural effusion accompanied by hemoptysis or other roentgenographic abnormalities, such as mass, infiltrate, atelectasis. Method: Mter initial examinations of sputum and pleural fluid through thoracentesis in 112 patients(male 75 cases, female 37 cases, mean age 53.2 years) who were admitted for evaluation of the cause of pleural effusion, we performed bronchoscopy and closed pleural biology in most patients with undiagnosed lymphocytic exudate and compared the diagnostic yield of both invasive methods according to hemoptysis or other roentgenographic abnormalities, and investigated the sole diagnostic contribution of bronchoscopy. Results: Tuberculosis(57 cases, 51%) was the most common cause of pleural effusion. Percutaneous pleural biopsy showed more diagnostic yield than bronchoscopy regardless of presence or absence of other clinical or radiologic abnormalities. In 25 cases with unknown etiology after pleural biopsy, additional diagnostic yield by bronchoscopy was 36 % (4/11) in patients with associated features and only 7 % (1/14) with lone effusion, and, as the sole mean for diagnsosis in all patients with pleural effusion, was only 4.5%(5/12). Conclusion : In a region of high prevalence of tuberculosis as a cause of pleural effusion, percutaneous pleural biospy is more effective method when invasive method is required for confirmative diagnosis of unexplained lymphocytic exudative pleural effusion, and bronchoscopy is unlikely to aid in the diagnosis of lone pleural effusion.

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인두신경증의 진단적 검사 및 치료성적

  • 홍원표;김은서;김지수;김동영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1996.04a
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    • pp.83-83
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    • 1996
  • 저자들은 이 연구를 통해 인두신경증의 원인적 요소를 알아보고 진단에 필요한 검사법의 선정 및 치료율을 향상시킬 수 있는 약제의 선택에 도움을 받고자 하였다. 상세한 문진과 이학적 검사를 통해 선정된 73명을 대상으로 전례에서 식도조영술, 식도위 내시경, 식도내압 검사 및 24시간 산도(pH)검사를 시행하였다. 최소 추적기간은 3개월 이었으며 아래와 같은 결과를 얻었다. 1. 대상례중 남자는 24명, 여자는 49명이었다. 2. 식도조영술상 54례(74%)에서 정상소견을 보였다. 3. 식도내압검사상 49례(67.1%)에서 정상소견을 보였다. 4. 24시간 산도검사상 15례에서 명확한 위식도 역류가 관찰되었으며 17례에서는 경도의 위식도 역류를 보여 총 43.8%에서 위식도 역류가 확인되었다. 5. Omeprazole, prepulsid 및 diazepam의 복합요법으로 총 61례(83.6%)에서 증상이 완전소실되거나 호전되었다. 특히 24시간 산도검사에서 위식도역류가 있었던 예에서는 87.5%에서 호전이상의 반응이 있었으며 위식도역류가 없었던 예에서는 80.5%에서 반응을 보였다. 이상의 결과로 보았을 때 식도조영술은 진단적인 가치가 떨어지며 식도내압 검사와 함께 24시간 산도측정이 치료제의 선택과 치료율의 향상에 기여할 수 있다고 사료되었다.

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