• Title/Summary/Keyword: 내시경 치료

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Recurrent Respiratory Papillomatosis improved by Treatment with Interferon-${\alpha}$ (인터페론 치료로 호전을 보인 재발성 유두종증 1예)

  • Kim, Ki Uk;Cho, Woo Hyun;Jung, Kyung Sik;Park, Hye Kyung;Lee, Jun Hee;Lee, Joung Wook;Lee, Jung Hyun;Kim, Yun Seong;Lee, Min Ki;Wang, Soo Geun;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.346-352
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    • 2003
  • Recurrent respiratory papillomatosis(RRP) is a chronic disease that is caused by the human papillomavirus(HPV) type 6 and 11. The most common site of the lesions is the larynx, but papillomas can occur throughout the respiratory and upper gastrointestinal tracts. Frequent recurrence of disease, can result in airway compromise and even death when papillomas either obstruct the airway or spread to the lung parenchyma. We encountered a case of a recurrent respiratory papillomatosis in a 23-year-old patient, who improved after treatment with interferon-${\alpha}$ The patiented with hoarseness, exertional dyspnea, and a productive cough. We report this case with a brief review of the relevant literature.

Development of Drug Eluting Stent for the Treatment of Benign Biliary Stricture by Electro-spray Method (전기분사를 이용한 양성담관 협착 치료용 약물방출 스텐트 개발)

  • Shin, Il-Gyun;Kim, Dong-Gon;Kim, Han-Ki;Kim, Sang-Ho;Jeon, Dong-Min;Suh, Tae-Seok;Jang, Hong-Seok
    • Polymer(Korea)
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    • v.36 no.2
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    • pp.163-168
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    • 2012
  • Recently, along with technology development of endoscopic equipment, the stent technology has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. In this study, paclitaxel-eluting metal stents for treatment of biliary benign stenosis were developed through an electrospray-coating method. Polyether-based polyurethane (PELLETHANE 2363-80AE$^{(R)}$)) and paclitaxel were coated onto the surface of a metallic stent and Pluronic F127 was used as an additive. As a result, physicochemical characterization of paclitaxel via SEM, FTIR, contact angle and XRD techniques revealed the information of solid state of paclitaxel-loaded PU film. The in vitro release profile showed a slower release rate with a higher content of paclitaxel.

Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.

Long-term Outcome after Minimally Invasive Treatment for Early Gastric Cancer beyond the Indication of Endoscopic Submucosal Dissection (내시경점막하박리술의 적응증을 넘어선 조기위암의 미세침습 치료 후 장기 추적 결과)

  • Weon Jin Ko;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.44-49
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    • 2017
  • Background: Recently, endoscopic submucosal dissection (ESD) with laparoscopic sentinel lymph node dissection, named ESN or endoscopic full-thickness gastric resection with laparoscopic sentinel lymph node dissection, named Hybrid-natural orifice transluminal endoscopic surgery (NOTES) was suggested the possibility of minimally invasive treatment for patients with early gastric cancer (EGC) who were beyond the indication of ESD. This study aimed to evaluate the outcomes of ESN or Hybrid-NOTES. Methods: We retrospectively analyzed patients treated with these therapies from January 2009 to May 2013 in terms of short- and long-term outcomes. Each patient was diagnosed with EGC but was not included in ESD indications and had the high risk of lymph node metastasis (LNM). Results: A total of 42 patients with EGC treated by ESN or Hybrid-NOTES. Of the 21 patients who underwent ESN, a total of 4 patients underwent additional gastrectomy, 1 with LNM, 1 with surgical complication, and 2 with noncurative resection. Of the 21 patients who underwent Hybrid-NOTES, a total of 5 patients underwent additional surgery, 1 with LNM, 2 with surgical complication, and 2 with noncurative resection. Overall survival was 100% over a mean follow-up of 75 months, but 3 patients underwent ESD or gastrectomy with metachronous lesion. And 1 patient who had received ESN was found to have a metastatic lymph node and undergo palliative chemotherapy. Conclusion: ESN or Hybrid-NOTES showed favorable short-and long-term outcomes. These methods may be utilized as a bridge between ESD and gastrectomy in the case of EGC which is more likely to have LNM beyond the ESD indications.

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Endoscopic Carpal Tunnel Release with Transparent Flexible Tube (유연한 투명도관을 이용한 내시경적 수근관 절개술)

  • Chae In-Jung;Park Jung-Ho;Han Seung-Beom;Oh Kwang-Jun;Lee Byung-Taek
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.120-123
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    • 2001
  • Purpose : We used transparent flexible tube which had provided the good visual field of median nerve when it was used in endoscopic release of transverse carpal ligament and evaluated the safety of that technique. Materials and Methods : We evaluated the 12 patients(20cases) who had been diagnosed as carpal tunnel syndrome and performed by endoscopic carpal tunnel release between Mar. 1997 and Mar. 2000. We used two portal technique and released the transverse carpal ligament with direct supervision of median nerve. Results : 14 cases$(70\%)$ were revealed excellent or good results and 6 cases$(30\%)$ were fair. No serious complications were shown such as nerve injury. Conclusion : We could avoid the complications of endoscopic carpal tunnel release using the transparent flexible tube which had provided tire good circumferential vision around the median nerve and it is unnecessary to maintain the wrist Joint hyperextension state during operation. Also that tube was easily obtainable in hospital so we need not to purchase the expensive operation apparatus.

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Study of Antituberculous Medications in Anthracofibrosis (기관지 탄분 섬유화증에서 항결핵약제의 투여에 관한 고찰)

  • Han, Sang-Hoon;Cha, Geun-Young;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Hwang, Jung-Hwa;Kim, Hyun-Jo;Yeum, Wook
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.224-231
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    • 2001
  • Purpose : An anthracofibrosis(AF), dark multiple anthracotic pigmentations combined with narrowing and obstruction of bronchi, was reported to be strongly related with past and active pulmonary tuberculosis. This study was performed to determine whether anti-tuberculous regiemens would be helpful in patients with anthracofibrosis who failed to demonstrate the evidences of pulmonary tuberculosis. Methods : Twenty-two patients with multiple anthracotic pigmentations in bronchial mucosa with luminal narrowing were enrolled in this study. The bacteriological and histological findings for Mycobacterium tuberculosis was reviwed in each patients. They are composed of 8 males and 14 females ranging from 55 to 85 years old in age. Results: The most common symptoms were coughing(73%, 16/22), followed by sputum(41%, 9/22), dyspnea on exertion(32%, 7/22), and hemoptysis(27%, 6/22). The evidence of pulmonary tuberculosis, defined by positive AFB smear or culture of Mycobacterium tuberculosis from sputum or bronchial washing fluid or histological findings of granuloma with caseous necrosis, were found in eleven patients(50%) and the others has showed no evidences. Among 11 patients without pulmonary tuberculosis, only one patient showed the evidences of pulmonary tuberculosis after 16 months, and the 8 patients still showed no evidence of pulmonary tuberculosis during follow-up periods of ranging from 8 months to 60 months. Conclusions : Beause the anthracofibrosis is closely related to tuberculosis, it needs to find out extensively the evidences of tuberculosis in patients with anthracofibrosis. Chemotherapy for tuberculosis should be administrated only with confirmation of tuberculosis on bacteriologic study.

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Endobronchial Tuberculosis in Patients with Pulmonary Tuberculosis (폐결핵에 병발하는 기관지 결핵에 관한 연구)

  • Kim, Sun-Young;Suhr, Ji-Won;Shin, Kyoung-Sang;Jeong, Seong-Su;Park, Sang-Gee;Kim, Ae-Kyoung;Cho, Hai-Jeong;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.138-146
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    • 1996
  • Background : Known as a kind of complication or a specific form of pulmonary tuberculosis, endobronchial tuberculosis caused several kinds of problems in diagnosis and managements. But the frequency of this disease are is widely variable, generally reported from as low as 10 - 20 % to as high as 40 - 50 %. We prospectively performed bronchoscopy in patients diagnosed as pulmonary tuberculosis to evaluate the frequency of endobronchial tuberculosis and its related findings. Method : From March, 1995 to February, 1996, we prospectively performed bronchoscopy in patients newly diagnosed as pulmonary tuberculosis and evaluated the frequency of endobronchial tuberculosis, its clinical features and laboratory findings including raiologic, microbiologic and physiologic aspects. Results : Number of patients diagnosed as pulmonary tuberculosis was 103 and 55 patients(53.4%) were found to have endobronchial tuberculosis. But the frequency were 43.8% in male and 76.7% in female, respectively. Frequently noted symptoms were nonspecific including cough, sputum, fever, weight loss in the order of frequency but cough was more frequent than in pulmonary tuberculosis. Physical examination showed rale, decreased breathing sound and wheezing and wheezing was more frequent than in pulmonary tuberculosis. All 7 subtypes were noted bronchoscopically and edema-hyperemia (stenotic without fibrosis) type was most frequently(32.7%) noted, and followed by chronic nonspecific bronchitis type, stenotic with fibrosis type and actively caseating type in the order of frequency. The relationship between subtypes of endobronchial tuberculosis and radiologic findings was insignificant. Right lung was involved more frequently than left lung and left upper lobe was most commonly involved site, and followed by right upper lobe and trachea. Acid-fast bacilli(AFB) positivity in sputum and / or bronchial washing fluid was 73% and suggested high risk of infectivity. Conclusion : The frequency of endobronchial tuberculosis in patients with pulmonary tuberculosis was higher than known and also suggested bronchoscopic examination to detect endobronchial involvement should be recommanded and careful management is also needed to prevent complications.

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Video-Assisted Thoracoscopic Decortication for management of Postpneumonia Empyema (폐렴후 합병된 농흉 치료에 대한 비디오 흉강경적 박피술)

  • 김보영;오봉석;양기완;임진수;서홍주;박종철
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.21-25
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    • 2003
  • Video-assisted thoracoscopic surgery (VATS) for decortication or debridement in the management of empyema thoracis has increased the available treatment options but requires validation. We present and evaluate our technique and experience with thoracoscopic management of pleural empyema, irrespective of chronicity. Material and Method : VATS debridement or decortication was performed with endoscopic shaver system in 40 consecutive patients presented with pleural space infections. A retrospective review was performed and the effect of this technique on perioperative outcome was assessed. Result : VATS evacuation of infected pleural fluid and decortication was successfully performed in 35 of 40 patients. The mean duration of preoperative symptoms before referral was 23$\pm$1.8 days. The mean duration of hospitalization before transfer was 13.5$\pm$1.5 days. Blood loss was 250 to 200 mL. Intercostal drainage was required for 5$\pm$3 days. The postoperative hospital stay was 5 $\pm$0.7 days. There were no operative mortalities. Conclusion : Video-assisted evacuation of infected pleural fluid and decortication is an effective modality in the management of the fibropurulent stage of empyema. An organized empyema should be approached thoracosco-pically, but may require open decortication.

Bronchoscopic Electrocautery with Electroprobe and Diathermic Snare in Patients with Malignant Airway Obstruction (중심성 폐암환자에서 악성 기도폐쇄에서 전기 탐침과 투열올가미를 사용한 전기 소작술의 효과)

  • You, Hong Jun;Choi, Pyoung Rak;Park, Eun Ho;Yang, Jae Hong;Choi, In Su;Kim, Hyoung Jun;Kim, Joo Hoon;Oak, Chul Ho;Cho, Hyun Myung;Jang, Tae Won;Jung, Maan Hong
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.504-509
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    • 2005
  • Background : Endobronchial tumors cause life-threatening dyspnea and can lower the quality of life due to central airway obstruction. In those cases with an intraluminal tumor, various bronchoscopic techniques are available for tumor debulking. The therapeutic effect of bronchoscopic electrocautery for palliation in patients with a symptomatic tumor obstruction was studied. Method : Nineteen patients with bronchogenic carcinomas (n=15) and metastatic tumors affecting the bronchi (n=4), between March 2002 and March 2005, were enrolled in this study. Electrocautery was performed under local anesthesia using an electroprobe and diathermic snare. Using flexible bronchoscopy, a follow-up bronchoscopic examination was performed 3-4 days later. Symptom improvement was evaluated by $FEV_1$, FVC and dyspnea score (Modified Borg Category Scale (0~10)), both before and after the electrocautery. Results : The success rate of electrocautery on the follow up examination was 84%. Patients with endoluminal airway lesions had a mean overall decrease in the size of the obstruction to $47.8{\pm}15.7%$. The mean Improvement in the dyspnea score immediately after the endobronchial tumor debulking was $2.78{\pm}1.42$. The average improvements in the $FEV_1$ and FVC after electrocautery were $0.32{\pm}0.19L$ and $0.5{\pm}0.22L$, respectively. There were 2 cases of complications related with electrocautery (one each of pneumothorax and pneumonia). Conclusion : Electrocautery using an electroprobe and diathermic snare was an effective and safe palliative treatment for a symptomatic endoluminal airway obstruction in lung cancer.

Community-based Helicobacter pylori Screening and its Effects on Eradication in Patients with Dyspepsia (지역사회에서 소화불량 환자의 Helicobacter pylori 감염에 대한 집단검진 및 치료효과)

  • Kim, Seong-Ho;Hong, Dae-Yong;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Sang-Kyu;Suh, Jeong-Ill;Kim, Mee-Kyung;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.285-298
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    • 2000
  • Objectives : To investigate the positive rate of Helicobacter pylori in patients with dyspepsia; medical compliance and related factors; the eradication rate a year after screening and related factors; the relationship between the eradication of Helicobacter pylori and the improvement of symptoms; and the estimated cost of three alternative approaches to treat Helicobacter pylori in the community. Methods : A total of 510 subjects with dyspeptic symptoms were selected and given the serological test in March 1998. The subjects were all adults over 30 years of age residing in Kyongju city. Results : Of the 510 selected subjects, 375 (73.5%) subjects proved positive for Helicobacter pylori on serological testing. Of these 304 (81.1%) who consented to an endoscopic examination, underwent a Campylobacter-like organism (CLO) test. Of these 304 subjects, 204 (67.1%), who had positive CLO test results, were given the triple therapy - tripotassium dicitrato bismuthate, amoxicillin, and metronidazole. To determine the eradication rate of Helicobacter pylori, 181 (88.1%) out of the 204 subjects who were given the triple therapy completed a follow-up urea breath test one year later. Of these, the Helicobacter pylori of 87(48.1%) subjects was eradicated. Among the 122 subjects who were medication compliant, the Helicobacter pylori eradication rate was 57.4% (70 subjects), while the eradication rates was only 28.8% (17subjects) in the non-compliant group. The Helicobacter pylori eradication was significantly related to compliance (p<0.01), but not to other characteristics and habits. The symptom improvement rate tended to be higher 62.1%), in the Helicobacter pylori eradicated group than in the non-eradicated group (59.6%). Conclusions : When the advantages and disadvantages of each alternative treatment were considered in the light of cost, antibiotic tolerance and the number of patients to be treated, alternative II was favorable in terms of cost. Alternative III was favorable in terms of the number of patients to be treated, antibiotic tolerance and early detection of gastric cancer. Further long-term research analyzing the cost-benefit and cost-effectiveness of each treatment will be needed as supporting material in creating new policies.

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