• Title/Summary/Keyword: 내시경 치료

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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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Double Bronchial Lesions Detected by Bronchoscopic Examination (기관지 내시경 검사상 발견된 2부위의 기관지 병변에 관한 연구)

  • Lee, Chang-Hee;Yoon, Jong-Kil;Kwak, Young-Im;Kim, Hyun-Kag;Lee, Choon-Taek;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.277-288
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    • 1994
  • Objectives : Multiple lung cancers and/or precancerous lesions can be developed because many bronchi are exposed to carcinogens simultaneously according to the concept of "Field Cancerization". We had performed a careful bronchoscopic examination and analysed the patients of double bronchial lesions who received the separate pathologic evaluation. Methods : We studied 21 patients of double bronchial lesions among 1855 patients of bronchoscopic examination from April 1990 to December 1993 in Korea Cancer Center Hospital. We classified the patients into three groups(double malignancies of different histology, double malignancies of same histology, and combination of malignant and benign lesions) and analysed the histologic type, location, radiologic findings, and clinical parameters. Results : Among 21 patients, six patients had double malignancies of different histology, eight had double malignancies of same histology, and seven had combination of malignant and benign lesions. Out of 14 double malignant cases, 11 cases are considered as synchronous multiple primary lung cancers. Combination of squamous cell carcinomas was found in 5 cases, combination of small cell carcinoma and squamous cell carcinoma was found in 4 cases. Combination of adenocarcinoma and squamous cell carcinoma and combination of squamous cell carcinoma and poorly differentiated carcinoma were found in 1 case respectively. All patients of synchtonous multiple primary lung cancers were male and had long smoking history(average 40 pack years). Among 21 cases of double bronchial lesions, only one lesion could be detected by prebronchoscopic radiologic examination including chest CT in 15 cases. Conclusions : The presence of double bronchial lesions including multiple primary lung cancers and the limitation of radiologic examination to detect early bronchial lesions encourage us to examine the whole bronchi carefully and to perform pathologic evaluations.

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Cryosurgery for Malignant Endobronchial Tumor (악성 기관-기관지 종양에 대한 냉동 수술법)

  • Cho, Jong Ho;Kim, Kwang Taik;Lee, Sung Ho
    • Korean Journal of Bronchoesophagology
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    • v.18 no.1
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    • pp.5-8
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    • 2012
  • Cryosurgery is a safe method for palliation of endobronchial malignancies causing airway obstruction. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryosurgery is considered to be a good method that is clinically applicable to a malignant endobronchial tumor. In cases with stenosis caused by an endoluminal tumor, cryo-recanalization with a cryoprobe was immediately effective in most of the patients. A novel technique described by Hetzel in 2004 to achieve rapid recanalization of central airway obstruction with endobronchial cryoprobe. Cryorecanalization technique is feasible and offers many advantages in the interventional therapy of malignant intraluminal tumors of the respiratory tract.

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Treatment of Lymphocytic Gastritis with Cyclosporine in a Cat (고양이 림프구성 위염에서 싸이클로스포린을 이용한 치료 증례)

  • Lee, Hwajoon;Park, So-Young;Ahn, Byeongwoo;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.108-111
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    • 2014
  • A 7-year-old spayed female domestic shorthair cat was referred for chronic intermittent vomiting. The frequency of vomiting increased recently, and the cat showed anorexia at presentation. There were no remarkable abnormalities on the blood analyses and diagnostic imaging. However, the endoscopic examination revealed focal erosions of the gastric body mucosa, and subsequent multiple biopsies were obtained. Histopathologic examination indicated mild to moderate lymphocytic gastritis. The vomiting was completely disappeared 7 days after the administration with prednisolone (PDS). However, because of side effects caused by the long-term PDS administration, cyclosporine was added on the prescription with tapered dose of PDS. The dog's condition improved with continued cyclosporine treatment, and no further vomiting and anorexia episodes have been noted. This case describes the successful management with administration of cyclosporine in feline lymphocytic gastritis.

FOREIGN BODY INGESTION DURING DENTAL TREATMENT IN PEDIATRIC PATIENT (치과치료시 발생한 이물질 삼킴에 대한 치험례)

  • Kim, Sun-Ha;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.29-32
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    • 2011
  • There are a lot of dental emergency situations and accidental aspiration or ingestion of a dental instrument is one of the common accidents in dental practice especially on disabied or pediatric patient with negative behavior. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. This is a case of an accident during the treatment of a 18 months male patient with caries of anterior deciduous teeth. During the treatment, the gauze was used by waterproofing instead of a rubber dam. #4 round bur (approximately 2.2cm long) which was put on the tray was cling to the gauze and the bur was fell into the patient's throat. The bur was 2.2cm long and very sharp so it could not be passed spontaneously through the pylorus, so we tried to remove the bur by esophagogastroduodenoscopy. Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure.

Three-dimensional Imaging with an Endoscopic Optical Coherence Tomography System for Detection of Airway Stenosis (기도협착 측정을 위한 내시경 광 결맞음 단층촬영법을 이용한 3차원 이미징)

  • Kwon, Daa young;Oak, Chulho;Ahn, Yeh-Chan
    • Korean Journal of Optics and Photonics
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    • v.30 no.6
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    • pp.243-248
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    • 2019
  • The respiratory tract is an essential part of the respiratory system involved in the process of respiration. However, if stenosis occurs, it interferes with breathing and can even lead to death. Asthma is a typical example of a reversible cause of airway narrowing, and the number of patients suffering from acute exacerbation is steadily increasing. Therefore, it is important to detect airway narrowing early and prevent the patient's condition from worsening. Optical coherence tomography (OCT), which has high resolution, is suitable for observing the microstructure of tissues. In this study we developed an endoscopic OCT system. We combined a 1300-nm OCT system with a servo motor, which can rotate at a high speed. A catheter was pulled back using a linear stage while imaging with 360° rotation by the motor. The motor was selected considering various requirements, such as torque, rotational speed, and gear ratio of pulleys. An ex vivo rabbit tracheal model was used as a sample, and the sample and catheter were immobilized by acrylic structures. The OCT images provided information about the structures of the mucosa and submucosa. The difference between normal and stenosed parts in the trachea was confirmed by OCT. Furthermore, through a three-dimensional (3-D) reconstruction process, it was possible to identify and diagnose the stenosis in the 3-D image of the airway, as well as the cross-sectional image. This study would be useful not only for diagnosing airway stenosis, but also for realizing 3-D imaging.

Helicobacter pylori Eradication and Risks of Metachronous Recurrence after Endoscopic Resection of Gastric Adenoma: A Systematic Review and Meta-Analysis (위선종의 내시경 절제 후 이시성 재발의 예방을 위한 헬리코박터 제균 치료: 체계적 문헌분석 및 메타분석)

  • Kim, Jie-Hyun;Nam, Su Youn;Chun, Jaeyoung;Youn, Young Hoon;Park, Hyojin
    • Journal of Digestive Cancer Reports
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    • v.8 no.2
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    • pp.91-96
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    • 2020
  • The effect of Helicobacter pylori (H. pylori) eradication on the development of metachronous recurrence after endoscopic resection (ER) of gastric adenoma is not well defined. The aim of this study was to assess the efficacy of H. pylori eradication after ER of gastric adenoma for the prevention of metachronous recurrence. A systematic literature review and meta-analysis were conducted using the databases Ovid-MEDLINE, EMBASE, Cochrane Library, KoreaMed, and KMBASE. Thus, a systematic review and meta-analysis was performed to investigate this relationship. Pooled risk ratio for metachronous gastric lesions with regard to H. pylori eradication was calculated, and heterogeneity was also measured. Five eligible studies were finally identified in systematic review, and included in meta-analysis. H. pylori eradication was associated with overall 55% lower odds of metachronous events (RR=0.55; 95 % CI 0.34-0.92). Based on the best available evidence, eradication of H. pylori can also provide protection against metachronous recurrence after ER of gastric adenoma.

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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A Case Report of Endobronchial Lipoma (기관지내 지방종 -체험 1례-)

  • Lee, Jong-Mok;Park, Jong-Ho;Baek, Hui-Jong;Jo, Jae-Il
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.116-118
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    • 1997
  • Endobronchial lipomas Are rare lesions that usually obstruct a major bronchus and cause irreversible pulmonAry damage distally. They are histologically benign tumors. But they can produce pulmonary damage or irreversible bronchiectasis if dignoses or tr atments are delayed. Whenever possible, the treatment of choice is resection by means of bronchoscopy. If endoscopic removal is not possible or lf the nature of the tumor is unclear, surgery is necessary. with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma . We present a case of endobronchial lipoma causing bronchial obstruction and peripheral organizing pneumonia with its clinical features. diagnosis find treatment methods.

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Relationship between Eradication of Helicobacter pylori Infection and Clarithromycin Resistance (Helicobacter pylori 감염의 치료와 Clarithromycin 내성간의 연관성)

  • Sohn Seung Ghyu;Lee Jong Hwa;Lee Jung Hun;Lee Sang Hee
    • Korean Journal of Microbiology
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    • v.41 no.3
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    • pp.177-182
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    • 2005
  • H. pylori strains were isolated from antral biopsies taken during upper endoscopy in 114 dyspeptic patients with no previous therapy against H. pylori. Rapid urease test, PCR amplification of SSA and cagA gene for H. pylori detection, and Western blot for CagA expression detection were performed. H. pylori infected patients were treated with omeprazole, clarithromycin (a macrolide), and amoxicillin. At 6 weeks after the discontinuation of therapy, the bacterial eradication rate was determined by endoscopy. The resistance rate to clarithromycin and amoxicillin was $20.2\%$ and $0.0\%$, respectively. The clarithromycin resistance was mainly caused by the A2142G mutation in the 23S rRNA gene of H. pylori. MICs of clarithromycin for the A2142G mutant isolates were significantly higher than MICs for the A2143G mutant isolates. H. pylori eradication was obtained in all patients with clarithromycin-susceptible isolates but not in patients with clarithromycin-resistant isolates (P = 0.0001). These results did not appear to be biased by any differences in CagA expression. The resistance of H. pylori to clarithromycin included in the therapeutic regimens is the most important reason for treatment failure. H. pylori antimicrobial susceptibility testing of the gastric biopsy culture should be performed before choosing the first triple therapy in infected patients and the increase in prevalence of clarithromycin resistance in Korea was problematic.