• Title/Summary/Keyword: 내시경 치료

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The Role of Colonoscopy in Children with Hematochezia (소아 선혈변에서 대장 내시경 검사의 역할)

  • We, Ju-Hee;Park, Hyun-Suk;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.155-160
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    • 2011
  • Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

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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Usefulness of Computed Tomography Gastrography in the Surgical Management of a Gastric GIST (위에 발생한 위장관간질종양의 수술적 치료에서 Computed Tomogrophy Gastrography의 유용성)

  • Han, Dong-Seok;Lee, Hyuk-Joon;Lee, Min-Woo;Kim, Se-Hyung;Lee, Kuhn-Uk;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.207-213
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    • 2006
  • Purpose: This study was performed to evaluate the usefulness of computed tomography (CT) gastrography in the surgical management of a gastric gastrointestinal stromal tumor (GIST). Materials and Methods: We retrospectively analyzed the clinicopathologic data of 38 patients who had undergone CT gastrography from among patients who had gastric GISTS surgically resected at the Department of Surgery, Seoul National University Hospital, between January 2001 and February 2006. We compared CT gastrography data, including tumor size and location and distance from the gastroesophageal junction or pylorus with endoscopic, surgical and pathologic findings. Results: The longitudinal tumor locations on CT gastrography and endoscopy were identical to the surgical findings. For tumor sizes on CT gastrography of less than 5 cm, we performed 11 (42.3%) laparoscopic wedge resections from among 26 cases. In the 12 cases with tumor sizes of 5 cm or over, only 1 (8.3%) laparoscopic wedge resection was performed. When the tumor was located in the middle third of the stomach, a laparoscopic wedge resection was performed in 88.9% (8/9) of the cases, but when it was located in the upper or lower third, a laparoscopic wedge resection was performed in only 13.8% (4/29) of the cases. Conclusion: Three-dimensional information from CT gastrography allows the surgeon to perform preoperative planning, including accurate localization.

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레이저의 의학적 응용과 전망

  • 윤길원
    • Proceedings of the Optical Society of Korea Conference
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    • 1995.06a
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    • pp.2-6
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    • 1995
  • 빛과 생체와의 interaction에 대한 연구, 레이저의 소형화와 신뢰성 향상, 빛 전달장치와 주변장치의 다양화등에 힘입어 레이저의 의학적 응용은 급속히 늘고 있다. 파장 및 照射모드의 연구로 치료의 質이 향상되고 있으며, 광섬유와 내시경을 통한 Minimally Invasive Surgery는 독자적인 수술 장르로 구축되고 있다. 새로운 레이저 수술 및 치료 procedure가 개발되고 있으며, 암진단 치려 및 진단장치등으로 응용 영역도 확대되어 레이저는 21세기 의학에서 절대적인 위치를 차지할 것으로 전망된다.

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Endoscopic Submucosal Dissection for Simultaneous Presence of GIST and Submucosal Tumor Type MALT-Lymphoma on the Stomach ? (동시에 발견된 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종의 내시경 치료)

  • In Kyung Yoo;Hoon Jai Chun;Yoon Tae Jeen;Bora Keum;Eun Sun Kim;Hyuk Soon Choi;Seung Joo Nam
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.24-27
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    • 2014
  • A 42-year-old female was referred to our department after find out submucosal tumor type lesion on cardia at local clinics. She experienced no specific symptom. On gastroscopy, two distinct neoplasms were detected. One of which was located in the cardia anterior wall of the stomach with the size of 2.0×1.1 cm, and the other one was localized in the cardia posterior wall of the stomach and its size was 1.5×1.2 cm. We performed endoscopic submucosal dissection. Pathological evaluation revealed the diagnosis of gastrointestinal stromal tumor (GIST) at the cardia anterior wall and malignant lymphoma from the mass localized cardia posterior wall of the stomach. We would like to report these rare synchronous tumors which were successfully treated by endoscopic resection in the same patient

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의료용 광계측 및 센서기기 동향 및 전망

  • An, Seon-Yeong
    • Photonics industry news
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    • s.36
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    • pp.36-41
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    • 2006
  • 의료용 광 계측은 의광학의 일부분으로 빛이 생체조직과 일으키는 상호작용을 이용하여 환자의 치료나 진단 또는 의학 기초분야의 발전에 효과적으로 사용하고 있다. 광 계측 및 센서기기를 응용하여 제품화된 의료용품들에는 혈당센서,혈압센서,내시경,검안기,영상진단기 등이 있다. 특히 혈당센서의 경우 급속하게 늘어가고 있는 당뇨병 환자의 수요에 비례한 시장이 현재 세계시장규모인 5조원에서 연간200%씩 증가될 것으로 예측되고 있다. 내시경의 세계시장은 매년 약 5% 내외의 성장을 거듭하고 있으며 검안기는 매년 약 7.2%의 성장률을 기록하고 있다.

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Treatment of Intraosseous Ganglion of the Talus with Hindfoot Endoscopy - A Case Report - (후족부 내시경술을 이용한 거골내 결절종의 치료 - 증례 보고 -)

  • Kim, Sung Yoon;Lee, Woo Chun
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.52-55
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    • 2012
  • An intraosseous ganglion typically exists in periarticular epiphysis or subchondral area, and is usually treated with open curettage of cyst or curettage and bone graft. We report a case of intraosseous ganglion of talus treated by endoscopic curettage and bone grafting with a review of the literature.

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Clinical and Bronchoscopic Features in Endobronchial Tuberculosis (기관지 결핵의 임상상과 기관지 내시경 소견)

  • An, Jin Young;Lee, Jang Eun;Park, Hyung wook;Lee, Jeong hwa;Yang, Seung Ah;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.532-539
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    • 2006
  • Background : The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions. Methods : From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis. Results : 458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months. Conclusion : Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

ESOPHAGEAL FOREIGN BODY REMOVAL WITH FIBEROPTIC ESOPHAGOSCOPY (식도이물의 굴곡형 내시경을 이용한 치료)

  • 박수헌
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.182-193
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    • 1996
  • 식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

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Recurrent Early Gastric Cancer with Liver Metastasis Mimicking Pancreaticobiliary Cancer (조기위암으로 위 절제술 후 갑자기 발생한 췌담도암으로 오인되었던 재발성 위암 1례)

  • Byung Hoo Lee;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.48-51
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    • 2013
  • We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.

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