• Title/Summary/Keyword: 대장 내시경 검사

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Clinical Features of Eosinophilic Colitis Developed in Early Infancy (영아 초기에 발생한 호산구성 대장염의 임상적 고찰)

  • Kwak, Jeong Won;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.122-129
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    • 2005
  • Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

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Unfolding In Virtual Colonoscopy Using Control Points of the Center Path (중심 경로의 제어점을 이용한 가상 대장 내시경에서의 펼친 영상 재구성)

  • Won, Jun-Yeon;Shin, Byeong-Seok
    • Journal of the Korea Computer Graphics Society
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    • v.10 no.1
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    • pp.23-28
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    • 2004
  • 가상 내시경의 주된 목적은 체내 장기의 3차원적 구조를 가시화하여 광학 내시경을 모사하는데 있다. 가상 내시경 기법 중 펼친 영상 가시화 기법(unfold rendering)은 장기의 내부 구조와 병변의 유무를 쉽게 판단할 수 있도록 하는 장점이 있다. 가장 일반적으로 사용 하는 중심 경로 기반의 광선 투사법은 곡률이 급격하게 변하는 경우 광선들이 교차하여 병변이 두개로 나타나 문제가 발생할 수 있다. 이를 해결하기위해 광선들이 겹치지 않도록 보장하는 여러 기법들이 발표되었지만 계산량이 많은 단점을 가지고 있다. 본 논문에서는 경로의 제어점을 이용하여 적은 비용으로 펼친 영상을 재구성하는 방법을 제안한다. 우선 모든 중심 경로의 제어점에서 경로에 수직인 절단면을 찾는다. 이때 제어점으로부터 방사상으로 광션을 투사하여 절단면과 만나는 장기 내 벽의 위치를 파악한다. 절단면간의 교차 검사 및 보정을 통해 절단연들이 서로 교차하지 않도록 조정한다. 제어점들 사이의 샘플점들은 앞서 구한 임의의 제어점에서 광선이 투사된 위치로 부터 다음 제어점에서 투사된 위치를 잇는 선분을 보간하여 광선 투사 위치를 결정하게 된다. 마지막으로 계산된 방향 따라 광선을 투사하여 영상을 생성한다.

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Relationship of Ultrasonographic Fatty Liver and Colorectal polyps (초음파로 진단된 지방간과 대장용종의 관련성)

  • Lee, Hye-Nam;Lim, Cheong-Hwan
    • Proceedings of the Korea Contents Association Conference
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    • 2011.05a
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    • pp.197-198
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    • 2011
  • 임상적으로 흔한 간질환인 지방간은 대부분의 경우에 초음파검사에 의해 진단이 된다. 초음파검사에 의한 지방간과 대장암의 전구병변이 될 수 있는 대장용종과의 관련성을 검진환자대상으로 일반요인과 대사증후군 요인 등 특정요인과 비교분석 하였다. 대장용종은 나이 50세 이상, 남자일수록, 공복시 glucose와 Triglyceride 수치가 높을 때, 지방간이 있을 때 발생빈도가 높았다. 상관관계분석에서는 지방간이 용종과의 관계도가 가장 높았고 위계적 회귀분석에서도 용종발생에 가장 영향력 있는 요인은 지방간이었다. 지방간인 경우 대장내시경검사를 고려해야 할 것이다.

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The Guideline for Colorectal Cancer Screening (대장암 선별검사 권고안)

  • Dong Il Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.17-20
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    • 2016
  • Colorectal cancer is the 2nd most common cancer in men, and the 3rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

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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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Acute Abdominal Pain after Ingestion of Bowel Cleansing Agent for Colonoscopy (장정결제 복용 후 발생한 급성 복통)

  • Kim, Hwon;Park, Jong Seol;Kim, Yong Sung
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.275-276
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    • 2018
  • 42세 여자가 갑작스러운 복통으로 소화기내과 외래를 방문하였다. 환자는 당일 건강검진 대장내시경이 예정되어 있었으며 전날 밤 장정결제인 피코라이트 산(sodium picosulfate hydrate 10 mg, magnesium oxide 3.5 g, citric acid 12 g; Pharmbio Korea Inc., Seoul, Korea)을 물에 녹이지 않고 그냥 복용한 후부터 증상이 발생하였다. 신체 검사에서 복부는 부드러웠으며 압통은 없었다. 즉시 시행한 상부위장관 내시경 검사에서 황색의 두터운 가피가 덮여 있는 다발성 병변이 위체부 대만 및 저부에서 관찰되었다(Fig. 1A). 가피는 생검 겸자를 이용해 쉽게 벗겨졌으며(Fig. 1B), 가피를 제거한 후 급성 출혈성 미란 병변들이 확인되었다(Fig. 1C). 이 환자에서 관찰된 위병변의 진단은 무엇인가?

Solitary Juvenile Polyps and Colonoscopic Polypectomy in Children (연소성 대장 용종의 내시경적 용종 절제술)

  • Cheon, Kyoung Whoon;Kim, Jae Young;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.236-241
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    • 2003
  • Purpose : This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. Methods : This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. Results : The mean age of the 19 cases was $4.7{\pm}2.8year$. The male to female ratio was 1 : 1.1. Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. Conclusion : Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.

Colonic Uptake Patterns of F-18-FDG PET in Asymptomatic Adults: Comparison with Colonoscopic Findings (무증상 성인의 F-18-FDG PET 대장 섭취양상 : 대장내시경 소견과의 비교)

  • Pai, Moon-Sun;Cho, Yoo-Kyung;Jung, Sung-Ae;Shim, Ki-Nam;Lee, Hong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.15-20
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    • 2005
  • Purpose: Physiologic intestinal FDG uptake is frequently observed in asymptomatic individuals for cancer screening FDG PET Colonic FDG accumulation is a well-known confusing findings that interfere true cancer detection or cause false positive. The aim of this study was to evaluate the pattern and intensity of colonic uptake in whole body FDG PET in asymptomatic healthy adults and to correlate them with colonoscopic findings. Materials and Methods: We reviewed retrospectively 64 subjects (age: 27-87, M:F=31:33) who underwent both FDG PET and colonoscopy for cancer screening. FDG uptake patterns were classified as focal, segmental and diffuse. Maximum SUV were measured. The PET results were compared with colonoscopic and histologic findings. Results: In 13 patients FDG bowel uptake was interpreted as focal, in 17 patients as segmental and in 34 patients as diffuse uptake. Six adenomas (17.6%, average diameter=5.0 mm) were found in diffuse pattern, 7 adenomas (41.1%, 5.6 mm) in segmental and 4 adenomas and 1 adenocarcinoma (38.5%, 16.4 mm) in focal uptake pattern. In patients with focal uptake, four were non-adenomatous pathologic lesions (30.8%, 2 intestinal tuberculosis, 2 mucosal ulcer). There is no difference of mean SUV between patients with adenoma and with negative colonoscopic results in each group of intestinal FDG pattern (Diffuse: $1.7{\pm}0.1\;vs.\;1.9{\pm}0.5$, Segmental: $4.8{\pm}3.6\;vs.\;4.2{\pm}1.2$, Focal: $6.5{\pm}4.7\;vs.\;3.5{\pm}1.3$). large adenomas (>1 cm) can be detected more in the focal uptake pattern (4 out of 5) rather than in segmental (1 out of 7) or diffuse uptake (none) and had higher SUV ($6.3{\pm}4.8$) than small adenomas ($3.5{\pm}3.0$) (statistically insignificant). Conclusion: focal FDG uptake is associated more often with large adenoma and other pathologic findings in colonoscopy. Segmental uptake cannot discriminate presence of adenoma from negative results, while diffuse pattern may have more chance to be normal.

The Significance of Small Polyp of Colon in Koreans (한국인에 있어서 대장의 작은 용종의 의의)

  • Kwon, Soon-Uk;Lee, Eun-Ju;Eun, Jong-Ryul;Choi, Sun-Taek;Lee, Hak-Jun;Jang, Byeong-Ik;Kim, Tac-Nyeun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.39-48
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    • 2000
  • Background: There arc two theories in the development of colon cancer. One is the adenoma-carcinoma sequence theory and the other is the de novo cancer theory. Western countries believe in the adenoma-carcinoma sequence theory, however there are many recent reports from, Japan about cancers developing from small adenomas. Methods: The present study analyzed 408 polyps from 508 cases that were taken by colonoscopic polypectomy at the Department of internal Medicine, Yeungnam University Hospital. Results: The percentage of patients who had a polyp was 41.3% (210 cases out of 526 cases), and the peak incidence was noted in patients in their 50s and 60s, There was no difference between the sexes, but we noted significant increase in the incidence of polyps in patients over the age of thirty. We found 395 polyps below 1cm and 13 polyps above 1cm. Among 408 polyps, 5 cases were cancerous polyps and 3 cases showed polyp size of less than 1cm each. The first case was a polyp of 0.4cm in size with elevated mucosa at the ascending colon. The second was 0.5cm in size with round elevation and hyperemic mucosa in the rectum. The third was 0.6cm in size with tubular elevation at the hepatic flexure. Conclusions: Colon polyp is a common disease in Koreans, Even small polyps can have cancer tissue, which should be removed if discovered during colonoscopy. We believe that not all colon cancer originates in the manner described by the adenoma-carcinoma sequence theory. However further studies with a larger sample population arc needed to determine the exact role of colon polyps in the development of colon cancer.

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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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