• 건강소식
• /
• v.35 no.6
• /
• pp.16-17
• /
• 2011

음식물을 받아들여 소화하는 위장. 최대 1,500ml 정도까지 커지는 위장은 식도와 연결된 분문으로 음식물을 받아 소화시키고 잠시 저장한 뒤 유문을 통해 십이지장으로 내려보낸다. 중요한 역할을 하는 만큼 이상이 생기면 소화 불량, 더부룩함, 배탈, 속 쓰림, 설사 등 여러 증상으로 SOS신호를 보내는데, 이 같은 경고를 쉽게 무시해 버리는 게 문제다. 특히 위암은 조기에 발견하면 90% 이상 완치될 수 있으므로 정기적으로 위장을 검사해야 한다. 내시경을 넣는 위내시경검사, 조영제를 마시고 X선 촬영을 진행하는 조영촬영검사가 대표적이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.10 no.1
• /
• pp.20-27
• /
• 2007

Purpose: This study was performed to review the recent experiences of pediatric gastrointestinal (GI) endoscopy done in one university hospital. Methods: A retrospective review of medical records was conducted of 1,040 pediatric cases who underwent GI endoscopy at the Pusan National University Hospital between January 2001 to June 2005. Results: A total of 1,040 endoscopies (upper 840 and lower 200) were performed. The male/female ratio was 1.25:1. Neonates and infants accounted for 6.0% and 16.5% respectively. Half of the children were below 5 years (mean age $8.5{\pm}2.1$ years). Upper and lower GI diagnostic endoscopies were performed in 634 and 163 children respectively. Abdominal pain (38.8%), vomiting (19.4%), foreign body (17.7%), and hematemesis (10.3%) were the main reasons for esophagogastroduodenoscopy. Hematochezia (56.0%), abdominal pain (27.5%) and diarrhea (3.0%) were the main reasons for colonoscopy. Upper GI therapeutic procedures included retrieval of foreign bodies, balloon dilatations of esophageal stricture, PEG, and variceal ligation in 148, 27, 15, and 3 children, respectively. Therapeutic lower GI endoscopies were performed in 37 children (polypectomy in 92%, argon lazer cauterization for angiodysplasia in 4%). Conclusion: GI endoscopy played an important role in the diagnosis and treatment of GI diseases in children. Procedures in younger aged children, cases evaluated by colonoscopy and therapeutic endoscopies are increasing in pediatric practice.

• Journal of the Korean Society of Radiology
• /
• v.10 no.6
• /
• pp.395-401
• /
• 2016

Upper gastrointestinal series is a diagnostic test that X-ray passes through the stomach after administering contrast media such as barium or gastrografin. Upper gastrointestinal series with an advantage of no side effect except temporary constipation or abdominal pain has been widely used to diagnose diseases of the gastrointestinal system. However, image degradation and diagnostic accuracy frequently occurred when improper movement and breath control were carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. The movie of the upper gastrointestinal series was made for improving inspection accuracy and image quality. The examinees encouraged to see the movie for waiting time before doing upper gastrointestinal series. In this study, image quality and diagnostic accuracy was examined for the effect of the movie about upper gastrointestinal series. 60 patients composed of each 10 people from 30s to 80s were selected randomly among both 2,940 examinees in 2014 and 3,076 examinees in 2015. Image quality was evaluated by the full width at half maximum of profile for each image using the Image J. The measurement of the full width at half maximum showed 0.208 mm and 0.133 mm for after and before seeing the movie. Thus it was verified that the movie education could improve the image quality and diagnostic accuracy for upper gastrointestinal series.

• Journal of the Korean Society of Radiology
• /
• v.84 no.3
• /
• pp.520-535
• /
• 2023

Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

• The Journal of the Korea Contents Association
• /
• v.10 no.9
• /
• pp.251-258
• /
• 2010

Despite significant advance in laparoscopy, upper gastrointestinal (UGI) series is still generally carried out for preoperative localization of gastrectomy. The aim of the study was to compare the accuracy of UGI series and postoperative pathological findings in the diagnosis and localization of gastric cancer. A retrospective review was carried out for 102 patients who underwent gastrectomy between October 2007 and April 2009. Preoperative reports of UGI series were compared with postoperative pathology reports and the accuracy of the preoperative reports was calculated. Two radiographer retrospectively reviewed the analysis of UGI series. postoperative pathology reports of the surgical specimens, were compared with the preoperative reports of the location and extent of the tumor were correct in 81 case("sure", 79.4%) and incorrect in 21 case("failed, 20.6%). In 92 case UGI series revealed intestinal metaplasia (90.2%) at consensus review and these results demonstrate the limitation of the UGI series in the diagnosis of type IIb gastric cancer with size less than 1.0cm and the poor detection of gastric cancer is that the overlying mucous membrane often appears to be normal in these patients. In conclusion, UGI series is accurate the detection of the tumor localization and diagnosis of intestinal metaplasia. However, for the overcome with the limitation of UGI series should be used accurate technique for the region of the stomach. To achieve this goal, it is necessary to determine the changes of the mucus membrane of the stomach and UGI series is gaining acceptance as a standard method for preoperative gastric cancer screening.

• Proceedings of the KSMRM Conference
• /
• 2001.11a
• /
• pp.25-34
• /
• 2001

복부의 자기공명영상(Magnetic resonance imaging； MRI)은 주로 간 질환의 검사에서 다른 영상검사로 해결되지 않은 궁금점을 풀기 위한 보조적인 검사로 주로 사용하였으나, 최근 들어서는 병변의 발견 및 감별진단에 직접적인 검사로도 자주 이용하고 있으며, 담췌관 질환이나 위장관 검사 등에도 적용범위가 넓어지고 있다. 이는 그간의 하드웨어 및 소프트웨어상의 발달로 인해, 위장관 연동운동이나 호흡에 따른 인공물을 억제하면서도 해부학적인 세부구조는 자세하게 나타낼 수 있는 우수한 영상을 얻을 수 있음으로써 가능하게 되었다. 고속영상은 영상의 질을 우수하게 할 뿐 아니라, 검사시간을 단축시켜서 더 많은 환자를 검사할 수 있게 하고, 한자가 검사에 더 잘 적응할 수 있게 하여준다. 단발(single-shot)기법의 고속 T2강조영상은 담췌관이나 위장관등 그간 MRI를 적용하기 어려웠던 부위에 대한 검사가 가능하게 하였으며, 고속의 3차원 T1강조 펄스대열(pulse sequence)은 단면에 따른 오기록(misregistration)이나 운동인공물이 적으면서도, 향상된 다평면적인 영상구성을 얻을 수 있게 하였다. ［l］. 본 강좌에서는 최근 수년간 복부 MRI의 응용을 증가할 수 있게 한 영상장치 및 펄스대열의 발전과 최근 국내에 시판이 허용되어 사용이 증가되고 있는 새로운 간자기공명조영제에 관해서 살펴보고자 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.2
• /
• pp.183-192
• /
• 2006

Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

• Journal of the Korean Society of Radiology
• /
• v.11 no.2
• /
• pp.109-116
• /
• 2017

Upper gastrointestinal series is non-invasive examination, and it is useful for patients or elderly patients who have difficulty in endoscopic examination because of absence of any side effects other than temporary constipation or abdominal pain. The entire image of the gastrointestinal tract can be seen and have been widely used in the diagnosis of upper gastrointestinal diseases. However, there is a possibility that radiation dose increases due to improper movement and breath control, when examination is carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. In upper gastrointestinal series to increase understanding of examination, to induce appropriate cooperation during examination, to reduce the number of retakes and shorten examination time, and to reduce dose of the subject, the procedure and precautions of the gastrointestinal test were made as a movie. We investigated the effectiveness of pre-education using the movie to reduce the inspection time, the number of re-shoots, and the reduction of exposure dose by watching the movie during the waiting time before examination. 120 patients that were selected each 20 patients aged from 30s to 80s were evaluated were evaluated for exposure dose, examination time, and the number of retakes before and after the movie training. The radiation dose, the examination time, and the number of retakes were respectively $3171.83{\mu}Gy{\cdot}m^2$ and $2931.73{\mu}Gy{\cdot}m^2$, 8.05 min, and 6.75 min, and 1.68 times and 1.22 times before and after movie training. It can be concluded that the movie training on the gastrointestinal examination influences the reduction of the examination time, the number of retakes and the reduction of the radiation dose.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.4 no.2
• /
• pp.181-190
• /
• 2001

Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

• Journal of the Korean Society of Radiology
• /
• v.13 no.6
• /
• pp.889-894
• /
• 2019

Upper gastrointestinal series is an examination that uses X-rays. It is important to defend against exposure to radiation during upper gastrointestinal examination because the organs, such as thyroid gland, lens, breasts, and gonads, with relatively high biological sensitivity to radiation are distributed on the examination area. We have made a whole body phantom that can change the depth of organs. radiation dose of eye, thyroid gland, breast and gonads were measured by the same procedure as the actual upper gastrointestinal examination. When performed only fluoroscopy the mean dose reduction of lens, thyroid gland, breast and gonads was 62.2%. The mean dose reduction of lens, thyroid gland, breast and gonads was 59.0% when both fluoroscopy and spot shoot were performed. Therefore, when performed upper gastrointestinal examination it was confirmed that shielding of the lens, thyroid gland, breast and gonads was effective in decreasing the exposure dose. The manufactured human phantom can be used in measuring radiation dose for deep organ because it can adjust the height corresponding to the organs located in the human body.