• 제목/요약/키워드: Achalasia

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소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술 (Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies)

  • 곽주영;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권2호
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    • pp.137-142
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    • 2005
  • 목 적: 소아의 선천성 및 후천성 식도 질환의 치료에 있어 내시경적 풍선 확장술의 안전성, 효과 그리고 기술적인 문제들을 평가하였다. 방 법: 1993년부터 10년 동안 선천성 및 후천성 식도 질환의 치료로 부산대학교병원 소아과에서 내시경적 풍선 확장술을 시행한 8명을 대상으로 이들의 의무 기록을 후향적으로 분석하였다. 시술은 풍선 카테터를 내시경 겸자구를 통해 삽입하여 내시경 직시 하에서 시행되었으며 최초로 사용되는 풍선의 크기는 식도의 내경과 협착 부위의 직경에 기초하여 결정하였다. 협착이 아주 심한 경우에는 먼저 유도 철선을 통과시킨 후, 유도 철선을 따라 풍선 카테터를 삽입시켰다. 풍선을 협착 부위에 위치시키고 서서히 확장하면서 목표하는 크기로 풍선이 팽창되면 1분 동안 확장된 상태를 유지하였다가 감압하여 1분 이상의 휴식을 가졌다. 확장 후 합병증이 없으면 풍선의 직경을 1 mm 간격으로 늘리면서 추가 확장하였다. 결 과: 남아가 3명, 여아가 5명이었고, 평균 연령은 4.2세였다. 8명의 환자에서 27회(환자 당 평균 3.2회)의 확장이 시행되었다. 기저 질환의 종류는 선천 성 식도 폐쇄에 대한 수술 후 발생한 식도 협착이 3예, 식도윤이 2예, 그 외 식도 무이완증, 빙초산에의한 부식성 식도염 그리고 고압성 식도 하부 괄약근이 각각 1예였다. 6~15 mm 직경의 풍선을 사용하였고, 최초 풍선의 크기는 협착의 형태와 정도에 따라 결정되었다. 합병증으로는 식도 천공과 심한 호흡 곤란이 각각 1예 있었다. 6예(75%)에서 시술 후 정상적인 음식 섭취를 보였다. 결 론: 내시경적 풍선 확장술은 소아의 선천성 및 후천성 식도 질환을 치료하는데 있어 안전하고 효과적인 방법이다.

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양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석 (Analysis of High-Resolution Manometry Results in LPRD Patients Who Do Not Response to PPI Medication)

  • 이창희;이현섭;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제23권1호
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    • pp.43-47
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    • 2012
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석 (Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication)

  • 이창희;이현섭;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제22권2호
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    • pp.151-155
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    • 2011
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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Comparative analysis on darcy-forchheimer flow of 3-D MHD hybrid nanofluid (MoS2-Fe3O4/H2O) incorporating melting heat and mass transfer over a rotating disk with dufour and soret effects

  • A.M. Abd-Alla;Esraa N. Thabet;S.M.M.El-Kabeir;H. A. Hosham;Shimaa E. Waheed
    • Advances in nano research
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    • 제16권4호
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    • pp.325-340
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    • 2024
  • There are several novel uses for dispersing many nanoparticles into a conventional fluid, including dynamic sealing, damping, heat dissipation, microfluidics, and more. Therefore, melting heat and mass transfer characteristics of a 3-D MHD Hybrid Nanofluid flow over a rotating disc with presenting dufour and soret effects are assessed numerically in this study. In this instance, we investigated both ferric sulfate and molybdenum disulfide as nanoparticles suspended within base fluid water. The governing partial differential equations are transformed into linked higher-order non-linear ordinary differential equations by the local similarity transformation. The collection of these deduced equations is then resolved using a Chebyshev spectral collocation-based algorithm built into the Mathematica software. To demonstrate how different instances of hybrid/ nanofluid are impacted by changes in temperature, velocity, and the distribution of nanoparticle concentration, examples of graphical and numerical data are given. For many values of the material parameters, the computational findings are shown. Simulations conducted for different physical parameters in the model show that adding hybrid nanoparticle to the fluid mixture increases heat transfer in comparison to simple nanofluids. It has been identified that hybrid nanoparticles, as opposed to single-type nanoparticles, need to be taken into consideration to create an effective thermal system. Furthermore, porosity lowers the velocities of simple and hybrid nanofluids in both cases. Additionally, results show that the drag force from skin friction causes the nanoparticle fluid to travel more slowly than the hybrid nanoparticle fluid. The findings also demonstrate that suction factors like magnetic and porosity parameters, as well as nanoparticles, raise the skin friction coefficient. Furthermore, It indicates that the outcomes from different flow scenarios correlate and are in strong agreement with the findings from the published literature. Bar chart depictions are altered by changes in flow rates. Moreover, the results confirm doctors' views to prescribe hybrid nanoparticle and particle nanoparticle contents for achalasia patients and also those who suffer from esophageal stricture and tumors. The results of this study can also be applied to the energy generated by the melting disc surface, which has a variety of industrial uses. These include, but are not limited to, the preparation of semiconductor materials, the solidification of magma, the melting of permafrost, and the refreezing of frozen land.