• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.218-223
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• 2001

저자들은 신경학적 증상을 주소로 내원한 환아에서 분문 무이완증을 진단하고 풍선확장술로 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제38권3호
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• pp.258-262
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• 2005

환자는 18세 여자로 6년 전부터 연하곤란 및 식사 후 빈번하게 구토가 발생하였으며, 최근 6개월 동안 15 kg의 체중 감소가 있었다. 식도 계측검사에서 식도이완불능증으로 진단되었다. 약물치료를 하였으나 증상이 호전되지 않아 복강경을 이용한 수술을 결정하였다. 복부에 5개의 트로카용 소절개를 시행하였고, 복강경을 이용하여 근절개술과 전방위저부주름술을 시행하였다. 수술 후 1일째 식도조영술을 시행하였다. 조영제가 누출 없이 원활하게 통과되었다. 수술 후 2일째 식이를 시행하였으며, 술 후 9일째 특별한 문제없이 퇴원하였다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권2호
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• pp.188-194
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• 2000

반복되는 구토로 인한 폐렴 증세로 내원하여 분문무이완증, 무루증, 신경인성방광 등의 소견을 보여 Triple A 증후군으로 진단받고, 식도하부 괄약근의 반복 확장술(pneumatic dilatation)로 증상이 소실된 환아 1례를 경험하였기에 이에 보고하는 바이다.

• 센서학회지
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• 제21권1호
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• pp.75-81
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• 2012

Optimizing the tapping time of a blast furnace is important to a stable operation and life extension. To optimize the tapping time of the blast furnace, the location of Hearth Liquid Level should be recognized. There are several ways to measure the hearth liquid level in the blast furnace, such as Electromotive Force(EMF) measurement, pressure measurement by putting in nitrogen probe and manometry with strain gauge. In this paper, it will be discussed using strain gauge among the three methods. Conventional strain gauge must be revised periodically. Since, internal pressure, temperature of internal refractory material and wind pressure have effect on the strain gauge. However, static pressure value is required to compensate. To solve these problems, this paper suggests finding relationship between Hearth Liquid Level and strain gauge output, adding digital filter in strain gauge. Using the proposed method, it was possible to estimate the hearth liquid level and determine the appropriate tapping time. Usefulness of the proposed method through simulations and experimental results are confirmed.

• 대한기관식도과학회지
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• 제3권1호
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• pp.79-83
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• 1997

The term laryngopharyngeal reflux (LPR) refers to the backflow of food or stomach acid back up into the larynx (the voice box) or the pharynx (the throat). Esophagopharyngeal reflux is suggested as an etiologic factor in laryngeal disease. To examine a possible esophageal basis for laryngopharyngeal symptoms, we studied 48 patients with persistent laryngopharyngeal symptoms, and 12 relative control subjects. Patients were evaluated for cervical symptoms by questionnaire and underwent gastrofiberoscopy, fiberoptic laryngoscopy, esophageal manometry and 24-hour ambulatory double-probe pH monitoring. We found LPR in fourteen out of 48 patients with cervical symptoms (29%). The LPR group consisted of nine men and five women. The symptoms that LPR patients complained were throat lump sensation, hoareness, sore throat, throat clearing, chronic coughing and dysphagia in order of frequency, and they were not different significantly from non-LPR patients. The laryngoscopic findings in LPR patients were posterior erythema, laryngeal edema and diffuse erythema, and there was also no significant difference between LPR group and non-LPR group. There was statistically significant correlation between LPR and gastroesophageal reflux (GER). We concluded that there is no pathognomonic symptoms or laryngoscopic findings in diagnosis of LPR, and 24-hour ambulatory double-probe pH monitoring is an essential diagnostic tool in LPR.

• Clinical Endoscopy
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• 제56권5호
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• pp.537-545
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• 2023

Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.64-69
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• 2009

고립성 직장 궤양 증후군은 흔치 않은 만성 질환으로 소아의 경우에는 보고가 드물며, 대장 내시경과 조직검사를 통해 진단할 수 있다. 저자들은 직장 탈항과 배변 시 점액성 혈변을 주소로 내원한 12세 남아에서 대장 내시경과 병리학적 진단, 항문 직장 내압 검사로 고립성 직장 궤양 증후군으로 진단하여 보고하는 바이다.

• Journal of Chest Surgery
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• 제31권3호
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• pp.329-335
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• 1998

55세 남자환자가 흉부 불편감, 연하장애와 연하통을 주소로 입원하였다. 식도내압검사상 하부식도 괄약근의 이완이 전혀 관찰되지 않았다. 식도 조영술상 "double-barrelled 식도" 또는 점막 선조(mucosal stripe) 소견을 보였다. 내시경 검사상 상부 식도에 기관-식도누공의 형태를 보는 듯한 개구부가 있었다. 또한, 하부 식도에는 두군데의 점막 열창이 보였다. 이후 환자는 금식과 비경구적인 영양공급을 하면서 수주간 치료하였나, 증상의 호전을 볼수 없었다. 그래서 전신 마취하에 상부식도에 있던 가성내강의 개구부를 일차봉합하였다. 수술후 환자는 경한 연하곤란을 제외하고는 증상이 좋아졌다. 환자는 조심스런 경구섭취를 하고 퇴원하였다. 환자는 외래에서 추적검사상 발열이나 연하장애가 없었으며, 식도 조영술상 호전되는 양상을 보였다. 저자들은 보존적 치료와 수술적 치료를 시행했던 자발성 점막하 식도 박리의 특이한 경우를 치험하였다. 이에 관련된 문헌과 함께 보고하는 바이다. 보고하는 바이다.

• 대한기관식도과학회지
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• 제2권2호
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• pp.232-237
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• 1996

Burning and lump sensation in the throat is a common disorder in middle aged woman. It is generally considered to be a neurotic origin but its pathophysiology is still remained unknown. The purpose of this study was to evaluate the prevalence of the Pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have any causative role in the pathogenesis of the globus sensation, and we also wanted to know whether such tests were necessary in evaluating those patients. Structural lesions were demonstrated in 21 cases(17.5 %) among 120 patients. But among 44 controls, there were also Two cases(4.5 %) of structural lesions, and there was less significantly difference in the prevalence of the structural lesions between the patients and controls(p=0.0625) Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 28 cases (23.3 %) of the patients, while only one case (2.3 %) of the controls revealed such abnormality ( p=0.0037). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls (p=0.0034). Globus sensation is a kind of symptom of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with globus sensation, Careful physical examination is also necessary to detect structural lesions in the pharynx and esophagus.

• Advances in pediatric surgery
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• 제1권1호
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• pp.68-72
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• 1995

Segmental dilatation of the colon is a very rare disease entity of unknown etiology and may mimic Hirschsprung's disease. It is characterized by dilatation of a segment of the colon of variable length with obstruction due to lack of peristalsis in a normally innervated intestine. Recently authors experienced a case of segmental dilatation of the sigmoid colon in a 6 month-old male, who presented with severe constipation, abdominal distention, and abdominal mass since 2 months of age. Down's syndrome and congenital nystagmus were associated. Barium enema demonstrated focal dilatation of the sigmoid colon, but the rectum and descending colon proximal t o the affected colon were of normal caliber. Rectal suction biopsy with acetylcholinesterase staining was normal and anorectal manometry showed normal rectosphincteric reflex. At operation, there was a massively dilated and hypertrophied sigmoid colon with increased tortuous serosal vessels, measuring 15 cm in length and 10 cm in width. Teniae coli were identifiable in the affected segment. Frozen section biopsies at the proximal, affected, and distal colon showed ganglion cells. Descending loop colostomy was constructed initially and segmental resection and end to end colocolostomy were carried out 3 months later. Final histologic examination showed 1) normal colonic mucosa with ganglion cells, 2) prominent submucosal fibrosis and marked muscular hypertrophy, 3) unremarkable acetylcholinesterase activity and immunohistochemical findings against S-100 protein. On 8 months follow-up, he has been doing well and moves bowels 1-2 times daily.