• Title/Summary/Keyword: 내시경 초음파 검사

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A Case of Tuberculous Peritonitis Diagnosed by Colonoscopic Biopsy (대장 내시경 생검으로 진단된 결핵성 복막염 1례)

  • Park, Hye Jin;Lee, Su Min;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yeon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.131-135
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    • 2004
  • Tuberculous peritonitis is a rare cause of intra-abdominal infection. Although sometimes asymptomatic, most of the patients have fever, weight loss, abdominal pain, and edema. The diagnosis of tuberculous peritonitis is difficult and sometimes delayed because of confusion of the disease with other illnesses and the non-specificity of signs and symptoms. Tuberculous peritonitis is examined with ultrasonography and computerized tomogram, but confirmed by biopsy or tuberculosis culture. Ascitic fluid is exudates with a lot of lymphocytes and elevated protein. Tuberculous peritonitis is treated successfully with isoniazid, rifampicin for one year, pyrazinamide for first 2 months and streptomycin for first one month. We experienced one case of tuberculous peritonitis with transudate of ascitic fluid, confirmed by biopsy using colonoscopy, and treated successfully.

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Diagnostic Strategy of Primary Site in Metastatic Bone Tumor (전이성 골종양에서 원발병소의 진단)

  • Shin, Kyoo-Ho;Suh, Ki-Won;Jahng, Jun-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.98-104
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    • 1997
  • We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

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SIALOLITHIASIS ON THE MOUTH FLOOR IN A CHILD (소아의 구강저에 발생한 타석증)

  • Lee, Hyo-Seol;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Song, Je-Seon;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.114-118
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    • 2009
  • Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

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Design of DICOM Standard Interface Module for Medical Image Standardization (의료영상 표준화를 위한 DICOM 표준 인터페이스 모듈 설계)

  • Kim, Sung-Hyun;Jeon, Jae-Hwan;Kim, Gwan-Hyung;Kang, Sung-In;Oh, Am-Suk
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2010.07a
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    • pp.221-224
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    • 2010
  • PACS(Picture Archiving Communication System)를 바탕으로 하는 DICOM(Digital Imaging and Communications in Medicine)은 주요 의료영상장비들 사이에 데이터와 영상을 효율적으로 교환하고 전송할 수 있도록 마련한 표준안으로 현재 대부분의 최신형 의료영상장비(CT, MR, DSA, CR(Computed Radiology), 초음파검사, 핵의학검사, 내시경검사, 조직병리검사, 등)들은 의료 영상 분야의 국제 표준인 DICOM 표준방식에 의해 영상을 제공하고 있다. 최근 이러한 의료영상장비들은 독립적으로 사용하기보다는 의료수술 모니터링 장비 등의 비 의학영상장비와 서로 연계하여 사용하는 경우가 많아졌다. 그러나 이러한 의료수술 모니터링 장비들은 DICOM 표준 데이터를 고려하지 못하므로 PACS를 통한 데이터 연계에 어려움이 있다. 따라서 본 논문에서는 표준 DICOM 포맷과 의료수술 모니터링 장비의 데이터 구조를 분석하여 non-DICOM 의료수술 모니터링 장비의 PACS 연동을 위한 방안을 제안하였다.

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An Association between Private Health Insurance and Use of Endoscopy, Sonography, CT, MRI, and PET (내시경, 초음파, CT, MRI, PET 검사와 민간의료보험의 관련성 연구)

  • You, Chang-Hoon;Kwon, Young-Dae;Choi, Ji-Heon;Kang, Sung-Wook
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.25-34
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    • 2014
  • This paper examined the effects of private health insurance (PHI) on the use of endoscopy, sonography, CT, MRI, and PET among Koreans. The data used was the four waves of the Korea Health Panel (2008-2011), and the number of subjects was 141,862 visits. We employed a pooled logistic regression mode which was corrected with cluster errors. The results showed that PHI was positively related to the use of endoscopy, but not related to the use of sonography, CT, MRI, and PET. It is, however, recommended that health policy makers pay attention to the effects of PHI on the use of sonography, CT, MRI, and PET.

Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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A Case of Mucinous Adenocarcinoma of the Sigmoid Colon in a Child (소아의 결장에서 발생한 원발성 선암종 1예)

  • Jung, Jae-Youl;Seo, Yu-Koyng;Kim, Ae-Suk;Lee, Sun-Ju;Cho, Sung-Min;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Kim, Dong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.81-85
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    • 2007
  • Colorectal carcinomas occur primarily in elderly people and are rare in children. Unlike adult colorectal carcinomas, the overall prognosis is very poor because of the usual delay in diagnosis and advanced stages at presentation or initial diagnosis, and a high incidence of aggressive tumor pathology such as mucinous adenocarcinoma. Colon cancer should not be excluded in children only based on age or barium enema results. Therefore, colonoscopy should be performed in pediatric patients with unexplained rectal bleeding and abdominal pain. We report a rare case of a child with a mucinous adenocarcinoma of the sigmoid colon in a 12-year-old boy, who presented with an abdominal mass and abdominal pain and review the medical literature.

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A Study on the Repeat Tests for Diagnosis at a Tertiary Hospital in Taegu City (3차진료기관(3次診療機關)과 환자의뢰기관간(患者依賴機關間)의 중복검사(重複檢査))

  • Park, Jae-Yong;Kim, Gui-Young
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.457-468
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    • 1993
  • This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.1%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow : the routine CBC was 75.0%, the liver function test was 72.1%, and the computer tomogram was 15.4%.

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Persistent Hymen and Pyocolpos in a Female Shih-Tzu Dog (시츄 개에서 발생한 처녀막 잔존증과 질축농증)

  • Kim, Minkyung;Kim, Keun-Yung;Park, Ji-Hun;Shin, Jeong-In;Kim, Tae-Hwan;Hong, Subin;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.246-249
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    • 2014
  • A 9-year-old intact female Shih-Tzu was presented with abdominal pain and abdominal distension. Since the animal's birth, the owner had never observed proestrous bleeding in the patient. Ultrasonography revealed segmental enlargement of the genital system. An ovariohysterovaginectomy was performed to remove the genital mass. The vagina was grossly dilated as a result of being filled with a solid black-green substance. A vaginogram was performed. Based on the surgical findings and vaginogram results, an imperforate hymen was diagnosed. One month from the first surgery, a stump pyocolpos developed between the sutured site and the obstructed portion. The persistent hymen was removed by endoscopy. However, peritonitis and sepsis developed after the procedure, and the dog died. Therefore, During operation of persistent hymen, a cruciate incision over the hymen strongly recommended to avoid additional post operative complications.

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of a Gastrointestinal Stromal Tumor of the Stomach -A Case Report - (내시경 초음파 유도하에 세침흡인 세포검사로 진단한 위의 위장관 기질 종앙 1예 보고)

  • Kim, Lucia;Kim, Hyung-Gil;Chu, Young-Chae;Park, In-Suh;Choi, Suk-Jin;Han, Jee-Young;Kim, Sun-Hee;Lee, Don-Haeng;Kim, Joon-Mee
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.178-182
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    • 2008
  • We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1 cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.