• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.315-319
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• 2007

Transgastric endoscopic cholecystectomy was successfully accomplished in a 1-year-old, 15 kg, female, mongrel dog. Single-working channel flexible gastric endoscope was used with the aid of one abdominal laparoscopic port. Gastrotomy was performed using endoscopic needle knife at the ventral antral region. Through the gastric incision endoscope was advanced and retroflexed for the visualization of gallbladder. For the better exposure of surgical field, gentle traction was applied at the fundus of the gallbladder using laparoscopic grasping forceps. Cystic duct and artery was ligated using endoclips. After transecting the duct and artery, gallbladder was dissected using endoscopic coagulating grasping forceps and needle knife. Resected gallbladder was retrieved through the mouth and gastric incision site was sutured using endoclips. There was no evidence of bile leakage or stomach leakage on postoperative day (POD) 3. On POD 16, gastric endoscopy and laparoscopy was performed. Gastric endoscopy revealed complete adhesion of incision site. The content of the peritoneum appeared healthy, with no sign of infection, bile staining, or organ injury. The omentum was adhered over resected gallbladder fossa and the serosal surface of gastrotomy site. This is the first report of NOTES cholecystectomy in the dog and provides new concept of cholecystectomy of the dog.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.198-206
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• 2000

Background : Pulmonary complications following bonemarrow transplantation (BMT) are common and associated with a high mortality rate. We investigated the yield, safety, and impact of fiberoptic bronchoscopy (FOB) for diagnosis of postBMT pneumoniae. Methods : From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with respiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL (bronchoalveolar lavage), TBLB (transbronchial lung biopsy), PSB (protected specimen brush). Results : The characteristics of the subjects were as follows : 37 males, 15 females, mean age of 31.3 years(l7-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following : 12 cytomegalovirus (CMV) (21.4 %), 7 pneumocystis carinii (PC) (12.5 %), 11 CMV with PC (19.6 %), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases (23.2%), 13 died of CMV pneumoniae (n=2), PCP (n=2),mixed infection with CMV and PC (n=3), underlying GVHD (n=1), underlying leukemia progression (n=1), or respiratory failure of unknown origin (n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleeding and 1 episode temporary hypoxemia. Conclusion : Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.

• Clinical and Experimental Pediatrics
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• v.45 no.9
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• pp.1134-1140
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• 2002

Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

• Tuberculosis and Respiratory Diseases
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• v.63 no.3
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• pp.283-288
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• 2007

A gastrointestinal metastasis from lung cancer is rare and is quite often found during an autopsy. A 58-year-old man was admitted with left upper back pain and a mass in the left upper lobe on the chest radiograph. The transbronchial lung biopsy revealed an adenocarcinoma of the lung. A gastroduodenoscopy was carried out to evaluate the indigestion and epigastric discomfort. The duodenofibroscopy revealed bulging mucosa on the minor papilla of the duodenum. A metastasis to the duodenum from an adenocarcinoma of the lung was diagnosed by a duodenofibroscopic biopsy of the bulging lesion. We report this rare case of an adenocarcinoma of lung with a metastasis to the duodenum.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.51-54
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• 2003

This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.182-185
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• 1998

Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

• Journal of Yeungnam Medical Science
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• v.23 no.1
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• pp.131-137
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• 2006

Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.103-111
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• 2003

Purpose: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. Methods: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. Results: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. Conclusion: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

• Tuberculosis and Respiratory Diseases
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• v.57 no.3
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• pp.242-249
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• 2004

Background : Because of the low sensitivity of sputum smear and culture, diagnosis of nontuberculous mycobacterium (NTM) pulmonary disease, especially in patients with bronchiectasis, is often difficult. We investigated the usefulness of bronchoscopy for the diagnosis of NTM pulmonary disease including M. avium complex (MAC) and M. abscessus in patients with bronchiectasis and multiple pulmonary nodules on chest computed tomography (CT). Methods : We reviewed 48 cases of patients who were performed bronchoscopic bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) under suspect of NTM pulmonary disease based on CT findings of bronchiectasis and multiple nodules from April 2002 to June 2003. Results : Twenty five of the 48 patients (54%; 12 MAC, 14 M. abscessus) were diagnosed as NTM pulmonary disease on the basis of the American Thoracic Society diagnostic criteria for NTM pulmonary disease. Sixteen of the 21 patients (76%; 5 MAC, 11 M. abscessus) with 3 or more positive sputum cultures of NTM were confirmed tissue invasion by TBLB. Five of the 24 patients (21%; 4 MAC, 1 M. abscessus) who could not be diagnosed with sputum cultures were diagnosed by bronchoscopic BAL and TBLB. Conclusion : Bronchoscopy is helpful for the diagnosis of NTM pulmonary disease and confirmation of tissue invasion by NTM, not only MAC but also M. abscessus, in patients with bronchiectasis and multiple nodules on chest CT scan.

• Bulletin of the Korean Space Science Society
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• 2009.10a
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• pp.31.3-31.3
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• 2009

견우와 직녀의 사랑 이야기가 얽혀 있는 두 별은 여름철을 대표하는 별들로서 중국 문화권에서는 지난 수 천 년 동안 매우 인기가 높은 별이었다. 두 별은 중국의 춘추전국시대의 노래를 모아 놓은 시경(詩經)에 이미 등장하고 있고, 서기 408년에 조성된 고구려의 덕흥리 고분 속에 있는 벽화에도 그려져 있다. 고려시대에는 이 별들에 대한 국가적인 제사를 지냈으며, 조선 시대에는 칠월칠석에 국왕이 신하들과 어울려 잔치를 베풀고 칠석시(七夕詩)를 지어서 책으로 편찬하는 일도 있었다. 한편 견우성은 주로 농사와 관계된 별점을 가지고 있었고, 시각제도와 긴밀한 관계가 있는 28宿(수)의 하나였으므로 천문학자들이 지속적으로 관심을 갖고 관측한 별이다. 그러한 관측의 결과는 고려사, 조선왕조실록, 승정원일기 등에 다수가 남아 있다. 그런데 동양 천문학에서 이미 널리 다루어졌던 문제 가운데 하나는, 바로 이 문학적 견우성과 천문학적 견우성이 일치하지 않는다는 것이다. 지금 일반 시민들에게 견우성은 독수리자리의 알테어(Altair)로 알려져 있다. 그러나 모든 사서와 고대 천문서 및 천문도가 지칭하는 견우성은 염소자리의 다비(Dabih)라는 별이다. 견우성이 28宿(수)의 하나라는 사실은 그 별(별자리)이 황도와 백도 근처에 있어야 함을 의미한다. 따라서 알테어는 적위가 높아서 도저히 28宿(수)에 속할 수가 없다. 게다가 알테어는 은하수 속에 들어가 있으므로, 견우와 직녀가 은하수를 사이에 두고 마주보고 있다는 일반적인 설화와도 어긋난다. 그럼에도 불구하고, 현재 대다수의 서적과 매체, 그리고 일반인을 대상으로 한 행사와 천문관에서 상영되는 프로그램들에는 모두 알테어를 견우성으로 하여 설명하고 있다. 이러한 불일치는 상당한 혼란을 초래하고 있는 상황이다. 이 연구에서는 이러한 불일치가 천문학적인 견우성과 인문학적인 견우성의 불일치로 보고, 이 문제를 실증적으로 접근해 본다. 즉, 고려사, 조선왕조실록, 승정원일기에 실려 있는 견우성 엄폐 관측 기록을 조사하여 한국사에서 전문 천문학자들은 어느 별을 견우성이라고 보아왔는지 알아보고, 또한 일반인들이 지은 시문에는 어떤 별을 견우성으로 여겼는지 고찰한다. 아울러 역사적으로 이 문제에 대한 선인들의 생각을 짚어보고, 중국과 일본의 학자들은 이 문제를 어떻게 바라보고 있는지를 살핀 다음, 마지막으로 현실적으로 이 문제를 어떻게 해결할 수 있는지 고찰해 본다.