• Title/Summary/Keyword: 위내시경검사

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Role of Endoscopic Ultrasonography in the Diagnosis of Gastrointestinal Stromal Tumors in the Stomach (위의 위장관 간질성 종양에 대한 내시경 초음파의 진단적 역할)

  • Yoon, Ji-Hoon;Kim, Hyun-Chul;Choi, Chang-Soo;Oh, Sang-Hoon;Choi, Young-Kil
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.120-126
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    • 2005
  • Purpose: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors(GISTs) and assessed differences between the two groups. Materials and Methods: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echoheterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. Results: Tumor sizes over 40 mm were observed in $85.7\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.000). Intralesional cystic spaces were noted in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.003). The outer margin was irregular in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.014). $85.7\%$ of the malignant and $13.0\%$ of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. Conclusion: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.

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A case of echinostomiasis with ulcerative lesions in the duodenum (십이지장 궤양을 동반한 호르텐스극구흡충 감염증례)

  • 채종일;홍성태
    • Parasites, Hosts and Diseases
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    • v.32 no.3
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    • pp.201-204
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    • 1994
  • Echinostomiasis is an endemic intestinal trematodiasis of humans in Korea We observed a human case of Echinostomn honense infection who had ulcerations on the duodenal mucosa. A 55-year old man living in Hamyang-gun, Kyongnam, complained of epigastric pain with hematemesis In April 1994. Endoscopy revealed lesions of early gastric cancer and duodenal ulcerations. A penetrating parasite into the duodenal mucosa was picked out, and identified as E. honense. As the patient was treated 10 praziquantel 10 mg/kg single dose,3 more E. hofene and 7 Metogonimw worms were recovered. This case demonstrates that echinostomiasis causes gross ulcerations in the duodenum.

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A human case of gastric anisakiasis by Pseudotewcnova decipiens larva (Pseudoterranova decipiens의 유충에 의한 위 아니사키스증 1례)

  • 손운목;설상영
    • Parasites, Hosts and Diseases
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    • v.32 no.1
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    • pp.53-56
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    • 1994
  • A case of gastric anisaklasis due to the larva of Pseunotewqnova decipiens was confirmed by gastroendoscoplc examination In April 23, 1991. The patient, residing In Pusan, was a 42-year-old housewife, who complained of severe epigastric pawn and recalled that the symptom suddenly attacked her about 6 hours after eating raw Sebqstes inermis. In the gastroendoscopic examination performed about 9 hours after the onset of the symptom, a long whitish nematode larva penetrating the gastric mucosa in the greater curvature of mid-body was found and removed with a biopsy forcep. The nematode was $29.73{\times}0.94mm$ in size, had an intestinal cecum reaching over mfd-level of the ventnculus and was identified as the 4th stage larva of f decfpiens.

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The Effects of Aromatherapy Hand Massage on Anxiety before Gastroscopy (아로마테라피 손마사지가 위내시경 대상자의 검사 전 불안에 미치는 효과)

  • Lee, Hea-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.12 no.1
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    • pp.36-42
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    • 2006
  • Purpose: The purpose of this study was to verify the effect of aromatherapy hand massage on the anxiety of gastroscopy clients. Method: The data were collected during the period from March 10 to May 20, 2004 at S-Hospital in Kyungi-Do. There were sixty subjects, 30 for the experimental and 30 for the control group. The data were analyzed by descriptive statistics, t-test, $X^2$-test and paired t-test with SPSS program. Result: The pulse rate was reduced significantly, but there were no significant differences in the systolic and diastolic blood pressure between two groups. The status anxiety of experimental group was lower than the control group, but there was no significant difference statistically. Conclusion: Aromatherapy could be useful in the nursing practice, and be utilized as a way of nursing intervention to reduce anxiety of the client in specific clinical situations.

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Clinical Application of Laryngeal EMG

  • 정성민
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.174-175
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    • 2003
  • 후두기능의 전기생리학적 특징에 대한 관심은 1940년대부터 시작되어 1950년대와 1960년대에는 유럽 및 일본에서 Faborg-Anderson, Hirano 등이 후두근전도의 임상적 적용에 대해서 보고한바 있으며, 1970년대부터는 미국에서도 Bleir, Miller등이 후두근전도의 임상적 역할에 대해 보고하고 있다 이와 같이 후두근전도가 임상에 도입된 지 오래되었고 신경후두학 분야에서 후두근육의 전기생리상태를 알 수 있는 아주 중요한 진단도구이나 아직까지 후두근전도는 양적인 평가가 가능한 표준화된 검사는 아니고 내시경이나 방사선학적 검사처럼 경험이 있는 의사에 의해 판독되어지는 검사로 음성장애가 있는 모든 환자에서 집단검진(screening test)으로 이용될 수 있는 검사도구는 아니다. 후두근전도가 임상에서 유용하게 이용되고 있는 질환은 성대운동 장애와 연축성 음성장애이다. 최근 성대운동 장애에 대한 다양한 수술방법이 개발되면서 수술 방법 및 시기 결정, 예후측정에 후두근전도의 이용이 필수적이 되었으며 또한 연축성 음성장애 환자에서 어떤 후두 근육에 botulinum toxin을 주사할 지를 결정하는 데 이용하고 있다. 이번 강의에서는 위 두 가지 질환을 중심으로 후두근전도의 임상적 유용성을 살펴보기로 하겠다.

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Evaluation of Endoscopic and Histological Change of Gastritis Related to Helicobacter pylori Eradication in Children (소아 Helicobacter pylori 위염에서 균 박멸과 관련된 위염의 내시경 및 조직학적 변화에 대한 연구)

  • Chang, Ju-Young;Kim, Han-Seong;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.18-27
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    • 2001
  • Purpose: The aims of this study are to investigate the effect of the eradication of H. pylori on histological change of gastric mucosa in children with H. pylori gastritis and to determine whether the histological grading by the Sydney system is valuable in predicting the effect of treatment. Methods: 1) Histological scores by the Sydney system and the endoscopic characteristics were assessed before and at least four weeks after anti-H. pylori therapy in 42 children with H. pylori gastritis. 2) In 32 children treated with omeprazole, amoxicillin and clarithromycin (OAC), pretreatment histological scores and endoscopic findings were compared between the eradicated and the noneradicated to evaluate their predictive value for the successful eradication. Results: 1) In the eradicated (27 cases), nodular gastritis significantly decreased from 89% to 63% (p<0.05). There was an significant improvement in the mean activity score from 2.06 before treatment to 0.24 after treatment (p<0.01). The mean inflammatory score also improved from 2.61 before treatment to 1.89 after treatment (p<0.05). Lymphoid follicles significantly decreased from 48% to 15% (p<0.05). Epithelial damage improved in all 4 cases. But in the noneradicated (15 cases), there was no significant change in the frequency of nodular gastritis, the mean activity score, the mean inflammatory score and the frequency of the lymphoid follicles. 2) In 32 children treated with OAC, there was a tendency that the higher was the pretreatment score of the bacterial density, the lower was the eradication rate of H. pylori (p=0.072). Conclusion: The loss of the polymorphonuclear cell infiltration is the most prominent histological change after successful eradication. There may be negative correlation of the grade of the bacterial density with the success rate of the anti-H. pylori therapy.

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Treatment of Lymphocytic Gastritis with Cyclosporine in a Cat (고양이 림프구성 위염에서 싸이클로스포린을 이용한 치료 증례)

  • Lee, Hwajoon;Park, So-Young;Ahn, Byeongwoo;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.108-111
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    • 2014
  • A 7-year-old spayed female domestic shorthair cat was referred for chronic intermittent vomiting. The frequency of vomiting increased recently, and the cat showed anorexia at presentation. There were no remarkable abnormalities on the blood analyses and diagnostic imaging. However, the endoscopic examination revealed focal erosions of the gastric body mucosa, and subsequent multiple biopsies were obtained. Histopathologic examination indicated mild to moderate lymphocytic gastritis. The vomiting was completely disappeared 7 days after the administration with prednisolone (PDS). However, because of side effects caused by the long-term PDS administration, cyclosporine was added on the prescription with tapered dose of PDS. The dog's condition improved with continued cyclosporine treatment, and no further vomiting and anorexia episodes have been noted. This case describes the successful management with administration of cyclosporine in feline lymphocytic gastritis.

A Case of Giant Gastric Schwannoma Accompanied with Bleeding (출혈을 동반한 거대 위 신경초종 1예)

  • Kim, Je-Yeon;An, Ji-Yeong;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.47-51
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    • 2006
  • The origin of a submucosal tumor is difficult to determine by endoscopic biopsy. One type of submucosal tumor, which originates in Schwann cell, a schwannoma represents 0.2% of all gastric tumors. We experienced the case of a 57-year-old female patient with a gastric schwannoma presenting with melena and anemia. Computed tomography and upper gastrointestinal endoscopy showed a protruded huge mass from 3 cm below the cardia to angle. Seven endoscopic biopsies indicated only necrotic debri and granulation tissue, chronic gastritis. Because we suspected an advanced gastric cancer, or lymphoma with bleeding, It was performed an operation for an exact diagnosis and a treatment for bleeding. A-post-operative histopathological, immunohistochemical examination led to the final diagnosis of a gastric schwannoma.

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The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery (위 점막하 종양에 대한 개복 및 복강경 위 절제술의 비교)

  • Lim, Chai-Sun;Lee, Sang-Lim;Park, Jong-Min;Jin, Sung-Ho;Jung, In-Ho;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.225-231
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    • 2008
  • Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

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Gastroduodenoscopic Findings and Effect of Therapy of Helicobacter pylori Infection in Children (소아 Helicobacter pylori 감염의 상부 위장관 내시경 소견 및 치료 효과)

  • Rhee, Kyung Shin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.12-20
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    • 2005
  • Purpose: Helicobacter pylori infection is known to be associated with acute or chronic abdominal pain and upper gastrointestinal bleeding in children. This study was performed to analyze the gastroduodenoscopic findings and the efficacy of triple therapy with omeprazole, amoxicillin and clarithromycin between one and two weeks of duration in children with H. pylori infection. Methods: We have assessed retrospectively 60 patients presented with acute or chronic abdominal pain or upper gastrointestinal bleeding. H. pylori infection was confirmed by endoscopic biopsy and rapid urease test. Out of 60 patients, 30 patients were treated with a combination of omeprazole, amoxicillin, and clarithromycin for one week, and the other 30 patients were treated for two weeks with the same medication. Efficacy of treatment was assessed 4 weeks after the termination of treatment by using the $^{13}C$ urea breath test. Results: The 60 patients with the complaint of diffuse abdominal pain, epigastric pain, vomiting or hematemesis were included in this study. One-week treatment group (group I) consisted of 30 patients (14 male, 16 female) with mean age of $11.6{\pm}2.67years$. Two-week treatment group (group II) consisted of 30 patients (11 male, 19 female) with mean age of $10.7{\pm}4.17years$. In group I, H pylori were eradicated in 26 out of 30 patients (86.7%). In group II, H. pylori were eradicated in 26 out of 30 children (86.7%). Both groups did $^{13}C$ urea breath test after 4 weeks after termination of the triple therapy. The eradication rates were same in both groups as 86.7%, 26 out of 30 patients in each group. The results of endoscopy were nodular gastritis 26 (43.3%), erosive gastritis 10 (16.7%), hemorrhagic gastritis 7 (11.7%), gastric ulcer 2 (3.3%) and normal finding 15 (25.0%). Conclusion: In this study, the nodular gastritis was most common endoscopic findings with H. pylori positive patients. The eradication rate of H. pylori with omeprazole, amoxicillin and clarithromycin was 86.7% and it would be highly effective as primary treatment with no significant differences in the eradication rate between one-week and two-week treatment groups. However, we should need more long-term follow-up data.

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