• Title/Summary/Keyword: 위 점막 출혈

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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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Studies on Physicochemical and Biological Properties of Depolymerized Alginate from Sea Tangle, Laminaria japonicus by Heating Hydrolysis -4. Inhibition Effects of Acute Gastritis Induced by $HCl{\cdot}ethanol$ Solution and Gastric Ulcer Induced- (다시마 (Laminaria japonicus) Alginate의 가열가수분해에 따른 물리${\cdot}$화학적 및 생물학적 특성에 관한 연구 -4. $HCl{\cdot}ethanol$용액과 침수스트레스에 의해 유발되는 랫드 위궤양의 억제효과-)

  • KIM Yuck-Yong;CHO Young-Je
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.33 no.6
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    • pp.520-523
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    • 2000
  • Anti-ulcer effects of depolymerized alginate (HAG-10, average molecular weight 10,000; HAG-50, average molecular weight 50,000; HAG-100, average molecular weight 100,000) obtained by hydrolysis of alginate by heating at $121^{\circ}C$, against $HCl{\cdot}ethanol$ and water-immersion stress in rats were investigated. The acute gastritis, induced by $HCl{\cdot}ethanol$, and the gastric ulcer, induced by water-immersion stress, were inhibited dose-dependently by administration of HAG-50, HAG-100 and alginate. Histopathological lesions of the gastritis and gastric ulcer in rats treated with HAG-50, HAG-100 and alginate were significantly lower than those in rats fed with HAG-10. The inhibition rates (${\%}$) on acute gastritis induced by $HCl{\cdot}ethanol$ and gastritis ulcer induced by water-immersion stress in rats, were $13.00{\%}\;and\;15.74{\%}$of HAG-10, $41.15{\%}\;and\;35.72{\%}$ of HAG-50, $41.58{\%}\;and\;35.37{\%}$ of HAG-100, and $45.17{\%}\;and\;41.11{\%}$ of alginate, respectively. These results suggested that HAG-50, HAG-100 and slginate had a protective effect against the gastritis and gastric ulcer. The effect was not as visible when using HAG-10 in rats. From the present results, it was suggested that HAG-50 was an effective anti-ulcer agent against $HCl{\cdot}ethanol$and water-immersion stress in rats.

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질병 전염성 후두기관염

  • 김순재
    • KOREAN POULTRY JOURNAL
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    • v.14 s.150
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    • pp.27-34
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    • 1982
  • 최근 일부지역에서 발병된 바 있는 전염성 후두기관염은 호흡곤란을 주특징으로 하는 닭의 급성 호흡기병이다. 피가 섞인 가래가 기관안에 가득차 있기 때문에 골골거리며 호흡이 대단히 답답하고 곤란하여 목을 길게 위로 빼고 입을 벌리고 괴성음을 내며 호흡을 하기도 한다. 기관의 점막이 붓고 염증이 생기며 점막이 탈락되면서 출혈하기도 하고 각혈을 하면서 응고된 혈액이 기관을 메꾸어 호흡이 곤란하게 되어 질식하여 죽는다. 이러한 증상은 동물이기에 그대로 보아 넘기기 쉬우나 숨통이 피와 가래로 메꾸어져 호흡을 하지 못하고 질식사하는 장면은 차마 보기 어려운 비참한 죽음의 질병이다. 이병은 과거에 발생이 없어 다행으로 여겨 왔으나 이제 부터는 이 전염병에 대한 예방대책을 강구하지 않으면 안되겠다.

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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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Delayed Primary Repair of Esophageal Rupture (식도천공 후 만기 일차 봉합술의 성적)

  • 김길동;정경영;김창수;박한기
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.46-51
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    • 1998
  • Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

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Protective Effects of Crude Mucin and Saponin from Dioscorea Rhizoma on Gastric Ulcer Induced by Alcohol in Rats (산약의 조추출 mucin과 saponin이 급성 위궤양이 유도된 흰쥐에 미치는 보호 효과)

  • Park, Young Mi;Lim, Jae Hwan;Jeong, Hyung Jin;Seo, Eul Won
    • Journal of Life Science
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    • v.24 no.11
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    • pp.1200-1208
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    • 2014
  • The aim of this study was to investigate the effect of crude mucin and saponin from Dioscorea Rhizoma on acute gastric ulcers in rats. The gastric ulcer group (GU group) and mucin-applied group (DR-M group) exhibited serious bleeding of the mucous membrane of the stomach due to the ulcers, as well as blood congestion for three days. The saponin-applied group (DR-S group) exhibited less mucous membrane bleeding, and reddened and inflamed membranes recovered dramatically within 24 hours. After developing an acute pgastric ulcer, the tissues of the stomach, intestine, and liver in the control group and the DR-M group exhibited edema in the submucous membrane, as well as serious bleeding. However, the DR-S group recovered quickly from mucous membrane bleeding due to gastric ulcer. The DR-M group did not show any notable changes in serum formation or activity of antioxidant enzymes compared to the GU rats. Increased AST and ALT activities were detected from the first day with saponin application in the gastric ulcer rats. As the AST and ALT activities decreased, the gastric ulcers recovered with the increased activities of the antioxidant enzymes. Accordingly, this study suggest that mucin in Dioscorea Rhizomahas no effect on the recovery of damaged stomachs due to gastric ulcers, but saponin is mainly responsible for decreasing tissue damage by activating antioxidant enzymes.

Pancreatic polypeptide family-PP, NPY, PYY (위장홀몬에 대한 최신 정보)

  • Lee, K.Y.
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.1-8
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    • 1988
  • 위장관에서 분비되는 많은 국소호르몬 중에서 이미 널리 알려진 것을 외에 구조적인 공통점을 가진 새로운 group인 pancreatic polypeptide family에 대한 정보를 요약하여 보았다. PP, NPY 및 PYY는 그 구조적 유사점들에도 불구하고 분비되는 장소가 판이하여, PP는 위와 췌장의 국소호르몬으로서, NPY는 중추 및 말초신경의 신경충동전달체로서, 또 PYY는 하부위장관 점막에서부터 분비되어 전신 호르몬처럼 작용하고 있다. 이들 NPY와 PYY의 혈관수축작용과 혈압상승작용은 우리의 흥미를 끌기에 충분하다. 특히 PYY는 주로 하부장관 특히 결장과 직장의 분비조직에서 많이 발견된다는 점과 돼지의 뇌혈관을 수축시켰다는 점이 주목할 만한 것이다. 우리나라에는 많은 고혈압 환자가 있으며, 고혈압을 비롯한 여러가지 원인에 의한 뇌졸중(뇌출혈 포함) 환자도 많이 발생하고 있다. 민간의 속설에 의하면 출혈성 뇌졸증이 기온이 낮은 계절에 보다 자주 발생하는 경향이 있으며, 이른아침 화장실에서의 배변시 자주 발생한다고 한다. 물론 이러한 속설을 뒷받침할 만한 자료가 없으므로 학문적 견지에서의 신빙성 여부를 논할 가치는 없겠으나, 배변시 비교적 강한 자극을 받고 활발한 운동을 하는 결장과 직장에 PYY의 분비세포가 집결되어 있다는 점과 PYY의 뇌혈관수축작용 및 혈압 상승작용 등을 고려해 볼 때, 출혈성 뇌졸증과 PYY의 상관관계는 추구해볼 만한 사항이라 사료된다.

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Clinical Features of Symptomatic Meckel's Diverticulum (증후성 멕켈 게실의 임상적 고찰)

  • Lee, Young Ah;Seo, Ji Hyun;Youn, Hee Sang;Lee, Gyeong Hun;Kim, Jae Young;Choi, Gwang Hae;Choi, Byung Ho;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.193-199
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    • 2006
  • Purpose: The proper diagnosis of Meckel's diverticulum (MD) is difficult and delayed because of the variety of clinical manifestations. We reviewed clinical characteristics of symptomatic MD to facilitate early detection. Methods: We analyzed retrospectively the clinical manifestations, diagnostic tools, histopathological findings, and operative findings in 58 patients with symptomatic MD. Results: The male to female ratio was 2.8 : 1. The most common symptom of MD was bleeding. Others symptoms included: vomiting, abdominal pain, irritability, abdominal distension and fever in the order of frequency. The clinical manifestations of symptomatic MD were lower gastrointestinal bleeding, intestinal obstruction, perforation, diverticulitis and hemoperitoneum, in the order of frequency. The causes of intestinal obstruction were intussusception, internal hernia, band, volvulus, invagination, in the order of frequency. Seventy five percent of patient with MD were diagnosed prior to 5 years of age. The most frequently used diagnostic tool was the Meckel's scan. The diverticulum was located 2 cm to 120 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 1 cm to 10 cm and 94% were less than 5 cm. The most common ectopic tissue found in the MD was gastric mucosa. Ileal resection was more frequently performed than diverticulectomy. Conclusion: In cases of unexplained gastrointestinal bleeding, obstruction and repeated intussusception, the meckel's scan, ultrasound and computed tomography shoud be considered to rule out MD, and if clinically necessary, an exploratory laparotomy when needed.

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Clinical Availability of Endoscopic Incision and Submucosal Dissection for the Treatment of Gastric Neoplasms (위종양성 병변에 대한 내시경 절개 점막하 박리법의 임상적 유용성)

  • Jung, Yoon-Ho;Eun, Soo-Hoon;Cho, Joo-Young;Jung, In-Seop;Ryu, Chang-Beom;Lee, Joon-Seong;Lee, Moon-Sung;Kim, Boo-Sung;Shim, Chan-Sup
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.76-83
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    • 2006
  • Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.

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A Histopathological Study on the Intestine of Mice and Rats Experimentally Infected by Fibricola seoulensis (Fibricola seoulensis에 실험 감염된 마우스 및 흰쥐 소장의 병리조직학적 연구)

  • 이순형;유병훈
    • Parasites, Hosts and Diseases
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    • v.23 no.1
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    • pp.58-72
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    • 1985
  • A histopathological study was carried out on the duodenum of mice and rats experimentally infected by F. seoulensis. Each mouse was infected with 500 metacercariae and killed after 1, 2, 3 days, 1 and 2 weeks from infection. Each rat was given 1, 000 metacercariae and was examined after 1, 2 and 4 weeks from infection. The duodenal tissue sections of mice and rats were stained with hematoxylin eosin, and PAS stained for the rats of 1 week group. The pathological findings are summarized as below. 1. There were no differences in mucosal findings between the mice and the rats, and between the location of duodenum, 1 and 5 em distal to the pylorus. 2. Each worm embraced a villus exclusively with its foliate fore body which was inserted into the intervillous spaces. The fluke pinched villous epithelia using its oral and ventral suckers. The tribocytic organ destroyed the villous epithelia deeply up to the stroma after 3 days from infection. 3. Apparent villous changes were observed in the mice after 3 days from infection. Villous changes were shortening, widening, blunting or fusion. The villous stroma showed edema, microscopic hemorrhage, capillary congestion, dilatation of lymphatics and inflammatory cell infiltration. The cells were lymphocytes, plasma cells, eosinophils and giant cells. Rarely submucosal and trans:nural inflammation was encountered.

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