• 제목/요약/키워드: Ascending colon

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A Case of Taenia asiatica Infection Diagnosed by Colonoscopy

  • Kim, Heung Up;Chung, Young-Bae
    • Parasites, Hosts and Diseases
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    • 제55권1호
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    • pp.65-69
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    • 2017
  • A case of Taenia asiatica infection detected by small bowel series and colonoscopy is described. The patient was a 42-year-old Korean man accompanied by discharge of movable proglottids via anus. He used to eat raw pig liver but seldom ate beef. Small bowel series radiologic examinations showed flat tape-like filling defects on the ileum. By colonoscopy, a moving flat tapeworm was observed from the terminal ileum to the ascending colon. The tapeworm was identified as T. asiatica by mitochondrial DNA sequencing. The patient was prescribed with a single oral dose (16 mg/kg) of praziquantel.

Colorectal carcinoma and chronic inflammatory demyelinating polyneuropathy: is there a possible paraneoplastic association?

  • Adnan Malik;Faisal Inayat;Muhammad Hassan Naeem Goraya;Gul Nawaz;Ahmad Mehran;Atif Aziz;Saad Saleem
    • Clinical Endoscopy
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    • 제56권2호
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    • pp.245-251
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    • 2023
  • A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.

간외 담도암 고선량률 관내근접방사선치료 시 몬테카를로 시뮬레이션을 통한 주변장기의 선량평가 연구 (Study of Radiation dose Evaluation using Monte Carlo Simulation while Treating Extrahepatic Bile Duct Cancer with High Dose Rate Intraluminal Brachytherapy)

  • 박주경;이승훈;차석용;이선영
    • 한국콘텐츠학회논문지
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    • 제14권2호
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    • pp.467-474
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    • 2014
  • MCNPX를 통하여 계산한 상대선량과 고체팬텀과 전리함을 이용하여 측정한 상대선량을 비교하여 몬테카를로 시뮬레이션의 정확성을 평가하였다. 그리고 간외 담도암 관내근접방사선치료를 몬테카를로 시뮬레이션에 적용하기 위해 192Ir 밀봉방사성선원을 모사하였고, 한국 성인남성 표준인을 기초로 하는 KMIRD형 팬텀을 이용하여 담도 및 주변 장기를 제작하였다. 간외 담도암 관내근접방사선치료를 MCNPX를 이용하여 담도 주변 정상장기의 비유효에너지와 초기방사능을 1 Ci로 설정하여 흡수선량을 산정하였다. 몬테카를로 시뮬레이션의 정확성 평가에서 상대선량 차이가 가장 많은 지점이 1.96%로 MCNPX에서 제시한 상대오차 2%를 만족하는 것으로 나타났다. 또한, 담도 주변 정상장기의 비유효에너지 및 흡수선량은 담도와비교적 인접한 위치에 있는 우측신장, 간, 췌장, 횡행결장, 척수, 위장, 소장이 높았고, 담도와의 거리가 떨어져 있는 장기들인 좌측신장, 비장, 상행결장, 하행결장, S상결장이 낮게 나타났다.

위장종양(胃腸腫瘍)에 있어서 혈청(血淸) Carcinoembryonic Antigen의 진단적(診斷的) 의의(意義)에 관(關)한 연구(硏究) (The Diagnostic Significances of Serum Carcinoembryonic Antigen in Gastrointestinal Tract Cancers)

  • 김종태;원경희;김열자;이종석;이학중
    • 대한핵의학회지
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    • 제17권1호
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    • pp.1-10
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    • 1983
  • Carcinoembryonic antigen (CEA) levels were measured in the serum of 35 normal control subjects and 179 cases of various benign and malignant gastrointestinal diseases. Malignant gastrointestinal tumors include 69 cases of stomach cancer, 24 cases of hepatoma and 33 cases of colorectal cancer. Benign gastrointestinal diseases include 29 cases of peptic ulcer and 24 cases of liver cirrhosis. The results were as followings: 1) Mean serum CEA level in normal control subjects was $6.9{\pm}3.3ng/ml$ and there was; no difference in mean serum CEA level between age and sex difference. 2) In malignant gastrointestinal tumors, mean serum CEA level in colorectal cancer, hepatoma and stomach cancer, were $54.3{\pm}88.9ng/ml,\;62.1{\pm}99.7ng/ml$ respectively. Serum CEA level showed positive rate of 67% in colorectal cancer, 63% in hepatoma and 62% in stomach cancer. There was no difference in mean levels and positivity of serum CEA between these 3 malignant tumor groups. 3) Positivity of serum CEA was 61% in malignant gastrointestinal tumor group in spite of 37% in benign gastrointestinal disease group. In both mean level and positivity of serum CEA, stomach cancer was much higher than peptic ulcer. But there was no difference in mean level and positivity of serum CEA level between hepatoma and liver cirrhosis. 4) In hepatoma serum CEA level showed positive rate of 62.5% and alpha-feto protein showed a rate of 58.3%. 5) Mean serum CEA levels in patients with cancer in rectal, cecal, sigmoid colon, ascending: colon and descending colon were $73.7{\pm}106.7ng/ml,\;69{\pm}84.8ng/ml$, $15.7{\pm}9.1ng/ml,\;7.5{\pm}10.6ng/ml$ and 4.0ng/ml respectively. Positive rate of serum CEA showed 86% in sigmoid. colon cancer, 68% in rectal cancer and 66% in cecal cancer. 6) In considering of histological background, there was no correlation between the degree of differentiation of tumor cell and the serum CEA level in colorectal cancer. According to Duke's classification, the mean serum levels of CEA were $8.8{\pm}11.4ng/ml$ in group A, $15.3{\pm}16.0ng/ml$ in group B and $68.5{\pm}101.5ng/ml$ in group C respectively. Positivity-of serum CEA in group A, Band C were 40%, 50% & 69% respectively. So there was significant correlation between the degree of elevation of serum CEA and tumor extension.

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크론씨병으로 진단된 소양인 환자 치험 1 례 (Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease)

  • 이승현;박단서
    • 동의생리병리학회지
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    • 제21권5호
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    • pp.1346-1351
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    • 2007
  • Crohn' disease is an auto-immune disease characterized by intermittent chronic diarrhea, high fever, weight loss, abdominal spastic pain or abdominal discomfort which is followed by granulomatous necrosis and cicatrical inflammation. It is also called segmental enteritis or granulomatous enteritis. In western medicine the exact cause is undefined, however it is presumed as an immunological unbalance in alimentary tract commoonly occured in ileum portion of small intestitine or ascending colon and therefore immuno suppressive agents(usually steroids) and anti-inflammatory drugs are prescribed. In case of emergency such as ileus, perforation of intestinal wall surgical methods are considered. In oriental medicine this falls under the category of diarrhea(泄瀉), dysentery(痢疾), splenic diarrhea(脾泄). As to the pathological mechanism the abnormal ascending and descending circulation of stomach and splenic energy(脾不升淸, 胃不下降) the hepatic stagnation(肝鬱氣滯) and dysfunction of small intestine in expelling urine and feces(小陽淸獨不利) all together causes such condition. Main treatments are inducing diuresis(利小便), warming kindey to reinforce yang(溫賢助陽), nourishing the middle energy to invigorate spleen(補中健脾), elimination of the dampness by cooling(淸熱燥濕). In this case the patient was diagnosed as soyangyin(少陽人) constitution and herb medicine soyangyin Hyongbangjihwan-tang(少陽人 荊防地黃湯), Sa-am acupuncture Sojangjeonggyeok(小腸政格) was applied. There was an significant improve in chief complaints and general conditions.

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

  • Iravani, Shahrokh;Kashfi, Seyed Mohammad Hossein;Azimzadeh, Pedram;Lashkari, Mohammad Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9933-9937
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    • 2014
  • Background: Colorectal cancer is the third most common type of cancer in males and the second in females in Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor for colorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of this study was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients and to investigate the variation between our populations with other populations. Materials and Methods: A total of 167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013 and specimens were taken through polypectomy and transferred to pathology. All data in patient files including pathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of < 0.05 was considered significant. Results: Mean age of participants was $57{\pm}15$. Some 84 were females (50.3%) and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) were in females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%) with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followed by 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, data being missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent type of lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70 (31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screening plans to prevent further healthcare problems with colorectal cancer in the Iranian population.

A Case of Ectopic Peritoneal Paragonimiasis Mimicking Diverticulitis or Abdominal Abscess

  • Kim, Min Jae;Kim, Sung-Han;Lee, Sang-Oh;Choi, Sang-Ho;Kim, Yang Soo;Woo, Jun Hee;Yoon, Yong Sik;Kim, Kyung Won;Cho, Jaeeun;Chai, Jong-Yil;Chong, Yong Pil
    • Parasites, Hosts and Diseases
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    • 제55권3호
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    • pp.313-317
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    • 2017
  • Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about $70{\mu}m$, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.

한국인에 있어서 대장의 작은 용종의 의의 (The Significance of Small Polyp of Colon in Koreans)

  • 권순욱;이은주;은종열;최선택;이학준;장병익;김태년;정문관
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.39-48
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    • 2000
  • 대장암의 발생에는 adenoma-carcinoma sequence 가설과 de novo cancer 가설이 있다. 서양에서는 adenoma-carcinoma sequence에 의해 주로 대장암이 발생한다고 생각하지만 최근 일본을 중심으로 1 cm 이하의 작은 용종에서 암 조직이 많이 발견되면서 어느 가설이 옳은 것인지에 대한 논란이 되고 있다. 이에 우리나라 사람에서의 작은 용종의 특성을 알고자 본 연구를 시행하였다. 연구 대상은 1999년 5월부터 1999년 9월까지 각종 소화기 증상 및 대장암의 감시검사를 원하는 환자를 대상으로 전향적 검사를 시행하였고 용종의 대장 내시경 소견과 조직검사 소견을 분석하여 용종의 발견빈도, 위치, 크기, 모양, 조직소견 등을 관찰하고 시술의 안정성을 조사 하였다. 전체 508명의 환자 중 210명에서 대장 용종이 발견되었고(41.3%), 나이별 분포는 50대와 60대에서 가장 많았으며 나이가 증가 할수록 의미있게 용종의 빈도가 증가하였으며, 남녀의 차이는 없었다. 용종의 육안적 소견상 Yamada type II가 가장 많았으며 1 cm 이하 크기가 395개였고 1 cm 이상인 것이 13개였다. 위치는 상행결장, 직장, S자형 결장 순으로 많았다. 1 cm 이하인 용종의 위치도 상행 결장, 직장, S자형 결장 순으로 많았다. 용종의 제거는 EMR을 가장 많이 이용하였고, cold polypectomy나 생검겸자를 이용한 제거, 고주파 올가미법으로 하였고 여러가지 이유로 제거가 불가능한 것은 생검겸자로 생검만 하였다. 용종제거후 출혈이나 천공 등의 합병증은 전례에서 없었고 합병증을 예방하기 위해 19예에서 clipping을 시행하였다. 전체 408개의 용종 중 5개의 용종에서 암성 조직이 발견되었다. 간 만곡부와 상행결장에 1.5cm, 2.0cm 크기의 유경성 용종이었고 조직 검사상 tubulovillous adenoma에 국소 암성 조직을 포함하고 있었으며 1 cm 이하의 용종은 상행결장, 직장, 간 만곡부에 0.4 cm, 0.5 cm, 0.6 cm 크기의 용종에서 암 조직이 발견 되었는데 모두 주위에 선종 조직이 없는 암성 용종이었다. 결론적으로 우리나라 사람에서 용종은 결코 드문 질환이 아니며 작은 용종에서도 암 조직을 관찰할 수 있기 때문에 대장 내시경 검사시 용종이 발견되면 반드시 모두 제거하여 검사하는 것이 좋으며 용종 절제술 후에 합병증을 예방하는 내시경적 시술을 병행하면 합병중음 충분히 예방할 수 있다고 생각하며 우리나라 사람에서 대장암의 발생이 모두 adenoma-carcmoma scquence에 의해서 발행하는 것인지에 대해서는 앞으로 더 많은 연구가 필요할 것으로 생각된다.

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대장 내시경으로 진단한 장결핵 1례 (A Case of Intestinal Tuberculosis Diagnosed by Colonoscopy)

  • 배상영;박선주;남승연;정지아;서정완;이선화
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제2권2호
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    • pp.245-249
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    • 1999
  • 저자들은 심한 빈혈과 복통을 주소로 내원한 폐결핵을 동반하지 않은 9세 여아에서 시행한 대장내시경 소견과 생검 조직의 배양 검사로 진단하고 항결핵제 치료로 증상이 호전된 예를 경험하여 보고하는 바이다.

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Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates

  • Bae, Jaeho;Jeong, Mi Jin;Shin, Dong hoon;Kim, Hyun Woo;Ahn, Sung Ho;Choi, Jun Ho;Yu, Hak Sun
    • Parasites, Hosts and Diseases
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    • 제58권6호
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    • pp.689-694
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    • 2020
  • Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.