• 제목/요약/키워드: Esophageal Diseases

검색결과 117건 처리시간 0.028초

미만성 식도경련의 한방 치료 : 증례보고 (Case Study of Korean Medicine Treatment of Diffuse Esophageal Spasm)

  • 김동윤;황미니;고휘형;백소영;이하늘;정해인;하나연;김진성
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.814-821
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    • 2019
  • Objective: This case study reports on the result of Korean medicine treatment of diffuse esophageal spasm. Methods: A 46-year-old female Korean patient with diffuse esophageal spasm received electroacupuncture, herbal medicine, and moxibustion treatment for 2 weeks in hospital. Results: Decreases in the visual analog scale (VAS) (from 8.7 to 7.0), numeric rating scale (NRS) (from 7.0 to 5.5), gastrointestinal symptom rating scale (GSRS) (from 9 to 6), and gastroesophageal reflux disease-health related quality of life questionnaire (GERD-HRQL) (from 46 to 38) scores were observed after the treatment. Conclusion: Evaluation of Korean medicine treatment is worthwhile for rare diseases like diffuse esophageal spasm.

Eosinophilic Esophagitis and Eosinophilic Gastroenteritis: Similarities and Differences

  • Yoshikazu Kinoshita;Norihisa Ishimura;Shunji Ishihara
    • Journal of Digestive Cancer Research
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    • 제6권1호
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    • pp.1-5
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    • 2018
  • Eosinophilic gastrointestinal disease (EGID), a chronic allergic condition characterized by dense infiltration of eosinophils in the digestive tract, is classified into two types, eosinophilic esophagitis (EoE), which features dense infiltration of eosinophils in the esophageal epithelial layer, and eosinophilic gastroenteritis (EGE), in which the entire digestive tract including the esophagus may be involved. Patients with EoE only have esophageal symptoms, since the other parts of the digestive tract are not involved. On the other hand, 80% of EGE patients have lesions in the small intestine. The esophageal epithelial layer in healthy individuals has no or negligible infiltration by eosinophils, while the small intestinal mucosal layer, especially the distal small intestinal mucosa, can show dense eosinophil infiltration even in the absence of disease. Therefore, histological changes observed in cases of EGE are not qualitative but rather quantitative, as compared to EoE, which has qualitative histopathological changes, indicating important pathogenetic differences between the types. Comparisons of clinical, laboratory, and morphological characteristics between EoE and EGE have revealed several interesting differences. Both EoE and EGE patients are frequently affected by atopic diseases, such as bronchial asthma and allergic rhinitis, and elevated plasma levels of Th2 type cytokines and chemokines are also similarly seen in both. On the other hand, age at diagnosis differs, as the former is generally found in individuals from 30 to 50 years old, while the latter appears in all age groups. Additionally, 80% of patients with EoE are male as compared to only 50% of those with EGE. Furthermore, approximately 60% of patients with EoE respond favorably to proton pump inhibitor (PPI) administration, whereas EGE patients rarely show a response to PPIs. Nevertheless, both diseases show a similarly favorable response to a six foods elimination diet and glucocorticoid administration. These similarities and differences of EoE and EGE provide important clues for understanding the pathogenesis of these EGID types.

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Human Papillomavirus Burden in Different Cancers in Iran: a Systematic Assessment

  • Jalilvand, Somayeh;Shoja, Zabihollah;Hamkar, Rasool
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7029-7035
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    • 2014
  • Certain types of human papillomaviruses (HPVs) are undoubtedly involved in genesis of human malignancies. HPV plays an etiological role in cervical cancer, but also in many vaginal, vulvar, anal and penile cancers, as well as head and neck cancers. In addition, a number of non-malignant diseases such as genital warts and recurrent respiratory papillomatosis are attributable to HPV. Moreover, HPV forms have detected in several other cancers including esophageal squamous cell carcinoma, lung, prostate, ovarian, breast, skin, colorectal and urinary tract cancers, but associations with etiology in these cases is controversial. The aim of this systematic assessment was to estimate the prevalence of HPV infection and HPV types in HPV-associated cancers, HPV-related non-malignant diseases and in cancers that may be associated with HPV in Iran. The present investiagtion covered 61 studies on a variety of cancers in Iranian populations. HPV prevalence was 77.5 % and 32.4% in cervical cancer and head and neck cancers, respectively. HPV was detected in 23.1%, 22.2%, 10.4%, 30.9%, 14% and 25.2% of esophageal squamous cell, lung, prostate, urinary tract cancers, breast and skin cancers, respectively. HPV16 and 18 were the most frequent HPV types in all cancers. The findings of present study imply that current HPV vaccines for cervical cancer may decrease the burden of other cancers if they are really related to HPV.

식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료 (Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • 제29권6호
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    • pp.672-674
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    • 1996
  • 유미흉은드물지만 심장수술,횡격막의 식도,대동맥 열공 부위의 수술합병증으로잘알려졌다. 특히 식도의 양성 또는 악성 종양에서 식도제거술이 필요한 영양 결핍상태의 환자에서 유미흥은호흘기능, 영양상태, 면역학적 인 면에서 치사율이 높은 위 험한 질병 이다. 본교실에서는 식도헙착 환자에서 식도열공을 통한 식도 제거술후 발생한 유미흥 1례를 경험하였다. 유미홍의 진단은 공장루를 통한 영양공급후 흥막 삼출액의 변화와 술후 5일째 흉막액의 Triglyceride 치의 증가로 진단하였다. 금식 상태에서도 하루 1500내지 2000cc의 유미삼출액이 배액되어 13일째 우 측 개흉술을 통해 횡격막 상부 흉관 결찰을 시 행하였으며, 좋은 결과를 얻을 수 있었다.

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식도천공의 치료 (Treatments of Esophageal Perforation - A Report of 14 cases -)

  • 구자홍;조갑호;김공수
    • Journal of Chest Surgery
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    • 제24권11호
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    • pp.1107-1114
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    • 1991
  • We have experienced fourteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Chonbuk National University Hospital during the period from mar. 1980 to Oct. 1990. The ratio between male and female patients was 5 : 9, and their age ranged from 22 years to 69 years. The causes of th eesophageal perforation were iatrogenic in 6 cases, foreign body 5 cases, diverticulitis 2 cases, and postpneumonectomy 1 case. The locations were cervical esophagus in 2 cases, upper thoracic in 2 cases, mid-thoracic 4 cases, and lower thoracic 6 cases. The underlying diseases associated with perforation were lye stricture, diverticulum, achalasia, and postpneumonectomy empyema. The treatments were supportive in 6 cases and combined with surgical measures in 8 cases. surgical measurs were as follows : incision and drainage in 2 cases, esophagectomy with esophagogastrostomy 3 cases, esophagocardiomyotomy with partial fundoplication in 1 case, simple closure with myoplasty and thoracoplasty 1 case, and empyema drainage and gastrostomy 1 case. There was no mortality.

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식도이물의 합병증에 관한 임상적 관찰 (Clinical Observation of Complications of Foreign Bodies in the Esophagus)

  • 이양선;조영채
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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    • pp.6.1-6
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    • 1979
  • 식도이물의 합병증은 희소하나, 간혹 예리한 골편, 예리한 금속성리물 및 이물의 장기체류에 의해 식도손상을 일으키는 이물자체에 의한 경우, 식도질환 환자의 진단, 치료 목적으로 식도경검사 때의 조그마한 부주의에 의한 경우 및 식도의 위치관계 등의 원인으로 합병증을 일으키어 자칫 잘못하면 치명적인 상태까지 야기시키는 수도 있다. 그러므로 여기에 대한 조기진단과 신속한 치료을 가하지 않으면 높은 사망률과 병변을 초래하기도 한다. 이러한 의미에서 저자는 식도이물자체에 의한 합병도 및 식도경검사시의 부주의에 의한 합병증 27례를 경험하였기에 문헌적고찰과 함께 보고하는 바이다.

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위식도역류질환과 인후두역류질환의 대한 최신지견 (Update of Pathophysiology in GERO/LPR)

  • 우정수
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.83-90
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    • 2010
  • The pathophysiology of Gastroesophageal reflux disease (GERD) has been known that it is developed when the offense-primarily the gastric acid-pepsin content of the refluxate-overcomes a 3-tiered esophageal protective defense. consisting of antireflux mechanisms, luminal clearance mechanisms, and tissue resistance. Laryngopharyngeal reflux (LPR), which is known as an extraesophageal variant of GERD, has been considered to be developed by transient lower esophageal sphincter relaxation (TLESR), direct mucosal injury by gastric contents, more sensitive mucosa compared to esophagus, and absence of buffering effect and aggravation of the injury due to pepsin. However, hypothesis of the pathophysiology in both entities are numerous and still lack of understanding for being a theory. There is no conflict that understanding the pathophysiology is necessary for resolving the problems of these diseases and numerous studies and results have been releasing. This review could provide clinicians dealing with GERD and LPR with applicable new information and help for overcoming the clinical obstruction.

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Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis

  • Chong, Byung Kwon;Yun, Jae Kwang;Kim, Joon Bum;Park, Do Hyun
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.401-404
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    • 2016
  • The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care.

식도 재건술 시 흉강경용기계문합기을 이용한 경부식-장문합술 (Cervical Esophago-Enteric Anastomosis with Straight Endostapler)

  • 김일현;김광택;박성민;이승렬;백만종;선경;김형묵;이인성
    • Journal of Chest Surgery
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    • 제32권10호
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    • pp.924-929
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    • 1999
  • Background: The use of the stapler n esophageal reconstruction after esophageal resection for benign or malignant esophageal diseases has become popular because it has less leakage at the anastomotic site and shorter operation time than manual sutures. However, the use of classic circular stapler has some complications such as stenosis and dysphagia that requires additional treatment. Such complications are closely related to the inner diameter of the anastomotic sites. In this study, the diameter of anastomotic site was compared after the use of circular stapler(EEA) and straight endoscopic stapler(endo GIA). Material and Method: The patients who received esophageal reconstruction by stapler from August 1995 to September 1997 were reviewed. The patients were divided into 2 groups. One group need the circular stapler, and the other group the straight endo GIA(14 cases with endo GIA 30mm, 24 with endo GIA 45mm). After a cervical esophago-enteric anastomosis, the stricture of anastomotic site and the incidence of dysphagia were compared between the 2 groups using an esophagography and the patient's symptoms. The follow-up period was 12months in average. Result: In the former group in which the circular stapler was used, 2 cases of anastomotic stenosis were reported. In comparison, none were reported in the latter group. Dysphagia were reported in 8 cases of the former group, and in 3 cases of the latter group(1 case in endo GIA 30 mm, 2 cases in endo GIA 45 mm). Conclusion: The use of endo GIA in esophago-enteric anastomosis resulted in a wider diameter of the anastomotic site, lesser stricture, and lesser incidence of dysphagia compared to the use of former circular stapler. Therefore, it is thought to be a better method in esophageal reconstructions.

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Clinical Application of an Image-Guided Intervention in Three Dogs

  • Choi, Minsik;Kwon, Dohoon;Ahn, Jisoo;Ko, Minjung;Ahn, Jiyoung;Jung, Joohyun;Kim, Hakhyun;Kang, Ji-Houn;Chang, Dongwoo
    • 한국임상수의학회지
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    • 제37권2호
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    • pp.100-105
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    • 2020
  • A 9-month-old, 11.3 kg, intact, male, mixed-breed dog was referred for treatment of cor triatriatum dexter (CTD); a 5-month-old, 1.9 kg, intact, male Maltese for pulmonic stenosis (PS); and a 3-year-old, 6.62 kg, intact, female West Highland white terrier for esophageal stricture with regurgitation. A balloon catheter intervention was performed in the dog with CTD, and subsequent color Doppler ultrasound and abdominal ultrasound showed normal blood flow across the perforated membrane dividing the right atrium and the disappearance of the severe ascites present before treatment. Balloon catheter intervention in the dog with PS reduced the blood flow through the stenosis from 5.82 m/s to 3.97 m/s. In the dog with esophageal stricture, balloon catheter intervention widened the esophagus and no subsequent regurgitation was observed. Balloon catheter intervention is an interventional radiology procedure that represents a definitive treatment option for various stenotic lesions in dogs, including CTD, PS, and esophageal stricture. Although interventional radiology procedures for these diseases have already been reported, details of procedures and successful outcome have not been reported in Korea.