• 제목/요약/키워드: endoscopy

검색결과 1,062건 처리시간 0.024초

Consideration of Cardia Preserving Proximal Gastrectomy in Early Gastric Cancer of Upper Body for Prevention of Gastroesophageal Reflux Disease and Stenosis of Anastomosis Site

  • Kim, Jihoon;Kim, Sungsoo;Min, Young-Don
    • Journal of Gastric Cancer
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    • 제12권3호
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    • pp.187-193
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    • 2012
  • Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

삼킴 장애 환자에서 보튤리눔 독소의 임상적 적용 (Clinical Applications of Botulinum Toxin in Patients with Dysphagia)

  • 조정해
    • 대한후두음성언어의학회지
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    • 제30권2호
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    • pp.77-81
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    • 2019
  • Dysphagia may result from dysfunction of any of the components involved in the complex neuromuscular interaction of swallowing. Hyperfunction of any of the muscles involved in swallowing is a frequent cause of dysphagia. The cricopharyngeus muscle (CPM) is a key component of the upper esophageal sphincter. Cricopharyngeus muscle dysfunction (CPD) refers to the muscle's failure to appropriately and completely relax or expand during deglutition. A variety of disease processes may cause CPD and accurate diagnosis is paramount for appropriate treatment. In appropriately selected patients, intervention at the CPM may yield significant improvement in dysphagia. Interventions include nonsurgical, pharyngoesophageal segment dilatation, botulinum toxin (BoNT) injection, and criccopharyngeal myotomy. Injections of BoNT in patients with CPD have been reported to result in marked relief of dysphagia. Different techniques for instilling BoNT into the CPM have been described. Awake, in-office CPM BoNT injection with electromyography and/or fluoroscopic or ultrasound guidance is performed transcervically or via flexible endoscopy. Operative CPM BoNT injection involves rigid laryngoscopy and esophagoscopy with direct visualization of the CPM. BoNT should be prepared in low-volume, high-concentration dilutions to minimize the potential for undesired diffusion of the toxin. The effects of BoNT occur within weeks of injection and typically last up to 5 or 6 months.

볼륨프로 하드웨어를 이용한 효율적인 투시투영 방법 (An Efficient Perspective Projection using $\textrm{VolumePro}^{TM}$ Hardware)

  • 임석현;신병석
    • 한국정보과학회논문지:시스템및이론
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    • 제31권3_4호
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    • pp.195-203
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    • 2004
  • 볼륨프로는 일반 PC상에서도 실시간 볼륨렌더링이 가능하도록 고안된 하드웨어이다. 그러나 볼륨프로는 직교투영(orthographic projection) 기능만 제공하기 때문에 가상 내시경과 같이 투시투영 (perspective projection)이 필요한 분야에는 이용할 수 없다. 이런 문제를 해결하기 위해 볼륨 데이터를 여러 개의 슬랩(slab)으로 분할하여 투시투영을 근사 하는 방법이 소개되었으나 이 방법은 시각 절두체에 포함되지 않은 부분까지 렌더링 하기 때문에 처리시간이 길어지는 문제가 있다. 본 논문에서는 볼륨프로의 크로핑(cropping) 기능을 이용하여 볼륨 데이타를 여러 개의 서브볼륨으로 분할함으로써 효율적인 투시투영이 가능하도록 하는 방법을 제안한다. 이 방법은 시각 절두체(view frustum)에 포함되는 부분만 렌더링하므로 슬랩을 이용하는 기존 방법과 동일한 화질을 가지면서 처리시간을 단축시킨다.

Mean Sojourn Time of Preclinical Gastric Cancer in Korean Men: A Retrospective Observational Study

  • Bae, Jong-Myon;Shin, Sang Yop;Kim, Eun Hee
    • Journal of Preventive Medicine and Public Health
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    • 제47권4호
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    • pp.201-205
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    • 2014
  • Objectives: This retrospective cohort study aimed to estimate the mean sojourn time (MST) of preclinical gastric cancer in Korean men. Methods: The subjects consisted of voluntary male screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative at a baseline screening performed between January 2007 and December 2011. A new case was defined if gastric cancer cells were present in the biopsy specimens obtained from gastroscopy. The follow-up period was calculated as the number of person-years between the date of baseline screening gastroscopy and positive findings at a subsequent screening. The MST was calculated using transition rates of gastric cancer to determine the best screening interval. Results: Of the 171 979 voluntary male screenees, 61 688 (36%) underwent subsequent screening gastroscopies between January 2007 and December 2011. A total of 91 incident cases were found during 19 598 598 person-years of follow-up. The MST of gastric cancer was 2.37 years (95% confidence intervals, 1.92 to 2.96), and those aged 40 to 49 years had a shorter MST than those 50 to 69 years did. Conclusions: These findings support the 2-year interval of screening recommended by the nationwide gastric cancer screening program in Korea. Further studies for the age-specific MST among women are needed.

식도에 발생한 거대 신경초종 (Giant esophageal schwannoma)

  • 김민재;송준철;김일;윤진탁;김영우;최영;주연호;강창현
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.21-24
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    • 2016
  • Esophageal schwannoma is a very rare submucosal tumor. We report successful management of esophageal schwannoma in a 41-year-old man who complained of progressively worsening dysphagia. A huge submucosal tumor was found via endoscopy and a chest computed tomography scan. Esophagectomy was performed with no post-operative complications. Post-operative immunohistochemistry staining showed a positive result for S-100 and negative results for c-kit and CD34. The post-operative mild dysphagia persisted, and the follow-up endoscopic findings revealed anastomosis site stenosis. Approximately 2 months later, we performed endoscopic balloon dilatation. We report herein a case of esophageal schwannoma with reviews.

위 사구종양 1예 (A Case of Gastric Glomus Tumor)

  • 이진성;최선택;이현욱;권병진;이지은;이시형
    • Journal of Yeungnam Medical Science
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    • 제28권2호
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    • pp.165-172
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    • 2011
  • Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dennis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5 cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

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위축성 비염 환자에서 성상신경절 블록의 치료효과 -증례 보고- (Stellate Ganglion Blocks in Atrophic Rhinitis)

  • 김승준;이우창;장원석;윤덕미
    • The Korean Journal of Pain
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    • 제14권2호
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    • pp.231-233
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    • 2001
  • Atrophic rhinitis is characterized by mucosal atrophy, bony absorption, persistent fetid odor and resistance to medical and surgical treatment. Stellate ganglion block (SGB) can be used as a therapeutic modality by improving the regional blood flow through sympathetic blockade. We present a case of a 57 year-old male patient who had been treated unsuccessully for atrophic rhinitis for several years by surgical and conservative measures. The patient presented at our pain clinic with shoulder pain and received stellate ganglion block once or twice a week. He received more than 75 SGBs in addition to the routine conservative treatment for atrophic rhinitis. As the number of blocks performed increased, the patient demonstrated subjective symptom relief. We measured regional mucosal blood flow using a laser doppler flowmeter after the 28th, 63rd and 75th blocks. Nasal mucosal blood flow was improved by 4.9%, 28.8% and 36.3% respectively. We also were able to observe the recovery of mucosal atrophy to an almost normal level by nasal endoscopy. The patient is currently free of symptoms and is being followed up on an outpatient bases.

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유공압 부품이 내장된 인쇄회로기판을 활용한 내시경 수술용 기복기의 개발 (Development of the Insufflator for Endoscopic Surgery using the Fluidic System in Printed Circuit Board)

  • 이희남;김인영;지영준
    • 대한의용생체공학회:의공학회지
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    • 제32권1호
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    • pp.32-36
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    • 2011
  • The insufflators in endoscopic surgery supply carbon dioxide to make the air-filled cavity in the abdomen. It contains many kinds of pneumatic and electronic parts and they are connected with the air tubes and electrical wires. The printed circuit boards (PCB) perform wiring, holding and cooling tasks in electronic systems. In this study, the PCB is used as the air channel for insufflators to decrease the cost, volume, and the malfunction according to aging of the device. Three layers of PCB made of FR4 are combined with prepreg as adhesive which has the internal airway channel according to the design. By mounting the pressure sensors and valves, the PCB based fluidic system is implemented. After calibration of flow sensor, the flow rate of the gas also can be measured. The climate test, temperature test, and biocompatibility test showed this idea can be used in insufflators for laparoscopic surgery.

경부종물의 진단 (Evaluation of The Neck Mass)

  • 송계원;윤석근;최병흔
    • Journal of Yeungnam Medical Science
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    • 제3권1호
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    • pp.1-11
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    • 1986
  • As public awareness of the various warning signs of malignancy increases, so does the concern evoked by the self identified finding of mass in the head and neck area. Not all the palpable masses are always significantly abnormal, but any nontender mass especially to the adult is significant enough to warrent further full investigation and follow up, the object of which should be to determine the possibility of malignancy and urgency of treatment. Approach to the diagnosis of the neck mass is so important in that it affects decision regarding further evaluation would lead to the determination of the most efficacious mode of therapy, eventually to the good prognosis. So, it should be emphasized that approach to the diagnosis of neck mass should be planned, systematic and thorough, this begins with the taking careful history following performance of complete examination of the head and neck especially to the nasopharynx, tongue base, pyriform sinus, palatine tonsil and larynx. Then a number of laboratory and radiologic studies are available, following triple endoscopy under general anesthesia and blind biopsy if needed. The most important rule to keep is that any biopsy procedures should be delayed to the last modality of effort to the diagnosis and if it should be done, under the plan of radical neck dissection.

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A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop

  • Chun, Eun Hee;Park, Hahck Soo
    • The Korean Journal of Pain
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    • 제29권1호
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    • pp.57-61
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    • 2016
  • Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.