• Title/Summary/Keyword: endoscopy

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Role of F-18 FDG PET or PET/CT in the Evaluation of Gastric Cancer (위암 평가에 있어 F-18 FDG PET 또는 PET/CT의 역할)

  • Yun, Mi-Jin
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.141-147
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    • 2006
  • PET detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after being diagnosed with gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivities for lymph node staging, the specificities of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of the primary tumor is low, the distant metastasis is also known to show low FDG uptake reducing its detection. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET.

A Case of Incomplete Congenital Duodenal Diaphragm Presented as Hematemesis (토혈과 동반된 십이지장 이물 적출 시진단한 선천성 불완전 십이지장 격막 1례)

  • Yeom, Hee Hyun;Kwon, Ki Beom;Park, Kyung Bae;Park, Joon Soo;Park, Jae Ock;Kim, Young Tong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.64-69
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    • 2005
  • We have experienced a case of incomplete congenital duodenal diaphragm with a foreign body (a button), which was found by endoscopy in a 13 month-old girl. She had symptoms of hematemesis, vomiting and bloody stool for a day probably due to foreign body impaction.

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Use of Lidocaine Patch for Percutaneous Endoscopic Lumbar Discectomy

  • Kim, Kyung-Hoon
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.74-80
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    • 2011
  • Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.147-150
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    • 2015
  • Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

Recurrent Pancreatitis Caused by Intraluminal Duodenal Diverticulum in an 11-year-old Girl - a Case Report - (십이지장 내강 내 게실로 인한 반복적인 췌장염 - 1예 보고 -)

  • Ji, Moon-Jong;Kang, Shin-Yong;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.175-179
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    • 2005
  • An 11-year-old girl with a history of two previous attacks of acute pancreatitis was admitted to another hospital. Her epigastrium was tender, and serum amylase was 657 IU/L and lipase 3131 IU/L. Abdominal computed tomography scan suggested necrosis of 30% of the pancreas. Retrograde endoscopic cholangiopancreatography showed a diverticulum covered by normal duodenal mucosa at the second portion of the duodenum, which was separated from the adjacent duodenal lumen by a radiolucent band at UGI series. The apex of the diverticulum was incised endoscopically using a needle knife papillotome. A follow-up endoscopy on the next day noticed bleeding from the incised edge of the diverticulum. Endoscopic hemostasis with hemoclipping and injection of hypertonic saline-epinephrine solution was not successful. The patient was transferred to Kyungpook National University Hospital, and open duodenotomy and excision of the diverticulum were performed. She has recovered well and remains asymptoatic.

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Evaluation of Clinical Effectiveness of 3D Digital Endoscopic Image (3차원 디지탈 내시경 영상의 임상적 효용성 평가)

  • Song, Chul-Gyu;Kim, Kyeong-Seop;Kim, Nam-Gyun
    • Korean Journal of Digital Imaging in Medicine
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    • v.5 no.1
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    • pp.26-31
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    • 2002
  • This paper represents the design of 3D endoscopic video system in order to improve visualization and enhance the ability of the surgeon to perform delicate endoscopic surgery. Minimally invasive techniques have set new standards in all surgical may experience less post-operative discomfort, shorter hospitalization, and quicker recuperation. Finally, the aim of the present study was to determine the influence of 2D and 3D video imaging on defined tasks on a laparoscopic trainer.

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Current Status of Health Screening in Korea (한국의 건강검진 현황)

  • Jo, Han-Ik
    • Journal of Korea Association of Health Promotion
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    • v.2 no.2
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    • pp.215-230
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    • 2004
  • Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea. Most of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites),chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress, early Psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests(CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT), endoscopy (gastroscopy, colonoscopy) , sonography(abdormen, thyroid, pelvis, breast) , cytology(cervix) ,bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MIRI, MIRI/Angio, molecular testings) were widely usedin hospital health screening programmes. In summary, a variety of were utilized by stages or programmes, however a few subjects. tests were utilized in health screening in Korea. Those tests according to sex and age in most of health screening program used tests to excess disregarding health screening subject.

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Congenital Tracheoesophageal Fistula without Atresia of the Esophagus (식도폐쇄를 동반하지 않은 선천성 기관식도로루의 치험 1예 보고)

  • Lee, Dong-Hyup;Lee, Cheol-Joo;Min, Hyun-Sik
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.253-258
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    • 1985
  • The congenital tracheoesophageal fistula without atresia of the esophagus is considered a rare variant, and the literature concerned to the tracheoesophageal fistula without atresia, is little in adult especially. The 22-year-old male was admitted to Yeungnam University Hospital with his chief complaints of weight loss (6kg/6 months), abdominal discomfort, and intermittent coughing. The diagnosis was made by the endoscopy and esophagography. The fistula was 1.5cm in diameter, 0.5cm in length. The level was around second thoracic vertebra. The operation was performed transpleurally through the right third intercostal space and the fistula was secured with interrupted silk suture after division. The fibrotic adhesion was seen around the tracheoesophageal fistula. The postoperative course was uneventful, and postoperative esophagogram revealed ho extraluminal leakage. Herewith we report this unusual case of isolated tracheo-esophageal fistula with review of literatures.

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A Case of Acute Intoxication with Glyphosate and Oxyfluorfen Containing Powder Herbicide ($Daejangun^{(R)}$) (Oxyfluoren이 함유된 입제 glyphosate 제초제(대장군) 급성 중독 1예)

  • Lee Seung Hee;Yi Kum Ho;Yoo Sung-Soo;Roh Heung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.110-113
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    • 2005
  • Glyphosate containing herbicides are an alternative to paraquat and have been widely used with increasing frequency in suicide attempts throughout Asia. It is an organophosphorus compound that is not a cholinesterase inhibitor. Daejangun powder consists of glyphosate ammonium, surfactant and another herbicide, oxyfluorfen. A 60-year-old man ingested about 300 g of Daejangun powder with 500 ml of water in a suicide attempt. He was brought to emergency room 6 hours after the ingestion and showed severe metabolic acidosis (pH 6.75), marked leukocytosis (WBC 35,800/$mm^3$), hypoglycemia (glucose 13 mg/dL) and increased liver enzymes (AST/ALT 1,683/418 IU/L). Later he developed aspiration pneumonia, acute renal failure and hyperchloremic acidosis. Upper gastrointestinal endoscopy which performed 5 days after the ingestion revealed corrosive injuries (grade 1) in both esophagus and stomach. However, intensive treatment with supportive measures improved the abnormal findings almost completely 4 weeks after the ingestion.

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A Case of Serious Caustic Injury after Ingestion of Hydrochloric Acid (염산으로 인한 중대한 부식성 손상 1례)

  • Park Hyun-Joo;Yi Hyeon-Gyu;Kim Pum-Soo;Roh Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.58-62
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    • 2004
  • Acid ingestion can cause not only caustic injury on esophagus and stomach but also fatal outcome through systemic complications. We report the case of a patient who died early after severe caustic injury with strong acid. A 38-year-old man who ingested about 400ml of hydrochloric acid of unknown concentration was transferred to our hospital from a private clinic, in which he was managed with gastric irrigation through a nasogastric tube. He was complaining dyspnea and abdominal pain. Physical examination demonstrated tenderness and rebound tenderness on epigastric region. Severe metabolic acidosis and leukocytosis were noted. Radiological findings suggested perforation of gastrointestinal tract, although the physical signs were not typical. Endoscopy revealed caustic injuries of grade I on esophagus and of grade Ⅲ on stomach, which indicate more severe injury on the stomach than on the esophagus. Exploratory surgery was recommended but unfortunately not permitted by his family. Despite intensive measures, his vital signs deteriorated rapidly and he died 50 hours after the ingestion.

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