Clinical Endoscopy

부식성 식도 및 위각부 협착의 비수술적확장술 치험 1예 ( Non-operative Dilatation of Corrosive Esophageal and Gastric Angular Stricture - A Case reoprt - ): Korean J Gastrointest Endosc 1989;9(2):151-155. Published online November 30, 1988

Abstract PDF: Acid ingestion causes a coagulative necrosis of the surface epithelium of the upper gastromtestinal tract. Its late sequence is luminal stenosis which frequently requires surgical repair. Nevertherless, in many cases, non-operative dilatation of luminal stenosis have been applicated, such as bouginations, balloon dilatations, endoscopic laser therapy, endoscopic electrocoagulation, endescopic microwave coagulation. These methods may give some considerable benefits in unoperable cases. Recently, we experienced a case of a 60-year-old man who had severe corrosive esophageal and gastric angular strictures by accidentally ingested hydrochloric acid and after many tiems of application of non-operative dilatation was able to have normal diet without dysphagia. So, we report this case with a review of literatures.

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식도정맥류 출혈에 대한 내시경적 경화요법의 장기적 평가 ( The Long Term Therapeutic Effects of Endoscopic Injection Sclerotherapy in Esophageal Varices Bleeding ): Korean J Gastrointest Endosc 1989;9(2):157-165. Published online November 30, 1988

Abstract PDF: Chronic progressive liver diseases, such as liver cirrhosis, eventually cause portal hypertension & hepatic coma, and among the cause of death from UGI bleeding variceal bleeding secondary to portal hypertension is the most common, over 50%. Clinical management for variceal bleeding includes IV vasopressin injection, insertion of Balloon tamponade administration of somatosatin or propranolol, and shunt operation, but the effect has not been promising. (continue...)

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위 점막하종양의 내시경적 소견과 상부위장관 조영술의 비교 ( Comparisons of Gastric Endoscopy and Upper Gastrointestinal Series in The Submucosal Tumor ): Korean J Gastrointest Endosc 1989;9(2):167-175. Published online November 30, 1988

Abstract PDF: Gastric submucosal tumors are occasionally symptomatic (bleeding) but usually found incidentally at endoscopy. To evaluate comparisons of gastric endoscopy and upper gastrointestinal series in the submucosal tumor, we studied 50 patients which were diagnosed as submucosal tumor at SNUH from 1985 to 1988. The results were as follow: 1) Gastric submucosal tumors occupied 2.2% of the stomach cancer. (continue...)

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내시경적 위용종절제술 66예의 임상적 고찰 ( Clinical Observations of 66 Endoscopic Gastric Polypectomies ): Korean J Gastrointest Endosc 1989;9(2):177-182. Published online November 30, 1988

Abstract PDF: Advance in fiberoptic endoscopy have improved diagnostic capabilities and management in patients with gastric polyps and increased experience with endoscopic polypectomy offers the most simple and safe method in removal of gastric polyps. Sixty six endoscopic gastric polypectomies was performed in 59 patients who visited Chonnam National University Hospital from 1980 to 1989 The results obtained were as follows. 1) The most patients were in the seventh decade followed by fifth, fourth decade. The ratio of male to female was 1: 1.95. 2) The common clinical symptoms with which patients presented were epigastric discomfort (54. 2%), epigastric pain (44.1%), indigestion (16.9%), nausea and vomiting (13.6%) and hematemesis (3.4%). The associated diseases of gastric polyp were chronic superficial gastritis (28.8%), chronic atrophic gastritis (13.6%), benign gastric ulcer, gastric caecer, cancer of ampulla of Vater. 3) The number of patients with single gastric polyp wa 47 (79.7%), and that of multiple gastric polyps was 12 (20.3%). The most common location of gastric polyps was gastric antrum (66.6%) follawed by gastric body (27.3%) and gastric fundus (6.1%). 4) The removed polyps were mostly 1.0 cm to 2.0 cm in size and in the gross findings by Yamadas classification, type IV (48.5%) was most common. 5) Histogical examinations revealed that 49.6% of remoyed polyps were hyperplastic polys and 18. 7% of those were adenomatous polyps. Only one case of adenomatous polyp had contaied focally malignant change of mucosa. 6) Almost all cases were in the absenee of significant complications, but three patients showed bleeding at the site of polypectomy, which controlled by conservative means.

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위에 발생한 암육종과 선암 1예 ( A Case of Carcinosarcoma and Adenocarcinoma of the Stomach ): Korean J Gastrointest Endosc 1989;9(2):183-186. Published online November 30, 1988

Abstract PDF: Carcinosarcoma is a rare malignant neoplasm consisting of both epithelial and nonepithelial components, that is, carcinoma and sarcoma in the same tumor. Since Queckenstedt reported the case of carcinosarcoma of the stomach in 1904, only 30 cases have been reported. We present a case of carcinosarcoma and adenocarcinoma of the stomach in 63-year-old man with the review of the literature.

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위에 발생한 가성임파종 3예 ( Three Cases of Gastric Pseudolymphoma ): Korean J Gastrointest Endosc 1989;9(2):187-193. Published online November 30, 1988

Abstract PDF: Gastric pseudolymphoma can be defined as a benign proliferation of lymphoid tissue and is also called the lymphoid hyperplasia or reactive lymphoreticular hyperplasia of the stomach. This lesion has been described in the orbital area, skin, salivary glands, mediastinum and other organs. The etiology of this disease is unknown but chronic inflammation and ulceration have been proposed as the etiologic mechanism in many cases. Most patients exhibit chronic, nonspecific, mild symptoms with the vast majority having symptoms for more than 1 year before undergoing diagnosis and treatment. Unfortunately, upper GI radiography rarely clarifies the diagnosis and gastroacopy is ineffective in establishing the diagnosis of pseudolpnphoma. Therefare, gastric resection is the only sure way to diagnose gastric pseudolympboma, as well as providing curitive therapy in most cases because of its possible malignant potential. There is no typical gross appearance of gastric pseudolymphoma and histologic diagoosis is essential. Smaller tumor size, infiltration with small, round mature lymphoeytos and various inflammatory cells, and formation of a true lymphoid germinal center favor a diagnosis of pseudolymphoma, We report 3 cases of histopathologically confirmed gastric pseudolymphoma after gastrectomy, which were initially suspected to be gastric lymphoma and early gastric cancer

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위궤양에 대한 KU-54 ( Aplaceⓡ ) 의 치료효과 ( Clinical Study of Ku-54 ( Aplaceⓡ ) in Gastric Ulcer ): Korean J Gastrointest Endosc 1989;9(2):195-201. Published online November 30, 1988

Abstract PDF: Although our present knowledge of the etiology of peptic ulcer is incomplete, the presence or absence of peptic ulcer is determined by the delicate interplay between aggressive factors (secreted gastric acid and pepsin) and defensive factors (mucosal resistance). Peptic ulcer is produced when the aggressive effects of acid-pepsin dominate the protective effects of gastric or duodenal mucosal resistance by predominance of aggressive factors or interruption of defensive factors. KU-54 enhances mucosal resistance to tissue injury by the increase of gastric mucosal blood flow, the stimulation of gastric mucosal metabolism, the increase of glycoprotein of gastric mucus, and the increase of ATP of gastric mucosa. We have treated 38 cases of gastric ulcers with KU-54 300 mg daily for 4-12 weeks for the evaluation of the therapeutic efficacy. Endoscopic, clinical, and laboratory assessments were undergone before and after 4 ~ 12 weeks of the treatment. Major symptoms of gastric ulcer have been improved in 83.3% after the medication with KU-54. The healing rate of gastric ulcer evaluated by endoscopy was observed in 33.3% after 4 weeks, 73.3% after 8 weeks, 76.6% after 12 weeks of the medication with KU-54. The utility rate of KU-54 was 86.7%. We could conclude that KU-54 is the utilizable drug for gastric ulcer.

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내시경으로 진단된 악성 십이지장-대장 누공 1예 ( A Case of Malignant Duodenocolic Fistula Diagnosed by Endoscopy ): Korean J Gastrointest Endosc 1989;9(2):203-205. Published online November 30, 1988

Abstract PDF: The occurrence of a fistula between the duodenum and the colon is very rare, although these two structures commonly lie in intimate relationship to each other. It is not uncommon for tumor of the right colon and proximal transverse colon to involve the duodenum by continuity, but fistulous connection between the duodenum and colon are infrequent In most of the reported malignant cases, the fistulas follow carcinomas of the transverse colon or the hepatic flexure of the colon. We report a rare case of malignant duodenocolic fistula which was first suspected by endoscopic examination and confirmed by operation.

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인공적으로 만든 총담관-십이지장 누공을 통한 내시경적 역행성 담관 조영술 2예 ( Endoscopic Retrograde Cholangiography Through Artificial Cheledochoduodenal Fistula ): Korean J Gastrointest Endosc 1989;9(2):207-213. Published online November 30, 1988

Abstract PDF: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most useful diagnostic tool in biliary and pancreatic disease. However, ERCP cannot be performed successfully in all patients. Cannulation failure is the most common cause of failure of ERCP. Mechanical pathologies, such as peri-Vater diverticulum, cancer of the papilla of Vater, and impacted stone were the common causes of cannulation failure. We experienced two cases of carcinoma of the papilla of Vater in whom cholangiography and insertion of the nasobiliary tube were performed througth an artificial choledoehoduodenal fistula made by a needle type diathermy knife, beacuse cannulation to the duct was failed due to the tumor.

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담낭암으로 오인한 담낭관 결석 및 담낭염의 증례 1예 ( A Case of Cystic Duct Stone and Cholecystitis Misdiagnosed as Gall Bladdr Carcinoma - A case report - ): Korean J Gastrointest Endosc 1989;9(2):215-219. Published online November 30, 1988

Abstract PDF: A 56 year old female was admitted because of the right upper quadrant mass for 4 days. She complained of intermittent colicky RUQ pain, fever and chills. So diagnostic procedures was performed: Blood chemistry testings. Ultrasonography. Barium enema, Liver scan, Hepatobiliary scan, ERCP and Abdomen CT, which diagnosed as gall bladder carcinoma. So explolaparotomy was performed and gross operative finding was gall bladder carcinoma with metastatic lymph node and cystic duct stone. So cholecystectomy, hemigastrectomy and anterior segmentectomy of right liver was done. But the biopsy result was cystic duct stone, cholecystitis and gall bladder empyema.

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Clostridium 배양검사로 확진된 위막성대장염 4예 ( 4 Cases of Pseudomembranous Colitis Confirmed by Clostridium Culture ): Korean J Gastrointest Endosc 1989;9(2):221-226. Published online November 30, 1988

Abstract PDF: Diarrhea is a common complication of antibiotics usage. The diarrhea ascribed to antibiotics usually consist of loose or watery stools, sometimes containing mucus but rarely grossly evident blood. Almost every antibiotics has been implicated, although cases related to the use of vancomycin or aminoglycosides are rare. Although the pathogenesis of antibiotics-associated diarrhea is not confirmed, recent studies have shown that a toxin of clostridium difficile is implicated as a cause of it. Diagnosis is made by detecting toxin in the stool or stool culture for C.difficile. Treatment is either directed at binding the toxin with anion exchange resins such as cholestyramine in mild case, or at eradicating the C.difficile organism with vancomycin, metronidazole or bacitracin for more severe cases. (continue...)

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