Clinical Endoscopy

단순 국소성 (局所性) 식도궤양의 임상적 고찰 ( Clinical Observation of Simple Localized , Esophageal Ulcer ): Korean J Gastrointest Endosc 1983;3(1):1-9. Published online November 30, 1982

Abstract PDF: Incidence of simple localized esophageal ulcer has been infrequent, but recently, clinical report of the disease has increased with remarkable improvement of diagnostic instrument and handling of endoscopy. Nine patients of simple localized esophageal ulcer with abrupt onset of symptoms and rapidhealing process were clinically studied and observed with the other literatures on the basis af age, sex, site, symptoms, causes, endoscopic findings, microscopic findings, and healing pracess. The results were followed. 1) The eiophageal ulcer revealed variable size and shape and generally localized middle third of esophagus. 2) History of therapeutic drug medication auch as capaule or/and tablet was noted mostly. 3) The symptoms were disappeared with general measures and ulcer lesions were comyletely healed without scar or stricture rapidly.

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내시경적 위생검조직진단의 정확도에 대한 분석 - 제1편. 위절제술 및 조직구축학적검색에 의해 확인된 236종양성증례의 재검토 - ( Diagnostic Accuracy in Endoscopic Gastric Biopsy - Part 1. Analysis of preoperative gastric biopsies in 236 cases with neoplastic lesions based on gastretomy and histotopographic investigation ): Korean J Gastrointest Endosc 1983;3(1):10-16. Published online November 30, 1982

Abstract PDF: Two hundreds and forty six preoperative endoseopic gastric biopsies from 236 conaecutive cases were subjected to the retrospective analyais of diagnostic accuracy among 597 tumor- bearing gastrectomy specimens confirmed by extended histotopographic investigations during a period of 1980 to 1981 at Seoul National University Hospital. The overall diagnostic accuracy of endoscopic gastric biopsy was 93.1% with 0.8% false positivity and 3.5% of false negative caaes; of those, the concordance rate of preoperative biopsy diagnosis based on the histotopographic investigation of the gastrectomy remained in 85.5%, whereas 75% of diagnostic discrepancy wae reaulted from inappropriate biopsy sampling or failure of neoplastic tissue obtainability; and the rest of 25% was mostly false negative cases. (continue...)

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출혈위궤양 - 자험례 (自驗例) 120예에 대한 임상적 검토 - ( Bleeding Gastric Ulcer - Clinical Observation of 120 Cases of Bleeding Gastric Ulcer): Korean J Gastrointest Endosc 1983;3(1):17-21. Published online November 30, 1982

Abstract PDF: Analyses were done on one hudred and twenty caaes of bleeding gastric ulcers diagnosed by emergency endoscopy for the past five years. The reaults are as the following: Much more cases were found in male than female and the most prevalent age group was 6th decade. The body of stomach along the lesser curvature was the most common bleeding site. No age related difference was noted in bleeding sites. Most common type of ulcer was in the round and shallow form. Five of six cases with exposed vessels showed atrophic changes in surrounding mucosa. Among the probable precipitating factors, analgesica, alcohols and certicosteroids were found in such order,

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위궤양 환자 306예의 크기를 중심으로한 임상적 고찰 ( Some Clinical Observation on 306 Cases of Gastric Ulcer ): Korean J Gastrointest Endosc 1983;3(1):22-26. Published online November 30, 1982

Abstract PDF: A clinical analysis was carrried out on 306 pts c Gastric ulcer who have visited the Depart on Internal Medicine. Daegue Catholic Hospital during the period from August 1980 to June l982. The result were as follows: of the total 306 cases, 249(81%) cases were male and 57(19%) cases were female, Male to female ratio was 4. 3: 1. Thirsty two percent of the cases blonged to the 6 tb decade, 25.5% to 5 th and 19% to 7 th decade. (continue...)

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위 십이지장궤양에 대한 H2수용체조해제 ( The Effect of H2-receptor in the Treatment of Peptic Ulcer ): Korean J Gastrointest Endosc 1983;3(1):27-34. Published online November 30, 1982

Abstract PDF: Treatment of peptic ulceration by suppression of gastric aeid, secretion with the histamine H,-receptor antagonist, cimetidine is now well established. Prior to the availability of ranitidine, cimetidine was the only histamine H2-receptor antagonist available for treatment of duodenal and gastric ulceration. The aim of this study was to compare the efficacy of ranitidine and cimetidine in accelerating the healing of duodenal ulcer. The therapeutic trials comparing ranitidine with cimetidine in a total of 44. out-patients with endoscopically diagnosed duodenal ulcer ivere entered into the study. 28 patients were treated with ranitidine 150mg twiee daily, and 16 patients with cimetidine 200 mg 4 times daily for 4 weeks. Overall endoscopic healing rates were 75%, on ranitidine and 64.3% on cimetidine, and so ranitidine appears to be slightly more effective than cimetidine although too small numbers af patients were studied to detcet any difference between drugs. Aa ranitidine is effective with administration twice daily, patient compliance may be better than with the 4 times daily treatment regimen adopted with cimetidine, though has not yet to be adequately demonstrated. There were no significant side-effects, either ranitidine or cimetidine, to the administration of the drug, except a case of dyspepsia on cimetidine regimen.

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소화성궤양에 대한 Ranitidine ( Zantac )ⓡ 의 치료효과 ( The Effect of the Ranitidine ( Zantac )ⓡ in the Treatment of Peptic Ulcer ): Korean J Gastrointest Endosc 1983;3(1):35-39. Published online November 30, 1982

Abstract PDF: The therapeutie efficacy of ranitidine was evaluated itn 48 in- and out- patients with endoscopically diagnosed 18 cases of gaetric ulcer and 30 casea of ducnienal ulcer. In the open study, every pabenta was treated with ranitidine 150 mg b.i.d. for 4 weeks, and waa followed up by gastroscopy after 4 weeks of the treatment. The reeults obtained were summarized as follows; 1) 15 out of 18 cases (83. 3%) of gastric ulcers and 26 out of 30 cases (86. 7%) of duodenal ulcers had been completely healed up in 4 weeks. 2) There was a significant relationship between healing of ulcer and the relief of symptoms (x =6.12, P<0.005).3) There were no significant untoward reactions, efther subjective or objective, to the administration of the drug, except one case of severe epigastic discomfort. In conclusion ranitidine appears to be fairy effective and safe for the treatment of patient with peptic ulcr diseases.

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위내시경으로 진단된 위암의 임상적 고찰 ( Clinieal Study of the Stomach Cancer diagnosed by Endoscopy ): Korean J Gastrointest Endosc 1983;3(1):40-45. Published online November 30, 1982

Abstract PDF: Gastrofiberscopic findings under direct vision were analysed in 248 patients who were diagnosed as gastric cancer from Feb. 1980 to March 1983 in Department of internal Medicine, Kang Nam Sacred Heart Hospital, Hallym Medical College, Seoul, Korea. (continue...)

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부산 경남지역 위암환자 226예에 관한 임상적 및 내시경적 고찰 ( Clinical Studies on 226 Cases of Stomach Cancer ): Korean J Gastrointest Endosc 1983;3(1):46-51. Published online November 30, 1982

Abstract PDF: Among 7,500 patients whom we have performed gastrofiberoscopy from July 1979 to June 1,982, 226 cases of stomach cancer were diagnosed. The frequency was 3. 0%. The ratio of male to female was 2: 1, the peak incidence, 69 cases(30.5%) was in 5th decade. 1) The frequency of stomach cancer among the age were 0. 5% in 1st decade, 0.4% in 2nd decade, 1.2% in 3rd decade, 2.5% in 4th decade, 5.9% in 5th decade, 12.6% in 6th decade 16.8% in 7th decade. (continue...)

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내시경적 용종절제술 (茸腫切除術) 47예 보고 ( A Clinical and Pathologic Study of Endoscopic Removal of Gastrointestinal Tract Polyps ): Korean J Gastrointest Endosc 1983;3(1):52-56. Published online November 30, 1982

Abstract PDF: The fifty gastrointestinal polyps, which were removed endoscopically frorn 47 patients at the Seoul National Univeraity. Hospital from January, 1978 to September, 1983, were reviewed with regard to the clinical and pathological features. The observed data are as follows; 1) Fifty polyps were reoved from 10 patients with gastric polyps and 37 patients with colonic polyps. Out of 37 patients 26 were male and 21 female, the sex ratio being 1.2: 1. 2) The gastric polyps were located in the body and antrum and 90 per cent of the colonic polyps were found in the left colon, especially in the rectosigmoid colon. 3) Out of the 10 gastric ployps snared, 8 could be retrivevd, 2 being lost. The histological examination showed that 3 were hyperplastic polyps, 2 gastritis verrucosa, 1 inflammatory polyp and the remaining 1 revealed intramucosel carcinoma with borderline epithelium. 4) Fourty polypectomies were performed in 37 patients with colonic polyps. Histological examination revealed that 24(60%) were adenomatous polyps, 9(22.5%) retention polyp, 4 (10.0%) inflammatory polyp and 3(7. 5%) Peutz-Jegher's poIyps. Among the adenomatous polys, 4 cases were complicated with focal adenocarcinoma. 5) Except the 2 cases of post-polypectomy bleeding, no other complication was encountered. The one case of hemorrhage after gastric polypectomy was treated with transfusion of 2 pints of whole blood, and the other case after colonic polypectomy required exploratory laparotomy because of inability of bleeding control by electrocoagulation.

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비투시하 중간형 대장내시경 검사 93예 보고 ( The Experiences of Medium Length ( 127 cm ) Colonofiberscope without the Help of Fluoroscope on 93 Cases ): Korean J Gastrointest Endosc 1983;3(1):57-63. Published online November 30, 1982

Abstract PDF: It is well known that total colonoscopy is one of the essential procedure to make diagnosis of colonic and terminal ileal diseases, to detect early atage of colonic cancer and to do prophylactic removal of premalignant polyp. Previously commonly used longer colonoscope has been reached to ileocecal area with patients much discomfort arising from excessive loop formation at sigmoid or transverse colon because of no limitation of the length. (continue...)

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내시경적 유두절개술로 총담결석의 (總膽結石) 비관혈적 치료 ( Common Bile Duct Stones removed by Endoscopic Papillotomy ): Korean J Gastrointest Endosc 1983;3(1):64-71. Published online November 30, 1982

Abstract PDF: Since 1976, 938 cases of E.R.C.P. were performed at the Kwangju Christian Hospital & since December 1981, 19 cases of Endoscopic papillotomy(E.P.T.) were performed, following Results were obtained: 1) Out of 19 cases which were diagnosed by E.R.C.P.; 17 cases of C.B.D. stones, 1 case of ascaris in bile duct, 1 case of remained C.B.D. stone diagnosed by T-tube cholangiogram after operation, & E.P.T. was done in total 19 casees. 2) During 1st E.P.T., 2 cases were removed by Dormia basket under direct visualization & during 2nd E.P.T., 5 cases were removed by Dormia basket under direct visulization & 12 cases were passed in stool & 3x3.5cm large stone passage was found. 3) Complications of E.P.T. were noted in 2 cases: 1 case of bleeding was treated by blood transfusion & 1 case of Acute pancreatitis was treated by medical care.

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담낭절제술환자에 있어서 ERCP 검사소견 ( Endoscopic Retrograde Cholangiopancreatography in the Evaluation of Postcholecystectomy Patients ): Korean J Gastrointest Endosc 1983;3(1):72-78. Published online November 30, 1982

Abstract PDF: Postcholecystectomy syndrome is the persistence or recurrence of symytom complex following cholecystectomy, The majority of the patients have mild symptoms. However, the cause of recurrent symptoms is often obscure and as a consequence, a plan of management is difficult to formulate. Recently ERCP has proved to be increasingly helpful in the investigation of postcholecystectomy patients. The purpose of this study was to test the effectiveness of the ERCP in the evaluation of patients with postcbiolecystectomy syndrorae. The results are as follows 1) 102 postcholecystectomy patients were studied by endoscopic retrograde cholangiopancreatography and successful cannulation with demonstration of at least one duct was achieved in 49 of 50 jaundiced patients and in 49 of 52 non-jaundiced patients. The overall success rate was 96. 1%. 2) The results of ERCP were normal in 26 patients(26.5%) and abnormal in 72 patients (73.5%), Only 3 of 50 jaundiced patients were normal, but 23 of 52 non-jaundiced patients showed no abnormal findings. 3) The most common abnormality was biliary stone in common bile duct and intrahepatic duct which were present in 51 patients(50%). Cholangitis without stone was next common finding which was in 13 patients(13%). Of the remaining patients have air biligram, 2 CBD stricture, 1 CBD aseariasis & 1 chronic pancreatitis. 4) Time lapse between onset of symptoms and cholecystectomy was variable. 31 patients were studied less than 2 years after cholecystectomy. 18 of these patients had jaundice and 13 had no jaundice. Within 2 years afte chklecystectomy, the biliary stone was most common finding which were present in 14 out of 31 patients.

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간외폐쇄성황달증의 내시경적 역행성 담췌관조영술에 관한 연구 ( Endoscopic Retrograde Chalangiopancreatography ( ERCP ) in Obstructive Jaundice ): Korean J Gastrointest Endosc 1983;3(1):79-84. Published online November 30, 1982

Abstract PDF: ERCP was performed in 34 cases of obstructive janndice at Busan National University Hospital between June 1981 and October 1982, and those findings were compared with the final surgical operative diagnoses. The results were as follows: 1) The ratio of male to female was about l. 6: 1 and most of them were in the 5th decade to 7th decade, 2) Upper abdominal pain and tenderness were the cardinal symptom and sign, 3) Successful ERCP was obtained in 32 cases among the total of 34 cases(94.1%)Selective success rates by indications were 77.8%(21/27) in suspected biliary lesions and 85.7%(6/7) in suspected panceatic lesions. 4) ERCP diagnoses were biliary stone(11 cases), eholangiocarcinoma(6 cases), pancreatic head ca. (4 cases), Ampulla of Vater ca. (2 cases), normal cholangiogram(2 cases), and normal parcreatogram(2 cases). 5) Eighteen cases out of 24 surgical operative cases were diagnosed by ERCP alone, The diagnostic rates of ERCP by surgical operation in obstructive jaundce was 75%. Complications of ERCP were not clinically significant. It suggests that ERCP is a very useful diagnostic method in the differential diagnosis of obstructive jaundice.

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위내시경에 의한 치솔 제거 ( Endoscopic Removal of Toothbrush ): Korean J Gastrointest Endosc 1983;3(1):85-88. Published online November 30, 1982

Abstract PDF: With the improvement of the instrument and technic, the gastrofiberoscope has been used not only in diagnostic purpose but in therapeutic purpose. One purpose of the therapeutic methods is to remove the gastric foreign bodies. So many type and shape of forceps and baakets have been usad. for the same purpose. ifn these easea, we uaed biopsy farcep and snare to remove swallowed toothbrushes, three casea in the stomaeh and one cuse in the duodenurn.

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상부소화관 내시경검사로 진단된 식도모닐리아증 4예 ( Four Cases of Esophageal Moniliasis Confirmed by Esophagoscopy ): Korean J Gastrointest Endosc 1983;3(1):89-93. Published online November 30, 1982

Abstract PDF: Candida Albicans is a saprophytic organism under normal circumstances and a limited pathogen when presents in large numbers. The common site of infection are the mouth, skin, vagina and respiratory tract. It is a common inhabitant of the G-I tract, where it does not usually cause symptoms. With impared defense mechanism or long-term antibiotic therapy, however it can became a significant pathogen. The clinical symptoms and endoscopic findings present a spectrum of changes depending on the degree of esophageal involvement. Painful awallowing and substernal chest pain are most common symptoms. Esophgeal infection is an unusual but impartant form of the diseases and can easily be confirmed by esophagoscopy. Recently we have experienced 4 cases of esophageal moniliasis confirmed by esophagoscopy and tissue biopay.

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중루유문 (重壘幽門) 3예 보고 ( Three Cases of Double Channel Pylorus ): Korean J Gastrointest Endosc 1983;3(1):94-97. Published online November 30, 1982

Abstract PDF: So-called, the double channel pylorus has been, relatively rarely, reported through out the world. All reported cases were almostly those of gastroduodenal fistula as a complication of peptic ulcer disease. The congenital forms of double pylorus were reported even more rarely. We found three cases of double channel pylorus in 25,000 cases endoscopy done at our unit. All those three cases were thought to be acqired form endoscopically, radiographically and histologically. One of those was undergone to operative resection because of uncontrollable bleeding and the others were on medical theraphy with satisfaction.

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다발성 원발성 악성종양 - 이중복암 (二重複癌) 1예 보고 - ( Multiple Primary Malignant Neoplasms - A case of double primary malignant cancer - ): Korean J Gastrointest Endosc 1983;3(1):98-102. Published online November 30, 1982

Abstract PDF: This is a case report of double primary malignant cancer occurred aynchronously in the stomach and lymphoid tissue, We report this case with review of literatures about the criteria, age distribution, predisposing factor, inidence, immunity and susceptibility of the primary malignant neoplasms. This case was a 59-year-old man who had Hodgkins disease and tubular adenocarcinoma, of the stomach. The diagnoais was verified histologically, Although multiple primary neoplaas are rare, the possibility of that must be conaidered seriously, And its hereditary predisposition and other predisposing factor muat be researched with enthuaiasm.

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맹장의 과립세포 종양 - 1예 보고 - ( Granular Cell Myoblastoma of the Cecum - Report of a case - ): Korean J Gastrointest Endosc 1983;3(1):103-107. Published online November 30, 1982

Abstract PDF: Granular Cell Myoblastoma is typically encountered in the skin, subcutaneous tissue nr oral cavity, but was rarely been found in the large intestine. In a series of 110, the two were in the cecum(18). Both patients, 36-and 43-year-old women, underwent radial excision of the lesion because of the clinical impresaion of the malignancy. The other Three patients with granular cell myoblastoma of the cecum, all asymptomatic and found incidentally, have been reported. From the available data, one was a man(22) and two were women (26,27). They were 17 (27), 40(26) and 71(22) years of age. One lesion, in the cecum, was excised at laparotomy that was performed under the irnpression of acute appendicitis, and disclosed a small polypoid submucosal nodule in the cecum incidentally(27). Another lesion, in the cecum, was excised at laparotomy following the discovery of a small cecal defect on barium enema examination 9260. The other lesion, in the cecum, was found at autopsy(22), This paper reports a case of granular cell myoblastoma of the cecum, including its colonoscopic finding.

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대장의 Stercoraceous 궤양 - 1예 보고 - ( Stercoraceous Ulcer of the Cecum - A case report - ): Korean J Gastrointest Endosc 1983;3(1):108-113. Published online November 30, 1982

Abstract PDF: Stercoraceous ulcerations of the colon are produced by hard fecaloma that collect in the coton. Bleeding and more seriously perforation are complications of these ulcerations. These are generally thought to be rare, but this may reflect the difficulty of establishing the diagnosis, both before and during operation. This disease is relatively neglected as well. This is reflected by the small number of case reported in the literature. Authors report a case of stercoraceous ulcer of cecum which confirmed under the colonofiberscopy and managed in the Department of General Surgery, College of Medicine, Ewha Womans University,

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