Clinical Endoscopy

식도정맥류에 동반된 상부소화관 질환 ( Combined Upper Gastrointestinal Lesions with Esophageal Varices ): Korean J Gastrointest Endosc 1985;5(1):1-6. Published online November 30, 1984

Abstract PDF: Upper gastrointestinal bleeding in cirrhotic patients is a serious emergency which is associated with high mortality. Cirrhotic patients commonly have, in additian to esophageal varices, other upper gastrointestinal lesions which accont for occasional bleeding episodes. Since the theapy of bleeding esophageal varices differs from the treatment of nonvariceal bleeding, delay and inaccuracy in determining the source of bleeding contribute ta high mortality. (continue...)

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식도의 결핵성 병변에 대한 임상적 고찰 ( Tuberculous Lesion of the Esophagus ): Korean J Gastrointest Endosc 1985;5(1):7-10. Published online November 30, 1984

Abstract PDF: Tuberculosis of the esophagus is rare. We experienced four patients with esophageal tuberculosis proven by esophagoscopic biopsy or surgical specimens. Case 1 was a patient with primary esophageal tabereulosis, case 2 was a patient with teberculous esophagobronchial fistula and case 3,4 were patients with esoyhageal perforation due to tuberculous traetion diverticulum of the esophagus. The clinical, radiological and esapbagoscopic findings may be nonspecific in diagnosis of esophageal tuberculosis. Therefore early diagnosis should be rested on a high index of suapieion and a cautious attention.

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약물유인성 식도궤양 ( Drug - Induced Esophageal Ulcers ): Korean J Gastrointest Endosc 1985;5(1):11-15. Published online November 30, 1984

Abstract PDF: Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,

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미란성 위염에 대한 Cimetidine ( Tagametⓡ ) 의 치료효과 ( The Effect of Cimetidine in Treatment of Erosive Gastritis ): Korean J Gastrointest Endosc 1985;5(1):17-22. Published online November 30, 1984

Abstract PDF: In an attempt to evaluate the efficacy ef cimetidine in treatment of erosive gastritis, a praspective study wras done in 9 cases of heworrhagie gastritia, 4 cases yunctiform gastritis, 9 caees verrueous gastritia, and 9 caseis mixed type, Four hundred mg of cimetidine was given in the morning and at bedtime for 3 weeks. Evaluation ef the efficacy was assessed by clinical syinptoms acoring and by endoscopic findings of erosion before treatment, on the 8th day, on the 15th day, and on the 22th day of treatment in all patients. The results were as follows; 1) Clinical sytnptoms in patients with erosive gastritis were epigastric discamfortness(83. 9%), heart burn(80. 0%), indigestion(77, 6%), hunger pain(74.2%), belching(71.0%), anotexla (48.4%) and nausea(45.5%). There was no differenees of symptoms among the type of erosion. 2) Percent decrease in clinical eyxeptoms were; 45% on the 8th day, 68% on the 15th day, 81% on the 22th day of treatment. Ciinical symptoms in patients with punetiform gastritis lasted longer than other typea. 3) Disappearance of the gastric mucossl erosion was seen in 8 cases of hemorrhagic gastritis, 6 case of mixed type, 5 cases of verruceous gastritis, 2 cases of punctiform gastritis, and overall 21 Cases(67.7%) on the 22th day of treatment, endoscopieally. Faur eases af punctiform gastritis were transformed into verrueous gastritis during the treatment. 4) Disappearance of the erosion was observed more frequently in the mueosa of oxyntic area than that of antrum. This study suggests that cimetidine appears to be effective for relief of elinical symptoms in patients with erosive gastritis, and for treatment of hemorrhagic gastritis and erosions in the mucosa of oxyntic area,

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긴급 내시경으로 진단된 상부 위장관 출혈의 임상적 고찰 ( Upper GI Bleeding Diagnosed by Emergency Endoscopy ): Korean J Gastrointest Endosc 1985;5(1):23-32. Published online November 30, 1984

Abstract PDF: Emergency endoacopy was performed in 315 patients for recent four years The source of upper GI bleeding in these 315 caaes were as follows: Esophageal varix(93), gastric ca(39), Mallory-weiss syndrome(14), gastric ca(38), Duodenal ulces(21), Erosive gastritis(14), Marginal ulcer(2), Combined case(24) Unknown cases(10), Essentiall Tx was not performed in 4 died case because of poor general conditions, After check up BP, Heart, Pluae rate, that examination was performed during drip infusion to be 'safety of cireulatary system. No compication were encountered. To confirm the source of bleeding at earlier stage, was useful to decid which way, that is conservative of surgical therapy in which better for the Management. The results are as follows: 1) The sex incidence of upper GI bleeding showed Male predominance c a ratio 4. 6: 1 and peak age groups were 4th & 5th decade. 2) Endoscopic diagnosis of npper GI bleeding in the studied case were in the order of Esophageal varix bleeding(29%), Gastric ulcer (23. 5%), Mallory weiss syndrome(12. 4%) Duodenal ulcer(6.7%) Erosive gastritis(4.4%) We could not find the bleedi site in 3.2% of the studied case. 3) The cause of emergeney endoseopy are Melena(19%), Hemstenesis(22.0%) and ccenbined (58. 4%) 4) Among the 315 cases of upper GI bleeding, 70. 1% of the cases revealed moderste degree of bleeding. 5) Among the 315 cases of apper BI bleeding, 28. 1% of the cases were confirmed of inducing factor. 6) Among the 315 cases of upper BI bleeding, 69% of the cases received an endcrscopic examination within 72 hr after initial episode of bleeding. (continue...)

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Doxycycline 에 의한 식도궤양 5예 ( Doxycycline - Induced Esophageal Ulcers ): Korean J Gastrointest Endosc 1985;5(1):33-35. Published online November 30, 1984

Abstract PDF: Esophageal ulcers induced by doxycycline is a rare complication. These patients usually complain of sudden onset of symptoms, ie acute substernal or chest pain and odynophagia without prior hietory of esophageal syraptoms. On esophagoscopic examination, there are upper or midesophageal ulcers, which heal after diseontinuation of the drug within 2 weeks. A history of ingestion of the doxycycline,with liquid jost before bedtime can be elicited. The exact eause of the xaucosal ulceration is not clear, but a direct irritant effeet on esophageal mucosa seems most likely. We report 5 cases of esophageal uleeration secondary to the ingestion of doxycydine. Esophagoscopy revealed esophageal ulcers in all patients and the patients hecame asymptomatic following stopping of tbe drugs and taking antacids.

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소아 종말회장 (終末回腸) Lymphoid Hyperplasia 의 대장내시경 진단 ( Diagnostic Pediatric Colonoscopy for Lymphoid Hyperplasia of Terminal Ileum ): Korean J Gastrointest Endosc 1985;5(1):37-40. Published online November 30, 1984

Abstract PDF: Lymphoid hyperplasia of the intestinal tract is a non-specific reactive change. Most of these inatances, it is associated with a benign clinical course and requires no treatment. In my 14 casea anaiysis of colonoscopic obaervation, sex distribution was 9 males and 5 females. Most frequent age of incidence was 7 cases at the age of 8 to 14. Barium Eaema acurracy for the detection of lymphoid hyplasia was 57%. The colonoscopic findinge of lymphoid hyperplasia showed mucosal hyperemia, dome shaped, like a worm appearance of nodular lymphoid hypertrophy and segmental or focal aggregation of lymphoid nodules. I perfarmed only biopsy with hot biopsy foreeps and confirmed lymphoid hyperplasia, histologically. Occasionally treatment was nat necessary, but sometimes surgery may be required in the case of severe cornplications, intussusception, bleeding and obstruction.

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췌장 지방분해효소로 치료한 지방위석 2예 ( The Successful Dissolution of 2 Cases of Fat Bezoars by Pancreatic Lipase ): Korean J Gastrointest Endosc 1985;5(1):41-44. Published online November 30, 1984

Abstract PDF: Gastric bezoars are large masses or concretions, composed with plant fiber, hair and miscellaneous foreign bodies, found in the stomach and occur usually as sequele of gastric surgery. We experienced 2 cases of fat bezoars which developed after drinking of melted beef fst. They had postprandial epigastric fullness and pain, those were relieved on supine and left recumbent position. Upper gastrointestinal series showed a large movable mass in the stomach in hoth cases. On gastrofibercopic examination, a large egg sized white bezoar was cordirmed in both cases and a gastrie ulcer at antrum associated in one case. In attempt to removal of the bezoars, we tried to break them, but failed because of its character. The patients were treated with pancreatic lipase containg digestives, Pancreon-F and Azintal. From one day after this treatment, symptoms were completely relieved. Five days later, we confirmed disappearance of bezoars by gastrofiberscopy. and upper gastrointestinal barium

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Condom 을 이용한 내시경적 위내 바둑알 제거 1예 ( Endoscopic Removal of Badug Stone by Condom ): Korean J Gastrointest Endosc 1985;5(1):45-47. Published online November 30, 1984

Abstract PDF: With remarkable progress in upper GI endoscopy; it has been applied to therapeutid purpose. ln this paper, we present one suceessful case of endoscopic extraction of BADUG STONE by biopsy forceps and contraceytive condom., Using a biopsy forceps and condom inserted through the fiberscope, BADUG STONE' was eaaily made to roll into the self-opening trawl net' and safly removed.

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십이지장 결핵 2예의 내시경적 고찰 ( Gastroscopic Observation of Duodenal Tuberculosis ): Korean J Gastrointest Endosc 1985;5(1):49-52. Published online November 30, 1984

Abstract PDF: Today, the duodenal tuberculosis is a very rare disease. Final diagnosis of duodenal tuberculosis is difficult due to inconsistent symptoms and nonspecific duodenal lesions. We found 2 cases of duodenal tuberculosis by gastrascopy. In gastroscopic findings, there were undetermined ulcers and irregular nodular mucosal changes.

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식도심막누관 1예 ( A Case of Esophagopericardial Fistula ): Korean J Gastrointest Endosc 1985;5(1):53-55. Published online November 30, 1984

Abstract PDF: Esophagopericardial fistala is a rare and usually life threatening complication of both benign and malignant esophageal disease. A case of pyopneumopericarduim in 45 year-old female is reported. Streptocoeeus viridana in pas celtore was isolated from pericardial pus. The disorder resulted from eaqyhagoyericardial fistula which probably developed as a complication of esophageal diverticnlum. The diagnasis of the fistula was established preoperatively on the basis of chest X-ray, esophagogram and. endoeeopic findings. The treatment was thoracotorny with drainage of pericardium, diverticulectomy and antimicrobial chemotherapy. The patieat improved postoperatively.

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위 가성임파종 1예 보고 ( A Case Report of Gastric Pseudolymphoma ): Korean J Gastrointest Endosc 1985;5(1):57-60. Published online November 30, 1984

Abstract PDF: A 46-year-old female was admitted to Soon Chun Hyang University hospital with a complaint of intermittent epigastric pain. X-ray and endoscopic pictures showed diffase irregular shallow depression which is similar to the macroscopic pattern of the type IIc early gastric cancer. But endoseopic biopsy showed no malignant cell infiltration. Hndoaeopic biopsy plays an important role in excluding the possibility of carcinoma. But operation shoud be considered inspite of biopsy result because malignant lymphoma ean not be completely ruled out. Histopathologic diagnosis was pseudolymphoma of stomach.

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원발성 위 악성임파종 ( Primary Gasric Malignant Lymphoma ): Korean J Gastrointest Endosc 1985;5(1):61-65. Published online November 30, 1984

Abstract PDF: This article is the case report of primary gastric malignant lymphoma which was diagnosed by laparatomy. A 24-year-old male was admitted because of epigastric pain and general weakness, He was taken by gastrofiberoscopy with biopsy, upper gastrointestinal series, ultrasonogram, and abdominal computerized tomogram. Endoseopic pieture demonstrated whitish to yellowish exudate in the ulcer base and the surround.ing mucosal elevation in the poterior wall of the antrum and lower body. In the X-ray and endoseapic findings, the lesion was considered as Borrmann III type carcinoma, but on the second endoscopic biopsy gastric lymphoma was suapected. Reaected stomach revealed an irregular ulceration with the surrounding mucosal elevation with a size of 5X7X10cm at the pasterior wall of the antrum. Bridging folds were observed on the surrounding elevated mucosa of the lesion. Histologically, the lesion was diagnosed as malignant lymphoma (poorly differentiated lymphocytic).

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Clostridium Difficile 에 의한 위막성 장염 1예 ( Pseudomembranous Colitis Caused by Clostridium Difficile ): Korean J Gastrointest Endosc 1985;5(1):67-71. Published online November 30, 1984

Abstract PDF: Pseudomembranous colitis (PMC) was first described by Finney as postoperative diphtheritic enteritis in 1893 and was known to be associated with antibiotics by Reiner et al in 1952. Most cases of antibiotic-associated PMC are now associated with cytotoxigenic C. difficile. The association of PMC several antibiotics is well docamented; however, its association with clindamycin appeared to be most striking. We experienced a male patient who developed tarry stool, abdominal pain and diarrhea after having recieved clindamycin for two weeks. The PMC diagnosed by colonofiberscopy with biopsy and C. difficile was identified by tissue-culture study. The patient was treated by oral vancomycin and healed. Described here a case of PMC with some review of literature.

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