Clinical Endoscopy

상부 위장관 이물질 15예의 내시경적 적출에 대한 임상적 고찰 ( A Clinical Review of the Endoscopic Removal of 15 Cases of Foreign Bodies in the Upper Gastrointestinal Tract ): Korean J Gastrointest Endosc 1987;7(1):1-4. Published online November 30, 1986

Abstract PDF: The clinical review was done on 15 cases with the foreign body in the upper gastrointestinal tract who visited and underwent endoscopic removal of foreign body at department of lnternal Medicine of Chonnam University Hospital and Namkwang Hospital from June 1982 to August 1987. The results are as follows: 1) The age distribution varied from 32 yeara to 83 years of age, being most prevalent at 6th decade, The ratio between male and femaie was 4:1, more prevelant in male. 2} Among 15 eases, 8 cases were lodged in the esophagus and 7 cases in the stomach. The foreign bodies in the esophagus were meat, pressure-through package, food materials and bone in order of frequency and those in the stomach were bezoar, persimmon seed, brown seaweed, tooth brush and suture materials. 3) Cambined diseases of upper gastrointetinal passage disturbance were 1 case of esophageal cancer and 3 cases of gastric outlet obstruction caueed by duodenal ulcers and gastric malignancy. Other combined diseases were schizophrenia, chronic alcoholism, diabetes mellitus and gastrie polyp. 4) Complications by foreign body were retropharyngeal abscess and phlegmonous esophagitis with esophageal ulcer.

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대장내시경의 진단적 의의 ( The Clinical Experience and Diagnostic Value of Colonoscope ): Korean J Gastrointest Endosc 1987;7(1):5-11. Published online November 30, 1986

Abstract PDF: The authers performed long coloaofiherscopy with barium enema study on 134 cases, of coloreatal diseasea, who had been admitted to the department of Internal Medicine, Kwangiu Christian Hospital from July 1984 to Aupist 1986, The results were following: 1) Among 134 cases of colonoacopy, abnormal findings were 70 cases (52.2%) and normal findings 64 cases (47.8%). 2) among 70 cases of colonoscopic abnormal findings, nonspecific inflammatory colitis were 27 cases, colon tuberculosis 15 cases, colon and rectal cancer 14 cases, colon polyps 8 cases, ulcerative colitis 3 cases, internal hemorrhoid 2 cases, sigmoid diverticular 1 case. 3) The cases in which the findings of barium contrast enema were compatible with those of colonoscopy were 84 cases (62.7%), not compatible 50 cases(37.3%). There were not compatible with findings in 4 cases of colon cancer (10 cases), 7 cases of colon tuberculosis (15 cases), 4 cases of colon polyps (8 cases), 1 case of ulcerative colitis (3 cases). 4) The insertion ratio to ileocecal valve was 79.1%. The rate of correct approach by a colonoscopy to the lesion site shown at barium contrast enema was 94.1%

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위막성 대장염의 임상적 고찰 ( A Clinical Study on Pseudomembranous Colitis ): Korean J Gastrointest Endosc 1987;7(1):13-17. Published online November 30, 1986

Abstract PDF: The purpose of this study is to review the clinical and pathological features of pseudomembranous colitis in Korea. Ten cases of psedomembranous colitis, which were diagnosed by sigmoidoscopy and biopsy at the Seoul National University Hospital from May 1982 to occtober 1985, were analyzed in terms of the age and sex distribution, underlying diseases, presumptive causative antimicrobials, symptomatology, involved site and tratment. 1) The disease was more prevalent above sixth decade with a slight preponderance on the female. 2) The underlying diseases of the patients were the uterine cervix cancer in 3 cases and one case each of the nasal polyp, cataract, degenerative arthritis, tuberculous gradmuloma, SLE with menngitis, CVA and gingival abscess. 3) As for the presumptive causative drugs, cephalosporin were assaciated in 6 cases, aminoglycoside m 7 cases, penlcillin in 3 cases, Bactrim in 3 cases, antituberculosis drugs in 1 case and anticancer drugs in 1 case. 4) As for the anatotmical distribution of the lesion, the rectum was involved in 5 cases, the rectum and sigmoid colon in 4 cases and up to the descending colon in 1 case. 5) All the cases were cured by medical treatment. In 5 cases, discontinuation of the antimicrobial drugs and supportive care only were effective and in other 5 cases, vancamycin and/or metronidazole together vrith cholestyramine were added to the regimen.

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궤양성 대장염 28예에 대한 임상적 고찰 ( Clinical Reviews on 28 Patients with Ulcerative Colitis ): Korean J Gastrointest Endosc 1987;7(1):19-26. Published online November 30, 1986

Abstract PDF: The ulcerative colitis is a relatively common disease in the European and North American countries aince Dr. Wilks has first reported the cases in 1895, But in Korea, this disease is a rare entity and only a few case have been reported. However, rescently the diagnoetic methods for ulcerative colitis are much developed we have experienced 28 cases of ulcerative colitis which were diagnosed by endoscopy, barium enema exam and biopsy. Therefore a total of 28 patient with ulcerative colitis diagnosed and treated at the department of internal medicine of HYUH from June 1979 to June 1986 was reviewed. We obtained the results as follows; 1) The sex distribution assumed a ratio of 1 to 1.33 with 12 males and 16 females. 2) The age dietribution was relatively even but the majority of cases were between 5th and 6th decade (32.1%), 3) The most prominent clinical symptoms were rectal bleeding, abdominal pain, diarrhea, fever, wight loss and vomiting. 4) Significant laboratory findins were anemia, eleveited ESR, leukocytosis, positive stool OB, electrolyte imbalance and decreased serum albumin level. 5) As to the extent of disease determined by the barium enema examination and endoscopic exam., rectum or rectosigmoid colon is involved in majority of the cases (92.8%). 6) The endoscopic examination was performed in all 28 cases and showed significant findings such as ulceration, hyperemia, mucosal friability, bleeding etcs. 7) The barium enema examination was performed in 19 cases and showed positive findings such as ulceration, luminal narrowing, bowel shortening and rigidity in 17 cases. 8) 21 of 28 patients treated by medical therapy showed relatively improved but 4 of 28 patients was exacerbated or relapsed and one has expired.

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소화성 궤양에 대한 Famotidine ( Gasterⓡ ) 의 임상효과의 검토 ( Overview of Clinical Experience in the Treatment of Peptic Ulcer with Famotidine ): Korean J Gastrointest Endosc 1987;7(1):27-30. Published online November 30, 1986

Abstract PDF: The aim of the investigation was to study the efficacy and safety of Famotidine (Gaster), a new, potent, histamine H-receptor antagonist. The Famotidine (40 mg p.o.h.s) was administered to 22 patients with 33 peptic ulcers for 4 weeks. Follow up checking was done at 2 week and 4 week by endoscopy and physical examination. All patients were carefully evaluated at regular intervals for adverse drugh reactions by clinical and laboratory examinations. By the end of study, 97% of the ulcers were healed by endoscopically and rapid and complete relief of epigastric pain was observed in all patients. Famotidine treatment was well tolerated and no alterations in laboratory tests were noted. Therfore, Famotidine was proved effective in the treatment of peptic ulcers (especially multiple ulcers) and was well tolerted on the short-term basis.

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내시경 절제술로 진단된 다발성 식도 평활근종 1예 ( A Case of Multiple Leiomyomas of the Esophagus ): Korean J Gastrointest Endosc 1987;7(1):31-34. Published online November 30, 1986

Abstract PDF: Benign tumors of the esophagus occur rarely as compared with the incidence of carcinomas. Among the benign tumors of the esophagus such as leiomyoma, lipoma, hemangioma, papilioma. polyp, cystetc. leiomyoma is the most common, although less than 10 percents of leiomyomas of the gastrointestinal tract are found in the esophagus. Most of leiomyomas of the esophagus present as solitary lesions but multiple tumors occur in about 4 percents of cases. Leiomyomas of the esophagus are diagnosed by thorough clinical evaluation, esophagogram and upper gastrofiberscopic examination but histological confirmation requires surgical or necropsy specimens. Occasionally gastrofiberscopic polypectomized specimens are used. We report one case of multiple leiomyomas of the esophagus located in between 25 cm and 40 cm distance from the incisor in a 38-year-old man who complained of vague substernal discomfort for about 10 years. Gastrofiberscopic polypectomized specimen was used for preoperative histological confirmation. The pathologic examination of the specimen showed leiomyoma of the esophagus.

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치솔이물에 의한 식도천공 1예 ( Esophageal Perforation Due to Swallowed Toothbrush ): Korean J Gastrointest Endosc 1987;7(1):35-37. Published online November 30, 1986

Abstract PDF: Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.

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인환세포암종과의 감별을 요한 위점막내 Russell 소체 함유 형질 세포 침윤 ( Russell Body - Containing Plasma Cell Aggregations Mimiccking Signet Ring Cell Carcinoma of the Stomach ): Korean J Gastrointest Endosc 1987;7(1):39-41. Published online November 30, 1986

Abstract PDF: This report presents a case with gastric ulcer whose gastric mucosal biopsy revealed heavy aggregations of Russell body containing plasma cells in the lamina propria and in peptic detritus. A sixty four year old female received an endoscopic examination for currently aggravated peptic ulcer symytoms, It revealed a small round ulcer with nodular margin along the greater curvature of high body, suggesting of early gastric carcinoma. Endoscopic biopsies (two times) confirmed heavy collections of Russell body-containing plasma cells which were once misinterpreted as signet ring cell carcinoma. Immonohistochemically they were strongly positive to both kappa and lambda light chains by pgtroxidase-antiperoxidase method. Each infiltrated cell contained one or more refractile intracytoplasmic eosinophilic globules, bcing associated with extracellular ones and heavy matare lympho-plasma cell infiltration. Differential diagnosis from neoplastic signet ring cells in endoscopic biopsy was diseussed.

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십이지장 제1부에 발생한 원발성 융모성 암종 2예 ( Villous Tumor of the Duodenum - Report of two cases - ): Korean J Gastrointest Endosc 1987;7(1):43-46. Published online November 30, 1986

Abstract PDF: Villous tumor of the duodenum are rare, only 89 cases having been reported and reviewed in several recent publication. Malignancy is discovered in approximately 30-45% leading to the recommandation that all such tumors be excised regardless of the endoscopic findings. Two cases of villous tumor of the duodenum were reported and locally excised. The pathologic specimens showed carcinoma in situ, no evidence of hematogenous and lymphatic metastasis.

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장중첩증을 동반한 Peutz - Jeghers syndrome 1예 ( A Case of Peutz - Jeghers syndrome Accompanied with Intussusception ): Korean J Gastrointest Endosc 1987;7(1):47-52. Published online November 30, 1986

Abstract PDF: The Peutz-Jeghers syndrome is a familial disesse charaeterized by mucocutaneaus pigmentation, gastrointestinal polyposis, and transmission of autosomal dominant trait. This syndrome is clinically important becuase of the coreplieation caused by the polyp, leading to abdominal pain, gastrointestinal bleeding, and intussusception. Authors experienced a case of Peutz-Jeghers syndrome admitted to Walace Memorial Baptist Hospital who was complained of recurrent abdominal pain, melanin pigmentation of lips, oral mucosa, and digits. UGI series, small bowel series, colon cnema, gastrofiberscopy, and colonoseopy revealed multiyle intestinal polyps. Pathologic findings on endoseopic polypectomy showed hamartomatous polyp.

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대장 및 소장에 병발한 악성임파종 1예 ( Concurrent Malignant Lymphoma of the Colon and Small Bowel as the Primary Origin ): Korean J Gastrointest Endosc 1987;7(1):53-57. Published online November 30, 1986

Abstract PDF: Primary gastrointestinal lymphoma primarily confined to gastrointestinal tract is relatively rare diaease. Although the lymphoma primarily involved colorectum or small bowel was commonly reported than primary gastric lymphoma in Korea, the concurrent primary lymphoma of colon and small bowel is very rare in reported cases. We report a case of combined primary malignant lymphoma of the jejunum and cecum, who was admitted due to melena and anemia. She had right hemicolectomy and end-to-side ileotransverse colostomy at 2 months ago, due to primary colon lymphoma. The laparotomy was performed and identified hard, 2 x 3 cm sized masses on distal 25 cm, 80 cm and 150 cm from the Treitz ligament. The histology of these small ma showed histiocytic lymphoma as same as cecal specimen. In general, the small bowel lymphoma shaws poor prognosis than gastric or colorectal lymphoma due to diffieulty in diagnosis and late symptoms, but this problem could be resolved through the knowledge about primary gastrointestinal lymphoma and the development of diagnostic methods.

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하부 소화관 출혈을 동반한 충수돌기의 점액류종 ( Appendiceal Mucocele with Lower Gastrointestinal Bleeding ): Korean J Gastrointest Endosc 1987;7(1):59-63. Published online November 30, 1986

Abstract PDF: The appendiceal mucocele is very rare disease of 0.2% incidence. About 24% of patients are asymptomatic and symptomatic patients present with pain in the right lower quadrant of abdomen in 64%, plapable maas in the right lower quadrant of abdomen in 50%, and rarely, melena, hematochezia, anemia, diarrhea, malaise, and abdominal distension. The gastrointestinal bleeding may be presented in the patient with intussusception, but the massive bleeding is generally absent. We report a case of appendiceal mucocele accompanying with gastrointestinal bleeding and review of literature.

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폐흡충증이 간 및 회맹장부위에 이소기생한 증례 ( A Case of Extrapulmonary Paragonimiasis Involiving Liver and Cecum ): Korean J Gastrointest Endosc 1987;7(1):65-69. Published online November 30, 1986

Abstract PDF: We report a caae of hepatic and intestinal infestation with paragonimus wewstermani complicating abscess formation. The pathway by which the paragonimus westermani reaehea liver and intestine is not well understood. However, there was possiblity that it may become lodged in other organs that the lung because of polonged larval migrations through the diaphragm or into various sites in the abdomen. The patient, 52-year-old female gave a history of having reyeatedly consumed raw crabs. An x-ray film of the chest showed clear lunga Skin test for paragonimus-westermani was positive. Abdominal ultrasonogram showed enlargement of the liver with multiple hypoechoic lesiona ERCP revealed multiple ie lesions in the right lobe of the liver. Abdaminal CT showed multifocal abscess cavities with slight rim enhancements. Above meetioned diagnostic procedures suggested liver abscess or hepatoma. Then, an exploratory laparotomy was done for a definite diagnosis, Frozen biopsy, from liver and surgically exe mass from ileocecal region revealed extrpulmonary paragnomiasis involving liver and cecum. Thus, the patient was treated with prasiquantel. Three months later, abdominal ultrasonogram demonstrated slight enlargement of the liver but no evidence of abnormal mass like lesions.

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대장내시경으로 진단된 맹장을 침범한 Behcet 씨 증후군 1예 ( Colonoscopically Diagnosed Case of Behcet's Syndrome Involving Cecum ): Korean J Gastrointest Endosc 1987;7(1):71-74. Published online November 30, 1986

Abstract PDF: Authors came acoss a case of Behcet's syndrome involving cecum. The patient was a 33-year-old female. Her chief complaint was right lower quadrant pain, Colonoscopy revealed several ulcerations the base of which was covered by thick whitish coat, They were surrounded by mulitiple nodular masses. Endoscopic biopsy showed noaspecific ulceration. The patient had a history of aphthous ulceration of mouth and external genitalia. So she was diagnosed to have Behcets syndrome. She underwent right hemicolectomy with tetminal ilectomy. We report this case with literiature review.

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대장내시경검사로 진단된 맹장계실염 1예 보고 ( A Case Report of Cecal Diverticulitis diagnosed by Colonofiberscopy ): Korean J Gastrointest Endosc 1987;7(1):75-78. Published online November 30, 1986

Abstract PDF: Diverticular disease of the colon is frequently involved in Western countries, which in korea, it is regarding as rare disease. In Western the diverticulosis is mainly affected on left side and increasing in according to age and false type is more frequent than ture type. While in oriental countries, the diverticulosis of the colon is mainly affected on right side and it is more frequent in younger patients. Cecal diverticulitis is known to a very rare disease and very difficult to be differenciated from acute scopy has purnished another useful tool in the differential diagnosis of diverticular disease. We experienced a case of cecal diverticultitis which had been diagnosed by colonofiberscopy and reviewed literatures briefly.

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만성췌염을 동반한 췌관내 회충 미립증 1예 ( A Case of Ascarid Chronic Pancreatitis Due to Impaction of Ascaris Lumbricoides into the pancreatic Duct ): Korean J Gastrointest Endosc 1987;7(1):79-81. Published online November 30, 1986

Abstract PDF: Authors report a case with recurrent epigastric pain who revesled to have chronic pancreatitis due to impaction of Ascaris lumbricoides into the pancreatic duct. She was a 41-year-old female who favored raw meat. ERCP revealed a living round worm in the pancreatic duct which was also showed by ultrasonegraphy and computed tomography. She underwent distal pancreatectomy and developed glucose intolerance but was well controlled.

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Choledochal cyst 1예 보고 ( A Case Report of Choledochal Cyst ): Korean J Gastrointest Endosc 1987;7(1):83-86. Published online November 30, 1986

Abstract PDF: Congential bile duct cysts, the so called "choledochal cysts" occur at all levels of the biliary tree and may be of saccular, diverticular, or fusiform configuration. There are 6 types of choledochal cysts proposed by todani et al based on roentgenologic and operative findings. This disease is usually diagnosed at the childhood or early adult life and predilection for orientals. Clinical manifestations are usually jaundice, right upper quadrant abdominal pain and abdominal mass. Here we are reporting a case of choledochal cyst, type IV-A diagnosed by abdominal ultrasonogram. 99mTc-DISIDA hepatobiliary scan and endoscopic retrograde cholangiopancreatogram.

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간장에 발생한 염증성 가성종양 1예 보고 ( Inflammatory Pseudotumor of the Liver - A case report - ): Korean J Gastrointest Endosc 1987;7(1):87-89. Published online November 30, 1986

Abstract PDF: The term "collagenous colitis" was coined by Lindstrom in 1976 to describe the patient with chronic watery diarrhea who had normal rectal mucosa by proctoscopy but who had a thick subepithelial collagenous deposit on biopsy, and now collagenous colitis is recognized as one of the more common causes of chronic diarrhea of obscure origin. But in this country only a few case has been reported. We have seen a 68-year-old man with chronic watery diarrhea with abdominal pain. Physical examination, laboratory and radiologic studies were no abnormal finding. Colonoscopy disclosed grossly normal mucosa through the entire colon but by histologic examination there are chronic inflammation in the lamina propria and thickened subepithelial collagen layer. Symptoms and pathologic findings of patient improved after treatment with sulfasalazine and prednisolone. (Korean J Castraintest Endosc 17: 79-84, 1997)

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흡수장애증후군을 동반한 전신성 원발성 Amyloidosis 1예 ( Generalized Primary Amyloidosis with Malabsorption Syndrome ): Korean J Gastrointest Endosc 1987;7(1):91-96. Published online November 30, 1986

Abstract PDF: A case of generalized primary amyloidosis with a reveiw of the literatures is reported. The 38 year old patient suffered from malabsorption syndrome for a year and was presented chronic renal failure with renal enlargment, myxedema and hemorrhagic gastritis. Biopsy of kidney and stomach revealed characteristic findings of amyloidosis by congo red stain and electronmicroscopy.

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복막위점액종 11예 ( 11 Cases of Pseudomyxoma Peritonei ): Korean J Gastrointest Endosc 1987;7(1):97-106. Published online November 30, 1986

Abstract PDF: Pseudomyxoma peritonei is a rare disorder chracterized by abdominal distension resulting from the accumulation of a mucinous, gelatinous, translucent material which arises from rupture of pre-existing mucinous cystadenomas and cystadenocarcinomas of the ovary and mucocele of the appendix. We report 11 cases of pseudomyxoma peritonei which were diagnosed by surgical and pathological findings. The results were as follows. 1) The mean age of 11 cases was 51 years and 5 cases were male and 6 cases were female and male to female ratio was 1 to 1.2. 2) Clinical manifestations in 11 cases were abdominal distension in 5 cases (45.5%), palpable mass in 4 cases(36.6%), abdominal pain in 4 cases(36.6%), nausea in 3 cases(27.3%), weight loss in 3 cases(27.3%), diarrhea in 2 cases(18.2%), constipation in 1 case(9.0%), anal bleeding in 1 case(9.0%) and defecation difficulty in 1 case(9.0%). The duration of symptoms was 2 days to 1 year. 3) The primary sites of pseudomyxoma peritonei were ovarian cancer in 3 cases(27.2%), appendiceal cancer in 2 cases(18.2%), gastric cancer in 2 cases(18.2%), rectal cancer in 1 case(9.1%), cecal cancer in 1 case(9.1%) and unknown origin in 2 cases(18.2%). 4) Following surgical interventions were performed; right hemicolectomy in 2 cases, palliative gastrojejunostomy in 2 cases, oophorectomy in 1 case, omentectomy in 1 case and right hemicolectomy with gastrojejunostomy in 1 case. 5) The adjunctive anti-cancer chemotherapy was done in 4 cases(36.4%) by combination of actinomycin D, adriamycin, CCNU, cisplatin, cytoxan and fluorouracil, And chemotherapy only was done in 2 cases and hyperthermia was done in 1 case.

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