1.A Case of Esophageal Perforation by an Endoscopic Biopsy.
Ki Seok AHN ; Ki Joong KIM ; Kwi Hwan MIN ; Chan Woong PARK ; Ji Woon KIM ; Yo An CHOI ; Joon Seong JUNG ; Kun Hyung KIM
Korean Journal of Gastrointestinal Endoscopy 1997;17(4):529-532
The esophagus or stomach can be perforated during diagnostic upper endoscopy in 0.03 to 0.1 percent. Instrumentation injury, as a whole, is probably the most common single cause of all cases of esophageal perforation. Most of the esophageal perforation result from either therapeutic maneuvers(dilation, sclerotherapy, foreign-body removal etc.) or underlying esophageal lesion(such as strictures or diverticular or neoplasm). Endoscopic perforation of the esophagus may be obvious immediately or within a few hours. Cervical pain, subcutaneous emphysema, fever, tachycardia, and characteristic radiographic appearances make the diagnosis easy, but some distal esophageal injuries are subtler, An immediate esophagogram should be obtained if peirforation is suspected. To select an appropriate course of management, precise delineation of location and the extent of perforation is necessary. The esophageal perforation can be managed conservatively by close observation, esophageal rest, and antibiotic coverage, but the mortality rate of medical treatment is near 12%. Causes of death are sepsis and multisystem organ failure. So we report a case of esophageal perforation by an endoscopic biopsy.
Biopsy*
;
Cause of Death
;
Constriction, Pathologic
;
Diagnosis
;
Endoscopy
;
Esophageal Perforation*
;
Esophagoscopy
;
Esophagus
;
Fever
;
Mortality
;
Neck Pain
;
Sclerotherapy
;
Scoliosis
;
Sepsis
;
Stomach
;
Subcutaneous Emphysema
;
Tachycardia
2.A case of esophageal bezoar consisted with candidiasis.
Yeong Yong KIM ; Ki Seok AHN ; Kwi Hwan MIN ; Ki Joong KIM ; Joon Seong JUNG ; Jin Woong LEE ; Tae Yong YOON ; Chan Woong PARK ; Ji Woon KIM
Korean Journal of Medicine 1998;54(5):723-727
Bezoars are persistent concretions of indigestible matter, usually seen in the stomach. But very rarely have bezoars been reported in the esophagus.. Most esophageal bezoars are either phytobezoars or medication bezoars occuring usually in the middle aged & elderly associated with underlying anatomical or functional abnormalities of esophagus. A variety of techniques has been developed recently in diagnostic and therapeutic endoscopy. So endoscopic management is safe and successful in most cases those required surgical management. We experienced an esophageal bezoar consisted with esophageal candidiasis in a patient who underwent esophago-gastric anastomosis and proximal gastrectomy due to early gastric cancer. The bezoar was removed by endoscopy and the esophago-gastric stenosis was treated with balloon dilator without any significant complication.
Aged
;
Bezoars*
;
Candidiasis*
;
Constriction, Pathologic
;
Endoscopy
;
Esophagus
;
Gastrectomy
;
Humans
;
Middle Aged
;
Stomach
;
Stomach Neoplasms
3.2 Cases of Endoscopic Ligation Therapy of a Dieulafoy Ulcer.
Joon Seong JUNG ; Yeong Yong KIM ; Jin Ung LEE ; Tae Yong YOON ; Ki Seok AHN ; Kwi Hwan MIN ; Ki Joong KIM ; Chan Woong PARK ; Kwan Su CHOI
Korean Journal of Gastrointestinal Endoscopy 1998;18(2):225-229
A dieulafoy ulcer is rarely recognized but is not an uncommon cause of massive, recurrent and frequently fatal gastrointestinal bleeding resulting from the erosion of an unusually large submucosal artery. Although the lesion has been predominantly found in the proximal stomach, it has also been detected throughout the gastrointestinal tract. Diagnosis can be made by observation of protruding and eroded arteries with pulsatile bleeding, or through detection of an adherent thrombus using an endoscopy. In the past, surgical intervention was believed to be the best treatment, but currently, therapeutic endoscopy is more favored, due to its recent success in achieving permanent hemostasis. We experienced 2 cases of Dieulafoy's ulcer of the stomach. Endoscopic ligations using an O ring were performed successfully.
Arteries
;
Cytochrome P-450 CYP1A1
;
Diagnosis
;
Endoscopy
;
Gastrointestinal Hemorrhage
;
Gastrointestinal Tract
;
Hemorrhage
;
Hemostasis
;
Ligation*
;
Stomach
;
Thrombosis
;
Ulcer*
4.Observation of 35 Cases of Mallory: Weiss Syndrome Diagnosed by Endoscopy.
Ki Seok AHN ; Young Yong KIM ; Jin Woong LEE ; Tae Yong YOON ; Ki Joong KIM ; Jun Seong JEONG ; Kwi Hwan MIN ; Chan Woong PARK ; Ji Woon KIM
Korean Journal of Gastrointestinal Endoscopy 1997;17(3):329-334
35 cases of Mallory-Weiss syndrome among 277 cases of upper gastrointestinal bleeding were ascertained by endoscopy at department of internal medicine St. Columban's hospital. The mean age was 41.6 years. All of 35 cases were found in male. Combined disease were gastritis(15 cases), peptic ulcer(7 cases) and esophageal varix(3 cases). The most common precipitating factor was vomiting, 22 cases among the 28 cases of vomiting(80%) developed after drinking. Endoscopic finding revealed active bleeding in 5 cases, blood clot without active bleeding in 22 cases, and scar change without bleeding evidence in 8 cases. Most cases had had hematemesis after active bleeding but 5 cases had had only melena without hematemesis. The Mallory-Weiss lacerations were located at stomach in 16 cases(46%), at esophagogastric junction in 11 cases(31%) and at esophagus in 8 cases. On the view of gastric direction, 14 cases were on anterior wall side, 9 cases were on posterior wall side, 11 cases were on lesser curvature side and one case was on great curvature side. Single lacerations were more common than multiple lacerations.
Cicatrix
;
Drinking
;
Endoscopy*
;
Esophagogastric Junction
;
Esophagus
;
Hematemesis
;
Hemorrhage
;
Humans
;
Internal Medicine
;
Lacerations
;
Male
;
Mallory-Weiss Syndrome
;
Melena
;
Precipitating Factors
;
Stomach
;
Vomiting
5.The effect of plasma on shear bond strength between resin cement and colored zirconia.
Chan PARK ; Seung Hwan YOO ; Sang Won PARK ; Kwi Dug YUN ; Min Kyung JI ; Jin Ho SHIN ; Hyun Pil LIM
The Journal of Advanced Prosthodontics 2017;9(2):118-123
PURPOSE: To investigate the effect of non-thermal atmospheric pressure plasma (NTAPP) treatment on shear bond strength (SBS) between resin cement and colored zirconia made with metal chlorides. MATERIALS AND METHODS: 60 zirconia specimens were divided into 3 groups using coloring liquid. Each group was divided again into 2 sub-groups using plasma treatment; the experimental group was treated with plasma, and the control group was untreated. The sub-groups were: N (non-colored), C (0.1 wt% aqueous chromium chloride solution), M (0.1 wt% aqueous molybdenum chloride solution), NP (non-colored with plasma), CP (0.1 wt% aqueous chromium chloride solution with plasma), and MP (0.1 wt% aqueous molybdenum chloride solution with plasma). Composite resin cylinders were bonded to zirconia specimens with MDP-based resin cement, and SBS was measured using a universal testing machine. All data was analyzed statistically using a 2-way ANOVA test and a Tukey test. RESULTS: SBS significantly increased when specimens were treated with NTAPP regardless of coloring (P<.001). Colored zirconia containing molybdenum showed the highest value of SBS, regardless of NTAPP. The molybdenum group showed the highest SBS, whereas the chromium group showed the lowest. CONCLUSION: NTAPP may increase the SBS of colored zirconia and resin cement. The NTAPP effect on SBS is not influenced by the presence of zirconia coloring.
Chlorides
;
Chromium
;
Molybdenum
;
Plasma Gases
;
Plasma*
;
Resin Cements*
6.A Case of Mucin-hypersecreting Biliary Papillomatosis: Including Review of Korean Literatures.
Dae Kyoum KIM ; Myung Hwan KIM ; Kyoung Min PARK ; Yoon Seon LEE ; Kwi Sook CHOI ; Hyun Soon SONG ; Jong Seok BAE ; Hyun Jun KIM ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE ; Young Il MIN ; Young Min KIM ; Jung Sun KIM ; Eun Sil YU
Korean Journal of Gastrointestinal Endoscopy 2003;26(3):167-171
The mucin-hypersecreting bile duct tumor is rare and its clinical, radiologic, and pathologic features are not well known. We report the case of mucin-hypersecreting biliary papillomatosis with malignant transformation including review of 11 korean literatures. A 65-year-old female was admitted to our hospital with fever, chills, and right upper quadrant pain. A CT scan showed marked dilatation of left intrahepatic duct with intraductal filling defects. During endoscopic retrograde cholangiograpy, mucin from the ampulla was observed and dilated common bile duct with multiple amorphous filling defects was noted. Cholangioscopy revealed muliple coral-like mucosal papillary projections with large amount of mucin in the left intrahepatic ducts. The patient underwent left lobectomy, and the biopsy revealed intraductal papillary adenocarcinoma in the background of papillary adenoma.
Adenocarcinoma
;
Adenocarcinoma, Papillary
;
Adenoma
;
Aged
;
Bile Ducts
;
Biopsy
;
Chills
;
Common Bile Duct
;
Dilatation
;
Female
;
Fever
;
Humans
;
Mucins
;
Papilloma*
;
Tomography, X-Ray Computed
7.Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival.
Hong Ki MIN ; Jae Ho LEE ; Seung Min JUNG ; Jennifer LEE ; Kwi Young KANG ; Seung Ki KWOK ; Ji Hyeon JU ; Kyung Su PARK ; Sung Hwan PARK
The Korean Journal of Internal Medicine 2015;30(2):232-241
BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons. RESULTS: A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 +/- 1.245 vs. 1.00 +/- 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10. CONCLUSIONS: PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients.
Adolescent
;
Adult
;
Cardiomegaly/diagnosis/epidemiology
;
Chi-Square Distribution
;
Female
;
Humans
;
Hypertension, Pulmonary/diagnosis/*mortality
;
Kaplan-Meier Estimate
;
Lung Diseases, Interstitial/diagnosis/mortality
;
Lupus Erythematosus, Systemic/diagnosis/*mortality
;
Lupus Nephritis/diagnosis/mortality
;
Male
;
Multivariate Analysis
;
Prognosis
;
Proportional Hazards Models
;
Raynaud Disease/diagnosis/epidemiology
;
Republic of Korea
;
Retrospective Studies
;
Risk Factors
;
Young Adult
8.Three Cases of Gallstone Ileus.
Hyun Soon SONG ; Myung Hwan KIM ; Hyun Jun KIM ; Dae Kyoum KIM ; Kwi Sook CHOI ; Kyang Min PARK ; Eun Hee KO ; Sang Soo LEE ; Dong Wan SEO ; Sung Gu LEE ; Young Il MIN
Korean Journal of Gastrointestinal Endoscopy 2003;26(2):114-118
Gallstone ileus is a mechanical obstruction caused by the impaction of one or more gallstones within the lumen of any part of the gastrointestinal tract. Gallstone ileus is frequently proceeded by an episode of acute cholecystitis. The resulting inflammation and adhesions facilitate the erosion of the offending gallstone through the gallbladder wall forming a cholecystoenteric fistula and allowing the passage of the gallstone. Fifty five-year-old, 71-year-old, and 74-year-old female patients were admitted to the Asan Medical Center for nausea, vomiting, and nonspecific abdominal pain. Erect abdominal plain film revealed several moderately dilated loops of small bowel with air fluid levels. Computed tomography showed the classic triad of findings of gallstone ileus. Dilated loops of small bowel, air in the biliary tree and an ectopic stone in the ileum were demonstrated. These impacted stones were removed by surgical intervention.
Abdominal Pain
;
Aged
;
Biliary Tract
;
Cholecystitis, Acute
;
Chungcheongnam-do
;
Female
;
Fistula
;
Gallbladder
;
Gallstones*
;
Gastrointestinal Tract
;
Humans
;
Ileum
;
Ileus*
;
Inflammation
;
Nausea
;
Vomiting
9.Gender Differences in Clinical Features and Anti-TNF Agent Use in Korean Ankylosing Spondylitis Patients.
Chang Hoon LEE ; Myeung Su LEE ; Kwi Young KANG ; Su Jin MUN ; Ji Min KIM ; Ho Seung YUN ; Seung Gi KWAK ; Ji Hyeon JU ; Kyung Su PARK ; Ho Youn KIM ; Sung Hwan PARK
Journal of Rheumatic Diseases 2012;19(3):132-137
OBJECTIVE: The aim of this study was to assess the gender differences in the clinical presentation and treatment patterns between Korean women and men with ankylosing spondylitis (AS). METHODS: We retrospectively analyzed the data from extensive clinical assessments of 721 patients (162 women and 559 men) with AS, who were diagnosed at Seoul St. Mary's Hospital, between January 2000 and September 2009. Clinical data, regarding the disease onset, disease duration, clinical presentations, status of human leukocyte antigen (HLA)-B27, and bone mineral density, were determined using a dual-energy X-ray absorptiometry (DEXA). Finally, we analyzed the medical treatments prescribed for these patients. RESULTS: The ratio of men to women was 3.45:1. Compared to men, women were older at the time of diagnosis, had shorter disease durations, and were diagnosed in earlier stages of the disease. More women had a history of uveitis at diagnosis than men. Back pain was the main presenting symptom, and its prevalence was the same in both genders. Fewer women showed cervical and thoracic axial involvement than men. Initially, more women had wrist and hand pain than men; however, at some point, peripheral arthritis development was equally likely in both genders. Women experienced shoulder pain, during the disease course, more often thanmen. On the other hand, men presented with knee and hip pain more often than women. Sulfasalazine and anti-TNF agents were more often prescribed to women. CONCLUSION: The presentation and progression of AS showed a difference between women and men. Because of these differences, AS should be considered when a women presents with peripheral arthritis or uveitis in the early stage of the disease.
Absorptiometry, Photon
;
Arthritis
;
Back Pain
;
Bone Density
;
Female
;
Hand
;
Hip
;
Humans
;
Knee
;
Leukocytes
;
Male
;
Prevalence
;
Retrospective Studies
;
Shoulder Pain
;
Spondylitis, Ankylosing
;
Sulfasalazine
;
Uveitis
;
Wrist
10.Intraductal Papillary Mucinous Tumor of the Pancreas Still Resectable 5 Years after Diagnosis.
Kwi Sook CHOI ; Myung Hwan KIM ; Yoon Seon LEE ; Jin Young KIM ; Dae Kyoum KIM ; Hyun Soon SONG ; Jong Seok BAE ; Hyun Jun KIM ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE ; Young Il MIN ; Jung Sun KIM ; Eun Sil YU
Korean Journal of Gastrointestinal Endoscopy 2003;26(3):172-176
Intraductal papillary mucinous tumor (IPMT) of the pancreas is a spectrum of conditions ranging from benign to malignant. It is known that the biologic behavior of IPMT is slower and less aggressive than that of pancreatic ductal carcinoma. We report a case of IPMT of pancreas resected 5 years after diagnosis. The carcinoma remained localized without evident stromal invasion or lymph node metastasis with the background of adenoma, suggesting a adenomacarcinoma sequence. This is a case report that may be helpful to study the natural history of IPMT, particularly slow progression of IPMT.
Adenoma
;
Carcinoma, Pancreatic Ductal
;
Diagnosis*
;
Lymph Nodes
;
Mucins*
;
Natural History
;
Neoplasm Metastasis
;
Pancreas*