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대장내시경 검사중 동맥혈 산소 포화도와 생리적 변화에 관한 연구
신원창,이진호,김관엽 인제대학교 1994 仁濟醫學 Vol.15 No.3
대장내시경 검사중 발생할 수 있는 동맥혈 산소 포화도의 감소와 혈압, 맥박, 호흡수의 변화가 어느정도 심하게 발생하는지, 또한 전처치 약물과의 관계, 검사 시행 도중에 생기는 통증과 대장고리(Loop)의 형성과 어떤 관계가 있는지 조사하기 위해 50명의 환자를 대상으로 연구하였다. We prospectively evaluated multiple physiologic parameters in 50 consecutive unselected patients undergoing elective colonoscopy. Changes observed during colonoscopy were then correlated with premedication, position of the endoscope and presence of looping, existence of comorbid medical conditions. Clinically important changes in oxygen saturation(28%), in blood pressure(22%), pulse rate(42%), and respiratory rate(14%) were noted. These clinically significant changes were associated with endoscopic looping and pain. In the remainder of patients, no obvious factor was associated with the observed alterations in physiologic parameters. There was no relation with presence of comorbid medical conditions, dose of premedication, and/or colon segment reached by the endoscope. Conclusively although there was no apparent morbidity associated with the induced changes in physiologic parameters, these data suggest that certain patients may be at increased risk of procedure -related morbidity and support the need for physiologic monitoring in high-risk patients.
소화성궤양 출혈의 에탄올 경화요법의 효과와 궤양 기저부 형태에 따른 지혈 치료의 필요성
신원창,김관엽 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1
The peptic ulcer is the most common cause of the upper gastrointestinal bleeding. We evaluated the efficacy of the sclerotherapy by endoscopic injection of ethanol for the bleeding peptic ulcer patients. We also evaluated the need of the sclerotherapy on the bleeding peptic ulcer according to the bleeding stigmata on the ulcer base. We classified the bleeding stigmata on the ulcer base with 4 group: active bleeding(21/345, 6%), visible vessel(122/345, 35%), red spot(97/345, 28%), no stigmata(105/345, 31%). The patients who manifested hernatemesis, melena, or both initially, were diagnosed as benign gastric ulcer(BGU, 179 patients) and duodenal ulcer(BDU, 166 patients). The median age was 57 year-old in the BGU patients and 37 year-old in the BDU patients. The sclerotherapy was performed to the 109 patients(58 BGU and 51 BDU patients), 96 patients(96/109, 89%) show permanent hemostasis. The hemostasis rate was 77% with active bleeding in the BGU patients, 75% with active bleeding in the BDU patients. There was no significant difference between sclerotherapy and observation group with visible vessel and red spot on the ulcer base of the bleeding peptic ulcer patients. Conclusively, the endoscopic sclerotherapy was very useful and effective treatment method for the bleeding peptic ulcer, but we suggested that all the bleeding peptic ulcer patients should not have done the sclerotherapy.
신원창,강성귀,김동기 대한구강보건학회 2001 大韓口腔保健學會誌 Vol.25 No.2
The purpose of this study is to prove the effectiveness of professional maintenance care to the periodontal disease by non-surgical approach with the toothpick method to improve the periodontal health. The patients of this study were composed of 46 patients(18 men and 28 women and mean age-50.6 yrs), suffering from chronic adult periodontitis, who had visited the department of preventive dentistry(Chosun, Univ, dental hospital, Kwang-ju city). All of the subjects were over 40 years old and be treated just by non-surgical method, Professional maintenance care using the toothpick method was performed every 3 months, and evaluations were also done after 1, 2, and 3 year- professional maintenance care based on the indices such as plaque index(O' Leary index), periodontal probing pocket depth, bleeding on probing, tooth mobility, the number of tooth loss, and the rate of tooth loss representing the state of periodontal health. Results are as follows ; 1. The longer the maintenance care, the more the effectiveness of controlling plaque, The rate of decrease in the dental plaque index was 1.5%, 4.2%, and 6.5% in 1, 2, and 3 year maintenance groups respectively(P>0.05). 2. The periodontal pocket depth decreased depends on the severity of periodontal pocket depth in all groups the maintenance years (P<0.05). 3. On the evaluation of the bleeding tendency on probing, there was a significant difference in 1 year-maintenance group(P<0.05), but the other groups did not show any difference statistically(P>0.05). 4. Tooth mobility has decreased in the maintenance years, but did not show any difference statistically(P>0.05). 5. The number and the rate of tooth loss among the patients of 1 year-maintenance group was 0.38, 1.44% respectively and that of 3 year-maintenance group was 0.44, 1.73% each. In conclusion, the results of this study mentioned above suggest that professional maintenance care should be operated effectively to prevent and to maintain the periodontal disease systematically on the purpose of improving the quality of life, and that it could be applied to the medical insurance system in order to try to make the most of the adult oral health care positively.