포스터 전시 : 소화기 ; 이중 풍선 소장내시경으로 진단된 멕켈 게실 1예

위준환,김진오,정인섭,고봉민,홍수진,조주영,이준성,이문성,심찬섭,김부성,진소영 대한내과학회 2005 대한내과학회 추계학술대회 Vol.69 No.10

캡슐내시경 검사의 전처치로 Sodium Phosphate의 경구 투여 효과

위준환,김진오,정인섭,이지현,김현정,고봉민,조주영,이준성,이문성,심찬섭,김부성 대한소화기내시경학회 2006 Clinical Endoscopy Vol.32 No.3

목적: 소장질환의 진단에 매우 유용한 검사로 인정받고 있는 캡슐내시경 검사는 전처치에 대한 표준화된 기준이 없는 실정으로 현재 각 병원에서 각기 다른 전처치를 하고 있다. 이에 저자들은 캡슐내시경 검사의 전처치에 따른 영상 판독의 적절성에 대해 평가하고자 하였다. 대상 및 방법: 2003년 3월부터 2004년 9월까지 본원에서 캡슐내시경 검사를 시행한 환자 중 전처치로 sennosides를 사용한 군 88명과 sodium phosphate를 사용한 군 41명을 대상으로 영상의 적절성을 후향적으로 비교하였다. Sennosides군은 전날 저녁 10시에 sennosides 8 g과 물 1 L, 검사 당일 아침 5시에 sennosides 8 g과 물 1 L를 마시게 하였으며 sodium phosphate군은 전날 저녁 8시에 sodium phosphate 45 mL와 물 45 mL를 함께 투여 후 물 2 L를 마시게 하였으며 당일 아침 5시에 sodium phosphate 45 mL와 물 45 mL 투여 후 물 1 L를 마시게 하였다. 이들의 판독은 RAPID 워크스테이션 영상 시스템을 통해 음식물, 기포, 점액, 그리고 담즙 등 판독장애 요인이 소장 점막 25% 미만을 차지하는 경우를 청결한 영상으로, 25% 이상인 경우를 판독에 부적절한 영상으로 정의하였다. 전체 소장 통과 시간에 대한 부적절한 영상의 시간 비를 객관적 수치로 평가하였으며 객관적 수치가 10% 미만인 경우를 적절한 전처치로 평가하였다. 결과: 적절한 전처치를 보이는 경우가 sennosides군에서 35예(35/88, 40%), sodium phosphate군에서 26예(26/41, 63%)였으며 sodium phosphate군에서 통계학적으로 유의한 좋은 영상을 보였다(p<0.05). 결론: 캡슐내시경 검사의 전처치로 sodium phosphate의 전처치가 sennosides를 전처치로 사용한 경우보다 더 좋은 영상을 얻을 수 있었다. Background/Aims: Capsule endoscopy is an effective diagnostic tool for detecting small bowel disease. However, the method of bowel preparation for capsule endoscopy has not been standardized. The aim of this study was to evaluate the efficacy of oral sodium phosphate as a preparation for capsule endoscopy. Methods: A total of 129 cases who underwent capsule endoscopy from Mar. 2003 to Sep. 2004 were analyzed retrospectively. Eighty- eight cases were prepared with sennosides (Alaxyl ) and 41 cases were prepared with sodium phosphate. The intestinal mucosa was defined as being unclean if the intestinal content, food materials, and bubbles covered more than 25% of the mucosal surface. Using a stopwatch, the exact time of the unclean image was recorded. The percentage of the unclean image for the small intestinal transit time (SITT) was calculated as an objective score. Small bowel cleansing was considered 'adequate' if the objective score was <10% and 'inadequate' if the objective score was 10% or greater. Results: 35 cases (40%) showed an adequate image in the sennosides and simethicone group and 26 cases (63%) showed an adequate image in the sodium phosphate and simethicone group. The adequacy rate was significantly higher in the sodium phosphate group than in the sennosides group (p<0.05). Conclusions: Capsule endoscopy prepared by sodium phosphate and simethicone produced a better visual image than sennosides and simethicone. (Korean J Gastrointest Endosc 2006;32:173-178)

포스터 전시 : 소화기 ; 이중 풍선 소장내시경으로 진단된 멕켈 게실 1예

위준환,김진오,정인섭,고봉민,홍수진,조주영,이준성,이문성,심찬섭,김부성,진소영 대한내과학회 2005 대한내과학회 추계학술발표논문집 Vol.2005 No.1

소장 질환에 있어 이중 풍선 소장 내시경 검사의 유용성

위준환 ( Jun Hwan Wi ),김진오 ( Jin Oh Kim ),정인섭 ( In Seop Jung ),고봉민 ( Bong Min Ko ),조주영 ( Joo Young Cho ),이준성 ( Joon Seong Lee ),이문성 ( Moon Sung Lee ),심찬섭 ( Chan Sup Shim ),김부성 ( Boo Sung Kim ) 대한장연구학회 2005 Intestinal Research Vol.3 No.2

Background/Aims: Conventional studies for small bowel such as small bowel series, enteroscopy with Push, Sonde and Ropeway method had some limitations such as high missing rate, incomplete study, long procedure time and patient inconvenience. Double balloon enteroscopy is a promising method to overcome these limitations. Our aim was to evaluate the usefulness of double balloon enteroscopy. Methods: Between Nov. 2004 and Feb. 2005, 24 patients with suspected small bowel disease underwent double balloon enteroscopy. Results: Indications for double balloon enteroscopy were obscure gastrointestinal bleeding, chronic abdominal pain and Crohn`s disease etc. Thirty eight cases of double balloon enteroscopy in 24 patients were performed. We could identify positive diagnostic findings in 20 of the 24 patients. In 16 obscure gastrointestinal bleeding patients, the causes of bleeding were 7 small bowel ulcers, 4 angiodysplasias, 3 Crohn`s diseases etc. Procedure-related complications were not observed in any patients. Conclusions: Double balloon enteroscopy is a useful and safe diagnostic tools in small bowel disease with high diagnostic accuracy (83%). (Intestinal Research 2005;3:140-144)

노인 심방세동 환자의 원인기저 질환 분석

조대경,위준환,염주협,고재민,이태호,정성오,김태훈,정봉기,남홍우,이홍순,유수웅,문언수 대한노인병학회 2000 Annals of geriatric medicine and research Vol.4 No.3

포스타 전시 발표 : 소화기 ; 위장관 악성종양에서 발생한 호산구성 간농양 3예

박정훈,위준환,김영석,김연수,심찬섭,김부성 대한내과학회 2004 대한내과학회 추계학술발표논문집 Vol.2004 No.1

불명료한 위장관 출혈에서 이중풍선 소장내시경의 유용성

정현구,김진오,위준환,정인섭,고봉민,조주영,이준성,이문성,심찬섭,김부성 대한내과학회 2005 대한내과학회 추계학술발표논문집 Vol.2005 No.1

원인 불명의 위장관 출혈에서 이중 풍선 소장내시경의 유용성

정현구 ( Hyun Ku Jung ),위준환 ( Jun Hwan Wi ),김진오 ( Jin Oh Kim ),정인섭 ( In Seop Jung ),고봉민 ( Bong Min Ko ),조주영 ( Joo Young Cho ),이준성 ( Joon Seong Lee ),이문성 ( Moon Sung Lee ),심찬섭 ( Chan Sup Shim ),김부성 ( Boo 대한내과학회 2007 대한내과학회지 Vol.73 No.3

Background: Double balloon enteroscopy was developed to improve access to the small intestine. The aim of this study was to evaluate the efficacy of double balloon enteroscopy in patients with obscure gastrointestinal bleeding. Methods: From November 2004 through August 2005, 24 consecutuve patients (14 males, 10 females; mean age 48±15.1 years, range 2181 years) with gastrointestinal bleeding of an obscure origin were enrolled in this study. The patients underwent enteroscopy using the double balloon technique for the following indications: (1) clinical evidence of gastrointestinal bleeding such as melena and hematochezia (the Hb levels ranged from 5.9 g/dL to 11.9 g/dL, mean 9.0±2.3 g/dL) (2) no site and cause of blood loss detected by upper endoscopy and colonoscopy. Results: Of 24 patients that underwent a double balloon enteroscopy, bleeding points were identified in 22 patients. The causes of bleeding were nine small bowel ulcera, six angiodysplasiaa, three cases of Crohn`s disease, two gastrointestinal stromal tumors, one Meckel`s diverticulum and one cecal diverticular ulcer. However, two cases showed negative findings. No patient suffered from procedure related complication. Conclusions: Double balloon enteroscopy is a safe and useful diagnostic tool for obscure gastrointestinal bleeding. (Korean J Med 73:267-273, 2007)

당뇨병 교육 방법이 당뇨병 환자의 식사요법 수행과 당화혈색소에 미치는 영향

김을상,문현경,이영남,이태훈,김성곤,고재민,손진희,유형준,송오금,남흥우,정성오,위준환,염주협,조대경 대한당뇨병학회 2000 Diabetes and Metabolism Journal Vol.24 No.5

Background: Diet control plays an important role in diabetic management, but it is often hard for diabetic patients to follow the dietary control program. Poor dietary compliance leads to metabolic derangements in patients with diabetes and it may derive mainly from defects in dietary education program rather than from patients themselves. Therefore, we performed a randomized prospective study to compare the effects of three different teaching methods for diet control. Methods: Forty eight diabetic patients with poor glycemic control (mean HbA1c 11.4±1.5%) were enrolled during hospitalization and allocated at random to three different teaching methods i.e. Conventional diet sheet instruction (Group 1), Food recording on every meal (Group 2), and Meal time demonstration (Group 3). For evaluation, knowledge about DM diet and barriers to diet control were assessed by a questionnaire. Consistency in carbohydrate intake (Coefficient of variation) and serial HbA1C measurements were used for the estimation of dietary compliance and glycemic control respectively. Results: During five months' follow-up period, there was no remarkable improvement in knowledge about diabetic diet control, dietary compliance and glycemic control in Group 1 patients. But both dietary compliance and glycemic control improved in Group 2 and 3 patients during follow-up period. In Group 2 CV (Coefficient of Variation) fell from 36.4±15.2% to 27.7±17.3% and in Group 3 from 32.1±9.6% to 23.2±10.5% (p$lt;0.05). In Group 2 HbA_(1c) fell from 12±2.2% to 8.3±2.0% and in Group 3 from 11.5±2.0% to 7.5±1.9%(p$lt;0.01). The change of HbA1c level showed an appreciable correlation with dietary compliance (r= 0.75). Among the perceived barriers to dietary practice in patients of Group 2 and Group 3, extrinsic factors related to knowledge lowered during the intervention (p$lt;0.05). Even though Group 3 patients had good dietary compliance, they still felt that intrinsic factors related to motive and attitude were the major barriers at the end of the study (p$lt;0.05). Conclusion: We found that meal time demonstration teaching method may improve dietary compliance and glycemic control compared with the conventional diet sheet instruction method.