위내시경 검사 전 맑은 유동식 섭취 시간 표준화를 위한 근거기반간호 사례

윤인자(Yoon, In Ja),조성희(Cho, Sung Hee),전주희(Jeon, Ju Hee),김혜영(Kim, Hye Young),윤보영(Yun, Bo Young),이상정(Lee, Sang Jung) 한국근거기반간호학회 2020 근거와 간호 Vol.8 No.1

연구논문 : 식생활라이프스타일에 따른 즉석밥 선택속성이 행동의도에 미치는 영향

윤인자 ( Inja Youn ),명소형 ( Sohyeong Myeong ),윤덕인 ( Deokihn Yoon ) 한국식생활문화학회 2015 韓國食生活文化學會誌 Vol.30 No.6

A Study of Instant rice selected attributes of instant rice, the decrease in rice consumption is in fact been hailed as a stock and based on dietary lifestyle through prior research, attempting to validate whether the behavior between the related implications. The instant rice revitalization plan of conducting were developed further, consumers want instant rice and at the same time. Confirmed based on the selected attributes of instant rice according to consumer dietary lifestyle through this research to know could have instant rice selection attributes affect the degree of the action. Compare the differences of regional instant rice selected attributes gradually increasing area for future research, instant rice consumers surveyed Seoul, Gyeonggi-do area only residing in the limitations of this study, which, because you are studying in different regions.

변비 클리닉에 내원한 환자의 민간 변비 관련제제 및 자가 치료 실태

천지현 ( Ji Hyun Cheon ),윤인자 ( In Ja Yoon ),명승재 ( Seung Jae Myung ),변정식 ( Jeong Sik Byeon ),고정은 ( Jung Eun Ko ),정기욱 ( Kee Wook Jung ),김병규 ( Ben Jamin Kim ),권승현 ( Seung Hyun Kwon ),도미영 ( Mi Young Do ),김도훈 대한소화기기능성질환·운동학회 2007 Journal of Neurogastroenterology and Motility (JNM Vol.13 No.1

목적 : 변비는 흔히 경험하게 되는 건강 문제이다. 많은 변비 환자들이 의사가 처방한 약제 이외에 다양한 치료제를 복용하고 있는 것으로 알려져 있다. 이번 연구에선 치료제의 종류와, 치료제에 대해 환자가 느끼는 주관적 효과, 부작용, 사용 동기에 대해 알아보고, 실제적으로 효과가 증명된 것인지 알아보고자 한다. 대상 및 방법 : 변비를 주 증상으로 3차 병원 변비 클리닉에 내원한 환자들 중 연구에 동의한 81명을 대상으로 연구자가 고안한 설문지를 이용하여 면접 조사를 시행하였다. 결과 : 조사된 민간요법은 총 30종으로 유산균을 가장 많이 사용하였다. 약국 구입약의 경우 자극성 완하제의 비율이 높았고(89.2%), 한방제제의 사용(18.5%)은 민간요법(81.5%)이나 약국 구입약(91.4%)의 이용에 비해 적었다. 약제에 대해 환자가 느끼는 주관적 효과는 요법에 따라 다양하였으며, 사용하게 된 동기는 주변으로부터의 권유가 많았다. 약국 구입약 복용 군과 한방제제 군에서 주당 3회 미만의 배변을 하는 사람이 유의하게 많았다(p<0.05). 결론 : 환자들은 변비 치료를 위해 의사가 처방한 약제 이외에도 다양한 종류의 약제들을 이용하고 있었다. 특히 한국인의 경우 변비 치료를 위해 우유를 사용하고 있는 점이 특이했다. 앞으로 여러 민간요법과 약제이용에 대한 관리와 함께 과학적인 접근이 이루어져야 할 것으로 생각된다. Background/Aims: Many people with constipation have a tendency to take various self-medications regardless of their prescription by their doctors. However, the relationship between these self-remedies and constipation hasn`t been well investigated in Korea. The aim of this study was to identify what kinds of self-remedies were used and also to determine the effectiveness of these remedies. Methods: 81 patients who visited the Constipation Clinic were enrolled, and they answered a questionnaire at an interview. Results: Thirty folk remedies were identified. Among these, products containing lactobacilli were the most commonly used remedy. The most commonly used drugs at pharmacy were stimulant laxatives, whereas Korean traditional medicine was less commonly used. Although the overall effectiveness of the remedies was found to be almost nil, the subjects used those drugs recommended by close acquaintances. The people with severe constipation (=3/week) had a tendency to overuse self-remedies, with statistical significance (p<0.05). Conclusions: Patients had a tendency to take various medications not prescribed by physicians. However, they didn`t know much about the side effects of these drugs. Supervision of folk remedies might be needed to improve therapeutic efficacy and prevent side effects. (Kor J Neurogastroenterol Motil 2007;13:45-52)

직장감각저하 환자에서 바이오피드백 치료에 대한장기간 효과 및 인자 분석

정기욱 ( Kee Wook Jung ),명승재 ( Seung Jae Myung ),변정식 ( Jeong Sik Byeon ),윤인자 ( In Ja Yoon ),고정은 ( Jung Eun Ko ),서소영 ( So Young Seo ),윤순만 ( Soon Man Yoon ),도미영 ( Mi Young Do ),김도훈 ( Do Hoon Kim ),김병규 ( Be 대한장연구학회 2008 Intestinal Research Vol.6 No.1

Background/Aims: Rectal hyposensitivity (RH) has been treated with conventional biofeedback therapy (BFT), whereas the effectiveness and long term results of this therapy are not known. We aimed to investigate the effectiveness of BFT for patients with RH by conducting a retrospective review of prospectively collected data. Methods: From June 2004 to March 2007, we enrolled those RH patients who underwent BFT. BFT was performed two or three times every week. Six months after BFT, the clinical response was evaluated by subjective and objective parameters. Results: A total of 82 RH patients underwent BFT. Fifty three patients finished BFT and the other 29 patients dropped out during BFT. Thirty six patients (67.9%) showed responsiveness (R) to BFT and 17 (31.5%) showed non-responsiveness (NR). The characteristics between the two groups showed no difference, except for the “desire to defecate” volume (116.1±25.2 in the R group vs. 140.0±43.9 in the NR group, p value <0.05) and the rectoanal inhibitory reflex (RAIR) (15.6±0.5 in the R group R vs. 27.6±18.2 in the NR group, p value <0.05). The R group showed a shorter colon transit time compared to NR group. At six months after BFT, a total of 20 patients were interviewed; 15 patients answered that they still had responsiveness (75%). Conclusions: The patients with RH showed a similar BFT response to that of the constipated patients. However, the patients with a more hyposensitive rectum and a longer colonic transit showed NR to BFT, suggesting RH is an important factor in BFT responsiveness. (Intest Res 2008;6:56-69)

28 서행성 변비환자에서 천수 감각부위에 대한 비침습적 전기자극치료의 효과

송혜경 ( Hye Kyoung Song ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),윤인자 ( In Ja Yoon ),권오련 ( Oh Ryoun Kwon ),고정은 ( Jung Eun Ko ),김태훈 ( Tae Hoon Kim ),장혜숙 ( Hye Sook Chang ),이진혁 ( Jin Hyuk Lee ),정훈용 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

단독 전기자극치료로 임상적 호전을 보인 직장 감각능 저하를 동반한 변비 환자 1 예

장혜숙(Hye Sook Chang),명승재(Seung Jae Myung),윤인자(In Ja Yoon),양석균(Suk Kyun Yang),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),민영일(Young Il MIn),유창식(Chang Sik Yu) 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2

Patients with intractable constipation often complain of social, physical and psychological stress. Recently, biofeedback therapy is widely used in the management of intractable constipation and improve the defecation act, particularly in cases of constipation associated with pelvic floor dyssynergia. However, some of constipated patients show only decreased rectal sensation and increased rectal compliance on the anorectal function tests. It is unclear whether the decreased rectal sensation is a cause or outcome of constipation and not known how to treat such cases. We recently experienced a 25-year-old female patient who complained of constipation. She had intractable constipation, which made her attempt a suicide. Colon transit time study and defecogram showed nonspecific findings. Her anorectal manometric findings were within normal ranges except rectal sensation and compliance. Rectal volume for desire and urge to defecate, and maximal tolerable volume were markedly increased and compliance was impossible to measure. She was treated by electrical stimulation therapy. After electrical stimulation therapy, her constipation symptoms improved dramatically. Furthermore, the desire and urge volume were decreased and the compliance became calculated. We report this constipation case with decreased rectal sensation and increased rectal compliance possibly treated by electrical stimulation therapy. (Korean Journal of Gastrointestinal Motility 2001;7:245-250)

갑상선기능저하증에 동반된 변비의 임상적 특징

김재일 ( Jaeil Kim ),명승재 ( Seung Jae Myung ),양동훈 ( Dong Hoon Yang ),윤인자 ( In Ja Yoon ),서소영 ( So Young Seo ),구현숙 ( Heun Sook Ku ),윤순만 ( Soon Man Yoon ),김경조 ( Kyung Jo Kim ),예병덕 ( Byong Duk Ye ),변정식 ( Jung 대한장연구학회 2010 Intestinal Research Vol.8 No.1

Background/Aims: Constipation is a well-recognized gastrointestinal symptom in patients with untreated hypothyroidism. Although thyroid function tests are recommended to exclude hypothyroidism in patients with constipation, there have been no reports to determine the causal relationship between thyroid function and constipation. The aim of this study was to determine the prevalence of hypothyroidism in constipated patients and the clinical features of constipation associated with hypothyroidism. Methods: A total of 1,481 constipated patients were included. These patients were divided into overt hypothyroidism, subclinical hypothyroidism, and normal thyroid function groups based on thyroid function tests. We reviewed the clinical presentation, anorectal function, colonic transit time, defecographic findings, and response to biofeedback therapy. Results: The prevalence of overt and subclinical hypothyroidism was 0.41% (men, 0.36%; women, 0.53%) and 1.76% (men, 1.28%; women 2.03%), respectively. There were no differences in total or segmental colonic transit times and subtypes of constipation among the normal thyroid function (n=54), overt hypothyroidism (n=4), and subclinical hypothyroidism groups (n=21). On anorectal manometry, the prevalence of dyssynergic defecation did not differ between the three groups. Rectal hyposensitivity was more frequent in the overt hypothyroidism group (overt hypothyroidism group, 50.0%; subclinical hypothyroidism group, 19.0%; normal thyroid function group, 20.4%) without statistical significance (P=0.372). Conclusions: The prevalence of overt and subclinical hypothyroidism in constipated patients was very low. The colonic transit time is not affected by thyroid function. (Intest Res 2010;8:48-57)

기능성 위장관질환에 있어서 식이 및 영양요법: 변비

이정미 ( Jeong Mi Lee ),김도연 ( Do Yeon Kim ),윤인자 ( In Ja Yoon ),정기욱 ( Kee Wook Jung ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2

Constipation is a common functional gastrointestinal symptom, the medical treatment of which is established. However, knowledge of diet and nutritional management for constipation is lacking. Based on current studies, fiber is effective in managing chronic constipation, but care should be taken in constipated patients with gaseous bloating. Increased fluid intake is controversial but may be beneficial, especially in conjunction with a stool-bulking agent. Other diet treatments lack high-quality evidence. A well-designed study to validate the effectiveness of diet, especially Korean diet, in the treatment of chronic constipation is needed. (Korean J Med 2016;90:111-114)

위식도 역류가 의심되는 소아에서 Multichannel Intraluminal Impedance-pH Metry의 유용성

이신혜 ( Shin Hye Lee ),장주영 ( Joo Young Jang ),윤인자 ( In Ja Yoon ),김경모 ( Kyung Mo Kim ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.1

Background/Aims: pH monitoring of the esophagus has been considered as the gold standard for the measurement of acid reflux. However, it has several limitations related to its inability to detect nonacid reflux. We conducted this study to characterize the proportion of acid and non-acid reflux events in children using pH-multichannel intraluminal impedance (MII) monitoring and to determine the correlation of the symptom index with non-acid and acid reflux events. Methods: Seventy-five children, aged from 9 days to 12 years, underwent 24 hour pH-MII monitoring at Asan Medical Center from March 2006 to June 2007. We investigated the underlying disease and main problems related to gastroesophageal reflux (GER) of the patients, the number of acid and nonacid reflux, symptom index, symptom sensitivity index in pH monitoring only and pH-MII monitoring. Results: While 2,247 reflux events were detected by MII, and only 967 reflux events were detected by pH probe alone. The percentage of acid reflux was 43% (967) and that of non-acid was 57% (1,280). The non-acid reflux increased at postprandial time (p<0.001). The symptom index increased when measured by pH-MII (31.1%) compared with those by pH probe alone (8.2%) (p=0.003). Conclusions: This study suggests that significant number of GER include non-acid reflux which cannot be detected by pH probe alone, therefore combining pH with MII monitoring is a valuable diagnostic tool for diagnosing GER in children. (Korean J Gastroenterol 2008;52:9-15)

소화기 ; 3차 병원에 내원한 한국인 변비 환자의 특성

김동회 ( Dong Hoi Kim ),명승재 ( Seung Jae Myung ),양동훈 ( Dong Hoon Yang ),윤인자 ( In Ja Yoon ),서소영 ( So Young Seo ),구현숙 ( Heun Sook Ku ),윤순만 ( Soon Man Yoon ),김경조 ( Kyung Jo Kim ),예병덕 ( Byong Duk Ye ),변정식 ( J 대한내과학회 2013 대한내과학회지 Vol.84 No.1

목적: 변비는 흔히 호소하는 위장관 증상 중의 하나로 2.6-9.2%의 유병률이 보고되었다. 그러나 유병률은 서구에 비해 비슷하지만 한국인 변비 환자에 대한 역학적 연구는 매우 미비한 실정이며, 또한 인종과 식이습관 등의 차이, 문화적인 요소를 고려할 때 서구 환자들과 대비되는 한국인 환자들의 특성이 있을 것으로 생각된다. 따라서 이 연구에서는 3차 병원을 내원한 한국인 변비 환자들에서 역학적인 요소, 생활 습관, 기저 질환 등의 특성들을 확인하고 생리적 검사를 시행하였다. 방법: 2000년 4월부터 2005년 1월까지 서울아산병원 변비클리닉에 변비를 주소로 내원한 338명의 환자를 대상으로 하였다. 연구자에 의해 고안된 설문지로 설문을 작성하도록 하고 설문지를 바탕으로 환자의 사회 인구학적 요소들과 변비와 연관된 배변 양상, 생활 습관, 변비의 증상, 기저 질환과 그에 대해 사용 중인 약물, 변비에 대하여 사용하는 약제 및 민간 요법 등에 대해 조사하였다. 또한 배변 조영술, 대장 통과 시간 검사, 항문 직장 내압 검사를 통해 변비를 분류하여 그 양상을 확인하였다. 결과: 총 338명의 환자 중 여자가 222명(65.7%), 남자가 116명(34.3%)이었고 평균 연령은 53.8±16.3세로, 대체적으로 연령이 증가할수록 환자의 수가 증가하는 양상이고 전체 환자의 42.6%가 60세 이상이었다. 변비의 유병률이 10년 이상인 환자가 42.9%였고 변비와 연관된 증상으로 복부 팽만감 (79.7%)이 가장 많았다. 64.3%의 환자들이 다양한 민간 요법을 사용한 적이 있었고 그 중에서도 동규자차, 다시마, 알로에를 많이 사용하였다. 자의적 변비 환자 중 89.1%가 로마 진단 기준 III에 따라 기능성 변비로 진단되었으나 나머지 환자들의 84%도 생리학적 검사에서 이상소견을 보였다. 생리학적 검사 결과를 통합하였을 때, 정상 통과 시간형 변비, 서행성 변비, 골반저 조율 장애, 혼합형 변비는 각각 21%, 27%, 29%의 분포를 보였다. 직장 감각 저하가 16.9%의 환자들에서 있었고 약 25%의 환자들이 배변 조영술에서 직장류, 직장 항문 중첩증 등의 해부학적 이상소견을 나타내었다. 결론: 우리나라 변비 환자들은 민간 요법을 많이 사용하면서 정확한 진단과 치료를 지연시키는 경향이 있다. 3차 병원을 내원한 환자들의 생리학적 검사 결과를 보면 이상소견이나 해부학적인 문제의 비율이 높은 편이므로 초기에 적극적인 검사를 시행하는 것이 변비의 진단과 치료에 도움이 될 것이다. Background/Aims: Korean patients with constipation have differences, both among themselves and as compared to other populations, with regard to race, diet, and cultural factors and are expected to have different characteristics to those of western patients, but few studies have been conducted in this regard. We evaluated the epidemiological and physiological characteristics of patients with constipation who visited a tertiary referral center. Methods: A total of 338 patients with constipation were included. They completed a questionnaire and took physiological tests such as defecography, colon transit time, and anorectal manometry. We classified the types of constipation according to the physiological tests and analyzed the results. Results: The mean age of the study patients was 53.8 ± 16.3 years and 42.3% of the patients were ≥ 60 years old. Patients who had tried folk remedies reached 64.3%. Among the self-reported patients with constipation, 89.1% satisfied the Rome III criteria for constipation. However, 84% of the patients who did not satisfy the criteria showed abnormal results on the physiological tests. Patients with normal transit constipation, slow transit constipation, and dyssynergic defecation were 21%, 27%, and 29% of the all patients, respectively. Rectal hyposensitivity was found in 16.9% of patients and 25% of them revealed anatomic abnormalities on defecography. Conclusions: Korean patients with constipation have a tendency to delay an accurate diagnosis and treatment and to use folk remedies. As physiological tests for patients with constipation who visited a tertiary hospital showed a relatively high rate of abnormal results, such as dyssynergic defecation and anatomic problems, active physiological evaluations should be considered for such patients. (Korean J Med 2013;84:49-61)