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의식하 진정 내시경(수면 내시경)에 대한 인터넷 의료 정보의 평가
이현정,오영재,홍일철,이준행,이풍렬,김재준,이종철 대한소화기내시경학회 2006 Clinical Endoscopy Vol.32 No.5
Background/Aims: The internet has become an important source of medical information not only for doctors but also for patients. Therefore, this study evaluated the quality of medical information on endoscopy under conscious sedation on the internet in Korea. Methods: 147 patients (mean age: 51 years, male:female 76:71) who visited the gastroenterology clinic were surveyed using a questionnaire about use of medical information on the Internet. The first 20 Internet sites using the key word 'endoscopy under sedation' were retrieved from the 5 most frequently used Internet search engines. The quality of information from a total of 63 websites was evaluated using a checklist. Results: Among a total 63 sites about endoscopy under sedation, 46 sites (73.0%) were made by private hospitals or private clinics and 60 sites (95%) were made for patients. The definition of endoscopy under conscious sedation was accurately mentioned in only 7 sites (11%). The complications and risk factors were mentioned in 29 sites (46%). Conclusions: Most websites made by private hospitals or private clinics overemphasized the merits of sedation. Websites with a more balanced point of view by official organizations may help improve the quality of medical information on the Internet. (Korean J Gastrointest Endosc 2006;32:307-312) 목적: 인터넷 이용이 보편화되고 편리해지면서 인터넷을 통한 의료 정보 검색이 증가하고 있다. 본 연구에서는 인터넷상의 의료관련 사이트들이 의식하 진정 내시경(수면 내시경)에 대하여 적합하고 정확한 의료 정보를 제공하고 있는지를 평가하고자 하였다. 대상 및 방법: 위장관 질환으로 소화기내과 외래를 방문한 환자들을 대상으로 의료정보 이용에 대한 설문 조사를 실시하였고, 검색 엔진 5개를 이용하여 의식하 진정 내시경(수면 내시경)을 핵심 단어로 각각 상위 20개 사이트(총 63개)를 선택하여 웹사이트의 특성과 질을 기준에 따라 평가하였다. 결과: 설문에 답한 147명의 평균 연령은 51세였고 남자 76명, 여자 71명이었다. 의료정보를 알기 위해 가장 많이 이용하는 정보원으로 75명(51%)이 텔레비전을, 가장 유용한 정보원으로는 41명(33.9%)이 의사를 선택했다. 수면 내시경을 핵심 단어로 검색된 총 63개의 웹사이트를 평가하였을 때 46개(73.0%) 사이트가 병의원 소속이었고 60개(95%) 사이트가 환자와 일반인을 대상으로 하고 있었다. 수면 내시경의 정의에 대해 바르게 설명하고 있는 사이트는 7개(11.1%), 위험 인자에 대해 설명하고 있는 사이트는 29개(46.0%)였다. 순환기 부작용과 호흡기 부작용에 대해 언급한 사이트는 각각 8개(12.7%), 10개(15.9%)였으며 사망 가능성에 대해 언급한 사이트는 4개(6.3%) 뿐이었다. 결론: 수면 내시경 사이트들은 대부분 환자나 일반인을 대상으로 만들고 있으며, 의료기관의 홍보 목적을 겸하고 있어 균형된 정보의 제공이라는 점에서 문제점을 노출시키고 있었다. 향후 인터넷 상의 다양한 의료 정보에 대한 체계적인 평가가 시행될 필요가 있으며, 비영리 기관에서 균형 잡힌 시각으로 의료 정보를 쉽고 자세하게 정확히 설명한 전문 사이트를 개발하고 널리 알려야 할 필요가 있다고 생각한다.
최원혁,박유정,홍일철,이한철,박세훈,최성철,이효락,정인경,정재훈,민용기,이명식,이문규,김광원,김원석 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.2
MEN1 is characterized by the combined occurrence of tumors of the parathyroids, pancreatic islet cells and the anterior pituitary. Pancreatic islet cell tumors occur in 40% of MEN1 patients. Pancreatic polypeptidomas occur most commonly but they are asymptomatic. Gastrinomas are the second most common type. VIPomas are rare and there has been no report of a case in Korea so far. We encountered a case of pancreatic VIPoma in MEN Type I. A 49 year old man was referred from his local hospital presenting with a sudden onset of an explosive watery diarrhea of 3 months duration. Abnormal findings in his blood chemistry were hypercalcemia and hypokalemia. The ^99mTc-sestamibi sintigraphy showed an increased uptake in right lower parathyroid gland. Abdominal CT demonstrated a mass of 6×4 ㎝ in tail of the pancreas and multiple lesions in both hepatic lobes. Serum levels of VIP hormones were elevated. Subtotal parathyroidectomy and subtotal pancreatectomy were done. Postoperatively his symptoms were improved transiently, however the patient showed repetitive attacks of watery diarrhea. So in order to palliate his symptoms, an RF ablation of the metastatic liver masses was performed. After that therapy his clinical symptoms were reduced dramatically. Unfortunately, the patients condition worsened again. Despite of continuous octreotide therapy, interferon and two courses of combination chemotherapy, the hepatic metastases failed to regress and the patient died 10 months after the diagnosis of a metastatic VIPoma. This is the first report of pancreatic VIPoma in MEN type I in Korea
Glutaraldehyde 와 자동 세척기를 이용한 내시경 소독방법의 임상에서의 유용성
김영호,손희정,윤성원,최규완,이남용,백승운,이준행,고광철,이풍렬,이종철,송재훈,안병훈,김재준,최원혁,홍일철 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6
Background/Aims: Safety of endoscopic procedures has been a major issue over the last 10 years. Most endoscopy units use 2% glutaraldehyde and automated endoscope reprocessors (AERs) for disinfecting gastrointestinal endoscopes. We attempted an in-use evaluation of the current reprocessing procedures. Methods: Thirty flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using 2% glutaraldehyde in an AER. Cultures were taken from biopsy channels (S-l), tip of the insertion tubes (S-2), umbilical cords (S-3), and angulation knobs (S-4). Results: In 63,3% (19/30) of endoscopes, there was no microbial contamination after disinfection procedures. The culture positive rates of S-l, S-2, S-3, and S-4 samples were 20,0%, 0.0%, 3.3%, and 20.0%, respectively. Microorganisms of 13 species were identified, but there was no pathogen related with reported infectious complications after endoscopic procedures. Conclusions: Current disinfection procedure using 2% glutaraldehyde and an AER appears to be very effective in decontaminating patient-used endoscopes. Low level microbial contamination of endoscopes after conventional reprocessing methods may not impose great risk on patients.
간세포암의 고주파 열치료 후 재발 양상과 이와 관련된 인자
안병훈(Byeong Hoon Ahn),최문석(Moon Seok Choi),이준행(Jun Haeng Lee),임윤정(Yun Jeong Lim),홍일철(Il Chol Hong),최원혁(Won Hyeok Choe),이준혁(Joon Hyoek Lee),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이풍렬(Poong Lyul Rhee) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.5
Background/Aims: There were few reports about the recurrence and related factors after radiofrequency ablation (RFA) in unresectable hepatocellular carcinoma (HCC). We assessed the recurrence rate and its related factors after RFA in patients with HCC. Methods: Thirty-nine patients (32 males and 7 females) with unresectable HCC were treated with percutaneous ultrasono-guided RFA. They had solitary tumor ≤4 cm or multiple tumor (≤3 in number and ≤3 cm in diameter) without history of transarterial chemoembolization or percutaneous ethanol injection therapy within 6 months. Results: The complete necrosis rate was 91.4% with few significant complications. Local and remote recurrence of HCC were observed in 30.7% and 66% of the patients during follow-up period of median 17 months. One-year local recurrence rate was lower in tumor smaller than 2.5 cm than in tumor bigger than 2.5 cm (5.6% vs. 28.5%, p=0.01). It was also lower in single tumor than in multiple tumor (12% vs. 60%, p=0.04). One-year remote recurrence rate was lower in Child A than in Child B (43.4% vs. 66.7%, p=0.04). Conclusions: RFA results in a high rate of complete necrosis with few significant complications in unresectable HCC. The local recurrence was fewer in small, single tumor and the remote recurrence was fewer in patients with Child A. (Korean J Gastroenterol 2001;38:350-356)
김주성(Joo Sung Kim),최문석(Moon Seok Choi),이준혁(Joon Hyoek Lee),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),박유정(Yu Jeong Park),최원혁(Won Hyeok Choe),홍일철(Il Chul Hong),이춘영(Choon Young Lee),이종철(Jong Chul Rhee),최규 대한소화기학회 2002 대한소화기학회지 Vol.39 No.1
Neurilemmomas are neurogenic tumors that arise from schwann cells of nerve roots. They commonly occur in the head and neck, extremity, mediastinum, and retroperitoneum area, but rarely, they occur in the gastrointestinal tract. In the gastrointestinal tract, the most common site is the stomach. They also occur in the small intestine, mesentery, and appendix. Recently, we have experienced a very rare case of neurilemmoma arising from the hepaticoduodenal ligament. We report this case with a review of literature. (Korean J Gastroenterol 2002;39:68-70)