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상부 위장관 내시경 검사시 전처치로서의 Midazolam 의 효과
임규성,차영수,홍성표,박필원,원욱희 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.2
The intravenous administration of midazolam is widely used as sedative premedication for upper gastrointestinal endoscopy. We performed a study to evaluate the effectiveness and safety of midazoiam as premedication for upper gastrointestinal endoscopy. Between June 1995 and October 1995, 112 patients of diagnostic esophago-gastroduodenoseopy were enrolled in the study. The patients were recieved a bolus midazolam 0.~03mg/kg or placebo, followed by typical anesthesia. The blood pressure, pulse and oximeter values were monitored. The systolic blood pressure and heart rate were increased during endoscopy in compared with before premedication, and normalized immediately. There was no significant change of arterial oxygen saturation. Midazolam induced amnesia completely in 49.2% and partially in 27.2%, and all patients were recovered completely in 1 hour. The tolerance score is higher in the midazolam group as compared with the placebo group(p$lt;0.05), and midazolam group would accept the same sedation for repeated endoscopies(p$lt;0.01). We conclude that midazolam has beneficial effects as premedication for upper gastrointastinal endoscopy without significant altteration in cardiopulmonary parameters. This suggest that midazolam may be used more frequently as premedication, especially in the cases of repeated endoscopy.
이상호,홍성표,박필원,김배영,원욱희,최욱선,임규성 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.5
Percutaneous endoscopic gastrostomy is used for long-term nutritional support and can be performed with relatively few complications. Among the major and minor complications, migration and erosion of the internal bumper into or through the abdominal wall, so called buried bumper syndrome has been described more recently. We describe a patient in whom internal bumper eroded into stomach wall and was completely covered by gastric epithelium 45 days after gastrostomy placement. The gastrostomy tube itself was patent, and the end still protruded into the lumen of the stomach. But, endoscopy was failed to remove the gastrostomy tube and surgical exploration was required in our case. We experienced a case of buried bumper syndrome after percutaneous endoscopic gastrostomy and report with a review of literatures.
김진안,성순희,허갑범,이현철,정윤석,박정수,원욱희,라선영 대한내과학회 1994 대한내과학회지 Vol.47 No.3
ACTH-independent Cushing's syndrome is caused by autonomous production of cortisol, usually by an adrenal adenoma, carcinoma, or primary adrenocortical micronodular dysplasia. Cushing's syndrome due to adrenocortical adenoma usually has a unilateral lesion and contralateral site becomes atrophic. We report a rare case of Cushing`s syndrome caused by ACTH-independent bilateral adrenocortical adenomas. A 48-year-old woman presented with Cushingoid features, diabetes mellitus and hypertension. Urinary free cortisol and 17-hydroxycorticosteroid excretion were 365.4 ug/ day and 16.2 mg/day, respectively. Both were not sup- pressed after administration of high-dose dexamethsone. Plasma ACTH was 3.5 pg/ml. Abdominal C-T revealed well defined bilateral adrenal tumors 4.0 cm in diameter on the ventral side of the right renal upper pole and 2.0 cm in diameter on the ventral side of left renal upper pole. Bilateral partial adrenalectomy was performed. The both adrenal glands showed all the pathologic features of adenoma.