• Journal of Radiation Protection and Research
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• 제38권4호
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• pp.214-227
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• 2013

MDCT의 등장과 함께 병적 증상이 없는 개인이 조기검진을 위해 CT검사를 하는 예가 꾸준히 증가하고 있다. 이러한 검사의 임상적 효용성과 방사선에 의한 암 발생위험에 대한 여러 가지 논란을 살펴보았다. 1. 저선량흉부CT(LDCT)를 이용한 폐암의 조기 검진 효용성을 보기 위해 설계된 무작위배정대조검사(randomized controlled trial)인 NLST(National Lung Screening Trial)의 분석 결과, CT선별검사가 선별검사를 하지 않은 그룹의 사망률 1.67%를 1.33%로, 20% (p=0.004) 감소시키는 것으로 나타났다. CT선별검사군에서 양성결과를 보인 사람의 96.4%는 위양성(false-positive)이었다. 그리고 방사선에 의한 폐암의 ERR (excess radiation risk)은 다른 고형암과는 달리 나이와 함께 감소하지 않으며, 더욱이 흡연 위험과 방사선 위험이 상승작용을 하여 폐암 검진 대상인 고위험군에게 더욱 위험할 수 있는 것으로 평가되었다. 따라서 방사선에 의한 위험이 NLST에서 관측한 이득을 상쇄할 수도 있다. 아직은 최적의 전략이 확립되지 않은 상태이므로 임상에서 광범위하게 적용하기에는 한계가 있다. 2. 대장CT검사(CT colonography)는 10 mm보다 큰 용종의 검출에는 정확도가 뛰어나지만 이보다 작은 경우에는 민감도와 특이도가 급격히 감소하고, 용종이 발견되어 제거하고자 하는 경우 다시 기존의 대장내시경을 이용해야 하는 불편함이 있다. 현재 대장CT검사 1회 시행의 평균유효선량은 약 8-10 $mS{\nu}$로 보고되어, 만약 이 검사가 많은 사람들을 대상으로 일상적으로 행해지면 공중보건에 영향을 미칠 수 있다. 따라서 집단검진 방법으로 정착하기 위해서 는 용종 크기 6-10 mm 범위에서 높은 민감도와 특이도를 확립하고, 하제를 사용하지 않는 방법을 개발하여야 하며, 선량을 더 감소시킬 수 있는 최적화된 전략을 세워 표준화하여야만 한다. 3. 전신CT검사는 그 효용성이 검증된 선행연구가 없는 상태이다. 이 검사는 약 90%의 검사자들에게서 최소한 하나 이상의 이상소견을 확인하였지만 그 중 약 2%만이 임상적으로 중요한 질환으로 판명되었다. 전신CT검사 1회 시행으로 인한 평균유효선량은 약 12 $mS{\nu}$이며 45세부터 75세까지 매년 검사를 받는 경우 LAR (lifetime attributable risk)이 1.9%로 보고되었다. 현재 의학계의 어떤 단체도 이 검사를 권고하고 있지 않다. 현재까지 CT선별검사는 정당화에 대한 충분한 논의를 위해 심도 있는 다양한 연구가 필요하며 최적화된 프로토콜이 확립된 후 이용하는 것이 바람직하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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• pp.68-71
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• 2018

Androgen therapy has proven efficacy in treating patients with bone marrow failure who are not candidates for bone marrow transplantation. Herein, we report on a case of colonic angioectasia secondary to oxymetholone use in an adolescent patient with Hoyeraal-Hreidarsson syndrome (HHS). A 13-year-old Caucasian male with HHS characterized by cerebellar hypoplasia, developmental delay, microcephaly, esophageal strictures and myelodysplasia presented with severe hematochezia from colonic angioectasia secondary to long-term oxymetholone therapy. These vascular lesions resolved spontaneously once this anabolic steroid was discontinued. While androgen therapy is often recommended for certain anemias and myelodysplastic syndromes, clinicians should be aware of the potential complication in developing these perceived uncommon colonic angioectasias. Moreover, pediatric gastroenterologists should familiarize themselves in identifying these vascular lesions by colonoscopy, especially among the high risk groups on long-term anabolic steroid therapy.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1993년도 제45차 추계 학술대회 연제집
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• pp.29-30
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• 1993

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.333-337
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• 1986

저자들은 증세 발현된 회맹판 주위 장관 지방 종 3예를 치험하였으며 특히 회장의 구역 지방 종증은 아주 희귀하여 문헌고찰과 함께 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1969-1974
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• 2013

The objective of this study was to determine the knowledge and associated factors regarding colorectal cancer screening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographic characteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conducted among 300 students ($21.3{\pm}1.4$ years old). The majority of the participants were Malay with a monthly family income of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regarding their lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%, respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy, barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate and multivariate analysis revealed that their age and the discipline which the students were studying significantly influenced their level of knowledge about colorectal screening. The present study results indicate that education campaigns about colorectal cancer should be promoted.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2001년도 춘계학술대회 논문집
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• pp.854-857
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• 2001

At present, colonoscopy is performed by means of quite long and flexible endoscopes and controlled manually. Although the flexibility of the distal tip allows the endoscope to follow the tortuous path of the colon, the insertion of the endoscope requires the endoscopist to exert forces on and to perform rotations of the proximal end; these actions cause discomfort to the patient. Though self-propelling colonoscopic systems has been suggested to overcome these problems, it is difficult to pass through highly curved regions of the intestine. In this paper, we introduce a steering mechanism for a self-propelling coloinlscope, the smart capsule, which has three actuator units. The mechanism is designed not only to move forward and backward but also to pass through the curved regions. We derived the governing equations of this mechanism. Active movements and motion control are developed.

• 대한기계학회논문집A
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• 제26권7호
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• pp.1296-1301
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• 2002

In recent years, the pathology in the colon grows up annually since people of all ages prefer to have less fiber and more fat food. Therefore, the colonoscopy is generalized in developed countries. But it requires much time to acquire a dexterous skill to perform an operation and the procedure is painful to the patient. Therefore, some studies on the development of autonomous colonoscope are carried out. In this paper, we propose a new and simple locomotive mechanism that can be propelled by elliptic motion of a leg. It has several legs that have constant phase difference each other and those legs are disposed along the upper and lower of the body. In order to evaluate the performance of locomotive mechanism, we carried out the simulations of moving characteristics and the experiments in the colon of a dead pig.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권2호
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• pp.206-211
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• 2000

저자들은 1년 전부터의 간헐적인 혈변을 주소로 내원한 14세 남자 환아에서 대장내시경 검사로 진단된 혈관이형성증 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Parasites, Hosts and Diseases
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• 제50권4호
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• pp.349-352
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• 2012

A 94-year-old female with end-stage renal disease presents with fever, fatigue, and hematochezia. She had previously resided in Hunan Province, China, and Myanmar, and she immigrated to Taiwan 30 years ago. Colonoscopy revealed a colonic ulcer. Biopsy of the colonic ulcer showed ulceration of the colonic mucosa, and many Paragonimus westermani-like eggs were noted. Serum IgG antibody levels showed strong reactivity with P. westermani excretory-secretory antigens by ELISA. Intestinal paragonimiasis was thus diagnosed according to the morphology of the eggs and serologic finding. After treatment with praziquantel, hematochezia resolved. The present case illustrates the extreme manifestations encountered in severe intestinal paragonimiasis.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2001년도 춘계학술대회논문집B
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• pp.289-294
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• 2001

The two prototypes of a Wheel Type Locomotive Mechanism Using Micro motor for a Capsule-Type Endoscope are outlined and realized. Basic concept of these mechanisms is to use a rod-shaped wheel, with which these mechanisms can go over the haustral folds inside colon. The actuator of Prototype I is geared dc motor and the actuator for steering is Shape Memory Alloy. Prototype I goes through the whole area of colonoscopy training model. Prototype II can not only go forward and backward, but also be steerable with 2 geared dc motors. Prototype II goes through dead pig colon.