Comparison of Whole versus Split-Dose PEG Solution for Colonoscopy Preparation on Patient Compliance, Quality of Bowel Cleansing, and Endoscopist's Satisfaction / 성인간호학회지

PURPOSE: This study was a randomized single-blind trial of whole versus split-dose PEG solutions for colonoscopy preparation to compare the patient compliance, quality of bowel cleansing, and endoscopist's satisfaction. METHODS: The participants were recruited from outpatients who planned to receive colonoscopy of C hospital in Busan. Sixty participants were randomly assigned to receive either a spit-dose group(n=30) consuming 2 liter of PEG solution twice, or a whole-dose group(n=30), consuming 4 liter of PEG solution once. These participants completed the questionnaire to assess their compliance before colonoscopy. The quality of bowel cleansing was assessed using the Ottawa Scale with the endoscopist who was blinded to the type of preparation, and their satisfaction by using VAS. RESULTS: The participants who did not completely consume 4 liter of PEG solution were less in split-dose than in whole-dose group (0% vs 13.3%). The split-dose group complained less about abdominal pain(t=2.644, p=0.009) and abdominal bloating(t=2.802, p=0.013) with a statistical significance. For the quality of bowel preparation, there were no significant differences in the bowel cleansing scores and the endoscopist's satisfaction between two groups. CONCLUSION: Colonic preparation with split-dose of PEG solution could be a more useful method for better patient compliance, with no significant impact on bowel cleansing quality.

The effect of propofol for conscious sedation during colonoscopy-A Prospective, Randomized Study / 대한내과학회지

BACKGROUND: The objectives of this study were to assess propofol as sedative agents for colonoscopy in the safety and efficacy, compared with midazolam plus meperidine. METHODS: 120 patients undergoing colonoscopy in a prospective study were randomly assigned to one of three medication regimens. Patients in group A (n=42) received i.v. 25 mg of meperidine and 2.5 mg of midazolam. Patients in group B (n=41) received i.v. a median dose of 96.59 mg of propofol (range 40-180) and patients in group C (n=37) received i.v. 25 mg of meperidine and a median dose of 77.03 mg of propofol (range 40-150), administered by a nurse with endoscopist supervision. Endpoints were patient satisfaction, procedure and recovery times and complications. RESULTS: The mean time to sedation was much faster in 2 groups using propofol (group A: 152+/-105.9 sec, group B: 52.9+/-46.5 sec, group C: 56+/-63.7sec; p<0.001). The mean time to reach the cecum was not different among the 3 groups. There were total 3 episodes of oxygen desaturation to <90%, as one in each group, but the patients were spontaneously recovered with only increasing O2 concentration and arousal. Patients in group C expressed better overall mean satisfaction than patients in group A (p=0.049), but difference was not found between group A and group B. The amnestic effect was better in two groups using propofol than group A (p=0.017) The mean dose of propofol was lower in the patients who received propofol combined with low dose of meperidine than those with propofol only (77.03 mg vs 96.59 mg, p=0.009). CONCLUSION: Nurse-administered propofol sedation with endoscopist supervision is believed to be safe and useful for colonoscopy with careful monitoring.

A Case of Penile Cancer Transformed from the Giant Condyloma Acuminata / 대한비뇨기과학회지

The incidence of Giant Condyloma Acuminata of the penis is unknown but considered rare. They are similar to condyloma acuminata, histologically and grossly similar to squamous cell ca. Most authorists consider that they get the real possibility of malignant change and they had been first described by Buschke in the German literatures in l896 as a variant of condyloma acuminata. A case of malignancy of the penis which has apparently transformed from Giant Condyloma Acuminata of the penis is herein presented with review of related literatures.