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Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center (단일 병원에서의 재발성 장중첩증과 병적 선두에 대한 임상적 고찰)

  • Lee, Kun-Song;Park, Yun-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.163-170
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    • 2009
  • Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

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Clinical Usefulness of Rapid Antigen Test on the Diagnosis of Influenza (인플루엔자 진단을 위한 신속 항원검사의 유용성)

  • Kim, Jae Seon;Choi, Hyon Joo;Ahn, Young Min;Hwang, Young Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1348-1353
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    • 2005
  • Purpose : Influenza is a respiratory disease which prevails widely every year and shows high morbidity and mortality among not only chronic invalids and the old, but also among infants and young children. To prevent community-acquired influenza infection, to facilitate prompt antiviral therapy and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for the influenza virus is needed. We evaluated a lateral-flow immunoassay(QuickVue Influenza Test), compared to viral culture. Methods : During two consecutive years from Jan. 2004 to June 2004 and from Feb. 2005 to Jan. 2005, 408 patients who were suffering from fever, cough and/or sore throat and myalgia were enrolled in our study. A total of 408 patients were tested with $QuickVue^{(R)}$(Quidel Co., San Diego, USA) influenza rapid antigen test and virus cultures at the same time. Results : Of the 408 patients tested, children who showed positive results at the virus culture numbered 77; among them, 55(71.4 percent) were type A/H3N2 and 22(28.5 percent) were type B. QuickVue influenza test had a sensitivity of 71.4 percent and a specificity of 95.8 percent. The positive and negative predictive values were 79.7 percent and 93.5 percent, respectively. Conclusion : In our study, this test had comparable high sensitivity and high specificity and many advantages, such as being easy to perform and simple to interpret, and showing rapid results. If rapid influenza antigen tests are widely applied in the clinic, we can begin treatment more rapidly and reduce influenza complications and the abuse of antibiotics.

Training, Working State and Ways of Improving Work of Sex Education Counselors in Health Centers (대구·경북지역 보건소 성교육 담당자의 훈련 및 업무현황과 개선방안)

  • Yeom, Seok-Hun;Kim, Chang-Yoon;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.159-175
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    • 2002
  • This present study was conducted to reduce problems by analyzing training and work of sex education counselors and to come up with ways of improving sex education counseling. A survey was performed in 57 subjects at health centers who finished training on sex education counseling in Taegu Metropolitan City and cities, kuns, and gus of Kyongsangbuk Province from December, 1999 to February, 2000 on general characteristics, items relating to the work of sex education, and ways of improving work. The results are as follows. Out of the sex education counselors, there were 55 females, taking 99% out of the total counselors, and the average age of these counselors was 42 years. There were 26 nurses, and their government grade was level 7 in 36 and level 6 in 14. The members who had finished sex education counseling at each public health center was 2.1 counselors at an average. Among those had finished sex education training, 30 was not in sex counseling. When analyzed the answers given by 27 sex counselors who were counseling at the time and the results are as follows. As for the amount of work, 15 answered to have too much work and 1 little; as for having pride on being a sex education counselor, 18 answered to felt pride and 7 so-so; as for materials for sex education and counseling, 25 answered to use videos, 23 books, 10 pictures, 8 beam projectors, and 7 slides. All of the subjects answered to have other responsibilities besides sex education and counseling, and the satisfaction felt on having other responsibilities was 6 satisfied, 12 average, and 2 dissatisfied. The proportion of work load in sex education counselors was other work besides sex education 76.2%, sex education at schools 7.6%. collecting sex education materials 5.7%, counseling of adolescents 4.9%. development of sex education materials 3.5%, and administrative work related to sex education 3.1%. The biggest problem of their work was over-load in 9 respondents, lack of sex education materials in 8, lack of training in 6, and shortage of professionals in 2. As for the answer on the ways of improving matters related to work of sex education counselors, the most frequent answer was that the organizations responsible for sex education needs to be more professional and systematic, followed by dividing the work load so that they could concentrate on developing education materials and sex education and counseling. Thus, the results of the present study indicated that in order to utilize human resources efficiently, the speciality of counselors needs to be considered when making personnel transfers among health centers, and continued activity as a sex education counselor needs to promoted by reducing other overloading tasks. And systematic re-training of the counselors needs to be done, and education manuals that are diverse and realistic to applicable to the children, who are to be the subjects of sex education, need to be developed and distributed.

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