• Advances in pediatric surgery
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• v.14 no.2
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• pp.189-195
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• 2008

Colorectal cancer is extremely rare in children. Unlike adult colorectal cancer, the overall prognosis of colorectal cancer in children is poor. Delayed diagnosis, advanced stages of the disease at presentation, and mucinous type of histology are the major determinants of poor outcome in childhood. A 13-year-old boy with abdominal pain visited our hospital. Physical examination andabdominal ultrasonography identified acute appendicitis with perforation. He underwent appendectomy and then the pathologic findings revealed mucinous adenocarcinoma. The cancer was located at the transverse colon and had metastases on peritoneal wall at $2^{nd}$ laparotomy. Extended right hemicolectomy was performed. He underwent palliative chemotherapy. After 4 months later, hepatic metastasis and aggravated peritoneal seedings developed. He died of renal failure and pneumonia 13 months after operation. We need to have a high index of suspicion for the possibility of a malignant colorectal tumor in any childhood case with nonspecific signs and symptoms.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.45-49
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• 2000

Henoch-Sch$\ddot{o}$nlein purpura is a systemic vasculitis of unknown etiology that is probably related to an autoimmune phenomenon. Henoch-Sch$\ddot{o}$nlein purpura is characterized by a purpuric rash, arthralgia, nephritis, and gastrointestinal manifestations. We reviewed 169 children hospitalized with a diagnosis of Henoch-Sch$\ddot{o}$nlein purpura between 1989 and 1998. One-hundred thirty-nine (82.2 %) had gastrointestinal findings including abdominal pain, nausea, vomiting and gastrointestinal bleeding. Surgical consultations were obtained for ten children, and laparotomy was performed in five. Three children suspected of having appendicitis underwent appendectomy. None had appendicitis. One child thought to have been intestinal strangulation was found to have hemorrhagic edema of the proximal jejunum and of the distal ileum. Another child underwent resection for an hemorrhagic infarct of the distal ileum. A high index of suspicion of this disease entity in the differential diagnosis of abdominal pain in children can avoid unnecessary laparotomy in most cases. However, life-threatening gastrointestinal complications may occur in low percentage of cases. Prompt recognition and adequate radiologic evaluation of the abdominal manifestation of this entity is necessary for early surgical intervention.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.2
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• pp.151-159
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• 2017

Purpose: The purpose of this study was to identify nursing demands according to general characteristics and diseases of inpatients to whom comprehensive payment systems apply. Methods: This study was designed as a retrospective research study using the electronic medical records of Hospital Information Systems (HIS). Participants were 836 subjects who received seven Diagnostic-Related Group diagnoses among inpatients of one tertiary hospital from January 1, 2015 to June 30, 2015. Data were analyzed using SPSS 23.0. Results: Nursing demand among inpatients'seven Diagnostic-Related Group diagnoses was relatively higher for appendectomy, cataract surgery, and hysterectomy, while there was a significant difference depending on the age, duration of admission, admission path, hospital entry method and Diagnostic-Related Group. Conclusion: The results can be utilized as basic data on accurate nursing demands that reflect various features of patients.

• Korean Journal of Clinical Pharmacy
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• v.12 no.2
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• pp.65-70
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• 2002

Prophylactic antibiotics in acute nonperforated appendicitis have been used for preventing infection after appendectomy. However, duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. The objective of this study was to identify appropriate duration of prophylactic antibiotics in acute nonperforated appendicitis by comparing two different antibiotic regimens for their wound infection rates. Eighty-four acute nonperforated appendicitis patients were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: cefoxitin 1 g every 8 hours given intravenously for 24hours or cefoxitin 1 g every 8 hours given intravenously plus sisomicin 75 mg every 12 hours given jntramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. Postoperative wound infections were detected in $4.8\%$ of the 72-hour-treated group (n=42), whereas none occurred in the 24-hour-treated group (n=42). However, the difference in the rates of wound infections between two groups was not statistically significant. The most frequently isolated microorganism from appendiceal tissues was E coli. In conclusion, administration of cefoxitin alone for 24 hours is sufficient as surgical prophylaxis in nonperforated appendicitis.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.1
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• pp.71-81
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• 1985

A clinical analysis has been made on 717 cases of tubal sterilization which had been performed at the Dept. of Obstet. & Gynecol., Kyung Hee University Hospital from Jan. 1, 1976 to Dec. 31, 1980. The results are as follows: 1) Prominant age group consisted of those 26-30 years old with frequency of 43.9%, the average being 30.6 years old. 2) Women having 2 living children represented 52.4% of the total and the average No. of living children was 2.5. 3) According to the sex of their children, 29.7% of all cases had one son and one daughter. 12.1% of cases had no son, while 25.7% of cases had no daughter, which showed a trend of male preference. 4) 47.7% of total cases had not experienced artificial abortion before sterilization and the mean No. of artificial abortion was 1.8. 5) With respect to interval between last delivery and tubal sterilization, 76.1% of cases was sterilized within postpartum period (including-c-section) and 12.4% of cases was sterilized within 3 years. 6) The contraceptive methods prior to sterilization were 42.8% with no method used, 17.7% by condom, 16.6% by oral pills, 14.9% by IUD method. 7) 84.5% of puerperal sterilization operation was performed within 48 hours after bearing. 8) Sterilization procedures were coincidentally performed with appendectomy (36.7%), D&E (15.8%), perineorrhaphy (5.0%), salpingectomy (1.8%), and ovarian cystectomy (1.5%). 9) General anesthesia was performed in the majority cases (88.4%). 10) Complications after the procedure were encountered in 7.8% (56 cases), but no intensive medical care was required for these complications. 11) The failure (0.3%) resulting in intrauterine pregnancies occured after the laparoscopic sterilization.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.145-153
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• 2011

Acute appendicitis is one of the most common diseases of young people that requires emergency operation. This is especially true for those age 10 years old and older. However, the numbers of cases of appendicitis are increasing in both the young and the elderly. The main purpose of this study is to understand the clinical features of acute appendicitis in children and elderly patients. We retrospectively compared clinical characteristics in 4 groups of patients who underwent appendectomy in our hospital. There were 16 patients in the pre-school age group, 9 were males and 7 females. The total number of patients in the juvenile group were 287, 156 were males and 131 females. The total numbers of patients in the adult group were 794, 436 were males and 358 females. The numbers of elderly patients were 189, 91 were males and 98 females. Complicated appendicitis was found in 15 patients (93.7 %) in the pre-school age group, 79 patients (27.5 %) in the juvenile group, 332 patients (41.8 %) in the adult group, and 96 patients (50.7 %) in the elderly group. Four patients (40 %) had generalized panperitonitis in the pre-school group. The occurrence of perforated appendicitis was the highest in the pre-school age group and the lowest in the juvenile group. Since generalized panperitonitis has a higher incidence in the pre-school age group, prudent and careful diagnosis and treatment are required for the pre-school age group.

• Women's Health Nursing
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• v.2 no.1
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• pp.25-39
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• 1996

The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2689-2692
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• 2014

Purpose: To investigate the risk factors for appendiceal metastasis of epithelial ovarian cancer and compare findings with the previous studies. Materials and Methods: One hundred and thirty-four patients with epithelial ovarian cancer were assessed in this study. All of them had undergone a surgical procedure including appendectomy. Of these, 21 (15.7%) patients who had appendiceal metastasis were analyzed as the case group and the patients with no metastasis were the controls, compared according to stage, grade, histology of tumor, preoperative Ca125 levels, presence of ascites, peritoneal cytology, diameter and site of tumor considered as risk factors. Results: We found statistically significant differences between the groups in terms of stage, grade, right-sided tumor location, presence of ascites, diameter of tumor${\geq}10cm$ and positive peritoneal cytology (p<0.05). In the logistic regression model, stage, grade, presence of ascites, right-sided location and diameter of tumor were independent risk factors. ROC curve analysis showed that stage, grade and diameter of the tumor were discriminative factors for appendiceal metastasis. Conclusions: In epithelial ovarian cancer, stage, grade, presence of ascites, right-sided location and large tumor size have importance for estimation of risk of appendiceal metastasis. As we compare our findings with previous studies, there is no definite recommendation for the risk factors of appendiceal metastasis in epithelial ovarian cancer and more studies are needed.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.118-125
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• 2001

The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.44-51
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• 2009

This study is a retrospective analysis of 1244 cases of the inguinal hernia in children under the age of fifteen years who were operated at the department of pediatric surgery, Inje University Busan Paik Hospital from March, 1997 to February, 2007. The ratio of male to female was 3.6:1. The type of hernia was indirect in all of the cases. The hernia was on the right side in 656 cases (53.9 %), left side in 467 cases (37.5 %), and bilateral in 121 cases (9.7 %). The hernia presented most frequently in infants under age 12 months; 364 cases (29.2 %). Fifty-nine cases (21.7 %) were in female and 305 cases (31.3 %) in male. There were 428 cases (33.6 %) in 1-3 years age group, 295 cases (23.7 %) in 4-6 years, 112 cases (9.0 %) in 7-9 years, 39 cases (3.1 %) in 10-12 years and 16 (1.2 %) in 13-15 years. The content of hernia sac was small bowel (59 %), omentum (31 %) in males and the ovary and tube (54 %) and small bowel (26 %) in female. The incidence of combined operation at the time was 3.2 %, and consisting of orchiopexy (67.5 %), frenulotomy (12.5 %), appendectomy (10 %), circumcision (5 %), and fistulotomy (5%). The incidence of combined disease was 2.8 % and consisting of undescended testis, Hirschsprung's disease, idiopathic hypertrophic pyloric stenosis, imperforate anus, and congenital heart disease. After unilateral inguinal hernia repairs, contralateral hernias developed in 34 patients. The laterality of the primary site of hernias were left in 19 cases (55.8 %), and right 15 cases (44.1 %). The 936 cases (75.2 %) were operated under general anesthesia; Mask bagging 663 cases (53.2 %), endotrachea intubation 257 cases (20.6 %), and laryngeal mask 16 cases (1.2 %). The remainder 308 cases (24.7 %) were operated under regional caudal anesthesia.