• 대한한방소아과학회지
• /
• 제37권3호
• /
• pp.133-133
• /
• 2023

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권4호
• /
• pp.329-345
• /
• 2020

Purpose: This was a nationwide population-based study conducted to investigate the epidemiology, treatment, disease outcomes, and associated factors of childhood intussusception in South Korea. Methods: Data from the Korean National Health Insurance Service database on all patients <18 years old diagnosed with intussusception from 2007 to 2017 were analyzed. Results: A total of 34,688 cases were identified among 30,444 patients. The overall incidence was 28.3/100,000 person-years with a male predominance. Most cases (83.1%) occurred in children <3 years old, with an annual incidence of 195.2, 200.1, and 118.6 cases per 100,000 children in their first, second, and third year of life, respectively. The median age at the first occurrence was 18.7 months, and it was higher in boys than in girls. The post-discharge recurrence rate was 10.6% (3,226/30,444) and the in-hospital recurrence rate was 6.1% (1,842/30,444). The total recurrence rate (post-discharge recurrence and/or in-hospital recurrence) was 15.0% (4,580/30,444). Enema reduction was successful in 90.0% of cases. Enema reduction was more successful in girls than in boys. A total of 3,296 (10.8%) patients underwent 3,481 surgeries, including 735 (21.1%) laparoscopic surgeries. Post-discharge recurrence and surgery were significantly affected by age, sex, and hospital type. Mortality was noted in nine cases (0.03%). Conclusion: Our study provides accurate epidemiologic data on the treatment and outcomes of intussusception through complete enumeration during an 11-year-period.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제16권3호
• /
• pp.162-170
• /
• 2013

Purpose: To detect major acute gastroenteritis virus (rotavirus, norovirus, astrovirus, and enteric adenovirus) and non-enteric type of adenovirus (AdV) in the stools of intussusception patients and to investigate the clinical role of detected viruses. Methods: From March 2012 to February 2013, major acute gastroenteritis virus and non-enteric type of AdV were isolated from stool samples that collected from 44 patients treated for intussusception in Chungnam National University Hospital. Patients were divided according to age and isolated virus. Results: Virus was detected in 28 (63%) stool specimens. The virus detection rate was significantly lower in patients aged under 12 months (p = 0.04). Twenty-two patients (78.6%) had non-enteric adenovirus, 4 (14.3%) had norovirus, 1 (3.6%) had sapovirus, and 1 (3.6%) had astrovirus. AdV subgroup C (AdV 1, 2, 5, and 6) comprised the majority with 20 cases (90.9%). A monthly increment-and-decrement pattern of intussusception was similar to that of viral detection in the stool samples. Enema reductions were successful in 39 patients and surgical manual reductions were performed in 5 patients. Virus was detected in 24 patients (61.5%) of enema reduction group and 4 patients (80.0%) of surgical manual reduction group. All of the detected viruses were non-enteric adenovirus subgroup C (AdV 1, 5, and 6) in surgical reduction patients. Conclusions: The virus detection rate was high in the stools of intussusception patients. The pattern of seasonal intussusception occurrence rate was parallel with seasonal these viral detection rate in the stool samples. These findings suggest that viral infection plays an important role in the development of intussusception and further research is warranted.

• Neonatal Medicine
• /
• 제28권1호
• /
• pp.22-28
• /
• 2021

Purpose: Meconium obstruction of prematurity (MOP) predisposes premature infants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clinically diagnosed patients with MOP whose obstructions were not relieved via conventional sonography-guided contrast enema. We retrospectively evaluated whether oral nonionic water-soluble contrast media relieves MOP. Methods: Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followed-up radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results: We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27⁺⁵ weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without air-fluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion: Nonionic oral water-soluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.

• Journal of Minimally Invasive Surgery
• /
• 제21권4호
• /
• pp.154-159
• /
• 2018

Purpose: Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. Methods: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. Results: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was $26.8{\pm}18.9$ months (range, 3.5~76.7 months), and the mean body weight was $12.9{\pm}3.9kg$ (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was $56.7{\pm}32.8min$. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra- or postoperative complications. Conclusion: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.

• 대한한방부인과학회지
• /
• 제22권1호
• /
• pp.203-230
• /
• 2009

Purpose: In order to know therapies used in the field of Obsterics & Gynecology of Oriental medicine. Methods: This survey investigated papers about clinical study, literature investigation for therapeutic methods and treatment reports published from 1999. 2${\sim}$2008. 11. Results: In the clinical studies, acupuncture is more frequently used than herbal medicine. But in the treatment reports, herbal medicine is most frequently used except some cases. Besides acupuncture and moxibustion was used frequently. In the treatment reports various acupuncture methods were used except vaginal bleeding or abdominal pain cases. Whole body acupuncture was used mainly. Pharmacopuncture, Sa-am Acupuncture, auricular acupuncture was also used frequently. And Dong's acupuncture, Hwa acupuncture was used sometimes. Moxibustion was tend to be used for dysfunctional uterine bleeding, menopausal disorder, urinary incontinence, vaginal bleeding or abdominal pain during pregnancy period, hyperemesis, recurrent miscarriage, postpartum disease, lochiorrhea. Also other treatment methods was used such as external therapy, aromatherapy, herbal retention enema, fumigation, electric lipolysis acupuncture, Chuna manual medicine, obesity management, acupuncture at uterus cervix, magnetic innervation therapy, exercise, cupping and physical therapy. Conclusion: These results suggests that acupuncture, moxibustion and herbal medicine are most frequent therapy in the field of Obsterics & Gynecology of Oriental medicine. And other therapy are used such as external therapy, aromatherapy, herbal retention enema, fumigation and so on.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제9권1호
• /
• pp.39-47
• /
• 2006

목 적: 임상적, 방사선과적인 소견을 근거로 소아장중첩증의 새로운 분류를 제안하고자 하였다. 방 법: 2003년 3월부터 2005년 7월까지 장중첩증으로 진단된 88예를 대상으로 의무 기록 정보를 분석하였다. 분류를 위해 환자의 나이, 장중첩증의 위치, 증상의 유무, 치료 방법, 비후된 장간막 림프절의 유무, 초음파 소견 이상의 6가지 요소를 후향적으로 검토하였다. 결 과: 1) 장중첩증의 발병 연령에 따라 신생아형 1예(1.1%)와 소아형 87예(98.9%)로 나눌 수 있었다. 2) 소아형은 발생 위치에 따라 소장형 14예(16.1%)와 소장-대장형 73예(83.9%)로 분류되었다. 소장형은 증상이 있는 군 12예와 증상이 없는 군 2예로, 증상이 있는 군은 일과성 장중첩증 8예(66.7%), 수술군 3예(25.0%), 관장 정복 1예(8.3%)였으며, 무증상 군은 복부 컴퓨터 단층 촬영에서 우연히 관찰된 2예였다. 소장-대장형은 수술군 19예(26.0%)와 비수술군 54예(74.0%)로 분류되었다. 3) 일과성 소장형 장중첩증 8예를 수술을 받은 소장형 6예, 정복된 소장-대장형 54예, 수술을 받은 소장-대장형 19예와 비교 분석한 결과, 일과성 소장형 장중첩증의 연령은 $38.0{\pm}22.9$개월로 다른 형태에 비해 의미 있게 높았고(p=0.003), 혈변은 전체 8예 중 1예(12.5%)로 의미 있게 낮았으며(p=0.022), 기면은 모든 예에서 관찰되지 않았다. 단순 복부 엑스선 사진상 일과성 소장형 장중첩증에서 복부 종물(p=0.015)과 기계적 장폐쇄증(p=0.001)은 상대적으로 낮게 관찰되었으며, 초음파상에서 종물의 크기는 일과성 소장형에서 $20.8{\pm}2.7mm$로 의미 있게 작은 크기를 보였다(p=0.0001). 4) 비후된 장간막 림프절 유무와 치료 방법 및 동반 질환과의 관련성 연구에서는 의미 있는 차이를 보이지 않았다. 5) 초음파상 과녁 모양인 경우 11예 중 7예(63.6%)가 일과성 소장형 장중첩증이었고, 나머지는 모두 정복이 가능하였으며 4예 중 3예는 소장-대장형이었으나, 1예는 회장-회장-대장형이었다. 도넛 모양인 23예 중 저에코성 외곽 테두리의 두께가 8.9 mm 이상인 8예(34.8%) 모두에서 수술을 요하였고, 8.5 mm 미만인 15예(65.2%) 모두는 정복이 가능하였다. 결 론: 소아 장중첩증은 영상학적인 소견과 임상적 특성에 따라 새롭게 분류될 수 있으며, 각 유형에 따라 적절한 치료를 유도하는데 중요한 지침이 될 수 있을 것으로 판단된다.

• Clinical and Experimental Pediatrics
• /
• 제51권2호
• /
• pp.219-221
• /
• 2008

저자들은 발열과 식욕저하를 주소로 패혈증 의증으로 전원 된 27일된 신생아에서 구토와 혈변 등은 없었으나, 입원 당시 복부팽만과 단순복부촬영에서 보인 소장 확장소견으로 개복술을 실시한 결과 선천성 밴드에 의해 내탈장된 소장이 압박되어 유발된 장폐색증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제17권3호
• /
• pp.531-536
• /
• 1984

Bochdalek hernia is common in infants and children, but extremely rare is adults. So diagnosis and treatment have been many problems. These are case reports of Bochdalek hernia in adults which were evaluated and corrected at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University during the past 7 years from June 1976 to August 1983. 1.Among the three cases, one was male and the others were female. 2.At first, they were diagnosed as G-I or respiratory disorders and treated symptomatically. But confirmed with UGI and barium enema. 3.All cases had ipsilateral hypoplasia of entire lung or lower lobe as combined anomaly and corrected as simple closure in two cases, pericardial patch closure in one case. 4.Postoperative course was smooth and uneventful.

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