• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.24-31
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• 2003

Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

• Journal of the Korea Convergence Society
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• v.4 no.2
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• pp.9-13
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• 2013

This study which improve pretreatment method was to increase effective diagnosis of barium enema to remind a more accurate action by training precautions, method of taking medicine, time and taking suitable laxative to patient. First, A total of 504 patients who received barium enema in the E university hospital were evaluated about repretreatment proportion of patients. 176 patients who were changed with precaution were evaluated about repretreatment. Second, Both 130 patients who were not changed with the type and amount of laxative and 137 patients who were changed with it were evaluated. Repretreatment rate was reduced about 10% since changed precautions. Stomachache was reduced about 21% due to chage methode to take the laxative improved. Patients who think cleanliness degree of bowel increased that it is going very well about 11.9% since improvement and decreased that it's not bad about 16.3%. The methods which accurately recognize precautions to patient decrease repretreatment rate, inconvenience and pain of patients due to repretreatment. Expectation mentlity for accurate inspection also had increased in that patients think that cleanliness degree of bowel was increased.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.631-638
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• 2016

Radiation proctitis is a common complication after radiotherapy for pelvic malignant tumors. This study was conducted to assess the efficacy of novel almagate enemas in hemorrhagic chronic radiation proctitis (CRP) and evaluate risk factors related to rectal deep ulcer or fistula secondary to CRP. All patients underwent a colonoscopy to confirm the diagnosis of CRP and symptoms were graded. Typical endoscopic and pathological images, risk factors, and quality of life were also recorded. A total of 59 patients were enrolled. Gynecological cancers composed 93.1% of the primary malignancies. Complete or obvious reduction of bleeding was observed in 90% (53/59) patients after almagate enema. The mean score of bleeding improved from 2.17 to 0.83 (P<0.001) after the enemas. The mean response time was 12 days. No adverse effects were found. Moreover, long-term successful rate in controlling bleeding was 69% and the quality of life was dramatically improved (P=0.001). The efficacy was equivalent to rectal sucralfate, but the almagate with its antacid properties acted more rapidly than sucralfate. Furthermore, we firstly found that moderate to severe anemia was the risk factor of CRP patients who developed rectal deep ulcer or fistulas (P= 0.015). We also found abnormal hyaline-like thick wall vessels, which revealed endarteritis obliterans and the fibrosis underlying this disease. These findings indicate that almagate enema is a novel effective, rapid and well-tolerated method for hemorrhagic CRP. Moderate to severe anemia is a risk factor for deep ulceration or fistula.

• Advances in pediatric surgery
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• v.7 no.2
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• pp.105-111
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• 2001

To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.946-953
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• 2005

Ileus is blockage of the intestine that prevents the contents of the intestine from passing to the lower bowel. In western medical treatment, surgery is mandatory for severe cases such as strangulation ileus. However more generally, conservative management is used for treatment. Examples of conservative management are decompression with tube, fluid treatment, enema and fasting cure. Until now, many oriental medical studies have been conducted on chronic ileus, but almost none on acute ileus. The results for the case in this report suggest that oriental medical treatment such as acupuncture, moxibustion, herbal medicine is effective in treating acute ileus. We think that further studies should be conducted on a combination therapy with other oriental medical treatment such as retention enema.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.650-661
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• 1998

The purpose of this study was to provide fundamental data for determining contents of Fundamental Nursing Practice and developing desirable bedside nursing techniques for clinical nursing areas. Subjects for this study were 86 nurses who were employees of two university hospitals located in Seoul and a district area. Data were collected by questionnaires. Items of Fundamental Nursing Practice were classified into 72 items according to the result from content analysis of 9 textbooks of Fundamental Nursing. The results are as follows : 1) Items which above 80% of respondents practiced during the school inside practice or clinical nursing practice course were axillary temperature measurement, radial pulse measurement, respiratory rate measurement, application of oral hygiene, hand-washing technique, application of hot and cold bags, intramuscular injection technique, open bed-making, soap enema method, application of nelaton catheterization and oral and nasal suction methods. 2) Above 90% of respondents replied that all items except temperature measurement and bed-making were requisite contents for Fundamental Nursing Practice. Above 10% of respondents replied oral and rectal temperature measurement and bed-making were unnecessary content. 3) Above 90% of respondents replied that operating methods of all items except isolation technique, admission and discharge procedures, and retention enema in the Fundamental Nursing Practice course and clinical situation were consistent. The main reasons that respondents did not apply methods which they learned in the Fundamental Nursing Practice course to the clinical situation were 'insufficient time', 'colleagues were using different methods', 'insufficient supply of instuments' or 'inappropriate appliances'.

• The Journal of Korean Academic Society of Nursing Education
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• v.10 no.2
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• pp.252-261
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• 2004

Purpose: This study attempts to develop the basic data of Constipation reduction program for institutionalized elderly by surveying the constipation and the ADL (Activities of Daily Living) of them. Method: Data are collected by nurses caring for four hundreds five institutionalized elderly during May through July in 2004. Questionnaire contains a bowel assessment, constipation control intervention, and ADL. Result: The constipation rate was found to be 43%. The 82.5% of the study sample was treated with laxatives, and a 59.9% of the sample was practicing enema. The average score of the ADL was 38.32(range: 0 - 100). According to surveying on the ADL in relation to the function of the constipation, ADL is found to be higher in the non-constipation group than the constipation group (t=-2.786, p=.006). Conclusions: The institutionalized elderly tended to have a high rate of constipation. The elderly having constipation was almost dependent on laxatives and enema for relaxing constipation. The high rate of constipation was related to the low performance of the ADL.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.63-67
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• 1994

A 70-year-old female patient was admitted due to the impression of lung abscess via local clinic. Chest P-A showed air shadow containing huge mass lesion in the right lower lung field, pericardio phrenic angle. But the patient complained of only mild upper respiratioy tract infection symptoms and the laboratory tests were within normal limits. Barium enema and chest C-T taken right after barium enema were performed in suggestion of the diaphragmatic hernia. Barium filled transverse colon and associated omentum were in the right anterior hemithorax surrounded by the hernial sac. The mass lesion shown in the chest P-A was compatible with the diaphragmatic hernia, Morgagni type. Operative reduction of the herniated bowel and simple closure of the diaphragm was performed.

• Advances in pediatric surgery
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• v.8 no.1
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• pp.54-61
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• 2002

Hirschsprung's disease (HD) is usually diagnosed in the newborn period and early infancy. The common presentation of HD in newborns consists of a history of delayed passage of meconium within the first 48 hours of life. The differential diagnosis in newborns is one of the clinical challenges of this disorder. A number of medical conditions which cause functional obstruction of the intestines are easily excluded. Neonates with meconium ileus, meconium plug syndrome, distal ileal atresia and low imperforate anus often present in a manner similar to those with HD in the first few days of life. Abdominal radiographs may help to diagnose complete obstruction such as intestinal atresia. Microcolon on contrast enema can be shown in cases with total colonic aganglionosis, ileal atresia or meconium ileus. Suction rectal biopsy or frozen section biopsy at operation is essential for differential diagnosis in such cases. HD is also considered in any child who has a history of constipation regardless of age. Older children with functional constipation may have symptoms that resemble those of HD and contrast enema is usually diagnostic. However, children with other motility disorders generally referred to as chronic idiopathic intestinal pseudoobstruction present with very similar symptoms and radiographic findings. These disorders are classified according to their histologic characteristics.; visceral myopathy, visceral neuropathy, intestinal neuronal dysplasia (IND), hypoganglionosis, immature ganglia, internal sphincter achalasia. Therefore, the workup for motility disorders should include rectal biopsy not only to confirm the presence of ganglion cells but also evaluate the other pathologic conditions.

• Journal of Korean Academy of Nursing
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• v.31 no.4
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• pp.619-630
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• 2001

Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.