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Necrotizing Enterocolitis - A Survey by the Korean Association of Pediatric Surgeons - (괴사성 장염 - 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, S.Y.;Kim, S.C.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, S.C.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Choi, K.J.;Choi, S.O.;Choi, S.H.;Han, S.J.
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.70-85
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    • 2006
  • A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.

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A Clinical Observation on Children with Transient Small Bowel Intussusception (일과성 소장형 장중첩증의 임상적 고찰)

  • Hur, Nam-Jin;Ryu, Min-Hyuk;Lee, Dong-Jin;Kwon, Jung-Hyeok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.160-168
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    • 2000
  • Purpose: The purpose of this study was to evaluate the clinical and abdominal ultrasonogra- phic(US) features of spontaneously reduced transient small bowel intussusception in chlidren. Methods: We retrospectively reviewed the clinical and US findings of 98 children with intussusception who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Mar. 1999 to Feb. 2000. Results: 1) Among 98 cases, there were 12 cases (12.3%) of transient small bowel intussusception(TSBI) and 86 cases (87.7%) of classic intussusception (CI). 2) The peak incidence of age in TSBI was over 3 years, which was older than that in CI. With regard to sex distribution, male predominated in both type. 3) Clinical symptoms and signs including cyclic irritability, vomiting, bloody stool, and abdominal mass in TSBI group were less common than those in CI group (41.7%, 33.4%, 0.0%, 0.0% vs 91.9%, 59.3%, 41.9%, 26.7%, respectively) but persistent abdominal pain was more common in TSBI group than in CI group (58.5% vs 11.2%). 4) The size of total target sign and surrounding peripheral hypoechoic rim of TSBI group on US were smaller than those of CI group ($11.95{\pm}2.61$ mm, $2.08{\pm}1.15$ mm vs $26.91{\pm}5.98$ mm, $7.86{\pm}2.77$ mm, respectively). 5) Concomittant illness was found more frequently in TSBI group than in CI group (66.7% vs 26.7%). 6) All case of TSBI group were reduced spontaneouly, which were confirmed by US, but none of CI group. Conclusion: Transient small bowel intussusception is probably more common than generally thought and its clinical and US findings is quite different from classical obstructing intussus-ception. Because all of our cases resulted in spontaneous reduction, we recommend careful observation and repeat examination rather than an immediate operation in transient small bowel intussusception.

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The Want for Home-Visit Health Care in Rural Olders (농촌지역(農村地域) 노인(老人)의 방문보건의료(訪問保健醫療) 요구도(要求度))

  • Kwag, Hwa-Soon;Kam, Sin;Kim, Jong-Yeon;Ahn, Soon-Gi;Jin, Dae-Gu;Lee, Kyung-Eun;Cha, Byung-Jun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.143-153
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    • 2002
  • This study was performed to examine the want for home-visit health care of health center and health sub-center in rural olders and to provide the basic data to develop strategies for efficient and effective home-visit health care delivery of public health facilities. The questionnaire survey by interview was conducted to 355 olders whose ages were all over 65 years, residing at a rural community, Myun, Gyeongsangbuk- do. Among study population, 64.5% replied that their self-rated health status were 'poor', 14.1% had low ADL and 14.9% had low IADL. Among study population, 73.5% replied that they had health problem which were in need of medical personnel's care. The existence of health problem were significantly different according to sex, age, marital status, health security status, occupation, economic status, circumstances for medical care, self-rated health status, ADL, and IADL(p<0.05). Among olders with health problem which were in need of medical personnel's care, 19.5% wanted to receive the home-visit health care. The degree of want for home-visit health care was higher significantly in olders whose ages were 75-year old or more(p<0.05), jobless olders(p<0.01), the aged persons who were not in harmony with other family members, olders whose self-rated health status were 'poor' and olders with low IADL. The major reasons why they wanted to receive the home-visit health care services were 'they had no helpers when they were sick' (64.7%), 'long distance to the medical facilities from their residence'(23.5%). The medication service was the most need service among home-visit health care services. The reasons why they didn't want to receive the home-visit health care services were 'we could walk and move' (60.0%), 'we wanted to have a direct contact with doctor' (25.7%) in the order of high rate. In multiple logistic regression analysis, the degree of want for home-visit health care were higher significantly in olders who were not in harmony with other family members and olders whose self-rated health status were 'poor'(p<0.05).

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Study on a pair of small spot of nonsexual gland hind of the larvae in Bombyx mori L. (I) (유충의 생식후원선이 아닌 한 쌍의 소반점에 관한 조사연구 (1))

  • 윤종관
    • Journal of Sericultural and Entomological Science
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    • no.11
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    • pp.51-54
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    • 1970
  • External features of silkworms are not evident during stage of larvae and pupae like in the stage of imagines. In general, therefore, sexing of larvae has been depended on Herold's gland of males or Ishiwata' sexual spots (Anterior sexual spots and posterior sexual spots) of a female 2-3 days after of the 5th age since it is relatively easy to classify in this period. Sometimes. however, we made mistake of sexing since a pair of small spot around the abdomen of 9th abdominal of males and posterior sexual spot of females was found at the same position. This study has been conducted in order to obtain essential points of classifing the above it will be summarized as follows: A. Existence of the males small spots on 9th abdominal segment were varied by races. Through observation races by races the more larvae which had the small spots were found in chinese races than the Japanese, and 57 percent of the Chinese orgin larvae of the small spot were picked among total counted males. B. The small spots were more or less roundly shaped just as posterior sexual spots of females, and these spots were colored slightly even the colors were somewhat different by races. Milky color was seen in the case of the posterior sexual spots. The small spots were observed smaller than the posterior sexual spots. It is difficult classify the sexual spots during stage of mature larvae, but it was easily classified small spots by the naked eye even in the same stage. The small spots were found at the same site of the posterior sexual spots. C. After sexing by based on the small spots and Herold's gland, the sexing through purpae bodies were carried out again to confirm its correctness. Average 5. 2 percent of more opposite sex were found in the latter. This figures supposed to be caused the location of the small spots coincide with the posterior sexual spots. D. The moths, no disorder were found in daily activities and their generative functions depend on the existence of the small spot and thickness of its color. E. It is presumed that existence of the small spots were caused by races, heredity nature, voltinism, moulting, and etc.

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Clinical Usefulness of the Line Probe Assay for Rapid Detection of Rifampicin-resistant Tuberculosis (Line probe assay를 이용한 신속한 rifampicin내성결핵 진단법의 임상적 유용성)

  • Hong, Sang-Bum;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.334-342
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    • 2001
  • Background : RpoB gene mutations have been found in about 96-98% of rifampicin (RMP)-resistant Mycobacterium tuberculosis. Recent reports confirm that the in laboratory settings a rpoB gene mutation can be used as a surrogate marker for multi-drug resistant tuberculosis. However, its usefulness in clinical applications has not been evaluated. This study was performed to confirm whether mutation analysis of the rpoB gene of M. tuberculosis is useful in clinical settings. Methods : The medical records of 33 patients in whom rpoB gene analysis was conducted using an INNOLiPA Rif. TB assay (LiPA) from June, 1998, to July, 2000, at the Asan Medical Center were retrospectively reviewed in 33 patients. The clinical characteristics in addition to the drug susceptibility and LiPA results were analyzed. The drug susceptibility test was considered as a gold standard method for M. tuberculosis susceptibility and these results were compared with those of the rpoB gene study and sequencing analysis. Sequencing analysis of the rpoB gene was done in cases where there was a discrepancy between the results of the drug susceptibility an d rpoB gene study. Results : The mean age and sex ratio was $42{\pm}18$, and 24:9 (M:F), respectively. There were 19 RMP susceptible (58%) and 14 RMP-resistant cases (42%) according to the rpoB gene study. The mean time from the request to reporting the results of the rpoB gene study was $5.2{\pm}2.6$ days. The mean gap from reporting the rpoB gene study to reporting the susceptibility was $56{\pm}35$ days. Twenty-eight cases (85%) showed identical results compared with the drug susceptibility results, whereas five cases (15%) showed contradictory results. When compared with the sequencing analysis, of the five cases that showed contradictory results, two had LiP A analysis errors and the remaining three were identical to the sequencing results. The rpoB gene study was of assistance in choosing the appropriate drugs in 28 cases (85%). Conclusions : An rpoB gene study using an LiP A assay was useful in rapidly diagnosing RMP-resistant tuberculosis, which enabled a proper choice of the appropriate drugs in clinical practices. However, an LiPA assay always should be performed in conjunction with microscopy, culture, and susceptibility tests.

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Relationship Between Reflective Light and Traffic Accidents Involving Power-Tillers (경운기의 반사등 유무와 교통사고와 관련성)

  • Lee, Kyung-Eun;Lee, Heun-Ji;Gwak, Won-Gun;Ji, Myung-Gu;Song, Hyun-Seok;Hong, Sun-Yeong;Kang, Mi-Jin;Ju, Seok;Lee, Kwan;Cheong, Kwan-Hae;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.61-70
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    • 2003
  • Objectives: Traffic accidents often occur to power tillers without reflective light in the dawn, evening and night. Because of this reason, there has been a 'campaign to attach reflective lights' to power-tillers in recent years. Therefore, the authors investigated the relationship between reflective light and traffic accidents involving power-tillers. Methods: We defined traffic accidents of power tillers as those cases of rear-end collision by a car in the dawn, evening or night. According to our definition, four cases were confirmed in Hyungok-myeon, Gyeongju and five cases in Gigye-myeon, Pohang. We selected a control group from people in the same village with similar age, sex, driving history and education. Results: The study group contained 9 accidents and 36 non-accidents. Power tillers with reflective light were 32 cases (72.7%) of 44 cases (excluded one case due to death). Of those, the status of reflective light was 'clean' in 18 cases (56.3%). The recognition that reflective light can prevent accidents was 'Yes' in 26 cases of 44 cases (59.1%). The recognition of the 'campaign to attach reflective lights' to power tillers was 'Yes' in 38 cases of 44 cases (86.4%). The recognition about the safety regulation of driving power-tillers was 'Yes' in 32 cases of 44 cases (72.7%). Odds ratio of traffic accidents for no reflective light was 7.00 (95% CI: 1.06-58.37). Conclusions: Although the 'campaign to attach reflective lights' to power tillers are going on, its effectiveness may unknown. Therefore, more extensive epidemiologic study is needed into the relationship between reflective light and power tiller traffic accidents, with effective administration of the government and the attention of medical persons.

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Analysis of neonatal sepsis in one neonatal intensive care unit for 6 years (최근 6년간 단일 신생아중환자실에서 발생한 패혈증 환자의 분석)

  • Chun, Peter;Kong, Seom-Gim;Byun, Shin-Yun;Park, Su-Eun;Lee, Hyung-Du
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.495-502
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    • 2010
  • Purpose : Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm. The objective of this study was to analyze the incidence rate, causative pathogens and clinical features of neonatal sepsis in one neonatal intensive care unit (NICU) for 6 years. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics including sex, gestational age, birth weight, Apgar score, length of hospitalization, length of total parenteral nutrition, presence of central venous catheter, underlying diseases, laboratory findings, microorganisms isolated from blood culture, complications and mortality in 175 patients between January 2003 and December 2008. Results : 1) Sepsis was present in 175 of 3,747 infants for 6 years. There were more gram-positive organisms. 2) The gram-negatives were more prevalent in preterm. There were no significant differences of other clinical features between two groups. 3) Underlying diseases were found in 73.7%, and the most common disease was cardiovascular disease. The most common organisms of gram-positives and gram-negatives were methicillin resistant Staphylococcus aureus (MRSA) and Serratia marcescens. 4) There was statistically significant difference on platelet counts between two groups (P<0.05). 5) Complications were found in 18.3% and septic shock was the most common. MRSA was the most common pathogen in sepsis with complication. 6) The mortality rate was 7.4%. 7) There were differences in monthly blood stream infection/1,000 patient-days. Conclusion : The studies about the factors that can influence neonatal sepsis will contribute to decrease the infection rates in NICUs.

A Study on Patterns of Sap Water Users of Acer mono (고로쇠나무 수액(樹液) 이용객(利用客)의 음용형태(飮用形態)에 관(關)한 연구(硏究))

  • An, Jong Man;Kim, Jun Sun;Kang, Hag Mo
    • Journal of Korean Society of Forest Science
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    • v.87 no.4
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    • pp.510-518
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    • 1998
  • This study was carried out to investigate the drinking patterns of sap water of Acer mono by on-the-spot visitors. The survey was done from late-February to mid-March in the 3 major sap water tapping regions, such as Piagol of Mt. Chiri in Kurey, Okryong of Mt. Baekun in Kwangyang, and Mt. Chokey in Sunchon, Chonnam. A total of 300 visitors over 20 years old, 100 visitors in each region, were interviewed personally to make up questionnaires, irrespective of sex. The purpose of drinking, the frequency of visit, the modes of traffic, the length of stay, drinking amount per person, one's opinions after drinking, drinking plans and patterns, and intention of drinking processed sap were investigated and examined. Wide range of age groups from twenties to sixties drank sap water. Visitors drank sap water in order to keep health, to promote mutual friendship, and so on. 44% of sap drinkers visited for the first time, and 71% visited by private automobiles holding the first place. 59.7% of visitors spent only a day, but 40.3% passed one or two nights to drink sap water. For drinking amount of sap water, $3-6{\ell}$ a was consumed by 31.3% of visitors, under $3{\ell}$ or $9-12{\ell}$ by 22.7% $6-9{\ell}$ by 12.7% and so forth. 74% of visitors felt sap water sweet and favorable, but were doubtful about the efficacy of sap water. 79.0% of visitors had a plan to drink sap water again next year, 40% of whom preferred a day's visit to overnight staying (29%) or 3 days' staying (6%). 45% answered to plan to drink sap water with having meals, and 43% with having meals and passing a night. More than half (54.3%) of the visitors were inclined not to drink processed sap water for the reasons of unreliable quality, unwillingness for process, change in quality, etc.

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Interrelationship of Tension-type Headache and Oral Parafunction (긴장성 두통과 이갈이 습관의 상호관계)

  • Huh, Ki-Hwei;Kim, Jin-Suk;Hong, Jung-Pyo;Chun, Yang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.79-85
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    • 2005
  • This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. 1. There was no difference in sex(p=0.91) and age(p=0.73) between two groups. 2. In the experimental group, dull pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.69). 3. In the experimental group, severe pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.40). 4. In the experimental group, pain shown bilaterally was presented more frequently than in the control group. But, there was no difference between two groups(p=0.52). 5. In the experimental group, pain was more increased by physical activities than in the control group. But, there was no difference between both groups(p=0.74). The pain of TTH patients with OPF was presented to be non-dull pain frequently and more bilaterally and severely, also increased more by physical activities than the pain of TTH patients without OPF. But, there was no significant difference between two groups. Therefore, it is considered that the pain of TTH is not influenced by OPF.

Comparison of Acute Symptoms Between a Alpine Agricultural Workers and General Workers in Gangwon-do (강원도 일부지역 고랭지 농업 농민과 일반 농업 농민의 농약중독 증상 비교)

  • Song, Jae-Seok;Park, Woong-Sub;Kwak, Yeon-Hee;Seo, Jong-Chul;Choi, Hong-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.29-37
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    • 2003
  • Objectives: This study was performed to evaluate the pesticide exposure status and acute pesticide poisoning symtoms among agricultural workers at Gangwon-do province alpine area. Alpine area was defined as the area higher than 400m. Methods: We analyzed 257 interviwed questionnaire about pesticide exposure, acute pesticide poisoning symptoms and other variables. Results: The result was shown that agricultural workers at alpine area used more pesticide than general agricultural workers for annual usage days(35.9 days vs 14.4 days), daily usage hours(6.7 hrs vs 2.8hrs, p<0.05). But there was no difference between general and alpine agricultural worker's herbicide exposure. Moreover, the alpine agricultural worker's acute pesticide poisoning symtom score was higher than general agricultural worker's. These difference was also found at result of regression analysis, under control the age, sex, monthly income. Most frequently suffered symptom was headache and dermatological problems. The symptom prevalence of dermatological problem, headache, general weakness, eye irritation, nausea were higher among alpine agricultural workers than general agricultural workers. Conclusions: As a result, agricultural workers at alpine area were more exposed to pesticide and suffered from pesticide poisoning symptoms. To prevent the symptoms and disease from pesticide exposure among agricultural workers at alpine area, more research and political effort will be needed.

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