• Title/Summary/Keyword: General Surgery

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Clinical Evaluation of Tissue Biopsy for Children with Neck Mass; A Single Center Study (조직검사를 시행한 소아 경부 종류의 임상적 고찰 : 단일 기관 연구)

  • Youn, You Sook;Yun, Hye Won;Kim, Sun Young;Sul, Ji Yeong;Song, Chang Jun;Kim, Jin Man;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.839-845
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    • 2005
  • Purpose : Neck masses, in pediatric population, derive from a multitude of congenital, inflammatory, or neoplastic diseases. The majority of these masses represent benign conditions. However, thorough clinical evaluation is required to rule out malignant diseases. We evaluated the causes, clinical characteristics and outcomes of children with neck masses who underwent tissue biopsy. Methods : A total of 28 medical records of children with neck mass who underwent tissue biopsy at Chungnam National University Hospital, from January 2000 to March 2004 were retrospectively analyzed. The methods of biopsy were ultrasonography guided core biopsy(CB), fine needle aspiration biopsy(FNAB) and excisional biopsy. Results : Out of 28 patients, half were boys. The most common location of the mass was the posterior cervical area(N=19, 67.9%). Laboratory findings of peripheral blood and serologic studies were nonspecific. In 25(89.3%) cases, CB or FNAB was initially performed for neck masses. Among them 10 cases(40%) were reactive hyperplasia, 8(32%) inflammatory granulation tissues, 4(16%) necrotizing lymphadenitis, and 3(12%) acute suppurative inflammations. Initially, excisional biopsy was performed for diagnosis in 3(10.7%) cases. Diagnosis of these cases was thyroglossal duct cyst, dermoid cyst and lymphoblastic lymphoma, respectively. Conclusion : Most neck masses in children were benign. CB and FNAB were safe methods for tissue sampling, without need for general anesthesia.

Clinical Survey of Cesarean Section (제왕절개술에 대한 임상적 고찰)

  • Kim, Jae-Wung;Lee, Young-Gi;Kim, Jong-Wook;Lee, Tae-Hyung;Park, Wan-Seok;Lee, Sung-Ho;Chung, Wun-Yong
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.249-260
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    • 1986
  • Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows : 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent(60.2%). 3. The most common indications for cesarean section were previous cesarean section(30.2%), CPD (26.9%), Malpresentation(22.7%), and fetal distress(3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion(31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499gm was the most prevalent(39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most(97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7%. Among the causes of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin, and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased(44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbity of lower segment transverse cesarean section was the least(14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.

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Effect of Ischemic Preconditioning on the Oxygen Free Radical Production in the Post-ischemic Reperfused Heart

  • Park, Jong-Wan;Kim, Young-Hoon;Uhm, Chang-Sub;Bae, Jae-Moon;Park, Chan-Woong;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.30 no.3
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    • pp.321-330
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    • 1994
  • The protective effect of 'ischemic preconditioning (PC)' on ischemia-reperfusion injury of heart has been reported in various animal species, but without known mechanisms in detail. In an attempt to investigate the cardioprotective mechanism of PC, we examined the effects of PC on the myocardial oxidative injuries and the oxygen free radical production in the ischemia-reperfusion model of isolated Langendorff preparations of rat hearts. PC was performed with three episodes of 5 min ischemia and 5 min reperfusion before the induction of prolonged ischemia (30 min)-reperfusion(20 min). PC prevented the depression of cardiac function (left ventricular pressure x heart rate) observed in the ischemic-reperfused heart, and reduced the release of lactate dehydrogenase during the reperfusion period. On electron microscopic pictures, myocardial ultrastructures were relatively well preserved in PC hearts as compared with non-PC ischemic-reperfused hearts. In PC hearts, lipid peroxidation of myocardial tissue as estimated from malondialdehyde production was markedly reduced. PC did not affect the activity of xanthine oxidase which is a major source of oxygen radicals in the ischemic rat hearts, but the myocardial content of hypoxanthine (a substrate for xanthine oxidase) was much lower in PC hearts. It is suggested from these results that PC brings about significant myocardial protection in ischemic-reperfused heart and this effect may be related to the suppression of oxygen free radical reactions.

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Experimental Study on the Effects of Ovariectomy and Estrogen on the Bone Pattern of Mandible in Rats (난소적출과 에스트로젠 투여가 백서의 하악골 구조에 미치는 영향)

  • Lee, Hyung-Soon;Hong, Sung-Gyu;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.83-94
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    • 1999
  • The purpose of this study was to evaluate the changes of cancellous and cortical bone and the effect of estrogen in ovariectomized rats. Fifty female rats, 250gm in body weight, were divided into three groups : ovariectomized group(OVE), ovariectomized and estrogen-injected group(OVE-EST), and sham operated and estrogen-injected group(EST). Bilateral ovariectomy was performed at the onset of the experiment. In OVE-EST group and EST group, estrogen was injected $50{\mu}g/kg$ B.W. every other days from 3 weeks after surgery to sacrifice. Each five rats were sacrificed after 5, 6, 7 weeks. One side of mandibular body was radiographed with a soft x-ray apparatus(Hitex Co., Ltd., Japan). Thereafter the obtained microradiographs were used for the morphometric analysis using a Image analyzer. The morphometric analysis was perforrmed for parameters such as total bone area, cortex bone area and medullary bone area. The other side of the mandibular bone was decalcified and embedded in paraffin as using a general method. The specimens were sectioned and stained with Mallory's anilline blue and observed light microscopically. The results were as follows. 1 In all groups, the proportion of cortex to total bone area was not significantly different. 2. In ovariectomized(OVE) group, the proportion of marrow cavity to medullary bone area increased significantly from 5 to 7 weeks(p<0.05). In ovariectomized and estrogen-injected(OVE-EST) group, it decreased significantly at 7 weeks, and in estrogen-injected(EST) group, it decreased significantly from 6 weeks(p<0.05). 3. Microradiogram and histopathologic findings revealed that marrow cavity was enlarged and osteoclasts were observed around irregular bone surface in OVE group. In OVE-EST group, the size of marrow cavity at 7 weeks was similar to that of control group. In EST group, as dense trabecular bone increased from 5 to 7 weeks, marrow cavity decreased.

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The Early Prognosis of Burn Patients with Elevated Initial Arterial Carboxyhemoglobin Level (초기 동맥혈 Carboxyhemoglobin 농도가 높았던 화상 환자들의 예후지표에 관한 연구)

  • Choi, Chang Soon;Kim, Cheal Hong;Kim, Keun Sook;Lee, Tae-Yu;Chung, Youn Son;Eom, Kwang Seok;Park, Young Bum;Jang, Seung Hun;Kim, Dong Gyu;Park, Myung Jae;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Jong Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.188-197
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    • 2003
  • Background : Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. Methods : Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. Results : COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were $16.6{\pm}17.8%$ and $60.7{\pm}28.8%$ (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. Conclusion : Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.

Urokinase Plasminogen Activator Receptor Gene Expression and Clinico-Pathologic Feature in Gastric Cancer Patients (위암 환자의 Urokinase Plasminogen Activator Receptor 유전자의 발현양상)

  • Kim Yong Gil;Lee Kyung Hee;Kim Min Kyung;Lee Jae Lyun;Hyun Myung Sue;Kim Sang Hun;Kim Hee Sun
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.207-212
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    • 2004
  • Purpose: Invasion and metastasis in solid tumors require the action of tumor-associated proteases. The serine protease urokinase-type plasminogen (uPA) and receptor (uPAR) appear to have a major function in these processes. Expression of the uPAR is elevated in breast and colon carcinomas, and this is often associated with invasiveness and poor prognosis. The purpose of this study was to determine whether the expression of the uPAR gene correlates with clinico-pathological parameters in human gastric carcinomas. Materials and Methods: We examined the expression of uPAR mRNA by using northern blot analysis and RT-PCR in 35 gastric carcinomas and the surrounding normal mucosa. Macroscopic and histopathological tumor findings and survival rates were obtained from the patient records and from endoscopic, surgical, and pathological reports. Results: The expression of uPAR and was higher in most neoplasms than in the corresponding normal mucosal tissue. uPAR mRNA expression in tumors correlated well with lymph-node metastasis (P<0.02) and tumor stage (P<0.01). The survival rate of patients with tumors displaying high uPAR expression levels was significantly lower (P<0.04) than that of patients without uPAR expression, but IL-8 showed only the tendency of survival difference. Conclusion: These results suggest that uPAR may be an important prognostic factor in human gastric carcinomas.

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Review of Anti-Leukemia Effects from Medicinal Plants (항 백혈병작용에 관련된 천연물의 자료조사)

  • Pae Hyun Ock;Lim Chang Kyung;Jang Seon Il;Han Dong Min;An Won Gun;Yoon Yoo Sik;Chon Byung Hun;Kim Won Sin;Yun Young Gab
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.3
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    • pp.605-610
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    • 2003
  • According to the Leukemia and Lymphoma Society, leukemia is a malignant disease (cancer) that originates in a cell in the marrow. It is characterized by the uncontrolled growth of developing marrow cells. There are two major classifications of leukemia: myelogenous or lymphocytic, which can each be acute or chronic. The terms myelogenous or lymphocytic denote the cell type involved. Thus, four major types of leukemia are: acute or chronic myelogenous leukemia and acute or chronic lymphocytic leukemia. Leukemia, lymphoma and myeloma are considered to be related cancers because they involve the uncontrolled growth of cells with similar functions and origins. The diseases result from an acquired (not inherited) genetic injury to the DNA of a single cell, which becomes abnormal (malignant) and multiplies continuously. In the United States, about 2,000 children and 27,000 adults are diagnosed each year with leukemia. Treatment for cancer may include one or more of the following: chemotherapy, radiation therapy, biological therapy, surgery and bone marrow transplantation. The most effective treatment for leukemia is chemotherapy, which may involve one or a combination of anticancer drugs that destroy cancer cells. Specific types of leukemia are sometimes treated with radiation therapy or biological therapy. Common side effects of most chemotherapy drugs include hair loss, nausea and vomiting, decreased blood counts and infections. Each type of leukemia is sensitive to different combinations of chemotherapy. Medications and length of treatment vary from person to person. Treatment time is usually from one to two years. During this time, your care is managed on an outpatient basis at M. D. Anderson Cancer Center or through your local doctor. Once your protocol is determined, you will receive more specific information about the drug(s) that Will be used to treat your leukemia. There are many factors that will determine the course of treatment, including age, general health, the specific type of leukemia, and also whether there has been previous treatment. there is considerable interest among basic and clinical researchers in novel drugs with activity against leukemia. the vast history of experience of traditional oriental medicine with medicinal plants may facilitate the identification of novel anti leukemic compounds. In the present investigation, we studied 31 kinds of anti leukemic medicinal plants, which its pharmacological action was already reported through many experimental articles and oriental medical book: 『pharmacological action and application of anticancer traditional chinese medicine』 In summary: Used leukemia cellline are HL60, HL-60, Jurkat, Molt-4 of human, and P388, L-1210, L615, L-210, EL-4 of mouse. 31 kinds of anti leukemic medicinal plants are Panax ginseng C.A Mey; Polygonum cuspidatum Sieb. et Zucc; Daphne genkwa Sieb. et Zucc; Aloe ferox Mill; Phorboc diester; Tripterygium wilfordii Hook .f.; Lycoris radiata (L Her)Herb; Atractylodes macrocephala Koidz; Lilium brownii F.E. Brown Var; Paeonia suffruticosa Andr.; Angelica sinensis (Oliv.) Diels; Asparagus cochinensis (Lour. )Merr; Isatis tinctoria L.; Leonurus heterophyllus Sweet; Phytolacca acinosa Roxb.; Trichosanthes kirilowii Maxim; Dioscorea opposita Thumb; Schisandra chinensis (Rurcz. )Baill.; Auium Sativum L; Isatis tinctoria, L; Ligustisum Chvanxiong Hort; Glycyrrhiza uralensis Fisch; Euphorbia Kansui Liou; Polygala tenuifolia Willd; Evodia rutaecarpa (Juss.) Benth; Chelidonium majus L; Rumax madaeo Mak; Sophora Subprostmousea Chunet T.ehen; Strychnos mux-vomical; Acanthopanax senticosus (Rupr.et Maxim.)Harms; Rubia cordifolia L. Anti leukemic compounds, which were isolated from medicinal plants are ginsenoside Ro, ginsenoside Rh2, Emodin, Yuanhuacine, Aleemodin, phorbocdiester, Triptolide, Homolycorine, Atractylol, Colchicnamile, Paeonol, Aspargus polysaccharide A.B.C.D, Indirubin, Leonunrine, Acinosohic acid, Trichosanthin, Ge 132, Schizandrin, allicin, Indirubin, cmdiumlactone chuanxiongol, 18A glycyrrhetic acid, Kansuiphorin A 13 oxyingenol Kansuiphorin B. These investigation suggest that it may be very useful for developing more effective anti leukemic new dregs from medicinal plants.

Diagnostic Role of Tc-99m MIBI Scintimammography in Suspected Breast Cancer Patients: Results of Unicenter Trial (유방암이 의심되는 환자에서 Tc-99m MIBI 유방스캔의 진단적 역할: 단일기관의 결과)

  • Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki;Bae, Young-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.234-242
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    • 2000
  • Purpose: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostic usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary lymph node metastasis. Materials and Methods: This study included 305 patients who underwent scintimammogtaphy for palpable breast masses or abnormal radiologic findings. Tc-99m MIBI scintimammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or FNAB and compared with the results of Tc-99m MIBI scintimammography. Results: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one ($2.44{\pm}0.97\;vs\;1.94{\pm}0.78$, p=0.01). Delayed L/N had no significant difference between malignant and benign breast diseases ($1.94{\pm}0.52\;vs\;1.91{\pm}0.73$, p=0.43). Conclusion: Our study revealed that Tc-99m MIBI scintimammography was an useful diagnostic tool for the diagnosis of breast cancer. And early L/N ratio might provide complementary role in the detection of breast cancer. But the Tc-99m MIBI scintimammography had limited value in the detection of small breast cancer (less than 1 cm) and axillary lymph node metastasis.

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Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

  • Li, Xing;Dong, Min;Wen, Jing-Yun;Wei, Li;Ma, Xiao-Kun;Xing, Yan-Fang;Deng, Yun;Chen, Zhan-Hong;Chen, Jie;Ruan, Dan-Yun;Lin, Ze-Xiao;Wang, Tian-Tian;Wu, Dong-Hao;Liu, Xu;Hu, Hai-Tao;Lin, Jia-Yu;Li, Zhuang-Hua;Liu, Yuan-Chao;Xia, Qing;Jia, Chang-Chang;Wu, Xiang-Yuan;Lin, Qu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6311-6316
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    • 2015
  • Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.

A Comparative Analysis of Clinical Features and Treatment Outcomes of Intussusception according to Age Distribution (연령에 따른 장중첩증의 임상양상 및 치료에 대한 비교분석)

  • Park, Bum Chul;Kim, Seok Young;Jung, Su Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.150-156
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    • 2005
  • Purpose: We divided the children diagnosed with intususception into three different age groups and compared the clinical symptoms and treatment outcomes in order to analysis diagnosis and treatment of Intusussception. Methods: A retrospective chart review was established of 159 patients diagnosed with intussuception who had been admitted to Department of Pediatrics and General Surgery, Bundang CHA hospital from January, 2000 to May, 2004. We divided the patients into three groups, according to their age. Those who were under five months of age (group I; 21 patients), those between 5~11 months of age (group II; 61 patients), and those older than 11 months of age (group III; 77 patients). Then we compared the age, sex, seasonal distribution of occurrence, the cause, the clinical features, radiologic review, the type of intusussception, surgical methods, recurrence rate and treatment outcomes, among these three groups. Results: On comparing the clinical symptoms and signs among the three groups, the most common major clinical symptom and sign was irritabiltity in all three groups. Vomiting with irritability was statistically more common in group I (p<0.05) and bloody stool was most frequent in group III. The average time taken until a diagnosis was made after the symptom onset was, 21 hours in group I, 20 hours in group II and 22 hours in group III. Which showed no significant difference. But there was a higher rate of delayed diagnosis in group I, which took over 48 hours until the diagnosis was made (group I; 23.8%, group II; 4.9%, group III; 7.8%). Simple abdominal X-rays showed more frequent instances of intestinal obstruction in group I (p<0.05). The primary treatment done was barium enema which showed a failure rate of 52.4% in group I, 26.2% in group II and 14.3% in group III. Showing the highest failure rate in group I. Conclusion: The youngest group had vague symptoms which lead to delayed diagnosis and more frequent surgical procedures. As so, we advocate the importance of further evaluation and close observation, considering intussusception in children with symptoms of irritability and vomiting, especially in the early infant group.

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