A Clinical Analysis of Intussusception in Infants and Children

PURPOSE: Intussusception is a very common pediatric problem and needs early management. This study evaluated the risk factors of intussusception in infants and children for early diagnosis and treatment. METHODS: 216 cases of pediatric intussusception occurring between 1993 and 1999 in Mokpo Catholic Hospital were investigated retrospectively. 164 patients treated with barium reduction comprised the barium reduction (BR) group and 52 patients treated with manual reduction or bowel resection was operation (OP) group. RESULTS: The age incidence under 1 year old was 108 patients (65.9%) in BR group, 45 patients (86.5%) in OP group. Male to female ratio was 1.8:1 in BR and 1.7:1 in OP, respectively. In the seasonal distribution spring was more common in both group (34.1%, 34.6%). 60.4% in BR group, 76.9% in OP group were revealed leukocytosis above 10.000/mm3 in serum. Previous combined diseases were upper respiratory infection (31.7%, 42.3%), acute gastroenteritis (1.2%, 1.9%) and multiple familial polyposis (0.5% in BR group). The frequent symptoms and signs were bloody stool (86.0%,92.3%), abdominal pain and irritability (86.6%, 82.7%), vomiting (76.9%, 67.3%), and abdominal mass (56.7%, 76.9%). Tachycardia was 12.2% in BR and 44.2% in OP. In plain abdominal radiography, intestinal obstructive pattern was present in 5.5% of BR group and 53.8% of OP group. Success rate of barium reduction within 24 hours after symptom appearance was 82.3%. Within 24-48 hours was 61.1%, above 48 hours was 25%. There was a statistically significant difference between BR group and OP group of patients under 1 year old, with tachycardia, symptoms for longer than 48 hours and obstructive pattern on plain abdominal radiography (p<0.05). Of surgical cases, 84.6% were idiopathic. The common anatomical type was ileo-colic type (53.9%). The methods of operation were manual reduction (94.2%) and bowel resection (5.8%). Postoperative complications occurred in 4 cases; 3 cases of wound infection and 1 case of pulmonary complication. Recurrence rate was 12.8% in BR group. CONCLUSION: Risk factors of high incidence such as under 1 year old, severe obstructive pattern on the plain abdominal radiograph, symptoms for longer than 48 hours, and tachycardia, were related with a low success rate of barium reduction. Therefore, a gentle barium enema is recommended in high risk patients for diagnosis and prompt surgical intervention.

A Clinical Analysis of Thyroid Tumor

BACKGROUND: Malignant thyroid tumors may mimic the clinical symptoms and signs of a non-malignant tumor in the early course of the disease. The choice of the treatment modality for a thyroid tumor can be based on exact interpretation of FNAC (fine needle aspiration cytology) and frozen section. METHODS: We have experienced 237 cases of thyroid tumors during the past ten years at St. Columban hospital. From September 1988 to August 1998, subjects were selected and a retrospective study was done. RESULTS: (1) Of the 237 cases in this study, 194 had non-malignant lesions and 43 had malignant lesions, a ratio of 4.5:1. (2) The female to male ratio was 9.2:1 with non-malignant lesions (female: 195/male: 19) and 9.8:1 with malignant lesions (female: 39/male: 4). (3) The age distribution was the 4th to the 6th decades, regardless of the nature of the lesions. (4) The duration of disease was within 3 months with 42.2% of subjects, and 71.8% of subjects came within first year of disease, regardless of the nature of lesions. (5) Thyroid function tests showed no abnormality with most of the patients, regardless of the nature of lesions. (6) Fine needle aspiration cytology biopsy showed a sensitivity of 32.7%, a specificity of 100%, and an accuracy of 90.8%, and revealed preoperative diagnostic validity. (7) Ultrasonography of the neck, showed a sensitivity of 32.7%, a specificity of 88.1%, and an accuracy of 77.4%, and had no diagnostic value. (8) With benign lesions, adenomatous goiters were most common (96 cases), and with malignant lesions papillary carcinomas were predominant (36 cases). CONCLUSIONS: FNAC and frozen section are valuable preoperative and intraoperative diagnostic tool for thyroid tumors.

Atmospheric Concentration of Heavy Metals of Pusan Area / 예방의학회지

This study was carried out to assess the present level of atmospheric metals. Five metals-lead, cadmium, chromium, manganese, vanadium-were checked on the industrial(Sasang) and residental area(Daeshindong) in the city of Pusan sampling period was the year of 1986, 1990, and 1994, and the sampling time was 2 days of each site. As the result of comparison with the atmospheric standard of ASHRAE(1980) the average concentrations of lead was above the standard, the average concentrations of chromium was around the standard, and the average concentrations of cadmium and vanadium was below the standard. The average concentrations of manganese was above the standard of industrial environment. And the average concentrations of five metals was higher in the industrial area than the residental area The average concentrations of lead cadmium and chromium showed the increase tendency by the year, and the average concentrations of vanadium showed no change, and the average concentrations of manganese showed the decrease tendency. As a result of correlation analysis, lead and cadmium(r=0.31), vanadium and manganese(r=0.24), vanadium and chromium(r=0.19) showed significance.

Hearing loss in Vogt-Koyanagi-Harada syndrome / 대한이비인후과학회지

No abstract available.