A Clinicostatistical Study of Congenital Alimentary Tract Obstruction

Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.

A Clinicostatistical Study of Congenital Alimentary Tract Obstruction

Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.

Monotest Compared to Standard PPD, 5TU, Mantoux Test

The Monotest was compared with the Mantoux test. A total of 404 primary school children were subjected to test. Each child was innoculated simultaneously to one side arm with purified protein derivative (PPD, 5TU) and to the another side arm with Monovacc(Institut Merieux). Results from each test were read seperately 72 hours after administration. When induration of 2mm or greater was considered a positive Monotest reaction and compared to a positive Mantoux reaction of 10mm or greater, the sensitivity of Monotest to Mantoux test was 91.56% and the specificity was 71.85%. When induration of 5mm or greater was considered a positive Monotest reaction and compared to a positive Mantoux reaction of 10mm or greater, the sensitivity of Monotest to Mantoux test was 42.77% and the specificity was 94.53%. From these results I would assume that the Monotest can be substituted for Mantoux test (PPD, 5TU) as screening test, preferably 2mm or greater induration of Monotest is considered as a positive result. All children with doubtful or positive reactions to a Monotest should be retested using the Mantoux technique because of relative high false positive rate.

Ketogenic Diet Trial for The Treatment of Minor Motor Seizures

A 3-years-old girl, diagnosed as infantile spasm and 5-years-old boy, diagnosed as akinetic seizure were subjected to ketogenic diet trial because of their poor responses anticonyulsant treatment After adding ketogenic diet trial, in the former infantile spasm case, her seizures were controlled satisfactorily and in the latter akinetic seizure case, the frequency of seizures decreasd fairly. It seemed to be beneficial to add kotogenic diet the anticonvulsant therapy for the treatment of minor motor seizure children. We report these results with some discussion and a brief review of related literature