Lively Korean three: with Audio-CD(Paperback) (Korean variation)
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1 1 May 27 May Aug. Oct. 9 330 15 (-) ++ There were ten cases which needed to be differentiated from Hirschsprung's disease at their bedside (Table 1). These ten cases showed unexpected results; they demonstrated the absence of a recto anal reflex even though the bowels were nonaganglionic. Three of these were septic, and two cases were suggestive of disease similar to neuronal intestinal dysplasia (NID; Puri and Nixon 1977; Scharli and Meier-Ruge 1981) from the pathological findings. Other cases included diseases such as aplasia of the thyroid, sigmoidal stenosis after necrotizing enterocolitis, lower rectal stenosis after perforation of rectum, sacral meningocele, and severe chronic enterocolitis.
C'est pourquoi la frequence des contractions ne saurait constituer un parametre fiable pour identifier les patients atteints de la maladie de Hirschsprung. La manometrie conventionnelle montra un reflexe de reliichement recto-anal specifique chez 90% des enfants sains, ce pourcentage atteignant meme 98%, compte tenu des reflexes non specifiques. On note souvent des reflexes non specifiques chez les nouveaux-nes, du fait peut-Hre d'une constriction du canal anal encore peu prononcee. Si, pendant l'examen, il est procede 11 une injection intraveineuse de prostaglandine F2 alpha, les reflexes non specifiques se transforment en reflexes specifiques.
3. Typical rectoanal relaxation reflex in a child with Hirschsprung's disease 1 min Balloon distens ion - .. 1. _ 5ml - 5ml Fig. 4. Atypical rectoanal relaxation reflex by balloon test and absence of the reflex by cold water in a child with Hirschsprung's disease The balloon distension elicited a typical rectoanal relaxation reflex in two subjects (Fig. 3) and an atypical reflex in nine. The reflex, although atypical, was induced more frequently in the young children group than in the other two age groups and in patients with a colostomy more frequently than in those without it.
Active Korean 3: with Audio-CD