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오정탁,최재영,박국인,Oh, Jung-Tak,Choi, Jae-Young,Park, Kook-In 대한소아외과학회 2007 소아외과 Vol.13 No.1
The use of subcutaneously tunneled, cuffed central venous catheters like Broviac's or Hickman's has increased and complications related to catheter removal has also increased. However, there are only few reports of complications that occur at the time of removal. The authors report an unusual case of catheter fracture during removal of Broviac catheter.
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오정탁,김대연,김성철,김인구,김해영,김현영,남소현,박귀원,박우현,박진영,서정민,이남혁,이명덕,이석구,이성철,정상영,정성은,정재희,최금자,최순옥,최승훈,최윤미,한석주,홍정,Oh, J.T.,Kim, D.Y.,Kim, S.C.,Kim, I.K.,Kim, H.Y.,Kim, H.Y.,Nam, S.H.,Park, K.W.,Park, W.H.,Park, J.Y.,Seo 대한소아외과학회 2013 소아외과 Vol.19 No.1
The Korean Association of Pediatric Surgeons (KAPS) performed the second nationwide survey on biliary atresia in 2011. It was a follow-up study to the first survey, which was performed in 2001 for the retrospective analysis of biliary atresia between 1980 and 2000. In the second survey, the authors reviewed and analyzed the clinical data of patients who were treated for biliary atresia by the members of KAPS from 2001 to 2010. A total of 459 patients were registered. Among them, 435 patients primarily underwent the Kasai operation. The mean age of patients who underwent the Kasai operation was $66.2{\pm}28.7$ days, and 89.7% of those patients had type III biliary atresia. Only five patients (1.4%) had complications related to the Kasai operation. After the Kasai operation, 269 (61.8%) of the patients were re-admitted because of cholangitis (79.9%) and varices (20.4%). One hundred and fifty-nine (36.6%) of the patients who underwent the Kasai operation subsequently underwent liver transplantation. The most common cause of subsequent liver transplantation was persistent hyperbilirubinemia. The mean interval between the Kasai operation and liver transplantation was $1.1{\pm}1.3$ years. Overall the 10-year survival rate after the Kasai operation was 92.9% and the 10-year native liver survival rate was 59.8%. We had 23 patients for primary liver transplantation without the Kasai operation. The mean age patients who underwent primary liver transplantation was $8.6{\pm}2.9$ months. In summary, among the 458 Kasai-operation and liver-transplantation patients, 373 lived, 31 died, and 54 were unavailable for follow up. One-third of the patient who survived have had complications correlated with biliary atresia. In comparison with the first survey, this study showed a higher survival rate and a greater number of liver transplantation.
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오정탁,한애리,손석우,최승훈,한석주,황의호,양우익,Oh, Jung-Tak,Han, Ai-Ri,Son, Suk-Woo,Choi, Seung-Hoon,Han, Seok-Joo,Hwang, Eui-Ho,Yang, Woo-Ick 대한소아외과학회 2001 소아외과 Vol.7 No.1
The pathophysiology of Hirschsprung's disease (HD) is not fully understood, but recent studies have disclosed that neural cell adhesion molecule (NCAM) and glial cell line-derived neurotrophic factor (GDNF) play important roles in the formation of aganglionic bowel of Hirschsprung's disease. To evaluate the roles of NCAM and GDNF in HD, immunohistochemical analysis was performed using formalin-fixed and paraffin-embedded tissue sections. On the basis of the results, we tried to evaluate them as diagnostic markers. The specimens were obtained from 7 patients with HD who underwent modified Duhamel operation. The diagnosis was based on the clinical findings and the absence of ganglion cells in the nerve plexuses by routine microscopy. NCAM immunoreactivity was found in the nerve plexuses and scattered nerve fibers in the smooth muscle layers of ganglionic segments. In aganglionic segments, the number of NCAM positive nerve fibers in the smooth muscle layers was significantly reduced compared with ganglionic segments. In two cases the nerve plexuses in aganglionic segments, NCAM was negligible. The smooth muscle cells showed diffuse immunoreactivity for GDNF and the staining intensity was not different in the aganglionic and ganglionic segments. However, higher expression of GDNF in the nerve plexus of the ganglionic segments was noted comparing to aganglionic segments. These data suggest that both NCAM and GDNF may play important roles in pathogenesis of Hirschsprung's disease and immunohistochemical staining for NCAM can be used as an ancillary diagnostic tool for HD.
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Second Serial Transverse Enteroplasty Procedure in an Infant with Extreme Short Bowel Syndrome
오정탁,고홍,Eun Young Chang,장혜경,한석주 대한의학회 2012 Journal of Korean medical science Vol.27 No.6
The serial transverse enteroplasty (STEP) procedure is a novel technique to lengthen and taper the bowel in patients with short bowel syndrome. The advantages of STEP include not only technical ease and simplicity, but also the ability to repeat the procedure. Herein,we report a case of extreme short bowel syndrome that was successfully treated by the second STEP procedure. A 3-day old newborn girl underwent STEP because of jejunal atresia with the small bowel length of 15 cm, but her bowel elongation was not enough to escape from short bowel syndrome. At the age of 6 months, she underwent a second STEP procedure. The bowel lengthening by the second STEP made her tolerable to enteral feeding with body weight gain and rescued her from short bowel syndrome. This case showed that second STEP is very helpful in treatment of extreme short bowel syndrome.
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