• Title/Summary/Keyword: 식도기형

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Seventeen Years' Experience with Ninety-six Esophageal Atresias (선천성 식도 폐쇄증 - 17년간의 96예 치험 분석 -)

  • Chun, Yong-Soon;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.140-148
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    • 1995
  • To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

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Normal Esophageal Length in Korean Children; Correlation of the Esophageal Length with Height Measured by Flexible Endoscopy (국내 소아의 표준 식도 길이; 내시경으로 측정한 식도 길이와 신장의 상관관계)

  • Cho, Kang Ho;Ryoo, Eeell;Hong, Hee Ju;Son, Dong Woo;Tchah, Han
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.172-176
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    • 2005
  • Purpose: There have been a few data about esophageal length in children and previous data are improper for application to various procedures. Because of the variability in height and weight of each the individuals especially in children, measurable external parameters are needed. Methods: We measured distance from upper incisor to esophago-gastric junction using a flexible endoscope and compared these data with age, height and weight in 262 children who underwent upper gastrointestinal endoscopy. Results: The mean age was $9.0{\pm}3.6year$ (from 2 days to 16 year of age), mean height was $132.89{\pm}23.49cm$ and mean length from upper incisor to esophago-gastric junction was $33.34{\pm}5.42cm$. Correlation between distance from upper incisor to esophago-gastric junction and height was the mostly predictable indicator of the esophageal length (Pearson correlation=0.944). We propose a formula [Esophageal length=4.419+($0.218{\times}height$)] as a indicator of the esophageal length (p=0.000, $R^2=0.891$). Conclusion: The esophageal length in children and for application to various procedures can be reliably predicted by using the height.

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Treatment of 5 Branchial Cleft Fistulas with Chemical Cauterization (화학 소작술로 치료한 새성 기형 5례)

  • 연제엽;정지성;이동욱
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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    • pp.56-59
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    • 2003
  • Branchial cleft fistula is one of the most common congenital neck masses. Most of the branchial cleft fistula patients complain of reucrrent neck infection or abscesses even with appropriate previous treatment. The traditional treatment of these patients was agreed to be a complete surgical removal of whole fistula tract with infection control. However this surgical treatment has risks of injuring important major vessels o. nerves adjacent to the track and difficulties in dealing with previous recurrent infections and scars of previous procedures such as drainage or incomplete surgical excision. Today, obliteration of internal opening with chemical or electrical cauterization has been introduced as a new way of treating branchial anomaly with a less invasive procedure. In this article, we reports 5 cases of branchial anomalies treated with TCA(trichloroacetic acid) chemical cauterization.

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OBSERVATIONS ON EMBRYONAL DEVELOPMENT OF HUMAN LARYNX (사람 배아의 후두발달에 관한 형태학적 관찰)

  • Choi, Gun
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.13-13
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    • 1991
  • 후두는 호흡기가 시작되는 부위로 후두의 태생학적 연구는 타장기에서와 같이 정상 후두의 해부학적 이해, 후두 기형의 병인의 이해 및 치료에 기초 자료가 된다. 그러나 사람 배아의 후두 발생에 관한 연구는 재료확보가 용이하지 않고 해부학적 난이성으로 매우 드물다. 이에 저자는 사람 배아의 후두 발달을 연구하고자 배령이 확인된 20례의 배아(배령 4 주에서 8 주 까지)의 연속절편에서 광학현미경하에 후두 발달의 형태학적 관찰을 시행하여 다음과 같은 결과를 얻었다. 1. 배령 4 주에 median pharyngeal groove, laryngotracheal sulcus 와 tracheoesophageal septum 이 관찰되었다. 2. 배령 5 주에 hypopharyngeal eminence, epithelial lamina of larynx와 arytenoid swelling이 관찰되었다. 3. 배령 6 주에 hyoid condensation과 tracheoesophagealfistula가 관찰되었다. 4. 배령 7 주에 epiglottis 가 확인되었고 hyoid bone, thyroid lamina 와 cricoid cartilage 의 condensation 및 muscular condensation 이 관찰되었다. 5. 배령 8 주에 laryngeal cartilage의 chondrification과 ventricle이 관찰되었으며, vestibulotracheal canal과 pharyngotracheal canal 의 교통은 관찰되지 않았다.

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Stenosis of Individual Pulmonary Veins (개별 폐정맥의 협착)

  • Lee, Mira;Choi, Kil Soon;Kim, Nam Su;Yum, Myung Kul;Kim, Yong Joo;Sul, In Jun
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.610-614
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    • 2003
  • Pulmonary hypertension may be associated with variable conditions such as the hyperkinetic state or pulmonary vascular obstruction. In these, stenosis of the individual pulmonary veins without any cardiac or vascular malformation is very rare. We experienced stenosis of individual pulmonary veins in a 10 months old boy who was admitted with recurrent dyspnea and cyanosis and then underwent angiogram and a lung perfusion scan.

A CLINICAL STUDY ON TRACHEAL STENOSIS (기관협착증에 관한 임상적 고찰)

  • 정무권;조진생;안회영;차창일;유세영;박주철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.13.1-13
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    • 1987
  • 저자들은 1984년 12월 17일부터 1987년 2월 26일까지 경희대학교 의과대학 부속병원 이비인후과 및 흉부외과에서 경험한 9례의 기관협착증환자를 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 연령 및 성별분포는 여자 3례, 남자 6례이었고, 10세이하 3례, 10대 2례, 20대 2례, 40대 이상이 2례 이었다. 2) 원인은 지속적 기관내삽입관에 의한 경우가 4례이었고 1례는 선천성 혈관기형인 double aortic arch에 의해 기관이 눌리어 기도협착증상이 있었던 경우이었다. 상기관절개술에 의한 경우가 2례, 경부외상 1례, 기관내 종양 2례이었다. 3) 협착부위의 길이는 1.5cm에서 2cm까지가 4례로 가장 많았고 3cm이내가 2례, 4cm이내 1례, 6cm이내 1례이었다. 4) 치료는 보존적인 방법으로 내시경하에서 육아조직 및 반흔조직을 laser를 이용하여 제거한 후 silastic stent 혹은 Montgomery T-tube 삽입후 4주에서 6주후 제거하여 치료한 경우가 2례이었고 협착부위절제 및 단단문합술을 시행한 경우가 6례이었다. 1례에서는 aortic arch division을 시행하였다. 5) 예후는 9례중 단단문합술을 시행한 6례 그리고 보존적 방법으로 laser를 이용한 육아조직의 제거 및 지지물삽입을 시행한 3례에서 모두 현재까지 재발은 보이지 않고 있다. 6) 기관협착의 길이가 1.5cm에서 4cm까지의 경우에는 supralaryngeal release procedure없이 단단문합술을 시행하였고 협착길이가 6cm인 1례에서는 supralaryngeal release를 하여 tension없이 문합술을 시행할 수 있었다.

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Bleomycin Sclerotherapy of Lymphatic Maformation in Head and Neck (Bleomycin을 이용한 선천성 림프관기형의 경화요법)

  • 성명훈;장선오;정종우;김진영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.108-108
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    • 1993
  • Cystic hygroma is a congenital anomaly of the lymphatic system for which the exact pathogenetic mechanism remains to be elucidated. It is filled with lymphatic fluid and commonly present in the cervical area in either single isolated or multiple form. It is usually innocuous without any pain but may be life-threatening when it is large enough to compromise the airway or interfere with swallowing. Since spontaneous regressions rarely occur, it requires surgical removal. However, this may be rendered difficult in multiple forms and in those with extensive infiltration into the surrounding tissue. This is a presentation of 10 pediatric patients with cystic hygroma who have been successfully treated by sclerotherapy using bleomycin at the authors' department.

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Left Bronchoesophageal Fistula Misdiagnosed as Chronic Empyema Thoracis (만성 농흉으로 오진되었던 좌측 주기관지식도루 - 치험 1례 -)

  • 이두연;조현민;정은규;함석진;김상진;이응석
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.68-72
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    • 2002
  • Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.

DENTAL MANAGEMENT OF CHILDREN WITH CORNELIA DE LANGE SYNDROME (Cornelia de Lange Syndrome 환아의 치과 치료)

  • Baik, Byeong-Ju;Kim, Jae-Gon;Yang, Yeon-Mi;Park, Jong-Ha;Kim, Sung-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.120-125
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    • 2004
  • Cornelia de Lange syndrome is a disorder of unknown etiology resulting in an syndrome characterized by specific dysmorphic features. Therefore this syndrome is diagnosed only by clinical features and other examinations for diagnostic aim are not effective. There are general growth retardation, mental retardation, hypertrichosis, confluent eye brows, low hair line, broad nasal bridge, anteverted nose tip, malformed limbs, webbing of toes, heart defect, gastroesophageal reflux disease, ear and ocular problems. Features associated oral structures are micrognathia, delayed eruption of teeth, cleft lip, cleft plate, thin upper lip and downturned angles of mouth. These are cases about two children who visited Department of Pediatric Dentistry of Chonbuk National University because of dental caries with Cornelia do Lange syndrome.

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Derodidymus in Korean-Native Calf (한우 송아지의 이두이안체)

  • 강문일;박영석;한동운
    • Korean Journal of Animal Reproduction
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    • v.23 no.1
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    • pp.69-73
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    • 1999
  • A calf with derodidymus was delivered from a 3-year old Korean-native cow with abortion last ime at Jangheong area in Chonnam Province. The anomaly with body weight of 35 kg was born t the normal time of parturition. During the parturition, however, the calf with twin head was onfirmed and the complete amputation between fore and hind limb was inevitably carried out or safety of the dam. The calf had normal skeleton and extremities but had two heads and cervical vertebrae divided from upper thoracic part. At necropsy, there were found totally 3 pairs of ore limbs including two pairs of hypoplastic ones hided in the thoracic limb and also found one air of sternum. One head had incomplete torsion or unilateral hypoplasia of mandible with artly hypoplastic skull. There were marked fusion and torsion from cervical to 3rd thoracic vertebra. No abnormality was found on all organs in the pleural and abdominal cavities except a rectal stricture formed at 5 cm away from the atresia ani.

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