• Journal of Chest Surgery
• /
• v.34 no.11
• /
• pp.858-860
• /
• 2001

VATER is a complex anomaly of multiple organs and often combined with cardiac anomalies. However, it can be cured with active surgical intervention. We achieved successful result with aggressive surgery in the patient with VATER and report it with references.

• Advances in pediatric surgery
• /
• v.12 no.2
• /
• pp.175-182
• /
• 2006

VATER association is defined as a combination of 3 or more anomalies- vertebra (V), imperforate anus (A), esophageal atresia with or without tracheoesophageal fistula (TE), renal and radial anomaly(R). We reviewed our experiences in one center to determine etiology, prevalence, clinical manifestation, other associated anomaly and prognosis. Two hundred and twenty-three cases that underwent operations for imperforate anus or esophageal atresia were analyzed retrospectively through medical records at Department of Pediatric Surgery, Asan Medical Center from June, 1989 to July, 2005. The total number of neonates who had been admitted during period of study were 46,773 and VATER association was 9 (0.019 %, 1.92 persons per 10,000 neonates). Median gestational age and birth weight were $37^{+4}wk$ ($35^{+1}$ - $41^{+4}$) and 2,594 g (1,671-3,660), respectively and median age of mother was 32 years (23-38). There was no family history. Three patients were twins but their counterparts had no anomalies. Patients who have 3 anomalies were 6, 4 anomalies in two and 5 anomalies in one patient. Vertebra anomalies were detected in 7(77.7 %), imperforate anus in 8(88.9 %), esophageal atresia in 5 patients (55.6 %), renal anomaly in 6(66.7 %), and radial anomaly in 5(55.6 %), respectively. Four patients are alive, 2 patients were lost during follow up period. Three patients died due to neonatal sepsis, respiratory dysfunction and cardiac failure. VATER association did not appear to be a definite risk factor, but merely a randomized combination of 5 anomalies. The prognosis was dependent on the other associated anomalies, appropriateness of management and operation. Careful follow-up and aggressive treatmentare required for improving survival and quality of life.

• Journal of Korean Theatre Studies Association
• /
• no.40
• /
• pp.97-124
• /
• 2010

In Manpasikchok(die Welle $bes{\ddot{a}}nftigende$ und Friede stiftende $Zauberfl{\ddot{o}}te$) trift der Protagonist Chongsu im Traum seinen Vater, den er nach der Trennung $w{\ddot{a}}hrend$ des Koreakrieges nicht wiedergesehen hat. Sein Vater besucht das Grab seiner Mutter, die nach der Trennung 56 Jahre lang allein gelebt hatte. Die Vaterfigur in Manpasikchok, die Oh Taesok gestaltet hat, ist die Vater-Imago des Autors. Sein Vater ist $w{\ddot{a}}hrend$ des Krieges von den nordkoreanischen Soldaten nach Nordkorea geschleppt worden und kam nicht $zur{\ddot{u}}ck$. Manpasikchok ist ein Versuch, seinen Wunsch, mit seinem Vater, den er durch die Teilung Koreas nicht wieder sehen konnte, wiederzutreffen und endlich Friede zu $schlie{\ss}en$, auf der $B{\ddot{u}}hne$ zu verwirklichen. Die Vater-Imago in Manpasikchok bleibt aber nicht auf der bibliographischen Ebene, sondern erweitert sich zu einem Archetyp der nationalen Mythologie, indem sie mit dem Mythos Manpasikchok zusammengebunden wird. Dadurch wird das $St{\ddot{u}}ck$ zu einem Diskurs um die koreanische Wiedervereinigung erweitert. Oh ${\ddot{u}}berlegt$ sich in seinem $St{\ddot{u}}ck$ ${\ddot{u}}ber$ die $M{\ddot{o}}glichkeit$ des Zusammentreffens und der $Vers{\ddot{o}}hnung$ zwischen den $S{\ddot{u}}dund$ Nordkoreanern, die seit ${\ddot{u}}ber$ 50 Jahre lang in ganz anderem System gelebt haben. Das wird durch die Szene des Treffens des Protagonisten mit seinem Vater auf der $B{\ddot{u}}hne$ exemplarisch vorgezeigt. In Manpasikchok wird die Grundlage zur inneren Vereinigung vorbereitet. $Zun{\ddot{a}}chst$ wird aus der Sicht der Nordkoreaner die $s{\ddot{u}}dkoreanische$ Gesellschaft, die an Habgier verhaftet ist, kritisiert. Als Alternative dazu wird das Gewissen, das die Habgier korrigieren wird, vorgeschlagen. Durch die Dialoge der Nordkoreaner wird die Wichtigkeit der Kommunikation betont, die erst dann verwirklicht werden kann, wenn sich die $S{\ddot{u}}d$- und Nordkoreaner mit gegenseitigem Vertrauen treffen. Manpasikchok bietet eine $M{\ddot{o}}glichkeit$ der kulturellen Vereinigung, indem sich die Leute aus beiden Teilen Koreas trotz des Dialekts gut kommunizieren. $Dar{\ddot{u}}ber$ hinaus bindet Oh Taesok das Volksspiel aus Nordkorea Bukchong $L{\ddot{o}}wenspiel$ mit dem $s{\ddot{u}}dkoreanischen$ Puppenspiel zusammen und veranschaulicht die Vereinigung als eine Perfomance auf der $B{\ddot{u}}hne$.

• Journal of the Korean Home Economics Association
• /
• v.31 no.4
• /
• pp.53-66
• /
• 1993

Ausgangspunkt der Untersuchung ist der weltweite soziale Wandel der letzten Jahrzehnte und sein Einflu${\beta}$ auf die Entstehung und Charakteristiken junger Familien. Ein Ausdruck dieses generellen Wandels ist der Meinungswandel im Zusammenhang mit elterlichen Funktionen. Untersucht wurde, ob Rollenvorstellungen und die Beziehung der Eltern zueinander in einer bestimmten Phase des Familienlebens, n mlich w hrend des bergangs zur Elternschaft, unterworfen sind. Beurteilt wurden bergangseffekte im Vergleich von Ver nderungen bei Erst und Zweiteltern, die im Zusammenhang mit dem Baby aufgetreten sind. Dieses Vorgehen basierte auf der Annahme, da${\beta}$ bei Ersteltern st rkere Effekte auftreten als bei Zweiteltern. Die Ergebnisse basieren auf 130 s dkoreanishcen Erst-bzw. Zweiteltern die w hrend der Schwangerschaft(ca. 6 Monat) erstmals befragt wurden und auf verbliebenen 89 Elternpaaren, die sich an einer zweiten Befragung drei Monate nach der Geburt des Babys beteiligten. Die Ergebnisse der Untersuchungen haben gezeight, da${\beta}$ die koreanischen Erstv ter noch st rker als die Zweitv ter eine egalit re Elternrolle vor und nach der Geburt des Kindes bef rworten. Beim bergang zur Elternschaft kam es also nicht zu einer nderung in der traditionellen bzw. egalit ren Rolleneinstellung bei koreanischen Erst und Zweiteltern. Damit sind sowohl Ergebnisse zur Generativit t w hrend bei M ttern kein Unterschied erkennbar ist, zeigen sich die Erstv ter weniger konservativ als die Zwdeitv ter. Zusammenhang zwischen ehelicher Zufreidenheit und Partnerdifferenzen in Rolleneinstellungen wurde gefunden: Paare, bei denen die M tter st rker egalit r orientiert ist als die vater, besitzen niedrigere Werte in ehelicher Zufriedenheit.

• Advances in pediatric surgery
• /
• v.11 no.2
• /
• pp.171-174
• /
• 2005

Chronic duodenal obstruction related to a congenital web is a rare anomaly, and is sometimes difficult to diagnose preoperatively. A case of partial duodenal obstruction by a foreign body in a 10-year-old girl with a congenital duodenal web is presented. She had a year history of intermittent epigastric discomfort without nausea, vomiting or growth retardation. Upper gastrointestinal series and gastroduodenoscopy disclosed a perforated web in the 2nd portion of the duodenum and a dark go stone just proximal to the web. The web was partly excised through a longitudinal duodenotomy crossing over the web. The Ampulla of Vater was located at 7 o'clock on the posterior surface of the duodenal web and was preserved. The duodenum was closed in transverse fashion. In cases of a longstanding duodenal foreign body, a congenital web should be considered.

• Advances in pediatric surgery
• /
• v.20 no.2
• /
• pp.65-68
• /
• 2014

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

• Journal of Korean Traditional Oncology
• /
• v.28 no.1
• /
• pp.45-53
• /
• 2023

Objectives: To report the reduction of adverse effects of chemotherapy and improvement in the quality of life in recurrent liver metastasis by Korean medicine treatments. Methods: In 2018, a 75-year-old male patient underwent surgery for primary cancer in the ampulla of Vater. In 2021, he was diagnosed with recurrent liver metastasis. Following the failure of tumor treatment with gemcitabine/cisplatin and the development of severe side effects, he decided to discontinue chemotherapy. Subsequently, with a significantly enlarged liver tumor, he resumed capecitabine/oxaliplatin treatment, alongside moxibustion, acupuncture, and herbal prescriptions from August 2021 to August 2023. The changes of chief complaints, abdominal CT, and laboratory findings were investigated. Results: After combined treatment of Korean traditional medicine and chemotherapy, the mass was decreased. Laboratory findings, and chief complaints of hand-foot syndrome, fatigue, abdominal distension, nausea and anorexia were improved. Conclustions: This case study suggests that Korean traditional medicine is effective in enhancing anticancer effects, suppressing the side effects of chemotherapy, and improving general conditions.

• Advances in pediatric surgery
• /
• v.9 no.1
• /
• pp.6-11
• /
• 2003

This study reviews 14 years' experience treating esophageal atresia with special emphasis on the clinical profile and outcome. From May 1989 to February 2003, 65 cases of esophageal atresia (EA) were treated at Asan Medical Center. Boys outnumbered girls 2.4 to 1. Prematutity and low birth weight were 27.7% and 38.5%. Esophageal atresia with distal tracheoesophageal fistula (TEF) was the most common type (87.7%), followed by pure EA and H type fistula. Forty-six patients (70.8%) had one or more associated anomalies, cardiac malformations were the most common. Duodenal atresia was found in 7 cases. There were 6 patients (9.2 %) with VATER cluster. VACTERL cluster was present in 18 patients (27.7%), one of who fulfilled the complete syndrome. Waterston group A, B and C made up 21.5%, 40.0% and 38.5% of the total group. Surgical treatment was attempted in 63 patients and deferred in 2 who had severe associated malformations. For EA with distal TEF, primary esophago esophagostomy was carried out in 51 cases, and division of TEF and gastrostomy in 4 cases and no operation in 2 cases. For pure EA, colonic graft was done in 2 after gastrostomy and esophagostomy, and esophago esophagostomy was performed in 2 after gastrostomy. Two patients with pure EA are waiting for the second operation after gastrostomy. Division of TEF was carried out in 2 cases with H type TEF. The overall survival rate was 76.9%, and survival by Waterston classification was 100% in group A, 80.8% in B and 60.0% in C. Thorough workup for associated anomalies, interdepartmental approach and more careful surgical decision and technique are required to improve the outcome of EA.

• The Korean Journal of Pancreas and Biliary Tract
• /
• v.22 no.4
• /
• pp.165-171
• /
• 2017

Background/Aim: There is little data on whether plastic stents with a larger diameter are patent for longer than small stents in patients with bile duct cancer. The aim of this study was to compare the stent survival between 7-French (Fr) and 10-Fr plastic stents and evaluate the factors affecting stent survival. Methods: Patients with biliary obstruction due to biliary tract cancer were enrolled at Yonsei University Wonju College of Medicine from January 2010 to October 2014. Results: A total of 215 patients (7-Fr:10-Fr = 89:126 patients) were retrospectively enrolled. The primary tumor sites were common bile duct (n = 111), hilar (n = 45), and ampulla of Vater (n = 59). Rates of stent migration and stent obstruction were not different between the two groups. The median duration of stent survival was 3.3 months in the 7-Fr group and 5.9 months in the 10-Fr group (p = 0.543). The diameter of the stent did not have an effect on stent survival (hazard ratio 1.11, 95% confidence interval 0.71-1.73, p = 0.649). Conclusions: 7-Fr and 10-Fr stents have similar rates of stent migration and stent obstruction. The stent survival of 7-Fr was not inferior to 10-Fr stents in the management of biliary tract cancer.