• Title/Summary/Keyword: Neonatal surgery

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Use of Neonatal Chondrocytes for Cartilage Tissue Engineering

  • KANG SUN WOONG;PARK JUNG HO;KIM BYUNG SOO
    • Journal of Microbiology and Biotechnology
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    • v.15 no.2
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    • pp.259-264
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    • 2005
  • Transplantation of cultured chondrocytes can regenerate cartilage tissues in cartilage defects in humans. However, this method requires a long culture period to expand chondrocytes to a large number of cells for transplantation. In addition, chondrocytes may dedifferentiate during long-term culture. These problems can potentially be overcome by the use of undifferentiated or partially developed cartilage precursor cells derived from neonatal cartilage, which, unlike chondrocytes from adult cartilage, have the capacity for rapid in vitro cell expansion and may retain their differentiated phenotype during long-term culture. The purpose of this study was to compare the cell growth rate and phenotypic modulation during in vitro culture between adult chondrocytes and neonatal chondrocytes, and to demonstrate the feasibility of regenerating cartilage tissues in vivo by transplantation of neonatal chondrocytes expanded in vitro and seeded onto polymer scaffolds. When cultured in vitro, chondrocytes isolated from neonatal (immediately postpartum, 2 h of age) rats exhibited much higher growth rate than chondrocytes isolated from adult rats. After 5 days of culture, more neonatal chondrocytes were in the differentiated state than adult chondrocytes. Cultured neonatal chondrocytes were seeded onto biodegradable polymer scaffolds and transplanted into athymic mice's subcutaneous sites. Four weeks after implantation, neonatal chondrocyte-seeded scaffolds formed white cartilaginous tissues. Histological analysis of the implants with hematoxylin and eosin showed mature and well-formed cartilage. Alcian blue/ safranin-O staining and Masson's trichrome staining indicated the presence of highly sulfated glycosarninoglycans and collagen, respectively, both of which are the major extracellular matrices of cartilage. Immunohistochemical analysis showed that the collagen was mainly type II, the major collagen type in cartilage. These results showed that neonatal chondrocytes have potential to be a cell source for cartilage tissue engineering.

Clinical Features and Surgical Outcome of Congenital Neuroblastoma of Adrenal Gland (부신 기원의 선천성 신경모세포종의 치료 경험)

  • Park, Hyo-Jun;Moon, Suk-Bae;Seo, Jeong-Meen;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.38-43
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    • 2009
  • With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.

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Case reports on neonatal mouth opening limitation due to congenital bilateral idiopathic hyperplasia of the coronoid processes (선천성 양측 특발성 오훼돌기 과형성으로 인한 개구장애의 증례보고)

  • Baek K.W.;Myung H.;Seo B.M.;Hwang S.J.;Lee J.H.;Choung P.H.;Kim M.J.;Choi J.Y.
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.2
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    • pp.133-139
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    • 2004
  • Congenital bilateral idiopathic hyperplasia of the coronoid processes presents with limited mouth-opening without visible maxillofacial deformity or temporomandibular joint dysfunction / disorder. According to Blanchard et al and McLoughlin et al, it was lnitially described in 1853 by Langenbeck, and the first cases were reported by Holmes in 1956. Since then, there have been regular reports of a certain number of cases. In 1995, McLoughlin et al recorded 79 published cases of bilateral hyperplasia of the coronoid processes. Among them, Fabie et al have found only 3 published cases relating to children younger than 8 years, and have presented the first case of objectively diagnosed restricted mouth opening from birth by pediatricians. Authors have experienced 2 child patients with mouth opening limitation who was diagnosed congenital bilateral idiopathic hyperplasia of the coronoid processes without any other TNJ morphology in Dept of Oral and Maxillofacial surgery, Seoul National University Dental Hospital in 2004. Coronoidectomy was performed and postoperative active mouth opening exercise is indicated. Authors report 2 cases of congenital bilateial idiopathic hypeiplasia of the coronoid processes with literature liview.

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Biocreative Alveolar Molding Plate Treatment (BioAMP) for neonatal unilateral cleft lip and palate with excessively wide alveolar cleft and maxillary arch width

  • HyeRan Choo;HyoWon Ahn
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.69-73
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    • 2024
  • Since its inception in Europe in the 1950s, alveolar molding treatment for neonates with complete cleft lip and palate has undergone significant evolution in both design and application methodology, demonstrating effectiveness in normalizing the alveolar cleft and nasal shape. However, excessively wide alveolar clefts accompanied by disproportionately wide total maxillary arch pose significant challenges when utilizing conventional alveolar molding methods involving cyclical adding and grinding of acrylic on molding plates. The current report introduces a novel alveolar molding method named Biocreative Alveolar Molding Plate Treatment (BioAMP), which can normalize the maxillary alveolar cleft and arch shape without laborious conventional acrylic procedures. BioAMP sets the target arch form and provides unrestricted space for natural growth of the maxillary alveolar bones while systematically reducing the total maxillary arch width in precise increments. Two exemplary cases are presented as proof-of-concept, showcasing the clinical innovation of BioAMP.

Pulmonary Air Leak in the Neonatal Respiratory Distress Syndrome (신생아 호흡 장애 증후군에서 폐외공기누출의 임상적 고찰)

  • 우석정
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.38-42
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    • 1999
  • Background: In neonatal respiratory distress syndrome patients, various types of pulmonary air leak contributes to elevate morbity and mortality. Although early surgical interventions can provide better results in several cases, whole clinical outcomes are poor. This study was designed to investigate the clinical aspects of pulmonary air leak in the neonatal respiratory distress syndrome patients and major contributing factors to mortality. Material and Method : We retrospectively evaluated 48 cases of pulmonary air leak in the neonatal respiratory distress syndrome patients from September 1994 to May 1997. Result: There were 15 cases of primary and 33 cases of secondary pulmonary air leakages. The prominent manifestations were pure interstitial emphysema in 19 cases(39.9%) and combined pneumothorax in 19 cases(39.9%). In clinical aspects, normal birth weight was dominant(83.4%), the onset occurred within 24 hours was in 28 cases(58.8%). The pulmonary diseases were meconium aspiration syndrome(25.2%) and hyaline membrane disease(33.2%). The overall hospital mortality was 25.2%, and the majority were hyaline membrane diseases. Conclusion: Although the overral mortality rate of these diseases were high, more detailed studies about immediate treatement, perinatal prevention, intensive care to geriatric problems were needed individually to improve outcomes.

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Prevention of Invasive Candida Infections in the Neonatal Intensive Care Unit (신생아 집중치료실에서 침습 칸디다 감염의 예방)

  • Kim, Chun Soo
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.15-22
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    • 2011
  • Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

Spontaneous Neonatal Gastric Perforation (신생아 위 자연천공)

  • Jung, Sung-Eun;Yang, Sook-Jin;Chun, Yong-Soon;Lee, Soong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.110-114
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    • 1996
  • Spontaneous gastric perforation is an important but rare cause of gastrointestinal perforation in neonates. Just over 200 cases have been reported in the literatures. In spite of recent surgical advances in its managements, mortality rate has been reported as high as 25-50%. Because of physiologic differences, immature immune mechanisms, variations in gastrointestinal flora and poor localization of perforation, a neonate with gastric perforation is at high risk. The pathogenesis is greatly debated. Five patients with spontaneous neonatal gastric perforation who were operated upon at the Department of Pediatric Surgery, Seoul National University Hospital from 1980 to 1993 were reviewed. Four patients were male and one female. The first indication of perforation was 1 day to 6 days of life. All of 5 perforations were located along the greater curvature of the stomach. The size of perforation ranged from 2 cm to 10 cm. Debridement and primary closure were performed in all patients. The operative mortality was 40%(2 of 5). The cause of perforation was not identified in all cases. Prematurity and necrotizing enterocolitis, synchronous or metachronous, were thought to he crucial prognostic factors. Earlier recognition and surgical intervention are necessary to reduce morbidity and mortality.

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Right Ventricle Exclusion in Severe Neonatal Ebstein's Anomaly (증상이 심한 신생아 엡스타인 기형에서의 우심실 제외)

  • Min, Sun-Kyung;Kim, Woong-Han;Lee, Young-Ok;Seong, Yong-Won;Park, Sung-Joon;Choi, Jin-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.518-521
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    • 2010
  • A one-day-old baby was transferred for cyanosis and heart murmur. Echocardiographic evaluation revealed that he had severe neonatal Ebstein's anomaly (Carpentier type C), pulmonary atresia, and pulmonary circulation via patent ductus arteriosus. Because the wall of the atrialized right ventricle was very thin, showed decreased contractility, and the small right ventricle showed pulmonary atresia, we decided that a two-ventricular repair was impossible. When the patient was one-month-old, he underwent right atrium reduction-plasty, a right ventricular exclusion procedure (including atrialized right ventricle resection and functional right ventricle plication), and right modified Blalock-Taussig shunt. He was discharged without specific problems. He received a bidirectional cavopulmonary shunt successfully at 4 months later.

Bochdalek's Hernia in Neonate -A Clinical Review of 14 Cases- (신생아 Bochdalek 탈장의 외과적 고찰)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.481-486
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    • 1995
  • During the Dec.1990 to April.1994, 14 patients were diagnosed in the Department of Thoracic and Cardiovascular surgery, Medical college of Chonnam National University,as having congenital Bochdalek hernia. All of them diagnosed and operated before the age of 20 days, neonatal period. 3 of 14 were died after operation, so mortality rate was 21%, the deaths occurred in 1,1,13 days neonate. In this retrospective study we describe our experience and results with review of the literature.

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