• Journal of Chest Surgery
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• v.30 no.2
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• pp.236-240
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• 1997

The management of neonate with long gap atresia without a fistula(type A) is complex and controversial. Various esophageal reconstruction include use of native esophagus or replacement with colon, stomach and small bowel. A severe premature male, at 28 weeks gestation weighing 1.2kg, was born with type A esophageal atresia in Chonnam University Hospital. Initial treatment consisted of gastrostomy under the local anesthesia and suctioning of proximal pouch, and than underwent delayed esophageal end to end anastomosis. A minimal leakage and mediastinitis ocurred postoperatively, but was treated by adequate drainage and negative suction from the leakage site through the gastrostomy. The patient was discharged in good general condition and normal weight of 5.4kg after 4 months after the surgery.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.3
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• pp.347-353
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• 1997

This study was to test whether in vitro/in vivo survival of vitrified mouse blastocysts was influenced by culture conditions and ET method. Mouse blastocysts were obtained from in vitro fertilization and cultured for 4 days in M16 medium, and they were vitrified in EFS40 which contained 40% ethlyene glycol, 18% Ficoll and 0.5 mol sucrose in PBS. In experiment I, in vitro and in vivo survival rate of these embryos were evaluated in different culture condition after thawing. When thawed embryos were cultured in M16 medium as a control, m-CR1 medium contained 20 amino acids (2% BME amino acis and 1% MEM non-essential amino acids solution) and 4 mg/ml BSA and cumulus monolayer cell co-cultured condition in mCR1 medium (10% FBS), their in vitro survival at 24 hr after thawing was not affected by culture condition (75.6, 83.1, 82.4%). However, in vivo survival rates of implantation in m-CR1 medium (80.4%) were significantly higher than those of M16 medium (51.2%), co-culture (57.1%) condition, although there was no difference in live fetuses rates on day 15 gestation (39.0, 49.0, 38.1%). In experiment II, the in vivo development potential of embryos by ET methods was examined. When blastocysts were transferred to the day 2, 3 pseudopregnant recipient without culture soon after thawing, no pregnant recipient was obtained on the day 2 pseudopregnancy, and 50% of pregnancy rates and 15.4% of live fetus rates were obtained on the day 3 pseudopregnant recipients. These results were significantly lower than those of transferred group (day 3 pseudopregnant recipients) after culture for 16 hr post thawing (73.5, 57.1%) (p<0.05). In experiment III, to elevate usability of delayed embryos in vitro/in vivo survival of vitrified embryos (day 4 early, day 5 early and expanding blastocyst) were examined. in vivo survival rates (live fetus, total implantation) were higher in day 4 early blastocysts (33.3, 66.7%) than in day 5 expanding blastocysts (29.0, 38.7%), although the highest in vitro survival rates were obtained in the day 5 expanding brastocysts (78.3%). Therefore, these results suggest that the in vitro/in vivo survival rates of vitrified embryos could be improve by the culture condition and ET method and that the in vivo development rates of delayed embryos were decreased with longer culture duration in vitro. It means that more effective cryopreservation was obtained in day 4 early blastocysts than in day 5 expanding blastocysts.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.543-548
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• 2007

Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.837-842
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• 2007

Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.