OBJECTIVE: Mycoplasma pneumoniae infection is known as one of the frequent causes of exacerbation of bronchial asthma and it can also be a trigger for the initiation of asthma. However, little is known about the pathogenesis of respiratory M. pneumoniae infection. Furthermore, there is little data on human cytokine production and its involvement in the pathogenesis of M. pneumoniae infection. In order to investigate the immunopathogenesis of M. pneumoniae infection, we investigated the cytokine production in the bronchoalveolar lavage ( BAL ) fluid of patients with M. pneumoniae pneumonia and viral pneumonia, and compared the results with those of control subjects. SUBJECT AND METHOD: BAL was performed with fiberoptic bronchoscopy in patients with M. pneumoniae pneumonia( n=9 ), viral pneumonia( n=9 ), and control subjects( n=6 ) aged 3 years to 9 years. M. pneumoniae pneumonia was documented by polymerase chain reaction and serologic analysis. Four respiratory viruses ( adenovirus, influenza A, influenza B, parainfluenza ) were detected by culture method. Cell pellets and supernatants were separated by centrifugation and Interleukin( IL ) - 2, Interferon( IFN )-r, IL-4, and IL-5 levels were measured in concentrated BAL supernatants by ELISA. RESULTS: Analysis of cytokines revealed significantly increased production of IL-4 ( p< 0.0001 ) and IL-2 ( p< 0.0001 ), in patients with M. pneumoniae pneumonia and significantly increased production of IL-2 (p <0.0001) in patients with viral pneumonia compared with those of the control subjects. Ratio of IL-4/IFN-r was significantly increased in patients with M. pneumoniae pneumonia ( p< 0.005 ) but not in patients with viral pneumonia compared with that of the control subjects. CONCLUSION: IL-4 production and IL-4/IFN-r ratio were increased in the BAL fluid of patients with M. pneumoniae infection. These findings suggest that predominant Th2 immune response could play an important role in the pathogenesis of M. pneumoniae infection.
Adenoviridae ; Asthma ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Bronchoscopy ; Centrifugation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Influenza, Human ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Mycoplasma pneumoniae* ; Mycoplasma* ; Paramyxoviridae Infections ; Pneumonia* ; Pneumonia, Mycoplasma* ; Pneumonia, Viral ; Polymerase Chain Reaction

An aberrant right subclavian artery, the most common congenital anomaly of the aortc arch, is rarely symptomatic during the infancy, if an anomalous origin of a right common carotid artery is also associateda varient of innomiate artery compression syndrome. We experienced a case of an aberrent right subclavian artery associated with an anomalous origin of the right common carotid artery in a female newborn, who showed severe respiratory distress soon after birth. The diagnosis was confirmed by aortogram and operative findings. the ligature and section of the aberrent right subclavian artery resulted in improvement of respiratory distress. A brief review of the related literature is also presented.
Arteries ; Brachiocephalic Trunk* ; Carotid Artery, Common ; Diagnosis ; Female ; Humans ; Infant, Newborn ; Ligation ; Parturition ; Subclavian Artery*

PURPOSE:Factors influencing postnatal growth are innumerable. It is known that genetic factors such as parental height and environmental factors such as nutrition, economic status and hormonal effects are important factors. The purpose of this study was to examine the factors affecting final adult height in normal children. METHODS:753 high school students (513 boys, 240 girls) who live in Seoul were studied. Height and body weight were measured and questionaires about sexual development were examined. We included the subjects who reached fianl adult height. The criteria of final adult height was as following: ages over 17 years in the boys and over 15 years in the girls and growth velocity was less than 1 cm per year. They had no systemic diseases and height standard deviation scores were more than -2.5. RESULTS: 1)Final adult heights were 173.1+/-.1cm in boys and 160.9+/-.7cm in girls. 2)Final adult height significantly correlated with father height(r=0.13, p<0.01), mother height(r=0.25, p<0.01), midparental height(r=0.25 p<0.01) and birth weight (r=0.16, p<0.01). 3)In short final adult height groups, birth weight and midparental height were significantly lower(p<0.05), but puberty onset age, body mass index and economic status were similar to normal stature groups. 4)Final adult height significantly correlated with target height.(r=0.43, p<0.01). In boys, the final adult height was 1.7cm taller than target height on the average. In girls, final adult height was 1.6cm taller than target height on the average. 5)In the group in which final adult height is less than target height, birth weights were significantly lower than those of the groups in which final height is greater than target height. CONCLUSIONS:Among factors affecting final adult height, parent height and birth weight were important. To predict final adult height, target height can be used simply and target height showed significant correlation with final adult height. In the case of showing differences between final adult height and target height, many factors including birth weight will influence the outcome.
Adolescent ; Adult* ; Age of Onset ; Birth Weight ; Body Mass Index ; Body Weight ; Child ; Fathers ; Female ; Humans ; Mothers ; Parents ; Puberty ; Seoul ; Sexual Development

No abstract available.
Lung* ; Oxygen* ; Rabbits* ; Ventilation*

No abstract available.
Extremities* ; Gangrene* ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus*

PURPOSE:In infants born intrauterine growth retardation(IUGR), there may be persistent short stature in childhood and adulthood, although most IUGR infants show some degree of catch-up growth. The purpose of this study was to describe the postnatal growth status in order to determine the incidence of catch-up growth. METHODS:This study was carried out with the 260 IUGR infants(birth weight<2,500gm) born at Inje University Sanggye Paik Hospital, from October 1989 to March 1995. RESULTS: 1)Mean gestational age was 38.3+/-.6weeks, mean birth weight was 2.3+/-.2kg and mean birth length was 46.1+/-.7cm. 2)Mean height standard deviation score(height SDS) was 0.02+/-.03. Height SDS was -0.002+/-.71 at 1 year of age, 0.03+/-.14 at 2 years of age, -0.03+/-.71 at 3 years of age, 0.01+/-.24 at 4 years of age, 0.16+/-.24 at 5 years of age, -0.08+/-.43 at 6 years of age. 3)Of the entire study group of the 260 children, 16 children (6%) were below 10 percentile in height. 1 of 36 (2.8%) was below 10 percentile in height at 1 year of age, 5 of 86(5.8%) at 2 years of age, none at 3 years of age, 6 of 44 (13.6%) at 4 years of age, 1 of 25 (4.0%) at 5 years of age, 3 of 17 (17.6%) at 6 years of age. 4)Height SDS significantly correlated with gestational age (r=0.57, p<0.01), birth weight (r=0.17, p<0.01) and midparental height (r=0.72, p<0.01). 5)Birth length and midparental height showed significant differences between catch-up group and non-catch-up group (p<0.01). Condusions:In summary, of the infants born IUGR, 94% showed catch-up growth. Birth length and midparental height were significantly lower in non- catch-up group.
Birth Weight ; Child ; Fetal Growth Retardation* ; Gestational Age ; Humans ; Incidence ; Infant* ; Parturition

PURPOSE: Many young children with no other asthma features have episodic wheezing that is triggered solely by viral respiratory infections. We investigated the differential cytology in an effort to determine whether significant differences in bronchoalveolar lavage(BAL) cellularity to the pathophysiology of wheezing exist between classic astham(CA) and viral associated wheeze(VAW) in children. METHODS: Bronchoscopy with BAL was performed on 44 children, 6 months and 15 years old: 12 CA, 13 VAW. 13 viral pneumonia(VP), and 6 control cases. Viral cultures were carried out. Differential cell counts were determined on cytospin slide stained with May Grunwald Giensu. RESULTS: Total BAL fluid recovered was similar in all group(37+/-2.5%, mean+/-SEM) No significant differences in the total cell counts were observed among the four groups. Compared with the control, newtrophil percentages of VAW and VP(38.6+/-7.1% and 42.4+/-6.9%, respectively) were significantly(P<0.05) elevated than those of VAW and VP(2.0+/-0.1% and 0.4+/-0.3%, respectively). All cell types did not differ significantly between VAW and VP. The blood totol cosinophil counts were correlated with the BAL eosinophil percentage levels(r-0.795, P=0.0000). CONCLUSIONS: In conclusion, neutrophils were prominent in children with viral associated wheeze, as eosinophils in those with classic asthma. Thses findings suggest that there are different implications of cell types for the pathophysiology in these two diseases.
Adolescent ; Asthma* ; Bronchoalveolar Lavage* ; Bronchoscopy ; Cell Count ; Child* ; Eosinophils ; Humans ; Neutrophils ; Respiratory Sounds* ; Respiratory Tract Infections

PURPOSE: Flexible bronchoscopy is an important diagnostic and sometimes therapeutic tool that can be used on infants and children using light sedation and local anaesthesia. The purpose of this study is to evaluate the contribution of the flexible bronchoscopy to clinical diagnosis and therapy in children. METHODS: We examined the first 100 consecutive flexible bronchoscopies performed in children under 15 years of age(median age, 7 years). RESULTS: Indications for bronchoscopy were bronchoalveolar lavage(39.3%), wheezing(12.5%), stridor/noisy breathing(10.7%), recurrent/persistent pneumonia(8.0%), atelectasis or bronchial toilet (7.1%), equivocal airway foreign body(6.3%), hemoptysis(4.5%), and miscellaneous other reasons (11.6%). Inspection was abnormal in 79.0% of all investigations and made a clinically meaningful contribution to diagnosis in 79.0%. Bronchoalveolar lavage cytology was abnormal in 77.3% of the 44 lavages. Viruses and bacteria were isolated in 33.3% of the 48 specimens cultured. Meaningful therapeutic result was obtained in 81.3% of the 16 therapeutic bronchoscopies including bronchial toilet and persistent atelectasis. CONCLUSION: A high yield of meaningful diagnostic information and therapeutic goal can be expected from flexible bronchoscopy in children.
Bacteria ; Bronchoalveolar Lavage ; Bronchoscopy* ; Child ; Diagnosis ; Humans ; Infant ; Pulmonary Atelectasis ; Therapeutic Irrigation

Iatrogenically developed immunosuppression-associated Kaposis sarcoma is the result of immunosuppressive therapy after an organ transplantation, particularly after a renal transplantation. Since the advent of powerful immunosuppressive agents such as cyclosporine, recently the incidence of Kaposis sarcoma has been increased. In addition to immunosuppression, other factors, such as genetic predisposition, environmental and geographic factors, and oncogenic viruses, may play a role in the pathogenesis of this tumor. Ilerein we report a case of Keposis sarcoma with multiple organ involvement of the skin, lung, small intestine and mesenteric lymph node in a renal allograft recipient who received cyclosporine and prednisolone. Reduction of the dosage of immunosuppressant for 1 month resulted in improvement of the cutaneous lesions.
Allografts* ; Cyclosporine ; Genetic Predisposition to Disease ; Geography ; Immunosuppression ; Immunosuppressive Agents ; Incidence ; Intestine, Small ; Kidney Transplantation ; Lung ; Lymph Nodes ; Oncogenic Viruses ; Organ Transplantation ; Prednisolone ; Sarcoma ; Sarcoma, Kaposi* ; Skin ; Transplants

We experienced a case of acquired bronchial stenosis in a male premature infant who had recurrent postextubation atelectasis of the right lung. Bronchography showed the stenosis of the distal portion of right main bronchus and the proximal portion of intermediate bronchus and autopsy findings showed ill-defined irregularly elevated nodule with fibrotic scarring in the trifurcation of right main bronchus. Endotracheal suction was suspected as the main cause. A brief review of literature was made.
Autopsy ; Bronchi ; Bronchography ; Cicatrix ; Constriction, Pathologic* ; Humans ; Infant, Newborn ; Infant, Premature ; Lung ; Male ; Pulmonary Atelectasis ; Suction*