The purpose of this study is to evaluate pulsed Doppler echocardiographic method (PD) for the measurement of pulmonary to systemic flow ratio (QP/Qs) and pulmonary arterial pressure in children. We studied 32 children with left to right shunt who had undergone cardiac catheterization, 11 children who had heart diseases without shunt and 14 normal children. Velocity time intergral (VTI) was calculated by triangulated meansurement [1/2(maximum blood velocityxejection time)]. Doppler blood flow was calculated from the equation : Doppler blood flow=VTIxcross sectional areaxheart rate. The following Doppler time intervals and ratio of intervals were also measured : preejection period(PEP), acceleration time(AT), ejection time (ET), PEP/AT, PEP/ET and AT/ET. Qp/Qs measured by PD was 1.09+/-0.15 (mean+/-SD) in children with no shunt and normal children. A high correlation was found between Fick and Doppler-derived Qp/Qs in children with left to right shunt (r=0.87). All the children with Qp/Qs less than 1.5 showed no significant discrepancy between two methods. The best correlation with pulmonary arterial pressure was achieved by the PEP/AT (r=0.84 vs systolic pressure). Sensitivity and specificity of PEP/AT for predicting pulmonary arterial hypertension were 79% and 95%, respecitively. In conclusion, it is thought that determination of Qp/Qs and prediction of pulmonary arterial pressure in children by PD is a useful, noninvasive method and triangulated measurement may be used as a simple and easy method for the measurement of Qp/Qs.
Acceleration ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Echocardiography ; Echocardiography, Doppler, Pulsed* ; Heart Diseases ; Humans ; Hypertension ; Sensitivity and Specificity

This study was carried out to investigate the intricate mechanisms of intraalveolar fibrosis, leading to the alveolar structural remodeling, of rat lungs treated with paraquat. Sixty-three male Sprague-Dawley rats, maintained on a stock diet, weighing 200.0 gm, average, were divided into 4 experimental groups. Group 1. Control group (10 rats). Intraperitoneal injections of 2-4 ml normal saline only. Group 2(13 rats). 10, 20, 25, 30 and 40 mg per kg of body weight was administered intraperitoneally. Animals were sacificed 5 hours. 1 and 3 days after paraquat treatment. Group 3(16 rats). 20, 25, 30 and 40 mg per kg of body weight was administered to the animal, and animals died 2-5 days after paraquat administration. Group 4(24 rats). The same amount of paraquat was administered to the animal as in the group 2. Animals were sacrificed 1, 2, 6, 8 and 10 weeks after paraquat treatment. Sacrificed animal lung was examined by gross, light-microscopic, immunohistochemical, ultrastructural observation, along with cellular and chemical analyses of bronchoalveolar lavage fluid. The results were as follows: Grossly, 6 rats of chronic stage (1-10 weeks survival) developed multiple wedge-shaped scars on both lungs. These scars were situated mainly along the bronchial trees, blood vessels and subpleural regions. Light microscopically, the salient features found of the chronic stage lungs were intraalveolar fibrosis. Intraluminal buds or polypoid masses projecting into the alveolar lumen and ducts. Elsewhere, loose connective tissue masses were found to fuse together to alveolar wall, obliterating the alveolar spaces with resultant severe alveolar structural remodeling. Immunohistochemically, fibronectin was found in the center of intraalveolar buds and polypoid mass, projecting into the alveolar lumen, and in the adjacent proliferating alveolar macrophages. An attempt to measure the amount of fibronectin in the bronchoalveolar lavage fluid failed. Electron microscopically, the chronic stage lung revealed marked proliferation of both alveolar macrophages and fibroblasts in the alveolar spaces, the latter containing actin-like microfilaments and collagen fibers arranged in bundles and spirals. In areas, myofibroblasts and smooth muscle cells also present. Cellular analysis of the bronchoalveolar lavage fluid in chronic stage lungs revealed no significant findings. It can be concluded, therefore: That intraalveolar fibrosis of the paraquat-treated lungs of the rat is probably mediated by intraalveolar migrations of the interstitial cells, the main task force being the connective tissue cells, passing through the defects created in the epithelial lining surface to its basement membrane, which were inflicted upon the alveolar wall by paraquat toxicity. Fibronectin, released by activated alveolar macrophages, may be responsible for the migrations of fibroblasts and myofibroblasts into the alveolar spaces to form the intraalveolar fibrosis with subsequent alveolar structural remodeling,
Male ; Humans ; Rats ; Animals

The present study was performed to observe tegumental ultrastructure of Echinoparyphium recurvatum according to developmental stages. Worms (1, 3, 5 and 15-day old) were recovered from chicks experimentally infected with metacercariae from Radix auricularia coreana. One-day old worms were elongated and ventrally concave, and covered with peg-like tegumental spines except the adjecent areas of the head crown and excretory pore. Type I sensory papillae were distributed on the lip of the oral sucker, and grouped ciliated papillae were around the oral sucker. Peg-like tegumental spines were densely distributed on the anterior surface of the ventral sucker level. The ventral sucker had an aspinous tegument and no sensory papillae. Tegumental spines on the posterior surface of the ventral sucker level were sparsely distributed and disappeared posteriorly. In 3 and 5-day old worms, the tegument around the oral sucker was aspinose and wrinkled concentrically. The ventral sucker had a wrinkled tegument and many bulbous papillae. Type I sensory papillae were distributed between the bulbous papillae. Tegumental spines were spade-shaped with a terminal tip. A total of 45 collar spines including 4 end group ones on both ventral corners was alternately arranged in 2 rows. The 15-day old worms were very stout and their tegumental spines were tongue-shaped without a terminal tip. From the above results, it is confirmed that the surface ultrastructure of E. recurvatum was generally similar to that of other echinostomatid flukes. However, some features, i.e., morphological change of tegumental spines and appearence of sensory papillae on the ventral sucker according to development, and number, shape and arrangement of collar spines, were characteristic, which may be of taxonomic and bioecological significance.
Animals ; Chickens ; Echinostomatidae/anatomy & histology/growth & development/*ultrastructure ; Life Cycle Stages ; Lymnaea/parasitology ; Microscopy, Electron, Scanning

Genus of aspergilli are ubiquitous saprophytic molds in nature, which are recognized about 700 species, at least eight are pathologic for human. Pulmonary aspergillosis is rare disease, most frequent presenting as secondary invasion, and aspergillosis of the nasal cavity is the most common sites of the extrapulmonary aspergillosis. Predisposing factors for pulmonary aspergillosis are chronic lung disease, tuberculosis, antibiotics, cytotoxins and neoplasia, hematologic disorders, and histoplasmosis etc. Authors have experienced 10 cases of pulmonary aspergillosis and a case of aspergillosis of nasal cavity in Dept. of Pathol. Chosun univ. hospital and christian hospital from Feb. 1981 to July 1984. Patient of pulmonary aspergillosis are received surgical resection and survived well without complications.
Humans ; Cytotoxins

This study was carried out to investigate the morphological changes in the exocrine and endocrine glands of rat pancreas treated with endotoxin. Thirty-five male Sprague-Dawley rats, maintained on a stock diet, weight 200.0 gm. average. were divided into two experimental groups. Group 1. Control group. Five rats. Intraperitoneal infections of 0.3 ml normal saline only. Group 2. Endotoxin-treated group. Thirty rats. 7.6 mg of endotoxin per kg. of body weight was administered intraperitoneally. Each of 5 experimental animal was sacrificed 30 minutes, 1, 2, 4, 6 and 8 hours after endotoxin treatment, followed by examinations of histochemical, light and electron microscopy of both transmission and scanning modes. The results were as follows: A. Light microscopic findings: A mild interstitial edema and hyperemia were noted 1-hour after endotoxin treatment. Cytoplasmic vacuolization at 2-hour level(2-hours after endotoxin administration), diminished staining quality of both endocrine and exocrine cells at 6-hour level. B. Electron microscopic examination: a. Transmission electron microscopy. The acinar cells of pancreas showed a mildly increased pre-lysosome at 30-minute level. At 1-hour level, appearance of secondary lysosome was noted in addition to the findings of mitochondrial swelling and decreased cristae; disarray and vacuolization of the RER; vacuolar change of Golgi apparatus. At 6-hour level, post-lysosomes. The changes in the endocrine glands were similar to the findings of exocrine glands just described with time lag of 1 to 2 hours. The endothelial cells of capillaries show swelling and pinocytotic vesicle formation, protrusion of the cytoplasmic processes into the capillary lumen and increased heterochromatin at 1-hour level. These findings became more prominent as time lapses. The lumen of the endothelium tends to be narrowed, filled with fibrin and other blood cell components which later terminated with occasional complete occlusion by the formation of thrombi. b. Histochemical study: Primary lysosomes of the control group revealed a strong reaction of the acid phosphatase whereas the endotoxin treated group with less reactivity limited in the peripheral zones of the lysosomes. Secondary lysosomes with partial reactions. However, the pre-lysosomes and post-lysosomes failed to demonstrate any acid phosphatase activity at all. c. Scanning electron microscopy. The endothelial cells of the capillaries, arterioles and venules demonstrated increased microvillous activity, broad bled formation, cytoplasmic protrusion into the luminal spaces and microthrombi formation at 1-hour level. Six-hour level onward there noted a junctional disruption and partial detachment from the subendothelium of the wall. It can be concluded, therefore: When the endotoxin enters the blood stream, it elicits endothelial injury followed by both exudation with resultant edema of the surrounding tissue and concomitant vascular occlusions due to thrombosis. This vascular occlusion, in turn, causes ischemic degenerative change of the cells of exocrine and endocrine glands of the pancreas which are followed by digestions of degradational materials from the injured cells through the lysosomal phagocytic system. Besides the above pathogenetic pathway, one can not rule out the possibility of the direct effects of the endotoxin to the cells of exocrine and endocrine cells of the pancreas also so rendered.
Male ; Humans ; Rats ; Animals

Classic pulmonary blastoma is a variant of carcinosarcoma which is seen almost exclusively in adults. By contrast, most cases of pulmonary blastoma in children have been described as having an exclusive mesenchymal composition, which was proposed as pleuropulmonary blastoma. Recently we experienced a case of pleuropulmonary blastoma, type 1. This 27-month-old male baby was transferred to our hospital due to the left tension pneumothorax. Chest CT revealed a subpleural pulmonary cystic lesion on the left upper lung and an open cystectomy was performed. Histologically the lesion was composed of variable-sized cystic structures lined with a single layer of respiratory-type epithelium. the underlying stroma was composed of sheets of small, round to oval, primitive tumor cells. Some of them had eccentric, eosinophilic cytoplasm, suggestive of rhabdomyoblastic differentiation. These rhabdomyoblastic cells were fuchsinophilic and positive with desmin and vimentin on immunohistochemistry.
Child ; Adult ; Male ; Female ; Humans

Arthroscopic anterior cruciate ligament reconstruction with bone-patella tendon-bone has been commonly using for ACL insufficient patients. Bone-patellar tendon-bone graft is a strong intra-articular substitute, which allows, by means of its bony end, a rigid fixation with early bone to hone healing. As a counterpart, potentially serious cornplications & donor site morbidity has been reported, such as patella fracture & patella tendon avulsion, anterior knee pain, patella tendinitis, dcmor site pain and bone defect. We suppose tightly packing the donor site bony defect with hetrograft (Lubboc) may be also useful. So, we analyzed the morphological change in bony defect and donor site morbidity between the group of non-replaced bony defect and the group of replaced bony defect using by heterograft (Lubboc). We replaceJ hetrograft into the patellar side bony defect in 15 knees and left alone in l5 knees. The average follow up period was 17 months. The results werc as follows: 1. Nearly norma1 appearance on the bony defect showed at the long tenn follow up roentgenogram in the group of replaced hetrograft, but scalloping on the pateltar bomp defect was seen in non-replaced group. 2. Donor site morbidity (pain or patellai tendinitis) was developed 8 knees in the replaced group, and 7 knees in the non-rep)aced group. 3. We conclude that the filled in the bony defect hy hone graft (heterografl:) can not decrease the donor site morbidi ty.
Anterior Cruciate Ligament Reconstruction ; Bone-Patellar Tendon-Bone Grafts ; Follow-Up Studies ; Heterografts* ; Humans ; Knee ; Patella ; Patellar Ligament* ; Pectinidae ; Tendinopathy ; Tissue Donors* ; Transplants

The authors experienced a case of anterior uneitis associated with secondary glaucoma caused by a cycitsercosis cellulosae in the anterior chamber of the left eye of a 39-year-old Korean male. The cyst appeared from the posterior surface of the iris through the pupillary margin of 10-o'clock position and grew larger and larger with automatic active movements, filling finally the nasal upper one third of the anterior chamber, but the cyst did not change the position to the 6-o'clock chamber angle. The cysticercus grown for almost four months was extracted successfully with a teethless, serrated, curved forceps with some resistance after opening the anterior chamber from 7~11-o'clock position without iris prolapse and any damage to the anterior lens capsule. The extracted cyst with the size of 8 mm X 6 mm X 3 mm was confirmed as a cysticercus cellulosae by parasitological examinations (Fig. 2,3). After the extraction of the cysticercus the uveitis and the increased intraocular tension subsided completely, remaining some brownish fine keratic precipitates, pigment masses on the anterior surface of the lens and irregularly somewhat dilated pupil due to partial posterior synechia. The naked vision O.S., however, was 20/25 using pin hole, and the eye has been still quiet during last 3 and half years following surgical extraction. In addition the authors have recently seen three cases of subconjunctival cystiticercosis cellulosae. In the first case the cysticercus with the size of 8 mm X 7 mm X 4 mm appeared at the nasal superior part of the bulbar conjunctiva O.D. of a three-year-old Korean male. In the second case the cyst with the size of 7 mm X 5 mm X 3 mm was seen at the nasal inferior part of the bulbar conjunctiva O.S. of a 12-year old Korean female. In the last case the cyst with the size of 10 mm X 8 mm X 5 mm was located beneath the plica semilunaris of 3-o'clock position O.D. of a 58-year-old Korean female. All the cysts were extracted successfully without any rupture, and they were confirmed as the cysticercus cellulosae histologically.
Adult ; Anterior Chamber* ; Child ; Conjunctiva ; Cysticercosis* ; Cysticercus* ; Female ; Glaucoma ; Humans ; Iris ; Male ; Middle Aged ; Prolapse ; Pupil ; Rupture ; Surgical Instruments ; Uveitis

During The last 11 years from Jan. 1980 to Dec. 1990, 72 cases of salmonellosis has been admitted to the Department of Pediatrics of National Medical Center and evaluated clinical difference between typhoid fever and salmonella gastroenteritis. The results were as follows: 1) The annual incidence of salmonella gastroenteritis insalmonellosis was increased in the latter half of the eighties. 2) Both salmonellosis had its peak incidence in the summer. 3) Salmonella gastroenteritis was highest in the age of less than 5 year in contrast with the age of 6~9 year in typhoid fever. 4) The specimens isolated salmonellae were blood and stool in most cases, especially blood in typhoid fever and stool in gastroenteritis. 5) S.typhi was 16 cases, salmonella group A was 3 cases, group B was 16 cases and Group D and E were a case in each in isolated salmonellae. 6) On the antibiotic sensitivity test, S.typhi was sensitive to the most antibiotics. but the salmonella group B was relatively resisitant to Ampicillin, Carbenicillin, Tetracycline and Chloramphenicol.
Ampicillin ; Anti-Bacterial Agents ; Carbenicillin ; Chloramphenicol ; Gastroenteritis ; Incidence ; Pediatrics ; Salmonella ; Salmonella Infections* ; Tetracycline ; Typhoid Fever

A nested polymerase chain reaction (PCR) was applied to detect and identify pathogenic Yersinia enterocolitica and Y. pseudotuberculosis. We used photochemical postamplification procedure with 8-methoxypsoralen to control carryover contamination. Using the ail and inv gene, the sensitivity and specificity of DNA amplification by nested PCR was considerably improved. The amplified fragment sizes were 298 bp for the ail gene and 295 bp for the inv gene. Amplification was successful when the template was derived from three sources: purified DNA, aliquots of boiled bacterial suspension and aliquots of lysed bacterial suspension. The detection limits were 10 fg of DNA and 2 * 10 colony forming units (CFU) for Y. enterocolitica and 10 fg DNA and 2 CFU for Y. pseudotuberculosis.
DNA ; Limit of Detection ; Methoxsalen ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Stem Cells ; Yersinia enterocolitica* ; Yersinia pseudotuberculosis* ; Yersinia*