No abstract available.
Hyperbilirubinemia, Neonatal* ; Phototherapy*

The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.

No abstract available.
Arrhythmias, Cardiac* ; Arteries* ; Child* ; Humans

BACKGROUND: To get the information about the clinical characteristics of the paroxysmal junctional tachycardia in children and to get the general principle in managing these children. METHOD: Analysis of the medical records of the 43 patients(male 30, female 13) with paroxysmal junctional tachycardia(JT) who had been followed-up in this hospital for a mean of 4.6 years(range 1 month up to 12 years) was done. RESULT: In 19 patients, JT started before 1 years of age : in 2, during gestational period, in 15, within 4 months of age, in 2, after 4 months of age. The next peak was 7 in the age of 5 years. The associated cardiac abnormalities were complex congenital defects in 2, tumor in 1, dilated and hypertrophic cardiomyopathy in 1 each. The significant hemodynamic disturbances during JT were noticed in 25. Among those whose surface electrocardiogram during JT were available, mean heart rate during JT was 232rpm(range 160-310) ; narrow QRS complex in 33 and wide in 1 ; P` wave in ST segment or T wave in 22. The delta waves were noticed after stopping JT and during followe up in 20. The types of delta waves were A in 7, B in 9, and indeterminate in 4. The different forms of delta waves unrelated to the degree of fusion were noticed in 6 ; disappearance or intermittent form of delta wave in 4. The efficacy of stopping JT was as follows : ATP 84.4%(38/45), diving reflex 50%(7/14), other vagal stimulation 71.4%(5/7), digoxin 72.7%(8/11), verapamil 54.5%(12/22), D/C cardioversion 62.5%(5/8), neosynephrine 100%(2/2). There were 2 deaths due to associated cardiac defects and 2 elective catheter ablations during the followe up period. The preventive medication with digoxin, beta blocker, and/or verapamil was succesful in 14, partially succesful in 11, failed in 14. The 7 persistent JT were treated with amiodarone in 3, with amiodarone and beta blocker in 1, with flecainide and digoxin in 1. In 1, surgical ablation of accessory pathway was done due to persistent JT. At present, JT do not recur or occur transiently without drugs in 29 ; with drugs, JT become controlled without recurrence in 4, with transient episodes in 4 and with intermittent episodes in 1. CONCLUSION: Althouh the JT in children is benign in most cases spite of the severity during the early period, JT is persistent in cases and needs potent drugs to control JT. Ablation of the foci may be necessary in these cases. Even in patients whose long-term results are benign, it is necessary to choose the optimal drugs to terminate and prevent the JT during the intervening period.
Adenosine Triphosphate ; Amiodarone ; Cardiomyopathy, Hypertrophic ; Catheters ; Child* ; Congenital Abnormalities ; Digoxin ; Diving ; Electric Countershock ; Electrocardiography ; Female ; Flecainide ; Heart Rate ; Hemodynamics ; Humans ; Medical Records ; Phenylephrine ; Recurrence ; Reflex ; Tachycardia* ; Verapamil

We analyzed neurodevelopmental outcome data of 36 selected studies. Data of individual studies were pooled by birth weight group: <800g, <1.000g, <1.500g and by time period of birth year: Period I (pre-intensive care era), 1960-67:Period II (beginning period of intensive care), 1968-76: and Period III (established period of intensive care), 1977-87. In all weight groups, survival and intact outcome rates based on live birth have progressively improved over the three period. The major neurodevelopmental handicap rate of the <1,500g decreased in Period III vs. Period I and Period II (66,70, and 45 per 1,000 live births in I, II, and III, respectively). However, the major handicap rate in the <800g and the <1,000g live births increased: in the <800g, from 48 per 1,000 live births in Period II to 101 in Period III and, in the <1000g, from 28 per 1,000 live births in Period I to 67 in Period II and 73 in Period III. Increases in major handicap rate in two lower weight groups were predominantly the effect of increasing number of survivors over these periods and had little to do with the change in handicap rates in the survivors. In the <1,500g, the magnitude of reduction in handicap rate in the survivors was sufficient to overwhelm the effect of increased survival, resulting in a reduction in the number of major handicapped children. We conclude that based on the currently avaiable reports, neonatal intensive care has provided very low birth weight infants with a reduction in mortality, an increase in intact outcome, and decrease in the number of major neurodevelopmentally handicapped children. We try to estimate the trend of major neurodevelopmental handicap and intactoutcome of infants with birth weights <1,500g in Korea and speculate that major handicap rate have progressively increased over the three period in spite of increase in intact outcome.
Birth Weight ; Disabled Children ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal* ; Korea ; Live Birth ; Mortality ; Parturition ; Survivors

Primary phycomycosis of the stomach within the ulcerative portion of early gastric carcinoma is presented in a sixty one year old male alcoholics. In the center of IIc type submucosal adenocarcinoma was a large deep ulcer (UL-IV) which was the only seat of phycomycetes infection accompanied with angioinvasion and exudative endovasculitis aside from unusual granuloma formation with Splendore Hoeppli phenomenon and eosinophilic response as in allergic granulomatous aspergillosis. The above features were reconstructed to indicate that the phycomycetes infection was confined to the type III area of IIc + III early gastric carcinoma, and that the local ulcerogenic lesion seems more contributory in its development than systemic factors including gastric carcinoma per se or alcoholic consumption.
Male ; Humans ; Adenocarcinoma

PURPOSE: Factors affecting the response to surfactant replacement therapy are considered as types of surfactant, and strategies of treatment including prophylactic vs rescue therapy, single vs multiple doses, methods of mechanical ventilation, and modes of surfactant delivery. Among those factors, response to surfactant replacement therapy according to the modes of surfactant delivery was rarely studied in the world. In preterm infants with RDS, we studied the efficacy and adverse effects of surfactant replacernent therapy according to the differences in the modes of surfactant delivery. METHOD: Preterm infant weighing 500-2,500g with RDS who required assisted ventilation were divided into two groups. One group is as follows five fractional doses with five positional changes after removal from ventilator by feeding tube technique. The other group is as follows; two fractional doses with two positional changes by side-port adaptor technique. Of the 30 infants enrolled, 15 were randomly assigned to each group. We compared the respiratory indices, chest radiologic response, clinical outcome after surfactant replacement, and adverse effects during dosing procedure. RESULT: There were no diffrences of patient profile between two groups. There were significant improvernent in FiO2, a/APO2, MAP, OI, and chest radiologic response following surfactant replacement therapy in both groups. No significant differences were noted in the adverse effects during dosing procedure and incidence of complication. CONCLUSION: In initial phase of RDS treatment with surfactant replacement therapy, two fractional doses with two positional changes by side-port adaptor technique improve respiratory indices, radiologic response without dernonstrable harmful effects as five fractional doses with five positional changes after removal from ventilator by feeding tube technique, however two fractional dosing procedure is more recommendable because of #more simple and convenient procedure.
Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial ; Thorax ; Ventilation ; Ventilators, Mechanical

We studied the effects of chronic hyperoxia (>95% oxygen for 14 days) in change of body weight, wet to dry lung weight ratio, and morphologic changes of lung tissue compared with that of room air (21% oxygen for 14 days) in Sprague-Dawley neonatal rat pups. The results were as follows: 1) In neonatal rat pups exposed to room air (normoxia group), body weight of initial 3 days of neonatal rat pups was 9.18 0.18g, and body weights of developing rat pups exposed to room air for 7, 10, 14 days were 14.07 1.90, 17.00 2.09, 23.07 1.93g respectively. In neonatal rat pups exposed to hyperoxia (hyperoxia group), body weight of initial 3 days of neonatal rat pups was 9.35 0.80 g, and body weights of developing rat pups exposed to hyperoxia for 7, 10, 14 days were 11.06 1.31, 12.64 1.77, 15,41 1.65 g respectively. These results suggest that changes of body weight in developing rat pups were stunted significantly in the hyperoxia group compared with normoxia group during 14days-experiment (p<0.01). 2) No appreciable difference of wet to dry lung weight ratio was noted at initial 3 days of neonatal rat pups between normoxia group and hyperoxia group, but considerably increased wet to dry lung weight ratio was noted significantly at 7 days of exposure in the hyperoxia group compared with the normoxia group (p<0.05). The difference of wet to dry lung weight ratio was not significant at 10, 14 days of exposure between normoxia group and hyperoxia group. These results suggested that relative water content of wet lung was at a peak at 7 days of exposure in hyperoxia group. 3) The lung from developing rat pups exposed to room air for 7 days had many small alveoli and numerous septal buds. However, in the lung from developing rat pups exposed to hyperoxia for 7 days, presence of pink staining material within the lumen of the air spaces (proteinaceous edema fluid) and increased interstitial cellularity due to infiltration by macrophages and neutrophils was observed, and these findings suggested acute exudative lung injury. 4) In most lungs from developing rat pups exposed to room air for 14 days, much increased alveolarization including the secondary septal bud formation was observed. However, in most lungs from developing rat pups exposed to hypeoxia for 14 days, increased septal and interstitial cellularity and thickness and interstitial fibrosis were observed significantly compared with normoxia group (p<0.01). In conclusion we could make a experimental animal model which had similar histopathologic finding of bronchopulmonary dysplasia in human infant and this model will be useful for research of pathogenesis of bronchopulmonary dysplasia.
Animals ; Body Weight ; Bronchopulmonary Dysplasia ; Edema ; Fibrosis ; Humans ; Hyperoxia* ; Infant ; Infant, Newborn ; Lung Injury ; Lung* ; Macrophages ; Models, Animal ; Neutrophils ; Oxygen ; Pulmonary Edema ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Amiodarone*

No abstract available.