PURPOSE: In the treatrnent of respiratory distress syndrome, Infants are often exposed to hyperoxia. It can generate oxygen free radical, damage to lung and bronchi, and inactivate pulmonary surfactant(PS). Antioxidant therapy in animal and human models has been tried to overcome this detrimental effects. We hypothesized that the addition of oxygen free radical such as hydrogen peroxide(H) could compromise surface active properties(SAP) of PS and that further addition of antioxidant such as catalaseR(CAT, Sigma chemical, St. Louis) could recover SAP. METHODS: We prepared combinations of mixtures with SurfactenR(S-TA, Tokyo Tanabe, Japan), H202 and CAT. 1)0.625mgPL(phospholipids)/ml or 1.25mgPL/ml S - TA and H202 were mixed to the final concentrations of 0.1 and 1mM H respectively, and incubated at 37C for one hour. 2) 0.625mgPL/rnl S - TA, H202 and CAT 10U were mixed to the final concentrations of lmM H202, and incubated at 37 degree C for one hour. We used Pulsating Bubble Surfactometer (Electronetics, NY) measure in vitro minimum and maximum surface tensions(ST) and area-surface tension relationship. RESULTS: 1) For 0.625mgPL/ml S-TA and 1mM H mixture minimum. ST after 5 min of pulsation increased significantly(P=0.007) and the area-surface tension curve was deformed. But they were comparable to control levels for 1.25mgPL/ml S-TA. 2) When CAT was added to 0.625mgPL/ml S-TA and 1mM H mixture, the resultant minimum ST after 5 min of pulsation dropped to the control levels with recovery of hysteresis curve(P=0.0001). CONCLUSION: PS could be inactivated by addition of high concentrations of H but SAP can be recovered either by increasing PS concentration or by further addition of antioxidant CAT. Therefore, we suggest that in case of suspected surfactant inactivation an increase in surfactant concentration or administration of antioxidant must be considered.
Animals ; Bronchi ; Catalase* ; Cats ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperoxia ; Infant ; Lung ; Oxygen

PURPOSE: Hemodynamically significant patent ductus arteriosus (PDA) may increase the mortality of premature infants who received ventilator care by aggravating hypoxia, acidosis, pulmonary edema and hypotension. The risk factors for PDA in premature infants are low gestational age, infusion of excessive fluid, and severity of neonatal respiratory distress syndrome. We studied the risk factors of PDA in very low birth weight infants (VLBW) to establish a guideline for the treatment. METHODS: VLBW infants who were born at Severance Hospital, Yonsei Medical Center from January, 1989 through December, 1995 and survived for at least 5 days with ventilator care were recruited for this study. Patent ductus arteriosus was diagnosed according to the clinical diagnostic criteria of Yeh (Yeh et al, 1981b). Thirty six infants had diagnosed as PDA (PDA group), and thirty seven infants who had not PDA were selected as control. Both groups of infants received restrictive fluid therapy. RESULTS: 1) Gestational age, sex, Apgar score, administration of surfactant, mode of delivery, toxemia and use of antenatal dexamethasone were similar between PDA and control infants. 2) In PDA group, ventilatory index and duration of vetilator care were significantly greater (P<0.05), and a/ApO2 was significantly lower than control group (P<0.05). There was no difference in peak inspiratory pressure at initial setting, the highest peak inspiratory pressure and mean airway pressure during ventilator care. 3) During the first 3 days of life, the urine output was similar between groups. On the 4th and 5th days of life, PDA group had significantly reduced urine ouput compared with control (on day 4; 2.6+/-1.1 ml/kg/h vs. 3.2+/-1.2ml/kg/h, P<0.05; on day 5, 2.9+/-1.4ml/kg/h vs. 3.6+/-1.6ml/kg/h, P<0.05) . 4) The percent weight loss compared to birth weight was siginificantly lower in PDA group (12.5% vs. 15.1%, P<0.05). 5) The PDA group had higher incidences of bronchpulmonary dysplasia and intraventricular hemorrhage (P<0.05). CONCLUSION: Among Vlnfants who received restrictive fluid therapy during the first 5 days of life, infants with PDA had reduced urine output and percent weight loss than control group.
Acidosis ; Anoxia ; Apgar Score ; Birth Weight ; Dexamethasone ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Fluid Therapy ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Mortality ; Pulmonary Edema ; Respiratory Distress Syndrome, Newborn ; Risk Factors* ; Toxemia ; Ventilators, Mechanical ; Weight Loss

Recent studies have demonstrated that the patients with psoriasis have various immune alternation in both humoral and cellular immunities. However the results of these are still controversial. These facts promoted us to analyze the immune cells (T cell, T subsets and B cell) by rosette method for these cells in peripheral blood of 15 patients with psoriasis. And we also analyzed the effects of photo- chemotherapy(PUVA) on these cells. The results were summerized as follows; 1. The mean values of T cell, T, T, cell and B cell in peripheral blood of the- patients with psoriasis before PUVA therapy were 56. 2+-5.7%, 35.1+-6.9%, 5. 5+l.4%, 11.6+4. 0% respectively, These results of immune cells showed signi- ficantly lower mean values when these were compaired with the mean values. of nomnal control group(T cell; 65. 2+-2.9%, TM cell; 45.8+-3.2%, T cell; 7.3+ 1.3% B cell; 16.2+2.4%), respectively (T cell, Tm Tg, p<0.01, B cell; p<0.05). 2. The mean values of T cell, T, T, cell and B cell in peripheral blood (countinue..)
Humans ; Immunity, Cellular ; Photochemotherapy* ; Psoriasis* ; PUVA Therapy

No abstract available.
Classification* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Killian-Jamieson diverticulum is a rare disease that is seen at the cervical esophagus. It has quite a different pathogenesis and anatomical location compared with that of Zenker's diverticulum. The pathophysiology and strategy for treating Killian-Jamieson diverticulum are not fully understood. We performed surgery using one incision for treating a case of Killian-Jamieson diverticulum and we review the medical literature that's related to this unusual diverticulum.
Diverticulum ; Diverticulum, Esophageal ; Esophageal Diseases ; Esophagus ; Rare Diseases ; Zenker Diverticulum

Primary ureteral tumor accounts for an estimated about 1 percent of all tumors of the urinary tracts. We observed one case of the ureteral tumor in 65 years old male patient and he was treated by complete nephroureterectomy with an excision of a cuff bladder wall around ureteral orifice. A case of primary ureteral tumor was reported with a brief review of the literatures.
Aged ; Humans ; Male ; Ureter* ; Urinary Bladder ; Urinary Tract

The surgical care of neonates, born weighing less then 1000 gram (Extremely Low Birth Weight; ELBW), is a very challenging problem to the pediatric surgeons. We report a survival case in which a successful operation for the spontaneous intestinal perforation was performed at the time when the baby weighed 630 g after 25.6 weeks' gestation. The child not only survived but also appears developmental normal at two years of age. The case is the smallest reported survivor in Korea after surgery. The cooperation between the pediatric surgeon and neonatologist is very important in the surgical management of ELBW neonate.
Child ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Newborn* ; Intestinal Perforation ; Korea ; Pregnancy ; Survivors

PURPOSE: Excessive apocrine gland secretion and bacterial decomposition cause axillary osmidrosis, which results in physical discomforts and social problems of patients. Many surgical procedures have been introduced such as skin excision and simple closure, local flap, skin graft, subcutaneous shaving and liposuction method, but the results were not satisfactory to patients and several complications, such as symptom recurrence, hematoma, seroma, delayed wound healing, skin flap necrosis and scarring remain as problems. METHODS: For the purpose of reducing these problems, we employed combined treatment of liposuction and rasping method. From January 2006 to February 2008, total of 54 patients were treated with this procedure for bilateral axillary osmidrosis. RESULTS: Follow-up evaluation period was from 2 months to 12 months, and the results were satisfactory. In our method, the length of skin incision is less than 1 cm, so the resultant scar is negligible. Apocrine glands in subcutaneous tissue were mostly removed by liposuction apparatus and remained other glands in subdermal area were mostly removed by rasping. The recurrence rate and postoperative complication were minimal. CONCLUSION: Our method is very simple, short in operation time, and generates excellent results without specific complication.
Apocrine Glands ; Cicatrix ; Follow-Up Studies ; Hematoma ; Humans ; Lipectomy ; Necrosis ; Postoperative Complications ; Recurrence ; Seroma ; Skin ; Social Problems ; Subcutaneous Tissue ; Transplants ; Wound Healing

A 42 year old male was operated with aortic root abscess and pseudoaneurysm. Aortic valve vegetations which measured 8x5 cm and root abscess were removed and debrided. We reconstructed root and noncoronary sinus with autopericardium. Antibiotics were administered for 4 weeks. In general, Aortic root abscess recurs frequently and mortality is high. It is usually requires early surgical eradication with antibiotics medication
Abscess* ; Adult ; Aneurysm, False* ; Anti-Bacterial Agents ; Aortic Valve ; Atrioventricular Block* ; Endocarditis ; Humans ; Male ; Mortality

A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day. ha
Diet ; Esophageal Neoplasms ; Esophagoscopy ; Esophagus* ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Pleura ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Ultrasonography