The pathogenetic role of intrauterine infection to the neonatal pulmonary injury and bronchopulmonary dysplasia was assessed by studying the interleukin-6 (IL-6) level in the umbilical cord blood and the early morphologic changes of the neonatal lung. Patients were grouped into bronchopulmonary dysplasia (4 cases), chorioamnionitis without chronic lung injury (4 cases), and 6 cases without morphologic evidence of chronic lung injury or placental inflammation. IL-6 level of umbilical cord blood was higher in babies with bronchopulmonary dysplasia (17.7 pg/ml) compared to those with chorioamnionitis (4.7 pg/ml) or those with morphologically normal lung and placenta (6.2 pg/ml). Morphologic parameters of neonatal pulmonary injury were hyaline membrane, terminal bronchiole inflammation, terminal bronchiole regeneration, alveolar collapse and fibroblastic proliferation. Bronchiolar regeneration was the most peculiar feature seen in the lung with bronchopulmonary dysplasia. Alveolar collapse and interstitial fibroblastic reaction were commonly seen in bronchopulmonary dysplasia. The postnatal age at death was higher in those with bronchopulmonary dysplasia, although the occurrence of the morphologic changes was related with the chronicity of those lesions. These findings suggest that intrauterine infection is an aggravating factor for the neonatal pulmonary injury and bronchopulmonary dysplasia, although the early stage of the lung injury is not a definitive indicator for the progressive pulmonary damage leading to the bronchopulmonary dysplasia.
Bronchioles ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Cytokines ; Female ; Fetal Blood ; Fibroblasts ; Humans ; Hyalin ; Hyaline Membrane Disease ; Infant, Newborn ; Inflammation ; Interleukin-6 ; Lung ; Lung Injury* ; Membranes ; Placenta ; Pregnancy ; Regeneration

On the contrary to congenital anomalies of intestinal rotation in pediatric patients, those in adults are generally nonsymptomatic and of little consequence. Occasionally, however, an adult may have midgut nonrotation and complain of chronic or recurrent abdominal pain. Intestinal nonrotation can be divided into complete or partial failure of rotation and into abnormalities affecting the proximal segment, the distal segment or both. We report herein a 43-year old female patient with symptomatic partial, cecocolic nonrotation.
Abdominal Pain ; Adult* ; Female ; Humans

Thin basement membrane nephropathy(TBMN) is defined histologically as follows: 1) By light rnicroscopy only minor abnormalities are detected in the glomeruli at most minor mesangial widening. 2) By electron microscopy, diffuse thinning of glomerular basement rnembrane is demonstrated. 3) By immunofluorescence, absence of immunoglobulins and complement components is demonstrated. 4) Alport's syndrome and systemic diseases that may affect the glomerular structure have been excluded. TBMN presented frequently with recurrent or persistent microscopic hematuria. Massive proteinuria such as in nephrotic syndrome rarely occurs in TBMN. We reported two cases of TBMN presented with typical minimal change nephrotic syndrome.
Basement Membrane* ; Complement System Proteins ; Fluorescent Antibody Technique ; Hematuria ; Immunoglobulins ; Microscopy, Electron ; Nephritis, Hereditary ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria

Despite major diagnostic advances, 10-30% of hepatic metastases of colorectal carcinoma remain undetected. In this study, CEA levels of peripheral (p-CEA), drainage venous blood(d-CEA) and gallbladder bile(b-CEA) in patients with colorectal cancer were determined to examine the significance of their CEA levels in predicting hepatic metastases. From January 1993 through May 1996, p-CEA, d-CEA and b-CEA were obtained in 50 colorectal carcinoma patients without gallbladder pathology. Synchronous hepatic metastases were found in 5 patients(Hm group) and 45 cases had no hepatic metastasis. Among the 27 cases who followed up over 2 years, metachronous hepatic metastases(Hr group) were found in 6 cases and remaining 21 cases had no metastases(Ho group). Elevation of p-CEA, d-CEA, and b-CEA was significantly correlated with lymph node metastases and hepatic metastasis. The b-CEA levels were significantly correlated with p-CEA(r=0.533926, p<0.0001) while d-CEA levels were not(r=0.276437, p=0.0520). Although all the levels of p-CEA, d-CEA, and b-CEA in Hr & Hm group were significantly higher than those in Ho group, d-CEA level was considered as most sensitive index in predicting hepatic metastases(mean 12.7 ng/ml in Ho, 88.6 in Hr, and 137.3 in Hm group. p<0.0001). The possible cut-off level of d-CEA was 40 ng/ml because all of the cases with d-CEA < 40 ng/ml had no hepatic metastasis nor hepatic recurrance, whereas 11 out of 12 patients with d-CEA > 40 ng/ml had hepatic metastases(5 synchronous, 6 metachronous). However it is impossible to establish the possible of b-CEA because of high false positive and negative rate in predicting metachronous hepatic metastases. In conclusion, it is suggested that d-CEA could be highly sensitive indicator for selecting high-risk patients of metachronous hepatic metastases of colorectal cancer.
Bile* ; Colorectal Neoplasms* ; Drainage* ; Gallbladder* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Pathology

PURPOSE: Numerous operative techniques have been developed to correct hypospadias. Tubularized incised plate (TIP) urethroplasty has recently been reported with good results. We analyzed the surgical outcome and complications in children with hypospadias using TIP urethroplasty. MATERIALS AND METHODS: Between July 1998 and July 2001, 28 patients with hypospadias were primarily corrected using TIP urethroplasty by one surgeon. The mean age of the patients was 4.2 years. A position of the meatus was coronal in six boys, at the posterior penile shaft in five, glandular in four, penoscrotal in four, at the anterior penile shaft in three, at the midshaft in three and the perineal in three. An 8 or 10 Fr Foley catheter was used as a urethral stent, which was removed at day 12 (10-15). RESULTS: Of the 28 patients, 23 were corrected with TIP urethroplasty only, and the other 5 combined with an onlay island flap. For the management of penile curvature, skin and ventral releases were used in 14 patients; with tunica albuginea placation used in the other 14. Postoperative complications were noted in 3 patients, of whom 2 developed urethrocutaneous fistula and one developed meatal stricture. The cosmetic results were very good in most patients. CONCLUSIONS: TIP urethroplasty can be used for all type of hypospadias. It has advantages, such as an excellent cosmetic appearance, preservation of the urethral plate and a lower complication rate than other urethroplasty techniques. Our results suggest that this technique is recommendable for the management of primary hypospadias as a first choice.
Catheters ; Child ; Constriction, Pathologic ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Postoperative Complications ; Skin ; Stents ; Urethra

Neonatal meningitis caused by the Group B beta-hemolytic streptococcus was first reported in 1958. In recent years this organism has assumed major importance in the etiology of neonatal infection. In Korea, this organism is likely to play an increasing role in neonatal infection. So this investigation was designed to report the 9 cases of Group Bbeta-hemolytic streptococcus infected neonates admitted to the NICU, department of Pediatrics, Hanil Hospital from January 1990 to June 1993. The results were as followings. 1) Onset of disease was between 12days and 32 days of age and male to female ratio is 1:2. 2) Two cases were delivered by c-section, seven cases were by NFSD and all of the infants had normal birth weight with full term at delivery. Maternal obstetric and neonatal complications were not detected in all cases. 3) The common presenting symptoms were fever in all cases, seizure in 6 cases, feeding difficulty, lethargy, vomiting, etc. 4) Group Bbeta-hemolytic streptococcus was isolated in CSF of all cases and in blood of 6 cases. 5) There were abnormal brain CT findings in 4 cases of group Bbeta-hemolytic streptococcal meningitis. 6) The sensitive antibiotics were Cefotaxime, Cefazoline, Erythromycin, Ampicillin, Chloramphenicol, Clindamyucin and Penicillin. 7) All cases were reconvered except one case that expired on the 1st day of admission and 6 cases were followed up for the period of 2months to 33months without neurologic sequelae, of which 1 case revealed decreased wave on Lt. hemisphere in ABR.
Ampicillin ; Anti-Bacterial Agents ; Birth Weight ; Brain ; Cefazolin ; Cefotaxime ; Chloramphenicol ; Erythromycin ; Female ; Fever ; Humans ; Infant ; Infant, Newborn ; Korea ; Lethargy ; Male ; Meningitis* ; Pediatrics ; Penicillins ; Seizures ; Streptococcus ; Vomiting

Background: Cranial nerve ganglia, which are prone to viral infections and tumors, are located deep in the head, so their detailed anatomy is difficult to understand using conventional cadaver dissection. For locating the small ganglia in medical images, their sectional anatomy should be learned by medical students and doctors.The purpose of this study is to elucidate cranial ganglia anatomy using sectioned images and three-dimensional (3D) models of a cadaver. Methods: One thousand two hundred and forty-six sectioned images of a male cadaver were examined to identify the cranial nerve ganglia. Using the real color sectioned images, real color volume model having a voxel size of 0.4 × 0.4 × 0.4 mm was produced. Results: The sectioned images and 3D models can be downloaded for free from a webpage, anatomy.dongguk.ac.kr/ganglia. On the images and model, all the cranial nerve ganglia and their whole course were identified. In case of the facial nerve, the geniculate, pterygopalatine, and submandibular ganglia were clearly identified.In case of the glossopharyngeal nerve, the superior, inferior, and otic ganglia were found. Thanks to the high resolution and real color of the sectioned images and volume models, detailed observation of the ganglia was possible. Since the volume models can be cut both in orthogonal planes and oblique planes, advanced sectional anatomy of the ganglia can be explained concretely. Conclusions The sectioned images and 3D models will be helpful resources for understanding cranial nerve ganglia anatomy, for performing related surgical procedures.

Anatomy must be known not only by medical students but also by health science students. Furthermore, common people had better know anatomy because anatomy helps them keep their own health and dig up their own curiosity of body. It is desirable that common people learn morphology and function of the human body using easy, familiar, and interesting anatomy cartoon. But we could not find such a Korean anatomy cartoon, so that we tried to make anatomy cartoon for common people as follows. For anatomy cartoon, anatomist decided anatomy contents to write sentences. Based on the sententces, raw illustrations of anatomy cartoon were drawn on the paper with a pencil. Final illustrations of anatomy cartoon (931 cuts) were drawn on Adobe Illustrator of the personal computer. In addition, anatomy comic cartoon composed of four cuts (100 episodes) were drawn. Anatomy term explanations, anatomy photographs, and anatomy movies were created and hyperlinked with the anatomy cartoon, all of which were distributed through homepage (anatomy.co.kr), CD title, and book. The anatomy cartoon will be helpful not only to anatomy study of the common people and health science students but also to preliminary anatomy study of the medical students.
Anatomists ; Exploratory Behavior ; Human Body ; Humans ; Microcomputers ; Students, Medical

In order to review anatomy lectures, medical students use the lecture materials, lecture notebooks, or recorded voices of lectures. These learning materials are not so effective as the movies of anatomy lectures. The purpose of this research is to help medical students review anatomy lectures by giving them the chance to replay the movies of anatomy lectures conveniently on the computer. For the purpose, an anatomy professor presented board lectures (about 14 hours) according to the anatomy units (introduction, back, upper limb, neck, head, thorax, abdomen, pelvis, perineum, and lower limb), which were recorded by camcorders to make movies. The movies were transferred to the computer; subsequently, edited suitably on the Adobe Premiere. The movies were compressed to make MPEG files (size 28.0 GBytes) and WMV files (size 1.4 GBytes). In case of the slide lecture, we made a program, on which lecture movies and slides could be watched concomitantly and conveniently. The movies of anatomy lectures were distributed off-line or on-line to help medical students review the anatomy lectures. This report about techniques of making movies will promote other anatomy professors to make movies of their own anatomy lectures.
Abdomen ; Head ; Humans ; Learning ; Lectures* ; Neck ; Pelvis ; Perineum ; Students, Medical ; Thorax ; Upper Extremity ; Voice

Visible Human Project dataset made in the United States has some problems which were caused by the cadaver selection, cadaver treatment, MRI (magnetic resonance image) scanning, and CT (computerized tomograph) scanning. Therefore, in this study, we intended to make better serially sectioned images, namely Visible Korean Human, which overcome the problems of Visible Human Project dataset. The better serially sectioned images will be the basis of better three dimensional images of the whole body, which are helpful in medical education An appropriate Korean male cadaver was selected for this study. Without injecting fixative, the cadaver's posture and direction were adjusted and fixed in an immobilizing box. Horizontal MRIs and CTs of the cadaver's whole body were scanned at 1 mm intervals. In addition, coronal and sagittal MRIs and CTs as well as movies of the MRIs and CTs were made. Age of the selected cadaver was young (32 years old), body size was Korean average (height 1,640 mm, weight 55 kg), and pathological findings were few. 1,718 couples of corresponding MRIs and CTs, in which anatomical structures appear clearly (pixel size 1 mm), were acquired. 276 couples of coronal MRIs and CTs as well as 505 couples of sagittal MRIs and CTs were acquired. Movies of all MRIs and CTs were acquired as well. The serially sectioned images acquired in this study will be helpful either in studying MRIs and CTs by referring to corresponding anatomical images or in studying anatomy and medicine by reconstructing MRIs, CTs, and anatomical images into three dimensional images.
Body Size ; Cadaver* ; Dataset ; Education, Medical ; Family Characteristics ; Humans ; Magnetic Resonance Imaging* ; Male ; Posture ; United States