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

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

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

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

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.

Migratory birds have been suspected as playing a central role in transmission of various trematodes, but few surveys have been undertaken in the Republic of Korea. In the present study, we describe new fauna of microphallid flukes in Korea. Two species of microphallids were found in the intestines of 2 migratory bird species, namely the red necked stints (Calidris ruficollis) and the terek sandpiper (Xenus cinereus), in a coastal area of Gunsan-si, Jeollabuk-do. The microphallids recovered from the latter were 451 microm in length and 217 microm in width, and the eggs were very small, 13 microm by 8 microm. They had the characteristic extracecal vitellaria intruding into the median posttesticular area, belonging to Endocotyle incana. Another microphallids were discovered from both migratory birds, 417 microm in length and 249 microm in width. The cirrus was projecting into the genital atrium in form of male papilla, and bounded by a muscular flap, termed pseudogonotyl. They were identified as Spelotrema pseudogonotyla in consideration of the distinctive male papilla and pseudogonotyl. Besides these flukes, Maritrema obstipum and Gynaecotyla squatarolae also were recovered. This paper is in fact the first report on the presence of Spelotrema and Endocotyle in Korea.
Animals ; Bird Diseases/*parasitology ; Charadriiformes/*parasitology ; Microscopy ; Republic of Korea ; Trematoda/anatomy & histology/*classification/*isolation & purification ; Trematode Infections/parasitology/*veterinary ; Zygote

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

Revascularizations of 14 occlusive arterial diseases in the lower extremities with the Transluminal Endarterectomy Catheter was done successfully. The causes of occlusions were atherosclerosis in 9 cases and cardiogenic thromboembolism in 5 cases. The site of lesions were at the common femoral artery in 1 case, the superficial femoral artery in 6 cases and the popliteal artery in 7 cases. The length of the lesion were below 5cm(n=3), 5-10cm(n=2), 11-20cm(n=6) and 21-30cm(n=3). Complications were distal embolism(n=1) and hematoma at the puncture site(n=1). No symptoms recurred in any cases during 2 months -15 months followup. Endarterectomy with Transluminal Endarterectomy Catheter was found to be an effective method for revasculizations of occlusive arterial disease in the lower extremity, especially in long segmental occlusion.
Atherosclerosis ; Catheters ; Endarterectomy* ; Femoral Artery ; Follow-Up Studies ; Hematoma ; Lower Extremity* ; Methods ; Popliteal Artery ; Punctures ; Thromboembolism