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

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

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.

The computerized image analysis is a useful tool for the quantitative assessment of histopathologic findings. In contrast to the usual microscopic examination by pathologists, the computerization should be accompanied with the standardization process of the image. We developed an algorithm to standardize images and to determine the optimal gray level threshold, using a myocardial fibrosis model. Sirius red staining was more convenient for the image analysis than Masson's trichrome staining because of a better contrast with the surrounding structures. To get an optimal measurement, light intensity was standardized at each of the fibrosis, myocardium and background. In this study, the most promising method to determine the degree of fibrosis was that of revising the background without tissue to a gray level of 200, obtaining a green component of the color image, revising the myocardial fiber to 163, and defining a partial ratio as fibrosis index when the gray level threshold was 120. These threshold levels and parameters were determined after drawing the binarization index curves according to the change of the gray level threshold and by the morphological examination of the actual binarization figures overlaid to the original color image. Through these processes we could get a consistent result on the myocardial fibrosis and we expect a similar principle applies when we analyze color images in the histopathologic quantitation by computerized image analysis.
Fibrosis* ; Myocardium

The treatment of urolithiasis in children has been changed dramatically by extracorporeal shock wave lithotripsy (ESWL) and endourological procedure in recent years. Especially, the use of extracorporeal shock wave lithotripsy has changed the place of open surgery in the treatment of urinary stones in children. A total of 24 children with 25 renoureteral units underwent treatment with Therasonic Lithotrirter System for urinary tract stones between Feb. 1992 and March 1996. The patient age ranged from 3 months to 14 years with a mean of 4.7 years. The location of stones were renal in 9, upper ureter in 6, and lower ureter in 10 cases. The average stone length was 14mm with a range of 5mm to 50rnm. Developmental anomalies of the urinary tract were noted in 2 children, and there were the incomplete duplicated ureter and the ureterocele. The excreted stones in 5 children were analysed biochemically and calcium oxalate stones were present in 3 cases, calcium phosphate stone in 1 and cystine stone in 1. A complete stone free rate was achieved in 91.7%. Except for one case, no specific complication occurred during or after treatment, but perioperative antibiotic prophylaxis was done Therefore, the authors conclude that extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of urinary stones in children.
Antibiotic Prophylaxis ; Calcium ; Calcium Oxalate ; Calculi* ; Child* ; Cystine ; Humans ; Lithotripsy ; Shock ; Ureter ; Ureterocele ; Urinary Calculi ; Urinary Tract* ; Urolithiasis

BACKGROUND: Contact immunotherapy using diphenylcyclopropenone (DPCP) has been used in the treatment of alopecia and warts. DPCP seemed to be a promising agent for viral disease including molluscum contagiosum (MCI). OBJECTIVE: The purpose of this study was to evaluate the effect of DPCP immunotherapy on MC in children. METHODS: Twenty three patients with multiple lesion of MC were treated with DPCP immunotherapy. RESULTS: Twelve patients (52.2%) showed cure, and eleven patients (47.8%) showed treatment failure. No severe side effects were seen. CONCLUSION: DPCP immunotherapy may be an effective treatment in children with MC without serious side effects.
Alopecia ; Child ; Humans ; Immunotherapy* ; Molluscum Contagiosum* ; Treatment Failure ; Virus Diseases ; Warts