PURPOSE: Chronic lung disease is a cause of significant morbidity and mortality in the neonatal respiratory distress syndrome. Although the exact mechanisms leading to the development of chronic lung disease are unknown, there is increasing evidence indicating that pulmonary inflammation contributes to the pathogenesis. The proinflammatory cytokines, interleukin(IL)-1beta, IL-8 may have a role to play in initiating the inflammatory response that is seen in chronic lung disease. In contrast, IL-10 is an antiinflammatory cytokine. The abnormal persistent inflammatory process in chronic lung disease may be due to dysregulation of these proinflammatory cytokines. So, to describe cytokine profiles of chronic lung disease in neonate, we analysed the IL-1beta, IL-8 and IL-10 levels in bronchoalveolar lavage fluid by ELISA technique. METHODS: We obtained bronchoalveolar lavage samples from 14 respiratory distress syndrome infants without chronic lung disease and 8 respiratory distress syndrome infants with chronic lungisease. The cytokine levels were assayed. RESULTS: The results were as follows: 1) IL-1beta levels were higher in chronic lung disease group(205.16+/-360.21pg/rnl) than group without chronic lung disease(21.21+/-26.14pg/ml)(P<0.05). 2) IL-8 levels were also higher in chronic lung disease group(166.16+/-347.26pg/ml) than group without chronic lung disease(49.85+/-105.27pg/ml)(P>0.05). 3) In contrast, IL-10 levels were lower in chronic lung disease group(78.29+/-138.69pg/ml) than group without chronic lung disease(111.29+/-155.27pg/ml)(P>0.05). CONCLUSION: These results suggest that the dysregulation of cytokines contributes to the pathogenesis of chronic lung disease. The difference in cytokine levels of bronchoalveolar lavage fluid can be used as a predictor for development of chronic lung disease.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Infant, Newborn ; Interleukin-10 ; Interleukin-8 ; Lung Diseases* ; Lung* ; Mortality ; Pneumonia ; Respiratory Distress Syndrome, Newborn

The association of colonic atresia in patients with Down syndrome is a rare anomaly. The incidence of congenital atresia of the gastrointestinal tract has been estimated to be about one in 1500 births. Colonic atresia is rarer still, and is throut to comprise about 5% to 10% of this group. This intestinal atresia occurs in about 30% to 50% of patient with Down syndrome. We experienced a case of Down syndrome associated with colonic atresia in a 1 day old male. His initial chief complaints at the admission were severe abdominal distension and Down appearance. Diagnosis was confirmed by chromosomal study and operative laparotomy with end-to-end ileodescending colostomy. We report the case with brief review of related literatures.
Colon* ; Colostomy ; Diagnosis ; Down Syndrome* ; Gastrointestinal Tract ; Humans ; Incidence ; Intestinal Atresia ; Laparotomy ; Male ; Parturition

Nevus flammeus is a benign but cosmetically devascating congenital inalformation involving mature capillaries. The copper vapor laser is a therapeutic device which had been newly applied to this. Yellow copper vapor light is absorbed by the intraluminal oxyhemoglobulin mo ecules, leading to the destruction of blood vessels. This study was undertaken to evaluate the histobigic findings in a patient with nevus flammeus according to the sequential time after copper vapor laser therapy. The results were as followed, One hour after treatment, nonspecific damages to the epidermis and upper part of the dermis were observed. The specific damage to the vessels which showed thrombi formations and partial disruption of the vessel walls was prominent. One cay after treatment, degeneration of the epidermis and sepaiation of the dermoepidermal junction were apparent. Three days after treatment, extravasations of a small amount of erythrocytes and inflanimatory cell infiltrations were present, especially around the vessels. Seven days after treatment, the capillaries showed a deposition of fiorinoid material around themselves. Partial disappearance of the vessel walls was seen. There was hisi ologic evidence of the replacement of abnormal ectatic vessels by normal appearing vessels with small uminal diameters, surrounded by endothelial cells.
Blood Vessels ; Capillaries ; Copper* ; Dermis ; Endothelial Cells ; Epidermis ; Erythrocytes ; Humans ; Lasers, Gas* ; Nevus* ; Port-Wine Stain*

To clarity the effect of biliary obliteration on copper metabolism of rat liver and on the hepatic morphology, 0.5% cuppuric sulfate was administered intraperitoneally for 42 days following ligation of the common bile duct (CBD) of Sprague-Dawley rats. The blood copper concentration, the hepatic copper content and the accumulation patterns of copper and copper binding protein in the liver were examined and compared with those of the simple CBD ligation group and the simple copper over loaded group. CBD ligation induced marked proliferation of bile ductular structures which, after expanding the portal tracts, invaded and divided the hepatic lobules. There was, however, no excess fibosis beyond what needed to support the new ductules. The blood copper concentration and the hepatic copper content were increased by copper overload with or without CBD ligation, particularly incases with CBD ligation. Liver cell necrosis did not occur by the overloaded copper alone in rats. The hepatic copper and copper binding protein were accumulated at periportal liver cells in the group of coppe overload after CBD ligatio, whereas they began to appear at perivenular hepatocytes in the simple copper overloaded group. In conclusion, it is suggested that CBD ligation does not induce excess fibrosis or liver cirrhosis in rat as far as during our experimental period, but affect significantly on copper metabolism by intrahepatic redistribution of the copper and the copper binding proteins.
Rats ; Animals

The occurrence of atrial fibillation during an electrophysiologic study or catheter ablation in patients with accessory pathways is a common problem and sometimes complicates the localization and ablation procedure of accessory pathways. In patients with sustained atrial fibrillation, it is often time-consuming to terminate atrial fibrillation by drugs or electrical cardioversion. We performed successful radiofrequency catheter ablation in a patient with right-sided accessory pathway during atrial fibrillation requiring repeated electrical cardioversion. The target site was determined by activation mapping and morphology of unipolar electrogram at a site of early ventricular activation.
Atrial Fibrillation* ; Catheter Ablation ; Electric Countershock ; Humans

Cryptococcosis is an acute, subacute or chronic infectian caused by the encap sulated yeast Cryptococcus neoformans. The case of Cryptococcosis is a 2 5/12 year-old boy with involvement of the skin, lungs, liver, spleen, lymph node and central nervous system is reported. He has suffered from fever, nausea., vomiting and multiple skin lesions for a month. Thcre were various cutaneous lesions consisting of papules, pustules, nodules, crusts and ulcers on the scalp, face, back, buttocks and both extremities. Diagnosis was confirmed by the clinical characteristics, histopathologic findings and culture of the C. neoformans from cerebrospinal fluid and marcerated skin tissue. He was successfully treated with combination of Amphotericin B and 5-fluorocytosine.
Amphotericin B ; Buttocks ; Central Nervous System ; Cerebrospinal Fluid ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Extremities ; Fever ; Flucytosine ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Nausea ; Scalp ; Skin ; Spleen ; Ulcer ; Vomiting ; Yeasts

Histiocytic medullary reticulosis is a rare, uniformly fatal, acute disease of the reticuloendothelial system. The disease is associated with fever, malaise, weakness, weight loss, lymphadenopathy, hepatosplenomegaly, jaundice, and purpura. Common laboratory findings are severe anemia, leukopenia, and thrombocytopenia. A 49-year-old male patient is described who had multiple purple nodules and tumors in the skin. A biopsy taken from a skin lesion showed a diffuse proliferation of atypical histiocytes in the dermis and subcutaneous tissue.However, erythrophagocytosis of these atypical histiocytes was not seen.
Acute Disease ; Anemia ; Biopsy ; Dermis ; Fever ; Histiocytes ; Humans ; Jaundice ; Leukopenia ; Lymphatic Diseases ; Male ; Middle Aged ; Mononuclear Phagocyte System ; Purpura ; Skin ; Thrombocytopenia ; Weight Loss

The long QT syndrome is believed to result from abnormalities of cardiac sympathetic innervation and of myocardial repolarization. The therapeutic modalities for patients with ventricular arrhythmias due to the long QT syndrome include beta blocker, cardiac sympathetic denervation, pacemaker and ICD implantation. Recently, we underwent transvenous ICD implantation in a patient with this syndrome who had recurrent syncopal episodes due to rapid polymorphic ventricular tachycardia and strong family history of sudden death.
Arrhythmias, Cardiac ; Death, Sudden ; Humans ; Long QT Syndrome* ; Sympathectomy ; Syncope ; Tachycardia, Ventricular

The long QT syndrome is believed to result from abnormalities of cardiac sympathetic innervation and of myocardial repolarization. The therapeutic modalities for patients with ventricular arrhythmias due to the long QT syndrome include beta blocker, cardiac sympathetic denervation, pacemaker and ICD implantation. Recently, we underwent transvenous ICD implantation in a patient with this syndrome who had recurrent syncopal episodes due to rapid polymorphic ventricular tachycardia and strong family history of sudden death.
Arrhythmias, Cardiac ; Death, Sudden ; Humans ; Long QT Syndrome* ; Sympathectomy ; Syncope ; Tachycardia, Ventricular

Photographic standards in plastic surgery is an important problem that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and postoperative comparisons. However, no photographic standards in plastic surgery were established in Korean Society of Plastic and Reconstructive Surgeons. We analyzed that inappropriate photographs in the total publishing photographs were counted on the Journals of the Korean Society of Plastic and Reconstructive Surgeons from 1995 to 2000. The causes of inappropriate photographs were categorized as six groups. We found three characteristics from photograph published on this journals. First, the ratio of inappropriate photographs were not decreased for recent six years - 30.6% in 1995 and 29,7% in 2000. The mean proportion of poorly qualifying photographs in total photos was 29.3% during six years. Second, the subject malposition due to incorrect anatomic landmark and technical errors were 34.8%., 20.0%, respectively. The markedly different size of pre-and postoperative subject, inappropriate orientation of camera (horizontally or vertically), inadequate patient preparation, others were 15.3%, 14.9%, 7.9%, 7.1% in order. Third, the most patient identity in this publication was recognizable regardless of patient consent(1673/1761, 95.0%). In our conclusion, first, the ease photographic standards for plastic surgeon in Korea was guided in our study. Second, we thought that the ease of using digital photography may be able to correct the inappropriate photographs due to technical errors of amateur. Third, we proposed that new format of permission for patient photographic authorization and release will be needed because of prevention against sue for invasion of privacy or release of identity in Korea.
Anatomic Landmarks ; Humans ; Informed Consent ; Korea ; Photography ; Privacy ; Publications ; Surgery, Plastic*