OBJECTIVE: Mycoplasma pneumoniae infection is known as one of the frequent causes of exacerbation of bronchial asthma and it can also be a trigger for the initiation of asthma. However, little is known about the pathogenesis of respiratory M. pneumoniae infection. Furthermore, there is little data on human cytokine production and its involvement in the pathogenesis of M. pneumoniae infection. In order to investigate the immunopathogenesis of M. pneumoniae infection, we investigated the cytokine production in the bronchoalveolar lavage ( BAL ) fluid of patients with M. pneumoniae pneumonia and viral pneumonia, and compared the results with those of control subjects. SUBJECT AND METHOD: BAL was performed with fiberoptic bronchoscopy in patients with M. pneumoniae pneumonia( n=9 ), viral pneumonia( n=9 ), and control subjects( n=6 ) aged 3 years to 9 years. M. pneumoniae pneumonia was documented by polymerase chain reaction and serologic analysis. Four respiratory viruses ( adenovirus, influenza A, influenza B, parainfluenza ) were detected by culture method. Cell pellets and supernatants were separated by centrifugation and Interleukin( IL ) - 2, Interferon( IFN )-r, IL-4, and IL-5 levels were measured in concentrated BAL supernatants by ELISA. RESULTS: Analysis of cytokines revealed significantly increased production of IL-4 ( p< 0.0001 ) and IL-2 ( p< 0.0001 ), in patients with M. pneumoniae pneumonia and significantly increased production of IL-2 (p <0.0001) in patients with viral pneumonia compared with those of the control subjects. Ratio of IL-4/IFN-r was significantly increased in patients with M. pneumoniae pneumonia ( p< 0.005 ) but not in patients with viral pneumonia compared with that of the control subjects. CONCLUSION: IL-4 production and IL-4/IFN-r ratio were increased in the BAL fluid of patients with M. pneumoniae infection. These findings suggest that predominant Th2 immune response could play an important role in the pathogenesis of M. pneumoniae infection.
Adenoviridae ; Asthma ; Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Bronchoscopy ; Centrifugation ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Influenza, Human ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Mycoplasma pneumoniae* ; Mycoplasma* ; Paramyxoviridae Infections ; Pneumonia* ; Pneumonia, Mycoplasma* ; Pneumonia, Viral ; Polymerase Chain Reaction

An aberrant right subclavian artery, the most common congenital anomaly of the aortc arch, is rarely symptomatic during the infancy, if an anomalous origin of a right common carotid artery is also associateda varient of innomiate artery compression syndrome. We experienced a case of an aberrent right subclavian artery associated with an anomalous origin of the right common carotid artery in a female newborn, who showed severe respiratory distress soon after birth. The diagnosis was confirmed by aortogram and operative findings. the ligature and section of the aberrent right subclavian artery resulted in improvement of respiratory distress. A brief review of the related literature is also presented.
Arteries ; Brachiocephalic Trunk* ; Carotid Artery, Common ; Diagnosis ; Female ; Humans ; Infant, Newborn ; Ligation ; Parturition ; Subclavian Artery*

No abstract available.
Lung* ; Oxygen* ; Rabbits* ; Ventilation*

PURPOSE:Factors influencing postnatal growth are innumerable. It is known that genetic factors such as parental height and environmental factors such as nutrition, economic status and hormonal effects are important factors. The purpose of this study was to examine the factors affecting final adult height in normal children. METHODS:753 high school students (513 boys, 240 girls) who live in Seoul were studied. Height and body weight were measured and questionaires about sexual development were examined. We included the subjects who reached fianl adult height. The criteria of final adult height was as following: ages over 17 years in the boys and over 15 years in the girls and growth velocity was less than 1 cm per year. They had no systemic diseases and height standard deviation scores were more than -2.5. RESULTS: 1)Final adult heights were 173.1+/-.1cm in boys and 160.9+/-.7cm in girls. 2)Final adult height significantly correlated with father height(r=0.13, p<0.01), mother height(r=0.25, p<0.01), midparental height(r=0.25 p<0.01) and birth weight (r=0.16, p<0.01). 3)In short final adult height groups, birth weight and midparental height were significantly lower(p<0.05), but puberty onset age, body mass index and economic status were similar to normal stature groups. 4)Final adult height significantly correlated with target height.(r=0.43, p<0.01). In boys, the final adult height was 1.7cm taller than target height on the average. In girls, final adult height was 1.6cm taller than target height on the average. 5)In the group in which final adult height is less than target height, birth weights were significantly lower than those of the groups in which final height is greater than target height. CONCLUSIONS:Among factors affecting final adult height, parent height and birth weight were important. To predict final adult height, target height can be used simply and target height showed significant correlation with final adult height. In the case of showing differences between final adult height and target height, many factors including birth weight will influence the outcome.
Adolescent ; Adult* ; Age of Onset ; Birth Weight ; Body Mass Index ; Body Weight ; Child ; Fathers ; Female ; Humans ; Mothers ; Parents ; Puberty ; Seoul ; Sexual Development

No abstract available.
Extremities* ; Gangrene* ; Haemophilus influenzae type b* ; Haemophilus influenzae* ; Haemophilus*

Joubert syndrome is a rare hereditary brain malformation and transmitted as an autosomal recessive tarit. This disorder is clinically characterized by episodic tachypnea and apnea, abnormal ocular movements, developmental delay and ataxia. Anatomic anomalies include cerebellar vermal agenesis with dilatation of the fourth ventricle. Symptomatic onset is in the neonatal period and prognosis is severe. We have experienced a case of Joubert syndrome in a 3months old male patient, who manifested by developmental delay, periodic tachypnea and apnea, abnormal eye movement, generalized hypotonia and hypoplasia of cerebellar vermis with the 4th ventricular dilatation on brain MRI. We presented this case with a brief review of literatures.
Apnea ; Ataxia ; Brain ; Dilatation ; Eye Movements ; Fourth Ventricle ; Humans ; Magnetic Resonance Imaging ; Male ; Muscle Hypotonia ; Prognosis ; Tachypnea

PURPOSE: Flexible bronchoscopy is an important diagnostic and sometimes therapeutic tool that can be used on infants and children using light sedation and local anaesthesia. The purpose of this study is to evaluate the contribution of the flexible bronchoscopy to clinical diagnosis and therapy in children. METHODS: We examined the first 100 consecutive flexible bronchoscopies performed in children under 15 years of age(median age, 7 years). RESULTS: Indications for bronchoscopy were bronchoalveolar lavage(39.3%), wheezing(12.5%), stridor/noisy breathing(10.7%), recurrent/persistent pneumonia(8.0%), atelectasis or bronchial toilet (7.1%), equivocal airway foreign body(6.3%), hemoptysis(4.5%), and miscellaneous other reasons (11.6%). Inspection was abnormal in 79.0% of all investigations and made a clinically meaningful contribution to diagnosis in 79.0%. Bronchoalveolar lavage cytology was abnormal in 77.3% of the 44 lavages. Viruses and bacteria were isolated in 33.3% of the 48 specimens cultured. Meaningful therapeutic result was obtained in 81.3% of the 16 therapeutic bronchoscopies including bronchial toilet and persistent atelectasis. CONCLUSION: A high yield of meaningful diagnostic information and therapeutic goal can be expected from flexible bronchoscopy in children.
Bacteria ; Bronchoalveolar Lavage ; Bronchoscopy* ; Child ; Diagnosis ; Humans ; Infant ; Pulmonary Atelectasis ; Therapeutic Irrigation

We experienced a case of acquired bronchial stenosis in a male premature infant who had recurrent postextubation atelectasis of the right lung. Bronchography showed the stenosis of the distal portion of right main bronchus and the proximal portion of intermediate bronchus and autopsy findings showed ill-defined irregularly elevated nodule with fibrotic scarring in the trifurcation of right main bronchus. Endotracheal suction was suspected as the main cause. A brief review of literature was made.
Autopsy ; Bronchi ; Bronchography ; Cicatrix ; Constriction, Pathologic* ; Humans ; Infant, Newborn ; Infant, Premature ; Lung ; Male ; Pulmonary Atelectasis ; Suction*

PURPOSE:The incidence of congenital adrenal hyperplasia(CAH) is 1/5,000- 1/20,000 births and thus the importance of the neonatal screening test is being emphasized. However, the reference value for the term and preterm infants has not yet been established and false positive values are frequent due the immature hypothalamic-adrenal axis of the preterm infants or the stress-induced adrenal dysfunction. Therefore, we analyzed the 17-hydroxyprogesterone(17-OHP) concentration in terms of gestational age, birth weight, and postnatal state to establish the reference range for the Korean term and preterm infants. METHODS:We analyzed the results of the CAH screening test retrospectively, which was performed on 737 neonates(624 fullterm neonates, 113 premature neonates) born between January 1998 through July 1998 in Inje University College of Medicine Sanggye Paik Hospital. Mean gestational age and birth weight of infants were 38.2+/-2.6 weeks and 3,116+/-674kg respectively. 17-OHP screening test was performed on 4.9+/-3.8days after birth by obtaining blood samples from the heelstick of neonates. 17-OHP concentration was measured by the ELISA kit(ICN Co.) and repeated the procedure if the result was higher than 35ng/ml. RESULTS: 1) 17-OHP concentration of the preterm infants was significantly higher than that of the fullterm infants(19.1+/-12.3ng/ml vs 11.7+/-7.8ng/ml, P=0.001). 17-OHP concentration was inversely proportional to gestational age. 2)17-OHP concentration was inversely proportional to birth weight(r=0.22, P>0.01). 17-OHP concentration according to birth weight was as follows.:below 1,500g was 26.7+/-11.7ng/ml, 1,500 to 2,000g was 18.0+/-13.9ng/ml, 2,001 to 2,500g was 17.9+/-10.5ng/ml, 2,501 to 3,000g was 12.1+/-7.9ng/ml, 3,001 to 3,500g was 11.5+/-8.1ng/ml, above 3,500g was 11.4+/-7.5ng/ml. There was a significant decline in the 17-OHP concentration as the birth weight increased. 3) 17-OHP concentration was gradually decreased as sampling date increased. 4) The gender of the infants did not influence the 17-OHP concentration(male 13.0+/-9.1 vs female 12.7+/-9.0). 5)17-OHP concentration were significantly higher in sick preterm infants than healthy preterm infants. 6)Six cases, whose 17-OHP concentration were greater than 35ng/ml, were all preterm and low birth weight infants. Reexamination after one week showed the value within normal range. No CAH cases were diagnosed in the study. CONCLUSION: 17-OHP concentration was inversely proportional to gestational age and birth weight. Therefore, reference ranges of 17-OHP concentration should be subdivided according to gestational age and birth weight. Further research about perinatal risk factors affecting the 17-OHP concentration will be required.
17-alpha-Hydroxyprogesterone* ; Axis, Cervical Vertebra ; Birth Weight ; Enzyme-Linked Immunosorbent Assay ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Mass Screening ; Neonatal Screening ; Parturition ; Reference Values ; Retrospective Studies ; Risk Factors

PURPOSE: Visual internal urethrotomy is a standard therapy for incomplete urethral stricture, and may also be a reasonable initial treatment for a short complete urethral stricture. The success rate and final results of the repeated internal urethrotomy were retrospectively assessed to figure out the appropriate indication for visual internal urethrotomy as an initial treatment for incomplete pendulous and bulbous urethral stricture; according to the stricture free month. MATERIALS AND METHODS: Between January 1990 and December 1999, an internal urethrotomy was primarily performed on 166 patients with urethral strictures. The exclusion criteria were complete urethral and posterior urethral stricture. Retrograde urethrography was performed under fluoroscopic control. When the stricture recurred, the urethrotomy was repeated as the primary procedure. RESULTS: With regard to the time to recurrence, the success rate of the group of stricture recurrence at 6 months was significantly lower than that of the stricture free group at 6 months. CONCLUSIONS: With regard to the stricture site and length, the stricture free month might be considered as an important predictor of the outcome of a repeated internal urethrotomy, and visual internal urethrotomy might be considered as an initial treatment method for incomplete urethral stricture under the following conditions; a bulbous stricture, a stricture length under 20mm, and stricture free at 6 months.
Constriction, Pathologic ; Endoscopy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Urethral Stricture*