In the care of neonates, complications from the use of mechanical ventilation and other treatment of respiratory problems have important effects on cardiac output, cerebral blood flow, cerebral oxygenation and cerebral venous return that at times result in brain injury. Hypercapnia or hypocapnia following mechanical ventilation during the first few days of life may result in adverse effect on the CNS in perterm and term infants. Hypocapnia, particularly at PaCO2 levels less than 25 to 30 mmHg, has been associated with periventricular leukomalcia, cerebral palsy and poor neurologic outcomes in preterm infants. Use of smaller tidal volumes combined with permissive hypercapnia to reduce ventilator-induced lung injury may protect against hypocapnia-induced brain injury. Recent randomized clinical studies have demonstrated the safety of mild permissive hypercapnia, but found only small clinical benefits. Several studies have reported that the use of postnatal dexamethasone for severe RDS evolving into BPD have adverse effects on growth and neurodevelopmental outcomes. The results of large long-term follow-up studies strongly suggest an association between use of postnatal dexamethasone and poor neurodevelopmental outcome including cerebral palsy. Further studies including an evaluation of neurodevelopmental outcome as a primary endpoint must be needed for postnatal use of systemic or inhaled steroid.
Brain Injuries* ; Brain* ; Cardiac Output ; Cerebral Palsy ; Dexamethasone ; Follow-Up Studies ; Humans ; Hypercapnia ; Hypocapnia ; Infant ; Infant, Newborn ; Infant, Premature* ; Oxygen ; Respiration, Artificial* ; Tidal Volume ; Ventilator-Induced Lung Injury

Malformations of umbilicus are a feature of many dysmorphic syndromes and the measurement of periumbilical skin length should be considered as the basic step in the description of the umbilical malformations. So, we measured the periumbilical skin length in the 103 normal neonates and obtained the following results. 1) The means (+SD) of the periumbilical skin length were the 11.7mm (+3.0) in the cranial site and the 8.2mm (+2.5) in the caudal site, and the cranial length was 3.5mm longer than the caudal length. 2) No difference was observed between the male and female groups in the periumbilical skin length. 3) Age was the only statistically significant variable associated with the periumbilical skin length and it was observed that the periumbilical skin length decreased according to the advance of age (hour).
Female ; Humans ; Infant, Newborn ; Male ; Reference Values* ; Skin* ; Umbilicus

No abstract available.
HLA-DR Antigens*

Clothing dermatitis frequently goes unrecognized either becaue he clinical picture is mistaken for other disorders, such as seborrheic dermatitis, and prurius, or beacuse it is difficult to trace the causal agent. Contact dermatitis to disperse dyes, especially to azo dyes, has been well known and the most frequent sources of sensitization to dyes are dresses, stockings, and trousers made of synthetic fabrics We described a case of hat band contact dermatitis due to disperse dyes, proven by a patch test. Although chrome was not proven by the diphenylcirbizide method, many dyes known to be contact allergens were proved in different kinds of hat bands.
Allergens ; Clothing* ; Coloring Agents* ; Dermatitis ; Dermatitis, Allergic Contact* ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Patch Tests

No abstract available.
Cor Triatriatum*

No abstract available.
Child* ; Humans ; Mycobacterium bovis* ; Skin* ; Tuberculin Test* ; Tuberculin*

This study was carried out to investigate the morphologic characteristics and localization of antigenic molecules of Pneumocystis carinii in experimentally induced P. carinii pneumonia in rats. After six weeks of administration of low protein diet and dexamethasone, Sprague-Dawley rats were sacrificed to submit lungs or bronchoalveolar lavage for the study. Monoclonal (092, 900, 902, and 904) and polyclonal (SP-D) antibodies were used for immunohistochemistry and immunoelectron microscopy (ITEM and ISEM). Immunohistochemically P. carinii organisms were well identified as clusters or separated forms in the alveolar spaces being frequently attached to the alveolar walls. Immunoelectron microscopically the adherences of gold particles were observed on the surface of all stages of the P. carinii. Occasionally positive immunogold labeling was observed in the cytoplasm of the trophozoites and on the pellicle of the intracystic bodies within the cysts. The monoclonal antibodies 092, 900, 902, and 904 reacted mainly with pellicles of P. carinii, whereas SP-D labeled on the pellicles, intracystic bodies, cytoplasms of the alveolar macrophages, and free floated surfactant material in the alveolar spaces. The immunogold particles were observed more diffusely and intensely in the cysts than in the trophozoites. These results indicate that antigen is mainly localized on the pellicles, and accumulated during development from the trophozoite to the cyst stages.
Animals ; Antibodies ; Antibodies, Monoclonal ; Bronchoalveolar Lavage ; Cytoplasm ; Dexamethasone ; Diet, Protein-Restricted ; Immunohistochemistry ; Lung ; Macrophages, Alveolar ; Microscopy, Electron ; Microscopy, Immunoelectron ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pulmonary Surfactant-Associated Protein D ; Rats ; Rats, Sprague-Dawley ; Trophozoites

No abstract available.
Brain Injuries* ; Brain*

The pulmonary microvasculatures of rats were studied by injection replicas prepared from Mercox. This medium enabled us to easily obtain consistent, stable, and complete injected replicas of the pulmonary vasculature. In order to investigate the three dimensional structures of the tributaries of the bronchial artery, such as the capillary plexus and vasa vasorum, we performed a scanning electron microscopic(SEM) study of the vascular casts, using Mercox CL-2B as a media. The alveolar capillaries revealed hexagonal or pentagonal rings of vascular networks. In some areas, the vascular rings composed a square network, The bronchial tree was supplied by the bronchial arteries which form a coarse capillary extending as far as the terminal bronchioles. Occasionally the capillary plexus was connected with adjacent capillary networks in and around the alveolar walls. The walls of the pulmonary artery revealed only a single layer of the vasa vasorum, but those of the pulmonary vein were surrounded by more complicated and well developed vasa vasorum than the pulmonary arterial side. The mean diameters of the venous vasa vasorum are greater than the arterial vasa vasorum.
Rats ; Animals

PURPOSE: The incidence of hyperkalemia and the factors contributing the serum potassium level within 72 hours after birth in extremely preterm infants were determined. METHODS: The incidence of hyperkalemia and differences of clinical features between hyperkalemic(> OR =6.5mEq/L) and normokalemic(<6.5mEq/L) groups were determined by reviewing medical records of 53 extremely preterm infants born at less than 28 weeks gestation. RESULTS: The mean birth weight and gestational age of were 912+/-6gram and 26.2+/-3weeks respectively. Thirty-six infants(67.9%) had at least one serum potassium level that exceeded 6.5mEq/L, and 15 infants with hyperkalemia(> OR =6.5mEq/L) had electrocardiographic abnormalities and eight infants had hyperkalemia-induced cardiac arrhythmia such as ven- tricular tachycardia, fibrillation and/or bradycardia. Serum potassium peaked in 13-36 hour postnatal age and the incidence of electrocadiographic abnormalities was highest in the 13-36 hour postnatal age group (P<0.05). Urine flow rate during the first 48 hours after birth was only significantly lower for hyperkalemic infants(P<0.05). Six infants with hyperkalemia died as a direct result of hyperkalemia-induced cardiac arrhythmia. CONCLUSION: Hyperkalemia frequently occurred within the first 72 hours of life in extremely premature infants. Serum potassium should be monitored closely to avoid life-threatening cardiac arrhythmia in these infants.
Arrhythmias, Cardiac ; Birth Weight ; Bradycardia ; Electrocardiography ; Gestational Age ; Humans ; Hyperkalemia* ; Incidence ; Infant ; Infant, Extremely Premature* ; Infant, Newborn ; Medical Records ; Parturition* ; Potassium ; Pregnancy ; Tachycardia