Dysregulated Production of IFN-g, IL-12, and IL-10 by Peripheral Blood Mononuclear Cells from Early Active Pulmonary and Multidrug-Resistant Tuberculosis Patients

In this study, we investigated profiles of the cytokines IFN-g, IL-12, and IL-10 in active pulmonary tuberculosis (EAPTB) patients, HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB) and in healthy tuberculin reactors (HTR). We studied the responses of peripheral blood mononuclear cells (PBMC) from 12 EAPTB patients and 15 MDR-TB patients to stimulation with a purified protein derivatives (PPD) antigen (Ag), and compared them with those from 14 HTR. Using ELISA, IFN-g production was found to be significantly depressed, while IL-10 was significantly elevated in both MDR-TB and EAPTB after in vitro stimulation with PPD, compared with those in HTR. Although there was no significant difference in IL-12 production among the three groups, mean IL-12 production was highest in patients with MDR-TB. In these patients, IL-12 production was significantly correlated with IL-10 expression, but not IFN-g production. In addition, neutralization of endogenous IL-10 led to enhanced IFN-g and IL-12Rb2 mRNA expression in TB patients. Our findings suggest that both groups of TB patients may have a similar disregulated pattern of IL-12, IL-10, and IFN-g production during M. tuberculosis infection. Furthermore, the results suggest a potentially pathogenic role for IL-10 in impaired Th1 immune responses in TB patients.

Infantile Hypertrophic Pyloric Stenosis Treated with Intravenous Atropine Sulfate

PURPOSE: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment. METHODS:From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed. RESULTS: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles. CONCLUSION: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy. (J Korean Pediatr Soc 2000;43:763-768)

The Effect of Massage on Premature Infants

PURPOSE: To determine the effects of massage therapy on growth, development, hormones, immune function, hepatic function, hematopoietic function and sleep pattern of preterm infants. METHODS: Thirty-one preterm infants of less than 35 weeks gestational age, who were admitted to Eulji Medical College Hospital Neonatal Intensive Care Unit between August 1998 and May 1999, and were in the state without mechanical ventilation or oxygen therapy, and hemodynamically stable with no acute disease state non congenital anomaly, and who were also fed by oral route or gastric tube, were enrolled in this study. The randomly selected massage group(15 neonates) received three 15-minute periods of tactile and kinesthetic stimulation daily for 7 days, and the control group(16 neonates) received general nursing care. We measured gastrin, thyroid function test, serum cortisol, CH50, IgG, IgM, CBC and liver function test in both groups before and after the study. During observation for 7 days, neonate behaviors were recorded every hour for 10sec using the analysis of 6 sleep-wake states. RESULTS: Although the massage group showed slight differences in blood level of Thyroid stimulating hormone, CH50, hemoglobin, hematocrit and body weight and alertness as compared with control group, there was no statistically significant difference between the two groups. CONCLUSION: Several positive effects of massage on the preterm infants that have been reported previously must be reevaluated.