Immunocytochemical Study for Detection of Lactoglobulin in Alveolar Macrophage of Cow Milk Aspirated Mouse / 소아알레르기및호흡기학회지

PURPOSE: It is difficult to detect small amount of aspiration into the lungs due to the lack of safe, sensitive and specific diagnostic tool. Recently, in animal studies, it has been reported that immunocytochemistry for lactoglobulin can be used to detect the minimal aspiration of cow milk. So, we tried to determine the difference between immunocytochemistry for lactoglobulin and Oil Red O stain of alveolar macrophages in cow milk aspirated mice. METHODS: Fifty seven mice with 6-8 weeks old and 30-40 g weighing were used. Mice received either single or multiple intranasal instillation of 0.05 ml cow milk for study and saline for control under the anesthesia with ketamine and xylazine. The trachea of mouse was cannulated with 20G Jelco needle and then, mouse lungs were lavaged 3 times with 0.5 ml of phosphate buffer solution at 4 hours, 12 hours, 24 hours after the last milk or saline instillation. Cells in bronchoalveolar lavage fluid(BALF) were stained with Oil Red O and immunocytochemistry for beta-lactoglobulin. RESULTS: After single aspiration of milk, no cellular difference was found in bronchoalveolar lavage fluid(BALF) when compared with saline aspirated group at 4 hours. But after repeated aspiration of milk, significant change was observed in the number of alveolar macrophage, neutrophil, lymphocyte and eosinophil. Immunocytochemical reactivity was not observed in alveolar macrophages of saline aspirated group. Lipid-laden alveolar macrophages were recovered rarely in Oil Red O staining. Immunocytochemical staining displayed stain-positive alveolar macrophages for beta-lactoglobulin at 4 hours after milk aspiration, it had a peak at 12 hours and decreased markedly at 24 hours. Immunocytochemical stain positive alveolar macrophages appeared similarly in number between single and repeated aspiration group. CONCLUSION: These observations suggested that alveolar macrophages could be detected more easily on immunocytochemistry for lactoglobulin than Oil Red O stain and immunocytochemistry could be used as a sensitive & specific diagnostic method for the detection of milk aspiration.

A Study on Correlation Among Cord Blood Arachidonic Acid Level, Birth Weight, and Placental Weight

PURPOSE: Arachidonic acid is known to have effects on cell growth as a controller of cell proliferation and a stimulator of platelet derived growth factor. We investigated the correlations among birth weight, placental weight and free arachidonic acid level in cord blood. METHODS: Twenty full-term well babies were included in this study. Those who had sepsis, IUGR, twin that may affect the level of arachidonic acid, birth weight, and/or placental weight were excluded. Free arachidonic acid level were measured by gas chromatographic-mass spectrometry. (GC-MS) Correlation Pearson Coefficients were used for statistical analyses. RESULTS: The correlation coefficients between birth weight and placental weight, birth weight and arachidonic acid level, and placental weight and arachidonic acid level were 0.727 (P0.05), 0.407 (P>0.05) respectively. CONCLUSION: There was statistically significant positive correlation between birth weight and placental weight. But since cord blood free arachidonic acid levels were not correlated with placental weight and birth weight, we conclude that cord blood free arachidonic acid level has no effects on fetal growth and placental growth.

A Study on Correlation Among Cord Blood Arachidonic Acid Level, Birth Weight, and Placental Weight

PURPOSE: Arachidonic acid is known to have effects on cell growth as a controller of cell proliferation and a stimulator of platelet derived growth factor. We investigated the correlations among birth weight, placental weight and free arachidonic acid level in cord blood. METHODS: Twenty full-term well babies were included in this study. Those who had sepsis, IUGR, twin that may affect the level of arachidonic acid, birth weight, and/or placental weight were excluded. Free arachidonic acid level were measured by gas chromatographic-mass spectrometry. (GC-MS) Correlation Pearson Coefficients were used for statistical analyses. RESULTS: The correlation coefficients between birth weight and placental weight, birth weight and arachidonic acid level, and placental weight and arachidonic acid level were 0.727 (P0.05), 0.407 (P>0.05) respectively. CONCLUSION: There was statistically significant positive correlation between birth weight and placental weight. But since cord blood free arachidonic acid levels were not correlated with placental weight and birth weight, we conclude that cord blood free arachidonic acid level has no effects on fetal growth and placental growth.

Surgical Management of Cecal Diverticulitis Detected during Appendectomy

PURPOSE: Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease. METHODS: Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998. RESULTS: There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA(R), GIA(R)) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage. CONCLUSION: We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.

IGF-I on the Expression of Gene Associated with Hypoxic Ischemic Brain Injury in the Neonatal Rats

PURPOSE: To investigate the effect of intraperitoneal injection of IGF-I after hypoxic ischemic brain injury on neuronal cell necrosis, apoptosis and expression of proapoptotic and antiapoptotic proteins bax and bcl-2, respectively. METHODS: The right carotid artery was cut between the double ligation. Then allowed to recover for 30 minutes followed by exposure to 8% oxygen at 37degree C for 2 hours. Devided 2 groups, control group(N=30) and IGF-I treated group(N=30). IGF-I treated group received IGF-I 20 microg 2 hours after hypoxic ischemic injury intraperitoneally. Rates were decapitated at 24 hours and 72 hours following hypoxic ischemic brain injury. After then, right hippocampal CA1 and CA3 neuronsof rat brains were examined. RESULTS: The apoptosis and necrosis was significantly less in IGF-I treated group than control group and necrosis was more prominent in CA1 neurons than CA3 neurons. Necrosis was slightly decreased at 72 hours in both groups(P<0.05). The apoptosis was more prominent at 24 hours than 72 hours after hypoxic ischemic injury(P<0.05). Bax protein expression was prominent in control group, especially at 72 hours(P<0.05) and less in the IGF-I treated group than control group. Bcl-2 protein expression was not detected in both group. CONCLUSION: The results from this study suggest that exogenous systemic IGF-I had a neuroprotective effect by inhibition of up-regulation of bax protein expression after hypoxic ischemic brain injury.

Effectiveness of Polaroid Photoscreening for Amblyogenic Fctors in Infants & Young Children

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.

Effectiveness of Polaroid Photoscreening for Amblyogenic Fctors in Infants & Young Children

PURPOSE: Amblyopia is the commonest cause of defective vision in childhood. It develops during the sensitive period of visual maturation which continues until about 7-8 years of age. The authors investigated the effect of a polaroid photoscreening camera designed to detect amblyogenic factors, including asymmetric and abnormal refractive errors, strabismus, ptosis and media opacities. METHODS: Fifty-four children aged 3-24 months were evaluated for amblyogenic factors using the polaroid photoscreening carnera from March 1998 to March 1999 in Chungnam National University Children's Hospital. Then each child underwent medical examination by an ophthamologist. Results The mean age was 9.0+/-4.5 months. The results of photoscreening were normal findings of 74.1%, abnormal findings of 25.9%, and slight eccentric fixation in 18 cases, normal findings in 9 cases, peripheral crescents in 13 cases, strabismus in 4 cases, myopia in 5 cases, hyperopia in 2 cases, anisometropia in 2 cases, ptosis in 1 case and reexam in 14 cases. The photoscreener had a sensitivity rate of 81.8%, a specificity rate of 88.4%, a positive predictive value of 64.3% and a negative predictive value of 95.0%. CONCLUSION: Polaroid photoscreening method is an easy, noninvasive and reliable mass screening method of detecting amblyogenic factors in undilated children.

Effect of Granulocyte-macrophage Colony-stimulating Factor in Neonatal Infection

PURPOSE: Neutrophils are central to the defences against bacterial infection, and in neonates the number of neutrophils are decreased due to inhibited production and phagocytic function. This induces high mortality rates in infants suffering from neonatal sepsis. Exogenous GM-CSF can increase the number of neutrophils and improve the phagocytic function. To establish the most cost effective dose of exogenous granulocyte-macrophage colony-stimulating factor in infected neonates, we divided infected patients into two groups. The serum level of granulocyte-macrophage colony stimulating factor, white blood cell count and absolute granulocyte count were compared. METHODS: This study included 22 infants with infection, admitted to the neonatal intensive care unit of Chungnam National University Hospital, between February 1998 and September 1999. Infected infants were divided into two treatment groups with exogenous GM-CSF 3 microgram/kg/day & 10 microgram/kg/day. The total WBC count, the absolute granulocyte count and the serum GM-CSF concentration of peripheral blood before use of GM-CSF, and those of 2nd, 5th and 7th day after use were compared. RESULTS: In 3 microgram/kg/day group, WBC count and the absolute granulocyte count and the serum GM-CSF concentration reached a peak after the 2nd injection of GM-CSF. In 10 microgram/kg/day group, the WBC count and the absolute granulocyte count increased gradually until 7th day. There was tendency for the total WBC counts, the absolute granulocyte count and the serum GM-CSF concentration of peripheral blood in 10 microgram/kg group to increase more than those of 3 microgram/kg group, after exogenous GM-CSF treatment. CONCLUSION: In neonates, we propose the exogenous GM-CSF treatment 10 microgram/kg/day as being more effective than 3 microgram/kg/day protocol, which is one of the safest and most effective methods to increase the total WBC count, the absolute granulocyte count and the serum GM-CSF concentration of peripheral blood.

Comparison of Hematologic and Serum Biochemistric Values at 1 Month of Age between Breast-fed and Formula-fed Infants

PURPOSE: We compared the hematologic data, serum biochemical and immunoglobulin values at 1 month of age and anthropometric variables at 1, 4, and 6 months of age between breast-fed and formula-fed infants. METHODS: Healthy full-term infants whose parents agreed with our study were enrolled. The hematologic and serum biochemical and immunoglobulin values were measured at birth and at 1 month of age. Anthropometric variables were measured at birth and 1, 4, and 6 months of age. RESULTS: In general, the hematologic and serum biochemical and immunoglobulin values were not different at 1 month of age between breast-fed and formula-fed infants. And there were no differences in growth between breast-fed and formula-fed infants from 0 to 6 months. CONCLUSION: There were no differences in growth and almost same values of hematology, serum biochemistry, immunoglobulin between breast-fed and formula-fed infants.

Comparison of Immunoglobulin Levels in Serum between Breast- and Formula-fed Newborns / 대한임상병리학회지

BACKGROUND: It had been well known that breast feeding to infants has many advantages and benefits comparing to formula feeding. So, We performed this study to clarify the relationship between immunoglobulin (Ig) levels and diet during newborn period. METHODS: We measured the levels of IgG, IgA and IgM by Array 360 System (Beckman Instruments, CA, U.S.A). Subjects were 29 breast-fed and 13 formula-fed newborns. We evaluated the results and analyzed the change of concentrations of IgG, IgA and IgM according to diet, sex and postnatal period. RESULTS: The levels of IgG, IgA and IgM in breast-fed newborns at postnatal 1-day were higher than formula-fed newborns, but the levels of Ig G and Ig A in formula-fed newborns at postnatal 30-day were higher than breast-fed newborns. CONCLUSIONS: There was no clinical signficance in the difference of IgG, IgA and IgM levels according to diet, sex and postnatal period, respectively.

Change in Granulocyte - Macrophage Colony - Stimulating Factor in Neonatal Infection

PURPOSE: The neuophils contribute as an important defence mechanism against bacterial infection. In neonates with infection, not only the number of neutrophils are decreased due to inhibited production but also phagocytic function is impaired resulting in high mortality rate. The purpose of this study is to establish the effectiveness of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) in infected neonates by comparing the serum levels of GM-CSF and various hematologic paratmeters in non-infected and infected neonates. METHODS: The study included 50 neonates without infection and 23 neonates with infection who were admitted to neonatal intensive care unit of Chungnam National University Hospital in between May 1998 and February 1999. The total number of white blood cell (WBC) counts, absolute granulocyte counts (AGC) and the serum GM-CSF concentration at birth were measured in non-infected neonates and they were stratified according to birth weight and gestational age. The total number of WBC counts, AGC and the serum GM-CSF concentration at postnatal 7th and 14th day were measured and compared with that of infected neonate's. Neonates with infection were divided either to receive exogenous GM-CSF & antibiotics or antibiotics only; The total number of WBC counts, AGC and the serum GM-CSF concentration at post-treatment 2nd and 7th day were measured and compared. RESULTS: Decreased total number of WBC counts, AGC and the serum GM-CSF concentration at birth were observed with lower birth weight and gestational age. In infected neonates, the total number of WBC counts, AGC and the serum GM-CSF concentration increased more when compared with that of non-infected neonates. Tendency towards increased total number of WBC counts, AGC and the serum GM-CSF concentration were observed after exogenous GM-CSF treatment. CONCLUSION: We recommend the use of GM-CSF in neonates with infection, especially those without increasing total WBC counts, and absolute granulocyte count as a norrnal physiological response.

Relationship of Perinatal Risk Factors and Neonatal Complications with Bayley Scales in Asphyxiated Newborns

PURPOSE: Prediction of developmental outcome after perinatal asphyxia is important but difficult. The objective was to evaluate the relationship of perinatal risk factors and neonatal complications with Bayley Scales of Infant Development II (BSID-II) scores in asphyxiated newborns. METHODS: Forty asphyxiated infants, admitted between January and December 1997, were studied at a mean corrected age of 12.7 months. Perinatal risk factors, neonatal complications and developmental outcome were evaluated. Subjects were classified by BSID-II scores: 23 infants with normal development [Mental Developmental Index(MDI) and Psychomotor Developmental Index(PDI) > or =85] in Group 1, and 17 with delayed outcome(MDI or PDI or =70), and Group2B 7 with significant delay(MDI or PDI < or =70)]. RESULTS: MDI and PDI in Groups 1 and 2 were 98.97.0 and 108.4+/-10.1 vs. 79.3+/-16.2 and 79.5+/-22.6, respectively. MDI and PDI of Groups 2A and 2B were 85.7+/-11.4 and 94.215.7 vs.8.4 and 58.6+/-11.0, respectively. There were no significant differences in Apgar score, fetal deceleration, seizure, meconium aspiration, pH, BE, pCO2, LDH, CPK, CPK isoenzymes, EE(and brain ultrasonographic findings between Groups 1 and 2. But ultrasonographic findings were significantly different between Groups 1 and 2B. CONCLUSION: There was no significant difference of perinatal risk factors or neonatal complications between normal and delayed developmental groups by Bayley scales in asphyxiated newborns.

Early Diagnostic Laboratory Tests of Disseminated Intravascular Coagulation in Newborn Infants

PURPOSE: The peak incidence of disseminated intravascular coagulation(DIC) in the pediatric age group is in the neonatal period. The objective was to determine the early diagnostic laboratory tests of DIC in newborn infants. METHODS: 46 neonates with DIC, admitted between January 1995 and November 1998 in NICU of Chungnarn National University Hospital, were compared with 49 newborn infants in control group. We checked platelet counts, PT, aPTT, FDP, fibrinogen and AT III in both groups. We defined abnormality of laboratory tests of DIC as values which outranged 2 S.D. of control group means. In DIC group, serial laboratory tests were performed in 35 patients. RESULTS: Symptoms or signs suggestive of DIC were abdominal distension(40%), bleeding(35%), apnea(15%), and lethargy(15%). The incidence of infection was 65%, and the incidence of keeping endotracheal tube, arterial line, umbilical venous catheterization, TPN and asphyxia was about 40%. Sensitivity of laboratory tests was as follows: fibrinogen was 63%, platelet count 59%, aPTT 49%. And specificity was 100% for FDP, 96% for platelet count, and 93% for fibrinogen. 22 patients showed at least one of the initially normal values changed to abnormal during follow up tests. The percentage of transition was 83% for fibrinogen and 64% for platelet count. In DIC group, 34 patients (74%) improved, but 12(26%) died. CONCLUSION: This study suggests that the most reliable initial diagnostic laboratory tests in DIC are fibrinogen and platelet counts.

Double-blind Randomized Dose Controlled Multicenter Study on Prevention of Anemia in VLBW Premature Infants Treated with High Dose rhEPO (recombinant human erythropoietin)

PURPOSE: Very low birth weight infants frequently suffer severe anemia. This study was designed to evaluate the effectiveness of rhEPO for prevention of anemia of prematurity and for reduction of the need for transfusion in very low birth weight infants. METHODS: Eighty very low birth weight infants(<1.5 kg) whose gestational age was under 33 weeks were enrolled at 9 university hospital in Korea. This study was conducted as a double-blind randomized, dose-controlled study. In high dose EPO group, 500 IU/kg of rhEPO was subcutaneously administered every other day for 17 times. In low dose EPO group, 250 IU/kg of rhEPO was subcutaneously administered every other day for 17 times. In control group, placebo was administered in the same manner. The effectiveness of rhEPO was evaluated for multiple parameters. RESULTS: 1) Infants receiving high dose rhEPO showed a significant increase in hemoglobin and hematocrit by 3 weeks(P<0.05). 2) Infants receiving high & low dose rhEPO showed an increase in reticulocyte count by 1 week(P<0.05). 3) There were no significant changes in platelet, WBC count, and ANC in each group. 4) Serum concentration of erythropoietin, iron, TIBC and ferritin were highly variable in study patients.5) Incidence of anemia k transfusion in high dose rhEPO group was lower than low dose and control group(P<0.05). 6) Number of patients who did not receive transfusion and whose hematocrit did not fall below 30% in high dose rhEPO group was significantly higher than in low dose and control group(P<0.01). CONCLUSION: High dose recombinant human erythropoietin(rhEPO) treatment for anemia of prematurity may minimize the decrease in hemoglobin and hematocrit, rapidly increase reticulocyte count and reduce the need for transfusion.

Neonatal Statistics of Korea in 1996: Collective Results of Live - Births , Neonatal Mortality , and Incidence of Dischage Against Medical Advice at 64 Hospitals

PURPOSE: To evaluate the nation-wide results of statistics related to the neonatal period of 1996, we collected data of a total of 64 hospitals in Korea (42 university hos- pitals and 22 general hospitals). METHODS: We obtained the results of 129,175 inboms and 9,379 outborns, and analyzed the statistics of live-births, ig, distribution of live-births by gestational age and birth weight, incidence of pre-term infants and low birth weight infants (LBWI), neonatal mortality, and incidence of discharge against medical advice (DAMA). RESULTS: According to birth weight, incidence of LBWI, normal birth weight, infant and high birth weight infants was 3.6%, 86.6% and 9.8%, respectively in the case of inborn group. But incidence of LBWI was higher in outborn group as compared with the inbom group. According to gestational age, incidence of preterm, term, and post-term was 11.1%, 87.1Yo and 1.8% respectively in the inbom group. The incidence of preterm in outborn group was higher than that of inborn group, because of the influnce of transpor- tation of high risk neonates to 2nd or 3rd levels of neonatal intensive care units (NICU). Overall neonatal mortality per 1,000 live-births was 9.3 in the inborn group amd 37.6% in the outborn group. These data revealed a high neonatal mortality, because the numbers of DAMA cases was also included. The incidence of DAMA was 0.44% and 1.15% in inborn and outborn groups, respectively. The percentage of the DAMA among the numbers of neonatal mortality was 47.2-48.8M in the inborn group. CONCLUSIONS: We obtained the statistics related to live-birth, incidence of prematurity and LBWI, neonatal mortality, and incidence of DAMA in Korea. The data revealed high levels of neonatal mortality (which included the sum of neonatal death and the number of DAMA) and incidence of DAMA in Korea at present. To achieve a low-level of neonatal mortality, more efforts to decrease the incidence of DAMA are needed. Also, a greater facility for NICU and a stronger support system from a nation-wide govemment policy and system of insurance are seen to be necessary.

Surfactant Treatment of other Diseases

No abstract available.

Surfactant replacement therapy in neonates with respiratory distress syndrome: A collective evaluation of trials from 16 hospitals

Surfactant replacement therapy in neonates with respiratory distress syndrome (RDS) has been introduced in our country since May 1990. The purpose of this study was to assess the effect and short-term outcome of surfactant replacement for neonatal RDS using collective data of uncontrolled trials from different hospitals in Korea. For the period May 1990 to Dec. 1991, a total of 68 RDS neonates were treated with a reconstituted bovine surfactant (Surfactant-TA) at 17 hospitals. Data on 60 neonates were collected from 16 hospitals and were analyzed in this study. In order to examine the factors that might influence the mortality, we performed a stepwise discriminant analysis. RDS was diagnosed according to accepted clinical and radiographic criteria at each hospital. The mean gestational age of 60 neonates was 31+/-3 weeks (1 SD, range, 24~40 wk) and the mean birth weight was 1549+/-566 grams (range, 590~3300 gm). Surfactant treatment resulted in a significant improvement in ventilatory requirement during the subsequent clinical course. However, there were large variations in the instillation procedure (single vs repeated instillations), dose of surfactant, and respirator settings after surfactant treatment. The neonatal mortality was 40% in this group. When the effect of surfactant treatment was compared between survival and death group, the magnitude of improvement was significantly less in death group than that in survival group. Factors affecting the neonatal mortality include a poor response to surfactant, sepsis and/or DIC, decreasing gestational age and weight, acidosis before treatment and air-leaks. We conclude that treatment with Surfactant-TA has an impact on the clinical course of RDS. To optimize the effects of surfactant therapy, the following refinement will be needed: better initial stabilization with respect to blood pressure, blood gases and pH, instillation techniquse including pre-and post-surfactant ventilation, weaning guidelines, dose, dose schedule, as well as timing of treatment, management of infection, and prevention of severe birth asphyxia.

Comparison and diagnostic accuracy of stable microbubble rating test and shake test for the early detection of respiratory distress syndrome

Respiratory distress syndrome of preterm infants remains a significant cause of morbidyty and mortality. Early, just after birth, prediction and recognition of RDS is so important. The precision and reliability of the stable microbubble test (SMR)and shake test as a predictor of respiratory distress syndrome were studied. A 110-neonate who was born at Chungnam National University Hospital between November 1991 to September 1992was selected randomely and studied. The results were as follows; 1) Among the 110 neonates, 13 cases were noticed as RDS. 2) Among the 13 infants with RDS, SMR results were zero and very weak in 11 cases, weak in 2 cases. Of the 97 infants with Non-RDS, 9 cases were weak, 88cases were medium and strong, positive predictive value and negative predictive value was 100%, 98% respectively. 3) Of the 13 infants with RDS, Shake test result were negative in 8 cases, 1+in 1 case, 2+in 1 case and 4+in 3 case. Of the 97 infants with Non-RDS, 3 cases were negative, 9 cases were 1+, 9cases were 2+ and 63 cases were 4+, positive predictive value and negative predictive value was 72.7%, 9 However, frequent relapses and severe side effects caused by such therapy necessitate development of a more specific and effective therapeutic regimen.Recently, a T cell derived cytokine, interleukin 4 (IL-4)is being recognized as a major cytokine up-regulating IgE production and response, while interferon- (IFN- )counteracts IL-4 actions to down-regulate the IL-4 induced IgE response. Hence, the present study is aimed to investigate the role of IL-4 in MCNS. Using freshly isol 4.9% respectively. We conclude that the rapidity, simplicity and reliability of the stable microbubble test is more useful as a bedside procedure in identifying of predicting the infants who are likely to develop RDS than shake test.

A case of successful pregnancy and birth in chronic renal failure patient receiving hemodialysis / 대한신장학회잡지

No abstract available.

Atypical manifestation of solid and papillary epithelial neoplasm of the pancrease: case report

We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.