Soft tissue sarcoma in neurofibromatosis type 1: A rare case of malignant peripheral nerve sheath tumor of the skin

Malignant peripheral nerve sheath tumor (MPNST) is a rare and often aggressive soft tissue sarcoma originating from the sheaths of peripheral nerves. Approximately 50% of MPNSTs occur in patients with neurofibromatosis (NF). These tumors often present as deep soft tissue lesions, arising from the nerve plexuses of the extremities or from the nerves extending from the trunk. They rarely occur in the skin, especially in patients with NF. Herein, we report our experience with an MPNST of the skin in a patient with NF.

A case of intramuscular xanthelasma palpebrarum found during blepharoplasty

Xanthelasma palpebrarum is the most common cutaneous xanthoma found on the medial side of the eyelid. The typical lesion is usually a flat and yellowish plaque on the skin. However, we report on a unique case of intramuscular xanthoma found during blepharoplasty for the correction of ptosis. A 53-year-old male patient visited our department with a complaint of a ptotic eyelid. He was concerned about the cosmetic appearance and the uncomfortable feeling while opening his eyes, and wanted these problems to be solved. A yellowish plaque of about 0.3 × 0.3 cm in size was found in the orbicularis oculi muscle during the surgery. The lesion was excised and xanthelasma was confirmed with biopsy. We have found this specific case of xanthelasma palpebrarum in the only muscle. Therefore, a careful approach to clinical and histologic examination and imaging is required for patients with these lesions.

Apoptosis and Expression of Nitric Oxide Synthase in Hypoxic Ischemic Cerebral Injury of Rats / 대한소아신경학회지

PURPOSE: Recently, it was reported that apoptosis in hypoxic ischemic cerebral injury is involved in neuronal injury while nitric oxide synthase(NOS) is involved in neuronal apoptosis. The aim of the present study is to investigate the relationship between the expression pattern of NOS and the apoptosis in hypoxic ischemic cerebral injury of rats. METHODS: To investigate the expression pattern of nitric oxide synthase and the relationship between apoptosis and activity of NOS, immunoelectron microscopic examination and in situ apoptosis detection(TUNEL) were performed in male Sprague Dawley rats. Ischemic injury was induced by permanent ligation of left common carotid artery and hypoxic injury by exposure of a mixture of 10% oxygen+90% nitrogen gas. Unicryl embedding method was used for immunoelectron microscopy and Apoptag kit for apoptosis. RESULTS: The number of apoptotic cells reached the highest at 24 hr, decreased after 72 hr and maintained the expression level until 168 hr. nNOS was expressed in neurons of the cortex, peaked at 24 hr and decreased after 72 hr. However, nNOS was not detected in the hippocampus. eNOS was expressed at 12 hr and at 24 hr in the hippocampus and the cortex, respectively, and persisted at each time point. iNOS was expressed after 72 hr in the cerebral cortex and the hippocampus. CONCLUSION: The expression of three isoforms of NOS in hypoxic ischemic cerebral injury was different in time. nNOS seems to be involved in cortical damage in the early phase of hypoxic ischemic cerebral injury and iNOS is related to apoptotic cell deaths in the late phase, but further study on their mechanisms will be needed.

Apoptosis and Expression of Nitric Oxide Synthase in Hypoxic Ischemic Cerebral Injury of Rats / 대한소아신경학회지

PURPOSE: Recently, it was reported that apoptosis in hypoxic ischemic cerebral injury is involved in neuronal injury while nitric oxide synthase(NOS) is involved in neuronal apoptosis. The aim of the present study is to investigate the relationship between the expression pattern of NOS and the apoptosis in hypoxic ischemic cerebral injury of rats. METHODS: To investigate the expression pattern of nitric oxide synthase and the relationship between apoptosis and activity of NOS, immunoelectron microscopic examination and in situ apoptosis detection(TUNEL) were performed in male Sprague Dawley rats. Ischemic injury was induced by permanent ligation of left common carotid artery and hypoxic injury by exposure of a mixture of 10% oxygen+90% nitrogen gas. Unicryl embedding method was used for immunoelectron microscopy and Apoptag kit for apoptosis. RESULTS: The number of apoptotic cells reached the highest at 24 hr, decreased after 72 hr and maintained the expression level until 168 hr. nNOS was expressed in neurons of the cortex, peaked at 24 hr and decreased after 72 hr. However, nNOS was not detected in the hippocampus. eNOS was expressed at 12 hr and at 24 hr in the hippocampus and the cortex, respectively, and persisted at each time point. iNOS was expressed after 72 hr in the cerebral cortex and the hippocampus. CONCLUSION: The expression of three isoforms of NOS in hypoxic ischemic cerebral injury was different in time. nNOS seems to be involved in cortical damage in the early phase of hypoxic ischemic cerebral injury and iNOS is related to apoptotic cell deaths in the late phase, but further study on their mechanisms will be needed.

Immunocytochemical Study for Lactalbumin in Alveolar Macrophage of Human Milk Aspirated Mouse

PURPOSE: Aspiration of foreign material into the lungs can cause acute or chronic pulmonary diseases. It is difficult to detect small amounts of aspiration due to the lack of safe, sensitive and specific diagnostic tests. Recently, in animal or human studies, it has been reported that immunochemistry for lactalbumin can be used to detect the minimal aspiration. So, the authors' investigation was designed to determine whether human milk phagocytized alveolar macrophages can be detected in human milk aspirated mice. METHODS: Sixty four male mice, 6-8 weeks old and 30-40 gm weighing, were used for this study. About 0.05 mL of human milk or normal saline were given intranasally once per day for 1 day or 3 days. Under anesthesia with ketamine and xylazine, the trachea of each mouse was cannulated with an 18G Jelco needle and then, each mouse's lungs were lavaged three times with 0.5 mL of phosphate buffer solution at 2, 8, 24, and 48 hours after the last milk or normal saline instillation. Cells in bronchoalveolar lavage fluid were stained with Oil Red O and immunocytochemistry for alpha-lactalbumin. RESULTS: Immunocytochemical reactivity for alpha-lactalbumin or lipid-laden alveolar macrophages were not observed in the normal saline aspirated groups. Immunocytochemical reactivity for alpha- lactalbumin were observed in the human milk aspirated groups. They showed a peak at 8 hours and decreased markedly at 24 hours but persisted even at 48 hours after aspiration. Immunocytochemical stain positive alveolar macrophages were noted similarly in number between single and multiple aspiration groups. CONCLUSION: These observations suggested that alveolar macrophages for lactalbumin could be more easily detected on immunocytochemistry than Oil Red O stain, and immunocytochemistry could be used as a sensitive and specific diagnostic test for the detection of human milk aspiration.

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.

Appraisal of Histamine Concentration on Skin Reactivity in Infancy / 소아알레르기및호흡기학회지

PURPOSE: It is well known that the histamine test is essential for positive control in the evaluation of allergy skin test. Estimation of the allergen wheal size without histamine control may be affected by child growth and observer's subjective factos. The skin test reactivity to histamine in infancy is weak and difficult to be used as be positived control. This study is to define the status of skin test reactivity to histamine, and any difference of reactivity between various concentrations of histamine in infancy. METHODS: The 241 babies including normal infants and prematurity in pediatric department of Chungnam National University Hospital from January 2001 to May 2001 were selected and divided into 5 groups by age. Three different Concentrations of histamine of 1, 5, and 10 mg/mL were injected on left forearm by prick procedure respectively. The differences of wheal size by age groups and concentrations of histamine were analyzed. RESULTS: No reaction was predominant in prematurity, weak reaction in birth to 6 months of age, and strong reaction in above 6 months of age. In the skin test reactivity by histamine concentrations, there was no difference of no reaction histamine concentrion of 1 and 5 mg.mL. But rate of no reaction to histamin was significantly lower in the concentration of 10 mg/mL. There was no difference for the rate of week reaction to histamine by histamine concentration. There were significant differences between concentrations of histamine, especially more in 10 mg/mL concentration for strong reaction. CONCLUSION: The skin test reactivity to standard histamine were weak in entire period of infancy, especially in under 6 months of age including prematurity. However, the reactivity to 10 mg/mL conc. of histamine were increased in all infants and different definitely in degree. It was suggested that 10 mg/mL of histamine concentration was more useful for positive control than standard histamine in infancy.

A Study on Dermatophagoides pteronyssinus Induced Cytokines Gene Expression in Peripheral Blood Mononuclear Cells / 소아알레르기및호흡기학회지

PURPOSE: Cytokines are known to play a major role in mediating many of the immunological and pathological findings of allergic disease. Many studies on allergen-specific T cell clones isolated from atopic individuals have shown that these cells produce cytokines of the Th2 phenotype. The purpose of the present study was to investigate cytokine patterns of T lymphocyte induced by Dermatophagoides pteronyssinus in atopic asthma. METHODS: Freshly isolated peripheral blood mononuclear cells of Dp(+) asthmatic children, Dp(-) asthmatic children, nonasthmatic children, and normal adults were stimulated with Dp antigen and examined for the induction of IFN-gamma, IL-2, IL-4, and IL-5 mRNA using RT-PCR. RESULTS: The lymphoproliferative response to crude Dp antigen was maximized at Dp concentration of 2.5 microgram/mL. The lymphoproliferative response was low in children including Dp(+) asthmatics, Dp(-) asthmatics and nonasthmatics, but that of normal adults was high. The expression of IFN-gamma was not so different in each group, but the expression of IL-4 was least in adults, and that of IL-5 was most prominent in Dp(+) asthmatic children. In adult healthy group, IFN-gamma expression without IL-4 and IFN-gamma without IL-5 was significantly higher than those in children. IL-5 expression with or without IFN-gamma was the highest in Dp(+) asthmatic children. IL-4 and IL-5 or IL-5 without IL-4 expression were observed more frequently in Dp(+) asthmatic children than in any other groups. Th2 response was most prominent in Dp(+) asthmatics, and Th1 response was most prominent in normal adult group. CONCLUSION: In conclusion, we observed significantly prominent Th2 response in Dp(+) asthmatic children, especially that of IL-5.

A Study on Serum Leptin Values by Elisa Method in Children / 대한소아소화기영양학회지

PURPOSE: Leptin is an adipocyte-derived blood-borne satiety factor that acts on its cognate leptin receptor in the hypothalamus, thereby regulating food intake and energy expenditure. We measured the leptin concentrations in serum of normal and obese children with human leptin ELISA kit, unlike previous study with leptin RIA kit and investigated the relationship between leptin concentrations and body mass index, gender, and age. METHODS: We measured serum concentrations of leptin in 67 children who were visited to the Department of Pediatrics, Chungnam National University Hospital during the period of 5 months from February, 1999 to June, 1999. Height, weight, obesity index, and body mass index were measured in 67 subjects. Leptin values in serum were measured by sandwich ELISA method. Data analysis was done according to the obesity, body mass index, gender and age. RESULTS: The mean concentration of leptin was 7.69±8.83 ng/ml in normal children group and 36.34±18.57 ng/ml in obese group. Serum leptin concentrations were significant correlation with the body mass index (p < 0.01). Serum leptin concentration was significant higher in the group of over 10 years of age (p < 0.01). Leptin levels showed no significant difference by gender. CONCLUSION: Serum leptin levels were significantly higher in obesity group than in control one, and they were correlated with body mass index and age. Measurements of leptin value by sandwich ELISA method are very useful and easily applicable to determine obesity.

Selective Gamma Globulin Treatment in Kawasaki Disease: The Comparison between Single 1g/kg and 2g/kg

PURPOSE: Treatment of Kawasaki disease with intravenous gamma globulin(IVGG), together with aspirin, has been dernonstrated to be safe and effective in preventing coronary artery lesion and systemic inflarnmation, but optimal IVGG dosage and administration method are still controversial. We compared the therapeutic efficacy and clinical response of single IVGG 1g/kg to that of IVGG lg/kg for comparable risk group of Kawasaki disease. METHODS: We conducted a prospective study involving 63 children with Kawasaki disease requiring IVGG treatment(Harada score> or =4) at Chungnam National University Hospital from February 1996 to January 1999. The children were assigned to receive IVGG either as a single infusion of 1g/kg(A group, 32 person) or 2g/kg(B group, 31 person) and aspirn(100mg/kg/day through acute phase, then 3 to 5mg/kg/day for 8 weeks of duration). RESULTS: There were no significant difference between the two groups according to clinical and laboratry data, including coronary artery lesions(group A, 31.3% and group B, 29.0%) before treatment. After IVGG treatment ratio of complication with coronary artery lesion(group A 1/32=3.1% and group B, 2/31=6.5%) and that of retreatment(group A, 4/32=12.5%, group B, 2/31=6.5%), duration of fever(group A, 1.3+/-1.6 days and group B, 0.7+/-1.4 days), hospital stay(group A, 7.0+/-1.4 days and group B, 6.5+/-2.0 days), laboratory finding and side effects of IVGG were not significantly different(P>0.05). The total dosage of IVGG was significantly lower in group A than group B(group A, 1.16+/-0.37g/kg, 375,421+/-207,351won and group B, 2.10+/-0.40g/kg, 641,498+/-274,750won (P<0.05). CONCLUSION: The therapeutic efficacy and clinical response of single 1g/kg therapy are comparable to that of single 2g/kg therapy.

Significance of Polymerase Chain Reaction Test for Diagnosis of Mycoplasma pneumoniae Pneumonia

PURPOSE: Mycoplasma pneumoniae is a common cause of lower respiratory disease, especially in children and young adults. The diagnosis, in most cases, is confirmed by serology. M. pneumoniae is difficult to culture because of its fastidious nature, and growth is too slow for diagnostic use. In this prospective study, the sensitivity and specificity of the PCR assay was evaluated with clinical samples. METHODS: We compared the nested PCR test with serological findings for detection of M. pneumoniae in clinical samples(sputum or throat swabs), obtained from 58 pneumonic children who were admitted to the pediatric department of Chungnam National University Hospital between February and September, 1997. RESULTS: Among 28 mycoplasma antibody positive cases, the number of positive cases of cold agglutinin test were 20. So sensitivity and specificity of cold agglutinin test were 71.4% and 80.0%. Positive predictive value and negative predictive value of cold agglutinin test were of 76.9% and 75.0%. Among 28 mycoplasma antibody positive cases, the number of positive cases of M. pneumoniae nested PCR were 26 cases. So sensitivity and specificity of M. pneumoniae nested PCR were of 92.8% and 100.0%. Positive predictive value and negative predictive value were of 100.0% and 93.7%. Four cases showing negative antibody, in acute phase serum and positive in convalescent, revealed positive for nested PCR test. CONCLUSION: It is concluded that nested PCR assay is a highly sensitive, specific test and is fast enough to allow for the early application of therapy with specific antibiotics.

A Study on Clinical Application of Harada's Scoring Method to Kawasaki Disease: Suggesting the revision of the criteria for IVGG treatment of KD in Korea

PURPOSE: We performed a study on clinical benefits of Harada's scoring method, problems of present criteria and requirement of the revision of that criteria for intrvenos gamma-globulin (IVGG) treatment of Kawasaki disease (KD) in Korea. METHODS: The patients of 104 cases who visited to Department of Pediatrics of Chungnam National University Hospital and diagnosed as KD were objective group. We classified the patients to high and low risk groups as two methods of Harada's scoring method and present criteria for IVGG treatment of KD in Korea, and analyzed the results after treatment by means of echocardiogram. RESULTS: 1. Characteristics of the patients 1) Duration to diagnosis: Mean duration was 6.0 3.5days after onset of fever. 2) Age of onset and male to female ratio: the patients of 84.6% were the age of 4 years or less, and male to female ratio was 1.8 to 1. 2. Coronary aitery lesion (CAL) abnormalities according to items of Harada's scoring method and classification of risk groups 1) The age of less than 12 months and CRP of 3+ or more were significant predictive factors 2) Classification of risk groups was significantly predictive in CAL development. 3. Classification of total cases The patients reserved to administration for IVGG according to Harada's scoring method and present criteria for IVGG treatment of KD in Korea were 63.5% and 50% respectively. If so in present criteria for IVGG treatment of KD in Korea, 50% of the KD patients were excluded for that application. 4. Outcome after treatment according to selective IVGG use by two methods 1) Selective IVGG use by Harada's scoring method: There was no significant difference in development of CAL between low risk group and high risk group, resulting in 1 case (14.3%) of 7 cases and 5 cases (9.4%) of 53 cases respectively. 2) Selective IVGG use by present criteria for IVGG treatment of KD in Korea: There were more significant cases at low risk group than those at high risk group in development of CAL, resulting in 3 cases (42.9%) of 7 cases and 5 cases (12.2%) of 41 cases respectively. 3) Outcome after treatment in patients not administered IVGG as low risk groups according to two methods: There were more significant cases in low risk group at present criteria for IVGG treatment of KD in Korea than those at Harada's scoring method in the development of CAL, resulting in 3 cases (42.9%) of 7 cases and 1 case (14.3%) of 7 ases respectively. 4) Outcome after treatment in patients administered IVGG as high risk groups according to two methods: There was no significant difference between high risk groups at both methods in the CAL development, resulting in 5 cases (12.2%) of 41 cases at present criteria for IVGG treatment of KD in Korea and 5 cases (9.4%) of 53 cases at Harada's scoring method. CONCLUSIONS: Harada's scoring method had more benefits in clinical application, selection of risk group, and outcome after treatment, So we propose the revision of present criteria for IVGG treatment of KD in Korea, suggesting another method as indication for selective IVGG treatment.

A Study on Spirometry Pattern of Normal Children

PURPOSE: Pulmonary function test is one of the most important tools in the management of patients with respiratory tract diseases and allergic diseases. In recent years pulmonary function tests have had a wide application in clinical pulmonary diseases. But, there were a few trials of pulmonary function test in normal children. So We performed spirometry-based pulmonary function tests of normal children. METHODS: We performed pulmonary function tests on 195 children without pulmonary symptomes of 6 grade primary school in Taejion, Korea. We measured mean and standard deviation of each pulmonary function value and evaluated about relationship between pulmonary function values and height, weight, age, and sex. And we also evaluated distribution of pulmonary function values. RESULTS: 1) The values of pulmonary function test items were generally higher in boys than those of girls. 2) Pulmonary function values incresed with height, weight and age. 3) Mean %FEV1 and %FVC were 90.5% and 82.7%, respectively. CONCLUSIONS: Pulmonary function values of normal children were distributed with wide range and each pulmonary function value (%FEV1, %FVC, FEV1/FVC) showed different distribution pattern.

Clinical Study of Febrile convulsion and Factors Related to Recurrence

We have reserched the relationship of their clinical pictures and factors related to the risk of recurrence of 75 patients with simple or complex febrile convulsions, who were admitted to the Departmenrt of Pediatrics, Chungnam National University Hospital from January 1987 to July 199. The 75patient were followed up and consisted of the 55 patients with initial or non-recurrent febrile convulsions and the othere 20 patients with recurrent febrile convulsions. The results were of follows; 1) The age of first episodes was under the 6 years in 94.6% and the first episode under the 12 months was 14.6% in initial cases and 55% in recurrent cases. 2) There were family history of convulsive disorder in 40% of recurrent cases, compared to 10.9% of initial cases. 3) In gestational age, there was no significant difference between initial and recurrent cases. 4) In sex distribution, the boys (66.7%) outnumbered the girls(33.7%) and the ratios was 2:1. Among the recurrent cases of 20 patients, the boys(90%) were much more than the girls(10%). 5) The patients of low birth weight had more febrile convulsions than large birth weight in both initial and recurrent cases. 6) There was no significant difference between initial and recurrent cases in the causes of febrile convulsion. 7) In abnormal EEG findings, recurrent cases were 30% more than 7.3% of initial cases. 8) There was no significant difference of number of seizure during a day in both initial and recurrent cases 9) In episodes of duration over 15 minutes, recurrent cases were 40% more than 23.7% of initial cases. 10) The resident of urban was 78.6% and of rural was 21.4%. 11) The types of convulsion were generalized in 92% of total cases and focalized in 8%. In the focal types, recurrent cases (15%) were much more than initial cases (5.5%). 12) In occurrence of seizures in body temperature above 40 degrees C, it was 5.5% in initial cases, whereas it was 20% in recurrent cases. 13) 13) There was no significant difference between initial and recurrent cases on fever duration before seizure.

A Study on the Serum Triglyceride Values in Children

The concentration of serum triglyceride values were studied at department of pediatrics, Chungnam National University Hospital. With the total 742 cases, among them 462 boys and 280 girls who were at the age of 2 months through 15 years old. Serum triglycerde values were measured to determine the distribution of values and evaluated on the basis of sex, age, height and weight percentile. The following results were obtained: 1) The mean value of the serum triglycerides were 88.11+/-35.76 mg/dl in boys and 94.82+/-34.56 mg/dl in girls. 2) In distribution of trglyceride level by percentile, the value of 90th percentile was 136 mg/dl. 3) The values of the serum triglyceride from 6 to 11 year old age group were significant low values in boys and girls.

Studies on the B Cell Proliferation and Differentiation Factors in Human B Cell System

We have studied the function of lymphokines on human tonsillar B cell prolifertion and differentiation. B cells were stimulated with Staphylococcus aureus Cowanl (SAC) or anti- bead. The followings showed the results of this study. 1) In B cell activation, SAC induced B cell DNA synthesis but anti-mubead did not. SAC could activate and proliferate B cells. Minimal number of B cells were required to proliferate effectively. 2) In B cell proliferation, SAC could proliferate B cell in the abscence of lymphokines. Exogenous IL-2 or IL-4 enhanced B cell proliferation. The roles of IL-2 were very important in B cell proliferation. The effect of IL-4 on the IL-2 induced B cell proliferation was inhibitory in SAC-B cells. IL-4 could enhance the proliferation of anti-mu bead activated B cells. 3) In B cell differentiation, IL-2 was a major factor to differentiate SAC activated B cells, but IL-4 did not. IL-6 had a synergistic effect on the differentiation. The results of this study showed that the different signal transduction mechanisms were involved in B cell proliferation and differentiation. The B cell resposes to lymphokine were different, and it is depend upon antigens or mitogens.

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 familial case of tricho-rhino-palangeal syndrome

No abstract available.

A significance of the sinusitis in asthma of children

No abstract available.

The normal serum total cholesterol level in children

No abstract available.