No abstract available.
Antibodies, Monoclonal* ; Chlamydia trachomatis* ; Chlamydia*

Between 1989 and 1993, 13 patients with pituitary adenoma underwent operation/radiosurgery at Yonsei University Hospital before their 18th birthday. This comprises an incidence of 5.3%(13/247) of all pituitary adenoma patients who were treated at our institution during the study period. There were 7 boys and 6 girls ranging in age from 10.6 to 17.9 years(average, 14.9 years). The mean follow-up period was 22.4 months(7-55 months). Immunohistochemical study revealed 4 prolactin(PRL)-secreting, 3 growth hormone(GH)-secreting(PRL was also positive in one), 1 adrenocortical hormone(ACTH)-secreting, 1 thyroid stimulating hormone(TSH)-secreting, and 4 non-functioning adenomas. Nine of 13 patients(77%) presented with symptomatic endocrinopathy due to hormonal hypersecretion and/or delay in linear growth or onset of puberty. Microadenomas comprised one of nine functionng adenomas, and one of 4 nonfunctioning adenomas, or 15% overall. In 10 patients(77%), at least one pituitary hormonal axis was abnormal. Transsphenoidal and transcranial resections were employed in 8 and 4 patients, respectively. One patient with nonfunctioning microadenoma underwent gamma knife radiosurgery. Endoclinologically successful treatment was possible in 4 of 9 functioning adenomas(44%). Gross total resections confirmed by follow-up study were achieved in 2 of 3 nonfunctioning adenomas. One nonfunctioning microadenoma treated by radiosurgery showed no progression on follow-up study 20 months after radiosurgery. Seven patients(54%) were treated successfully with either operation or radiosurgery. Adjuvant therapy was applied to 5 patients. Overall tumor control was achieved in 91%. Long-term partial or full hormone replacement was necessary in 69%. It is concluded that early diagnosis, vigorous approach to complete cure, and more strict endocrinological management for sexual maturation and growth are mandatory in management of pediatric pituitary adenomas.
Adenoma ; Adolescent* ; Axis, Cervical Vertebra ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Pituitary Neoplasms* ; Puberty ; Radiosurgery ; Sexual Maturation ; Thyroid Gland

BACKGROUND: In this study, we investigated the effects of reduced-dose craniospinal radiotherapy (CSRT) followed by tandem high-dose chemotherapy (HDCT) with autologous stem cell rescue (ASCR) in children with a newly diagnosed high-risk medulloblastoma (MB) or supratentorial primitive neuroectodermal tumor (sPNET). METHODS: Between March 2005 and April 2007, patients older than 3 years with a newly diagnosed high-risk MB or sPNET were enrolled. The patients received two cycles of pre-RT chemotherapy consisting of cisplatin, etoposide, vincristine, and cyclophosphamide (cycle A), and carboplatin, etoposide, vincristine, and ifosphamide (cycle B), followed by CSRT with 23.4 Gy and local RT with 30.6 Gy. After four cycles of post-RT chemotherapy (cycles A, B, A, and B), tandem double HDCT with ASCR was performed. RESULTS: A total of 13 patients (MB=11, sPNET=2) were enrolled. Of these, one patient progressed, one patient died of septic shock after the second cycle of B, and one patient relapsed after the third cycle of B. The 3-year event-free survival (EFS) rate of the patients intended for HDCT was 76.9%, whereas the 3-year EFS rate of the patients who received HDCT was 100%. No treatment-related mortality occurred during HDCT. CONCLUSION: Although the follow-up period was short and the patient cohort was small in size, the results of this study are encouraging. The limited toxicity and favorable EFS rate observed in children treated with reduced-dose CSRT followed by HDCT and ASCR warrant further exploration in a larger study population.
Carboplatin ; Child ; Cisplatin ; Cohort Studies ; Cyclophosphamide ; Disease-Free Survival ; Etoposide ; Follow-Up Studies ; Humans ; Medulloblastoma ; Neuroectodermal Tumors, Primitive ; Shock, Septic ; Stem Cells ; Vincristine