PURPOSE:Craniopharyngioma is one of the most important intracranial tumors in pediatric age which causes multiple pituitary hormone deficiencies. We have studied clinical characteristics in patients with craniopharyngioma, focusing on changes of endocrine function, change of growth pattern, and change of body mass index before and after surgery. In addition, we wanted to know the effect of growth hormone therapy on growth velocity and body mass index, and to identify contributing factors for spontaneous growth in spite of growth hormone deficiency. METHODS:A total number of 17 patients who were diagnosed as having craniopharyngioma at the Department of Pediatrics, Asan Medical Center during the period of January, 1991 to December, 1997 were included in this study. Retrospectively, we reviwed medical records as to their endocrine function tests and auxoloogical data before, after surgery. RESULTS: 1)The number of patients of male and female were 9 and 8 respectively. Mean age was 7.3+/-4.3 years. 2)Preoperatively, 3 patients were thyroid hormone deficient, 3 patients were corticosteroid deficient, and 3 patients suffered from diabetes inspidus. 3)Postoperatively, GH and TSH deficiency were found in 100%, ACTH in 88.2%, ADH in 82.3%, and LH/FSH in 60%, 53% respectively. 4) Mean growth velocity in 14 GH deficient patients without growth hormone treatment for 2 years were 3.5+/-2.4cm/year during the 1st year and 3.1+/-1.7cm/year during the 2nd year. Although height standard deviation score(Ht. SDS) was decreasing trend as -0.24+/-2.19 at diagnosis, -0.94+/-1.73 at 1 year later, and -0.76+/-1.76 at 2 years later, it was not statistically significant. To our suprise, 4 out of 14 patients achieved greater growth velocity than nomal in spite of growth hormone deficiency during the 1st year after operation. 5) Although the mean body mass index of 14 GH deficient patients without GH treatment was increasing trend as 17.9+/-3.5 at diagnosis, 19.0+/-4.5 at 1 year later, and 19.9+/-4.8 at 2 year later, it was not statistically significant. 6) The mean Ht. SDS increased significantly in 7 patients treated with growth hormone(P<0.05) for 2 years, but change of body mass index was not significant. 7) Comparision of postoperative serum prolactin levels and changes of body mass index between spontaneous growth and stunted growth group did not reveal significant difference. CONCLUSION: Since most patients with craniopharyngioma become multiple pituitary hormone deficient after operation, it is important to predict and detect pituitary dysfunction to manage it effectively. Although patients with postoperative GH deficiency responded well to GH treatment, further study is needed to clarify what are the main contributing or prognostic factors for spontaneous growth without growth hormone treatment.
Adrenocorticotropic Hormone ; Body Mass Index ; Chungcheongnam-do ; Craniopharyngioma* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Male ; Medical Records ; Obesity ; Pediatrics ; Prolactin ; Retrospective Studies ; Thyroid Gland

Ependymomas constitute no more than 5 to 7% of all primary CNS neoplasm and their biologic behavior is difficult to predict by microscopic appearances. Recently, many studies have attempted to correlate biologic behavior with tumor proliferation index, tumor suppressor gene and oncogene using immunohistochemical stains. We evaluated 25 cases of surgically resected intracranial ependymomas for the proliferation activity using Ki-67, and expression of p53 and bcl-2 protein with regard to the prognosis. The cases were divided into 17 ependymomas (WHO Grade II), 3 papillary ependymomas (WHO Grade II), and 5 anaplastic ependymomas. Clinically, the patients were divided into two groups, recurrent (18 cases) or non-recurrent (7 cases). The Ki-67 proliferation index was significantly higher in the recurrent group (p<0.05) and in the younger ages (correlation index=0.534). Although Ki-67 proliferation index was higher in anaplastic ependymoma, it was not significant statistically (p>0.05). p53 protein expression tended to increase in the patients who had anaplastic ependymoma and in the recurrent group. bcl-2 expression was not correlated with histologic grade or recurrence of the tumor. We conclude that Ki-67 proliferation index and p53 expression are important markers for predicting biologic behavior of ependymoma.
Coloring Agents ; Ependymoma* ; Genes, Tumor Suppressor ; Humans ; Oncogenes ; Prognosis ; Recurrence

No abstract available.
Amino Acids* ; Animals ; gamma-Aminobutyric Acid* ; Horns* ; Neurons* ; Rats* ; Receptors, GABA*

Purpose : As the recombinant human growth hormone has been widely available, a lots of parents having short statured children are interested in promoting growth of them whatever the etiologies of short stature they have. However, the growth hormone therapy for growth-promoting effect is only justified in well-established indications such as growth hormone deficiency, fumer syndrome, and chronic renal insufficiency. This study was undertaken to classify the children with chief complaint of short stature by its cause and giving the basic epidemiologic data for it so that the size of population in which growth hormone is indicated can be estimated. Methods : According to Ranke's etiologic classification, we categorized the 579 children who visited our pediatric endocrinology clinic with chief complaint of short stature during the period of March 1994 to August 1996. In this prospective study, history regarding growth was taken, physical examination and laboratory tests including bone age, thyroid function, blood chemistry were carried out. The auxological data were analyzed. Additional chromosomal study or growth hormone provocative tests were performed when needed. Results : Out of 579 patients, 360(62.2%) were classified as normal and 127(21.9%) were classified as normal variants which consist of familial [74(12.8%)], constitutional [48(8.5%)], and mixed familial & constitutional short stature[5(0.9%)]. Pathologic short stature was found in only 80(13.8%). Those are growth hormone deficiency(28), Tumer syndrome(16), intrauterine growth retardation(14) in order. Other etiologies list varieties of dysmorphism, skeletal dysplasia, chromosomal disorders. Conclusions : This results suggest the vast majority of children with chief complaint of short stature are normal or normal variants. Only 7.8% of children who visited our clinic were indicated for growth hormone therapy.
Chemistry ; Child* ; Chromosome Disorders ; Classification* ; Endocrinology ; Growth Hormone ; Human Growth Hormone ; Humans ; Parents ; Physical Examination ; Prospective Studies ; Renal Insufficiency, Chronic ; Thyroid Gland

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

PURPOSE:Although Hashimoto's thyroiditis is the most common cause of goiter in children and adolescents, it is not clear what proportion of patients become hypothyroid and which tests are the best predictors of this state. To determine whether these kinds of variations occur in the course of Hashimoto's thyroiditis and whether the size of the thyroid gland or immunologic markers correlate with the course or outcome of Hashimoto's thyroiditis are main objects of our study. METHODS:A total number of 48 patients who were diagnosed as having Hashimoto's thyroiditis at the Department of Pediatrics, Asan Medical Center during the period of January, 1992 to December, 1997 were included in this study. Retrospectively, we reviewed medical records as to their clinical and labaratory data. RESULTS:Thyroid function status at initial diagnosis of Hashimoto's thyroiditis were euthyroidism(33.3%), compensatory hypothyroidism(33.3%), overt hypothyroidism (27.1%), hyperthyroidism(8.3%) in order. Positivity of antithyroglobulin antibodies and antimicrosomal antibodies were 77.1% and 66.7% respectively. In 33 patients, 12(36.4 %) were on remission status after 3 years from initial diagnosis. Antithyroglobulin antibody titer was significantly decreased after 2-year follow up in remission group. Initial antithyroglobulin antibody titer and thyroid function status were not related to remission status after 3-year from diagnosis. CONCLUSION: About 36% of patients with Hashimoto's thyroiditis can be in remission after 3-year from diagnosis. Decrease of antithyroglobulin antibody titer is related to remission status. Further study is necessary to know what can be the predicting factors for early remission, for example, initial thyroid function status, initial antithyroid antibody titier, circulating immune complex, age, sex and size of thyroid.
Adolescent ; Antibodies ; Antigen-Antibody Complex ; Biomarkers ; Child ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Goiter ; Humans ; Hypothyroidism ; Medical Records ; Pediatrics ; Retrospective Studies ; Thyroid Gland* ; Thyroiditis*

Persistent burning and derythema were present for 10 months cin he lower lip of a 55-year-old woman, who had extreme melalignment of the anterior maxillary teeth. Candida albicans was identified not only from the surface material of the lower lip but also from tl.e malaigned dental cleft, which was thought to be the source of the organisms. We feel that the impor.ance of malaligned theeth as a source of candida albicans miist be kept in mind when we face persis ent cheilitis in a patient whose teeth arrangement is bad.
Burns ; Candida albicans ; Candida* ; Cheilitis ; Female ; Humans ; Lip ; Middle Aged ; Tooth*

BACKGROUND: The number of nongonococcal urethritis(NGU) cases is exceeding more and more that of Gonorrhea in developeing nations and some of the developing countr es such as Korea. The best evidence for an etiologic role for Trichomonas Vaginalis is in nongonococcal urethritis. OBJECTIVE: We compared the effects of Tetracycline to Tetracycine and Metronidazole in the treatment of male patients with nongonococcal urethritis and wished to find out the incidence of Trichomon-as Vaginalis in male patients with nongonocaccal urethritis indirectly. METHOD: From January, ],989 to December, 1992, three hundred male patients with nongococcal urethritis(NGU) at the Venreal Disease Clinic of Choong-Ku Publi Health Center in Seoul were allocated randomly into one of two treatment regimens. and one hundred sixty eight patients were followed. RESULTS: Eighty(83.4%) of ninty six patients treated with Tetrac; cline, 500mg, PO, q.i.d. for 14 days were cured. Sixty two(86.2%) of seventy two patients treatec with Tetracycline, 500mg, PO, q.i. d. for 14 days and Metronidaole. 2.0gm, PO, for 1 day were cured. There is no significant different between the 2 groups in treated rates(P<0.05). CONCLUSION: It suggests that male patients with nongonococcal ure1hritis due to trichomoniasis are rare in Korea. This may be die to the fact that the incidence of trichorioniasis has been declining since the 1960s. It also suggests not only the need for further studies on tool is disease but also more studies on other causes of nongonocoqeal urethritis, its treatment and epidernio.ogical study.
Gonorrhea ; Humans ; Incidence ; Korea ; Male* ; Metronidazole* ; Seoul ; Tetracycline* ; Trichomonas vaginalis ; Urethritis

A 26 year old female presented complaining of a pea-sized nodule on her left lower eyelid for 10 years duration. Histopathological study showed several cysts in the dermis surrounded by secretory cells. The cysts were filled with decapitatory secretions. Positive staining with carcinoembrynic an tigen(CEA) was detected by immunoperoxidase technique. These clinical and histopathological findings suggest apocrine hidrocystoma developed on the left lower eyelid.
Adult ; Dermis ; Eyelids ; Female ; Hidrocystoma* ; Humans ; Immunoenzyme Techniques

No abstract available.
Adenocarcinoma* ; Colon* ; DNA* ; Flow Cytometry* ; Ploidies*