PURPOSE:Differential diagnosis of sexual precocity has been aided by new imaging techniques and endocrine evaluation. Sexual precocity, defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys, was studied to evaluate the sex incidence and etiology of sexual precocity. METHODS:A total 95 children(87 girls and 8 boys) who were diagnosed with sexual precocity at St. Mary's Hospital, Catholic University Medical College from 1984 to 1996, were studied. All underwent standard anthropometric measures. They were assinged to diagnostic categories on the basis of clinical assessment, endocrine evaluation, radiologic imaging, and pelvic ultrasonography. RESULTS: 1) The most common cause of sexual precocity was premature thelarche, 50 cases(52.6%) of all children. 2) Central precocious puberty was noted in 7 girls and 3 boys(female to male ratio 2.3:1). The causes were not identified in 6 cases(85.7%) in girls, but the causes were not found in 1 cases(33.3%) in boys. The idiopathic central precocious puberty occurs at least two fold more frequently in girls than in boys. 3) Incomplete precocious puberty was noted in 29 girls and 5 boys(female to male ratio 5.8:1). In the causes of 29 girls with incomplete precocious puberty, congenital adrenal hyperplasia were found in 23 cases, autonomous functional ovarian cyst in 5 cases and McCune-Albright syndrome in 1 case. In the causes of 5 boys with incomplete precocious puberty, virilizing adrenal cortical tumor were found in 3 cases, congenital adrenal hyperplasia in 1 case, and hepatoblastoma in 1 case. CONCLUSION: Sexual precocity occurs at least ten fold more frequently in girls than in boys. Premature thelarche is the most common form of sexual precocity.
Adrenal Hyperplasia, Congenital ; Child ; Diagnosis ; Female ; Fibrous Dysplasia, Polyostotic ; Hepatoblastoma ; Humans ; Incidence* ; Male ; Ovarian Cysts ; Puberty, Precocious ; Ultrasonography

No abstract available.

We report a case of 53-year-old man with plasmacytoid transitional cell carcinoma of the urinary bladder, which may be confused with plasmacytoma. The patient initially presented with gross hematuria and dysuria for two months. Cystoscopy and radiologic studies revealed multiple intraluminal protruding masses on the urinary bladder invading perivesical fat tissue. After urinary cytologic examination and cystoscopic biopsy, radical cystectomy and pelvic lymph node dissections were done. Urine cytology showed single cells and poorly cohesive cells with round eccentric nuclei, bi-or multi-nucleation, indistinct nucleoli, coarse chromatin, and abundant basophilic cytoplasm within relatively clear background. The cytologic findings of tumor cells were similar to the plasma cells seen in plasmacytoma. The tumor of the bladder was composed of discohesive, individual cancer cells with diffuse pattern that simulated lymphoma or plasmacytoma. Immunohistochemical and electron microscopic studies clearly established the epithelial nature of the neoplasm. Recognition of this plasmacytoid type of transitional cell carcinoma of the urinary bladder can avoid the misdiagnosis.
Child ; Male ; Female ; Humans ; Biopsy

The thyroid gland is highly sensitive to the carcinogenic effects of ionizing radiation. The development of benign thyroid nodules, thyroid carcinoma and thyroid dysfunction following radiotherapy during childhood has been documented. Recently we experienced two cases of thyroid tumor after irradiation. One is a 14-year-old boy with thyroid follicular carcinoma who had received mantle irradiation(3,000cGy) eight years previously for Hodgkin' disease. The other is a 15-year- old boy with thyroid follicular adenoma who had received craniospinal irradiation (3,600cGy) seven years previously for CNS relapse of acute lymphoblastic leukemia. We recommend frequent sonographic evaluation and early suppression of thyroid stimulation in an attempt to arrest the development of neoplastic changes in long term survivors of childhood malignancies who received radiation therapy.
Adenoma ; Adolescent ; Craniospinal Irradiation ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radiation, Ionizing ; Radiotherapy ; Recurrence ; Survivors ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

No abstract available.
Female ; Humans ; Ovary*

urpose:Adipocyte specific hormone, leptin is thought to regulate appetite and body weight, and serum level of leptin correlate with body fat content not only in adulthood but also in childhood. Adults who received cranial irradiation for childhood acute lymphoblastic leukemia are prone to hypothalamic damage in the form of growth hormone deficiency and leptin insensitivity. The purpose of this study is to evaluate the effect of total body irradiation on serum leptin concentration at short- term follow-up. METHODS:Twenty-four acute leukemia patients undergoing bone marrow transplantation(BMT) were enrolled in this study. They were divided into total body irradiation(TBI) group(n=13) and non total body irradiation(NTBI) group(n=11). Body mass index and leptin concentration at 1 week before BMT and 1 day, 1 week and 4 weeks after BMT were checked. Serum leptin concentration was measured by RIA method. RESULTS:Leptin concentration was well correlated with BMI(r=0.689, P<0.05). BMI were 17.96+/-2.48, 17.58+/-2.39, 17.39+/-2.30, 17.74+/-2.31 in TBI group and 16.91+/-1.88, 16.53+/-1.91, 16.50+/-1.96, 16.78+/-1.82 in NTBI group at 1 week before BMT and 1 day, 1 week and 4 weeks after BMT. Lepin concentrations were 4.31+/-3.57ng/ml, 3.22+/-2.87ng/ml, 3.78+/-4.41ng/ml, 3.46+/-2.96ng/ml in TBI group and 3.46+/-1.84ng/ml, 2.60+/-1.11ng/ml, 2.71+/-1.61ng/ml, 3.61+/-3.27ng/ml in NTBI group at 1 week before BMT and 1 day, 1 week and 4 weeks after BMT. BMI was different at each time period(P<0.05) but not different between two groups. Lepin concentration was not different between two groups and at each time period. CONCLUSION: Serum leptin concentration was not changed, but BMI was significantly decreased by total body irradiation at short-term follow-up.
Adipose Tissue ; Adult ; Appetite ; Body Mass Index ; Body Weight ; Bone Marrow Transplantation* ; Bone Marrow* ; Child* ; Cranial Irradiation ; Follow-Up Studies ; Growth Hormone ; Humans ; Leptin* ; Leukemia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Whole-Body Irradiation*

No abstract available.
Funnel Chest*

No abstract available.
Bone Density* ; Female ; Humans ; Hypogonadism*

No abstract available.
Amenorrhea* ; Female

PURPOSE:The most important regulatory factor for IGF-I and IGFBP-3 known so far GH and food intake. Poor nutrition in children with acute lymphocytic leukemia(ALL) increase morbidity during treatment. The aim of this study was to assess the changes of serum IGF-I and IGFBP-3 concentration during induction chemotherapy in 13 children with acute lymphocytic leukemia. METHODS:13 children aged between 1.6 and 13.5 years with ALL were studied the changes of serum IGF-I and IGFBP-3 concentration before, at 2 and 4 weeks after induction chemotherapy. Serum IGF-I and IGFBP-3 were measured using radioimmunoassay. Results : 1) Mean serum IGF-I and IGFBP-3 concentration before induction chemotherapy in ALL patient was significantly lower than the those of normal control(p<0.05). 2) Mean serum IGF-I and IGFBP-3 concentration at 2 weeks of induction chemotherapy were significantly higher than the those of the basal levels (p<0.05). 3) Mean serum IGF-I and IGFBP-3 concentration at 4 weeks after induction chemotherapy were significantly higher than the those of the basal levels (p<0.05). Conclusion : Concentration of serum IGF-I and IGFBP-3 in patients with ALL were significantly increased during induction chemotherapy. These results are probably related to improvement of nutritional status following induction chemotherapy.
Child* ; Eating ; Humans ; Induction Chemotherapy* ; Insulin-Like Growth Factor Binding Protein 3* ; Insulin-Like Growth Factor I* ; Nutritional Status ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Radioimmunoassay