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*

In 2005, the ILAE conceptually defined epilepsy as a disorder of the brain, characterized by an enduring predisposition to generate epileptic seizures and by its psychosocial consequences. In clinical practice, this definition of epilepsy is usually taken to mean at least two unprovoked seizures more than 24 h apart. The operational definition for special circumstances that do not meet the criteria of two unprovoked attacks has been recommended. In 2014, the ILAE refined the practical definition of epilepsy. With this definition, epilepsy is a disease of the brain with either: (1) at least two unprovoked (or reflex) seizures occurring more than 24 h apart; (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; (3) diagnosis of an epilepsy syndrome. Epilepsy is considered to be resolved for individuals past the applicable age of an age-dependent epilepsy syndrome or those who have remained seizure-free for the past 10 years, without seizure medicines for the past 5 years.
Brain ; Diagnosis ; Epilepsy* ; Recurrence ; Seizures

BACKGROUND & OBJECTIVE: Magnetic resonance angiography is helpful noninvasive evaluation of intracranial arteries and, in some patients, may spare invasive angiography which has potentially serious complication. However, it's diagnostic value in vertebrobasilar artery disease has not yet been evaluated. METHODS: MRA and axial brain MRI of 47 patients with acute cerebellar and/or brainstem ischemia, 26 patients with middle cerebral artery territory infarction, and 40 age matched normal controls were reviewed. Patients wit potential risks of cardiac embolization were excluded. MR Angiography was performed by three dimensional time-of-flight gradient-echo technique. Th diagnosis of vessel stenosis was made only when the lumen diameter was reduced by less than 50% on 3-D images to avoid overestimation of MR angiography. RESULTS: Forty-seven patients had cerebellar and/or brainstem infarction: with signal hyperintensities in T2-weighted MRI sequences. Pons was the most common infarcted site(28/47), followed by medulla (17/47), and cerebellum (11/47). The sensitivity of MR angiography in detecting vascular occlusive lesions of vertebrobasilar artery was 57.5% (28/47) in cerebellar and/or brainstem infarction patients, while 7 of 26 (26.9%) in middle cerebral artery territory infarction, and 2 of 40 (5%) in age matched control subjects showed occlusion or stenosis. MR angiography detected vascular occlusive lesions more frequently on vertebral arteries (25/47, 53.2%) than basilar artery (13/47, 27.7%). And occlusive or stenotic lesions of vertebral arteries were ipsilateral to ischemic lesion sites in 12 of 17 patients(70.6%), There was no difference between deep small lacunar stroke and perforator occlusion in pons. Absence of flow void on axial T2W imaging was seen only in 9 of 47 patients (19.1%). CONCLUSIONS: The results in this present study suggest that MR angiography is moderately sensitive diagnostic tool in vertebrobasilar occlusive disease although it has limitation in detection of smaller branches occlusion. Except vertebral arteries occlusion, absence of flow void in axial MR imaging is not a reliable findings.
Angiography ; Arteries ; Basilar Artery ; Brain ; Brain Stem Infarctions* ; Brain Stem* ; Cerebellum ; Constriction, Pathologic ; Diagnosis ; Humans ; Imaging, Three-Dimensional ; Infarction ; Ischemia ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Pons ; Stroke, Lacunar ; Vertebral Artery

No abstract available.
Gonadotropins* ; Growth Hormone* ; Humans* ; Hypogonadism*

No abstract available.
Fallopian Tubes* ; Female ; Mucous Membrane* ; Sterilization*

No abstract available.