PURPOSE:Decreased bone mineral density(BMD) has been reported in girls with Turner syndrome. Estrogen therapy is recommanded to improve sexual infantilism and decreased BMD. Short stature is also characteristic finding in patients with Turner syndrome. Treatment modality for short stature has included estrogen, anabolic steroids and growth hormone(GH). Recently GH therapy in GH deficient children could increase BMD in addition to improve short stature. We observed the treatment effects on bone mineral density in patients with Turner syndrome. METHODS: Bone Mineral Density in second to fourth lumbar spine area were measured by dual energy X-ray absorptiometry in 56 girls with Turner syndrome, before and after growth hormone and/or estrogen. All Turner girl was confirmed by clinical and chromosomal examination. RESULTS: 1) There was no significant difference in BMD according to karyotype. 2) The mean BMD of untreated Turner syndrome was 0.752+/-0.122g/cm2. 3) The mean BMD before and after GH treatment were 0.620+/-0.028g/cm2, 0.793+/-0.093g/cm2 respectively. The mean BMD before and after estrogen treatment were 0.761+/-0.125g/cm2, 0.918+/-0.141g/cm2 respectively. In combined group, the BMD were 0.752+/-0.087g/cm2 and 0.939+/-0.134g/cm2. Growth hormone was also effective to improve BMD as well as estrogen. But the changes of BMD were more significant in estrogen and combined group(p<0.05). 4) A significant positive correlation was found between age and BMD(p<0.05). CONCLUSIONS:Estrogen therapy can accelerate epiphysial maturation and compromise final height. Growth hormone therapy in Turner girls was effective for improvement bone mineral density as well as growth improvement. But growth hormone and estrogen combined therapy or Estrogen therapy is more effective to improve bone mineral density in Turner syndrome. Estrogen replacement can be delayed for a while on growth hormone treatment and the appropriated time of estrogen therapy should be elucidated.
Absorptiometry, Photon ; Bone Density* ; Child ; Estrogen Replacement Therapy ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Sexual Infantilism ; Spine ; Steroids ; Turner Syndrome*

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

Repeat cesarean section is one of the leading causes to make increasing a rate of cesarean section. Trial of labor TOL after cesarean section is attempt to reduce the rate of repeat cesarean section. Trial of labor has been well established as a safe alternative in carefully selected women with transverse scars in the lower uterine segment. This study was based on 104 cases of delivery with prior cesarean birth at the Chonbuk National University Hospital from January, 1991 to June, 1997. The results were as follows: 1) Among 1400 cases with previous cesarean delivery, trial of labor was done in 104 cases (7.4%). Among 104 cases, vaginal birth was successfully completed in 96 cases (92.3%). 2) Among 28 cases with PGE2, vaginal tablet, vaginal delivery was done in 23 cases (82.1%). 3) Among 22 cases with more than 4 of Bishop score, vaginal delivery was done in 21 cases (95.5%), and among 6 cases with less than 3 of Bishop score, vaginal delivery was done only 2 cases (33.3%). 4) There was no matemal death or uterine rupture in the cases of trial of labor, But in 2 cases, uterine dehiscence was observed in 4 cases and postpartal bleeding (more than 400ml) was developed. 5) In the cases of cesarean section, mean of hospital day was 7 days and medical fee was about 400,000 won. In the cases of vaginal birth after cesarean section, mean of hospital day was 2.6 days and medical fee was about 100,000 won. In condusion, vaginal birth after cesarean section is safe and effective alternative to elective repeat cesarean section and also the use of PGE, vaginal tablet is so effective to increase success rate of vaginal delivery. After all, positive these trials might decrease cesarean rate and increase maternal health and quality of medical care.
Cesarean Section ; Cesarean Section, Repeat ; Cicatrix ; Dinoprostone ; Fees, Medical ; Female ; Hemorrhage ; Humans ; Jeollabuk-do ; Maternal Health ; Parturition ; Pregnancy ; Prostaglandins E ; Trial of Labor ; Uterine Rupture ; Vaginal Birth after Cesarean* ; Vaginal Creams, Foams, and Jellies

We had a female patient with soft tissue tumor involving large portion of Achilles tendon. After resection of tumor, Achilles tendon was reconstructed using an allogenic human fascia lata manufactured by Pfrimmer-Viggo. EMG findings on postoperative 8 months show marked improvement of function of medial and lateral gastrocnemius muscles. Biopsy specimen of fascia lata allograft, which was acquired during TAL 8 months postoperatively, shows myxoid degeneration, a few lymphocytic infiltration and some foreign body giant cells. Functional, histologic and EMG findings suggest that human fascia lata allograft could be used to bridge defect of Achilles tendon being resected during tumor surgery.
Achilles Tendon ; Allografts ; Biopsy ; Fascia Lata ; Fascia ; Female ; Giant Cells, Foreign-Body ; Humans ; Muscles

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.
Ampulla of Vater ; Barium ; Child ; Constipation ; Duodenal Obstruction* ; Duodenum ; Enema ; Female ; Humans ; Infant, Newborn ; Laparotomy ; Meals ; Stomach ; Ultrasonography, Prenatal ; Vomiting ; Weaning

Palpable inguinal mass in children should be differentiated from inguinal hernia, hydrocele, lymph node, and tumor. Though using ultrasonography, fatty tumor would be misdiagnosed as incarcerated inguinal hernia containing fatty component. We experienced the huge inguinal lipoblastoma in 5-year-old girl mimicking recurrent incarcerated hernia. Laparoscopic exploration revealed it was not incarcerated hernia but well demarcated bulging mass from abdominal wall. Mass was about 10x4x3 cm and extended from internal inguinal ring to saphenous opening. It was near total excised because of right external iliac vein injury. Pathologically, it was proven as lipoblastoma containing mature adipocyte with lipoblast and fibrous septa. Postoperatively, we noticed a segmental thrombotic occlusion of external iliac vein. After 1 year, she has no symptom related to occluded vessel. The remained lipoblastoma showed no interval change. Even lipoblastoma has a good prognosis with low recurrence rate, we need careful follow-up.
Abdominal Wall ; Adipocytes ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hernia ; Hernia, Inguinal* ; Humans ; Iliac Vein ; Inguinal Canal ; Lipoblastoma* ; Lipoma ; Lymph Nodes ; Prognosis ; Recurrence ; Ultrasonography

Coronaviruses (CoVs) are the largest positive-sense RNA viruses with a wide range of natural hosts. To date, seven types of coronaviruses (HCoV-NL63; Human coronavirus NL63, HCoV-229E; Human coronavirus 229E, HCoV-OC43; Human coronavirus OC43, HCoV-HKU1; Human coronavirus HKU1, SARS-CoV; Severe acute respiratory syndrome-related coronavirus, MERS-Co; Middle East respiratory syndrome coronavirus, and SARS-CoV-2; Severe acute respiratory syndrome-related coronavirus) are known to cause disease in humans, and three of the CoVs (SARS-CoV, MERS-CoV, and SARS-CoV-2) cause severe, occasionally fatal, respiratory infections in humans. In November 2002, the case of severe acute respiratory syndrome (SARS), a new respiratory illness caused by SARS-CoV, was first reported in Guangdong Province, China. For the next several months, the SARS outbreak resulted in more than 8,000 cases of infection and 800 deaths. In June 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia with 2,373 reported viral infections and 823 associated deaths until February 2019. The outbreak of the MERS-CoV pandemic also occurred in South Korea in May 2015. In late December 2019, another novel coronavirus called SARS-CoV-2, genetically linked to SARS-CoV, emerged in Wuhan, Hubei Province of China that has spread worldwide. Outbreaks of coronavirus-infections are occurring frequently in the 21st century; therefore, it seems very likely that another pandemic of coronavirus can emerge anytime in the future. In this review, we outlined the biological characteristics of coronaviruses and summarized the status of vaccine development against SARS-CoV-2, SARS-CoV, and MERS-CoV in preparation for the unpredictable emergence of coronavirus pandemic.

Pediatric inguinal hernia is the most prevalent surgical condition in children and accounts for nearly half of all pediatric surgical procedures performed. The primary cause of pediatric inguinal hernia is a patent processus vaginalis (PPV), which often requires surgery. Traditionally, the standard treatment involved high ligation of the PPV through a small incision combined with laparoscopic methods. These minimally invasive techniques offer improved cosmetic outcomes and are increasingly favored in clinical practice. This review aimed to present the current surgical techniques for pediatric inguinal hernia treatment, with a focus on various laparoscopic approaches. Additionally, it discusses the optimal timing for treating hernias in neonates and preterm infants as well as specialized surgical strategies for adolescent patients. This review highlights advancements in surgical methods that accommodate the specific needs of different age groups within the pediatric population.

Pediatric inguinal hernia is the most prevalent surgical condition in children and accounts for nearly half of all pediatric surgical procedures performed. The primary cause of pediatric inguinal hernia is a patent processus vaginalis (PPV), which often requires surgery. Traditionally, the standard treatment involved high ligation of the PPV through a small incision combined with laparoscopic methods. These minimally invasive techniques offer improved cosmetic outcomes and are increasingly favored in clinical practice. This review aimed to present the current surgical techniques for pediatric inguinal hernia treatment, with a focus on various laparoscopic approaches. Additionally, it discusses the optimal timing for treating hernias in neonates and preterm infants as well as specialized surgical strategies for adolescent patients. This review highlights advancements in surgical methods that accommodate the specific needs of different age groups within the pediatric population.

Pediatric inguinal hernia is the most prevalent surgical condition in children and accounts for nearly half of all pediatric surgical procedures performed. The primary cause of pediatric inguinal hernia is a patent processus vaginalis (PPV), which often requires surgery. Traditionally, the standard treatment involved high ligation of the PPV through a small incision combined with laparoscopic methods. These minimally invasive techniques offer improved cosmetic outcomes and are increasingly favored in clinical practice. This review aimed to present the current surgical techniques for pediatric inguinal hernia treatment, with a focus on various laparoscopic approaches. Additionally, it discusses the optimal timing for treating hernias in neonates and preterm infants as well as specialized surgical strategies for adolescent patients. This review highlights advancements in surgical methods that accommodate the specific needs of different age groups within the pediatric population.