Growing Teratoma Syndrome of the Pineal Gland Recognized Very Early during Chemotherapy in a Child with a Non-Germinomatous Germ-Cell Tumor / 임상소아혈액종양

The growing teratoma syndrome (GTS) is defined as the development of mature low-grade elements in the absence of a recurrent non-germinomatous germ-cell tumor (NGGCT) after partial response to multimodal treatment. It is uncommon and may occur in intracranial NGGCTs. Here, we report that a 7-year-old boy with intracranial NGGCT presented with precocious puberty and developed growing teratoma syndrome only 2 weeks after the first cycle of chemotherapy.

Growing Teratoma Syndrome of the Pineal Gland Recognized Very Early during Chemotherapy in a Child with a Non-Germinomatous Germ-Cell Tumor / 임상소아혈액종양

The growing teratoma syndrome (GTS) is defined as the development of mature low-grade elements in the absence of a recurrent non-germinomatous germ-cell tumor (NGGCT) after partial response to multimodal treatment. It is uncommon and may occur in intracranial NGGCTs. Here, we report that a 7-year-old boy with intracranial NGGCT presented with precocious puberty and developed growing teratoma syndrome only 2 weeks after the first cycle of chemotherapy.

Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies / 소아과

PURPOSE: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. METHODS: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam(R) and/or Tornado(R) coils. RESULTS: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. CONCLUSION: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

Perivascular epithelioid cell tumor (PEComa) of the ascending colon: the implication of IFN-alpha2b treatment / 소아과

A 7-year-old boy presented with hematochezia and abdominal pain. A 3.7-cm-sized mass was identified in the ascending colon by abdominal computed tomography and colonoscopy. The patient underwent surgical resection. Pathological examination revealed a low-grade perivascular epithelioid cell tumor (PEComa). PEComa in the colon is very rare. Only a few cases have been reported so far. An effective treatment method for this rare tumor has not been established yet. The patient received adjuvant interferon-alpha immunotherapy for 1 year. He has been tumor-free for 26 months since the initial diagnosis. This report is the first documented case of the use of interferon-alpha for pediatric PEComa of the colon.

A Case of Congestive Heart Failure in Adolescent with Diabetes Mellitus / 대한소아내분비학회지

The number of patients with diabetes mellitus continues to increase worldwide. Diabetes is strongly associated with cardiovascular disease including myocardial infarction, hypertension and diabetic cardiomyopathy. The prevalence of heart failure is twice as high in diabetic men and five times as high in diabetic women aged between 45 and 74 years. We report a case of congestive heart failure in an adolescent with type 1 diabetes mellitus. A 16-year-old girl, who had been treated for diabetes mellitus since 10 years ago, presented with dyspnea, orthopnea and generalized edema. Echocardiography showed dilated left ventricle and systolic dysfuction. She improved with treatment by diuretics, digoxin, angiotensin-converting enzyme inhibitors and glycemic control.

A case of subcutaneous paragonimiasis presented with pleural effusion / 소아과

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae from crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection, but several ectopic paragonimiasis cases have also been reported. Among them, cases of subcutaneous paragonimiasis are rare, especially in children. We report a case of subcutaneous paragonimiasis of the right abdominal wall with pleural effusion with hepatic involvement and without abnormal pulmonary infiltration in a boy aged 2 years and 5 months. He had eaten soybean sauce-soaked freshwater crabs (kejang) 6 months prior to complaining of right abdominal wall distension. On evaluation, right pleural effusion without abnormal pulmonary infiltration was detected, as well as blood eosinophilia, an elevated serum IgE level, pleural fluid eosinophilia and a positive enzyme-linked immunosorbent assay that detected P. westermani antibody in the serum. Thoracentesis, praziquantel administration, and excision of subcutaneous lesions were performed. After treatment, the eosinophil count and serum IgE level were decreased, and the subcutaneous lesions did not recur. The frequency of paragonimiasis has decreased recently, but it is still prevalent in Korea. Paragonimiasis should be suspected if pleural fluid eosinophilia is associated with blood hypereosinophilia and a high level of serum IgE; however clinicians should obtain a thorough history of travel and food habits.

Infantile risk factors for obesity in preschool children / 소아과

PURPOSE: Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. METHODS: A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. RESULTS: There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. CONCLUSION: Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

A comparative study of anemia in hemodialysis patients and CAPD patients / 대한신장학회잡지

No abstract available.