A Case of Choroid Plexus Papilloma of a Child with Anorexia and Failure to Thrive / 대한소아신경학회지

Choroid plexus papilloma is a very rare disease in children. The manifestations of the disease differ according to the tumor size and the location. Increased CSF production by the tumor, hydrocephalus and symptoms of increased ICP are the main symptoms. The first line of treatment is surgical excision, but sometimes excision itself is very difficult due to the site and the size of the mass. Adjunctive radiation therapy or chemotherapy is not recommended. Since gross total resection without adjunctive therapy offers highest likelihood of success. Significant prognostic factors are sex, age, time of diagnosis, the duration between the appearance of symptoms and diagnosis, tumor volume, tumor site and the extent of surgery. We report a case of choroid plexus papilloma, in a child with anorexia and failure to thrive.

Organotypic Slice Culture of Rat Hippocampus for Neuroscience Research / 대한소아신경학회지

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.

Organotypic Slice Culture of Rat Hippocampus for Neuroscience Research / 대한소아신경학회지

PURPOSE: Organotypic slice cultures are suitable for morphological and electrophysiological studies, and a valuable method to evaluate physiological and pathological responses to external stimuli. This study was designed to establish a method and to assess its values of organotypic slice cultures of rats' hippocampus for neuroscience research. METHODS: 8-day-old neonatal Sprague-Dawley rat's brain was dissected quickly and the brain was removed. Both of the hippocampi were dissected out in Petri dishes and placed on a chopper or tissue cutter with Gey's balanced salt solution(GBSS). Slices of 450 micrometer were cut and separated by adding of a drop of GBBS. Extra GBBS was aspirated. Transfer tissue slices of Millicell membrane were inserted in six-well plates containing 1 mL of warmed Gahwiler's media. Six-well plates were placed in an incubator at 36 degrees C with 5% CO2, and the media were changed regularly every 2 to 3 days. Some tissues were placed in 4% paraformaldehyde for staining and others were placed in Phosphate buffered saline(PBS) for 30 min for Western blotting. Then, we stained the free-floating, cryocutting or paraffin embedded slices with H&E or the days of 6, 9, 14 and 24 in vitro(DIV), and evaluated any changes of tissues and neurons by an image analysis system RESULTS: Hippocampal cultures had well-defined cell body layers of dentate gyrus, CA1, 2, 3 and 4 as early as the day of 6 in vitro(DIV). After 14 DIV, the cultures became gradually thinner from 450 micrometer to 150 micrometer. After 21 DIV, there were migrations of cells away from the margins of the slices and degenerative changes of some neuronal cells occurred. But pyramidal cells always were organized in well-defined cellular layer even after several weeks in the culture. Therefore, the best results were obtained by culturing slices of 6 to 14 DIV. Slice cutures was maintained after 4 weeks in vitro, but the oppotunity of contamination and infection increased as the periods of cultures trolonged. In staining, after any tissue was cultured in 2 weeks in vitro, no differentiation of the morphology and distribution in dentate gyrus, CA1, 2 and 3 were seen. In organo-typic slice culture of rats' hippocampus, we witnessed growth of glial and neuronal cell, and found pyramidal and granular cells. NeuN proteins were identified by Western blotting, and the density of NeuN protein bands was at the maximum value on the day of 9 in vitro. CONCLUSION: Since the organotypic slice cultures of rats' hippocampus were similar to the hippocampus in vivo in terms of anatomical and cellular morphology, it will become a valuable method for neuroscience research.

A Case of Central Diabetes Insipidus with Growth Hormone Deficiency and Loss of Hyperintense Signal in the Posterior Lobe / 대한소아내분비학회지

Central diabetes insipidus is a rare disorder that can result as a consequence of diverse etiologies, including malformations, autoimmune, infiltrative(e.g. neoplastic or histiocytosis) or traumatic processes, as well as mutations in the gene encoding arginine vasopressin. Idiopathic central diabetes insipidus is a diagnosis of exclusion, one that has been made less frequently through the decades. Idiopathic central diabetes insipidus in children and adolescent requires a frequent follow-up regimen using serial brain MRI and CSF examinations especially if an isolated pituitary stalk thickening or loss of a hyperintense signal in the posterior lobe is observed. Also, so-called "idiopathic" central diabetes insipidus warrants close follow-up to determine the etiology, especially if anterior pituitary hormone deficiencies are detected. We report a case of idiopathic central diabetes insipidus with growh hormone deficiency and loss of a hyperintense signal in the posterior lobe. He is a 13 years old. We are scheduled to follow-up with serial contrast enhanced brain MRI and CSF evaluation for the early detection of an evolving occult hypothalamic-stalk lesion.

The Significance of Hyperlipidemia as a Predictive Factor of Relapse in Corticosensitive Nephrotic Syndrome

PURPOSE: One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. METHODS: We analyzed the medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient`s urine becomes protein free. RESULTS: There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone 60mg/m2 daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased and proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein A1 (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). CONCLUSIONS: This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed.