Clinical Characteristics of Pheochromocytoma in Korean Children / 대한소아내분비학회지

PURPOSE: Pheochromocytoma is a catecholamine-producing tumor that arises from the chromaffin cells of the adrenal medulla or the sympathetic ganglia. This study was undertaken to evaluate the clinical profiles of children with pheochromocytoma. METHODS: We retrospectively reviewed the clinical, radiological and outcome of 16 children who had been diagnosed as pheochromocytoma from May, 1984 to July, 2006 in the department of pediatrics, Seoul National University Hospital. RESULTS: The mean age at diagnosis was 12.3+/-3.4 years (range, 7.1-20 yrs). The male to female ratio was 10:6. The major symptoms were hypertension in 87.5%, sweating in 75%, tachycardia in 68.8% and headache in 62.5%. The sensitivities of 24 hour urinary norepinephrine and metanephrine were 100 %. All tumors were localized by combined study of CT, ultrasonography, MRI or (123)I-MIBG scan. Single (123)I- MIBG scan had sensitivity as 92.9%. Sporadic cases were 13 (81.3%). Bilateral pheochromocytomas were observed in 6 patients (37.5%). The pheochromocytoma developed in 6 patients with underling disease; von Hippel-Lindau (VHL) syndrome (3), neurofibromatosis (1), and cyanotic congenital heart diseases (2). Adrenalectomy was performed in 13 patients, and tumorectomy was in 3 patients. Two patients were diagnosed as malignant pheochromocytoma. CONCLUSION: Because the symptoms are deceptive and variable, the hormonal and radiological study should be performed carefully in suspected cases. The pheochromocytoma can now be operated safely. The tumor might present as a component of other syndromes such as multiple endocrine neoplasia type 2, neurofibromatosis, and VHL syndrome. Thus comprehensive consideration is needed at initial diagnostic approach.

A Case of Ruptured Ovarian Cyst in a Newborn

Ovarian cysts are the most common cystic abdominal masses in female newborns. It is believed to be derived from an overstimulation of the ovarian follicles by maternal, placental, and fetal hormones. Although most ovarian cysts resolve spontaneously, surgical management is mandatory for life-threatening, complicated cases, including torsion, intracystic hemorrhage, and rupture of the cyst. Rupture of ovarian cysts is thought to be exceedingly rare, but can lead to severe hemorrhagic ascites or peritonitis. We managed a case of a ruptured ovarian cyst in a female newborn who presented with mild abdominal distension and two episodes of gross hematuria. Exploratory laparotomy revealed a right ovarian cyst with torsion and rupture. She was successfully treated with a right salpingo-oophorectomy with no sequelae.

Androgen Hormone Inhibits Expression of iNOS and COX-2 Protein in Rat Vascular Smooth Muscle Cell

We investigated the effects of testosterone and dihydrotestosterone on inflammatory response of iNOS and COX-2 expression in rat vascular smooth muscle cells. Rat vascular smooth muscle cells (VSMC) stimulated with bacterial lipopolysaccharide (LPS; 10microgram/ml) for 24 hours were incubated with increasing amounts of testosterone and dihydrotestosterone (1 and 100 nM). LPS was found to induce inflammatory response of iNOS and COX-2 mRNA and protein in VSMC. These processes were affected by male sex steroid hormones. For 3 hours, however, pretreatment of the cells with 100 nM each of testosterone and dihydrotestosterone suppressed LPS induced iNOS and COX-2 protein expression. RT-PCR analysis revealed that testosterone and dihydrotestosterone did not inhibit mRNA expression of iNOS and COX-2 stimulated by 24 hours of LPS incubation. Proliferation rate was slower in VSMC treated with testosterone and dihydrotestosterone. Testosterone enhanced androgen receptor expression, and LPS significantly reduced androgen receptor protein expression in VSMC. These results indicate that the expression of both iNOS and COX-2 proteins was suppressed by testosterone and dihydrotestosterone in LPS stimulated VSMC and leading to reduction of vascular inflammation.

The Effect of Vasoactive Intestinal Peptide on Cord Blood CD34 (+) Cells / 대한소아혈액종양학회지

PURPOSE: We investigated the expression of vasoactive intestinal peptide (VIP), VIP receptor 1 (VPAC1), VIP receptor 2 (VPAC2) genes in the human umbilical cord blood CD34 cells, and the ability of VIP to stimulate human primitive as well as monopotent hematopoietic progenitors. METHODS: We isolated RNA from umbilical cord blood CD34 cells, and then performed RT-PCR, and sequencing. The umbilical cord blood CD34 cells were cultured with the various concentrations of VIP for burst-forming unit of erythrocyte (BFU-E), colony-forming unit of granulocyte/monocyte (CFU-GM), colony-forming unit of graulocyte/erythrocyte/monocyte/megakaryocyte (CFU-GEMM), and colony-forming unit of megakaryocyte (CFU-Mk). RESULTS: The RNA coding for VPAC1 was detected in human umbilical cord blood CD34 cells. VIP significantly stimulated the growth of CFU-GEMM and CFU-Mk. CONCLUSION: The present results suggest that VIP is an important neuropeptide in the early proliferation of human primitive as well as megakaryocyte progenitors.

A Case of Transfusion Transmitted Malaria Infection in Extremely Low Bith Weight Infant

The incidence of malaria in Korea is significantly on the rise since its reemergence in 1993 and no screening test that can prevent the infection has been available. Very low birth weight infants are especially susceptible to malaria infection due to transfusions from multiple donors. We report a case of transfusion transmitted Plasmodium vivax infection in a 120-day-old infant of a gestational age 24 weeks with birth weight of 700 gm who was successfully treated with hydroxychloroquine.