Clinical features of children's brain tumors according to location / 소아과

PURPOSE: This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. METHODS: A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. RESULTS: The male to female ratio was 1:0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. CONCLUSION: The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.

Iron Status in Korean Middle School Students and Possible Association with Obesity

BACKGROUND: Iron deficiency (ID) in Korean adolescents still remains a problem. This study aimed to assess the prevalence of iron status and investigate the relationship between the iron status and obesity. METHODS: Hematological examinations were performed on apparently healthy 12~14 year old students (M:F=451:442) living in Incheon during September, 2004. ID was defined as a serum ferritin concentration <10ng/mL. The diagnosis of iron deficiency anemia (IDA) was established when anemia (male <12.5g/dL, female <12g/dL) was associated with a ferritin level <10ng/mL and/or transferrin saturation <16%. Using age- and gender-specific BMI percentiles, overweight was defined as a BMI=85th percentile. RESULTS: The prevalence of ID and IDA were 8.4 and 15.6% and 0.9 and 4.5% in males and females, respectively. Using an analysis based on the BMI, the prevalence of obesity were 21.8 and 16.2% in males and females, respectively. The prevalence of ID in male students was decreased in the obesity (0.0%) compared with the non-obesity group (11.4%). In female students, ID showed a higher frequency in the non-obesity (20.4%) compared with the obesity group (12.0%). CONCLUSIOM: Iron deficiency still remains a major nutritional problem in adolescent females, with the prevalence of obesity significantly increasing. Although no association between the prevalence of iron deficiency and obesity was shownin this study, it is important to screen for iron deficiency and obesity, and provide effective nutritional education. Furthermore, the association of obesity with iron deficiency in relation to eating behavior should be investigated.

A Case of Prader-Willi Syndrome with Bilateral Hutch Diverticula Associated with Vesicoureteral Reflux

Our patient is the first reported case of Prader-Willi syndrome(PWS) with bilateral Hutch's diverticula. We believe that hypotonia in PWS is associated with multiple bladder diverticula and vesicoureteral reflux. We conclude that PWS can be considered a possible associated syndrome in patients with multiple bladder diverticula.

A Case of Psychogenic Cough / 소아알레르기및호흡기학회지

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.

A Case of Juvenile Polyposis Presented with Protein Losing Enteropathy / 대한소아소화기영양학회지

Juvenile polyposis is an uncommon condition characterized by the development of multiple juvenile polyps predominantly in the colon but also in the rest of the gastrointestinal tract. Patients with juvenile polyposis commonly present with rectal bleeding, diarrhea, abdominal pain, anemia, prolapse of the polyp. We experienced a juvenile polyposis in a 7 year-old male patient with protein losing enteropathy who was diagnosed by 99MTc-human serum albumin abdominal scintigraphy, colonoscopy, and small bowel series. Proctocolectomy with ileostomy was performed and then protein losing enteropathy was resolved.