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Background Since the consensus-based diagnostic algorithm for intestinal Behcet’s disease (iBD) was proposed by the IBD Study Group of the Korean Association for the Study of Intestinal Diseases, there were few studies regarding the prognosis of iBD according to the diagnostic algorithm. Methods We reviewed the medical records of patients who had ileocecal ulcers with clinical impression of iBD from March 1986 to August 2019 in Seoul St. Mary’s Hospital and evaluated factors at the time of diagnosis which were related with adverse events (AEs, major operation or admission from iBD) and disease-free survival (DFS). Results Among 204 eligible patients, a total of 163 were included in the study after exclusion of 41 patients with ileocecal ulcers from other disorders. The male-to-female ratio was 1:1 and the mean age at the time of diagnosis was 48.9 ± 15.9. The number of definite, probable, suspected, and non-diagnostic iBD was 18 (11.0%), 64 (39.3%), 37 (22.7%), and 44 (27.0%), respectively. Patients with definite, probable, and suspected iBD developed more AEs compared with patients with non-diagnostic iBD (p = 0.026). After exclusion of patients with non-diagnostic iBD, univariate analysis showed accompanying haematologic disorders, haemoglobin Conclusion Patients with definite, probable, and suspected iBD have a poor prognosis compared with patients with non-diagnostic iBD. Accompanying with haematologic disorders, anaemia, fever, and colonic involvement at the time of diagnosis are poor prognostic factors in patients with iBD.

We studied the association of cytotoxic T lymphocyte antigen-4 gene (CTLA4) polymorphisms with the development of type 1 diabetes (T1D) in Korean children and adolescents. A total of 176 Korean subjects (92 females and 84 males) with childhood-onset T1D were studied. The A/G polymorphism at position 49 in CTLA4 exon 1 and the C/T polymorphism at position -318 in the CTLA4 promoter were analyzed by PCR-RFLP methods. The genotype and allele frequencies of the CTLA4 polymorphisms in the T1D patients were not different from those in the controls. These polymorphisms were not associated with the clinical characteristics or the development of autoimmune thyroid disease in the T1D patients. The frequency of the A allele was significantly higher in the patients that did not have two out of the three susceptible HLA-DRB1 alleles, which were DRB1*0301, *0405 and *09012, compared to the controls (P

Long-term survivors of hematopoietic stem cell transplantation (HSCT) during childhood and adolescence are at risk of developing endocrine complications. The purpose of this study was to evaluate the long-term endocrine complications and their associated risk factors among such patients. We reviewed the data from 111 patients (59 males and 52 females) who underwent HSCT at the mean age of 8.3+/-4.1 yr. Thirty patients (27.0%) had growth impairment, and seven (21.2%) out of 33 patients who attained final height reached final height below 2 standard deviation (SD). The final height SD score of the patients conditioned with total body irradiation (TBI) was significantly lower than that of the patients conditioned without TBI (-1.18+/-1.14 vs. -0.19+/-0.78, P=0.011). Thirteen patients (11.7%) developed hypothyroidism (11 subclinical, 2 central) 3.8+/-1.8 (range 1.6-6.2) yr after HSCT. Nineteen (65.5%) out of 29 females had evidence of gonadal dysfunction, and 18 (64.3%) out of 28 males had evidence of gonadal dysfunction. The risk for gonadal dysfunction was significantly higher in females conditioned with busulfan/cyclophosphamide (P=0.003). These results suggest that the majority of patients treated with HSCT during childhood and adolescence have one or more endocrine complications. Therefore, multiple endocrine functions should be monitored periodically after HSCT until they reach adult age.

Familial hypokalemic periodic paralysis (HOPP) is a rare autosomal-dominant disease characterized by reversible attacks of muscle weakness occurring with episodic hypokalemia. Mutations in the skeletal muscle calcium (CACNA1S) and sodium channel (SCN4A) genes have been reported to be responsible for familial HOPP. Fifty-one HOPP patients from 20 Korean families were studied to determine the relative frequency of the known mutations and to specify the clinical features associated with the identified mutations. DNA analysis identified known mutations in 12 families: 9 (75%) were linked to the CACNA1S gene and 3 (25%) to the SCN4A gene. The Arg528His mutation in the CACNA1S gene was found to be predominant in these 12 families. Additionally, we have detected one novel silent exonic mutation (1950C>T) in the SCN4A gene. As for a SCN4A Arg669His mutation, incomplete penetrance in a woman was observed. Characteristic clinical features were observed both in patients with and without mutations. This study presents comprehensive data on the genotype and phenotype of Korean families with HOPP.

To assess the demographic and clinical findings of measles patients during three epidemics from 1989 to 2001.A total 520 medical records of measles patients were analyzed retrospectively and divided into three groups; those who were admitted during 1989-1990 (group I, 116 patients), those admitted during 1993-1994 (group II, 127 patients), and those admitted during 2000-2001 (group III, 277 patients).For the age distribution, there was no difference in the proportion of2 years of age (61%, 58% and 57%, respectively) for the three groups. However, in each outbreak, there were significant differences in the distribution ofor = 2 years children who had mostly received one-dose measles-mumps-rubella (MMR) vaccination. The age distribution had changed with a significant increase in older children in subsequent outbreaks. In the last 2000-2001 outbreak, there was a pattern for increased attack rates with increasing interval since the initial vaccination. There was no statistical difference between the three groups in gender ratio, MMR vaccination rate inor = 2 years of age, duration of fever, and complications. No difference was found in all the clinical and laboratory parameters between the anti-measles IgM antibody negative patients and the positive patients.The age distribution of admitted children with measles in each outbreak has changed over time since the introduction of one-dose MMR vaccination. This finding suggests that the secondary vaccine failure may have played a large role in the last measles outbreak.

Aim: The diagnosis of Kawasaki disease (KD) in those outside the typical age range (6 months−4 years) is often delayed, potentially worsening prognosis. The features of KD in children ≤6 months and ≥5 years were compared with those presenting within the more typical age distribution. Methods: Korean children with complete diagnostic criteria for KD were grouped according to their age at presentation: Group A (≤6 months), Group B (7 months−4 years) and Group C (≥5 years). The clinical features, laboratory findings and outcome in each group were compared. Results: Of 136 children presenting to a single centre between 1999 and 2003, 10 children were in Group A, 114 in Group B and 12 in Group C. The mean total fever duration was 8 days in Group C and 6.2 days in Group A (P = 0.03). All children in Group C had cervical lymphadenopathy, compared with 50% of Group A and 64% of Group B (P = 0.01). Coronary artery lesions were commoner in older children (Group C, 42%) compared with Group B (17%, P = 0.05). All children had an equivalent leukocytosis, but Group C had significantly higher neutrophil counts (P = 0.001). Group A had significantly lower mean haemoglobin (P = 0.003) and total protein (P = 0.002) at presentation and a more marked thrombocytosis 1 week after intravenous immunoglobulin therapy (P

Mycoplasma pneumoniae pneumonia (MP) is responsible for 10-40% of cases of pediatric community-acquired pneumonia. Occasionally, progression to severe pneumonia occurs despite appropriate antibiotic therapy. We retrospectively evaluated the effect of prednisolone in 15 children with MP whose clinical and radiographic course worsened despite broad-spectrum antibiotics, including appropriate macrolides. The mean ( +/- SD) age was 6.1 +/- 1.9 years, and 10 were boys. All children had received macrolides at presentation, but they had persistent fever and progressively worsening radiographic findings. In addition to broad-spectrum antimicrobial therapy, we added prednisolone (1 mg/kg for 3-7 days, then tapered over 7 days) on day 6 (+/-1.5 days) of admission. Fourteen children became afebrile within 24 hr, and their clinical status and radiographic findings improved over several days. The white blood cell count at presentation was 7,500 +/- 2,000/mm3, with a proportion demonstrating lymphopenia (lymphocyte differential, 19.7 +/- 5.7%). In conclusion, corticosteroid treatment appeared to be temporally associated with clinical and radiographic improvement, and may be helpful for reducing morbidity in children with macrolide-nonresponsive severe MP. Further studies may be warranted.

The purpose of this study was to retrospectively investigate the relationship between age and clinical manifestations and laboratory findings in patients with measles. The study included 216 patients admitted to a hospital in Daejeon, 1 of the largest cities in South Korea, during the 2000-2001 measles outbreak: very young children (2 y old; 159 patients), school age children (9-11 y old; 34 patients), and young adults (16 y old; 23 patients). Few of the very young children (9%), but most of the older children (86%) had a history of a prior measles-mumps-rubella vaccination. There were no statistical differences between the 3 groups in terms of the total duration of fever, length of hospitalization, occurrence of complications (defined as hospitalization for more than 7 d) or anti-measles IgM positivity. A reduction in the number of white blood cells and lymphocytes was observed in all age groups. The levels of C-reactive protein were not different between very young children and older children, but hepatic involvement was more prevalent in young adults. In conclusion, the clinical course including the complications experienced was similar in all the measles patients regardless of age.

We reviewed 12 patients who had Kikuchi-Fujimoto disease (KFD) and presented with prolonged fever and lymphadenopathy. The clinical and laboratory aspects of the patients confirmed by excisional lymph node biopsy were analyzed. The mean age of the children was 11.0 ± 3.0 years (range: 6–15 years). The male-to-female ratio was 1.4:1. The median duration of fever before admission and the total duration of fever was 13 days (range: 7–65 days) and 19.5 days (range: 9–75 days), respectively. One patient had supraclavicular lymphadenopathy, 10 had cervical involvement, and 1 had axillary lymphadenopathy. All of the histologic findings of the lymph node biopsies showed the characteristic findings consistent with KFD, such as paracortical necrosis with karyorrhexis and an increase in the number of phagocytic histiocytes and atypical lymphocytes. As for the laboratory findings, leukopenia (3600 ± 900 per mm3), anemia (hemoglobin 11.4 ± 1.2 g/dL), an elevated erythrocyte sedimentation rate (44 ± 18 mm/hour), and a relatively low C-reactive protein level (1.3 ± 1.1 mg/dL) were noted. Eight patients received conservative therapy with antipyretics, and 3 patients were treated with prednisolone. KFD is a rare disease yet should be considered in the differential diagnosis for older children with prolonged fever and lymphadenopathy.

Objective Measurements of serum insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) are utilized in the diagnostic work-up and clinical management of children with growth disorders. We designed this study to establish the reference values of serum IGF-I and IGFBP-3 levels according to age, sex and pubertal stage in Korean children and adolescents. Methods For the study, 1378 healthy Korean children and adolescents aged 0 to 17 years (722 boys, 656 girls) were randomly selected. Blood samples were collected, and the stored sera were assayed for IGF-I and IGFBP-3 using immunoradiometric assay (IRMA, Immunotech). The R 2.8.1 program (Bell Laboratories) was used to generate reference percentile curves for IGF-I and IGFBP-3 according to age, sex, and pubertal stage Results Serum IGFBP-3 level was higher in girls compared to that in boys of the same ages throughout the pubertal period, whereas IGF-I was only higher for girls younger than 13 years of age. Serum levels of IGF-I and IGFBP-3 increased steadily with age in the prepubertal stage, followed by a progressive decline thereafter. Peak levels of serum IGF-I and IGFBP-3 were observed two years earlier in girls compared to those in boys (13 vs. 15 years of age, respectively). Serum IGF-I and IGFBP-3 concentrations were highest at Tanner stage IV in boys and girls, with a subsequent decline. Conclusions Our reference value model based on age, sex, and pubertal stage can improve the diagnostic utility of IGF-1 and IGFBP-3 levels in the evaluation and management of Korean children and adolescents with growth disorders.

Background Aseptic meningitis is a relatively frequent childhood disease and virologic data suggest that enteroviruses are the commonest etiologic agents. We evaluated the epidemiologic characteristics of aseptic meningitis in Daejeon, South Korea from 1987 to 2003. Methods 2201 medical records of children with aseptic meningitis admitted to The Catholic University of Korea, Daejeon St Mary's Hospital were retrospectively analyzed. Results Outbreaks of aseptic meningitis were observed in 1990, 1993, 1996, 1997, 2001 and 2002. The age distribution of cases was relatively uniform, with a higher incidence in those aged < 1 year and 4–7 years. The male-to-female ratio was 2:1. There was a higher incidence of disease in the summer (May to August, 74.1% of total). Comparison of the largest epidemics in 1997 and 2002 showed significant differences in the incidence in those < 1 year (11.8% vs. 4.4%, respectively; P = 0.001). Neurologic sequelae were observed in 0.7% of the patients. Conclusion Aseptic meningitis, rare before the 1980s in Korea, has since become a common clinical entity. Since 1990, outbreaks of aseptic meningitis have occurred every 1 to 3 years in Daejeon in keeping with Korea-wide epidemics. The frequency of disease affecting children less than one year of age may reflect herd immunity to the epidemic strain.

The risk of osteoporosis or osteopenia is known to increase after childhood cancer treatment. The purpose of this study was to evaluate patterns of bone mineral density (BMD) and factors related to decreased BMD in childhood cancer survivors. We studied 78 patients (34 males, 44 females) treated for acute lymphoblastic leukemia, acute myelogenous leukemia or chronic myelogenous leukemia during childhood. Clinical data, laboratory finding, bone age, lumbar BMD (LBMD) and femur neck BMD (FNBMD) were investigated. Chronological age at evaluation was 11.6±3.4 yr in males and 13.0±3.3 yr in females. Primary disease, chronological age at treatment, body mass index (BMI), method of treatment (chemotherapy, radiotherapy), endocrine function, presence of chronic graft-versus-host disease (cGVHD) and relevance of BMD standard deviation score (SDS) were evaluated. LBMD and FNBMD of the subjects were -0.91±1.41 and -1.13±1.79, respectively. Twenty (25.7%) patients had LBMD SDS lower than -2. Nineteen (24.4%) patients had FNBMD SDS lower than -2. The patients treated with hematopoietic stem cell transplantation had lower LBMD SDS (-1.17±1.39 vs -0.43±1.33, P=0.025). The risk of having LBMD SDS

Counterflow centrifugal elutriation (CCE) has been a highly efficient physical method for separating T cells from bone marrow (BM) without impairing cell function and yield. To investigate the usefulness of CCE, the hematopoietic potential as well as the level of T cell contamination in rotor-off (R/O) fraction of BM was studied using a murine bone marrow transplantation (BMT) model [C3H/He (H-2k)-->BALB/C (H-2d)]. The total recovery of cells after CCE procedure was 71.4%. Morphologically, R/O fraction contained abundant mononuclear cells and a few lymphocytes. The numbers of colony forming unit for granulocyte/monocyte (CFU-GM), Sca-1+ cells, and T cells were compared among four fractions of CCE (fractions at flow rate of 17, 25, 28 mL/min, and R/O fraction). The number of CFU-GM per 10(5) nucleated cells in each fraction were significantly higher in R/O fraction (331.3 +/- 34.4) compared to unfractionated marrow (UM) (21.1 +/- 1.3) and fraction of 17 mL/min (FR 17) (23.7 +/- 2.2 ) (chi2 = 0.0044). Neither fraction of 25 mL/min (FR 25) nor fraction of 28 mL/min (FR 28) contained CFU-GM colonies. The concentration of Sca-1+ cells in R/O fraction was significantly higher (1.96-fold) than UM (p < 0.05), and 80.0 +/- 10.1% of Sca-1+ cells in UM were recovered in R/O fraction; 88.1% of Thy-1.2+ T cells were eliminated in R/O fraction (p < 0.05). Mice receiving UM after lethal irradiation (875cGy) suffered from severe graft-versus-host disease (GVHD) and all five died within 7 days after BMT procedure (Group A). Of interest, mice receiving mixture of R/O fraction with lymphocyte-rich fraction (FR 25 plus FR 28) to equalize T cell number as UM, developed severe GVHD and four out of five died (probability of survival; 20%) (Group B). Mice receiving R/O fraction had mild GVHD and four out of five survived for at least 90 days (probability of survival; 80%) (Group C). In group C, probability of survival (p = 0.0006) was higher, and severity of GVHD (p = 0.0043) and progression rate of GVHD (p = 0.02) was lower. In conclusion, the elutriated R/O fraction cells of BM have the advantages of stable engraftment and tolerable GVHD in murine allogeneic BMT with complete major histocompatibility disparity. This could be directly applicable to patients with high risk of GVHD and graft failure in upcoming clinical trials.

Pathologically, Kawasaki disease (KD) is a systemic vasculitis which can show some complications as arthritis during the natural course. It is observed usually in the acute or subacute stage of 15%–45% of KD patients [3, 4, 5]. The 5 children, out of 217 patients with KD, who presented with arthritis after defervescence on intravenous immunoglobulin (IVIG) treatment were retrospectively reviewed. All patients met the diagnostic criteria of KD at the initial time of presentation and patients 1, 2, 4 and 5 were readmitted because of arthritis. Initially, all patients were treated with IVIG at a dose of 2 g/kg, and with acetylsalicylic acid (30– 50 mg/kg). Two patients (numbers 3 and 4) failed to respond the first dose of IVIG and became afebrile after the second dose of IVIG (1 g/kg). The arthritis was observed at mean of 10.4±1.3 days (range 8 to 13 days) after the onset of fever, and at a mean of 5.8±1.8 days (range 3 to 10 days) after defervescence after the final dose of IVIG. For the types of arthritis, the polyarticular cases showed involvement of all phalangeal joints of both hands with additional involvement of at least one other joint including the left knee joint in patient 1, and bilateral knee, wrist and ankle joints in patient 3. In the pauciarticular types, there was bilateral involvement of hip joints in patient 2, right hip joints and the right third interphalangeal joint in patient 4, and the left knee joint in patient 5. All patients with arthritis responded effectively to high doses of acetylsalicylic acid (80 mg/kg/day for 10–14 days, patients 1 and 2) or ibuprofen (30 mg/ kg/day for 2–4 weeks, patients 4 and 5) or corticosteroids (patient 3). One child (patient 3), after responding to the second dose of IVIG therapy, showed an acute onset of polyarthritis with relapsed fever and elevated laboratory values. She was unresponsive to ibuprofen and received the methylprednisolone pulse therapy (15 mg/kg for 3 days) with ibuprofen for 2 months. There has been no relapse for 6 months after treatment. HLA B27 was negative for all three cases which were examined (Table 1). Children with KD in the acute stage commonly present with oedematous hands and feet, especially in young infants. Considering the pathogenesis of KD as a systemic vasculitis, the swelling and tenderness of extremities may be combined with arthritis. However, in this study, we selected those patients with arthritis which occurred after defervescence with IVIG treatment. Among 217 KD patients observed over a 6-year period (1998–2003), only 5 (2%) showed this type of arthritis. IVIG therapy in KD is more effective than high dose acetylsalicylic acid therapy in inducing defervescence, normalising the laboratory findings and preventing cardiac complication [2, 6]. Because the anti-inflammatory effect of IVIG on arthritis also is more effective than that of acetylsalicylic acid, the incidence of arthritis in the subacute stage of KD has decreased in the IVIG era. Arthritis after infection with Streptococcus, Shigella or Chlamydia is known as reactive arthritis or postinfectious arthritis. Reactive arthritis develops within 1–4 weeks after the primary infection and some patients are positive for HLA B27 [1]. The fact that arthritis occurs regardless of high dose acetylsalicylic acid therapy in the subacute stage [3] and after high dose IVIG therapy suggests that this type of arthritis in KD is a reactive arthritis due to an unknown pathogen.

Results: GV during the first year of GnRHa treatment was 5.9 ±1.0 cm/yr and decreased significantly to 5.4±1.1 cm/yr during the second year of treatment (P = 0.005). GV during the third year (5.0±1.0 cm/yr) was not different from GV during the second year. During the second year of treatment, 8.2% and 36.7% of the girls had a GV < 4 cm/yr and < 5 cm/yr, respectively. Girls with relatively low GV during the second year of treatment (< 5 cm/yr) showed higher risk of advanced BA (≥ 11 yr) at 1 year (55.6% vs. 19.4%; odds ratio [OR], 5.2; P = 0.022). In multivariate logistic regression analysis, more advanced BA at 1 year (OR, 6.1; 95% confidence interval [CI], 1.57-23.87) and lower height SDS for BA at 1 year (OR, 0.24; 95% CI, 0.06-0.94) were associated with relatively decreased GV (< 5 cm/yr) during the second year of GnRHa treatment. Conclusion: GV during and after the second year of GnRHa treatment in girls with idiopathic CPP remains within the normal prepubertal range, and relatively low GV during GnRHa treatment is associated with more advanced BA and lower height SDS for BA.

Background Recent clinical observation reported that there was a significant correlation between change in circulating vascular endothelial growth factor (VEGF) levels and the occurrence of severe acute graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT), but the action mechanisms of VEGF in GVHD have not been demonstrated. Methods This study investigated whether or not blockade of VEGF has an effect on acute GVHD in a lethally irradiated murine allo-HSCT model of B6 (H-2b)→B6D2F1 (H-2b/d). Syngeneic or allogeneic recipient mice were injected subcutaneously with anti-VEGF peptides, dRK6 (50 µg/dose) or control diluent every other day for 2 weeks (total 7 doses). Results Administration of the dRK6 peptide after allo-HSCT significantly reduced survival with greaterclinical GVHD scores and body weight loss. Allogeneic recipients injected with the dRK6 peptide exhibited significantly increased circulating levels of VEGF and expansion of donor CD3+ T cells on day +7 compared to control treated animals. The donor CD4+ and CD8+ T-cell subsets have differential expansion caused by the dRK6 injection. The circulating VEGF levels were reduced on day +14 regardless of blockade of VEGF. Conclusion Together these findings demonstrate that the allo-reactive responses after allo-HSCT are exaggerated by the blockade of VEGF. VEGF seems to be consumed during the progression of acute GVHD in this murine allo-HSCT model.

Purpose : The gonadotropin-releasing hormone (GnRH) test results of girls with precocious puberty were analyzed to determine whether this test can efficiently and clearly differentiate between central precocious puberty (CPP) and other disorders. Methods : Clinical and laboratory data of 54 girls with precocious pubertal signs were reviewed. Intravenous GnRH test was performed with blood samples obtained at 0, 30, 60, and 90 minutes. A peak luteinizing hormone (LH) level of ≥5.0 IU/L was indicative of CPP. Results : Of the 40 girls with CPP, 36 (90.0%), 3 (7.5%), and 1 (2.5%) showed peak LH levels at 30, 60, and 90 minutes, respectively. A percentage of girls whose peak LH ≥5.0 IU/L up to 30, 60, and 90 minutes was 92.5%, 100%, and 100%, respectively. The peak LH/follicle stimulating hormone (FSH) ratio of girls with CPP was 0.89±0.49 and was 1.0 showed higher chronological age (CA) (8.3±0.6 vs. 7.7±1.0 years, P=0.033), bone age (BA) (10.9±0.8 vs. 9.7±1.1 years, P=0.001), and BA-CA difference (2.6±0.7 vs. 2.0±0.7 years, P=0.009) than those of girls with peak LH/FSH ratio of ≤1.0. Higher percentage of girls with peak LH/FSH ratio of >1.0 showed advanced breast development (≥Tanner III) (93.7% vs. 41.7%, P=0.001). Conclusion : LH levels after 30 and 60 minutes of intravenous GnRH administration are the most useful for diagnosing CPP in girls. (Korean J Pediatr 2009;52:1377-1382)

Purpose : Ghrelin, being secreted from the stomach, stimulates growth hormone secretion and controls energy homeostasis by increasing appetite. Leptin, being secreted from the adipocytes, controls weight and energy homeostasis by decreasing appetite. Leptin concentration is reported to increase after childhoodcancer therapy. This study was aimed to compare ghrelin and leptin concentrations in normal children and children who received cancer therapy. Methods : We enrolled forty-three patients who were diagnosed with cancer and received radiotherapy or chemotherapy during Dec. 2004 through Dec. 2005 in St. Marys hospital and Kangnam St. Marys hospital. Forty-five healthy children were selected as a control group whose age, gender, weight and height were similar to those of cancer group. The serum leptin and ghrelin concentrations were alsomeasured by radioimmunoassay. Results : The cancer group showed higher BMI and leptin concentrations. The control group showed higher concentrations of ghrelin. Both control and cancer groups revealed positive correlations between leptin concentrations and BMI. Ghrelin concentrations in the control group showed negative correlations with age, height, weight and BMI but no significant correlation was found in the cancer group. All the parameters in the group treated with chemotherapy only were not different from those in the group treated with chemotherapy and irradiation. But the level of ghrelin in the acute myeloid leukemia group was much higher than those in the acute lymphoblastic leukemia group. Conclusion : Patients with pediatric cancer treatment have presented higher BMI and leptin concentrations but lower ghrelin concentrations than those in healthy children. Because of the relatively short duration and cross sectional method of the study, however, further long term and prospective study will be required in the future.

As a result of the widespread use and enhanced quality of high-resolution radiological techniques, a recent report has revealed a relatively high prevalence of small adrenal tumors in patients with untreated congenital adrenal hyperplasia due to 21-hydroxylase deficiency. However, there are scarcely any pediatric cases of adrenocortical tumor following long-term treatment in patients suffering with congenital adrenal hyperplasia. We report here on a pediatric female case of adrenocortical adenoma despite adequate long-term treatment for the salt-losing type of congenital adrenal hyperplasia.

Purpose:Ghrelin stimulates the secretion of growth hormone and other pituitary hormones, and has orexigenic effects. It may have a physiologic role in fetal and neonatal growth. Leptin secreted by the adipocytes reflects fat mass in infants as well as adults. The aim of this study was to evaluate the relation of cord blood ghrelin and leptin levels to body weight(BW), body mass index(BMI), insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3) levels in appropriate for gestational age(AGA) newborns. Methods:Sixty healthy AGA newborns(31 males and 29 females, gestational age[GA] 34-42 weeks) were included in this study, whose BW and BMI were measured at delivery. Umbilical cord venous blood samples were withdrawn, and ghrelin and leptin were measured by radioimmunoassay. Cord blood IGF-I and IGFBP-3 were determined by immunoradiometric assay. Results:The mean levels of ghrelin were inversely correlated with BW(r=-0.29, P

Purpose:In this study, we analyzed the short term changes of thyroid function, incidence and risk factors of thyroid dysfunction soon after allogeneic hematopoietic stem cell transplantation (HSCT) in children. Methods:We enrolled 80 pediatric patients following allogeneic HSCT, at the Catholic HSCT center between January, 2004 and February, 2006. Serum TSH (thyroid stimulating hormone), total serum thyroxine and total serum triiodothyronine levels were systematically measured in 80 patients before the HSCT, and at 1 month, 6 months and 12 months after HSCT. Results:Thyroid function statistically decreased at 1 month after HSCT(P

목 적 : 마이코플라즈마 폐렴 환아들의 연령에 따라 임상 양상과 방사선 소견 및 검사실 소견에서 차이가 있는가를 알아보고자 하였다. 방 법 : 2003년 7월부터 2004년 2월까지 가톨릭대학교 대전성모병원 소아과에 입원한 마이코플라즈마 폐렴 환아들을 입원 기록지와 흉부 방사선 소견을 후향적으로 분석하였다. 진단은 입원 및 퇴원시 2차례 마이코플라즈마 항체 검사에서 항체가가 4배 이상 증가하거나 음성에서 양전(>1 : 40)된 환아 75명을 대상으로 하였다. 대상 환아를 연령에 따라 2세 이하 군(16명), 3~5세 군(35명) 및 6세 이상 군(24명)으로 나누었다. 결 과 : 입원 기간 및 총 발열 기간은 3군간에 차이가 없었다. 백혈구 수(및 림프구 비율)는 2세 이하 군에서 $12,400{\pm}4,000/mm^3$ ( $36.5{\pm}15.1%$ ), 3~5세 군에서 $10,500{\pm}3,500/mm^3$ ( $29.4{\pm}9.6%$ ), 6세 이상군에서 $7,600{\pm}3,300/mm^3$ ( $24.1{\pm}7.6%$ )을 보였다(P 【Purpose : We investigated the clinical manifestations, radiographic and laboratory findings of children with M. pneumoniae pneumonia(MP) according to their age. Methods : A total of 75 children with MP who admitted to The Catholic University, Daejeon St. Mary's Hospital from July 2003 to February 2004, were classified into the three age groups : the ${\leq}2$ years of age(16 children), the children between 3 and 5 years of age(35 children), and the ${\geq}6$ years and older(24 patients). The diagnosis of MP was depended on the titers of anti-mycoplasma antibody that were measured 2 times, at admission and at discharge. Results : The total duration of the fever and the length of hospitalization were not different among the age groups. Although the white blood cell(WBC) value and differential was significantly different between the groups(P ${\leq}2$ years old group, but 16 cases(66.6%) in the >6 years old group(P】