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Chung LY, Nam HK, Rhie YJ, Huh R, Lee KH. Prevalence of idiopathic scoliosis in girls with central precocious puberty: effect of a gonadotropin-releasing hormone agonist. Ann Pediatr Endocrinol Metab 2020; 25:92-96. [PMID: 32615688 PMCID: PMC7336263 DOI: 10.6065/apem.1938164.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/28/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and occurs in children between 10 to 18 years old, during periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), due to early growth spurt, AIS is expected to develop before 10 years of age. Both AIS and CPP are more common in girls than in boys. The aim of this study was to determine the prevalence of AIS in girls with CPP and to evaluate the effect of treatment with gonadotropin-releasing hormone (GnRH) agonists on progression of scoliosis in these patients. METHODS We retrospectively reviewed medical records of 553 girls, 338 with CPP and 215 without CPP. Scoliosis angle was measured on the standing frontal radiograph of each patient according to the Cobb method. Patients with a Cobb angle of 10° or more were diagnosed with scoliosis. For girls with CPP, followup spine radiographs were collected 1 year after treatment with GnRH agonists. Progression of scoliosis before and after treatment was compared in terms of Cobb angle changes. RESULTS AIS was more prevalent in girls that were affected by CPP compared to controls without CPP (11.5% vs. 6.0%, CPP girls vs. non-CPP girls, respectively, P=0.031). The peak serum luteinizing hormone level positively correlated with Cobb angle (R2=0.015, P=0.023) in the CPP group. No progression of scoliosis was observed in CPP girls after one year of GnRH agonist treatment. Additionally, the prevalence of scoliosis decreased in CPP girls after 1 year of the treatment. CONCLUSION We report that the prevalence of AIS is higher in girls with CPP than in non-CPP patients. A regular follow-up schedule for spine radiographs should be considered to reduce the risk of progression. Furthermore, GnRH agonist treatment for CPP may have a suppressive effect on progression of AIS.
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Affiliation(s)
- Lindsey Yoojin Chung
- Department of Pediatrics, Myongji Hospital, Hanyang University College of Medicine, Ilsan, Korea
| | - Hyo-Kyoung Nam
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea,Address for correspondence: Kee-Hyoung Lee, MD, PhD Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Goryeodae-ro Seongbuk-gu, Seoul 02841, Korea Tel: +82-2-920-6604 Fax: +82-2-922-7476 E-mail:
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Park EG, Cho SY, Lee J, Kim J, Cho H, Kim J, Huh R, Ki CS, Kim OH, Jin DK. First Korean Case of Infantile Hypophosphatasia with Novel Mutation in ALPL and Literature Review. Ann Clin Lab Sci 2016; 46:302-307. [PMID: 27312557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hypophosphatasia is a rare hereditary disorder characterized by defective bone and tooth mineralization and deficiency of tissue non-specific alkaline phosphatase activity. The prognosis for the infantile form is poor, with approximately 50% of patients dying within the first year of life from respiratory failure. We describe the clinical and biochemical findings as well as the molecular analysis of a Korean boy with infantile hypophosphatasia and present a literature review. A 1-month-old boy visited the clinic because of poor feeding, frequent vomiting, hypotonia, and failure to thrive from birth. Laboratory tests revealed high total calcium, low phosphorous, low alkaline phosphatase, low parathyroid hormone, and normal 25-hydroxyvitamin D. Intravenous hydration with normal saline was started, and dietary calcium intake was restricted. Skeletal X-rays showed a markedly increased distance of the anterior fontanelle, impaired mineralization, and rachitic changes in the metaphyses. By Sanger sequencing of the ALPL gene, we identified two heterozygous variants, including a missense (c.334G>A; p.Gly112Ser) and a nonsense (c.1039C>T; p.Gln347*) variant. The c.334G>A (p.Gly112Ser) variant had previously been reported in a patient with lethal type hypophosphatasia, while the nonsense c.1039C>T (p.Gln347*) variant was novel. In the current case, the accurate diagnosis and prompt intervention-including dietary calcium intake restriction, tracheostomy to prevent progression to respiratory failure, and fundoplication with gastrostomy to ensure the administration of adequate calories-seemed to play an important role for avoiding preventable morbidity and premature mortality.
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Affiliation(s)
- Eu Gene Park
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoon Cho
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihyun Kim
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heeyeon Cho
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsup Kim
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ok-Hwa Kim
- Department of Radiology, Woorisoa Children's Hospital, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Departments of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee YK, Huh R, Kim J, Ahn K, Sung KW, Cho J. Late-onset noninfectious interstitial lung disease following autologous haematopoietic stem cell transplantation in paediatric patients. Respirology 2016; 21:1068-74. [PMID: 27072744 PMCID: PMC7169184 DOI: 10.1111/resp.12787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 12/29/2015] [Accepted: 01/19/2016] [Indexed: 01/29/2023]
Abstract
Background and objective High‐dose chemotherapy (HDCT) followed by autologous haematopoietic stem cell transplantation (HSCT) is widely used in paediatric cancer patients, but few data about noninfectious interstitial lung disease (ILD) following this treatment are available. Therefore, we aimed to evaluate the incidence, clinical features and risk factors of noninfectious ILD after HDCT in paediatric patients. Methods This was a retrospective cohort study of paediatric solid tumour patients who underwent HDCT and autologous HSCT between 1997 and 2012. ILD was diagnosed using clinical symptoms and radiography after excluding cardiac, renal and infectious causes. Risk factors were analysed using a Cox proportional hazard regression model. Results Three hundred and forty patients were enrolled, and the median age was 3 years (interquartile range 1–7). Eight patients (2.4%) were diagnosed with noninfectious ILD. The median duration of symptom onset was 30 months (range 7–74). Six (75%) of eight ILD patients died during the study period, even though steroids were administered for treatment. High‐dose cyclophosphamide use (hazard ratio = 11.37, 95% confidence interval = 1.38–93.32, P = 0.023) and sex (hazard ratio = 0.10, 95% confidence interval = 0.01–0.84, P = 0.034) were associated with late‐onset, noninfectious ILD upon multivariate analysis. Conclusion The incidence of noninfectious ILD after HDCT and autologous HSCT was not negligible, and the clinical features of ILD showed late onset and a poor prognosis. Female gender and high‐dose cyclophosphamide treatment may be risk factors for noninfectious ILD, but further studies with a larger number of ILD patients are suggested. We investigated noninfectious interstitial lung disease after autologous transplantation in 340 paediatric patients. The incidence was 2.4%. The symptom onset was late and the prognosis was poor. High‐dose cyclophosphamide and female gender were risk factors of interstitial lung disease.
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Affiliation(s)
- Yoon-Kyoung Lee
- Department of Paediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Paediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihyun Kim
- Department of Paediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Paediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Woong Sung
- Department of Paediatrics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joongbum Cho
- Department of Critical Care Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract
This study evaluated the efficacy of a stepwise regimen of estradiol valerate for height control in girls with Marfan syndrome. Eight girls with Marfan syndrome who had completed estrogen treatment for height control were included. Estradiol valerate was started at a dose of 2 mg/day, and then was increased. The projected final height was estimated using the initial height percentile (on a disease-specific growth curve for Korean Marfan syndrome [gcPFHt]), and the initial bone age (baPFHt). After the estrogen treatment, the projected final height was compared to the actual final height (FHt). The median baseline chronological and bone age were 10.0 and 10.5 years, respectively. After a median of 36.5 months of treatment, the median FHt (172.6 cm) was shorter than the median gcPFHt (181.0 cm) and baPFHt (175.9 cm). In the six patients who started treatment before the age of 11 years, the median FHt (171.8 cm) was shorter than the median gcPFHt (181.5 cm) and baPFHt (177.4 cm) after treatment. The median differences between the FHt and gcPFHt and baPFHt were 9.2 and 8.3 cm, respectively. In two patients started treatment after the age of 11, the differences between FHt and gcPFHt, and baPFHt after treatment were -4 and 1.4 cm, and -1.2 and 0 cm for each case, respectively. A stepwise increasing regimen of estradiol valerate may be an effective treatment for height control in girls with Marfan syndrome, especially when started under 11 years old.
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Affiliation(s)
- Dong-Yun Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Sun Hyun
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk-Kyung Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Koo Yoon
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - DooSeok Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim SJ, Kwak HH, Cho SY, Sohn YB, Park SW, Huh R, Kim J, Ko AR, Jin DK. Pharmacokinetics, Pharmacodynamics, and Efficacy of a Novel Long-Acting Human Growth Hormone: Fc Fusion Protein. Mol Pharm 2015; 12:3759-65. [DOI: 10.1021/acs.molpharmaceut.5b00550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Su Jin Kim
- Department
of Pediatrics, Myongji Hospital, Seonam University College of Medicine, Goyang, Republic of Korea
| | - Hyun-Hee Kwak
- Biopharmaceutical
Research Laboratoy, Dong-A Socio Holdings Research Institute, Gyeonggi, Republic of Korea
| | - Sung Yoon Cho
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Bae Sohn
- Department
of Medical Genetics, Ajou University Hospital, Suwon, Republic of Korea
| | - Sung Won Park
- Department
of Pediatrics, Jeil Hospital, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Rimm Huh
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jinsup Kim
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ah-ra Ko
- Clinical
Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department
of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kim H, Kim J, Huh R, Cho SY, Jin DK. Elevation of serum creatine kinase during methimazole treatment of Graves disease in a 13-year-old girl and a literature review of similar cases. Ann Pediatr Endocrinol Metab 2015; 20:106-9. [PMID: 26191516 PMCID: PMC4504990 DOI: 10.6065/apem.2015.20.2.106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 01/18/2023] Open
Abstract
We report a 13-year-old girl with Graves disease, who showed an increased level of serum creatine kinase (CK) accompanied by myalgia after methimazole (MMI) treatment. This patient developed muscular pain two weeks after MMI administration, along with increased CK levels. The level of thyroid hormone was within the normal range when she showed increased CK levels. After the MMI dose was decreased and levo-thyroxine was added, serum CK levels decreased to normal and the myalgia improved. The pathophysiologic mechanism of this effect has not yet been elucidated. An acute relatively hypothyroid state occurs secondary to antithyroid drug (ATD) administration in chronic hyperthyroidism, which may cause changes in the CK levels. In this report, we present a rare pediatric case, along with a literature review of similar cases. In the initial state of MMI treatment, myalgia should be detected and when it occurs, CK levels should be measured. The clinical strategy of monitoring CK levels with the aim of normalizing thyroid hormones is helpful in case of the development of adverse reactions, such as myalgia, during ATD treatment for Graves disease in children.
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Affiliation(s)
- Hyeseon Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsup Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yang A, Lee YH, Nam SY, Jeong YJ, Kyung Y, Huh R, Lee J, Kwun Y, Cho SY, Jin DK. Birth seasonality in Korean Prader-Willi syndrome with chromosome 15 microdeletion. Ann Pediatr Endocrinol Metab 2015; 20:40-5. [PMID: 25883926 PMCID: PMC4397272 DOI: 10.6065/apem.2015.20.1.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/09/2014] [Accepted: 12/30/2014] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Prader-Willi syndrome (PWS) is a well-known genetic disorder, and microdeletion on chromosome 15 is the most common causal mechanism. Several previous studies have suggested that various environmental factors might be related to the pathogenesis of microdeletion in PWS. In this study, we investigated birth seasonality in Korean PWS. METHODS A total of 211 PWS patients born from 1980 to 2014 were diagnosed by methylation polymerase chain reaction at Samsung Medical Center. Of the 211 patients, 138 were born from 2000-2013. Among them, the 74 patients of a deletion group and the 22 patients of a maternal uniparental disomy (UPD) group were compared with general populations born from 2000 using the Walter and Elwood method and cosinor analysis. RESULTS There was no statistical significance in seasonal variation in births of the total 211 patients with PWS (χ(2)=7.2522, P=0.2982). However, a significant difference was found in the monthly variation between PWS with the deletion group and the at-risk general population (P<0.05). In the cosinor model, the peak month of birth for PWS patients in the deletion group was January, while the nadir occurred in July, with statistical significance (amplitude=0.23, phase=1.2, low point=7.2). The UPD group showed the peak birth month in spring; however, this result was not statistically significant (χ(2)=3.39, P=0.1836). CONCLUSION Correlation with birth seasonality was identified in a deletion group of Korean PWS patients. Further studies are required to identify the mechanism related to seasonal effects of environmental factors on microdeletion on chromosome 15.
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Affiliation(s)
- Aram Yang
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Lee
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soon Young Nam
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yu Ju Jeong
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yechan Kyung
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jieun Lee
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Younghee Kwun
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoon Cho
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Cho SY, Asharani P, Kim OH, Iida A, Miyake N, Matsumoto N, Nishimura G, Ki CS, Hong G, Kim SJ, Sohn YB, Park SW, Lee J, Kwun Y, Carney TJ, Huh R, Ikegawa S, Jin DK. Identification andIn VivoFunctional Characterization of Novel Compound HeterozygousBMP1Variants in Osteogenesis Imperfecta. Hum Mutat 2015; 36:191-5. [DOI: 10.1002/humu.22731] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/29/2014] [Indexed: 11/12/2022]
Affiliation(s)
- Sung Yoon Cho
- Department of Pediatrics, Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - P.V. Asharani
- Institute of Molecular and Cell Biology; Proteos Singapore
| | - Ok-Hwa Kim
- Department of Radiology Gachon University Gil Medical Center; Incheon Republic of Korea
| | - Aritoshi Iida
- Laboratory for Bone and Joint Diseases; RIKEN Center for Integrated Medical Sciences; Tokyo Japan
| | - Noriko Miyake
- Department of Human Genetics; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Naomichi Matsumoto
- Department of Human Genetics; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Gen Nishimura
- Department of Pediatric Imaging; Tokyo Metropolitan Children's Medical Center; Fuchu Japan
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Geehay Hong
- Department of Laboratory Medicine and Genetics; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Su Jin Kim
- Department of Pediatrics; Kwandong University College of Medicine; Myongji Hospital; Goyang Republic of Korea
| | - Young Bae Sohn
- Department of Medical Genetics; Ajou University Hospital; Ajou University School of Medicine; Suwon Republic of Korea
| | - Sung Won Park
- Department of Pediatrics; Kwandong University College of Medicine; Cheil General Hospital and Woman's Health Care Center; Seoul Republic of Korea
| | - Jieun Lee
- Department of Pediatrics, Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Younghee Kwun
- Department of Pediatrics, Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Thomas J. Carney
- Institute of Molecular and Cell Biology; Proteos Singapore
- Lee Kong Chian School of Medicine; Nanyang Technological University; Singapore
| | - Rimm Huh
- Department of Pediatrics, Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases; RIKEN Center for Integrated Medical Sciences; Tokyo Japan
| | - Dong-Kyu Jin
- Department of Pediatrics, Sungkyunkwan University School of Medicine; Seoul Republic of Korea
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Sohn YB, Cho SY, Lee J, Kwun Y, Huh R, Jin DK. Safety and efficacy of enzyme replacement therapy with idursulfase beta in children aged younger than 6 years with Hunter syndrome. Mol Genet Metab 2015; 114:156-60. [PMID: 25219292 DOI: 10.1016/j.ymgme.2014.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/26/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
Abstract
Idursulfase beta (Hunterase®) has been used for enzyme replacement therapy (ERT) of patients with mucopolysaccharidosis II (MPS II, Hunter syndrome) aged 6 years or older since 2012 in Korea. The objective of this study was to evaluate the safety and efficacy of ERT with idursulfase beta in Hunter syndrome children younger than 6 years. This study was a 52-week, single center, single arm, open-label clinical trial (NCT01645189). Idursulfase beta (0.5mg/kg/week) was administered intravenously for 52 weeks. The primary endpoint was safety assessed by adverse events (AEs). Secondary endpoints included vital signs, physical examination, ECG, laboratory tests, anti-idursulfase antibodies, and efficacy represented by changes in urinary glycosaminoglycan (GAG) at week 53 from baseline. In addition, growth indices and developmental milestones (Denver II test) were evaluated as exploratory variables. All six patients experienced at least one AE. A total of 109 AEs were reported. One patient experienced a serious AE (hospitalization due to gastroenteritis) that was considered not to be treatment related. One patient (16.7%) experienced infusion-related adverse drug reactions (ADRs), developing urticaria six times and a cough five times. There were no serious ADRs and no clinically significant changes in vital signs, physical exam, laboratory parameters, or ECG. Of the six patients, four (66.7%) showed anti-idursulfase antibodies and neutralizing antibodies on at least one occasion during the study. At week 53, urinary GAG was significantly reduced by -35.1±30.6mgGAG/g creatine from baseline (P=0.038). This study indicates that the safety and efficacy of idursulfase beta are similar to those reported in Hunter syndrome patients aged 6 years or older.
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Affiliation(s)
- Young Bae Sohn
- Department of Medical Genetics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jieun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yonghee Kwun
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Rimm Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Chang MS, Han JC, Lee J, Kwun Y, Huh R, Ki CS, Kee C, Cho SY, Jin DK. A novel splice site mutation in the PAX6 gene in a Korean family with isolated aniridia. Ann Clin Lab Sci 2015; 45:90-93. [PMID: 25696017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Aniridia is a rare congenital ocular disorder of complete or partial iris hypoplasia. Frequently associated ocular changes include corneal abnormalities, cataract, glaucoma, and foveal hypoplasia. In most cases, aniridia is caused by decreased dosage of the paired box 6 (PAX6) gene, which is located in chromosome 11p13. We report the case of a Korean family with isolated aniridia inherited in an autosomal dominant manner. The proband was a one-month-old boy. He presented with bilateral complete aniridia and congenital glaucoma. His four-year-old sister had bilateral complete aniridia, glaucoma, and a corneal ulcer. His father had bilateral microcornea and cataract without aniridia. Using PAX6 sequencing analysis, we identified a deletion at the splice donor site of intron 8 in the proband (c.357+1delG). To our knowledge, this variant has not been previously described.
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Affiliation(s)
| | | | | | | | | | - Chang-Seok Ki
- Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Sung Yoon Cho
- Department of Pediatrics, Hanyang University Guri Hopistal, Hanyang University College of Medicine, Guri, Korea
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Wejaphikul K, Cho SY, Huh R, Kwun Y, Lee J, Ki CS, Jin DK. Hypoparathyroidism in a 3-year-old Korean boy with Sotos syndrome and a novel mutation in NSD1. Ann Clin Lab Sci 2015; 45:215-218. [PMID: 25887879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sotos syndrome is a common genetic overgrowth syndrome caused by a mutation of the NSD1 gene, which is located at chromosome 5q35 and normally encodes a histone methyltransferase protein. The general characteristics of this syndrome include a characteristic facial appearance, developmental delay, and overgrowth, resulting in macrocephaly and tall stature. We describe rhabdomyolysis and hypocalcemia due to hypoparathyroidism in a 3-year-old Korean boy with Sotos syndrome. He was diagnosed with Sotos syndrome based on the typical phenotype and has a heterozygous nonsense mutation (c.4710C>A [p.Cys1570*]) of the NSD1 gene, which causes a premature stop codon and a truncating protein mutation. Hypoparathyroidism has never been described in Sotos syndrome. This report may therefore expand the phenotypic spectrum of this syndrome.
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Affiliation(s)
- Karn Wejaphikul
- Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sung Yoon Cho
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Rimm Huh
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Younghee Kwun
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jieun Lee
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Huh R, Cho SY, Kim J, Ki CS, Jin DK. Letter to the Editor: A Novel Mutation in the CREBBP Gene of a Korean Girl with Rubinstein-Taybi syndrome. Ann Clin Lab Sci 2015; 45:458-461. [PMID: 26275701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Rubinstein-Taybi syndrome (RTS) is a rare congenital disorder characterized by broad thumbs and halluces, dysmorphic facial features, mental retardation, and short stature. Mutations in the cAMP-response element binding protein-BP (CREBBP) gene (50-60% of cases) and E1A-binding protein (EP300, 3%) are known genetic causes in affected individuals. Here, we describe a genetically confirmed Korean RTS patient with atypical features, including Hirschsprung disease and growth hormone deficiency. Mutational analysis revealed a novel heterozygous frameshift mutation, c.2064_2077del14 (p.Gly689Cysfs*32) in the CREBBP gene.
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Affiliation(s)
- Rimm Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsup Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee J, Isojima T, Chang MS, Kwun YH, Huh R, Cho SY, Sohn YB, Jin DK. Disease-specific growth charts for Korean infants with Prader-Willi syndrome. Am J Med Genet A 2014; 167A:86-94. [PMID: 25339260 DOI: 10.1002/ajmg.a.36816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/12/2014] [Indexed: 11/07/2022]
Abstract
Patients with Prader-Willi syndrome (PWS) present with short stature and obesity. The growth pattern of children with PWS is different from that of the healthy population. Therefore, it is not appropriate to use normal growth charts to evaluate the growth status of children with PWS. We aimed to develop disease-specific growth charts for height and weight for nongrowth hormone-treated Korean infants with PWS aged between 0 and 36 months and to use these growth charts for the evaluation and management of infants with PWS. We conducted a retrospective review of the medical records of 122 infants with genetically confirmed PWS. Data on the patients' height and weight measurements before they underwent growth hormone treatment were recorded. Disease-specific growth charts were generated and the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles were calculated using the LMS (refers to λ, μ, and σ, respectively) smoothing procedure for height and weight. The disease-specific growth charts for Korean infants with PWS can be used when examining infants with PWS and when evaluating their growth at later stages for comparison purposes. They are also useful for monitoring growth patterns, nutritional assessments, and recording responses to growth hormone treatment.
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Affiliation(s)
- Jieun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Cho SY, Huh R, Chang MS, Lee J, Kwun Y, Maeng SH, Kim SJ, Sohn YB, Park SW, Kwon EK, Han SJ, Jung J, Jin DK. Impact of enzyme replacement therapy on linear growth in Korean patients with mucopolysaccharidosis type II (Hunter syndrome). J Korean Med Sci 2014; 29:254-60. [PMID: 24550654 PMCID: PMC3924006 DOI: 10.3346/jkms.2014.29.2.254] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/13/2013] [Indexed: 12/04/2022] Open
Abstract
Hunter syndrome (or mucopolysaccharidosis type II [MPS II]) arises because of a deficiency in the lysosomal enzyme iduronate-2-sulfatase. Short stature is a prominent and consistent feature in MPS II. Enzyme replacement therapy (ERT) with idursulfase (Elaprase®) or idursulfase beta (Hunterase®) have been developed for these patients. The effect of ERT on the growth of Korean patients with Hunter syndrome was evaluated at a single center. This study comprised 32 patients, who had received ERT for at least 2 yr; they were divided into three groups according to their ages at the start of ERT: group 1 (<6 yr, n=14), group 2 (6-10 yr, n=11), and group 3 (10-20 yr, n=7). The patients showed marked growth retardation as they got older. ERT may have less effect on the growth of patients with the severe form of Hunter syndrome. The height z-scores in groups 2 and 3 revealed a significant change (the estimated slopes before and after the treatment were -0.047 and -0.007, respectively: difference in the slope, 0.04; P<0.001). Growth in response to ERT could be an important treatment outcome or an endpoint for future studies.
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Affiliation(s)
- Sung Yoon Cho
- Department of Pediatrics, Hanyang University Guri Hopistal, Hanyang University College of Medicine, Guri, Korea
| | - Rimm Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sun Chang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jieun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Younghee Kwun
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Hyun Maeng
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jin Kim
- Department of Pediatrics, Kwandong University College of Medicine, Myongji Hospital, Goyang, Korea
| | - Young Bae Sohn
- Department of Medical Genetics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Sung Won Park
- Department of Pediatrics, Kwandong University College of Medicine, Cheil General Hospital & Woman's Health care Center, Seoul, Korea
| | - Eun-Kyung Kwon
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Ju Han
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jooyoun Jung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Cho SY, Yoon YA, Ki CS, Huh HJ, Yoo HW, Lee BH, Kim GH, Yoo JH, Kim SY, Kim SJ, Sohn YB, Park SW, Huh R, Chang MS, Lee J, Kwun Y, Maeng SH, Jin DK. Clinical characterization and molecular classification of 12 Korean patients with pseudohypoparathyroidism and pseudopseudohypoparathyroidism. Exp Clin Endocrinol Diabetes 2013; 121:539-45. [PMID: 24127307 DOI: 10.1055/s-0033-1349867] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Pseudohypoparathyroidism (PHP) is defined as resistance toward parathyroid hormones. PHP and pseudopseudohypoparathyroidism (PPHP) are rare disorders resulting from genetic and epigenetic aberrations within or upstream of the GNAS locus. This study investigated the clinical characteristics and performed a molecular analysis of PHP and PPHP. METHODS A total of 12 patients with (P)PHP from 11 unrelated families (4 with PHP-Ia, 6 with PHP-Ib, and 2 with PPHP) were characterized using both clinical and molecular methods. Clinical features included the presenting symptoms, Albright hereditary osteodystrophy features, and resistance to hormones. Comprehensive analysis of the GNAS and STX16 loci was undertaken to investigate the molecular defects underlying (P)PHP. RESULTS All PHP-Ib patients displayed hypocalcemic symptoms. All PHP-Ia patients showed resistance toward TSH, in addition to PTH. In most patients with PHP, when the diagnosis of PHP was first established, hypocalcemia and hyperphosphatemia were associated with a significant increase in serum PTH levels. One patient with PHP-Ia was diagnosed with growth hormone deficiency and showed a good response to human recombinant growth hormone therapy. 6 patients with PHP-Ia and PPHP showed 5 different mutations in the GNAS gene. 5 patients with PHP-Ib displayed a loss of differentially methylated region (DMR) imprints of the maternal GNAS. One PHP-Ib patient showed a de novo microdeletion in STX16 and a loss of methylation of exon A/B on the maternal allele. No patients revealed paternal disomy among 4 patients with PHP-Ib. CONCLUSIONS Identification of the molecular causes of PHP and PPHP explains their distinctive clinical features and enables confirmation of the diagnosis and exact genetic counseling.
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Affiliation(s)
- S Y Cho
- Department of Pediatrics, Hanyang University Guri Hopistal, Hanyang University College of Medicine, Guri, Republic of Korea
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Han IB, Huh R, Chung SS, Kim OJ. Cerebellopontine angle epidermoid tumour presenting with bilateral gaze nystagmus. Br J Neurosurg 2008; 22:441-3. [DOI: 10.1080/02688690801911614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Pulsatile tinnitus is a rarely occurring symptom of vascular origin. Most frequently, the symptoms are due to an arteriovenous malformation, to a tumor of the jugular glomus or to a local arterial stenosis. A 39-yr-old Korean male suffering from pulsatile tinnitus of the left ear was diagnosed to have dural arteriovenous malformation of the jugular bulb. Magnetic resonance imaging and angiography revealed a high-velocity vascular lesion encroaching the internal jugular vein and sigmoid sinuses. Digital subtraction angiography demonstrated a dural arteriovenous malformation involving the jugular bulb. The arterial supply was from the neuromeningeal branch of the left ascending pharyngeal artery and inferior tympanic artery. Stenosis of the left jugular vein caused retrograde venous drainage through the contralateral transverse sinus. Superselective embolization of these feeding arteries was successfully performed using 25% mixture of N-butylcyanoacrylate and lipiodol. In postembolization period, his complaints of pulsatile tinnitus and buzzing noise behind his left ear disappeared.
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Affiliation(s)
- J Y Park
- Pundang CHA Hospital, Pochon CHA University, Sungnam, Korea
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Abstract
Stereotactic radiosurgery has been an important treatment modality in the treatment of pituitary adenomas. However, it has the disadvantage of a delayed effect on hormonal normalization compared with microsurgical resection of functioning pituitary adenomas. To define the efficacy of radiosurgery in the treatment of functioning pituitary adenomas, 37 cases with a mean follow-up duration of 26.9 months were analyzed. There were 18 prolactinomas, 11 cases with acromegaly, and 8 cases with Cushing s disease. The mean maximum dose was 54.8 Gy. The tumor margin was encompassed within the 50 to 90% isodose. The level of serum prolactin, growth hormone, and 24-hour urine free cortisol were evaluated for hormonal follow-up according to the relevant endocrinopathy. There was 35.1% hormonal normalization and an 81.8% decline in hormone levels to below 50% of the preoperative value (hormonal response). Hormonal normalization was obtained in 13 patients (mean latency = 22 months). A hormonal response was seen in 30 patients (mean latency = 7.6 months). The maximum dose and tumor volume included in the prescription isodose were significantly correlated with the latency period from radiosurgery to hormonal normalization. These results suggest that early hormonal normalization can best be achieved by a high maximum dose (at least 55 Gy) and broad coverage of the target tumor volume within the prescription dose thereby increasing the integral dose.
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Affiliation(s)
- S H Kim
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Twenty-seven patients with tumor-related secondary facial pain were treated by stereotactic radiosurgical procedures between November 1991 and October 1998. They had 14 meningiomas, 11 schwannomas (one trigeminal, 10 vestibular), one nasopharyngeal cancer and one chordoma. The mean maximum dose administered was 26.4 Gy (range 16 to 35 Gy) and the margin of the tumor was encompassed within the 45 to 90% isodose. The patients were analyzed based on their pain relief with a mean follow-up duration of 32.1 months. In 24 patients (85.7%), there was initial pain improvement after radiosurgery, but half had recurrent pain. A pain response was obtained in 12 cases (pain response rate = 42.9%), five were pain free and seven had pain reduction. On the follow-up MRI, a decrease in tumor volume of more than 20% of the preoperative volume occurred in 14 of 25 cases. The mean time interval to initial pain improvement (10.3 months) and pain response (5.7 months) were shorter than for a decrease in tumor volume (18.6 months). Tumor-related secondary facial pain was less responsive to stereotactic radiosurgery than idiopathic trigeminal neuralgia. It would seem that the mechanism of pain relief in radiosurgery is not only trigeminal root decompression secondary to tumor volume reduction, but also other mechanisms involving inactivation of abnormal electrical transmission may be involved.
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Affiliation(s)
- J W Chang
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Abstract
This investigation was undertaken to characterize CSF flow at the level of the aqueduct of Sylvius with a phase-contrast cine MR pulse sequence in 28 healthy volunteers. Sixteen patients with obstructive hydrocephalus and 11 patients with normal pressure hydrocephalus (NPH) were investigated with the same sequence before and after CSF diversion. The peak CSF flow velocity and stroke volume in the aqueduct increased significantly in the NPH group and decreased significantly in the obstructive hydrocephalus group. After lumboperitoneal shunting in the NPH group, the retrograde flow of CSF was anterogradely converted and the peak flow velocities decreased somewhat. The clinical diagnosis of NPH was well correlated with the results of cine MRI. After endoscopic III ventriculostomy in the obstructive hydrocephalus group we noted increased CSF flow velocity with markedly increased stroke volume at the prepontine cistern. Phase-contrast cine MR is useful in evaluating CSF dynamics in patients with hyperdynamic aqueductal CSF or aqueductal obstruction.
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Affiliation(s)
- D S Kim
- Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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Abstract
A prospective study of 36 consecutive patients with congenital arachnoid cysts treated endoscopically is reported. There were 15 female and 21 male patients. The mean age at the time of diagnosis was 12.3 years (10 days to 38 years). Arachnoid cysts were located in the suprasellar region in 16 patients, the sylvian fissure in 11, the quadrigeminal cistern in 4 and the posterior fossa in 5. Endoscopic fenestration was combined with cysto-peritoneal shunting for 6 temporal cysts and with ventriculo-peritoneal shunting in 1 suprasellar cyst. Mean postoperative follow-up was 4.2 years (range 1-8 years). Follow-up imaging studies showed that 28 arachnoid cysts (77.8%) were obliterated after endoscopic procedures. Long-term clinical results were good in all patients, although the cysts of 8 patients were not reduced in size. There was no mortality or morbidity. We conclude that endoscopic procedures may be a promising alternative to microsurgical operations or shunting for the treatment of arachnoid cysts.
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Affiliation(s)
- J U Choi
- Department of Neurosurgery, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.
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