Central precocious puberty (CPP) is less common in boys than girls; very little data is reported on effect of gonadotropin-releasing hormone analog (GnRHa) treatment in boys with CPP. The aim of the study was to evaluate growth changes in boys with CPP and early puberty (EP) treated with GnRHa therapy for 1 year. In 60 (39 CPP and 21 EP) boys with confirmed diagnosis of CPP and EP, auxological [height, height standard deviation score (Ht SDS), bone age (BA), Predicted adult height (PAH)] and endocrinological parameters were obtained at baseline, at 6 months, and at 1 year after GnRHa treatment in boys with CPP and EP. During the treatment a decline in Ht SDS and growth velocity, luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone levels were observed (p＜0.01); and a deceleration in the maturation of bones after 1 year GnRHa treatment was observed (p＜0.01). PAH SDS was increased during treatment with GnRHa (p＜0.01). There was significant difference in PAH SDS between organic CPP and non-organic CPP (p＜0.05). The present data indicate that GnRHa therapy significantly improves growth prognosis in boys with CPP and EP.

Achondroplasia is associated with craniofacial abnormality, musculoskeletal deformations, and respiratory, cardiovascular abnormalities. So, anesthetic management is one of clinical challenges. Herein, we report and discuss a case of achondroplastic patient underwent osteosynthesis for femur fracture, which was chosen on the base of patient’s anatomical and physiological characteristics. The patient had thoracolumbar kyphosis (21.8°), previous spine surgery, short neck, obstructive sleep apnea, and mild cervical limitation. Intubation was conducted with smaller cuffed endotracheal tube under videolaryngoscope guidance. Mechanical ventilation was applied with volume control mode, using a tidal volume of 8-10 ml/kg without positive end-expiratory pressure. The patient was supine after placing support under shoulders and head during intubation and surgery. Intraoperative body temperature was maintained using air-forced waring blanket. Complete and careful preoperative evaluation is absolutely important to select the appropriate anesthetic method. Ideal anesthetic management in each case should be based on an individualized decision-making.

A solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm that was first documented in pleura, but ubiquitous in nature, involving extrapleural sites such as the upper respiratory tract, mediastinum, head and neck. To date, about 21 cases of SFT of the breast have been reported. Herein, we presented a 60-year-old Korean female with a palpable mass in the left breast. Ultrasonography with near-oval shape, and well-circumscribed margins suggested a benign lesion, so complete resection was performed. With immunohistochemical staining, we could obtain a definitive diagnosis. Since some SFTs have unpredictable clinical course, long-term follow-up is needed for all patients.

Acute disseminated encephalomyelitis (ADEM) is a rare, postinfectious autoimmune inflammatory demyelinating disease of the central nervous system. ADEM presents clinically encephalopathy in association with polyfocal neurologic deficits. Of them, optic neuritis is less common symptom. We experienced ADEM with optic neuritis associated with Mycoplasma pneumoniae infection in a 5 year-old girl. She initially presented lethargy, irritability, ataxia and loss of pain sense on right hand and progressed to decreased visual acuity and papilledema of both eyes on the 4th hospital day. Brain magnetic resonance imaging showed multiple bilateral hyperintense lesions in the subcortical white matter on T2 weighted images. After administration of intravenous immunoglobulin and high dose intravenous methylprednisolone, she recovered completely.

Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder that predominantly affects the stomach and the small intestine, although its pathogenesis is not yet known precisely. EGE shows distinct peripheral eosinophilia and eosinophilic infiltration of the intestinal wall. A 12-month-old girl who was breastfeeding presented with bilateral eyelid swelling without gastrointestinal symptom. Laboratory examination showed peripheral eosinophilia and hypoalbuminemia and iron deficiency anemia. Gastric and duodenal biopsy specimens revealed eosinophilic infiltration of the mucosal layer. We experienced a case of eosinophilic gastroenteritis without any gastrointestinal symptom, associated with maternal food contained allergen.

Tuberculosis (TB) is still a significant public health problem in Korea. In many cases, it is not easy to diagnose TB. A 13-year-old male patient was admitted for left chest pain for 6 months period. Chest radiography done two months ago during the school screening revealed a pleural effusion in the left lung. All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for Acid-fast bacilli. There was no evidence of a malignant effusion. A pleural fluid examination revealed features suggestive of an empyema. Thick and yellowish pus was drawn out. Pleural fluid analysis presented White blood cell 5,200/mm3, and neutrophil-dominant with 60% of neutrophil. In an effort to attain a diagnosis, a video-assisted thoracoscopy procedure was performed with pleural drainage and biopsies. Active chronic granulomatous pleuritis was found through pleural biopsies. He was responsive to treatment and received 6 months of anti-TB therapy with complete clinical resolution. If the clinical picture is in confusion, pleural biopsy is occasionally indicated to diagnose TB pleuritis.