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Craniopharyngioma 患者에 對한 內分泌學的 考察

Endocrine Studies in Patients with Cranipharyngioma

소아과 1965년 8권 1호 p.25 ~ 36
서세모,
소속 상세정보
서세모 (  ) - 연세대학교 의과대학 소아과학교실

Abstract


20 patients with craniopharyngioma from 1950 to 1962 at the Children´s Hospital Medical Center,Boston, Massachusetts were studied, before and after the removal of the tumor, on the following parameter of endocrine functions:
1) Thyroid function was studied by the measurement of PBI (or BEI), cholesterol, RAI uptake, BMR, RBC uptake and by the evaluation of hight and bone age.
Pre-operatively, 9 patients had hypothyroidism. The most common finding in them was retarded height and bone age, the latter being more retarded than the former- Such finding was observed in 7 of them. Post-operatively, 18 patients had hypothyroidism.
2) Adrenocortical function was studied by the rest mg level of urinary 17 KS & 17 OH and ACTH & Methopyrapone tests.
8 patients had normal urinary 17 OH level preoperatively, but, since none of them had ACTH & Methopyrapone tests, no definite conclusion could be drawn. 10 patients were studied post-operatively and 9 were proved to have a decreased function.
*Department of Pediatrics. Harvard Medical School. Boston. Mass.. U. S. A.
3) Gonadal function was studied by the urinary 17 KS & FSH level, estrogen effect from vaginal smear and the development of external genitalia.
Pre-operatively, 2 patients who were in adolescence had normal function. One patient had accelerated function with precocity and the remaining 17 were not conclusive because they were in preadolescence. Post-operatively, among 7 patients who were in adolescence, 6 showed decreased function. Studies on the remaining 13 patients, who were in preadolescence, were not conclusive except for one who had precocity pre-operatively and remained so in the post-operative period.
4) Growth was evaluated by the measurement of height(or length), weight and bone maturation.
Pre-operatively, 8 patients showed retarded linear growth, 3 showed obesity and 3 showed emaciation. Post-operatively, despite the prolonged use of thyroid hormone in an adequate dosage, 11 patients showed retarded linear growth, suggesting a possibility of de-creased secretion of growth hormone, 11 patients showed obesity and 4 patients showed emaciation. A po ssible relationship between change in body weight and change in the secretion of fat mobilizing hormone from
the pituitary gland and/or the damage of hyp:)thalamic centers; e.g., ventromedial and lateral area were discussed.

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