• Journal of the Korea Convergence Society
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• v.12 no.6
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• pp.39-47
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• 2021

The purpose of this study is to analyze the differences among short statured children with growth hormone deficiency, idiopathic, and normal children in order to find the effect of growth hormone deficiency on tooth developmental stage. We classified children diagnosed with short stature at the Pediatrics in Yeungnam University Hospital as subjects due to idiopathic and growth hormone deficiency. We analyzed the relationship between short stature and tooth development through the measuring of oral panorama and body index. Only the eruption of lateral incisors showed significant difference between short statured with growth hormone deficiency and idiopathic. Almost all tooth eruption was significantly delayed on short statured children with growth hormone deficiency compared to average group. In conclusion, short stature children with either growth hormone deficiency or idiopathic were affected not only in their somatic stature but also dental maturity. We look forward to this study presenting basic data for orthodontic therapy.

• Journal of the Korea Convergence Society
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• v.12 no.10
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• pp.89-96
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• 2021

This study is aimed to establish the direction of orthodontic treatment by analyzing the differences in the dental arch development due to the cause of short stature. Dental diagnostic tests were conducted on patients who were diagnosed with short stature. Idiopathic short statured children were classified through the paired sampling based on the age and gender of a short statured children with growth hormone shortage. Control groups were classified using same method as above, after selecting candidates with an arch length of less than 3mm and malocclusion. In conclusion, short statured children with growth hormone shortage or idiopathic had the higher rate of crowding and the small value of overbite compared to normal children. Therefore orthodontic treatment for short statured children needs treatment plan included evaluation for Arch length discrepancy to treat a crowding early. This study will provide important data for successful orthodontic treatment according to the characteristics of dental occlusion of short statured children.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.865-870
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• 2005

Purpose : The use of growth hormone(GH) to promote growth in normal short children without classical GH deficiency is controversial. Numerous foreign studies have shown the effects of GH therapy in children with idiopathic short stature(ISS) whereas few has been interested in Korea. Therefore, this study is designed to investigate the effects of GH therapy on ISS by observing correlations and changes among various growth parameters such as, insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3). Methods : This study was conducted retrospectively with 15 children with ISS in Chungbuk National University Hospital in Korea. Mean age was $11.44{\pm}2.81$ and the children were treated with 0.66 IU/kg/wk dosage of GH for 1 or 2 years. Also, the growth parameters before and after the GH therapy were observed. Results : Height standard deviation score(HT-SDS) was increased from $-1.85{\pm}0.70$ to $-1.58{\pm}0.56$ at 1 year and to $-1.21{\pm}0.37$ at 2 years after GH therapy. Predicted adult height standard deviation score(PAH-SDS) was also increased from $-2.10{\pm}0.52$ to $-1.67{\pm}0.59$ at 1 year, and to $-0.96{\pm}0.60$ at 2 years. Serum IGF-I and IGFBP-3 levels were significantly increased after 1 year and marginally increased after 2 years of GH therapy. Conclusion : It is concluded that GH therapy has growth promoting effect. The significant increase in IGF-I and IGFBP-3 levels during the GH therapy suggests that IGF-I and IGFBP-3 are useful predictors of response to the use of GH therapy. It is expected that larger patient samples would provide more reliable information about the effect of GH therapy.

• Clinical and Experimental Pediatrics
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• v.46 no.4
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• pp.363-369
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• 2003

Purpose : Pharmacologic provocation test of growth hormone(GH) is a non-physiologic method and has several limitations for diagnosing growth hormone(GH) deficiency. Spontaneous GH release studies could be important in understanding the pathophysiology of children with poor growth but normal responses to GH provocation tests. Also, the relationship between nocturnal GH secretions and sleep patterns in short stature children is poorly understood. The aim of this study is to determine whether there are differences in sleep patterns and nocturnal GH secretory profiles between idiopathic short stature children and a normal stature group. Methods : Spontaneous nocturnal GH secretions and sleep patterns were evaluated in 12 prepubertal idiopathic short stature children with normal responses to provocation tests and 9 normal stature controls. Blood samples were taken every 30 minutes from 22:00-06:30 and sleep patterns were analyzed by polysomnography. Results : The mean GH level during sleep was significantly lower in short stature children than in controls. The peak GH level after sleep, coincident with the first slow wave sleep, was lower in the short stature group. The slow wave sleep times of short stature children were decreased compared with those of normal subjects. Conclusion : These results suggest that overnight serial GH sampling is helpful to identify short stature children with subnormal GH secretions, and sleep structure differences may be associated with decreased overnight GH secretions in short stature children.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.356-363
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• 2009

Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.665-671
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• 2006

Purpose : To study the effects of growth hormone(GH) treatment on glucose metabolism and insulin resistance in children with idiopathic short stature(ISS). Methods : Glucose and insulin concentrations were measured during oral glucose tolerance test (OGTT) before and after GH treatment(0.6-0.7 IU/kg/week) in 20 patients with ISS. Insulin resistance was assessed by homeostasis model assessment(HOMA). Results : During OGTT, the mean blood glucose level did not show any significant changes after GH treatment. However, mean blood insulin levels of fasting and 30 minutes of OGTT showed significant increases after GH treatment, accompanying significant increases of insulin resistance. There was no difference in change of glucose, insulin levels and insulin resistance before and after GH treatment between two groups of body mass indices(BMI) of 25< and >25. There also was no significant difference between two groups of with and without family histories of diabetes mellitus (DM). There was no case of newly developed impaired glucose tolerance, fasting glucose tolerance, nor newly developed DM. Conclusion : GH treatment with doses of 0.6-0.7 IU/kg/week for mean 9.6 months in patients with ISS did not show any significant changes in blood glucose levels during OGTT. However, GH treatments induced considerably higher fasting insulin levels compared to pretreatment, resulting in statistically higher insulin resistance. Higher BMI and family history of DM did not induce any significant changes in glucose, insulin level and insulin resistance after GH treatment than the other groups.

• Development and Reproduction
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• v.10 no.4
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• pp.215-225
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• 2006

Precocious puberty is defined as the appearance of secondary sex characteristics before age 8 years in girls (or menarche before age 9 years) and before 9 years in boys. The age of onset of puberty is progressing to younger age. The pubertal activation of gonadotrophin releasing hormone(GnRH) release requires coordinated changes in excitatory or inhibitory amino acids, growth factors, and a group of transcriptional regulators. A number of factors affecting precocious puberty were explored, including the role of genetic factors, nutrition(body fat) and exposure to endocrine disrupting chemicals. In addition to the psychosocial disturbances associated with precocious puberty, the premature pubertal growth spurt and the accelerated bone maturation result in reduced adult height. Precocious puberty may be gonadotrophin-dependent premature activation of the GnRH pulse generator or gonadotrophin-independent. In rapidly progressing central precocious puberty, GnRH agonists appear to increase final height. However more data on the effect and long-term safety of GnRHa are needed.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.170-175
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• 2014

The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.2
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• pp.1-10
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• 2021

Objectives We aimed to examine health-related economic analysis of available interventions on idiopathic short stature (ISS). Methods Eight studies were reviewed from English, Korean, and Chinese databases which were published up to December 24, 2020. Effectiveness, utility, and cost data were extracted from the studies and descriptive analysis of the individual studies was conducted Results Five studies were chosen. In the two economic evaluation studies, the incremental cost-effectiveness ratio (ICER) of growth hormone (GH) treatment was presented by performing cost-effectiveness analysis based on the deterministic decision tree approach for the GH and untreated group. Final adult height and direct medical costs were analyzed as effectiveness and cost outcomes. In 1 review article, an ICER of GH was presented based on systematic review on the effects of the GH treatment. In the two clinical trials, the effectiveness and cost of the 12 months Oriental medicine combination treatment were presented in comparison with the GH treatment alone. There were no literatures that provided utility data of available intervention on ISS. Conclusions The results of this study will be used as basic data for the economic analysis of Oriental medicine treatment on ISS in the future.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.1
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• pp.1-17
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• 2021

Objectives We aimed to analyze traditional Chinese medicine (TCM) literatures in regards to the pattern identification and related symptoms of idiopathic short stature (ISS). Methods We searched relevant literatures published up to September 29, 2020 through three Chinese electronic databases. We performed frequency analysis of the selected studies by extracting information on pattern identification, clinical symptoms, and TCM treatments presenting pattern identification of ISS. Results Sixteen studies were included. Spleen deficiency, kidney deficiency, dual deficiency of spleen-kidney, and liver-kidney yin deficiency were frequently reported. Clinical symptoms of the spleen deficiency include sallow complexion, body constituent weakness, anorexia, lack of qi and no desire to speak, and loose stools. Herbal medicines (HMs) such as Sijunzi-tang were frequently reported. Clinical symptoms of the kidney deficiency include cold limb and fear of cold, soreness and weakness of waist and knees, and clear and long urine. HMs such as Bishendihuang-wan were frequently reported. Clinical symptoms of the dual deficiency of spleen-kidney include body constituent weakness, spirit lassitude and lack of strength, anorexia, soreness and weakness of waist and knees, and cold limb and fear of cold. HMs such as Sijunzi-tang plus Bishendihuang-wan were frequently reported. Clinical symptoms of the liver-kidney yin deficiency include tidal fever and night sweating, heat in the palms and soles, dizziness, and dry throat. HMs such as Liuweidihuang-wan were frequently reported. Conclusions This was the first study to analyze the frequency of pattern identification and related symptoms on ISS. In the future, a standardized Korean medicine pattern identification system should be established.