• Herbal Formula Science
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• v.31 no.4
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• pp.373-388
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• 2023

Objectives : This study aimed to provide basic data for research by investigating non-clinical experimental studies on herbal medicines and its compounds for precocious puberty. Methods : A search was conducted for all literature until October 2023 using combinations of keywords such as precocious puberty, puberty, and chinese medicine in three databases (Pubmed, OASIS, and ScienceON). Results : 1. In animal experiments, studies were mainly conducted using a model that induced precocious puberty by subcutaneously administering danazol to SD rats on the 5th day after birth, and in cell experiments, precocious puberty was induced by treating GT1-7 cells with kisspeptin 10 or estradiol. 2. Anemarrhenae Rhizoma, Phellodendri Cortex, and Prunellae Spica were mainly used as herbal medicine to evaluate their efficacy on precocious puberty in non-clinical experiments. 3. Macroscopic observation, hematological analysis, histological analysis, and genetic analysis were performed as methods to analyze the experimental results. Conclusions : In this study, the effects of herbal medicine on precocious puberty and non-clinical research methods were confirmed. Based on the results of this study, it is expected that non-clinical effectiveness and mechanism research on materials that are clinically effective in Traditional Korean Medicine will be revitalized.

• 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.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.294-299
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• 2010

Although the increasing incidence of central precocious puberty (CPP) in Korea has recently raised public concerns about health and growth problems, there are many areas of uncertainty regarding the pathogenesis, diagnosis, and management of CPP. In this paper, we review the definition of precocity, the assessment of CPP, and the hormonal abnormalities that support the diagnosis. In addition, we review the practical guidelines regarding the clinical use of gonadotropin-releasing hormone analogs in children with CPP. Indications for treatment, determination of dosage, monitoring during treatment, and discontinuation of therapy are discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.30.1-30.7
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• 2020

Background: Dental studies of precocious puberty have focused on examination of jaw and dentition growth. The aim of the study was to analyze the relationship between precocious puberty and maxillary dental developmental abnormalities (DDAs). Methods: This retrospective study was conducted on the Korean patients in whom dental panoramic and hand-wrist radiographs had been taken before they were 15 years of age. The maxillary DDAs were assessed as mesiodens, congenital missing teeth, peg-shape lateral incisors, or impacted teeth. The chronological ages of the control group members were within the normal range of the hand-wrist bone age. Others with a peak luteinizing hormone of ≥ 5 and < 5 IU/L were allocated to central precocious puberty (CPP) and peripheral precocious puberty (PPP), respectively. Results: Of the enrolled 270 patients, 195, 52, and 23 were allocated to the control, CPP, and PPP groups, respectively. The maxillary DDAs were significantly more prevalent in the CPP group than in the other groups. Among those with maxillary DDA, the mesiodens predominated. Age- and sex-adjusted multivariate analysis revealed maxillary DDA (odds ratio, 3.36; 95% CI, 1.60-7.05) and especially mesiodens (odds ratio, 5.52; CI, 2.29-13.28) to be significantly associated with CPP. Conclusions: Maxillary DDAs were significantly more prevalent in the CPP group than in the PPP or control groups. Among the many types of maxillary DDAs, mesiodens was significantly associated with CPP and may be considered a predictor of the development of CPP.

• Childhood Kidney Diseases
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• v.23 no.2
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• pp.124-127
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• 2019

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.

• Clinical and Experimental Pediatrics
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• v.46 no.4
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• pp.400-403
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• 2003

Congenital adrenal hyperplasia(CAH) is a recognized cause of precocious pseudopuberty. Some children with CAH also develop true precocious puberty with early maturation of the hypothalamic-pituitary-gonadal axis. We review a case of CAH who eventually developed central precocious puberty nine months after initial treatment with corticosteroid. A 3-year-old boy visited complaining of rapid growth, a large penis and frequent penile erections. This patient was diagnosed with CAH with elevated 17-OH progesterone and cortical hypertrophy of adrenal gland on CT scan. His gonadotropin levels were within the normal prepubertal range. Even on treatment with corticosteroid he grew rapidly and had testicular enlargement, pubic hair development and rapid bone maturation. At second admission, his gonadotropin levels were elevated both basally and in response to LHRH stimulation, suggesting that the CAH led to early activation of pubertal gonadotropin secretion(true precocious puberty). He was treated with monthly depot injections of a LHRH analog in addition to the hydrocortisone. His second sexual characteristics regressed gradually and rate of linear growth and bone maturation decreased.

• Journal of Korean Medical Science
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• v.33 no.51
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• pp.329.1-329.9
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• 2018

Background: Brain magnetic resonance imaging (MRI) is routinely performed to identify brain lesions in girls with central precocious puberty (CPP). We aimed to investigate the prevalence and type of brain lesions among Korean girls with CPP and evaluate the need for routine brain MRI examinations. Methods: This retrospective cross-sectional study evaluated data on 3,528 girls diagnosed with CPP from April 2003 to December 2016, and identified 317 girls who underwent sellar MRI. Exclusion criteria were patients with a known brain tumor or who did not undergo brain MRI due to refusal or the decision of the pediatric endocrinologist. Results: Normal sellar MRI findings were observed in 291 of the 317 girls (91.8%). Incidental findings were observed in 26 girls (8.2%). None of the patients had pathological brain lesions. Conclusion: The prevalence of intracranial lesions among girls who were generally healthy and without neurological symptoms but diagnosed with CPP was lower than that previously reported. Furthermore, none of the identified lesions required treatment. It may be prudent to reconsider the routine use of brain MRI to screen all patients with CPP, especially if they are healthy and neurologically asymptomatic, and are girls aged 6-8 years.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.64-70
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• 2014

Objectives The purpose of this study is to find out how taking oriental herbal medicine may affect the sex hormone levels in a patient who was diagnosed with prematurity. Methods We prescribed 120 cc of oriental herbal medicine twice daily for a month to a patient suspected of the precocious puberty due to 11 pg/ml of the estradiol level. Upon finishing the course of oriental herbal medicine, the patient was retested for the follicular stimulating hormone, luteinizng hormone and estradiol levels. Results After administration, all levels of luteininzing hormone, follicular stimulating hormone and estradiol were decreased. There was no diagnosable evidence for the idiopathic central precocious puberty in the gonadotropin releasing hormone stimulation. Conclusions Oriental herbal medicine is a good alternative treatment of choice for the precocious puberty. However, more in-depth studies are to be followed.

• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.1-7
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• 2015

Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

• Clinical and Experimental Pediatrics
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• v.59 no.9
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• pp.355-361
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• 2016

The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women.