• Clinical and Experimental Pediatrics
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• v.55 no.12
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• pp.481-486
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• 2012

Purpose: Precocious puberty is defined as breast development before the age of 8 years in girls. The present study aimed to reveal the diagnosis of Korean girls referred for precocious puberty and to compare the constitutional and endocrinological features among diagnosis groups. Methods: The present study used a retrospective chart review of 988 Korean girls who had visited a pediatric endocrinology clinic from 2006 to 2010 for the evaluation of precocious puberty. Study groups comprised fast puberty, true precocious puberty (PP), pseudo PP, premature thelarche, and control. We determined the height standard deviation score (HSDS), weight standard deviation score (WSDS), and body mass index standard deviation score (BMISDS) of each group using the published 2007 Korean growth charts. Hormone tests were performed at our outpatient clinic. Results: The PP groups comprised fast puberty (67%), premature thelarche (17%), true PP (15%), and pseudo PP (1%). Advanced bone age and levels of estradiol, basal luteinizing hormone (LH), and peak LH after gonadotropin-releasing hormone stimulation testing were significantly high in the fast puberty and true PP groups compared with the control group. HSDS, WSDS, and BMISDS were significantly higher in the true PP group than in the control group (P<0.05). Conclusion: The frequent causes of PP were found to be fast puberty, true PP, and premature thelarche. Furthermore, BMISDS were significantly elevated in the true PP group. Therefore, we emphasize the need for regular follow-up of girls who are heavier or taller than others in the same age group.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.2
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• pp.281-285
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• 1999

Kallmann's syndrome has both a general and specific connotation in describing general condition of gonadotropin-releasing hormone (GnRH) deficiency or a particular cluster of anomalies associated with primary eunuchoidism. The familial occurrence of hypogonadotropic hypogonadism associated with anosmia, color blindness, synkinesia, and mental defect is the classic Kallmann's syndrome. Interestingly, anosmia, or lack of smell, was not found in the absence of gonadal deficiency in the original study of this disorder. This disorder was found on both sexes, but the male to female ratio was 11:1, and Kallmann's syndrome is more often listed under disorders of male hypogonadism for this reason. Gross anatomy has shown disorders of the olfactory bulbs associated with Kallmann's syndrome and it was demonstrated a failure of GnRH-containing cells to migrate from the olfactory placode to the hypothalamus and preoptic area. We have experienced a case of Kallmann's syndrome which showed a hypoplasia of olfactory bulb in MRI during the workup of primary amenorrheic patient. So we report this case with a brief review of literatures.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.1
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• pp.63-73
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• 2017

Objectives The purpose of this study is to analyze recent clinical studies on treatment for precocious puberty. Methods 28 clinical studies from January 2009 to December 2016 about precocious puberty from the China Academic Journal (CAJ), China National Knowledge Infrastructure (CNKI), were selected and reviewed: 22 case control studies and 6 case series. Results The main traditional Chinese medicine (TCM) treatment was the herbal decoctions and granules. The frequently used herbs were root of Bupleurum falcatum (柴胡), fruit of Prunella vulgaris var. aleutica (夏枯草), root stem of Anemarrhena asphodeloides (知母), dried fungus nucleus of Poria cocos (茯苓), Rehmannia glutinosa var. purpurea (生地黃), peony Paeonia suffruticosa Andrews (牧丹皮), bark of Phellodendron amurense (黃柏), roots of a plant Paeoniae lactiflora (白芍藥). On the other hand, the main western medicine (WM) for precocious puberty was Gonadotropin-releasing hormone agonist (GnRHa). Total effective rate of the TCM group was 62.96-100%, that of the WM group was 36.6-93.3% and that of the TCM-WM group was 77.8-93.75%. Conclusions Traditional Chinese medicine has been shown as an effective treatment for precocious puberty. These research results can be utilized in other clinical studies and in treatment of precocious puberty.

• Clinical and Experimental Reproductive Medicine
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• v.24 no.2
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• pp.179-185
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• 1997

$23{\sim}40$세 (평균 연령 31.6세)의 자궁내막증 환자35명 (1기 7명, 2기 7명, 3기 14명, 4기 7명)을 대상으로 gonadotropin-releasing hormone agonist (Goserelin) 3.6 mg을 한달 간격으로 6개월 복부의 피하에 이식한 후 자궁내막증에 대한 치료 효과와 부작용을 알아보기 위하여 매달 호르몬 검사와 증상에 대한 설문조사를 시행하였다. 투여 1개월 후 혈청 estradiol농도는 30 pg/mL이었고 이후 치료중 $10{\sim}20$ pg/mL를 유지하였으며 투여를 중간한 1개월 후 50 pg/mL로 증가하였다. 혈청 LH농도는 치료 중 유의하게 감소하였으며 투여를 중단한 후 증가하였다. FSH는 투여 1개월 후 감소하였으나 2개월후부터 계속 치료전과 같은 농도를 유지하였다. 혈청 CA-125치는 19명중 10명에서 치료전에 35 mIU/mL이상으로 증가되었으며 치료 2개월 후부터 모두 정상으로 감소되었다. 월경곤란증은 치료 3개월째 완전히 소실되었고 성교통은 치료가 끝날 때까지 20%의 환자에서 지속되었다. 백혈구수, 혈색소, 전해질, 단백질, 빌리루빈 및 간효소는 치료 중 모두 정상이었다. 혈압과 체중도 치료전, 치료중에 변화가 없었다. 투여후 86%의 환자가 안면홍조를 63%에서 질건조증을 20%가 두통, 우울을 호소하였다. 이와 같은 부작용은 투여를 중단한 1개월 후 모두 소실되었으며 부작용 때문에 투여를 중단한 예는 없었다. 이상의 결과로 GnRH-a는 난소의 estradiol생산을 완벽하게 중단시키고 골반증상을 완하시켜 자궁 내막증 치료에 효과적이라고 사료되며 안면홍조와 같은 부작용의 빈도가 높기 때문에 향후 호르몬 보충요법을 병행하는 것이 바람직 하다고 사료된다.

• 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.

• Clinical and Experimental Reproductive Medicine
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• v.47 no.4
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• pp.237-244
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• 2020

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

• Development and Reproduction
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• v.25 no.4
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• pp.269-277
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• 2021

Effects of water temperature and hormones on ovarian development of conger eel in Korea were investigated. Ovarian development was analyzed by measuring gonadosomatic index (GSI) and oocyte diameter with histological methods. At rearing water temperatures of 12℃, 14℃, and 16℃, GSI value increased from 3.66 at the start of the experiment to 7.44, 8.82, and 7.34 at the end of the experiment, respectively. At rearing water temperatures of 12℃, 14℃, and 16℃, egg diameter increased from 245.11-300.25 ㎛ at the start of the experiment to 377.62-480.27 ㎛, 396.72-498.54 ㎛, and 382.29-475.69 ㎛ at the end of the experiment, respectively. Follicular oocyte development revealed that primary yolk globule stage observed from January to March. It entered to secondary yolk globule stage in April and remained at the same stage until July. As a result of examining effects of three hormones (human chorionic gonadotropin (HCG), luteinizing hormone releasing hormone analogue (LHRHa), and salmon pituitary extraction (SPE) on ovarian development, HCG was found to be the most effective one. The progress from diapause of the secondary yolk globule stage to migratory nucleus stage of oocytes could be induced by treating fish with HCG at 1,000 IU/kg. The effect of hormone treatment on ovarian development of conger eel in Korea was the most effective at water temperature of 14℃.

• Clinical and Experimental Reproductive Medicine
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• v.45 no.4
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• pp.183-188
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• 2018

Objective: The purpose of this retrospective study was to evaluate the appropriateness of various follicle-stimulating hormone (FSH) starting doses in expected normal responders based on the nomogram developed by La Marca et al. Methods: A total of 117 first in vitro fertilization cycles performed from 2011 to 2017 were selected. All women were expected normal responders and used a recombinant FSH and flexible gonadotropin-releasing hormone antagonist protocol. The FSH starting dose was empirically determined (150, 225, or 300 IU). The FSH starting dose indicated by La Marca's nomogram was determined using female age and serum $anti-M{\ddot{u}}llerian$ hormone or basal FSH levels. If the administered dose was exactly the same as the proposed dose, the cycle was assigned to the concordant group (34 cycles). If not, it was assigned to the discordant group (83 cycles). Optimal ovarian response was defined as a total of 8-14 oocytes, hypo-response as < 8 oocytes, and hyper-response as > 14 oocytes. Results: Between the concordant and discordant group, ovarian response (optimal, 32.4% vs. 27.7%; hypo-response, 55.9% vs. 54.2%; and hyper-response, 11.8% vs. 18.1%) and the number of total or mature oocytes were similar. Ovarian hyperstimulation syndrome was rare in both groups (0% vs. 1.2%). The implantation rate, clinical pregnancy rate, miscarriage rate, and live birth rate were all similar. Conclusion: The use of the proposed FSH starting dose determined using La Marca's nomogram did not enhance the optimal ovarian response rate or pregnancy rate in expected normal responders. Individualization of the FSH starting dose by La Marca's nomogram appears to have no distinct advantages over empiric choice of the dose in expected normal responders.

• The Journal of Pediatrics of Korean Medicine
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• v.36 no.3
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• pp.1-18
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• 2022

Objectives The purpose of this study was to investigate the current status of interventional clinical trial registration for children with precocious puberty and to secure basic data for the design of clinical trials for traditional Korean medicine treatment of precocious puberty. Methods The following resources were used to search for data: Clinicaltrial.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and Clinical Research Information Service (CRIS), using the search terms, 'Precocious puberty', 'child'. All clinical trials which were registered as of June 2022 were used. Results For the intervention and clinical trial design, gonadotropin releasing hormone (GnRH) analog was reported in 41.7% of trials, and single group assignment was performed in 66.7% of the studies. Prior consent had not been reported in 50% of the studies. Tanner stage and GnRH stimulation tests were reported by multiple trials as inclusion criteria, and prior treatment experiences for trial drugs were reported as exclusion criteria. The peak serum concentration of luteinizing hormone following GnRH stimulation test was used as a primary outcome in 45.8% of clinical trials, and other growth-related indicators such as growth rate, height, and predicted adult height were also reported. Conclusions In consideration of the design, eligibility criteria, and outcome measurement of the existing clinical trials identified in this study, it should be referred to in the design of clinical trials for traditional Korean medicine treatment of precocious puberty.

• Journal of Animal Science and Technology
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• v.64 no.2
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• pp.312-329
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• 2022

Feed cost is the main factor affecting the economic benefits of pig industry. Improving the feed efficiency (FE) can reduce the feed cost and improve the economic benefits of pig breeding enterprises. Liver is a complex metabolic organ which affects the distribution of nutrients and regulates the efficiency of energy conversion from nutrients to muscle or fat, thereby affecting feed efficiency. MicroRNAs (miRNAs) are small non-coding RNAs that can regulate feed efficiency through the modulation of gene expression at the post-transcriptional level. In this study, we analyzed miRNA profiling of liver tissues in High-FE and Low-FE pigs for the purpose of identifying key miRNAs related to feed efficiency. A total 212~221 annotated porcine miRNAs and 136~281 novel miRNAs were identified in the pig liver. Among them, 188 annotated miRNAs were co-expressed in High-FE and Low-FE pigs. The 14 miRNAs were significantly differentially expressed (DE) in the livers of high-FE pigs and low-FE pigs, of which 5 were downregulated and 9 were upregulated. Kyoto Encyclopedia of Genes and Genomes analysis of liver DE miRNAs in high-FE pigs and low-FE pigs indicated that the target genes of DE miRNAs were significantly enriched in insulin signaling pathway, Gonadotropin-releasing hormone signaling pathway, and mammalian target of rapamycin signaling pathway. To verify the reliability of sequencing results, 5 DE miRNAs were randomly selected for quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The qRT-PCR results of miRNAs were confirmed to be consistent with sequencing data. DE miRNA data indicated that liver-specific miRNAs synergistically acted with mRNAs to improve feed efficiency. The liver miRNAs expression analysis revealed the metabolic pathways by which the liver miRNAs regulate pig feed efficiency.