• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.379-383
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• 2014

Recombinant growth hormone (GH) is an effective treatment for short children who are born small for gestational age (SGA). Short children born SGA who fail to demonstrate catch-up growth by 2-4 years of age are candidates for GH treatment initiated to achieve catch-up growth to a normal height in early childhood, maintain a normal height gain throughout childhood, and achieve an adult height within the normal target range. GH treatment at a dose of $35-70{\mu}g/kg/day$ should be considered for those with very marked growth retardation, as these patients require rapid catch-up growth. Factors associated with response to GH treatment during the initial 2-3 years of therapy include age and height standard deviation scores at the start of therapy, midparental height, and GH dose. Adverse events due to GH treatment are no more common in the SGA population than in other conditions treated with GH. Early surveillance in growth clinics is strongly recommended for children born SGA who have not caught up. Although high dose of up to 0.067 mg/kg/day are relatively safe for short children with growth failure, clinicians need to remain aware of long-term mortality and morbidity after GH treatment.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.121-124
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• 2016

Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported in Korea. Here we report 2 cases of TS and GHD. In case 1, GHD was initially diagnosed. Karyotyping was performed because of the presence of the typical phenotype and poor response to growth hormone therapy, which revealed 45,X/45,X+mar. The patient showed increased growth velocity after the growth hormone dose was increased. In case 2, a growth hormone provocation test and chromosomal analysis were performed simultaneously because of decreased growth velocity and the typical TS phenotype, which showed GHD and a mosaic karyotype of 45,X/46,XX. The patient showed spontaneous pubertal development. In female patients with short stature, it is important to perform a throughout physical examination and test for hormonal and chromosomal abnormalities because diagnostic accuracy is important for treatment and prognosis.

• Clinical and Experimental Reproductive Medicine
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• 제21권3호
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• pp.241-245
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• 1994

Despite increasing success rate of IVF, poor response to ovarian stimulation remains a problem. So, attempts to improve ovarian responses, for example, by using combined gonadotropin-releasing hormone analogue(GnRH-a) and human menopausal gonadotropin(hMG) have shown limited success. It is reported that response of granulosa cells in vitro to FSH is stimulated by co-incubation with IGF-l, and IGF-l production can be increased by growth hormone. This suggest that combination regimen of G.H. and hMG may augment follicle recruitment. In fifteen patients who had previous history of poor ovarian response to gonadotropin stimulation after pituitary suppression with mid -luteal GnRH-a, the effectiveness of cotreatment with G.H. in IVF program was evaluated using a combination regimen of G.R. and hMG at Korea University Hospital IVF Clinic. Ovarian responses to gonadotropin stimulation in control and GH-treated cycles assessed by total dose and duration of hMG treatment, follicular development and peak $E_2$ level, number of eggs retrieved, and fertilization rates were also assessed. In each group, serum and follicular fluid IGF-1 concentrations on day of egg collection were measured by RIA after acidification and extraction by reveresed phase chromatography. Patients receiving G.H. required fewer days and ampules of gonadotropins, developed more oocytes, and more embryos transferred. But, the differences were not statistically significant, except the duration of hMG treatment. Our data showed a significantly higher concentration of IGF-l in the serum, not in the follicular fluid, of patients treated with G.H. compared with control group. These data suggest that growth hormone treatment does not improve the ovarian response in women with limited ovarian reserve to gonadotropin stimulation for IVF.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.274-280
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• 2019

Purpose: To analyze the growth response to growth hormone (GH) therapy in prepubertal patients with Noonan syndrome (NS) harboring different genetic mutations. Methods: Twenty-three patients with prepubertal NS treated at Pusan National University Children's Hospital between March 2009 and July 2017 were enrolled. According to the disease-causing genes identified, the patients with NS were divided into 4 groups. Three groups were positive for mutations of the PTPN11, RAF1, and SOS1 genes. The five genes undetected (FGU) group was negative for PTPN11, RAF1, SOS1, KRAS, and BRAF gene mutations. The influence of genotype was retrospectively analyzed by comparing the growth parameters after GH therapy. Results: The mean chronological age at the start of GH treatment was $5.85{\pm}2.67years$. At the beginning of the GH treatment, the height standard deviation score (SDS), growth velocity (GV), and lower levels of insulin-like growth factor-1 (IGF)-1 levels were not statistically different among the groups. All the 23 NS patients had significantly increased height SDS and serum IGF-1 level during the 3 years of treatment. GV was highest during the first year of treatment. During the 3 years of GH therapy, the PTPN11, RAF1, and SOS1 groups showed less improvement in height SDS, IGF-1 SDS, and GV, and less increase in bone age-to-chronological age ratio than the FGU group. Conclusion: The 3-year GH therapy in the 23 prepubertal patients with NS was effective in improving height SDS, GV, and serum IGF-1 levels. The FGU group showed a better response to recombinant human GH therapy than the PTPN11, RAF1, and SOS1 groups.

• 한국발생생물학회지:발생과생식
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• 제4권2호
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• pp.237-242
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• 2000

흰쥐 시상하부에서 합성ㆍ분비되어 뇌하수체 전엽에서의 growth hormone (GH) 분비를 촉진하는 growth hormone releasing hormone (GHRH)이 시상하부 이외 조직들 (extrahypothalamic tissues)인 태반, 생식소, 그리고 뇌하수체 전엽에서도 발현됨이 보고되었다. 본 연구는 흰쥐 뇌하수체 전엽에서 발현되는 GHRH의 기능을 조사하기 위해 i)세포 배양을 시행하면서 GHRH의 세포내 함량, 분비 그리고 세포분획법 (cell-fractionation)을 사용하여 분리한 뇌하수체 세포 유형별로 GHRH 함량을 방사면역측정법으로 조사하였고, ii)체외배양 중인 뇌하수체 전엽세포의 증식에 미치는 GHRH의 효과를 측정하기 위해 [$^3$H] thymidine incorporation assay를, 그리고 iii) GHRH의 세포분열 촉진 효과와 세포내 c-fos 유전자 발현과의 상관관계를 조사하기 위해 northern blot analysis를 시행하였다. GHRH 방사면역측정법을 시행한 결과 상당량의 GHRH-like 분자들이 흰쥐 뇌하수체 전엽내에 존재하고, 체외 세포배양시 분비됨을 관찰하였다. 세포분획을 사용한 실험에서 GHRH 함량은 gonadotrope, somatotrope, lactotrope 그리고 thyrotrope 순으로 나타났다. 이 러한 결과는 흰쥐 뇌하수체 전엽에서 생성된 GHRH가 국부적인 조절인자, 특히 상이한 유형의 세포들 간의 상호조절 (cross-talk)을 통해 뇌하수체 전엽에서의 세포분열과 분화, 그리고 기능조절에 관여할 가능성을 보여주었다. GHRH는 체외 배양중인 뇌하수체 전엽세포의 [$^3$H] thymidine incorporation을 농도의존적으로 증가시켰으며, 이러한 GHRH의 세포분열 촉진 효과는 예상대로 세포내 oncogene 활성 의 증가를 통해 일어나는 것임을 c-fos northrn blot으로 확인하였다. 결론적으로, 본 연구는 흰쥐 뇌하수체 전엽에서 합성되는 GHRH가 paracrine 또는 autocrine 기작으로 GH의 분비 촉진 이외에도 세포분열의 조절함을 시사하는 것이다.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.845-851
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• 2010

Purpose: Recombinant human growth hormone (rhGH) has been widely used to treat short stature. However, there are some concerns that growth hormone treatment may induce skeletal maturation and early onset of puberty. In this study, we investigated whether rhGH can directly affect the neuronal activities of of gonadotropin-releasing hormone (GnRH). Methods: We performed brain slice gramicidin-perforated current clamp recording to examine the direct membrane effects of rhGH on GnRH neurons, and a whole-cell voltage-clamp recording to examine the effects of rhGH on spontaneous postsynaptic events and holding currents in immature (postnatal days 13-21) and adult (postnatal days 42-73) mice. Results: In immature mice, all 5 GnRH neurons recorded in gramicidin-perforated current clamp mode showed no membrane potential changes on application of rhGH (0.4, $1{\mu}g/mL$). In adult GnRH neurons, 7 (78%) of 9 neurons tested showed no response to rhGH ($0.2-1{\mu}g/mL$) and 2 neurons showed slight depolarization. In 9 (90%) of 10 immature neurons tested, rhGH did not induce any membrane holding current changes or spontaneous postsynaptic currents (sPSCs). There was no change in sPSCs and holding current in 4 of 5 adult GnRH neurons. Conclusion: These findings demonstrate that rhGH does not directly affect the GnRH neuronal activities in our experimental model.

• Childhood Kidney Diseases
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• 제12권1호
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• pp.38-46
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• 2008

목적 : 성장장애는 만성 신부전에서 중요한 합병증으로 최근 성장호르몬 사용으로 이를 극복하려는 시도가 이루어지고 있다. 본 연구에서는 소아 만성 복막투석 환자에서 성장호르몬의 치료 효과와 성장에 영향을 주는 요인을 알아보고자 하였다. 방법 : 2001년부터 2007년까지 7년간 삼성서울병원에서 만성신부전으로 복막투석을 시행한 적이 있거나 현재 투석 중인 36명의 환자 중에서 1년 이상 성장호르몬을 사용한 환자 17명을 대상으로 후향적으로 의무기록을 분석하였다. 17명 중 1년 간 성장호르몬을 사용한 후의 Ht-SDS가 치료 후 감소되었거나 혹은 증가하지 않은 6명과 성장호르몬 치료 1년 후 Ht-SDS가 증가된 11명으로 나누어 두 그룹간의 차이를 비교하였다. 결과 : 17명의 환자 중 남자가 12명 여자가 5명이었으며, 투석 시작시의 평균 연령은 7.7${\pm}$5.2 세, 성장호르몬 투여 시작시의 평균 연령은 8.5${\pm}$4.8 세였다. 성장이 잘 된 그룹과 그렇지 않은 그룹간의 비교에 있어서는 성장이 잘된 군이 그렇지 않은 군에 비해 성장호르몬 투여시의 Ht-SDS가 더 작았으며(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048), 잔여 신기능(residual renal Kt/V)이 더 좋았다(1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02). 17명의 환자 중 성장호르몬을 3년 간 사용한 8명의 환자들을 분석해보면 성장호르몬 치료 초기 Ht-SDS 의 증가가 없었던 군은 지속적인 성장호르몬 사용에도 불구하고 여전히 Ht-SDS의 증가가 없었다. 결론 : 만성 복막투석 환자들에게 있어 성장장애가 심한 환자 일수록 성장호르몬 치료효과가 좋았고, 복막투석 중 잔여신기능 유지가 성장호르몬의 효과를 높이기 위해 중요하였다. 또한 성장호르몬 치료 시작 1년 후 Ht-SDS가 증가하였는지를 평가하는 것이 장기간 성장호르몬을 사용할 때의 효과를 예측하기 위해 중요할 것으로 생각된다.

• Asian-Australasian Journal of Animal Sciences
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• 제21권5호
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• pp.707-714
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• 2008

The experiment was conducted to evaluate the effect of ${\beta}$-1,3/1,6-glucan on growth performance, immunity and endocrine responses of weanling piglets. One hundred and eighty weanling piglets (Landrace$\times$Large White, $7.20{\pm}0.25kg$ BW and $28{\pm}2$ d of age) were randomly fed 1 of 5 treatment diets containing dietary ${\beta}$-1,3/1,6-glucan supplemented at 0, 25, 50, 100 and 200 mg/kg for 4 wks. Each treatment was replicated in 6 pens containing 6 pigs per pen. On d 14 and 28, body weight gain, feed consumption and feed efficiency were recorded as measures of growth performance. Peripheral blood lymphocyte proliferation and serum immunoglobulin G (IgG) were measured to study the effect of dietary ${\beta}$-1,3/1,6-glucan supplementation on immune function. Plasma prostaglandin E2 (PGE2), growth hormone (GH) and ghrelin were measured to investigate endocrine response to ${\beta}$-1,3/1,6-glucan supplementation. Our results suggest that average daily gain (ADG) and feed efficiency had a quadratic increase trend with dietary ${\beta}$-1,3/1,6-glucan supplementation from d 14 to 28, whereas it had no significant effect on average daily feed intake (ADFI). The treatment group fed with 50 mg/kg dietary ${\beta}$-1,3/1,6-glucan supplementation showed a numerical increase in ghrelin, a similar change trend with ADG and no significant effect on GH. Lymphocyte proliferation indices, serum IgG and plasma PGE2 concentrations varied linearly with dietary supplementation levels of ${\beta}$-1,3/1,6-glucan on d 14. Higher levels of ${\beta}$-1,3/1,6-glucan may have a transient immuno-enhancing effect on the cellular and humoral immune function of weanling piglets via decreased PGE2. Taking into account both immune response and growth performance, the most suitable dietary supplementation level of ${\beta}$-1,3/1,6-glucan is 50 mg/kg for weanling piglets.

• Asian-Australasian Journal of Animal Sciences
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• 제16권8호
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• pp.1193-1198
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• 2003

An increase in frequency of administration of exogenous growth hormone (GH) or GH-releasing hormone was reported to be a model to increase blood circulating insulin-like growth factor-1 (IGF-1) and to improve growth performance in animals. We have investigated the effect of twice daily administration of GH-releasing peptide-2 (GHRP-2) on growth performance, GH responsiveness and plasma insulin-like growth factor IGF-1 in swine. We administered to eight swine, 3 control and 5 treatment, a twice daily s.c. injections of GHRP-2 ($30{\mu}g/kg\;BW$) for a period of 10 days. Every day blood samples immediately taken before injections of GHRP-2 or saline, at 08:00 h and 16:00 h, were measured for IGF-1 concentrations. Blood samples for GH assay were collected every 20 min on days 1, 6 and 10, from 1 hour before and 3 h after GHRP-2 or saline injections at 08:00 h. GH peak concentrations and GH area under curve (GH AUC) on day 1, 6 and 10 in treatment group of swine were higher than those in control swine (p<0.05). Twice daily administration of GHRP-2 caused a significantly attenuation (p<0.05) of GH peak concentrations ($80.25{\pm}13.87$, $39.73{\pm}5.72$ and $27.57{\pm}6.06ng/ml$ for day 1, 6 and 10, respectively) and GH AUCs ($3,536.15{\pm}738.35$, $1,310.31{\pm}203.55$ and $934.37{\pm}208.99ng/ml$ for day 1, 6 and 10, respectively). However, there was no significant difference in GH peak concentration and GH AUC between day 6 and 10. Plasma IGF-1 concentration levels were higher in treatment than control group of swine (p<0.05) after 3 days of the treatment, and the levels reached a plateau from day 3 to 10 of experiment. Growth performance did not alter by GHRP-2 administration, even though a numerical increase of body weight gain and feed efficiency was observed. These results indicate that twice daily administration of GHRP-2 for 10 days in swine did not significantly influence on growth performance, caused an overall attenuation of GH response, and that elevation of plasma GH concentrations caused by GHRP-2 administration increased plasma IGF-1 concentrations, even though an attenuation of GH response was observed.

• Journal of Community Nutrition
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• 제8권2호
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• pp.76-89
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• 2006

By improving body composition, such as fat, lean body mass and total body weight, an exercise program can be an effective treatment of obesity. The effects of exercise on obesity have been confirmed via various approaches such as type, intensity, duration, frequency, and combination with diet. Combined exercise and diet is the most efficient strategy for weight loss, and exercise alone could improve metabolism irrespective of weight loss. In addition, physical activity, including exercise, is emphasized to avoid a 'yo-yo' phenomenon. Exercise increases lipolysis stimulated by such factors as catecholamine, growth hormone (GH), and hormone sensitive lipase (HSL). Moreover, changes in insulin and cortisol through exercise affect adipose tissue, which is known as not only an energy storage locale, but also as an endocrine organ. Adipocytokines secreted by adipose tissue respond to signals that modulate metabolism and inflammation. Exercise has generally shown positive effects on adipocytokines, and these effects increase in conjunction with a hypocaloric diet. However, a long duration and a high intensity of exercise could induce an inflammatory response. This review summarizes the effects of exercise on obesity treatment, which contributes to the exercise and nutritional fields, particularly of community nutritionists. (J Community Nutrition 8(2): 76-89, 2006)