• Title/Summary/Keyword: early puberty

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Effect of GnRH analogue on the bone mineral density of precocious or early pubertal girls (성조숙증 혹은 조기 사춘기가 있는 여아에서 단기간의 성선자극호르몬 방출호르몬 효능약제 사용이 골밀도에 미치는 영향)

  • Lim, Jeong Sook;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1370-1376
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    • 2009
  • Purpose:Treatment of precocity with gonadotropin releasing hormone analogue (GnRHa) might theoretically exert a detrimental effect on the bone mass during pubertal development. We investigated the short-term changes in bone mineral density (BMD) during GnRHa treatment and the enhancement in the changes with the co-administration of GnRHa and human growth hormone (hGH). Methods:Forty girls with precocious or early puberty who were using GnRHa for more than 1 year were enrolled. Of them, 14 concurrently received hGH. Lumbar bone mineral density was measured before and after the treatment, and bone mineral density-standard deviation scores (BMD-SDSs) were compared according to chronologic age (CA) and bone age (BA), as well as according to the administration of GnRHa alone (Group I) or the co-administration of hGH and GnRHa (Group II). Results:BMDs before and after treatment were in the normal range according to CA but were significantly lower according to BA (P<0.05). During treatment, BMD-SDSs did not change according to CA but significantly increased according to BA (P<0.05). BMD-SDSs in group I did not change during treatment according to CA or BA, while those in group II increased significantly according to BA (P<0.05), but not according to CA. Conclusion:Lumbar BMD was adequate according to CA at initial manifestation of precocity but was lower if compared to BA, that is, BMD did not increase with BA. Because co-treatment with hGH significantly increased BMD-SDSs according to BA, hGH co-treatment could be considered during GnRHa therapy.

CHILDHOOD TRAUMA:RESILIENCE AND RISK FACTORS ON DEVELOPMENTAL TRAJECTORY (소아기 외상 : 발달경로에 따른 보호 및 위험인자)

  • Kim, Young-Shin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.15-23
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    • 2002
  • Knowledge regarding the resilience factors and risk factors of the childhood trauma on the developental trajectory is in its infancy due to the lack of prospective follow-up studies in the childhood trauma and limited understanding of the complex reciprocal interactions between childhood trauma, develop-ent and various aspects of children's environment. These difficulties in the conceptual framework and research methods in the childhood trauma are partly reflected in the inconsistencies, even controversies, of the results in the childhood trauma researches. Despite these difficulties, common aspects of the risk factors and resilience of the childhood trauma on the development can be identified from the previous studies. The resilience to the negative outcome on the development by childhood trauma includes:sex female before puberty, male after puberty or infancy), high socioeconomic status, no organic problem, easy temperament, no previous experience with early loss or separation, younger age at the trauma, better problem solving capacity, high self-esteem, internal locus of control, high coping skills, ability to identify interpersonal relationships, ability to play, sense of humor, having capable parents, having a warm relaionship with at least one of the parents, high education and participating in the organized religious activities. These commonalities of the results suggest that risk and resilient factors of the childhood trauma are interdependent, each factor has multiplicity in the impacts on the children's development according to the developmental stage of the child, family and children's other environment, trauma and stressor have diverse effects according to their intensity and risk and resilience factors could have synergistic or antagonistic effects to each other. To develop comprehensive understanding on the relationship between childhood trauma and developmental psychopathology, risk and resilience factors and to develop effective and efficient prevention and intervention, research on the effect of the stress on the neurodevelopment, on the individual differences of the response to the trauma including genetic factors and constitution, and on the brain plasticity should be accompanied in the future.

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Two Cases of Supernumerary Nipple (과다 유두(Supernumerary Nipple) 2례)

  • Lee, Jeong-Woo;Yang, Jung-Dug;Lee, Jung-Hun;Choi, Kang-Young;Kim, Gui-Rak;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.695-698
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    • 2010
  • Purpose: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. Methods: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a $2.8{\times}3.1\;cm$-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. Results: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. Conclusion: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

The effect of treatment timing on maxillary protraction treatment response - A comparison of prepubertal and pubertal patients (치료시기에 따른 상악골 전방견인효과 - 사춘기전과 사춘기의 비교)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Baik, Hyoung-Seon;Lee, Ji-Hyun
    • The korean journal of orthodontics
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    • v.32 no.5 s.94
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    • pp.301-312
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    • 2002
  • Treatment timing is a very important factor to consider in treating skeletal Class III patients by means of maxillary protraction. According to the literature maxillary Protraction should be carried out at an early age before puberty. However, no scientific data were presented to support this statement and recent studies supported by statistical data showed disagreement concerning the optimum treatment time of maxillary protraction. Therefore, there is no agreement about the optimum treatment time of maxillary protraction. In this study hand-wrist X-rays were taken from 119 patients and subjects were grouped into prepubertal and pubertal group according to their skeletal maturity. Pretreatment and posttreatment lateral cephalometric X-rays were taken and treatment effects were compared. The average treatment time was 6.5 months for the prepubertal group and 6.1 months for the pubertal group. The obtained results were as follows ; 1. The amount of maxillary forward movement was the same for Pretreatment and pubertal group. 2. The amount of maxillary downward movement was the same for prepubertal and pubertal group. 3. The amount of mandibular downward and backward rotational movement was the same for prepubertal and pubertal group. 4. Dental effects were the same for prepubertal and pubertal group.

A Cytogenetic Study in Patients with Sex Chromosome Abnormalities (성염색체이상증후군의 핵형 분석)

  • Seo, Hyun Ji;Lee, Ji Hye;Lee, Heung Kyo;Jung, Seung Hee;Lee, Kun Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1317-1323
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    • 2005
  • Purpose : This study was performed to evaluate the recent frequency of karyotypes in different sex chromosome abnormalities and to evaluate the age and clinical manifestations at diagnosis. Methods : Peripheral blood leukocytes were obtained from subjects who were clinically suspected to have sex chromosome abnormalities and referred to the cytogenetic laboratory in the Department of Pediatrics, Kyungpook National University Hospital from February 1981 to August 2001. Results : The relative frequencies of different sex chromosome abnormalities were Klinefelter(52 percent), Turner(42 percent), XXX syndrome(3 percent) and mixed gonadal dysgenesis(3 percent). The populations of different karyotypes in Klinefelter syndrome were 47,XXY(97 percent) and 46,XY/47,XYY(3 percent). The populations of different karyotypes in Turner syndrome were 45,X(67 percent,), mosaicism(23 percent), and structural aberrations(10 percent). The populations of different karyotypes in XXX syndrome were 47,XXX(67 percent,) and 46,XX/47,XXX(33 percent). All mixed gonadal dysgenesis were 45,X/46,XY. Eighty one percent of sex chromosome abnormalities was diagnosed after puberty. Patients diagnosed with Klinefelter and Turner syndrome in infancy showed nearly normal phenotypes or had minor congenital malformations. Conclusion : Early diagnoses of sex chromosome abnormalities is required to prevent associated morbidities and to maximize growth and development. We have to pay careful attention in diagnoses of Turner syndrome because of the high proportion of mosaicism and structural aberrations.

Studies on Early Selection of Excellent Gilts for Improvement of Reproductive Efficiency I. First Estus and Litter Size of Candidate Gilts (번식효율 증진을 위한 후보 종빈돈의 조기선발에 관한 연구 I. 후보 종빈돈의 첫발정 일령과 산자수)

  • 손동수;이장희;최선호;연성흠;류일선;서국현;허태영;박성재;조규호
    • Journal of Embryo Transfer
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    • v.18 no.3
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    • pp.249-255
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    • 2003
  • These studies were performed to improve the reproductive efficiency of gilts and we investigated the effects of puberty periods, first mating time and backfat thickness and will adapt to these results for early selection of excellent gilts. The main results were as follows; 1. First heats on birth season were showed 194.14 day, 163.25 day, 160.25 day and 157.92 day at birth of spring, summer, autumn and winter, respectively and birth of spring was significantly latest among other seasons (p<0.01). 2. First service on birth season were revealed 222.05 day in spring, 193.00 day in summer, 199.20 day in autumn and 190.11 day in winter. birth of spring was significantly latest among others (p<0.01). 3. First heat period of cadidated gilt had 13∼16 mm backfat thickness was 180.32 day, 171.24 day in 17∼20 mm and 162.20 day in 21∼23 mm and was showed delay in thin backfat gilts. There was no differences among backfat thickness. 4. First service of cadidate gilt had 13∼16mm backfat thickness was 211.12 day, 202.43 day in 17∼20 mm and 195.43 day in 21∼23 mm and was showed delay in thin backfat gilts. There was no differences among backfat thickness. 5. The litter size were 9.64 in gilts under 160 day of first heat, 10.14 in 161∼180 day, 9.56 in 181∼200 day and 9.13 in over 201 day. There showed the largest litter size in 161∼180 day of first heat but was no differences. 6. The litter size in gilts under 180 day of first service was 9.13, 9.75 in 181∼200 day, 10.13 in 201∼220 day and 9.45 in over 221 day. There showed the largest litter size in 201∼220 day of first service but was no differences. 7. The litter size of gilt had 13∼16 mm backfat thickness on first service was 9.33, 9.81 in 17∼20 mm and 10.17 in 21∼23 mm and was showed delay in thin backfat gilts. There was no differences among backfat thickness.

Biological Functions of N- and O-linked Oligosaccharides of Equine Chorionic Gonadotropin and Lutropin/Chorionicgonadotropin Receptor

  • Min, K. S.
    • Proceedings of the KSAR Conference
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    • 2000.10a
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    • pp.10-12
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    • 2000
  • Members of the glycoprotein family, which includes CG, LH, FSH and TSH, comprise two noncovalently linked $\alpha$- and $\beta$-subunits. Equine chorionic gonadotropin (eCG), known as PMSG, has a number of interesting and unique characteristics since it appears to be a single molecule that possesses both LH- and FSH-like activities in other species than the horse. This dual activity of eCG in heterologous species is of fundamental interest to the study of the structure-function relationships of gonadotropins and their receptors. CG and LH $\beta$ genes are different in primates. In horse, however, a single gene encodes both eCG and eLH $\beta$-subunits. The subunit mRNA levels seem to be independently regulated and their imbalance may account for differences in the quantities of $\alpha$ - and $\beta$ -subunits in the placenta and pituitary. The dual activities of eCG could be separated by removal of the N-linked oligosaccharide on the $\alpha$-subunit Asn 56 or CTP-associated O-linked oligosaccharides. The tethered-eCG was. efficiently secreted and showed similar LH-like activity to the dimeric eCG. Interestingly, the FSH-like activity of the tethered-eCG was increased markedly in comparison with the native and wild type eCG. These results also suggest that this molecular can implay particular models of FSH-like activity not LH-like activity in the eCG/indicate that the constructs of tethered molecule will be useful in the study of mutants that affect subunit association and/or secretion. A single-chain analog can also be constructed to include additional hormone-specific bioactive generating potentially efficacious compounds that have only FSH-like activity. The LH/CG receptor (LH/CGR), a membrane glycoprotein that is present on testicular Leydig cells and ovarian theca, granulosa, luteal, and interstitial cells, plays a pivotal role in the regulation of gonadal development and function in males as well as in nonpregnant and pregnant females. The LH/CGR is a member of the family of G protein-coupled receptors and its structure is predicted to consist of a large extracellular domain connected to a bundle of seven membrane-spanning a-helices. The LH/CGR phosphorylation can be induced with a phorbol ester, but not with a calcium ionophore. The truncated form of LHR also was down-regulated normally in response to hCG stimulation. In contrast, the cell lines expressing LHR-t63I or LHR-628, the two phosphorylation-negative receptor mutant, showed a delay in the early phase of hCG-induced desensitization, a complete loss of PMA-induced desensitization, and an increase in the rate of hCG-induced receptor down-regulation. These results clearly show that residues 632-653 in the C-terminal tail of the LHR are involved in PMA-induced desensitization, hCG-induced desensitization, and hCG-induced down-regulation. Recently, constitutively activating mutations of the receptor have been identified that are associated with familial male-precocious puberty. Cells expressing LHR-D556Y bind hCG with normal affinity, exhibit a 25-fold increase in basal cAMP and respond to hCG with a normal increase in cAMP accumulation. This mutation enhances the internalization of the free and agonist-occupied receptors ~2- and ~17-fold, respectively. We conclude that the state of activation of the LHR can modulate its basal and/or agonist-stimulated internalization. Since the internalization of hCG is involved in the termination of hCG actions, we suggest that the lack of responsiveness detected in cells expressing LHR-L435R is due to the fast rate of internalization of the bound hCG. This statement is supported by the finding that hCG responsiveness is restored when the cells are lysed and signal transduction is measured in a subcellular fraction (membranes) that cannot internalize the bound hormone.

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The Effect of Sexual Maturity and Self-Concept on Interest in Appearance and Appearance Management Behavior for Female Students in Elementary and Middle School (초.중등 여학생의 성 성숙과 자기개념이 외모관심도와 외모관리행동에 미치는 영향)

  • Lee, Hwa-Jin;Shin, Hye-Won
    • Journal of Korean Home Economics Education Association
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    • v.23 no.3
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    • pp.185-200
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    • 2011
  • The purpose of this study was to investigate if these factors affect the correlation between the female adolescent interest in appearance and appearance management behavior with self-concept and sexual maturity. To achieve this, a survey was conducted for the female students in elementary and middle school in the Seoul area. The results of this study were as follows. 1. The comparison of students' interest in appearance and appearance management behavior showed that the middle school students showed higher scores in both matters. 2. Elementary students generally held more positive self-concept, with domestic self value shown statistically high 3. Tanner Stage 2.3. the early puberty stage, for elementary school students, and Tanner Stage 3.4. the growth and development stage, for middle school students. The percentage of students who had already entered menstruating turned out to be only 33% for elementary students but 90% for middle school students. Their subjective views of sexual maturity were also different as elementary students had negative feeling when they thought their sexual maturity were maturity were earlier than their peers' while middle school students were just the opposite. 4. The study on the impact of self-concept and sexual maturity on the interest in appearance of female students in elementary and middle school showed that elementary students had a higher interest in appearance that corresponded to the lower domestic self-concept and a higher social self-concept. On the other hand, middle school students showed higher interest in appearance, corresponding to their higher social self-concept, lower domestic self-concept, more negative feeling of sexual maturity, and higher feeling of physical self-concept. The study on the impact of interest in appearance, self-concept, and sexual maturity on the appearance management behavior of elementary and middle school female students revealed that elementary students with a higher interest in appearance were more enthusiastic about appearance management. Middle school students' appearance management behavior turned out to be higher, corresponding to their higher interest in appearance, lower domestic self-concept, and higher social self-concept.

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Secondary Chondrosarcoma Arising from Osteochondroma(tosis) (골연골종(증)에서 발생한 속발성 연골육종)

  • Cho, Hyun-Min;Rhee, Seung-Koo;Kang, Yong-Koo;Chung, Yang-Guk;Lee, An-Hi;Park, Jung-Mi;Bahk, Won-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.21-26
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    • 2010
  • Purpose: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). Materials and Methods: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and fi ve were female. The mean age was 34 years. The mean follow-up period was 54 months. Results: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. Conclusion: Comprehensive understanding of clinical, radiological and pathological features of secondary chondro sarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.

Biological Functions of N- and O-linked Oligosaccharides of Equine Chorionic Gonadotropin and Lutropin/Chorionic Gonadotropin Receptor

  • Min, K.S.
    • Korean Journal of Animal Reproduction
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    • v.24 no.4
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    • pp.357-364
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    • 2000
  • Members of the glycoprotein family, which includes CG, LH, FSH and TSH, comprise two noncovalently linked $\alpha$- and $\beta$-subunits. Equine chorionic gonadotropin (eCG), known as PMSG, has a number of interesting and unique characteristics since it appears to be a single molecule that possesses both LH- and FSH-like activities in other species than the horse. This dual activity of eCG in heterologous species is of fundamental interest to the study of the structure-function relationships of gonadotropins and their receptors. CG and LH $\beta$ genes are different in primates. In horse, however, a single gene encodes both eCG and eLH $\beta$ -subunits. The subunit mRNA levels seem to be independently regulated and their imbalance may account for differences in the quantities of $\alpha$ - and $\beta$-subunits in the placenta and pituitary. The dual activities of eCG could be separated by removal of the N-linked oligosaccharide on the $\alpha$-subunit Asn 56 or CTP-associated O-linked oligosaccharides. The tethered-eCG was efficiently secreted and showed similar LH-like activity to the dimeric eCG. Interestingly, the FSH-like activity of the tethered-eCG was increased markedly in comparison with the native and wild type eCG. These results also suggest that this molecular can implay particular models of FSH-like activity not LH-like activity in the eCG/indicate that the constructs of tethered molecule will be useful in the study of mutants that affect subunit association and/or secretion. A single-chain analog can also be constructed to include additional hormone-specific bioactive generating potentially efficacious compounds that have only FSH-like activity. The LH/CG receptor (LH/CGR), a membrane glycoprotein that is present on testicular Leydig cells and ovarian theca, granulosa, luteal, and interstitial cells, plays a pivotal role in the regulation of gonadal development and function in males as well as in nonpregnant and pregnant females. The LH/CGR is a member of the family of G protein-coupled receptors and its structure is predicted to of a large extracellular domain connected to a bundle of seven membrane-spanning a-helices. The LH/CGR phosphorylation can be induced with a phorbol ester, but not with a calcium ionophore. The truncated form of LHR also was down-regulated normally in response to hCG stimulation. In contrast, the cell lines expressing LHR-t631 or LHR-628, the two phosphorylation-negative receptor mutant, showed a delay in the early phase of hCG-induced desensitization, a complete loss of PMA-induced desensitization, and an increase in the rate of hCG-induced receptor down-regulation. These results clearly show that residues 632~653 in the C-terminal tail of the LHR are involved in PMA-induced desensitization, hCG-induced desensitization, and hCG-induced down-regulation. Recently, constitutively activating mutations of the receptor have been identified that are associated with familial male-precocious puberty. Cells expressing LHR-D556Y bind hCG with normal affinity, exhibit a 25-fold increase in basal cAMP and respond to hCG with a normal increase in cAMP accumulation. This mutation enhances the internalization of the free and agoinst-occupied receptors ~2- and ~17- fold, respectively. We conclude that the state of activation of the LHR can modulate its basal and/or agonist-stimulated internalization. Since the internalization of hCG is involved in the termination of hCG actions, we suggest that the lack of responsiveness detected in cells expressing LHR-L435R is due to the fast rate of internalization of the bound hCG. This statement is supported by the finding that hCG responsiveness is restored when the cells are lysed and signal transduction is measured in a subcellular fraction (membranes) that cannot internalize the bound hormone.

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