• The Journal of Pediatrics of Korean Medicine
• /
• v.30 no.1
• /
• pp.45-58
• /
• 2016

Objectives The purpose of this study is to investigate about chief complaints of Korean pediatrics and adolescent outpatients in the ${\bigcirc}{\bigcirc}$ university hospital for their recent trend. Methods The study was composed of 4,677 new patients aged between 1 month and 20 years who had been visited pediatrics in ${\bigcirc}{\bigcirc}$ university hospital from 2012 January to 2015 December. Results 1. Among those patients, majority was early childhood as 51.4%, followed by early childhood, late childhood, infancy, and adolescence. 2. Chief complaints in this population have been recorded in the fall the most as 29.6%, but the distribution was inconsistent. 3. To categorize, digestive-related chief complaints were the highest as 30.6%, followed by respiratory, supplemental use, growth, psychiatrics. Respiratory-related chief complaints increased dramatically in the fall. 4. In infancy and early childhood, digestive/respiratory complaints were common, whereas, growth complaints were common in late childhood and adolescence. 5. Digestive/respiratory complaints have been over 50% out of all chief complaints annually. Psychiatric and growth-related complaints have been trending up, whereas, supplemental/skin complaints have decreased every year. 6. Specifically, anorexia were the most common in digestive complaints, and rhinitis/sinusitis were top among respiratory complaints. Precocious puberty and developmental disability increased every year. Conclusions The most common chief complaints were digestive and respiratory-related, and precocious puberty and growth issues have been trending up lately. Based on this result, more studies that targets precocious puberty and growth problems are needed.

• The korean journal of orthodontics
• /
• v.50 no.3
• /
• pp.181-187
• /
• 2020

Objective: This study aimed to evaluate the differences in cephalometric characteristics and skeletal maturation in girls with central precocious puberty (CPP) via lateral and hand-wrist radiographs. We also aimed to identify the indicators that are most effective for determining skeletal maturity in these patients. Methods: The study included 70 Korean girls (mean age, 8.5 ± 0.5 years) diagnosed with CPP at the Department of Pediatrics, and 48 normal healthy age-matched girls who visited the Department of Orthodontics and had no history of hormone treatment or growth problems. Skeletal maturation was evaluated using lateral cephalometric and hand-wrist radiographs using cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI). Results: The mean mandibular plane angle was smaller in the CPP group than in the control group (35.8° ± 4.9° vs. 39.0° ± 6.5°), resulting in greater posterior facial height (p = 0.003). SMI was significantly greater in the CPP group (3.5 ± 1.4 vs. 2.0 ± 1.0) than in the control group (p = 0.001) and was significantly associated with CPP (r = 0.492; p = 0.001), whereas CVMI was not. Conclusions: In comparison with the control group, the CPP group exhibited a smaller mandibular plane angle, greater posterior facial height, and greater skeletal maturation. SMI may be more suitable than CVMI for determining skeletal maturation in CPP. Hand-wrist radiography is recommended in addition to lateral cephalogram for predicting growth in girls with CPP.

• Clinical and Experimental Pediatrics
• /
• v.65 no.4
• /
• pp.172-181
• /
• 2022

Pubertal onset is known to result from reactivation of the hypothalamic-pituitary-gonadal (HPG) axis, which is controlled by complex interactions of genetic and nongenetic factors. Most cases of precocious puberty (PP) are diagnosed as central PP (CPP), defined as premature activation of the HPG axis. The cause of CPP in most girls is not identifiable and, thus, referred to as idiopathic CPP (ICPP), whereas boys are more likely to have an organic lesion in the brain. ICPP has a genetic background, as supported by studies showing that maternal age at menarche is associated with pubertal timing in their offspring. A gain of expression in the kisspeptin gene (KISS1), gain-of-function mutation in the kisspeptin receptor gene (KISS1R), loss-of-function mutation in makorin ring finger protein 3 (MKRN3), and loss-of-function mutations in the delta-like homolog 1 gene (DLK1) have been associated with ICPP. Other genes, such as gamma-aminobutyric acid receptor subunit alpha-1 (GABRA1), lin-28 homolog B (LIN28B), neuropeptide Y (NPYR), tachykinin 3 (TAC3), and tachykinin receptor 3 (TACR3), have been implicated in the progression of ICPP, although their relationships require elucidation. Environmental and socioeconomic factors may also be correlated with ICPP. In the progression of CPP, epigenetic factors such as DNA methylation, histone posttranslational modifications, and non-coding ribonucleic acids may mediate the relationship between genetic and environmental factors. CPP is correlated with short- and long-term adverse health outcomes, which forms the rationale for research focusing on understanding its genetic and nongenetic factors.

• Clinical and Experimental Pediatrics
• /
• v.49 no.7
• /
• pp.718-725
• /
• 2006

The pubertal activation of gonadotrophin releasing hormone(GnRH) requires coordinated changes in excitatory or inhibitory amino acids, growth factors, and a group of transcriptional regulators. The age of onset of puberty is progressing to younger age. Factors affecting early puberty include genetic traits, nutrition(body fat) and exposure to endocrine disrupting chemicals. In rapidly progressing central precocious puberty, gonadotrophin releasing hormone(GnRH) agonists(GnRHa) appear to increase final height if treated early stage. Further large scaled long-term follow-up study of the effects of GnRHa on final height is needed.

• Journal of Sasang Constitutional Medicine
• /
• v.29 no.2
• /
• pp.174-181
• /
• 2017

Objectives Five cases of early puberty patients were diagnosed and treated according to Sasang constitutional medicine. Methods Seven year-old girl and four nine year-old girls visited the children's development clinic and were diagnosed as Sasang constitutional types according to clinical investigations. Their breast stages were in the 2nd degree of SMR(sexual maturity rating). Three were Taeeumin and two were Soeumin, so they were prescribed according to their Sasang constitutional types and complaints. Results and Conclusions It could show that early puberty patients can be given treatments and managements according to Sasang constitutional medicine.

• The Journal of Pediatrics of Korean Medicine
• /
• v.20 no.3
• /
• pp.161-169
• /
• 2006

Objectives : Patients who visit oriental medical hospital for growth treatment are increasing. So we aimed to classify the tendency of the patients. Methods : We studied 231 patients who visited Oriental medical hospital for growth treatment from January 2004 to August 2005. We classified sex ratio, height percentile, symptom form of the Oriental medicine, age ratio and developed complication of patients. We used X-ray, endoscope for nasal cavity, blood sample, the Standard Growth Table made by the Korean Association of Pediatrics, 1998. Results : The results which were classified as follows; boys were 50.2 percentile, girls were 49.8 percentile. The classification according to age stage resulted as follows; infant stage 1.3 percentile, preschool age 13.4%, school age 28.6%, rapid growth stage 22.9 percentile, puberty 33.8 percentile. The classification according to height percentile resulted as follows; 3 percentile or under 12.1%, 25 percentile or under 48.9%, 50 percentile or under 25.6%, 75 percentile or under 10.8%, 75 percentile excess 2.6%. The classification according to disease resulted as follows; paranasal sinusitis 12.1 percentile, allergic rhinitis 10 percentile, atopic dermatitis 5.6 percentile, nocturia 3 percentile, convulsion or tic disorder 2.2 percentile, precocious puberty 1.3 percentile, Tuner syndrome 0.9 percentile, developmental disability 0.4 percentile. Conclusions : Sex ratio of children patients who visited Orienatal medical hospital were nearly the same. 13.4% of hospital visit children patients were taller than average. Most of the male children patients were school ages while the female were in puberty. 35.5% of them have developed complication as follows; paranasal sinusitis, allergic rhinitis, atopic dermatitis, nocturia, convulsion or tic disorder, precocious puberty, Tuner syndrome and developmental disability.

• Clinical and Experimental Pediatrics
• /
• v.51 no.6
• /
• pp.634-639
• /
• 2008

Purpose : There has been considerable disagreement regarding the most appropriate dosage of gonadotropin-releasing hormone agonist in cases of central precocious puberty. The aim of this study was to determine the appropriate dosage for suppression of the puberty in girls with central precocious or early puberty. Methods : Twenty-two girls with early puberty were randomly subjected to 3 types of dosages of leuprolide acetate for at least 6 months. The number of cases in groups 1, 2, and 3 were 7, 7, and 8, and dosages were 70, 90, and $110{\mu}g/kg/-month$, respectively. Height, weight, bone age, Tanner stage of breast development, and serum levels of LH, FSH, estradiol, and progesterone were measured before treatment and after 6 months of treatment. The number of cases of puberty suppression was compared using a modified puberty suppression score with a nonparametric chi-square test. Results : There were no significant differences of chronologic and bone ages among the groups. There was a significant decrease in height SDS gain after 6 months in group 3 (P<0.05) compared with groups 1 and 2. Serum levels of LH, FSH, estradiol and progesterone were all significantly decreased after treatment in all 3 groups (P<0.05). The number of cases of puberty suppression in each group were 4 (57%), 5 (71%), and 8 (100%). There was a significantly increased proportion of suppression of puberty in group 3 (P<0.05). Conclusion : It was necessary to use a higher dose of gonadotropin-releasing hormone agonist to suppress early puberty in girls; however further longitudinal study will be needed for their prognosis of final adult height.

• Child Health Nursing Research
• /
• v.26 no.1
• /
• pp.98-106
• /
• 2020

Purpose: This study utilized data from the Korean National Health and Nutrition Examination Survey (KNHANES) to explore differences in the timing of menarche in Korean girls according to blood heavy metal concentrations. Methods: This study performed a secondary analysis of cross-sectional data from the sixth KNHANES. Data from 179 female children and adolescents aged 10~18 were included in this study. The relationships of blood heavy metal concentrations (lead, mercury, and cadmium) with age of menarche were analyzed using complex sample multiple logistic regression. Results: In the participants of this study, the geometric mean values of blood lead, mercury, and cadmium concentrations were 1.15±0.04 ㎍/dL, 1.80±0.08 ㎍/L, and 0.30±0.03 ㎍/L, respectively. Mercury poisoning (>5 ㎍/L) was found in 1.5% of participants. Furthermore, significant relationships were found between blood lead and mercury concentrations and age at menarche (p for trend: p<.001 and p=.015, respectively). Conclusion: Through an analysis of national big data, this study found evidence that Korean girls showed a younger age at menarche in response to higher blood lead and mercury concentrations. To prevent and manage precocious puberty in Korean children and adolescents, a systematic policy that monitors both exposure to environmental hazards and blood heavy metal concentrations is needed.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.3
• /
• pp.481-485
• /
• 2004

Rabson-Mendenhall syndrome(RMS) is first characterized in 1955 by Rabson and Mendenhall. RMS is a rare autosomal recessive variant with insulin resistance. This is due to insulin receptor mutations or other target-cell defects in insulin action. General findings include acanthosis nigricans, hypertrichosis, onychauxis, growth retardation, precocious puberty, genital enlargement, protuberant abdomen and xerotic skin. Characteristic oral and maxillofacial findings include dental dysplasia, coarse facial skin, prognathic jaw and fissured tongue. In this case report, dental characteristics of a 4-year old boy with Rabson-Mendenhall syndrome are described.

• Korean Journal of Animal Reproduction
• /
• v.24 no.1
• /
• pp.41-47
• /
• 2000

Gonadotropin receptors are members of the seven-transmembrane (TM) receptor family, Point mutations in the lutropin/choriogonadotropin receptor (LH/CGR) have been shown to cause constitutive activation which results in precocious puberty in affected males, We introduced one of the mutation, D556Y, into the LH/CG receptor and the same high affinity binding mutant (D556Y) receptor clone cell for wild type LH/CGR (LH/CGR-wt) was chosen for further analysis, In contrast to cells expressing LH/CGR-wt, it was demonstrated that the mutant receptor exhibited markedly increased basal cAMP production in the absence of agonist, suggesting that autonomous Leydig cell activity in familial male-precocious puberty (FMPP) is caused by a constitutively activating LH/CGR.