Enuresis is intermittent urinary incontinence during sleep at night in children aged 5 years or older. The main pathophysiology of enuresis involves nocturnal polyuria, abnormal sleep arousal, and low functional bladder capacity. In rare cases, enuresis is an early symptom of endocrine disorders such as diabetes or thyroid disorders. Herein, we report a case of a 12-year-old girl with enuresis as a rare initial presentation of Graves' disease. She complained of nocturnal enuresis from a month before visiting our clinic. She also complained of urinary frequency, headache, and weight loss. On physical examination, she had tachycardia, intention tremors, and a diffuse goiter on her anterior neck with bruit on auscultation. Her thyroid function test results revealed hyperthyroidism, and Graves' disease was diagnosed as the thyroid stimulating hormone receptor autoantibody was positive. After treatment for Graves' disease with methimazole, symptoms of enuresis resolved within 2 weeks as she became clinically and biochemically euthyroid. In children with secondary enuresis, Graves' disease should be considered as a differential diagnosis, and signs of hyperthyroidism should be checked for carefully.
Kim, Eun Young;Park, Sang Kee;Song, Chang Hun;LIm, Sung-Chul
Clinical and Experimental Pediatrics
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v.48
no.2
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pp.143-147
/
2005
Purpose : The aim of the this study was to evaluate the effect of various perinatal conditions on TSH and thyroid hormone levels in cord blood. Methods : Cord blood samples were collected from 130 neonates immediately after birth. TSH, $T_3$, and free $T_4$ levels were measured by the radioimmunoassay(RIA) method. The effects of gestational age, sex, birth weight, delivery method, perinatal asphyxia, maternal diabetes mellitus(DM), and preeclampsia on TSH and thyroid hormone levels were assessed by ANOVA test, Student t-test, and multiple regression analysis. Results : Birth weight and sex did not affect TSH and thyroid hormone levels. TSH level increased according to gestational age(P<0.05). TSH level was $4.42{\pm}0.66{\mu}IU/mL$ in infants born vaginally, which was higher than that of cesarian section delivery($3.31{\pm}0.33{\mu}IU/mL$)(P<0.05). TSH level was $5.18{\pm}0.93{\mu}IU/mL$ in asphyxiated newborns and $2.97{\pm}0.84{\mu}IU/mL$ in non-asphyxiated newborns(P<0.05). TSH level in infants with maternal DM($8.911{\pm}1.25{\mu}IU/mL$) was higher than that of infants without maternal DM($4.32{\pm}0.42{\mu}IU/mL$)(P<0.05). TSH level was $5.28{\pm}0.42{\mu}IU/mL$ in infants with maternal preeclampsia and $3.65{\pm}0.46{\mu}IU/mL$ in infants without maternal preeclampsia(P<0.05). Thyroid hormones were lower in infants with perinatal asphyxia(P<0.05). In asphyxiated infants, $T_3$ level was $75.33{\pm}55.65ng/mL$ and free $T_4$ was $0.54{\pm}0.21ng/mL$. $T_3$ and free $T_4$ level was $109.85{\pm}41.77ng/mL$ and $0.76{\pm}0.22ng/mL$ each in infants without perinatal asphyxia. Among the perinatal factors, gestational age, 1 min Apgar score and maternal DM influenced TSH level independently. Conclusion : In our study, cord blood TSH and thyroid hormone levels were affected by perinatal stress events.
Objectives : Effects of Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) on intellectual development and learning ability were investigated growth and intellectual impairment rat with insufficient nutrition diet. Methods : We divided male Sprague-Dawley rats into 4 groups(A, B, C, D). They were normal group(A), growth deficiency rat with insufficient nutrition diet group(B), growth deficiency rat with 0.1% Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) group(C) and growth deficiency rat with 0.2% Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) group(D). They were administered for 5 weeks. We measured body weight, serum growth hormone, insulin-like growth factor and thyroid stimulating hormone, RBC, concentration of Hb and PCV ratio, total WBC and its composition, the values of plasma glutamic oxaloacetic transaminase(GOT) and glutamic pyruvic transaminase(GPT) activities and morris water maze test in escape distance, escape time and escape speed. Results : 1. Body weight showed a tendency to increase in the Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups and 0.2% Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) group showed significantly different than control groups. 2. Serum growth hormone, insulin-like growth factor and thyroid stimulating hormone showed a tendency to increase in Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups, however these values showed no significantly different. 3. About the counts of RBC, 0.1% and 0.2% Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups showed significantly different than control groups. Concentration of Hb was higher than control group in Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups. And 0.2% Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) group showed significantly different than control groups in PCV ratio. 4. The counts of total WBC and its composition showed no significantly different in all treatment groups. 5. The values of plasma glutamic oxaloacetic transaminase(GOT) and glutamic pyruvic transaminase(GPT) activities showed no significantly different in all treatment groups. 6. In the morris water maze test, in escape distance and escape speed, Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups showed no significantly different than control group. But Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) groups showed the increasing tendency. Conclusions : So Kyungohkgo($Qi{\acute{o}}ng\;y{\grave{u}}\;g{\grave{a}}o$) have an effect of promoting growth of rats and might be effect to treat various kinds of growth delay in children.
Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.
Lee, Ye Seung;Choi, Joong Wan;Bae, Eun Ju;Park, Won Il;Lee, Hong Jin;Oh, Phil Soo
Clinical and Experimental Pediatrics
/
v.58
no.7
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pp.263-266
/
2015
Purpose: Ventricular repolarization is assessed using the QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged QTc is associated with an increased risk of arrhythmias and cardiac mortality. As there have been few reports regarding the effects of hyperthyroidism on ventricular repolarization, we studied the association between serum free thyroxine (free T4 [fT4]) and thyroid stimulating hormone (TSH) levels and the QTc interval. Methods: Thirty-eight patients with hyperthyroidism (<30 years old) were included, and we used their clinical records and available ECGs (between August 2003 and August 2011) to evaluate the association between their fT4 and TSH levels and their QTc interval. In addition, we studied the ECGs of 72 age-matched patients with no hyperthyroidism (control group) and compared their data with that from the patients group. Results: The QTc duration in patients with hyperthyroidism was significantly prolonged compared to that in the control subjects (P<0.001). In addition, the number of hyperthyroid patients with abnormal prolonged QTc was significantly higher than that in the control group (P<0.001). Among the patients with hyperthyroidism, patients with prolonged QTc and borderline QTc had higher fT4 levels and there was positive correlation between their fT4 levels and their QTc interval (P<0.05). However, no correlation was observed between their TSH levels and their QTc interval. Conclusion: We report that hyperthyroidism is associated with QTc prolongation. The correlation between the fT4 levels and the QTc interval suggests that thyroid status is associated with QTc values and the risk of cardiac mortality.
The purpose of this study is to investigate the differences fatty acids and hormonal parameters in the spawning and non-spawning season between the diploid and induced triploid Far Eastern catfish, Silurus asotus. The measured triploids were produced by cold shock for 50 min at $4^{\circ}C$ in May 2014, the spawning season of diploid was in May, and the non-spawning season was designated in January. Estradiol and testosterone and gonadosomatic index of diploid were higher than those of induced triploid in spawning season (P<0.05), and those of diploid in spawning season were higher than non-spawning season. On the other hand, thyroid stimulating hormone and thyroxine of induced triploid were higher than those of diploid in spawning season (P<0.05). Erythrocyte count of diploid was higher than that of induced triploid in spawning season and non-spawning seasons. Mean corpuscular volume and mean corpuscular hemoglobin of induced triploid were higher than those of diploid in both seasons (P<0.05). Percentages of total saturated fatty acids and n-3 polyunsaturated fatty acids of induced triploid were higher than those of diploid in spawning season, but those of diploid were higher in non-spawning season (P<0.05). Percentages of total mono unsaturated fatty acids and total n-6 polyunsaturated fatty acids of diploid were higher than those of induced triploids in spawning season, while those of induced triploid in non-spawning season were higher (P<0.05). Therefore, induced triploids in the spawning season tend to concentrate on growth and lipid-synthesization, whereas, diploids concentrate on reproduction and gonadal maturation rather than on growth. In non-spawning season, growth and lipid-synthesization were not significantly different between diploid and induced triploid.
Objective: This study was conducted to investigate chromosomal abnormalities and their correlations with clinical and radiological findings in females with primary amenorrhea (PA). Methods: Detailed forms were recorded for 470 females, including the construction of three-generation pedigrees. Peripheral venous blood was drawn, with informed consent, for cytogenetic analysis. Results: An abnormal karyotype was found in 16.38% of participants. The incidence of structural abnormalities (6.8%) exceeded that of numerical abnormalities (6.15%). Turner syndrome represented 45% of all numerical abnormalities. Furthermore, the Y chromosome was detected in 5% of females with PA. Among the structural chromosomal abnormalities detected (n=32) were mosaicism (25%), deletions (12.5%), isochromosomes (18.75%), fragile sites (3.12%), derivatives (3.12%), marker chromosomes (3.12%), and normal variants (29.125%). An examination of secondary sexual characteristics revealed that 29.6% of females had a complete absence of breast development, 29.78% lacked pubic hair, and 36.88% exhibited no axillary hair development. Radiological findings revealed that 51.22% of females had a hypoplastic uterus and 26.66% had a completely absent uterus. Abnormal ovarian development, such as the complete absence of both ovaries, absence of one ovary, one absent and other streak, or both streak ovaries, was observed in 69.47% of females with PA. Additionally 43.1%, 36.1%, 67.4%, and 8% of females had elevated levels of serum follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and prolactin, respectively. Conclusion: This study underscores the importance of karyotyping as a fundamental diagnostic tool for assessing PA. The cytogenetic correlation with these profiles will aid in genetic counseling and further management of the condition.
Kim, Hee-Jin;Park, Hae-Young;Kim, Jeong-A;Kang, Il-Hyun;Kim, Tae-Sung;Han, Soon-Young;Kang, Tae-Seok;Park, Kui-Lea;Kim, Hyung-Sik
Toxicological Research
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v.22
no.4
/
pp.307-313
/
2006
The development of in vitro assays has been recommended to screening and testing the potential endocrine disruptors (EDs). These assay systems focus only on identifying the estrogenic or antiestrogenic activity of EDs, whereas a few studies have been carried out to screen the thyroid hormone (TH) disruptors. The aim of this study was to evaluate a test system to detect TH disruptors using rat pituitary tumor $GH_3$ cells. The test system is based on the TH-dependent increase in growth rate. As expected, L-3,5,3-triiodothyronine ($(T_3)$ markedly induced a morphological change in $GH_3$ cells from flattened fibroblastic types to rounded or spindle-shaped types. $T_3$ stimulated $GH_3$ cell growth in a dose-dependent manner with the maximum growth-stimulating effect being observed at a concentration $1{\times}10^9M$. In addition, $T_3$ increased the release of growth hormone and prolactin into the medium of the $GH_3$ cells culture. Using this assay system, the TH-disrupting activities of bisphenol A (BPA) and its related compounds were examined. BPA, dimethy/bisphenol A (DMBPA), and TCI-EP significantly enhanced the growth of $GH_3$ cells in the range of $1{\times}10^{-5}M\;to\;1{\times}10^{-6}M$ concentrations. In conclusion, this in vitro assay system might be useful for identifying potential TH disruptors. However, this method will require further evaluation and standardization before it can be used as a broad-based screening tool.
Kim, Mee-Kyung;Shon, Yun-Hee;Nam, Kyung-Soo;Son, Ok-Lye;Kim, Cheorl-Ho;Jeon, Byung-Hun
Journal of Physiology & Pathology in Korean Medicine
/
v.19
no.3
/
pp.623-627
/
2005
Abnormal thyroid cell proliferation has a very important role in hypothyroidism. Thyroid stimulating hormone (TSH) stimulates proliferation and maintains differentiated function in thyroid follicular cells. A functioning rat thyroid cell line (FRTL) was used to study the effect of Gamgung-tang (GGT, Glycyrrhizae Radix, black beans, Angelicae Radix and Cnidii Rhizoma) on proliferation and cAMP accumulation of thyrocytes. Proliferation of cell was assessed by DNA synthesis and incorporation of $[^3H]thymidine$ into DNA. The concentration of cAMP was measured simultaneously with growth assessment. Extract of GGT ($0.15{\sim}0.9\;mg/ml$ increased DNA synthesis in a dose-dependent manner. GGT at 0.6 (p<0.05) and 0.9 mg/ml (p<0.01) significantly increased $[^3H]thymidine$ incorporation. A comparable effect was observed with TSH. GGT also enhanced cAMP accumulation. These results indicate that GGT increases the proliferation of thyrocytes and may be considered a promising agent for the treatment of autoimmune thyroid disease.
One of the major challenges in methadone maintenance therapy (MMT) for drug dependence is the physiological side effects on endocrine hormones. Because of the key role of the thyroid gland in the normal functioning of the human body and brain, this study examined the effect of MMT on thyroid function. Thyroid hormones (T3, T4, and thyroid-stimulating hormone (TSH)) were evaluated in normal and user treated with MMT who were referred to the Province Clinical & Pathology Center of Urmia, Iran. The study was conducted for three months using the Case Series method. A total of 270 samples were collected, 215 were from individuals who were not treated, whereas 55 were from men treated with methadone. Average levels of T3 and T4 in non-treated sample of men are $1.34{\pm}0.02ng/mL$ and $90.96{\pm}1.38ng/mL$ while the corresponding values for patients treated with methadone are $1.39{\pm}0.04ng/mL$ for T3 and $94.57{\pm}2.72ng/mL$ for T4. Mean TSH levels of the non-treated group and the methadone consuming group were $1.75{\pm}0.08{\mu}IU/mL$ and $3.17{\pm}0.45{\mu}IU/mL$, respectively. These results indicate that although men treated with methadone had higher levels of T3, T4, and TSH than normal individuals, only the difference in TSH level was significant. The importance of this difference among individuals on methadone maintenance programs should be investigated in larger samples over long periods of time. Additionally, the effects of methadone treatment on women should be examined.
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