Localization of estrogen receptors-alpha and -beta and androgen receptor in the human growth plate at different pubertal stages.
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Sex steroids are required for a normal pubertal growth spurt and fusion of the human epiphyseal growth plate. However, the localization of sex steroid receptors in the human pubertal growth plate remains controversial. We have investigated the expression of estrogen receptor (ER) alpha, ERbeta and androgen receptor (AR) in biopsies of proximal tibial growth plates obtained during epiphyseal surgery in 16 boys and eight girls. All pubertal stages were represented (Tanner stages 1-5). ERalpha, ERbeta and AR were visualized with immunohistochemistry and the number of receptor-positive cells was counted using an image analysis system. Percent receptor-positive chondrocytes were assessed in the resting, proliferative and hypertrophic zones and evaluated for sex differences and pubertal trends. Both ERalpha- and ERbeta-positive cells were detected at a greater frequency in the resting and proliferative zones than in the hypertrophic zone (64+/-2%, 64+/-2% compared with 38+/-3% for ERalpha, and 63+/-3%, 66+/-3% compared with 53+/-3% for ERbeta), whereas AR was more abundant in the resting (65+/-3%) and hypertrophic zones (58+/-3%) than in the proliferative zone (41+/-3%). No sex difference in the patterns of expression was detected. For ERalpha and AR, the percentage of receptor-positive cells was similar at all Tanner pubertal stages, whereas ERbeta showed a slight decrease in the proliferative zone during pubertal development (P<0.05). In summary, our findings suggest that ERalpha, ERbeta and AR are expressed in the human growth plate throughout pubertal development, with no difference between the sexes. (+info)
Accuracy of skeletal age assessment in children from birth to 6 years of age with the ultrasonographic version of the Greulich-Pyle atlas.
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OBJECTIVES: For the evaluation of skeletal age, the methods of Greulich-Pyle and Tanner-Whitehouse are generally used in clinical practice. Our investigation was undertaken to determine whether the ultrasonographic version of the Greulich-Pyle atlas is capable of assessing skeletal age. If so, we aimed to describe the standards for the ultrasonographic version of the Greulich-Pyle atlas for each year during the first 6 years of life. METHODS: Ninety-seven subjects underwent left hand and wrist radiography and ultrasonographic examination for bone age assessment during a 1.5-year study. Estimated bone ages derived from the plain radiography and "hand and wrist ultrasonography charts" interpreted by use of the Greulich-Pyle atlas were compared statistically. RESULTS: The estimated bone ages from plain radiography and hand and wrist ultrasonography charts interpreted by use of the Greulich-Pyle atlas were significantly correlated; 71.1% of male patients had the same age in both methods, and in 84.4% of patients, the difference was less than 6 months. In 65.5% of female patients, both methods revealed the same age, and in 88.5% of them, the difference was less then 6 months. CONCLUSIONS: The ultrasonographic version of the Greulich-Pyle atlas can be used to estimate bone age even in ultrasonography departments. This method is highly correlated and a valid alternative to plain radiography for bone age estimation. This enables estimation of skeletal age in ultrasonography departments easily without exposing the patient to radiation. (+info)
Appraisal of bone maturity age derived from broadband ultrasonic attenuation in Japanese children and adolescents.
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It is clinically important to evaluate the level of skeletal maturation in juveniles to determine the appropriate timing for orthodontic treatment. The purpose of this study was to assess the age of bone maturity by using an ultrasonic bone analyzer (Cuba Clinical, McCue Ultrasonics Ltd., Winchester, U.K.), Broadband ultrasonic attenuation (BUA:dB/MHz) was measured at the left calcaneus as an effective indicator of the age of bone maturity. The subjects consisted of 249 males and 304 females aged 12 to 29 years who had not suffered constitutional bone disease or a disease of the endocrine system. The peak value of BUA considered as bone maturity was 104.44 at the age of 19 years in males and 77.80 at the age of 16 years in females, and the peak age range was indicated as 18-19 years in males and 13-16 years in females by statistical evaluation. The peak age range indicated by BUA was wider in females than that in males. The present results can be used as reference ages for maturity in growth prediction for orthodontic treatment of Japanese children and adolescents. The heights and weights of the subjects were also collected as basic data. A significant positive correlation was observed between BUA values and weight (r = 0.34 p < 0.01 in females, r = 0.52 p < 0.01 in males). BUA is known to describe the quality of bone because the calcaneus is a loading bone. The relation between bone quality and growth has not been discussed. Further research is required to investigate this relationship. (+info)
Growth patterns after surgery for virilising adrenocortical adenoma.
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Analysis of growth in nine girls after successful surgical removal of a virilising adrenocortical adenoma showed that five girls continued to grow rapidly for up to 18 months after operation and subsequently had normal growth velocities. The other four girls grew at normal rates after surgery. Only one girl showed progressive advance in bone age after operation and she subsequently had precocious puberty. (+info)
Longitudinal auxological study in a female with SHOX (short stature homeobox containing gene) haploinsufficiency and normal ovarian function.
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OBJECTIVE: To report on auxological data in the combination of SHOX (short stature homeobox containing gene) haploinsufficiency and normal ovarian function. DESIGN: Longitudinal auxological study in a 14 Year 9 Month old Japanese girl with Leri-Weill dyschondrosteosis accompanied by mesomelic short stature, who had a submicroscopic pseudoautosomal deletion involving SHOX, and pubertal development of an almost average tempo. METHODS: Auxological data were assessed by the age-matched standards for Japanese females. RESULTS: The standard deviation scores (SDSs) for height, leg length (LL), and arm span remained below the normal range from childhood and worsened during puberty, whereas those for sitting height (SH) remained within the normal range and stayed almost constant throughout the observation period. Consequently, the SDSs for SH/LL ratio remained above the normal range from childhood and deteriorated during puberty. The decreased pubertal height gain was caused by a diminished pubertal height spurt and abrupt growth cessation shortly after menarche. The SDSs for hand length and palm length remained within the normal range but decreased during puberty, and those for head circumference remained within the normal range and stayed almost constant throughout the observation period. CONCLUSIONS: The results suggest that, in individuals with SHOX haploinsufficiency and normal ovarian function, auxological abnormalities related to mesomelia are evident from childhood and worsen further during puberty because of the skeletal maturing effects of ovarian estrogens. (+info)
Distribution of lengths of the normal femur and tibia in Korean children from three to sixteen years of age.
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To develop a standard growth curve of the lower extremity in Korean children from 3 to 16 yr of age, the lengths from a total of 2087 normal long bone segments (582 femurs and 645 tibias in boys, and 417 femurs and 443 tibias in girls) were measured. Children were grouped by years of bone age, which was determined by using the Korean specific bone age standard; TW2-20 method. The growth spurt occurred in girls from eight to eleven years by bone age, and in boys from eleven to thirteen years. The mean tibial length relative to the mean femoral length was 0.78 in boys and 0.79 in girls. The overall growth pattern was similar to that observed in American children in the 1960s. Korean children and adolescents appear to have a different tempo of skeletal maturation during pubertal growth from that of English and American children and adolescents. The Korean standard growth curve and the Korean bone age chart allow determination of the presence of any existent growth abnormalities and prediction of future remaining growth in lower extremities. These normative growth standards can be used for leg-length equalization purposes in children with anisomelia. (+info)
Extended recombinant human growth hormone treatment after renal transplantation in children.
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Recombinant human growth hormone (rhGH) was administered to 13 pediatric renal allograft recipients, ages 7.6 to 17.7 yr, who were 14 to 92 months posttransplant and growth retarded as manifested by either a standard deviation (SD) more negative than -2.00 or a height velocity index of less than 25%. The rhGH was given either daily or thrice weekly (0.375 mg/kg/wk) for a period of 12 to 36 months. Growth velocity increased from 2.7 +/- 2.1 SD for the 12-month period before the initiation of treatment of 6.3 +/- 2.9 SD (P less than 0.00005) and 5.2 +/- 2.9 SD (P less than 0.02) after 12 and 24 months of treatment, respectively. Although individual recipients had improvement in their SD scores, the mean values did not increase despite the increased growth velocity. Except for a 0.5-yr increase over 24 months in two recipients, the bone age did not increase at a rate greater than the increase in chronologic age. Four rejection episodes occurred in two recipients during rhGH treatment--an incidence not greater than that which occurred during a comparable time interval before the initiation of treatment. The calculated creatinine clearance declined from 66 +/- 26 SD mL/min/1.73 m2 at the initiation of treatment to 55 +/- 30 SD mL/min/1.73 m2 at 24 months and 52 +/- 28 SD mL/min/1.73 m2 (P = not significant).(ABSTRACT TRUNCATED AT 250 WORDS) (+info)
Prevalence of growth hormone deficiency of children in Beijing.
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103,753 (male 51,994, female 51,759) primary and middle school students aged 6-15 years in two districts in Beijing city were surveyed from October 1987 to April 1989. The heights of the students were measured. According to the height standard of northern cities in China, 202 students with heights below the 3rd percentile for age were requested for detailed history, physical examination, screening GH test bone age, T4, SGPT, chest X-ray, routine urine test and sex chromatin (in female). If GH less than 10 micrograms/L, two provocative tests (L-dopa or clonidine and insulin hypoglycaemia test) were done. Then the heights of the short students were observed for 1/2-2 years. GHD was diagnosed in 12 cases based on the GH peak levels less than 10 micrograms/L in two provocative tests, whose growth velocity was slower than that for students of the same age and sex. Of these subjects with GHD, total GHD (GH less than 5 micrograms/L) was present in 7 and partial GHD (GH = 5-9.9 micrograms/L) in 5. The 12 GHD students (male 9, female 3) aged 8.9-15.7 years accounted for 1/8,646 in the total surveyed students. The male and female GHD accounted for 1/5,777 and 1/17,253 in the total males and females respectively. (+info)