PURPOSE: Among children who visited hospital because of short stature, malnutrition-related short stature(MRSS) is often observed. Most of these children showed significantly decreased appetite without medical cause. Leptin is a very important weight regulating protein through a feedback signal between adipose tissue and the satiety center. IGF-I and insulin are also very important weight regulating hormones with adipogenic and somatotropic effects. Therefore, we have undertaken this study to examine the levels of leptin, IGF-I and insulin in MRSS and to analyze the relationship among these growth factors. METHODS: Twenty children more than 5 years old, who visited Sanggye Paik Hospital due to poor growth were enrolled. Their weight and height are less than 10 percentile of the Korean weight standard curve. All subjects had no organic disorders and their growth hormone levels were normal. Twenty healthy children whose height and weight were between the 25-75 percentiles were enrolled as a control group. The serum levels of leptin, IGF-I and insulin were measured by RIA method. RESULTS: 1)Leptin concentration was significantly lower in the MRSS than in the control group(2.35+/-1.05 vs 3.20+/-2.31 ng/mL, P<0.05, Fig. 1). 2)IGF-I concentration was significantly lower in the MRSS than in the control group(176.4+/-93.1 vs 258.2+/-221.3 ng/mL, P<0.05, Fig. 2). 3)Insulin concentration was lower in the MRSS than in the control group but showed no significant differences(17.9+/-13.9 vs 21.8+/-14.0 microIU/mL, Fig. 3). 4)Leptin was positively correlated with body weight(r=0.49, P<0.05) and BMI (r=0.55, P=0.01) in the control group, but was not correlated in the MRSS group. 5)IGF-I was positively correlated with body weight(r=0.61, P<0.05) and height (r=0.56, P<0.05) and BMI(r=0.50, P=0.05) in the control group, but was not correlated in the MRSS group. 6)There were no correlations among leptin, IGF-I and insulin both in the control and MRSS group. CONCLUSION: We speculate that low leptin and IGF-I concentrations in MRSS group might be related to the result of a poor nutritional state and might be an adaptive mechanism to reduce energy expenditure to increase appetite. To elucidate the underlying mechanism of poor appetite and adaptational changes of leptin, IGF-I and insulin, further studies with more cases are needed.
Adipose Tissue ; Appetite* ; Child* ; Child, Preschool ; Energy Metabolism ; Growth Hormone ; Humans ; Insulin* ; Insulin-Like Growth Factor I* ; Intercellular Signaling Peptides and Proteins ; Leptin*

No abstract available.
Growth Hormone*

No abstract available.
Intercellular Signaling Peptides and Proteins*

No abstract available.
Eating*

To determine the incidence rate of school accidents and its associated factors, a cohort observation was carried out in a boys' high school of a total 2,324 students for an academic year from March 1986 to February 1987. Data for accidents were collected by the author (school nurse) as students came to the school health station for treatment of accidental injury. Data for school activities were obtained from the diary of academic affairs. A total of 603 students made 1,126 visits to the station for accidental injury during the study period that gave an average 1.9 accidents per student. The average number of visits for accidental injury per day was 5.1 and the incidence rate of accidental injury was 2.2 per 1,000 student days. Each class had about 30 accidents on the average in a year. However there were two classes that had exceptionally high incidence rate of accidents; 54 accidents in one class where 10 athletes were assigned and 58 accidents in the other class where the teacher in charge was on vacation for two months. The highest incidence rate of accident was observed in June (3.4 per 1,000 student days) and the lowest rates were in December and February (1.5 and 0.7 per 1,000 student days, respectively) and there were no appreciable difference by day of week. Accidents were caused by mischief or carelessness of students in 62.2% and by the inappropriate tools and facilities of school in 18.6%. The accidents caused by tools and facilities were mainly due to the antiquated chairs and tables. Referral rate to hospital for severe injury was three times higher in cloudy days and five times higher in rainy days than in clear days. There was almost no accident during the examination period but increased after the examination. Based on these findings, following measures are recommended to prevent school accident: disperse the athletes throughout the classes; should the teacher in charge leave the class for a long period, replace with another teacher who is familiar with the class to keep order; replace or repair the inappropriate tools and facilities; and warn the students for the risk of accident or broadcast music or let the students have light physical exercise to relieve the tension in cloudy or rainy day and after examination.
Athletes ; Cohort Studies* ; Daegu* ; Exercise ; Humans ; Incidence* ; Linear Energy Transfer ; Music ; Referral and Consultation ; School Health Services

PURPOSE:Growth retardation is a serious clinical problem in children with chronic renal failure(CRF). Dialysis and renal transplantation do not provide an improvement in growth velocity. Possible causes of growth retardation are nutritional deficiency, electrolyte imbalance, uremia, renal asteodystrophy and chronic anemia. However, catch-up growth cannot be achieved after correcting these factors. There is no concordance about disturbances of growth hormone(GH)-insulin-like growth factor-I (IGF-I) axis. in CRF. This study was designed to evaluate the growth status, IGF-I, GH and the effect of GH in CRF. METHODS:Twelve children with CRF(five were treated conservative, seven were transplanted) were included. IGF-I, stimulated GH, 24 hour integrated concentration of GH (IC-GH)were measured. Six were given rhGH(0.1U/kg/day) for average one year. RESULTS: 1)Growth velocity(GV) was 3.2+/-0.8cm/yr(conservative therapy:3.3+/-0.7, transplanted:2.9+/-0.8). Height standard deveation score(SDS) was -2.4+/-1.3cm/yr(conservative therapy group:-3.3+/-1.4, transplanted group:-1.3+/-0.4). Bone age lagged 2.1+/-13yr behind chronological age. 2) IGF-I concentrations were normal. 3)Stimulated GH levels were normal(16.6+/-3.3ng/ml) except one patient. Twenty- four hour IC-GH were less than 3.2ng/ml in 4 patients. 4)After GH therapy, GV increased 3.3+/-0.7cm/yr to 5.4+/-0.8cm/yr and Ht SDS increased -3.3+/-1.4 to -2.9+/-1.5 in the conservatively treated group. GV increased 2.9+/-0.8cm/yr to 5.5+/-1.8cm/yr and Ht SDS increased -1.3+/-0.4 to -0.8+/-0.5 in the transplanted group. CONCLUSION: Stimulated GH was normal but spontaneous secretion of GH was decreased in some patients with CRF. This neurosecretory dysfunction may be one causative factor in CRF. For these patients GH replacement therapy will be effective in promoting growth.
Anemia ; Axis, Cervical Vertebra ; Child* ; Dialysis ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor I ; Kidney Failure, Chronic* ; Kidney Transplantation ; Malnutrition ; Uremia

OBJECTIVES: The purpose of this investigation was to determine whether women with unexplained elevations of maternal serum human chorionic gonadotropin(hCG) at 14-20weeks gestation are at incresed risk for poor pregnancy outcomes. METHODS: 661 pregnant women undergoing second trimester triple marker screening test for Down syndrome and neural tube defect and delivered at our hospital were reviewed. Of 656 pregnancies that did not have maternal serum alpha feto-protein> or =2.5 multiples of the median(MoM), risk for poor pregnancy outcomes include to preeclampsia, preterm delivery, preterm rupture of membrane(PROM), small for gestational age(SGA) and fetal distress was evaluated in women with elevated hCG(> or =2.0 MoM) compared with women without elevated hCG(<2.0 MoM). RESULTS: Pregnancies with elevated hCG levels were at increased risk for preeclampsia (risk ratio 3.4, 95% confidence interval 1.5-7.6) but elevated hCG levels were not significantly associated with preterm delivery, PROM, and SGA and fetal ditress independent with preeclampsia. CONCLUSION: Pregnancies with elevated second-trimester hCG appear to be at higher risk of subsequent preeclampsia and this finding supports the theory that placental vascular changes that ultimately lead to preeclampsia begin at least by the second trimester. But further studies must be to determine how such information can be used to improve pregnany outcome.
Chorion ; Chorionic Gonadotropin* ; Down Syndrome ; Female ; Fetal Distress ; Humans* ; Mass Screening ; Neural Tube Defects ; Pre-Eclampsia* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Pregnant Women ; Rupture

This study was performed to evaluate the effect of placebo(emotional stimulus) on physical fitness and psychological wellbeing. The subjects for the study were divided into tow groups. One experimental group received placebo and the other control group did not receive. Each group was composed of 15 women. The subjects continued aerobic exercise for an hour each time, three times a week, for eight weeks. The enhancement of physical fitness has been evaluated by body weight, BP, pulse rate, skinfolds thickness, circumference of waist and hip, body fat, % body fat, lean body mass, % lean body mass they were measured three times every 4 weeks. Also to evaluate the enhancement of psychological wellbeing, the self-esteem and self-perception were measured. The results can be summarized as follows : 1. The % body fat of experimental group decreased significantly than that of control group(p<0.1). 2. The % lean body mass of experimental group decreased significantly than that of control group(P<0.1). 3. There was no significant difference of other physical fitness factors between experimental group and control group. 4. There was no significant difference of self-esteem between experimental group and control group. 5. There was no significant difference of self-perception between experimental group and control group. From these results, it may be concluded that placebo(emotional stimulus) which received during aerobic exercise period is partially effective in the enhancement of the physical fitness.
Adipose Tissue ; Body Weight ; Exercise* ; Female ; Heart Rate ; Hip ; Humans ; Physical Fitness* ; Placebo Effect ; Self Concept

PURPOSE: Short stature is the most constant finding in Turner syndrome. Short stature in Turner syndrome has lately received considerable attention, mostly because of recent attemp to improve growth by hormonal treatments; growth hormone, oxandrolone, estrogen. The aim of this study was to find out whether growth promoting treatment would improve final height in girls with Turner syndrome. METHODS:Seventy-one girls with the clinical chracteristics Turner syndrome verified by karyotype analysis were entered into this study. The following selection criteria for final adult height were used; Chronological age of more than 14years old, bone age of more than 15years old and growth velocity of less than 0.5cm per 6months. Analysis was performed by means of multiple regression analysis between descriptive data; modality of treatment with oxandrolone and/or estrigen, parental height, karyotype and final adult height. RESULTS: 1) The final adult height of untreated Turner syndrome was 138.9+/-3.9cm. 2)The final adult height in 29 GH treated Turner girls was 143.9+/-6.5cm, significant higher value than 42 GH untreated Turner girls height, 139.8+/-5.2cm(p<0.01). 3) The final height in GH only group and combined group were 141.2+/-6.0cm, 146.2+/-6.2cm, respectively. The combined therapy was more effective than GH therapy(p<0.01). 4) The final height in 32 patients with karyotype of 45,X was 141.6+/-5.6cm, and that of 31 structural aberration group was 140.3+/-6.2cm. There was no significant difference between two groups. But in mosaicism, only numeric abnormalities, the final height 145.9+/-6.1cm was much more higher than other two groups(p<0.05). 5) The final adult height in Turner syndrome was in good correlation with target height. Final adult height(cm)= 1.01*Target height(cm)- 4.97 r=0.51, p<0.05. 6) There was positive correlation between final adult height and height SDS at start GH treatment and negative correlation with age at start GH treatment. The delta height (final height - height at start treatment) correlate with GH treatment duration. CONCLUSIONS:The final adult height in Turner syndrome in a given ethinic or national population varies in the same way as adult height in normal women. Growth hormone therapy may increase final height in Turner syndrome irrespective of ethinic or national difference. Further growth was observed in GH combined with estrogen or oxandrolone.
Adult* ; Estrogens ; Female ; Growth Hormone ; Humans ; Karyotype ; Mosaicism ; Oxandrolone ; Parents ; Patient Selection ; Turner Syndrome*

PURPOSE:Factors influencing postnatal growth are innumerable. It is known that genetic factors such as parental height and environmental factors such as nutrition, economic status and hormonal effects are important factors. The purpose of this study was to examine the factors affecting final adult height in normal children. METHODS:753 high school students (513 boys, 240 girls) who live in Seoul were studied. Height and body weight were measured and questionaires about sexual development were examined. We included the subjects who reached fianl adult height. The criteria of final adult height was as following: ages over 17 years in the boys and over 15 years in the girls and growth velocity was less than 1 cm per year. They had no systemic diseases and height standard deviation scores were more than -2.5. RESULTS: 1)Final adult heights were 173.1+/-.1cm in boys and 160.9+/-.7cm in girls. 2)Final adult height significantly correlated with father height(r=0.13, p<0.01), mother height(r=0.25, p<0.01), midparental height(r=0.25 p<0.01) and birth weight (r=0.16, p<0.01). 3)In short final adult height groups, birth weight and midparental height were significantly lower(p<0.05), but puberty onset age, body mass index and economic status were similar to normal stature groups. 4)Final adult height significantly correlated with target height.(r=0.43, p<0.01). In boys, the final adult height was 1.7cm taller than target height on the average. In girls, final adult height was 1.6cm taller than target height on the average. 5)In the group in which final adult height is less than target height, birth weights were significantly lower than those of the groups in which final height is greater than target height. CONCLUSIONS:Among factors affecting final adult height, parent height and birth weight were important. To predict final adult height, target height can be used simply and target height showed significant correlation with final adult height. In the case of showing differences between final adult height and target height, many factors including birth weight will influence the outcome.
Adolescent ; Adult* ; Age of Onset ; Birth Weight ; Body Mass Index ; Body Weight ; Child ; Fathers ; Female ; Humans ; Mothers ; Parents ; Puberty ; Seoul ; Sexual Development