Relationship between Chronologic Age and Bone Age at Diagnosis of Central Precocious Puberty / 대한소아내분비학회지

PURPOSE: Precocious puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys younger than 9 years. Central precocious puberty (CPP) is gonadotropin releasing hormone (GnRH) dependent process and the result of premature activation of hypothalamic-pituitary-gonadal axis. CPP accelerates the linear growth, skeletal maturation, and premature epiphyseal fusion. So CPP results in decrement of final adult height. The purpose of this study is the analysis of the relationship with chronologic age and bone age at the beginning of treatment. METHODS: We enrolled patients treated with GnRH agonist for CPP from January 2003 to January 2005. Their bone age was examined by the method of Greulich & Pyle. We retrospectively examined medical records for sex, chronologic age, bone age, height and Tanner stage. RESULTS: A total of 56 patients were included, only 4 patients were boys. The mean chronologic age and the mean bone age were 7.8+/-1.6 years, 9.4+/-1.9 years in female, respectively; 7.9+/-2.0 years, 12.4+/-0.9 years in male, respectively. Bone age exceeded chronologic age by 1.6+/-1.1 years in female, by 4.6+/-1.8 years in male. The difference between chronologic age and bone age was greater in boys compared to girls by 3.0 years. Such a difference was prominent in advanced Tanner stage in female. CONCLUSION: This study shows that bone age exceeded chronologic age by 1.6+/-1.1 years when CPP was diagnosed in girls. However, further data were needed to set a standard due to variation heterogeneity in distribution of the chronologic age of the control. Additionally, follow up data on improvement of expected adult height after GnRH agonist treatment are needed in order for 1.6+/-1.1 years, a standard, to have a significant value.

Epidemiology of Respiratory Syncytial Virus Lower Respiratory Tract Infection and Analysis of Risk Factors in Severe Infections from 1995 to 2004 / 소아알레르기및호흡기학회지

PURPOSE: Respiratory syncytial virus (RSV) infection is the one of the leading causes of hospitalization of infants in the worldwide. In particular, children younger than 6 weeks of age prematurity, bronchopulmonary dysplasia, congenital heart disease, neuromuscular disease, or immunosuppressive states are likely to have severe RSV infection. This study aims to review the epidemiologic characteristics of RSV infection and to examine the relationship of risk factors for severe disease courses and length of hospital stay. METHODS: A total of 294 patients with acute lower respiratory tract infections by RSV who were hospitalized in Samsung Medical Center from December 1995 to June 2004 were enrolled in this study. The medical records were retrospectively reviewed. RSV was detected with rapid RSV antigen test or viral culture of nasopharyngeal aspirates. RESULTS: The male to female ratio was 1.7: 1. Children under 2 years old made up 86 percent; bronchiolitis and pneumonia patients made up 90 percent. Outbreaks of RSV occurred in September through February. One or more risk factor for severe RSV infection were present in 40 percent. The group with risk factors had longer length of hospital stay (P< 0.05), were more likely to be admitted to the pediatric intensive care unit (PICU) and required oxygen therapy and mechanical ventilation (P< 0.05) compared to the groups without risk factors. CONCLUSION: Infants and children with high risk factors are likely to develop severe RSV infection. Early detection and proper management is necessary in Korea, especially in fall and winter.