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1.
Eur J Cell Biol ; 103(1): 151377, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38006841

ABSTRACT

Peroxisome proliferator-activated receptor-gamma coactivator-1α (PGC-1α) transcriptional coactivators are key regulators of energy metabolism-related genes and are expressed in energy-demanding tissues. There are several PGC-1α variants with different biological functions in different tissues. The brain is one of the tissues where the role of PGC-1α isoforms remains less explored. Here, we used a toxin-based mouse model of Parkinson's disease (PD) and observed that the expression levels of variants PGC-1α2 and PGC-1α3 in the nigrostriatal pathway increases at the onset of dopaminergic cell degeneration. This increase occurs concomitant with an increase in glial fibrillary acidic protein levels. Since PGC-1α coactivators regulate cellular adaptive responses, we hypothesized that they could be involved in the modulation of astrogliosis induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Therefore, we analysed the transcriptome of astrocytes transduced with expression vectors encoding PGC-1α1 to 1α4 by massively parallel sequencing (RNA-seq) and identified the main cellular pathways controlled by these isoforms. Interestingly, in reactive astrocytes the inflammatory and antioxidant responses, adhesion, migration, and viability were altered by PGC-1α2 and PGC-1α3, showing that sustained expression of these isoforms induces astrocyte dysfunction and degeneration. This work highlights PGC-1α isoforms as modulators of astrocyte reactivity and as potential therapeutic targets for the treatment of PD and other neurodegenerative disorders.


Subject(s)
Astrocytes , Transcription Factors , Mice , Animals , Astrocytes/metabolism , Transcription Factors/genetics , Transcription Factors/metabolism , Protein Isoforms/genetics , Protein Isoforms/metabolism , Dopamine/metabolism , Brain/metabolism , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/genetics , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolism
2.
J Microsc ; 290(3): 161-167, 2023 06.
Article in English | MEDLINE | ID: mdl-37038805

ABSTRACT

In the last years, microtomography has proved to be a powerful technique on insects' studies, allowing a detailed view of the structures' internal with a high resolution. One of the most important advantages about the use of microtomography in these studies is the fact that the dissection is not necessary, which decreases considerably the number of samples used on the insects' research. Some insects are used constantly in studies about morphology, metamorphosis, and reproduction, because they work as a model for others, and Rhodnius prolixus is one of the most studied in this group. This insect is also one of the main insect vectors of Chagas disease that kills around 12,000 people every year in Latin America. Some studies using laboratory microtomography conventional scanners combining with the correct staining methods have proved that it could be a powerful tool in biological research, allowing the visualisation of low-density tissues. The main goal of the present work was to use staining protocols to study Rhodnius prolixus with laboratory microtomography conventional scanners. The experiments were carried out at the imaging lab in the Theoretical Biology Department, University of Vienna, using an Xradia MicroXCT and at the University of Oslo, using a Skyscan 2211.


Subject(s)
Chagas Disease , Rhodnius , Animals , Humans , Rhodnius/anatomy & histology , Chagas Disease/diagnostic imaging , Insect Vectors , Staining and Labeling
3.
Actas urol. esp ; 46(6): 367-376, jul. - ago. 2022. tab
Article in Spanish | IBECS | ID: ibc-208687

ABSTRACT

Objetivo: Este estudio compara el estado actual y las características de los programas de formación de la residencia de urología de EE. UU. y China.Métodos: Se realizó una evaluación comparativa de la trayectoria, la estructura, el plan de estudios, la experiencia quirúrgica, las actividades académicas, los sistemas de evaluación y otros aspectos de la formación de los residentes en China y EE. UU.Resultados: Los programas de residencia de urología de China y EE. UU. difieren entre sí en muchos aspectos. Los requisitos de acceso al programa de residencia de urología de EE. UU. son más rigurosos, y la especialización de la formación en EE. UU. está más condensada. Además, en EE. UU. la formación clínica e investigativa es más práctica y el sistema de evaluación es más diverso y basado en competencias. Adicionalmente, las oportunidades laborales tras la residencia difieren sustancialmente entre estos dos países. Convertirse en cirujano urológico independiente no es el objetivo específico de la formación de la residencia urológica en China, y esto requiere mucho más tiempo de formación que en EE. UU.Conclusión: Los programas de residencia de urología en EE. UU. y China tienen un formato y unas características propias. La formación en China se centra en técnicas y procedimientos generales, mientras que los programas en EE. UU. siguen un plan de estudios más estandarizado. Tanto EE. UU. como China pueden ser un buen complemento para la creación de programas de formación que, en última instancia, proporcionen una atención de alta calidad a los pacientes (AU)


Objective: This study compares the present status and traits of urology residency programs in the United States and China.Methods: The flow path, structure, curriculum, operative experience, scholarly activities, evaluation systems and other aspects of training were comparatively evaluated between China and the United States.Results: Urology residency training programs are different between China and the United States in many aspects. Admission requirements for the United States urology residency program are more rigorous, and the specialty training program in the United States is more concentrated. Furthermore, residency programs in USA have much more practical clinical and research training, and their evaluation process is more diverse, and it has been designed to assess competencies. Moreover, job opportunities after residency substantially differ between these two countries. Becoming an independent urologic surgeon is not the specific goal of the Urology residency training program in China, and it would require more training time than in the United States.Conclusion: Urology residency training programs in the United States and China have a unique format and characteristics. The training programs in China are focused on general techniques and procedures, while training programs in USA follow a more standardized curriculum. Both USA and China may complement each other to create training programs that would ultimately provide high-quality patient care (AU)


Subject(s)
Humans , Education, Medical, Graduate , Internship and Residency , Curriculum , Urology , United States , China
4.
Actas Urol Esp (Engl Ed) ; 46(6): 367-376, 2022.
Article in English, Spanish | MEDLINE | ID: mdl-35260372

ABSTRACT

OBJECTIVE: This study compares the present status and traits of urology residency programs in the United States and China. METHODS: The flow path, structure, curriculum, operative experience, scholarly activities, evaluation systems and other aspects of training were comparatively evaluated between China and the United States. RESULTS: Urology residency training programs are different between China and the United States in many aspects. Admission requirements for the United States urology residency program are more rigorous, and the specialty training program in the United States is more concentrated. Furthermore, residency programs in USA have much more practical clinical and research training, and their evaluation process is more diverse, and it has been designed to assess competencies. Moreover, job opportunities after residency substantially differ between these two countries. Becoming an independent urologic surgeon is not the specific goal of the Urology residency training program in China, and it would require more training time than in the United States. CONCLUSION: Urology residency training programs in the United States and China have a unique format and characteristics. The training programs in China are focused on general techniques and procedures, while training programs in USA follow a more standardized curriculum. Both USA and China may complement each other to create training programs that would ultimately provide high-quality patient care.


Subject(s)
Internship and Residency , Urology , China , Curriculum , Education, Medical, Graduate , Humans , United States , Urology/education
5.
Int Endod J ; 54(8): 1394-1402, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33829659

ABSTRACT

AIM: To evaluate the influence of pH variation on the solubility and water sorption of a premixed calcium silicate-based root canal sealer (EndoSequence BC Sealer) compared to the gold standard based on epoxy resin (AH Plus Jet) after immersion in distilled water and phosphate-buffered saline (PBS). METHODOLOGY: Solubility and water sorption were evaluated after immersion in distilled water or PBS at several pHs (5, 7 and 12) and the values were calculated as percentages of the original mass after 24 h, 7 and 30 days of immersion. The crystalline structures present in the sealers and surface precipitates were assessed by X-ray diffraction. The Shapiro-Wilk's test revealed that data were normally distributed; thus, statistical analysis was performed using one-way anova and Tukey's tests or independent t-test, assuming a 5% α-error. RESULTS: EndoSequence BC Sealer was associated with significantly greater water sorption and solubility compared to AH Plus Jet in all tested conditions (P < 0.05). The acid environment increased the 24 h solubility of EndoSequence BC Sealer immersed in PBS (P < 0.05) and did not induce significative changes in the water sorption (P > 0.05). Alkaline pH reduced the solubility of EndoSequence BC Sealer and increased that of AH Plus Jet at all experimental times and soaking media (P < 0.05). Alkaline environment also significantly increased the water sorption of AH Plus Jet immersed in PBS (P < 0.05). Immersion in PBS significantly reduced the solubility of EndoSequence BC Sealer and significantly increased that of AH Plus Jet (P < 0.05). Precipitates on the surface of EndoSequence BC Sealer corresponding to hydroxyapatite and calcium carbonate were detected after immersion in PBS at pH 5 and 7 for 30 days. CONCLUSIONS: EndoSequence BC Sealer had significantly greater solubility and water sorption than AH Plus Jet. Although the alkaline pH and soaking media directly influenced the solubility and water sorption of the sealers, the solubility of AH Plus Jet remained within the limits recommended by ISO 6876, whilst the solubility of the EndoSequence BC Sealer did not comply with ISO recommendations in all the conditions tested.


Subject(s)
Root Canal Filling Materials , Calcium Compounds , Dental Pulp Cavity , Epoxy Resins , Materials Testing , Silicates , Solubility , Water
6.
Sci Rep ; 10(1): 18934, 2020 11 03.
Article in English | MEDLINE | ID: mdl-33144603

ABSTRACT

Amphibians are models for studying applied ecological issues such as habitat loss, pollution, disease, and global climate change due to their sensitivity and vulnerability to changes in the environment. Developmental series of amphibians are informative about their biology, and X-ray based 3D reconstruction holds promise for quantifying morphological changes during growth-some with a direct impact on the possibility of an experimental investigation on several of the ecological topics listed above. However, 3D resolution and discrimination of their soft tissues have been difficult with traditional X-ray computed tomography, without time-consuming contrast staining. Tomographic data were initially performed (pre-processing and reconstruction) using the open-source software tool SYRMEP Tomo Project. Data processing and analysis of the reconstructed tomography volumes were conducted using the segmentation semi-automatic settings of the software Avizo Fire 8, which provide information about each investigated tissues, organs or bone elements. Hence, volumetric analyses were carried out to quantify the development of structures in different tadpole developmental stages. Our work shows that synchrotron X-ray microtomography using phase-contrast mode resolves the edges of the internal tissues (as well as overall tadpole morphology), facilitating the segmentation of the investigated tissues. Reconstruction algorithms and segmentation software played an important role in the qualitative and quantitative analysis of each target structure of the Thoropa miliaris tadpole at different stages of development, providing information on volume, shape and length. The use of the synchrotron X-ray microtomography setup of the SYRMEP beamline of Elettra Synchrotron, in phase-contrast mode, allows access to volumetric data for bone formation, eye development, nervous system and notochordal changes during the development (ontogeny) of tadpoles of a cycloramphid frog Thoropa miliaris. As key elements in the normal development of these and any other frog tadpole, the application of such a comparative ontogenetic study, may hold interest to researchers in experimental and environmental disciplines.


Subject(s)
Anura/growth & development , Larva/ultrastructure , X-Ray Microtomography/veterinary , Algorithms , Animals , Image Processing, Computer-Assisted , Larva/growth & development , Synchrotrons
7.
Int J Pharm ; 527(1-2): 103-114, 2017 Jul 15.
Article in English | MEDLINE | ID: mdl-28522427

ABSTRACT

The use of particulate adjuvants offers an interesting possibility to enhance and modulate the immune responses elicited by vaccines. Aluminium salts have been extensively used as vaccine adjuvants, but they lack the capacity to induce a strong cellular and mucosal immune response. Taking this into consideration, in this study we designed a new antigen delivery system combining aluminium salts with chitosan. Chitosan-aluminium nanoparticles (CH-Al NPs) exhibited a mean diameter of 280nm and a positive surface charge. The newly developed CH-Al NPs are more stable at physiological environment than classical CH NPs, showing no cytotoxic effects and revealing potential as a delivery system for a wide range of model antigens. In vivo studies showed that mice immunized with hepatitis B surface antigen (HBsAg)-containing CH NPs display high anti-HBsAg IgG titers in the serum, as well as the highest antigen-specific IgG on vaginal washes. Furthermore, in contrast to mice receiving antigen alone, mice immunized with the particulate adjuvant were able to elicit IgG2c antibody titers and exhibited higher antigen-specific IFN-γ levels in splenocytes. In conclusion, we established that CH-Al NPs, combining two immunostimulants to enhance both humoral and cellular immune responses, are a safe and promising system for antigen delivery. Our findings point towards their potential in future vaccination approaches.


Subject(s)
Adjuvants, Immunologic/chemistry , Aluminum/chemistry , Chitosan/chemistry , Hepatitis B Surface Antigens/immunology , Hepatitis B Vaccines/immunology , A549 Cells , Animals , Female , Humans , Mice , Mice, Inbred BALB C , Nanoparticles/chemistry
8.
Phys Med ; 32(6): 812-7, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27184550

ABSTRACT

Microtomography using synchrotron sources is a useful tool in biological imaging research since the phase coherence of synchrotron beams can be exploited to obtain images with high contrast resolution. This work is part of a series of works using phase contrast synchrotron microtomography in the study of Rhodnius prolixus head, the insect vector of Chagas' disease, responsible for about 12,000 deaths per year. The control of insect vector is the most efficient method to prevent this disease and studies have shown that the use of triflumuron, a chitin synthesis inhibitor, disrupted chitin synthesis during larval development and it's an alternative method against insect pests. The aim of this work was to investigate the biological effects of treatments with triflumuron in the ecdysis period (the moulting of the R. prolixus cuticle) using the new imaging beamline IMX at LNLS (Brazilian Synchrotron Light Laboratory). Nymphs of R. prolixus were taken from the Laboratory of Biochemistry and Physiology of Insects, Oswaldo Cruz Foundation, Brazil. Doses of 0.05mg of triflumuron were applied directly to the abdomen on half of the insects immediately after feeding. The insects were sacrificed 25days after feeding (intermoulting period) and fixed with glutaraldehyde. The results obtained using phase contrast synchrotron microtomography in R. prolixus showed amazing images of the effects of triflumuron on insects in the ecdysis period, and the formation of the new cuticle on those which were not treated with triflumuron. Both formation and malformation of this insect's cuticle have never been seen before with this technique.


Subject(s)
Head/diagnostic imaging , Head/growth & development , Molting , Rhodnius/anatomy & histology , Rhodnius/growth & development , Synchrotrons , X-Ray Microtomography/methods , Animals , Benzamides/pharmacology , Molting/drug effects , X-Ray Microtomography/instrumentation
9.
Indian Pediatr ; 40(1): 29-35, 2003 Jan.
Article in English | MEDLINE | ID: mdl-12554915

ABSTRACT

McCune Albright Syndrome (MCAS) is an association of, Café-au-lait macules, polyostotic fibrous dysplasia and autonomous hyperfunctioning endocrinopathy. This is a rare disorder seen more commonly in females. We evaluated 7 (6F & 1M) cases under six years of age (4 months to 5.5 yrs) presenting with Café-au-lait spots, polyostotic fibrous dysplasia and/or sexual precocity. All the 7 cases had large Café-au-lait spots, radiologic features of polyostotic fibrous dysplasia were seen in 5 cases. Six girls had precocious puberty with large ovarian follicles and elevated S. Estradiol levels (14-65 pg/dl) with prepubertal gonadotropin levels in 5 of them. Medroxy-progrestrone acetate was used to treat the sexual precocity. Five girls on follow up for 6 months (6mo-16mo) showed cessation of menstrual episodes and regression of ovarian follicles in three, regression in breast size in one, and three girls continued to grow at a height velocity >95th centile for age. Skeletal lesions and skin features did not show any change. No other endocrinopathy was noted. Gonadotropin independent precocious puberty was the only endocrine affection seen in this series.


Subject(s)
Fibrous Dysplasia, Polyostotic/diagnosis , Puberty, Precocious/diagnosis , Cafe-au-Lait Spots/etiology , Child, Preschool , Estradiol/blood , Female , Fibrous Dysplasia, Polyostotic/complications , Fibrous Dysplasia, Polyostotic/drug therapy , Gonadotropins/blood , Humans , Infant , Male , Medroxyprogesterone Acetate/therapeutic use , Progesterone Congeners/therapeutic use , Puberty, Precocious/drug therapy , Puberty, Precocious/etiology , Treatment Outcome
10.
Article in English | MEDLINE | ID: mdl-11458252

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the diagnostic efficacy of Ektaspeed Plus film (EPF), a charge-coupled device (CCD), and photostimulable phosphor (PSP)-based digital images for detection of simulated periapical lesions. STUDY DESIGN: Lesions were simulated in the periapical areas of 24 human mandibular sections invested in acrylic using burs of sizes #1, 2, 4, and 6 and imaged using EPF, CCD, and PSP sensors. Percent correct response scores, sensitivity, and specificity values were computed for all variables. Repeated-measures analysis of variance and post hoc testing were performed to determine the effects of imaging modality, observer, and lesion sizes with respect to lesion detection. RESULTS: EPF displayed the highest sensitivity and specificity, followed by PSP and CCD images (P <.001). Percent correct score was the highest for 3 of 4 observers when EPF was used. Analysis of variance revealed significance (P <.001) with respect to all variables. Observers with experience in digital image-viewing performed better than those without such experience (P <.001). Intraobserver agreement was fair (kappa = 0.5). CONCLUSIONS: EPF outperformed CCD and PSP images when observers could manipulate image characteristics.


Subject(s)
Periapical Diseases/diagnostic imaging , Radiography, Dental, Digital/instrumentation , X-Ray Film , Analysis of Variance , Humans , Mandible , Observer Variation , Radiographic Image Enhancement/instrumentation , Radiographic Image Enhancement/methods , Radiography, Dental, Digital/methods , Sensitivity and Specificity , Statistics as Topic
11.
Indian Pediatr ; 34(6): 481-90, 1997 Jun.
Article in English | MEDLINE | ID: mdl-9357203

ABSTRACT

OBJECTIVE: To study the clinical, biochemical, hormonal, radiological and histopathological profile of adrenocortical tumors in children; to assess the clinicopathological correlations and note the future outcome. DESIGN: Retrospective and prospective study. SETTING: Hospital based; Endocrine Service of our institution and other institution based services. SUBJECTS: 14 children (Females = 11, Males = 3) with adrenocortical tumor, aged 8 months to 13 years (mean age 5.1 +/- 3.42 years), seen over a period of 9 years. RESULTS: Females predominated (F:M = 3.7:1). Majority (64%) had a mixed picture with cushingoid features and virilization, whereas 36% presented only for virilization. Elevated serum cortisol levels with loss of diurnal variation was noted only in those with mixed clinical presentation. Adrenal androgen elevation was noted in majority of cases as virilization was common to all. CT confirmed the diagnosis of tumor, 7 on either side. Thirteen cases were operated. Histopathologic diagnosis was carcinoma in 7 and adenoma in 6 cases. Three of the seven with carcinoma died within 3 months to 2 years but two of these with small tumours (weight 60-65 g and diameter < 6 cm) were well at 2 and 5 years, while as one of the six with a large adenoma had recurrence and metastasis after three years. CONCLUSION: Female preponderance was marked (4 times), 43% of tumors had occurred by 3 years of age and 64% by 6 years. Neither the hormonal parameters nor the histopathology correlated well with the biological behavior and outcome. Prolonged and vigilant follow up is essential.


Subject(s)
Adrenal Cortex Neoplasms/diagnosis , Adrenocortical Adenoma/diagnosis , Adrenocortical Carcinoma/diagnosis , Adolescent , Adrenal Cortex Neoplasms/epidemiology , Adrenal Cortex Neoplasms/physiopathology , Adrenocortical Adenoma/epidemiology , Adrenocortical Adenoma/physiopathology , Adrenocortical Carcinoma/epidemiology , Adrenocortical Carcinoma/physiopathology , Age Distribution , Child , Child, Preschool , Female , Humans , Incidence , India/epidemiology , Infant , Male , Prognosis , Prospective Studies , Retrospective Studies , Risk Factors , Sex Distribution , Survival Rate
13.
Arch Pediatr Adolesc Med ; 150(6): 623-8, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8646313

ABSTRACT

OBJECTIVE: To assess pretreatment and posttreatment pituitary gland size by magnetic resonance imaging in children with subtle or overt signs of long-standing hypothyroidism. DESIGN: Etiologic diagnosis of hypothyroidism was confirmed by thyrotropin, triiodothyronine, and thyroxine assays; thyroid antibody tests; and radionuclide thyroid scan. Repeated magnetic resonance imaging was obtained after 6 to 12 months of therapy with levothyroxine sodium to restore a euthyroid state. SETTING: Endocrine service at a hospital for children in Bombay, India. PATIENTS: Ten children whose mean (+/-SD) chronologic age, bone age, and duration of symptoms were 11.39 +/- 1.81, 3.78 +/- 2.05, and 6.95 +/- 2.91 years, respectively. One patient was seen for acute neurologic symptoms suggesting a suprasellar lesion. RESULTS: Magnetic resonance imaging showed homogeneous diffuse enlargement of the pituitary gland in all patients. The superior margin of the gland was flat in five patients and convex in the rest, with suprasellar extension and partial or complete obliteration of the infundibulum in three and mild compression of optic chiasma in two, thus mimicking a sellar or suprasellar tumor. Pretreatment pituitary mean (+/-SD) vertical height in the coronal plane was 10.02 +/- 2.24 mm, with a posttreatment regression to 4.93 +/- 1.11 mm (P < .001, Student's t test) and restoration of clinical and hormonal euthyroid status. CONCLUSION: Awareness of pituitary enlargement and the rare occurrence of neurologic symptoms and chiasmal syndrome are important in children with longstanding congenital hypothyroidism.


Subject(s)
Congenital Hypothyroidism , Hypothyroidism/diagnosis , Pituitary Gland/pathology , Adolescent , Child , Female , Humans , Hypertrophy , Hypothyroidism/drug therapy , Magnetic Resonance Imaging , Male , Thyroxine/therapeutic use
17.
Indian J Med Res ; 100: 36-42, 1994 Jul.
Article in English | MEDLINE | ID: mdl-7927551

ABSTRACT

A total of 25,244 full term consecutive newborns were screened for hypothyroidism at 24 to 96 h of birth using the filter paper technique for thyroxine. The screening protocol based on our pilot study considered filter paper thyroxine (FP-T4) values of 51 to 80 ng/ml (-1 SD) as borderline and < 50 ng/ml (-2 SD) as high risk for congenital hypothyroidism. FP-T4 and/or serum T4 and TSH were reestimated in all neonates with FP-T4 < 80 ng/ml. A total of 4775 (18.9%) newborns (FP-T4, 51 to 80 ng/ml in 4435 and < 50 ng/ml in 340) needed the recall; 2237 (50.4%) with FP-T4 51 to 80 ng/ml recalled by letters and 283 (83.3%) of the 340 subjects with FP-T4 < 50 ng/ml recalled by home visit, responded by 6 wk of age. Congenital hypothyroidism was confirmed in 6 newborns. FP-T4 in one persisted at 55 ng/ml on follow up and in the remainder both initial and repeat values were < 50 ng/ml. Follow up serum T4 values were subnormal (7.8-50.2 ng/ml) and serum TSH elevated (80-1233 IU/ml). Technetium thyroid scan showed agenesis in 3, ectopia in 2 and normal gland with probable dyshormonogenesis in one. Three other newborns (FP-T4 93 to 143 ng/ml) escaped primary detection and were referred later for congenital hypothyroidism. The incidence of congenital hypothyroidism by primary screening was 1:4207 (6 of 25,244) but with these 3 missed cases, probably 1:2804. Congenital hypothyroidism was reconfirmed in all 9 infants between the ages of 2 1/2 to 4 yr.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Hypothyroidism/diagnosis , Neonatal Screening/methods , Thyroxine/blood , Congenital Hypothyroidism , Follow-Up Studies , Humans , Infant, Newborn , Pilot Projects
19.
Indian J Pediatr ; 60(3): 445-50, 1993.
Article in English | MEDLINE | ID: mdl-8253496

ABSTRACT

Ten children, five boys and five girls with true precocious puberty at an early age were found to have hypothalamic hamartomas on brain imaging. Very early onset of puberty, varying from a few weeks to three years of age, and rapid progression were characteristic. Accelerated growth velocity and markedly advanced bone age were evident in all. Gonadotropin and gonadal hormone levels were elevated above the prepubertal range. Six children had associated developmental delay or hyperactivity.


Subject(s)
Hamartoma/complications , Hypothalamic Neoplasms/complications , Puberty, Precocious/etiology , Child, Preschool , Female , Gonadal Steroid Hormones/blood , Hamartoma/blood , Hamartoma/diagnosis , Humans , Hypothalamic Neoplasms/blood , Hypothalamic Neoplasms/diagnosis , Hypothalamus/pathology , Infant , Magnetic Resonance Imaging , Male , Puberty, Precocious/blood , Puberty, Precocious/diagnosis
20.
Indian Pediatr ; 30(5): 607-23, 1993 May.
Article in English | MEDLINE | ID: mdl-8282387

ABSTRACT

Eighty children (58 girls and 22 boys) with isosexual precocity seen in the past eight years were evaluated clinically and investigated to identify the underlying cause. Of these, 50% (29 girls and 11 boys) had centrally mediated true precocious puberty (TPP). The girls could be classified into five major groups (I) Central precocious puberty 29-subclassified into idiopathic (ITPP, 15) and organic or neurogenic (NTTP, 14), (II) Premature thelarche (PT, 20), (III) Premature menarche (PM, 2), (IV) Premature adrenarche (PA, 5), and, (V) Others: hypothyroid (n = 1), and McCune Albright Syndrome (n = 1). ITPP as a cause of precocity in girls was seen less often (52%) and NTPP more often (48%) compared to most Western series, with tubercular meningitis as the cause in 31% and hypothalamic hamartomas in 10%. Though the LH and estradiol levels were significantly higher (p < 0.05) in TPP, compared to PT, these were not helpful in differentiating because of considerable overlap. LH-predominant-response (LH/FSH ratio > 1) to LHRH testing was seen in TPP. Amongst the 22 boys, 11 (50%) had TPP, ITPP in 27% and NTPP in 73%. Hamartomas (n = 4) and TBM (n = 3) contributed equally to NTPP; pineal tumor was seen in one. The adrenal (n = 7) and testicular (n = 2) causes together involved 41% of the boys with precocity, congenital adrenal hyperplasia (CAH) CAH, 11-beta hydroxylase being the commonest cause. Of the 6 boys witdeficiency was found in four and nonsalt losing form of 21-hydroxylase deficiency in 2. Testicular and adrenal tumors and testotoxicosis were noted in one case each. The etiologic factors were more varied in boys.


Subject(s)
Puberty, Precocious/etiology , Puberty, Precocious/physiopathology , Adrenal Gland Diseases/complications , Age Determination by Skeleton , Breast/growth & development , Central Nervous System Diseases/complications , Child , Child, Preschool , Female , Humans , Infant , Male , Menarche/physiology , Penis/growth & development , Puberty, Precocious/classification , Retrospective Studies , Testicular Diseases/complications
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