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PubMed1999

[Testicular hypogonadisms].

The testis is involved in male sexual differentiation during prenatal life, development of secondary sexual characteristics at puberty and reproduction and sexuality in adults. The testis has two functions, testosterone secretion and spermatogenesis. Testicular failures have different clinical presentations according to age and the relative extend of the decrease of testosterone secretion and sperm production. Diagnosis might be done at birth, because of ambiguous genitalia, micropenis, hypospadias, cryptorchidism; in teenagers because of delayed puberty; in adults because of sexual problems and regression of sexual characteristics or infertility. The increase of gonadropin levels indicates the testicular origin of hypogonadism. Since spermatogenic failure was often more severe than endocrine defect, FSH was often more elevated than LH. The causes of testicular failure are numerous, the description at the molecular level of genetic causes is in progress. Intracytoplasmic sperm injection greatly enhanced the possibility of conception.

Adult↗
PubMed1987

[Ultrasonic measurement of the uterus in juvenile diabetic patients and possible corrections between genital development and diabetes mellitus. 2].

The sonographically determined length of uterus in 100 insulin-dependent diabetic girls of the age-classes 1964 to 1974 are considered in relation to diabetes mellitus. In order to recognise the possibility of a disturbed development of the inner genitals during puberty of juvenile diabetics, the uterus development is considered in relation to ossification age, duration of diabetes, and to the period before or after the 10th year of age as well as before respectively after menarche. Before the 16th year of age the growth curves of the uterus in all metabolism groups show non-significant delays, which are difficult to interpret. Up to the 18th year the course of the curves reach a similar standard of development--that is an average of 60 mm. In order to determine the precise moment of the diagnostic and therapeutic activity in delayed puberty development, it seems to us appropriate to use the sonographic measurement of the uterus length in addition to the definition of ossification age.

Adolescent↗
PubMed2005

Treatment of precocious puberty in two patients with Turner mosaicism.

Turner's syndrome (TS) is clinically characterized by reduced growth, ovarian dysgenesis and infertility. The majority of patients with TS do not undergo spontaneous pubertal development. We report two patients with mosaic Turner karyotype who experienced precocious pubertal development. The first patient responded well to LHRH analog treatment and now has regular menses and has nearly achieved her target height. The second patient was treated with both LHRH analog and recombinant growth hormone. LHRH analog delayed puberty for the patient and the recombinant growth hormone increased the patient's predicted height from 145 cm to 158 cm. This report emphasizes that the treatment goals and modalities of patients must be tailored to the individual to optimize pubertal and growth outcomes.

Child↗
PubMed1990

Response to growth hormone treatment and final height after cranial or craniospinal irradiation.

Growth hormone (GH) deficiency (GHD) induced by cranial irradiation has become a frequent indication of hGH substitutive therapy. This study analyses the growth response to hGH therapy and the factors involved in the decrease in growth velocity observed after cranial irradiation. One hundred children (61 boys and 39 girls) given cranial radiation for pathology distant from the hypothalamo-pituitary area were studied. Fifty-six of them received hGH therapy for GHD resulting in decreased growth velocity. The initial annual height gain in the cranial-irradiated group was comparable to that of patients treated for idiopathic GHD; additional spinal irradiation significantly reduced the growth response. Twenty-eight hGH-treated patients reached final heights which were compared to those of 2 untreated irradiated groups, one with GHD (n = 27) and the other with normal GH secretion (n = 17). The height SD score changes observed in hGH therapy were +0.3 in the cranial (n = 10) and -1.2 SD in the craniospinal (n = 18) groups. GH deficiency had contributed to a mean height loss of 1 SD and spinal irradiation to a loss of 1.4 SD. The small effect of hGH therapy on final height is probably linked to the small bone age retardation at onset of hGH therapy and to the fact that irradiated children entered puberty at a younger age in terms of chronological age (10.6 +/- 0.3 yr in girls and 11.0 +/- 0.3 yr in boys) and bone age (9.6 +/- 0.4 yr in girls and 12.6 +/- 0.3 in boys) than the idiopathic GHD patients. These data suggest that the results of hGH therapy in irradiated children might be improved with higher and more fractionated hGH doses and, in some patients, by delaying puberty using luteinizing hormone releasing hormone analogs.

Body Height↗
PubMed1989

Further evidence that prolactin controls the prepubertal sexual development in the female rat.

To assess the role of prolactin (PRL) in the puberty onset and the ovarian aromatase activity, hyper- and hypoprolactinemic conditions were induced by treating chronically prepubertal female rats with PRL and bromocriptine, respectively. Injection of rat PRL (5 micrograms, twice daily) from day 20 onward advanced the day of vaginal opening. By contrast, the suppression of PRL release by bromocriptine, which was provided in the drinking water at a concentration of 40 micrograms/ml, caused a significant delay in the age of occurrence of vaginal opening. This bromocriptine-induced delayed puberty was prevented by the concomitant administration of exogenous PRL, suggesting that the effect of bromocriptine is exerted through its suppressive effect on the endogenous PRL release. The in vitro release of estradiol by the ovaries from 30-day-old rats treated with PRL was found to be higher than that from the control animals, when the ovaries were perifused for 6 h with an excess of androstenedione. On the other hand, the ovaries perifused in the presence of androgen produced less estradiol in the bromocriptine-treated rats than in their controls. It appears, therefore, that PRL is more likely related to the aromatase activity in the maturing ovary. These results suggest that PRL may be one of the factors that regulate the timing of puberty onset by influencing the aromatase activity in the ovary.

Animals↗
PubMed1983

Chemosignal effects on puberty in young female mice: urine from pregnant and lactating females.

A series of 8 experiments tested the effects of urine from pregnant and lactating female mice on sexual maturation of young females. Urine collected from females at various intervals during pregnancy and lactation and painted on the nares of young test females produced different effects on the age of puberty depending upon the collection interval. The urinary substance which accelerates puberty is found in the bladder urine of both pregnant and the lactating females as well as in the excreted urine of females that are both lactating and also simultaneously pregnant. Four separate experiments demonstrated that grouping pregnant or lactating females at various densities, either with other females in the same stage of reproduction, or with nonreproductive females, resulted in excretion of urine which did not accelerate or delay puberty in young test mice. These results conform with a general hypothesis regarding the release of urinary chemosignals in female house mice as indicators of the adequacy of social and environmental conditions for successful reproduction.

Animals↗
PubMed2003

Prenatal stress affects the rate of sexual maturation and attractiveness in bank voles.

Field studies reveal that bank vole females' mobility and aggression increase during pregnancy. Here we investigated the reaction of pregnant females to social stress evoked by short but frequent meetings with another female at the same stage of pregnancy. The stress neither evoked pregnancy termination nor affected pregnancy duration but had a long-term effect on the reproductive activity of the offspring. Prenatal stress reduced the rate of sexual maturation of voles as estimated at the age of 20 days. Uterine weights of prenatally stressed females and testes weights of prenatally stressed males were significantly lower than in offspring born to nonstressed mothers. Olfactory signals are known to be important in the sexual preferences of bank voles. Adult prenatally stressed females were more attractive to other adult females than were nonstressed animals. For bank vole males, however, prenatal stress decreased the attractiveness of females; adult males selected nonstressed females over stressed partners, by odor. This study shows that prenatal conditions evoked by short but frequent encounters with another pregnant female lead to delayed puberty in females and males, and decrease sexual attractiveness in adult offspring. These two negative effects may significantly limit the reproduction of prenatally stressed offspring.

Aging↗
PubMed2005

Clinical and anthropometric profile of children with celiac disease in Punjab (North India).

This prospective study was carried out to evaluate the clinical and anthropometric profile of 71 children confirmed to have celiac disease on the basis of clinical features, duodenal biopsy and unequivocal improvement on gluten-free diet. Serological tests were performed in 35 cases. The patients were divided into three age groups <5 years, 5-10 years, and >10 years as per the age of presentation to the hospital. Mean age was 8.7 years with a slight female preponderance. Diarrhea was the commonest presentation in group I and failure to thrive in group III. All patients in group III, had weight for age (w/a) <3rd percentile and majority (83 per cent) had short stature, with delayed puberty in all. All children had significant improvement in symptoms and growth on gluten restriction. None of the patients had been suspected to have celiac disease before, which signifies that in spite of increasing incidence of celiac disease, this disease is grossly under-diagnosed in North India where wheat is the staple diet. It is essential to make an early diagnosis of celiac disease in children to prevent growth delay.

Adolescent↗
PubMed2003

Disorders of pubertal development: precocious puberty.

Puberty is a complex developmental process culminating in sexual maturity. This transitional period begins in late childhood and is characterized by maturation of the hypothalamic-pituitary-gonadal axis, the appearance of secondary sexual characteristics, acceleration of growth, and, ultimately, the capacity for fertility. Significant endocrinologic changes accompany these developmental events. Disorders of pubertal development may occur at any of the steps of the maturational process leading to either precocious or delayed puberty. A thorough understanding of the normal pubertal process is important to the accurate diagnosis and treatment of pubertal disorders.

Adolescent↗
PubMedDate not supplied

Role of growth hormone in ovarian physiology and onset of puberty.

OBJECTIVE: To review the role of growth hormone (GH) in the timing of puberty and to summarize the interactions between the somatotrophic and reproductive axes. The use of recombinant GH in patients with GH deficiency is outlined. METHODS: A MEDLINE search was performed of English language manuscripts dealing with the role or use of GH in puberty and reproduction. RESULTS: Growth hormone appears to augment the rate of sexual maturation once a pubertal pattern of gonadotropin secretion is established. Growth hormone may modulate gonadal steroid production by increasing hepatic insulin-like growth factor-I production or by acting directly on GH receptors, localized recently in the granulosa cells and corpus luteum in the human ovary. Patients with isolated GH deficiency exhibit short stature, truncal adiposity, and delayed puberty. However, patients with isolated GH deficiency ultimately undergo spontaneous puberty, and women with GH receptor defects are fertile, suggesting that GH most likely acts as a co-gonadotropin to augment the actions of FSH and LH on estradiol and progesterone production. CONCLUSIONS: Growth hormone appears to increase the rate of sexual maturation once a pubertal pattern of pituitary gonadotropin secretion is established. The ovary is a site of GH reception and action, where it can potentiate steroidogenesis and gametogenesis either directly or through endocrine actions. Continued basic and clinical research is needed to characterize further the role of GH in reproductive physiology.

Animals↗
PubMed1993

Ultrasensitive new immunoassays for gonadotropins in the evaluation of puberty.

The increased sensitivity and specificity of new immunometric gonadotropin assays make them particularly useful to study the ontogenesis of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion in normal and abnormal puberty. The results show that the gonadotropin-releasing hormone pulse generator is functionally active even in prepubertal children with selective occurrence of LH and FSH pulses after the onset of sleep. The onset of puberty is associated with a major increase in pulse amplitude and a small increase in pulse frequency, expressed as a progressive increase in day-time pulsatility, and a gradual reduction of sleep-entrained amplification. Daytime gonadotropin measurements may better distinguish pubertal stages than nighttime sampling because of less overlapping. As the changes are greater with the sensitive assays, the diagnosis of pubertal disturbances is improved. It is easier to differentiate constitutionally delayed puberty and hypogonadotropic hypogonadism, but biologically overlapping phenomena cannot be separated by even sensitive assays. The augmentation of LH secretion after onset of sleep might be missing in hypogonadotropic hypogonadism and is proposed as a new, somewhat complicated, diagnostic approach. As serum concentrations of FSH in prepubertal children are much higher than those of LH, the measurement of FSH in this age group is particularly useful, and lower-than-normal levels can be found in gonadotropin-releasing hormone-independent precocious puberty as well as in pituitary defects.

Adolescent↗
PubMed2002

Effects of flutamide on puberty in male rats: an evaluation of the protocol for the assessment of pubertal development and thyroid function.

To establish a test protocol for the rodent 20-d thyroid/pubertal assay, flutamide, a non-steroidal androgen antagonist, was administered to intact male Sprague-Dawley rats from postnatal d 33 for 20 d, and several reproductive endpoints were examined to assess the sensitivity of a number of parameters with respect to the detection of endocrine-related effects. Immature male rats were divided into 4 groups and given flutamide once daily by oral gavage at doses of 0, 1, 5, or 25 mg/kg/d. Prepuce separation was significantly delayed in flutamide-treated rats (5 and 25 mg/kg/d). One day after the last dose, the rats were sacrificed. Flutamide treatment resulted in a significant reduction in the weights of epididymides, ventral prostate, seminal vesicles plus coagulating glands and fluid, levator ani plus bulbocavernosus muscles, Cowper's glands, and glans penis. The weight of adrenal glands decreased at 25 mg/kg/d, while testes and any other organ weights were unaffected. No microscopic changes were observed in the thyroid glands. Serum levels of testosterone were significantly increased in the flutamide-treated groups (5 and 25 mg/ kg/d) and serum levels of estradiol were also increased (25 mg/kg/d). No differences were observed in the serum thyroxine levels. These results indicate that flutamide delays puberty in the male rat, and its mode of action appears to be via altered secretion of steroids, which subsequently affect the development of the reproductive tract. Thus, this assay might be used as an alternative for screening antiandrogenic activities of chemicals.

Androgen Antagonists↗
PubMed1984

A simple test for the hormonal assessment of early puberty in boys.

The initial hormonal changes in male puberty occur at nighttime, with episodic rises of LH and testosterone (T). Only much later do the daytime levels of these hormones rise. Nocturnal sampling is impractical for routine clinical assessment, so we have examined the relationship between peak nocturnal T levels and those produced in the same subject by a single intravenous injection of gonadotrophin releasing hormone (GnRH, 100 micrograms) in the morning. Nocturnal T profiles and daytime GnRH tests have been conducted in eight boys in early (delayed) puberty, three with pubertal gynaecomastia in later puberty, two normal men, and one man with gynaecomastia. Excellent agreement was obtained between peak nocturnal and post-GnRH T levels. The serum testosterone level 3 hours after 100 micrograms IV GnRH is a simple and useful hormonal marker of pituitary-Leydig cell activity during puberty.

Adolescent↗
PubMed1981

A comparative study of psychosexual adjustment in men with testicular cancer and acute leukemia.

Twenty-five men with testicular germ cell tumors were compared by developmental history and past and present psychologic adjustment to 25 men with acute leukemia. The mean age was 30 years for the cancer group and 25 years for the leukemia group. Current and Past Psychopathology Scales (18 scales of prior and 8 of present adjustment) were rated during a semistructured interview. The following differences were found in developmental history: Onset of puberty was 12.4 years for leukemics and 15.1 years for the cancer group (P less than 0.001); cryptorchidism was found in 20% of cancer patients and 4% of leukemia; incidence of opiate drug abuse was 36% in cancer patients and 24% in leukemia patients; psychiatric disturbance prior to illness characterized 32% of the cancer group and 12% of the leukemia group. Major psychiatric illness was diagnosed in 20% of the testicular cancer group and 4% of the leukemia group. Findings of delayed puberty and psychiatric disturbance in men with germ cell testicular tumors as compared to leukemics suggest a possible impairment of the hypothalamic-pituitary-gonadal axis. The etiology of this impairment is discussed (genetic factors, prenatal endocrine milieu, abnormal luteinizing hormone (LH) receptors, and abnormal interaction between dopaminergic system, LH, and endorphins).

Acute Disease↗
PubMed1993

Melatonin and human puberty: current perspectives.

Many studies of melatonin in human puberty are difficult to interpret in light of methodological considerations such as the use of single blood samples collected either during the day or at night; a small number of observations; the failure to include the temporal characteristics of melatonin secretion; the definition of puberty by the use of broad clinical features without use of hormonal markers of puberty; the lack of control for the actual duration and intensity of light exposure during the days preceding the study; and the cross sectional nature of most studies. The few studies that have examined the plasma melatonin rhythm in humans by multiple blood sampling overnight or over 24 hr suggest that normal pubertal development (as well as normal ovarian function) are not linked to alterations in the plasma melatonin profile. There is, however, some evidence to suggest that disorders of the hypothalamic-pituitary-gonadal axis (delayed puberty, precocious puberty, hypothalamic amenorrhea) may be linked to altered plasma melatonin profile, at least in some cases. These findings, taken together with strong evidence for the role of the pineal gland in the reproductive function of other vertebrate species, render unlikely the inference that the pineal gland has no role in the development and function of the human reproductive axis. Thus, one may speculate that a pineal-puberty relation does exist in humans and that the research techniques applied to date have been inadequate to uncover this relation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

[Diagnostic principles of gonadal dysgenesis in adolescents].

103 patients aged 11-20 with short stature and/or with delayed puberty were studied. Among all patients classical form of gonadal dysgenesis was diagnosed in 31 patients (karyotype 45,X- 17 patients, 45,X/46,XX- 14), "mixed" gonadal dysgenesis in one patient (karyotype 45,X/46,XY)-, "pure" gonadal dysgenesis- in 5 cases (karyotype 46,XY-in 4 , 45,X -- in one). The majority of cases (66) were diagnosed as ovarian dysgenesis with the mosaic karyotype- 46,XX/45,X. In the clinical diagnostics of ovarian dysgenesis some difficulties were aroused because of slight reduction of height and delayed sexual development, mild appearance absence or somatic anomalies. The main diagnostic criteria for the various forms of gonadal dysgenesis are detection of characteristic karyotype and hypogonadotropic hypogonadism. Characteristic phenotype is more informative in the cases of classical and "mixed" forms of gonadal dysgenesis. Early diagnosis of gonadal dysgenesis is very important for effective correction of height and sexual development. Timely begin hormonal therapy may avoid complications induced bihypoestrogenia, such are: osteoporosis, cardiovascular diseases and etc. Karyotype investigation and in the cases of revealing Y chromosome material, and therefore gonadectomy must precede the beginning of hormonal therapy.

Adolescent↗
PubMed2003

Reproduction in female yaks (Bos grunniens) and opportunities for improvement.

This paper reviews seasonal breeding, puberty, postpartum anestrus, embryonic loss and calf survival and their constraints in female yaks. Methods for improving fertility in postpartum yak cows are also considered. Yaks are seasonal breeders with mating and conception restricted in the warm season. Puberty generally occurs in the 2nd to the 4th warm season following birth, i.e. between 13 and 36 months of age. The cows usually have a long postpartum anestrus period; only a small proportion of the cows return to estrus in the 1st breeding season after calving, most come into estrus in the 2nd and 3rd years. Nutritional status is the most important determinant of reproduction in female yaks. Reproductive success is a direct result of the availability of pasture determined by climate, season, and management practices. Milking delays puberty by reducing milk intake (restricted suckling) and growth rate for the calf. Milking interferes with grazing and prolongs the duration of postpartum acyclicity in cows. Calves born early in the season have a longer suckling season than those born later in the season before the onset of winter. Thus, they can have their first cycle in the breeding season of the following year, while those born late in the season may not have their first estrus until 25 or 26 months of age. Cows calving early in the season are more likely to return to estrus in the year of calving because they have a longer period to recover from the demand on body reserves before the onset of winter. Inbreeding in smallholder yak farms is also discussed and minimizing inbreeding by exchanging bulls among different herds is suggested. Reproductive efficiency can be improved by nutritional supplementation during the winter, however, the most cost-effective and practical strategy for this needs to be determined. Early weaning or restricted suckling may shorten the duration of postpartum acyclicity, however, it is impractical due to reduced growth rates and increased winter mortality of early weaned calves. A single treatment with either GnRH, or PGF(2alpha)+GnRH can successfully induce estrus in yak cows that calved in previous years (with or without calf) but did not calve in the current year, however, it has little effect in cows nursing a calf born in the current year. The effects of administration of exogenous progestogens plus GnRH on the fertility of yak cows are worthy of further study.

Anestrus↗
PubMed1999

[Neurofibromatosis type 1 in childhood].

Neurofibromatosis 1 is one of the most common genetic disorders in man. Although almost every body system can be involved, it most frequently affects the skin, the nervous system and the skeleton. Major disease features are café-au-lait spots, axillary/inguinal freckling, neurofibromas and Lisch' nodules. The complications are quite variable, making it impossible to predict the clinical course in an individual patient. To summarize the problems associated with this disease we have quantified manifestations and complications in a group of 38 children with neurofibromatosis 1 who were seen at the University Hospital in Trondheim, Norway between 1987 and 1997. The results are based upon the medical records as well as clinical examination. A wide variety of initial symptoms was recorded, but the majority of the children had café-au-lait spots and axillary/inguinal freckling, two of the seven disease features included in the diagnostic criteria given by the National Institutes of Health. The most frequent complications were tumours, with highest incidence of optic pathway gliomas, disturbances of growth and puberty, delayed psychomotor development and learning disabilities. The risk of complications necessitates regular follow-up in a paediatric department. An annual assessment by an ophthalmologist is also recommended, as well as Visual Evoked Potentials/MRI as screening for optic glioma in children under ten years of age.

Adolescent↗