Efficacy of Triptorelin 3-Month Depot Compared to 1-Month Depot for the Treatment of Korean Girls with Central Precocious Puberty in Single Tertiary Center

Chung Lindsey Yoojin,Kang Eungu,Nam Hyo-Kyoung,Rhie Young-Jun,Lee Kee-Hyoung 대한의학회 2021 Journal of Korean medical science Vol.36 No.34

Background: Triptorelin depot is largely used to treat central precocious puberty (CPP) in children, and a 3-month depot has been introduced. However, data about the 3-month gonadotropin-releasing hormone use for treatment of CPP in Korean girls are not available. This study was conducted to compare the efficacy of a triptorelin 11.25 mg 3-month depot with that of a 3.75 mg 1-month depot in suppressing pubertal development for the treatment of CPP. Methods: A retrospective study, including 106 girls with CPP treated with triptorelin, was conducted. Fifty patients were treated with a triptorelin 3-month depot, and 56 were treated with a triptorelin 1-month depot. Serum luteinizing hormone (LH), follicle-stimulating hormone, and estradiol levels were analysed every 6 months after the visit. The height and bone age of each patient was evaluated at the beginning of treatment, after 6 months, and one year after therapy. Results: The baseline characteristics of the girls treated with a 3-month depot were similar to those of the girls treated with a 1-month depot. A suppressed levels of LH to the triptorelin injection (serum LH < 2.5 IU/L) at 6 months was seen in 90.0% and 98.2% of the girls treated with the 3-month and 1-month depots, respectively (P = 0.160). After 1 year of treatment, a suppressed levels of LH was seen in 93.5% and 100% of the girls treated with the 3-month and 1-month depots, respectively (P = 0.226). Height velocity showed no significant difference between the two groups. Degree of bone age advancement decreased from 1.22 ± 0.07 and 1.22 ± 0.08 years at baseline (P = 0.914) to 1.16 ± 0.07 and 1.17 ± 0.08 in the girls treated with the 3-month and 1-month depots after 1 year, respectively (P = 0.481). Conclusion: This study showed that the efficacy of long-acting triptorelin 3-month was comparable to 1-month depot regarding hormonal suppression and inhibition of bone maturation. The triptorelin 11.25 mg 3-month depot is an effective treatment for girls with CPP.

Clinical Utility of Rapid Plasma Neutrophil Gelatinase-Associated Lipocalin Assays for Diagnosing Acute Kidney Injury in Critically Ill Newborn Infants

Lindsey Yoojin Chung,최원식,최의경,신정희,임형은,최병민 대한신생아학회 2017 Neonatal medicine Vol.24 No.4

Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as an early marker of acute kidney injury (AKI). This study was designed to evaluate the clinical utility of the rapid plasma NGAL assay for diagnosing AKI in critically ill newborn infants in the neonatal intensive care unit (NICU). Methods: The medical records of 178 critically ill newborn infants >34 weeks of gestational age who underwent plasma NGAL measurement during the first week of life in the Korea University Ansan Hospital NICU from February 2011 to August 2015 were retrospectively reviewed. Plasma NGAL levels were measured at bedside by using a commercial competitive immunoassay kit simultaneously with serum creatinine (Cr) level determination. Results: Of 178 newborn infants enrolled in this study (study group), 25 infants had AKI (AKI group) while 153 infants had no AKI (control group). The plasma NGAL level in the AKI group (114.0 [76.5–281.5] ng/mL) was significantly higher than that in the control group (74.0 [52.5–122.5] ng/mL, P=0.001). Moreover, plasma NGAL levels were found to be correlated with serum Cr levels in the study group (r=0.208, P= 0.005). Plasma NGAL achieved an area under the receiver operating characteristic curve of 0.705 for detecting AKI (95% confidence interval: 0.593–0.817). The best cutoff plasma NGAL level for AKI diagnosis was 100 ng/mL. Conclusion: The rapid plasma NGAL assay has diagnostic value for AKI in critically ill newborn infants >34 weeks of gestational age. Further investigations with a larger population are needed to confirm the potential use of plasma NGAL levels for diagnosing AKI in newborn infants.

Metabolic Syndrome in Children and Adolescents

Yoojin Lindsey Chung,Young-Jun Rhie Ewha Womans University School of Medicine 2022 EMJ (Ewha medical journal) Vol.45 No.4

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that include hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity and is strongly associated with an increased risk for diabetes and cardiovascular disease onset in obese adults and children. A progressively greater number of children and adolescents are being affected by this syndrome due to the constant increase in the prevalence of obesity. Like obesity, childhood MetS highly tracks to adulthood. The pathogenesis of MetS includes the interaction between obesity, insulin resistance, and inflammation. Early diagnosis and intervention are important in order to conduct lifestyle modification. In this article, we review the definition and pathophysiology of MetS, the importance of screening, and prevention and treatment options for MetS in childhood.

Prevalence of idiopathic scoliosis in girls with central precocious puberty: effect of a gonadotropin-releasing hormone agonist

Chung Lindsey Yoojin,Nam Hyo-Kyoung,Rhie Young-Jun,Huh Rimm,Kee-Hyoung Lee 대한소아내분비학회 2020 Annals of Pediatirc Endocrinology & Metabolism Vol.25 No.2

Purpose: Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and occurs in children between 10 to 18 years old, during periods of growth spurts and puberty changes. In patients with central precocious puberty (CPP), due to early growth spurt, AIS is expected to develop before 10 years of age. Both AIS and CPP are more common in girls than in boys. The aim of this study was to determine the prevalence of AIS in girls with CPP and to evaluate the effect of treatment with gonadotropin-releasing hormone (GnRH) agonists on progression of scoliosis in these patients. Methods: We retrospectively reviewed medical records of 553 girls, 338 with CPP and 215 without CPP. Scoliosis angle was measured on the standing frontal radiograph of each patient according to the Cobb method. Patients with a Cobb angle of 10° or more were diagnosed with scoliosis. For girls with CPP, follow-up spine radiographs were collected 1 year after treatment with GnRH agonists. Progression of scoliosis before and after treatment was compared in terms of Cobb angle changes. Results: AIS was more prevalent in girls that were affected by CPP compared to controls without CPP (11.5% vs. 6.0%, CPP girls vs. non-CPP girls, respectively, P=0.031). The peak serum luteinizing hormone level positively correlated with Cobb angle (R2=0.015, P=0.023) in the CPP group. No progression of scoliosis was observed in CPP girls after one year of GnRH agonist treatment. Additionally, the prevalence of scoliosis decreased in CPP girls after 1 year of the treatment. Conclusion: We report that the prevalence of AIS is higher in girls with CPP than in non-CPP patients. A regular follow-up schedule for spine radiographs should be considered to reduce the risk of progression. Furthermore, GnRH agonist treatment for CPP may have a suppressive effect on progression of AIS.

인간 코로나 바이러스를 중심으로 2017-2019년 소아청소년 호흡기 바이러스감염증의 역학 및 특성: 경기 북서부지역 단일기관의 후향적 연구

Park Hyoungsuk,Cho Kyoung Won,Chung Lindsey Yoojin,Kim Jong Min,Song Jun Hyuk,Kim Kwang Nam 대한소아감염학회 2023 Pediatric Infection and Vaccine Vol.30 No.2

Purpose: A change is expected in the pattern of respiratory viruses including human coronavirus (HCoV) after the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, identifying the distribution of respiratory viruses before the COVID-19 outbreak is necessary. Methods: We retrospectively analyzed the results of samples of nasal swabs collected from children under aged ≤18 years who were hospitalized at Myongji Hospital, Gyeonggi-do due to acute respiratory infections from 2017 to 2019. Viruses were detected by real-time reverse transcription polymerase chain reaction (RT-PCR). Results: Out of 3,557 total patients, 3,686 viruses were detected with RT-PCR including coinfections. Of the 3,557 patients, 2,797 (78.6%) were confirmed as PCR-positive. Adenovirus and human rhinovirus (hRV) were detected throughout the year, and human enterovirus was most detected during summer. Respiratory syncytial virus, influenza virus, and HCoV were prevalent in winter. In patients with croup, parainfluenza virus was most frequently detected, followed by hRV and HCoV. The PCR positive rate in summer and winter differed significantly. Conclusions: Respiratory virus patterns in northwestern Gyeonggi-do were not much different from previously reported data. The data reported herein regarding respiratory virus epidemiological information before the COVID-19 outbreak can be used for use in comparative studies of respiratory virus patterns after the COVID-19 outbreak.

Clinical Validation of a Deep Learning-Based Hybrid (Greulich-Pyle and Modified Tanner-Whitehouse) Method for Bone Age Assessment

Lee Kyu-Chong,Lee Kee-Hyoung,Kang Chang Ho,Ahn Kyung-Sik,Chung Lindsey Yoojin,Lee Jae-Joon,Hong Suk Joo,Kim Baek Hyun,Shim Euddeum 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.12

Objective: To evaluate the accuracy and clinical efficacy of a hybrid Greulich-Pyle (GP) and modified Tanner-Whitehouse (TW) artificial intelligence (AI) model for bone age assessment. Materials and Methods: A deep learning-based model was trained on an open dataset of multiple ethnicities. A total of 102 hand radiographs (51 male and 51 female; mean age ± standard deviation = 10.95 ± 2.37 years) from a single institution were selected for external validation. Three human experts performed bone age assessments based on the GP atlas to develop a reference standard. Two study radiologists performed bone age assessments with and without AI model assistance in two separate sessions, for which the reading time was recorded. The performance of the AI software was assessed by comparing the mean absolute difference between the AI-calculated bone age and the reference standard. The reading time was compared between reading with and without AI using a paired t test. Furthermore, the reliability between the two study radiologists’ bone age assessments was assessed using intraclass correlation coefficients (ICCs), and the results were compared between reading with and without AI. Results: The bone ages assessed by the experts and the AI model were not significantly different (11.39 ± 2.74 years and 11.35 ± 2.76 years, respectively, p = 0.31). The mean absolute difference was 0.39 years (95% confidence interval, 0.33– 0.45 years) between the automated AI assessment and the reference standard. The mean reading time of the two study radiologists was reduced from 54.29 to 35.37 seconds with AI model assistance (p < 0.001). The ICC of the two study radiologists slightly increased with AI model assistance (from 0.945 to 0.990). Conclusion: The proposed AI model was accurate for assessing bone age. Furthermore, this model appeared to enhance the clinical efficacy by reducing the reading time and improving the inter-observer reliability