Dynamics of bioactive luteinizing hormone-human chorionic gonadotropin during the first 7 days of life.

Serum luteinizing hormone-human chorionic gonadotropin bioactivity (B-LH) was measured daily in seven male and four female full-term newborns during the first 7 days of life. The B-LH levels were elevated in both sexes during the 1st day of life; subsequently, values decreased in both sexes. In males, they reached a nadir on the 4th day of life. A gradual secondary rise was then observed with B-LH levels on the 7th day significantly higher than on day 4 (p less than 0.025). By contrast, the B-LH levels in the females continued a gradual decline to levels significantly lower on day 7 as compared to day 4 (p less than 0.05). To determine whether pulsatile B-LH secretion occurs in newborns, serum concentrations were measured every 20 min for 2 h in eight male and seven female full-term neonates on the 7th day of life. Pulsatile secretion of B-LH was detected in six males and six females. This study demonstrates that pulsatility of gonadotropin secretion is characteristic of neonates as early as 7 days of life and that there is a dichotomy between the levels of B-LH in males and females; levels in females decline progressively from day 1 through 7, whereas in males, a nadir is reached on day 4 with a secondary rise developing thereafter. This male sex-specific rise is presumably the drive responsible for the characteristic postnatal increase in testosterone which peaks at 1 to 2 months of age.

Sexual precocity in a male due to thoracic polyembryoma.

A 7-year-old boy with sexual precocity of recent onset was found to have elevated levels of chorionic gonadotropin, alpha fetoprotein, and testosterone. Removal of a retropleural, posterior mediastinal mass with an intraspinous epidural extension was followed by prompt declines in the plasma concentrations of the tumor markers and cessation of adolescent development. The neoplasm proved to be a polyembryoma, unusual in the multiplicity of its embryoid bodies and extra gonadal location. Following local irradiation and two years of systemic chemotherapy, the patient, now 13 years of age, has done well except for evidence of testicular tubular insufficiency.

Epidemiology of high-tension electrical injuries in children.

Twenty-seven acute high-tension electrical injuries were seen in seven years at the Shriners Burns Institute. All were in boys 7 to 16 years old; 13 suffered amputation(s) and 2 died. Most accidents occurred when boys climbed utility poles (9), trespassed, generally around transformer substations (9), or contacted power lines when tree climbing (5). All occurred in daylight, generally between 4 and 6 PM, on weekends in warm weather with boys in groups. Preventive education directed to this high-risk population should illustrate properties of high-voltage electricity, effects on the body, and how to cope with peer pressures in unstructured time.

Cushing syndrome, sexual precocity, and polyostotic fibrous dysplasia (Albright syndrome) in infancy.

The sexual precocity of polyostotic fibrous dysplasia is occasionally accompanied by other endocrine disorders, but in only two previous instances has Cushing syndrome been reported. The history of a 6-month-old girl is presented, in whom this syndrome was complicated by congenital Cushings syndrome. Although endocrinopathies of polyostotic fibrous dysplasia have usually been ascribed to a central (hypothalamic) origin, the findings in this patient suggest autonomous hyperfunction of the peripheral endocrine glands, with the Cushing syndrome caused by hyperplastic nodules in the adrenal glands and the precocity by luteinized follicular cysts of the ovary.