Background and Methods Mutations in the estrogen-receptor gene have been thought to be lethal. A 28-year-old man whose estrogen resistance was caused by a disruptive mutation in the estrogen-receptor gene underwent studies of pituitary-gonadal function and bone density and received transdermal estrogen for six months. Estrogen-receptor DNA, extracted from lymphocytes, was evaluated by analysis of single-strand-conformation polymorphisms and by direct sequencing. Results The patient was tall (204 cm [80.3 in.]) and had incomplete epiphyseal closure, with a history of continued linear growth into adulthood despite otherwise normal pubertal development. He was normally masculinized and had bilateral axillary acanthosis nigricans. Serum estradiol and estrone concentrations were elevated, and serum testosterone concentrations were normal. Serum follicle-stimulating hormone and luteinizing hormone concentrations were increased. Glucose tolerance was impaired, and hyperinsulinemia was present. The bone mineral d...

https://www.nejm.org/doi/pdf/10.1056/NEJM199410203311604

Estrogen Resistance Caused by a Mutation in the Estrogen-Receptor Gene in a Man

Tables for predicting adult height from skeletal age. Revised for use with the Greulich-Pyle hand standards.

https://www.semortho.com/article/S1073-8746(05)00021-6/pdf

The Cervical Vertebral Maturation (CVM) Method for the Assessment of Optimal Treatment Timing in Dentofacial Orthopedics

Background Severe osteogenesis imperfecta is a disorder characterized by osteopenia, frequent fractures, progressive deformity, loss of mobility, and chronic bone pain. There is no effective therapy for the disorder. We assessed the effects of treatment with a bisphosphonate on bone resorption. Methods In an uncontrolled observational study involving 30 children who were 3 to 16 years old and had severe osteogenesis imperfecta, we administered pamidronate intravenously (mean [±SD] dose, 6.8±1.1 mg per kilogram of body weight per year) at 4-to-6-month intervals for 1.3 to 5.0 years. Clinical status, biochemical characteristics reflecting bone turnover, the bone mineral density of the lumbar spine, and radiologic changes were assessed regularly during treatment. Results Administration of pamidronate resulted in sustained reductions in serum alkaline phosphatase concentrations and in the urinary excretion of calcium and type I collagen N-telopeptide. There was a mean annualized increase of 41.9±29.0 percent ...

https://www.nejm.org/doi/pdf/10.1056/NEJM199810013391402

Cyclic administration of pamidronate in children with severe osteogenesis imperfecta.

Formation and resorption of three deciduous teeth in children.

This Atlas is principally based on the Brush Foundation Study of Human Growth and Development, conceived in 1929 by Professor T. Wingate Todd of Western Reserve University School of Medicine. This intensive study collected data on the maturation of human anatomy through the meticulous X-raying of a series of research subjects enrolled in the study as juveniles-some as young as three months-and thereafter routinely weighed and measured at three-month to one-year intervals, depending on their age. This Atlas utilizes not only the X-ray films to which Todd had access but, also, those which were obtained in the six years subsequent to Todd's publication of his Atlas of Skeletal Maturation of the Hand. The X-ray standards in the present volume are, therefore, the first to be based exclusively on the research of the Brush Foundation Study.

Radiographic Atlas of Skeletal Development of the Hand and Wrist

A Radiographic standard of reference for the growing hand and wrist

In 1964, this standard was prepared at the request of the National Center for Health Statistics so that the skeletal age of the bones in the growing hand and wrist could be read from the films of the children and youths–age 5 to 18 years—from 40 areas of the United States who have been included in the National Health Survey.



The major directive from the National Center was to prepare a standard so that a skeletal age could be assigned to each growing bone without any reference to the sex or the age of the subjects in the Survey.



Between 1928 and 1964, the attributes of the present standard had been tested in the United States and abroad using films of children and youths of all races and several forms of standards. The widely-used radiographic form was chosen.



Contact-size prints of 26 films of the hand and wrist were arranged as a maturity series to illustrate transitional osseous features which appear in the radiographic shadows of each bone during growth. A description of these features and standardized bone ages for males completed each standard plate.



Copies of a Manual containing the standard as used by the NHS film readers, details of its preparation, bone age equivalents for females related to the 26 standard films, and some new examples of use of bone ages will be provided for participants to this evaluation of skeletal age standards for children and youths.

William Walter Greulich

Papers

Radiographic Atlas of Skeletal Development of the Hand and Wrist

A Radiographic standard of reference for the growing hand and wrist

Attributes of the radiographic standard of reference for the National Health Examination Survey