Puberty is a complex and coordinated biologic process of sexual development that leads to complete gonadal maturation and function, and attainment of reproductive capacity. The pubertal activation of pulsatile gonadotropin-releasing hormone (GnRH) secretion requires coordinated changes in excitatory and inhibitory neurotransmitters, growth factors, and a group of transcriptional regulators. Kisspeptin and its putative receptor, G protein-54 signaling complex, have recently emerged as essential gatekeepers of GnRH activation. Precocious puberty is defined as the onset of secondary sexual characteristics before the age of 8 years for girls and 9 years for boys. The prevalence of precocious puberty is rapidly increasing in Korea. Factors affecting early puberty include genetic traits, nutrition, and exposure to endocrine disrupting chemicals. Precocious puberty may cause psychosocial problems with inappropriate early biological maturation and significant impairment of final height due to accelerated bone maturation. In rapidly progressing central precocious puberty, GnRH agonists appear to increase final height without significant side effects, if administered in the early stages. Further large-scale randomized controlled studies of the long-term safety and efficacy of GnRH agonist treatment are needed.
Adolescent ; Endocrine Disruptors ; Female ; Gonadotropin-Releasing Hormone ; Gonads ; Humans ; Intercellular Signaling Peptides and Proteins ; Korea ; Neurotransmitter Agents ; Prevalence ; Puberty ; Puberty, Precocious* ; Sexual Development

After the enactment of the laws for special medical devices, quality assurance for medical imaging devices such as computed tomography, magnetic resonance imaging, and mammography has been widely performed in Korea and the results of quality assurance tests for these imaging devices also have been markedly improved. However, this is not the end. The ultimate goal of quality assurance for medical imaging might be the overall quality improvement over the whole process of imaging studies in medical fields. From this point of view, quality assurance of medical imaging has a long way to go. In this review, we will look some future perspectives of the quality assurance of medical imaging.
Diagnostic Imaging* ; Jurisprudence ; Korea ; Magnetic Resonance Imaging ; Mammography ; Quality Improvement ; Ultrasonography

The purpose of health screening is to reduce disease-related mortality and related medical costs through the early detection and treatment of specific diseases. However, if the quality of public health screening is poor, it not only fails to achieve the purpose of screening, but may also increase the demand for expensive individual opportunistic health examinations. To prevent these adverse situations, the Basic Act for Health Screening was established in 2010, and quality assessment of medical institutions for cancer screening has been performed from 2008. Radiologists have an integral role in radiologic examinations for screening; thus the Korean Society for Radiology has made a substantial effort to participate in quality control and improvement of the imaging quality for public health screening.
Diagnostic Imaging* ; Early Detection of Cancer ; Mammography ; Mass Screening* ; Mortality ; Public Health* ; Quality Control ; Ultrasonography

Imaging modalities have developed in tandem with technical developments in recent years. It is common practice worldwide to establish a medical imaging quality control system in accordance with resources and need. In2003, the Korean governmentinstituted a medical imaging quality control system for high-priced and high-end medical imaging equipment. Magnetic resonance imaging (MRI), computed tomography (CT), and mammography were included in this program. General image quality has continuously improved, but some problems remain. The medical imaging quality control program will be extended to other equipment such as positron emission tomography-CT, simulation CT for radiation treatment, and extracorporeal shockwave lithotripsy. Education programs for equipment control personnel should be improved and the quality control system should be refined.
Diagnostic Imaging* ; Education ; Electrons ; Korea* ; Lithotripsy ; Magnetic Resonance Imaging ; Mammography ; Quality Control ; Technology, Radiologic

The quality management processes used by industrial companies have become commonplace in the healthcare system and are proving successful in improving quality and controlling costs. The total quality management system is important for safe and efficiently run medical imaging. Quality management includes quality control, quality assurance, and continuous quality improvement in all aspects of medical imaging to improve the quality of healthcare. For quality improvement of medical imaging, medical imaging accreditation programs are being systematically implemented in many countries including Korea. Quality management in the medical imaging process will be effective within a system of cooperation among stakeholders and professionals. In this review, I describe the concept and basic definition of quality management in medical imaging and introduce quality management programs from countries outside Korea.
Accreditation ; Delivery of Health Care ; Diagnostic Imaging* ; Korea ; Quality Assurance, Health Care ; Quality Control ; Quality Improvement ; Quality of Health Care ; Total Quality Management

No abstract available.
Diagnostic Imaging*

Health equity implies the absence of unjust and preventable differences in health among groups of people. The Korean government has been promoting health equity policies by setting National Health Plan objectives for improving health equity, along with specific programs to achieve the targets by 2020. As shown by a World Health Organization commission, tackling the social determinants of health is essential to making progress in health equity. So far, there appear to be some hopeful trends in Korea toward a reduction in the social disparity in healthy life years according to the evaluation of National Health Plan 2020. Further effort is needed to continue measuring the problems and evaluating the associated actions, as well as strengthening policies and programs to overcome the weaknesses in the ability of the National Health Plan 2020 to improve health equity.
Hope ; Korea ; Social Determinants of Health ; World Health Organization

In March 2011, after a series of discussions, the Korean government released a basic plan for functional reestablishment of medical institutions. However, the policy has ended up reestablishing the functions and roles of medical institutions without considering the advance of medical technologies and the emergence of new forms of providers. The advances of the medical knowledge and technologies enable the provision of lower-cost, higher-quality, more accessible healthcare services. Therefore, the reestablishment of medical institutions' functions needs to be done on the basis of medical technology advancement. In this article, policy suggestions and managerial implications for healthcare service providers are discussed based on disruptive innovation. It is expected to contribute to the discussions on the healthcare delivery system of Korea.
Delivery of Health Care ; Korea

Application of iodinated radiographic contrast media (RCM) has increased recently because of the number of computed tomography examinations using RCM is increasing rapidly. The awareness regarding potential adverse reactions due to contrast media and the necessary precautions to be taken is of utmost importance both for radiologists and referring physicians since the adverse reactions including hypersensitivity reactions to RCM are still unpredictable and reported in significantly increasing number among exposed patients year by year. In 2011, Korean guideline for the safe use of RCM was published by the Korean Society of Radiology and Korean Academy of Asthma, Allergy and Clinical Immunology. On behalf of these organizations a committee named Korean Network of Allergists & Radiologists for Research of Radio-contrast Media-associated Adverse Reactions (KOAR3A) was formed and collaborated to develop guidelines. Its major purpose is to provide a clinically practical and evidence-based manual full of useful information regarding patient screening, premedication, recognition of adverse reactions, and emergency treatment of such reactions in daily practice as well as other problems, especially kidney toxicity and endocrine problems in consultation with the corresponding medical specialists.
Asthma ; Contrast Media ; Drug Toxicity ; Emergency Treatment ; Humans ; Hypersensitivity ; Injections, Intravenous ; Kidney ; Mass Screening ; Premedication ; Specialization

Failure to thrive (FTT) is a term used to describe growth failure in infants and toddlers. The three categories of FTT are based on anthropometric measurements of weight, length, and head circumference for age. Type 1 FTT is the failure to gain weight due mainly to inadequate nutrition. Type 2 FTT is a clinical condition associated with short stature induced by endocrine or genetic factors. Type 3 FTT results from chromosome anomalies or central nervous system abnormalities. Pediatric endocrinologists may be involved in treating patients with short stature of type 2 FTT. Pediatric gastroenterologists may be interested in patients with malnutrition of type 1 FTT, and pediatric psychologists may play a major roll in treating those with non-organic FTT or feeding disorders. This review introduces a new paradigm of clinical approaches to FTT in infants and toddlers to emphasize the importance of multidisciplinary clinical approaches to FTT.
Central Nervous System ; Failure to Thrive ; Head ; Humans ; Infant ; Malnutrition