PURPOSE: During the recent decades, the age at menarche continued to decline in Korea and worldwide. Prior studies have suggested that early menarche may increase the risk of various social, psychological, and physical health problems in young adolescent girls, but little is known about the determinants associated with early menarche. The purpose of this study is to evaluate independent determinants of early menarche among 5th~6th female graders in South Korea. METHODS: Our analysis was conducted in 95 menarcheal girls and 95 age-matched pre-menarcheal girls residing in Daegu, South Korea. Demographic and lifestyle characteristics were collected using survey questionnaires for children and parents. Dietary information was assessed by 2 day~24 hour food records and survey questionnaires, which were completed by both children and their parents. Anthropometric data were obtained from the student health check-ups at the school. RESULTS: A multiple logistic regression analysis using a conditional likelihood method was performed for simultaneous evaluation of several risk factors. There were significant differences in that higher proportion of obesity (OR, odds ratio = 5.60, 95% CI, confidence interval = 1.34~23.42), shorter sleep duration (OR = 0.45, 95% CI = 0.23~0.87), and younger mother's age at menarche (OR = 0.64, 95% CI = 0.44~0.93) were observed in the menarcheal group compared to the premenarcheal group. CONCLUSION: These findings indicate a possible association of sleep duration, mother's menarcheal age, and obesity with age at menarche. A well-planned, prospective cohort study is warranted to examine causal relationship.
Adolescent ; Child ; Cohort Studies ; Daegu ; Female ; Female* ; Humans ; Korea ; Life Style ; Logistic Models ; Menarche* ; Obesity ; Odds Ratio ; Parents ; Prospective Studies ; Puberty ; Risk Factors

A case of left temporal gliosarcoma is reported. The patient was a 40-year old man who had headache, behavior change, dysphasia, and mental confusion for about 2 months duration. On brain CT, a large partially cystic mass with homogeneous enhancement was located at left temporal lobe and associated with remarkable peritumoral edema and mass effect. Angiographic tumor vascularity was faintly visualized. Surgical subtotal resection of the tumor and post-operative radiotherapy offered transient symptomatic improvement, being followed within several months by clinical deterioration and regrowth of the tumor on brain CT. Light microscopic studies of the H & E and special stained specimens showed two different components within the tumor in a mixed fashion, i.e. intermingled glioblastoma multiforme and fibrosarcoma. Electron microscopic study of the sarcomatous cells disclosed intracytoplasmic Weibel-Palade-like bodies, a specific marker of endothelial cells. The fibrosarcomatous component of gliosarcoma is believed to be originated from malignant transformation of the hyperplastic endothelial cells within the anaplastic glioma. Literature concerned with gliosarcoma is reviewed.
Adult ; Aphasia ; Brain ; Edema ; Endothelial Cells ; Fibrosarcoma ; Glioblastoma ; Glioma ; Gliosarcoma* ; Headache ; Humans ; Radiotherapy ; Temporal Lobe

PURPOSE: In some patients with velopharyngeal insufficiency(VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure(CPAP) is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. METHODS: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation, nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during follow- up of more than a year after CPAP therapy. RESULTS: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. CONCLUSION: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy, but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.
Endoscopy ; Follow-Up Studies ; Humans ; Velopharyngeal Insufficiency

PURPOSE: The purpose of study was to identify how patients experienced chemotherapy-induced peripheral neuropathy (CIPN) and quality of life related to CIPN. METHODS: This was a descriptive research. We collected data from 105 patients with chemotherapy-induced peripheral neuropathy. They completed a self-reported questionnaire including Eastern Cooperative Oncology Group (EORTC) CIPN20 and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. RESULTS: In the study, duration of peripheral neuropathy was 9.4 month and 54.3% of patients used pharmacological or non-pharmacological interventions. Patients reported the highest score for sensory scale and it's score was 38.74+/-20.24. The scores for motor scale and autonomic scale were 21.95+/-19.19 and 26.61+/-21.0 respectively. This showed that patients more suffered from sensory neuropathy than any other domain of neuropathy. The most frequently selected two items were 'did you have tingling fingers or hands?' and 'did you have tingling toes or feet?'. CONCLUSION: The results of this study will provide useful information for chemotherapy-induced peripheral neuropathy.
Fingers ; Humans ; Peripheral Nervous System Diseases ; Quality of Life ; Surveys and Questionnaires ; Research Personnel ; Toes

PURPOSE: The purposes of this study were to identify job definition, duties and tasks of Korean oncology Advanced Practice Nurses (APNs) and assess frequency, importance, and difficulty for each of duty and task using the DACUM method. METHODS: The DACUM committee was organized with nine oncology APNs. The committee documented the job definition, duties and tasks based on their daily job descriptions. Validity of the elicited duties and tasks was tested by a study team and 6 oncology APNs. Data were collected using a questionnaire survey from 53 oncology APNs. RESULTS: The job description of oncology APNs was identified 12 duties and 66 tasks. Among the twelve duties, 'education for patients/ families' was the most frequently performed and was the most important duty. 'Case management' was the most difficult duty. Among 66 tasks, 'providing education for patients/families' was most frequently performed. 'Providing education for patients/families' and 'assessing patient condition comprehensively' were the most important tasks. 'Implementation research' as the principal investigator was perceived as the most difficult task. CONCLUSION: In this study, Korean oncology APNs' job performances were identified and analyzed. It is recommended that job description for oncology APNs needs to be standardized and reshaped in advanced way in future.
Humans ; Job Description ; Surveys and Questionnaires ; Research Personnel

PURPOSE: Kabuki syndrome is a multiple malformation syndrome that was first reported in Japan. It is characterized by distinctive Kabuki-like facial features, skeletal anomalies, dermatoglyphic abnormalities, short stature, and mental retardation. We report two cases of Kabuki syndrome with the surgical intervention and speech evaluation. METHODS: Both patients had velopharyngeal insufficiency and had a superior based pharyngeal flap operation. The preoperative and postoperative speech evaluations were performed by a speech language pathologist. RESULTS: In case 1, hypernasality was reduced in spontaneous speech, and the nasalance scores in syllable repetitions were reduced to be within normal ranges. In case 2, hypernasality in spontaneous speech was reduced from severe level to moderate level and the nasalance scores in syllable repetitions were also reduced to be within normal ranges. CONCLUSION: The goal of this article is to raise awareness among plastic surgeons who may encounter such patients with unique facial features. This study shows that pharyngeal flap operation can successfully correct the velopharyngeal insufficiency in Kabuki syndrome and post operative speech therapy plays a role in reinforcing surgical result.
Abnormalities, Multiple ; Dermatoglyphics ; Face ; Hematologic Diseases ; Humans ; Intellectual Disability ; Japan ; Reference Values ; Speech Therapy ; Velopharyngeal Insufficiency ; Vestibular Diseases

Purpose: This study compared clinical and radiologic differences between cystic biliary atresia (cBA) and choledochal cyst (CC) type Ia/b. Methods: Infants (≤12 months old) who were diagnosed with cBA or CC type Ia/b from 2005 to 2019 were retrospectively reviewed. Imaging features on preoperative ultrasonography (US) and magnetic resonance imaging (MRI) were compared between the cBA and CC groups. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were performed for the diagnosis of cBA. Changes in cyst size were also evaluated when prenatal US exams were available. Results: Ten patients (5.5% of biliary atresia cases) with cBA (median age, 48 days) and 11 infants with CC type Ia/b (Ia:Ib=10:1; median age, 20 days) were included. Triangular cord thickness on US (cutoff, 4 mm) showed 100% sensitivity and 90.9% specificity (AUC, 0.964; 95% confidence interval [CI], 0.779 to 1.000) and cyst size on MRI (cutoff, 2.2 cm) had 70% sensitivity and 100% specificity (AUC, 0.900; 95% CI, 0.690 to 0.987) for diagnosing cBA. Gallbladder mucosal irregularity on US and an invisible distal common bile duct on MRI were only seen in the cBA group (10 of 10). Only the CC group showed prenatal cysts exceeding 1 cm with postnatal enlargement. Conclusion Small cyst size (<1 cm) on prenatal US, triangular cord thickening (≥4 mm) and gallbladder mucosal irregularity on postnatal US, and small cyst size (≤2.2 cm) and an invisible distal common bile duct on MRI can discriminate cBA from CC type Ia/b in infancy.

PURPOSE: This study was conducted to determine the accuracy of ultrasonography (US) in the detection of a traumatic pneumothorax. METHODS: We prospectively evaluated thoracic US for the detection of a pneumothorax in blunt thoracic trauma patients. The presence of "lung sliding"and "comet tail" artifacts were determined in patients by using ultrasound before radiologic verification of a pneumothorax by residents and attending physicians of the emergency department who had been instructed in thoracic ultrasound. Finally, the diagnosis of a pneumothorax was confirmed by using chest computed tomography (CT). RESULTS: Forty nine patients were enrolled in this study. Twenty-five of the 49 patients had a pneumothorax at chest CT, and for 24 patients, the pneumothoraces had been detected at thoracic US and for 13 patients, they were seen at supine chest radiography. The sensitivity and the specificity of US were 96% and 92%, relatively the positive predictive value was 92%, and the negative predictive value was 96%. The sign of disappearance of "lung sliding" had a sensitivity and negative predictive value of 100% and a specificity of 88% for the diagnosis of a pneumothorax. The absence sign of a "comet tail"artifact had a specificity and positive predictive value of 100%, and a sensitivity of 95% for the diagnosis of a pneumothorax. CONCLUSION: In this study, US was more sensitive than supine chest AP view in the detection of a traumatic pneumothorax. Thoracic US is a reliable method for the detection of a pneumothorax and should be added to the currently performed FAST examination in trauma cases.
Artifacts ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Humans ; Pneumothorax* ; Prospective Studies ; Radiography ; Sensitivity and Specificity ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography*

BACKGROUND: Production of neuronal progenitors is usually stimulated in the forebrain subventricular zone of mice after the intracerebroventricular infusion of prolactin. As a preliminary study, we infused prolactin to the male rat brain to test the hypothesis that prolactin promotes new cell proliferation in the brain and functional recovery after focal ischemia. METHODS: Male rats were subjected to intraluminal middle cerebral artery occlusion. Prolactin was administered to the surface of the brain for 5 or 14 days starting 24 or 48 hours after stroke onset at doses of 6.4 microgram per day. We administered the same volume of saline to the other ischemic rats used as a control group. Some rats were killed 6 or 17 days after stroke for analysis of infarct volume and newly generated cells within the subventricular zone and the striatum. The other rats were tested for neurological recovery 24 days after stroke. RESULTS: There was no significant difference of infarct volume among the experiment groups. Treatment with prolactin did not increase the numbers of bromodeoxyuridine-immunoreactive cells in the subventricular zone and the striatum. Treatment with prolactin did not enhance neurological recovery in all tests performed. CONCLUSIONS: In this preliminary study, prolactin did not enhance new cell generation in the male rat brain nor reduce the neurological deficits after ischemic stroke.
Adult* ; Animals ; Brain Ischemia* ; Brain* ; Cell Proliferation ; Humans ; Infarction, Middle Cerebral Artery ; Infusions, Intraventricular ; Ischemia ; Male* ; Mice ; Neurons ; Prolactin ; Prosencephalon ; Rats* ; Stem Cells ; Stroke

PURPOSE: Advances in the treatment of congenital heart disease and a decline in the incidence of rheumatic fever has led to changes in the causative organisms and the clinical outcome of infective endocarditis(IE). We sought to analyze the clinical outcome, prognostic factors, causative organisms and corresponding antibiotic sensitivity in IE. METHODS: Retrospective analysis of medical records of 104 children diagnosed and treated with IE at Severance Hospital, Yonsei University College of Medicine from January 1986 to June 2003 was undertaken. According to the Duke criteria, 55 patients were classified into the definite group(DG) and possible group(PG). RESULTS: Thirty one cases(56.4%) fulfilled the criteria for the definite group in the Duke criteria, whereas 24 cases(43.6%) fulfilled the criteria for the possible group. The most common chief complaint on admission was fever(93%). The most common infecting organism was Staphylococcus aureus, which was found in 14 cases(48.3%). Three cases(21.4%) of this organism were methicillin- resistant S. aureus(MRSA). Other causative organisms were alpha-streptococcus(seven cases, 24.1%), Staphylococcus epidermidis(three cases, 10.3%), Citrobacter freundii(one case, 3.8%), Enterococcus faecium(one case, 3.4%) and Candida albicans(three cases, 10.3%). Penicillin-resistant organisms were found in 90.5%(19/21) of total cases and the most sensitive antibiotics were vancomycin(13/13, 100 %) and teicoplanin(12/12, 100%). One case of IE due to MRSA unresponsive to vancomycin was treated with Arbekacin. CONCLUSION: The incidence of IE caused by S. aureus, especially MRSA, is increasing. Multi-drug resistant organisms are also emerging as a frequent cause of IE. Thus, in patients strongly suspected of having IE in patients with underlying heart disease, glycopeptides such as vancomycin combined with aminoglycosides should be considered, and if fever and positive blood cultures continue despite treatment with glycopeptides, a consideration of the use of new antibiotics may improve the treatment results.
Aminoglycosides ; Anti-Bacterial Agents ; Candida ; Child ; Citrobacter ; Endocarditis* ; Enterococcus ; Fever ; Glycopeptides ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Incidence ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Rheumatic Fever ; Staphylococcus ; Staphylococcus aureus ; Vancomycin