PURPOSE: The determination of skeletal age is important for the analysis of growth and growth disorders in children. The aim of this study is to investigate the difference of bone age comparing Greulich-Pyle (GP) and Tanner Whitehouse (TW3) methods. We also evaluated the reproducibility of results of each method by different observers (interobserver variation) and by same observer (intraobserver variation). METHODS: Bone ages were assessed from left hand-wrist radiographs of 200 children (108 males and 92 females) aged 7 to 15 years by GP and TW3 methods. To evaluate the reproducibility of each method, 102 radiographs were assessed independently by three observers and 100 radiographs were reassessed by one same observer using both methods. RESULTS: The average bone age by GP and TW3 were 10.65+/-2.24 years and 10.48+/-2.18 years, respectively (P<0.01). There is significant correlation between GP and TW3 methods (R(2)=0.94, P<0.01). The interobserver variation of GP and TW3 was not different significantly (0.51+/-0.44 years by GP vs 0.54+/-0.42 years by TW3). The intraobserver variation also was not different significantly (0.48+/-0.44 years by GP vs 0.45+/-0.37 years by TW3). CONCLUSION: Our data indicate that bone age by TW3 method was slightly younger than that by GP method but similar, and the reproducibility of both methods were not different. Therefore, both GP and TW3 methods are useful for estimation of bone age in Korea children.
Age Determination by Skeleton ; Aged ; Child ; Growth Disorders ; Humans ; Korea ; Male ; Observer Variation ; Reproducibility of Results

PURPOSE: Because NELL2 expression is strictly restricted only in neurons in developing and post- differentiated neural tissues, it is thought to be involved in the neuronal differentiation during development and in the maintenance of neuronal physiology in the post-differentiated neurons. In this study, we examined whether NELL2 is involved in the regulation of cell cycle and apoptosis in the hippocampal neuroprogenitor HiB5 cells. METHODS: Effects of NELL2 on the cultured HiB5 cell numbers, DNA fragmentation, and proteins involved in the regulation of the cell cycle were measured. RESULTS: NELL2 induced a decrease in cell numbers and an increase in G1 phase arrest. Moreover, transfection of NELL2 resulted in an increase of DNA fragmentation that shows an evidence of apoptosis. Contents of proteins involved in the regulation of cell cycle were also changed by transfection of NELL2 expression vectors. CONCLUSION: This study suggests that NELL2 plays an important role in the regulation of cell cycle and apoptosis of neurons.
Apoptosis ; Cell Count ; Cell Cycle* ; DNA Fragmentation ; G1 Phase ; Neurons* ; Physiology ; Transfection

BACKGROUND: The aim of this study was to investigate annual changes in pulmonary function in workers who were exposed to inorganic dust. METHODS: The subjects were 2,922 male patients who had been diagnosed with pneumoconiosis more than twice during 6 years from 2005 to 2010. RESULTS: Of the 2,922 cases, forced vital capacity (FVC) decreased by 54 mL in 1 year. In contrast, the annual change of forced expiratory volume in one second (FEV1) decreased by 56 mL. CONCLUSION: This is the first study that has investigated the annual change in pulmonary function in workers exposed to inorganic dust. The results will help estimate the pulmonary condition of patients who are unable to perform a pulmonary function test due to age or a disorder.
Dust ; Forced Expiratory Volume ; Humans ; Lung ; Male ; Pneumoconiosis ; Respiratory Function Tests ; Vital Capacity

PURPOSE: Adolescence is a period of growth and development in body structure and physiologic, psychologic, and social functioning. Smoking and drinking in this period are very harmful and may lead to other forms of substance abuse. We surveyed the actual aspects of smoking and drinking among Korean adolescents and analyzed associated factors. METHODS: A survey was performed among adolescents using a questionnaire about smoking and drinking. Data were collected from students who visited pediatric clinics for routine school examinations from July to November 2007. RESULTS: A total of 2,546 adolescents (smoking 1,512; drinking 1,034) participated in the study. The overall smoking and drinking rates were 29.2% and 48.2%, respectively, and the mean age at the first instance of smoking and drinking was 13.8 and 14.1 years, respectively. Among drinking adolescents, 30.1% were offered a drink by their parents, although most adolescents were encouraged to smoke or drink by their friends. Dissatisfaction with family and school life, economic status, and school performance was associated with a higher smoking and drinking rate (P<0.001). Broken families were associated with a high rate of smoking, but peer satisfaction was not related to smoking or drinking. The frequency and amount of smoking and drinking in adolescents were as high as those in adults. Social sanctions seemed insufficient to keep adolescents from smoking and drinking. CONCLUSION: Adolescent smoking and drinking are highly influenced by family and school environments, so more active social sanctions are required, including parental involvement and legislation preventing adolescents from smoking and drinking.
Adolescent ; Adult ; Alcohol Drinking ; Drinking ; Friends ; Growth and Development ; Humans ; Korea ; Parents ; Surveys and Questionnaires ; Smoke ; Smoking ; Substance-Related Disorders

PURPOSE: Gonadotropin-releasing hormone agonist (GnRHa) is known for improving final adult height in patients with central precocious puberty (CPP). This study aimed to investigate the age of menarche and near adult height in girls with CPP who had been treated with GnRHa. METHODS: In this retrospective study, we reviewed the medical records of 71 Korean girls with CPP who had started menarche or reached over 13 years of bone age after long-term GnRHa treatment. We estimated near adult height using the Bayley-Pinneau method and identified the age of menarche in girls with CPP. RESULTS: Mean chronological and bone age at menarche were 11.9+/-0.7 and 12.8+/-0.4 years, respectively. The period between menarche and the end of treatment was 14.0+/-5.6 months. Posttreatment near adult height was 163.8+/-4.7 cm, which was significantly greater than pretreatment predicted adult height (158.7+/-4.1 cm). CONCLUSION: GnRHa treatment in girls with CPP could improve final adult height and made the age of menarche close to that of the general population.
Adult* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Medical Records ; Menarche* ; Puberty, Precocious* ; Retrospective Studies

PURPOSE: In the pediatric population, Rathke's cleft cysts (RCCs) are known to be an infrequent cause of headaches, visual disturbances, and pituitary dysfunction. We investigated the clinical characteristics of children in whom RCCs were incidentally discovered and evaluated whether RCCs influence the treatment response of patients with proven endocrinopathy. METHODS: A retrospective analysis was conducted in 34 patients with RCCs who were diagnosed between 2006 and 2013 at Hallym University Medical Center. Their clinical, hormonal, and imaging findings were reviewed. We evaluated the clinical outcomes of the patients with concomitant RCCs and endocrinopathy compared to matched controls. RESULTS: Twenty-six of 34 patients with radiologically proven RCCs had endocrine disorders. They were 9 boys and 17 girls, with ages ranging from 4.8 to 17.4 years at the time of the diagnosis. Of these, 7 (27%) had idiopathic short stature, 7 (27%) had growth hormone deficiency (GHD), and 12 (46%) had central precocious puberty (CPP). Nineteen of 26 patients (73.1%) showed low signal intensities on T1-weighted images (T1WI) and high signal intensities on T2-weighted images. The incidence of hypointensity on T1WI was higher in the patients with RCCs accompanied by endocrinopathy than in those without endocrinopathy (P=0.033). The treatment outcomes of the patients with CPP and GHD with and without RCCs were similar. CONCLUSION: CPP and GHD patients with a small RCC (less than 20 mm) expressing cystic magnetic resonance intensity can be managed with medical treatment, although the RCCs need to be closely monitored in radiological studies to observe their growth.
Academic Medical Centers ; Adolescent* ; Central Nervous System Cysts* ; Child* ; Diagnosis ; Dwarfism, Pituitary ; Female ; Growth Hormone ; Headache ; Humans ; Incidence ; Puberty, Precocious ; Retrospective Studies

Purpose: Although Mycoplasma pneumoniae (M. pneumoniae) infection can cause wheezing in non-asthmatic children, the mechanisms of this symptom remain unclear. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability, and is also known to be elevated in cases of chronic pulmonary disease such as asthma. We hypothesized that VEGF may increase in children with acute M. pneumoniae pneumonia and wheezing. Methods: Nine patients with clinical and laboratory evidence of acute M. pneumoniae pneumonia were enlisted from children admitted to Korea University Hospital. They had had more than one episode of wheezing during the illness, which was confirmed by a physician; they comprised the wheezer group. The individuals with M. pneumoniae pneumonia without wheezing were 63 in number, and they comprised the non-wheezer group. Patients with a history of asthma or who had received asthma medications were excluded. Serum concentrations of VEGF, total IgE, eosinophil cationic protein (ECP), and peripheral blood eosinophil counts were measured. Results: The serum VEGF concentrations were higher in the wheezer group (mean+/-SD; 650.2+/-417.9 pg/mL) than in the non-wheezer group (376.5+/-356.2 pg/mL, P=0.049). M. pneumoniae antibody (1:1,380 vs. 1:596, P=0.048) and serum total IgE (591.8 IU/mL vs. 162.2 IU/mL, P=0.032) were higher in the wheezer group than in the non-wheezer group. There were no differences between the two groups in terms of serum ECP concentration or blood eosinophil count. Conclusion: In the presence of wheezing, serum VEGF concentrations were higher in the children with M. pneumoniae pneumonia. This finding suggests that VEGF may associate with wheeze-related symptoms in children with acute M. pneumoniae pneumonia.
Asthma ; Capillary Permeability ; Child ; Eosinophil Cationic Protein ; Eosinophils ; Humans ; Immunoglobulin E ; Korea ; Lung Diseases ; Mycoplasma ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Sounds ; Vascular Endothelial Growth Factor A

The timing of puberty onset varies greatly among individuals, and much of this variation is modulated by genetic factors. This study aimed to identify the kisspeptin receptor (KISS1R) gene variations and to investigate the associations between these variations and central precocious puberty (CPP). Korean girls with CPP (n = 194) and their healthy controls (n = 99) were included in this study. The entire coding region and the exon-intron boundaries (exon 1 through 5) of the KISS1R gene were directly sequenced. Seven polymorphisms were identified in the KISS1R gene. A missense change c.1091T>A, and an intron variant c.738+64G>T showed significantly higher allele frequencies in CPP patients than in controls (c.1091T>A: 30.7% vs. 22.2%, P = 0.031; c.738+64G>T: 45.6% vs. 35.9%, P = 0.023). The missense variant (c.1091T>A) was a nonsynonymous polymorphism that induces amino acid substitution of p.Leu364His. The haplotype CAGTGTC was detected more frequently in the CPP group (P = 0.042). The sequence variants of the KISS1R gene can be inducible factors in the development of CPP. The association between sequence variants and CPP should be validated by further evidence obtained from larger samples of children with CPP.
Adolescent ; Amino Acid Substitution ; Child ; Clinical Coding ; Female* ; Gene Frequency ; Genetic Variation* ; Haplotypes ; Humans ; Introns ; Puberty ; Puberty, Precocious*

Exposure to endocrine disrupting chemicals (EDCs), particularly during developmental periods, gives rise to a variety of adverse health outcomes. Bisphenol A (BPA) is a well-known EDC commonly found in plastic products including food and water containers, baby bottles, and metal can linings. This study investigates infant exposure to BPA and the effect of bottle-feeding on serum BPA levels in infants. Serum BPA levels in normal healthy infants 6 to 15 months of age (n=60) were evaluated by a competitive ELISA. BPA was detected in every study sample. Serum BPA levels of bottle-fed infants (n=30) were significantly higher than those of breast-fed infants (n=30) (96.58+/-102.36 vs 45.53+/-34.05 pg/mL, P=0.014). There were no significant differences in serum BPA levels between boys (n=31) and girls (n=29). No significant correlations were found between serum BPA levels and age, body weight, birth weight, and gestational age. Bottle-feeding seems to increase the risk of infant exposure to BPA. Establishment of health policies to reduce or prevent BPA exposure in infants is necessary.
Benzhydryl Compounds/*blood ; Birth Weight ; Body Weight ; Bottle Feeding ; Endocrine Disruptors/*blood ; Environmental Exposure ; Female ; Humans ; Infant ; Male ; Phenols/*blood

Kawasaki disease (KD) can cause acquired heart disease and systemic vasculitis in children. It is treated with intravenous immunoglobulin (IVIG). A significant complication is development of coronary artery lesions such as dilatations or aneurysms. However, uncommon complications can occur, like autoimmune hemolytic anemia when IVIG is used. We present a case of autoimmune hemolytic anemia associated with KD. Dilatation of right coronary artery was found at echocardiography and he was treated twice with IVIG (2 g/kg) with interval of 48 hours. Laboratory finding showed hemoglobin 7.1 g/dL, hematocrit 20.8%, corrected reticulocyte 5.86%, total bilirubin 0.29 mg/dL, lactate dehydrogenase 425 IU/L, and haptoglobin 5 mg/dL. Normocytic, normochromic anemia with anisopoikilocytosis was found on peripheral blood smear, and direct antiglobulin test was positive. The patient was started on oral prednisolone for 3 weeks, with which all symptoms resolved. We report this rare case, prompting consideration of IVIG associated complications when treating KD.
Anemia ; Anemia, Hemolytic, Autoimmune ; Aneurysm ; Bilirubin ; Child ; Coombs Test ; Coronary Vessels ; Dilatation ; Echocardiography ; Haptoglobins ; Heart Diseases ; Hematocrit ; Humans ; Immunization, Passive ; Immunoglobulins ; Immunoglobulins, Intravenous ; L-Lactate Dehydrogenase ; Mucocutaneous Lymph Node Syndrome ; Prednisolone ; Reticulocytes ; Systemic Vasculitis