PURPOSE: We assessed the relationships between iron and vitamin D statuses in breastfed infants and their mothers and evaluated the determinants of iron and vitamin D deficiencies in breastfed infants. METHODS: Seventy breastfed infants aged 4-24 months and their mothers participated in this study from February 2012 to May 2013. Complete blood counts, total iron binding capacity, and levels of C-reactive protein, iron, ferritin, calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D (25(OH)D) in infants and their mothers were measured. RESULTS: A history of maternal prepregnancy anemia was associated with lower ferritin and 25(OH)D levels in both infants and their mothers. The 25(OH)D level of infants correlated with maternal 25(OH) D levels. The independent risk factors for iron deficiency in breastfed infants were the duration of breastfeeding (odds ratio [OR], 6.54; 95% confidence interval [CI], 1.09-39.2; P=0.04) and infant body weight (OR, 2.65; 95% CI, 1.07-6.56; P=0.04). The determinants for vitamin D deficiency were the infant's age (OR, 0.15; 95% CI, 0.02-0.97; P=0.046) and maternal 25(OH)D level (OR, 0.74; 95% CI, 0.59-0.92; P=0.01). CONCLUSION: A maternal history of prepregnancy anemia requiring iron therapy was associated with lower current ferritin and 25(OH)D levels in both infants and their mothers. Therefore, physicians should monitor not only iron but also vitamin D levels in infants who are breastfed by mothers who had prepregnancy anemia.
Alkaline Phosphatase ; Anemia ; Anemia, Iron-Deficiency ; Blood Cell Count ; Body Weight ; Breast Feeding ; C-Reactive Protein ; Calcium ; Ferritins ; Humans ; Infant Nutrition Disorders ; Infant* ; Iron* ; Mothers* ; Risk Factors ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

PURPOSE: Pubertal gonadotropin secretion shows circadian pattern and the luteinizing hormone (LH) levels tend to rise in later stages of puberty in girls. We studied the usefulness of basal LH in the evaluation of central precocious puberty with emphasis on the influence of sampling time. METHODS: Medical records of 334 girls that underwent gonadotropin-releasing hormone stimulation test (GnRHST) were reviewed. Auxological and laboratory data were compared between those with early morning (EM, before 10 AM) and late morning/afternoon (LM/A, after 10 AM) basal samples. RESULTS: Among those in sexual maturity rating (SMR) 2, EM samples showed higher basal LH (P=0.004) compare to LM/A samples, whereas those in SMR 3 showed no difference in LH levels between EM and LM/A samples. Among girls with pubertal response, EM group showed higher basal LH (P=0.031) and follicular stimulating hormone (P=0.008) than LM/A group. The EM basal LH was more closely related with the peak stimulated LH than the LM/A basal LH did (rs=0.871 vs. rs=0.524). The optimal basal LH cutoffs to predict a pubertal response to GnRHST were 0.11 IU/L with a sensitivity of 66.7% and a specificity of 78.7% in EM group, and 0.07 IU/L with a sensitivity of 60.0% and a specificity of 78.9% in LM/A group, respectively. CONCLUSION: In girls with early stages of puberty, EM basal LH is a more sensitive screening tool than the LM/A basal LH. Diurnal variation should be considered in evaluating children with precocious puberty.
Adolescent ; Child ; Female* ; Gonadotropin-Releasing Hormone ; Gonadotropins* ; Humans ; Luteinizing Hormone ; Mass Screening ; Medical Records ; Puberty* ; Puberty, Precocious ; Sensitivity and Specificity

PURPOSE: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. METHODS: Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non–HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS: The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P < 0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non–HDL-C (P < 0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non–HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. CONCLUSION: The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.
Adolescent* ; Alanine Transaminase ; Child* ; Cholesterol* ; Dyslipidemias ; Fasting ; Glucose ; Homeostasis ; Humans ; Hypertriglyceridemia ; Insulin ; Insulin Resistance ; Lipoproteins* ; Obesity ; Overweight* ; Prevalence ; Sensitivity and Specificity

Hyperkalemia is often detected in young infants, particularly in association with acute pyelonephritis or a urinary tract anomaly. Cases of hyperkalemia in this population may also be due to transient pseudohypoaldosteronism, or immaturity of renal tubules in handling potassium excretion. Symptoms of hyperkalemia are non-specific, but are predominantly related to skeletal or cardiac muscle dysfunction, and can be fatal. Therefore, treatment has to be initiated immediately. Administration of fludrocortisone for hyperkalemia is appropriate in cases with hypoaldosteronism, but is challenging in young infants with hyperkalemia due to renal tubular immaturity, without pseudohypoaldosteronism. We report the case of a 25-day-old male presenting with persistent hyperkalemia with normal serum aldosterone, who was admitted with a first episode of pyelonephritis and unilateral high-grade vesicoureteral reflux. The patient was treated successfully with fludrocortisone.
Aldosterone* ; Fludrocortisone ; Humans ; Hyperkalemia* ; Hypoaldosteronism ; Infant ; Male ; Myocardium ; Potassium ; Pseudohypoaldosteronism ; Pyelonephritis* ; Urinary Tract ; Vesico-Ureteral Reflux

Purpose: The study was examined to investigate the influence of nurse manager and peer group caring behaviors on organizational socialization and nursing performance Methods: The subjects were 286 clinical nurses from a general hospital in S city. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and hierarchical regression analysis with the SPSS 25.0 program. Nurse manager and peer group caring behaviors, organizational socialization, and nursing performance were measured using organizational climate for caring scale, peer group caring interaction scale, organizational socialization and performance measurement scale for hospital nurses. Results There was no significant difference in organizational socialization between nurse manager and peer group caring behaviors. The significant predictors of nursing performance were position (β=-.26), nurse manager caring behaviors (β=.23), and peer group caring behaviors (β=.17). These variables explained 23% of the variance in nursing performance. Conclusion: The results suggest that it is necessary to increase both manager and peer group caring behaviors in order to improve nursing performance.

The job characteristics and competencies of 285 dietitians in employee foodservices were investigated by worker-oriented job analysis methodology. The purposes of this study were to : a) determine the knowledge, abilities, skills and other characteristics(KASO) needed for dietitians in two types of employee foodservice groups(self-operated vs. contracted), b) categorize KASO items by factor analysis and c) provide job information and job descriptions for dietitians in employee foodservices. The job analysis questionnaire was consisted of questions concerning the 134 KASO items. The questionnaire was mailed to 250 dietitians who are members of The Korean Dietetic Association Practice Group in self-operated foodservices(group A) and 250 dietitians who are employed in contracted foodservice companies(group B). Completed were received from 285 dietitians(121 in self-operated, 164 in contracted) ; with response rate of 57%. Statistical data analysis was completed using the SPSS/win and the SAS/win packages. The results of this study can be summarized as follows. 1) Through factor analysis, the 134 KASO items were regrouped into 6 categories: 'primary dietetic tasks concerning menu management and administrative work regarding merchants', 'primary dietetic tasks concerning procurement and purchasing of food and supplies and meal production and service control', 'primary dietetic tasks concerning facility, sanitation and safety control', 'secondary dietetic tasks concerning nutrition education and research', 'secondary dietetic tasks concerning foodservice operation management' and 'human attributes'. 2) Analysis of the total scores(average scores of degree of frequency, importance and entry requirements of KASO items within 6 categories), group A showed high priorities placed on 'human attributes', 'procurement and purchasing of food and supplies and meal production and service control', 'menu management and administrative work regarding merchants', 'whereas group B showed high priorities placed on 'human attributes', 'foodservice operation management'.
Data Interpretation, Statistical ; Education ; Equipment and Supplies ; Job Description ; Meals ; Nutritionists* ; Postal Service ; Sanitation ; Surveys and Questionnaires

The job characteristics and competencies of 285 dietitians in employee foodservices were investigated by worker-oriented job analysis methodology. The purposes of this study were to : a) determine the knowledge, abilities, skills and other characteristics(KASO, hereafter) needed for dietitians in two types of employee foodservice groups(self-operated vs. contracted) and b) the analysis of the degree of frequency and importance and entry requirements of KASO items listed below : their degree of frequency, the level of importance and their function as entry requirements. The 134 KASO items would be divided into 12 task categories. The questionnaire was mailed to 250 dietitians who are members of The Korean Dietetic Association Practice Group in self-operated foodservices(hereafter group A) and 250 dietitians who are employed in contracted foodservice companies(hereafter group B). Completed were received from 285 dietitians(121 in self-operated, 164 in contracted) ; with a response rate of 57%. Statistical data analysis was completed using the SPSS/win and the SAS/win packages. The results of this study can be summarized as follows. 1) Analysis of the degree of frequency, importance and entry requirements of 134 KASO items in group A showed a high priority(score<4.0) placed on 14 items in relation to dietetic tasks and 9 items in relation to human attributes, whereas in group B 19 items in relation to dietetic tasks and 11 items in relation to human attributes. 2) Comparing responses about the KASO items in the 12 task categories, there was a significant difference between the two sample groups with regard to degree of frequency : group A scored 3.29, group B scored 3.50(p<0.01). With regard to importance of KASO items in 12 task categories, group A scored 3.78 and group B scored 3.88 showing no significant differences. With to entry requirements of KASO items in 12 task categories, group A scored 3.29 and group B scored 3.46 showing a significant difference(p<0.05).
Data Interpretation, Statistical ; Humans ; Nutritionists* ; Postal Service ; Surveys and Questionnaires

Complex chromosome rearrangements (CCRs) are structural chromosomal rearrangements involving at least three chromosomes and more than two breakpoints. CCR carriers are generally phenotypically normal but related to higher risk of recurrent miscarriage and having abnormal offspring with congenital anomalies. However, most of CCR carriers are not aware of their condition until genetic analysis of either abortus or affected baby or parental karyotyping is performed. Herein, we present the case that CCR carrier patients can be identified by preimplantation genetic testing of preimplantation embryos. An infertile male patient with severe oligoasthenoteratozoospermia was diagnosed balanced reciprocal translocation, 46,XY,t(3;11) (p26;p14) at first. After attempting the first preimplantation genetic testing for structural rearrangement (PGT-SR) cycle, we found the recurrent segmental gain or loss on 21q21.3-q22.3 of five out of nine embryos. As a result of karyotype re-analysis, the patient’s karyotype showed a balanced CCR involving chromosomes 3, 11, and 21 with three breakpoints 3p26, 11p14, and 21q21. The patient underwent two PGT-SR cycles, and a pregnancy was established after the transfer of an euploid embryo in the second cycle. Amniocentesis confirmed that the baby carried normal karyotype without mosaicism. At 37 weeks gestation, a healthy girl weighting 3,050 g was born.

PURPOSE: This study was conducted in order to develop morning bread using powdered citrus peels and to examine the effect of its several biological activities for 12 weeks in overweight adults (BMI ≧ 23) living in dormitories of Chonbuk National University. METHODS: Control bread was prepared using the same formula except for replacing the wheat flour with 3% citrus peel powder. Subjects were classified according to two groups: Intake group of 3% citrus peel powder fortified morning bread (n = 30) and general morning bread (n = 30). RESULTS: The results of our study showed no significant effects of citrus peel powdered morning bread on anthropometric indices and biochemical characteristics among overweight adults. Despite the slight reduction in total-cholesterol, LDL-cholesterol, GOT, and GPT (p < 0.05), no significant differences in changes of these values were observed between the two groups. CONCLUSION: The short duration of our intervention might have resulted in the lack of any significant effect. Therefore, conduct of further studies with longer duration is warranted in order that the results from this study can be utilized as a basis for the development of food products with citrus peel powder.
Adult ; Bread* ; Breakfast ; Citrus* ; Coronary Artery Disease ; Flour ; Humans* ; Jeollabuk-do ; Overweight ; Powders* ; Triticum

Primary pulmonary hypertension is a condition characterized by sustained elevations of pulmonary artery pressure without demonstrable cause. It is incurable and progressive clinical entity. The incidence has been estimated at approximately 1 to 2 cases per million people in the general population. The maternal mortality of primary pulonary hypertension in pregnancy was said to be 30% and the first month after delivery represents the period of highest risk. We experienced a 27-year-old women with primary pulmonary hypertension diagnosed in postpartum period. She was transferred from the department of obstetrics to internal medicine due to dyspnea on the first day of postpartum. She was diagnosed by perfusion lung scan, chest CT and confirmed by echocardiography. This diagnosis were supported by findings of pulmonary angiogram and cardiac catheterization. Initially she was treated with diuretics, aspirin and anticoagulant therapy, and as a result of the treatment, her symptoms improved. However after 8months has elapsed, exertional dyspnea was worsening. Thus she was treated with calcium channel blocker, aspirin and diuretics and was followed at 1 month interval on the outpatient clinics.
Adult ; Ambulatory Care Facilities ; Aspirin ; Calcium Channels ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Diuretics ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Incidence ; Internal Medicine ; Lung ; Maternal Mortality ; Obstetrics ; Perfusion ; Postpartum Period* ; Pregnancy ; Pulmonary Artery ; Tomography, X-Ray Computed