No abstract available.

PURPOSE: To provide accurate information on induced labor and find strategies to enhance women's childbirth satisfaction. METHODS: Participants were pregnant women expected to have normal vaginal delivery. A total of 113 women with induced labor and 61 women with spontaneous labor were surveyed. Data were collected using a questionnaire and electronic medical records. RESULTS: The following variables related to labor progress showed significant differences between the induced labor group and the spontaneous labor group: length of the first stage of labor in primigravidas, use of analgesic, incidence of uterine hyperstimulation, incidence of fetal distress, and medical treatment for the expectant mother. Delivery type and the incidence of postpartum complications showed significant difference between the two groups. Induced labor women's childbirth satisfaction was mainly affected by the process of labor whereas spontaneous labor women's childbirth satisfaction was affected by the outcome of childbirth. CONCLUSION: Medical staff should have accurate information on the risk of induced labor and the benefits of a natural delivery. Moreover, medical staff should provide necessary information and environment for women to participate in the decision-making process.
Electronic Health Records ; Female ; Fetal Distress ; Humans ; Incidence ; Labor, Induced ; Medical Staff ; Mothers ; Parturition* ; Postpartum Period ; Pregnancy ; Pregnant Women

Purpose: The effects of circadian blood pressure (BP) alterations on the development and progression of microvascular complications in type 1 diabetes mellitus (T1DM) patients are unknown. We evaluated the effects of circadian BP alterations with development of microvascular complications during follow-up with patients with childhood-onset T1DM. Methods: We investigated the medical records of 81 pediatric patients with T1DM who underwent 24-hour ambulatory BP monitoring (ABPM) between January 2009 and February 2010. Results: Mean age at diagnosis and ABPM evaluation was 8.0±3.9 and 15.6±2.4 years, respectively. Hypertension (daytime, nighttime, and 24-hour mean hypertension) data were available in 42 patients. During the 8 years of follow-up after ABPM, microvascular complications occurred in 8 patients (diabetic retinopathy [DR] alone in 5, microalbuminuria alone in 2, and both in 1), of whom 7 had nondipper BP. Nighttime diastolic BP, nighttime mean arterial pressure, and glycated hemoglobin A (HbA1c) level were higher in patients with DR than in those without DR (P<0.05 for all). Daytime or nighttime BP and presence of dipper BP were not related to microvascular complications, but diabetic microvascular complications were more likely to occur in patients with an older age at diagnosis and higher HbA1c level. The proportion of patients with DR was higher in those with nondipper hypertension (83.3%) compared with dipper and nondipper normotension (0% and 16.7%, respectively; P=0.021). Conclusion As a predictor of microvascular complications, nondipper hypertension was not significant. Glycemic control rather than nondipper hypertension is the predominant factor determining DR in T1DM patients.

Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.
Adipose Tissue ; Adiposity ; Adolescent ; Adrenal Glands ; Endocrine Disruptors ; Epigenomics ; Female ; Humans ; Menarche ; Puberty ; Reproduction

We report a man who exhibited pure agraphia after suffering a left subcortical infarction involving part of the thalamus and the basal ganglia. His writing difficulty was characterized by stopping, letter omission, and substitution in spontaneous writing and writing to dictation, but he was able to copy normally. Decreased perfusion in the left frontal lobe and temporal cortex was noted on brain single-photon-emission computed tomography . This patient's agraphia persisted at follow-up 52 days later. We suggest that the subcortical lesion in this patient caused pure agraphia secondary to diaschisis of the interconnected cortical area.
Agraphia ; Basal Ganglia ; Brain ; Cerebral Infarction ; Coat Protein Complex I ; Follow-Up Studies ; Frontal Lobe ; Humans ; Infarction ; Perfusion ; Stress, Psychological ; Thalamus ; Writing

Acute transient salivary gland swelling is a rare complication of general anesthesia. These swellings usually resolve over a few hours without sequelae. The etiology of the salivary gland swelling is unclear. However, they are considered to be associated with cough or straining on the endotracheal tube and mechanical blockage of salivary gland duct. Anesthesiologists should know the possible causes, lack of clinical significance, and the course of these transient salivary gland swellings in order to reassure the patient. We report bilateral submandibular gland swelling developed after endotracheal anesthesia in a 4-year-old girl.
Anesthesia ; Anesthesia, General* ; Child, Preschool ; Cough ; Female ; Humans ; Salivary Glands ; Submandibular Gland*

OBJECTIVES: This study was conducted to develop the screening questionnaire (Adolescent Mental Health and Problem Behavior Questionnaire, AMPQ) for detecting mental health problems and various problem behaviors in adolescents. METHODS: First, six main domains of questionnaire were defined and preliminary sub-items were collected through literature study, consultation data from field mental health experts, and preliminary survey study. Next, with these 52 preliminary items, we conducted nationwide survey on 1,267 middle and high school students of five districts of Korea. RESULTS: Through reliability test and factor analysis 34 items were finally filtered out. The Cronbach's alpha of these 34 items was .88. And correlation with K-YSR and K-CBCL were .34 (p<.01) and .68 (p<.01). CONCLUSION: AMPQ, which is comprised of relatively short list of items and at the same time covers overall mental health and problem behaviors in adolescents can be used by non-professionals as a screening questionnaire in school settings or mental health centers.
Adolescent ; Humans ; Mass Screening ; Mental Health ; Surveys and Questionnaires

PURPOSE: The effect of accelerated aging on color stability of various dual-cured self-adhesive resin cements were evaluated in this study. MATERIALS AND METHODS: Color stability was examined using three different brands of dual-cured self-adhesive resin cements: G-CEM LinkAce (GC America), MaxCem Elite (Kerr), and PermaCem 2.0 (DMG) with the equivalent color shade. Each resin cement was filled with Teflon mold which has 6 mm diameter and 2 mm thickness. Each specimen was light cured for 20 seconds using light emitting diode (LED) light curing unit. In order to evaluate the effect of accelerated aging on color stability, color parameters (Commission Internationale de l'Eclairage, CIE L*, a*, b*) and color differences (DeltaE*) were measured at three times: immediately, after 24 hours, and after thermocycling. The L*, a*, b* values were analyzed using Friedman test and DeltaE* values on the effect of 24 hours and accelerated aging were analyzed using t-test. These values were compared with the limit value of color difference (DeltaE*=3.7) for dental restoration. One-way ANOVA and Scheff's test (P<0.05) were performed to analyze each DeltaE* values between cements at each test period. RESULT: There was statistically signifi cant difference in comparison of color specifi cation (L*, a*, b*) values after accelerated aging except L* value of G-CEM LinkAce (P<0.05). After 24 hours, color difference (DeltaE*) values were ranged from 2.47 to 3.48 and L* values decreased and b* values increased in all types of cement and MaxCem Elite had high color stability (P<0.05). After thermocycling, color change's tendency of cement was varied and color difference (DeltaE*) values were ranged from 0.82 to 2.87 and G-CEM LinkAce had high color stability (P<0.05). CONCLUSION: Color stability of dual-cured self-adhesive resin cements after accelerated aging was evaluated and statistically significant color changes occurred within clinically acceptable range.
Aging* ; Fungi ; Polytetrafluoroethylene ; Resin Cements*

BACKGROUND: In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown. METHODS: Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Patients were treated with glucocorticoid after adrenalectomy and were reevaluated every 1 to 6 months using a rapid adrenocorticotropic hormone (ACTH) stimulation test. RESULTS: Levels of basal 24-hour urine free cortisol (UFC), serum cortisol after an overnight dexamethasone suppression test (DST), and serum cortisol and 24-hour UFC after low-dose DST and high-dose DST were all significantly lower in patients with SC compared with OC. Basal ACTH levels showed significantly higher in patients with SC compared with OC. The probability of recovering adrenal function during follow-up differed significantly between patients with OC and SC (P=0.001), with significant correlations with the degree of preoperative cortisol excess. Patients with OC required a longer duration of glucocorticoid replacement to recover a normal ACTH stimulation test compared with patients with SC (median 17.0 months vs. 4.0 months, P<0.001). CONCLUSION: The HPA axis recovery time after adrenalectomy in patients with SC is rapid and is dependent on the degree of cortisol excess. More precise definition of SC is necessary to achieve a better management of patients and to avoid the risk of under- or over-treatment of SC patients.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome* ; Dexamethasone ; Follow-Up Studies ; Humans ; Hydrocortisone ; Retrospective Studies