The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.

Purpose: Pediatric diabetes is a common health burden worldwide. This study aimed to investigate the prevalence of fasting hyperglycemia in Korean youth aged 10–18 years and to evaluate its association with metabolic indicators. Methods: To assess the risk of diabetes in domestic children and adolescents, the prevalence of fasting hyperglycemia was calculated, a trend was evaluated using multi-year Korea National Health and Nutrition Examination Survey (KNHANES) data, and multivariate analysis was performed to evaluate the relationships between hyperglycemia and metabolic factors. Results: The prevalence of fasting hyperglycemia, defined as impaired fasting glucose (fasting glucose level > 100 mg/dL and < 125 mg/dL), or diabetes mellitus (fasting glucose ≥ 126 mg/dL) was estimated in Korean teenagers. The prevalence increased from the fourth (2007–2009) to the fifth (2010–2012), sixth (2013–2015), and seventh (2016–2018) KNHANES surveys, from 5.39 to 4.79, 10.03, and 11.66 per 100 persons, respectively. In multivariate analysis, systolic blood pressure and serum triglycerides were higher in the fasting hyperglycemia group; systolic blood pressures were 109.83 mmHg and 112.64 mmHg and serum triglycerides were 81.59 mg/dL and 89.60 mg/dL in the normal blood glucose and fasting hyperglycemia groups, respectively. Conclusion The prevalence of fasting hyperglycemia among children and adolescents has increased over the past decade, and this increase is potentially associated with metabolic abnormalities such as hypertension and hypertriglyceridemia. Effort is urgently required to reduce this chronic medical burden in adolescence.

Objectives: To conduct a comparative study of children’s health in South Korea versus North Korea focusing on air pollution. Methods: We used annual mortality rate, prevalence, and environmental indicators data from the World Bank and World Health Organizations (WHO). Trend analysis of the two Koreas was conducted to evaluate changes in health status over time. Spearman’s correlation analysis was used to find out the correlation between environmental indicators and children’s health status. Results: We found a distinct gap in children’s health status between the two Koreas. While North Korea reported a higher death rate of children than South Korea, both showed a decreasing trend with the gap narrowing from 2000 to 2017. The prevalence of overweight and obesity increased and that of thinness decreased in both Koreas. Except PM2.5 exposure, South Korea reported higher figures in most indicators of air pollutant emissions (South Korea, mean (SD)=28.3 (2.0); North Korea, mean (SD)=36.5 (2.8), P-value=0.002). Conclusion This study empirically discovered the gaps and patterns of children’s health between South Korea and North Korea. North Korean children experienced more severe health outcomes than children in South Korea. These findings imply that epigenetic modification caused by environmental stressors affect children’s health in the two Koreas despite similar genetic characteristics. Considering the gaps in children’s health between the two Koreas, more attention and resources need to be directed towards North Korea because the necessary commodities and services to improve children’s health are lacking in North Korea.

Purpose: Group B streptococcus (GBS) is a causative organism of invasive infections in neonates and pregnant women as well as in non-pregnant adults. Among 10 known serotypes of GBS, uncommon serotypes, such as IV and VI to IX, can cause invasive infections in immunocompromised patients. However, opsonophagocytic antibodies against these serotypes in human sera and intravenous immunoglobulin (IVIG) have not yet been studied.IVIG therapy is used to treat or prevent invasive infections in patients with primary antibody deficiencies. Here, we analyzed the activity of opsonophagocytic antibodies against GBS in IVIG preparations. Methods: Opsonophagocytic antibody activity (opsonic index [OI]) against seven GBS serotypes (II and IV to IX) was evaluated in 16 commercially available IVIG preparations using the opsonophagocytic assay (OPA) in HL-60 cells and baby rabbit complement assay during 2015–2016 in South Korea (UAB GBS OPA, at http://www.vaccine.uab.edu). Results: The estimated serum trough levels of OIs against GBS exceeded the limit of detection (≥4) in all IVIG preparations. For serotype VII, the serum levels of OIs were 6–136, the lowest among all serotypes. An IVIG dose of 400 mg/kg was found to be appropriate for immunocompromised individuals to prevent invasive GBS infections. Conclusions Most immunoglobulin products displayed high levels of opsonophagocytic activity against GBS, except for serotype VII. IVIG preparations could serve as a therapeutic or immunomodulatory agent for immunocompromised individuals.

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

Purpose: Group B streptococcus (GBS) is a causative organism of invasive infections in neonates and pregnant women as well as in non-pregnant adults. Among 10 known serotypes of GBS, uncommon serotypes, such as IV and VI to IX, can cause invasive infections in immunocompromised patients. However, opsonophagocytic antibodies against these serotypes in human sera and intravenous immunoglobulin (IVIG) have not yet been studied.IVIG therapy is used to treat or prevent invasive infections in patients with primary antibody deficiencies. Here, we analyzed the activity of opsonophagocytic antibodies against GBS in IVIG preparations. Methods: Opsonophagocytic antibody activity (opsonic index [OI]) against seven GBS serotypes (II and IV to IX) was evaluated in 16 commercially available IVIG preparations using the opsonophagocytic assay (OPA) in HL-60 cells and baby rabbit complement assay during 2015–2016 in South Korea (UAB GBS OPA, at http://www.vaccine.uab.edu). Results: The estimated serum trough levels of OIs against GBS exceeded the limit of detection (≥4) in all IVIG preparations. For serotype VII, the serum levels of OIs were 6–136, the lowest among all serotypes. An IVIG dose of 400 mg/kg was found to be appropriate for immunocompromised individuals to prevent invasive GBS infections. Conclusions Most immunoglobulin products displayed high levels of opsonophagocytic activity against GBS, except for serotype VII. IVIG preparations could serve as a therapeutic or immunomodulatory agent for immunocompromised individuals.

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

Non-sexually acquired genital ulceration, also known as Lipschutz ulcer, is a rare condition that typically occurs in prepubertal and pubertal girls. It can be misdiagnosed as a sexually transmitted disease or even a sign of child abuse, causing great anxiety for patients and their families. It is often accompanied by systemic symptoms such as fever, myalgia, or lymphadenopathy. Several viruses such as Epstein-Barr virus, cytomegalovirus, and mumps virus have been associated with this entity. Furthermore, Mycoplasma pneumonia has rarely been linked to such ulcers in the literature. We present a case of Lipschutz ulcer in a sexually inactive 11-year-old girl.

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants’electronic medical records were analyzed using descriptive statistics, t-test, x 2 -test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients’ nursing dependency on nursing care.