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Purpose@#The aim of this study was to examine whether gonadotropin-releasing hormone (GnRH) agonist treatment is effective in preserving final height in patients with central precocious puberty (CPP) or early puberty (EP). @*Methods@#The medical records of 40 patients with CPP and 206 patients with EP who completed GnRH agonist treatment following diagnosis were analyzed retrospectively. Height and height standard deviation (height SDS) scores based on bone age (BA) were measured and calculated at baseline, after treatment completion, and at final follow-up to compare changes within and between groups. Predicted adult height (PAH) was estimated by the height corresponding to height SDS for BA in girls at 18 years 11 months of age based on the growth chart. @*Results@#PAH at baseline did not differ significantly between the CPP group (153.67±4.95) and the EP group (154.77±3.72). In the CPP group, PAH significantly increased at treatment completion (156.01±4.61) and at final follow-up (158.52±6.04) compared to baseline. In the EP group, PAH significantly increased at treatment completion (157.7±3.60) and at final follow-up (159.31±4.26) compared to baseline. The increase in PAH at all timepoints compared to baseline did not significantly differ between the CPP and EP groups. @*Conclusion@#Both CPP and EP groups had significantly greater PAH after treatment, with no difference in the amount of increase between groups. These results show that GnRH agonist treatment can help increase final height even in patients diagnosed with EP after the age of 8 years.
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Purpose@#This study aimed to identify prognostic factors based on treatment outcomes for congenital diaphragmatic hernia (CDH) at a single-center and to identify factors that may improve these outcomes. @*Methods@#Thirty-five neonates diagnosed with CDH between January 2011 and December 2021 were retrospectively analyzed. Pre- and postnatal factors were correlated and analyzed with postnatal clinical outcomes to determine the prognostic factors. Highest oxygenation index (OI) within 24 hours of birth was also calculated. Treatment strategy and outcome analysis of published literatures were also performed. @*Results@#Overall survival rate of this cohort was 60%. Four patients were unable to undergo anesthesia and/or surgery. Three patients who commenced extracorporeal membrane oxygenation (ECMO) post-surgery were non-survivors. Compared to the survivor group, the non-survivor group had a significantly higher occurrence of pneumothorax on the first day, need for high-frequency ventilator and inhaled nitric oxide use, and high OI within the first 24 hours. The non-survivor group showed an early trend towards the surgery timing and a greater number of patch closures. Area under the receiver operating characteristic curve was 0.878 with a sensitivity of 76.2% and specificity of 92.9% at an OI cutoff value of 7.75. @*Conclusion@#OI within 24 hours is a valuable predictor of survival. It is expected that the application of ECMO based on OI monitoring may help improve the opportunity for surgical repair, as well as the prognosis of CDH patients.
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Purpose@#Since premature infants are sensitive to the changes in blood glucose levels and body temperature, maintaining these parameters is important to avoid the risk of infections. The authors implemented the Golden Hour protocol (GHP) that aims to close the final incubator within one hour of birth by implementing early treatment steps for premature infants after birth, such as maintaining body temperature, securing airway, and rapidly administering glucose fluid and prophylactic antibiotics by securing breathing and rapid blood vessels. This study investigated the effect of GHP application on the short- and long-term clinical outcomes. @*Methods@#We retrospectively analyzed the medical records between 2017 and 2018 before GHP application and between 2019 and 2020 after GHP application in preterm infants aged 24 weeks or older and those aged less than 33 weeks who were admitted to the neonatal intensive care unit. @*Results@#Overall, 117 GHP patients and 81 patients without GHP were compared and analyzed. Peripheral vascularization time and prophylactic antibiotic administration time were shortened in the GHP-treated group (P=0.007 and P=0.008). In the short-term results, the GHP-treated group showed reduced hypothermia upon arrival at the neonatal intensive care unit (P=0.002), and the blood glucose level at 1 hour of hospitalization was higher (P=0.012). Furthermore, the incidence of neonatal necrotizing enteritis decreased (P=0.043). As a long-term result, the incidence of BPD was reduced (P=0.004). @*Conclusion@#We confirmed that applying GHP improved short- and long-term clinical outcomes in premature infants aged <33 weeks age of gestation, and we expect to improve the treatment quality by actively using it for postnatal treatment.
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Purpose@#We used the Bayley Scales of Infant and Toddler Development (BSID)-III to analyze the incidence and risk factors of developmental delay in very-low-birth-weight infants without severe brain lesions. We further examined the correlation between the cumulative dexamethasone dose and developmental assessment results. @*Methods@#We retrospectively analyzed data of preterm infants (birth weight <1,500 g) admitted to our neonatal intensive care unit between January 2014 to December 2020. The BSID-III scores obtained between the corrected ages of 12 and 24 months and after 24 months were analyzed. Developmental delay was defined as a composite score of <85 for the cognition, language, and motor domains. Univariate and multivariate analyses of developmental delay risk factors and developmental changes from the first to second BSID-III were performed. Correlations between the accumulated dexamethasone dose used for bronchopulmonary dysplasia (BPD) and the first and second test scores were analyzed. @*Results@#Seventy-one and thirty-six infants completed the first and second tests, respectively. In both tests, developmental delay was most commonly observed in the language domain (26.8%, 47.2%). In multivariate analysis, mild BPD was identified as a developmental delay risk factor (P<0.05), whereas prenatal steroid use reduced the developmental delay risk (P<0.05). All domain scores were lower in the second test than in the first test. The cognition and language domain scores in the second test decreased with increasing cumulative dexamethasone doses. @*Conclusion@#Very-low-birth-weight infants typically experience language delay, which can persist as they age.
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We reviewed past studies on the identification of familial relationships using 22 short tandem repeat markers. As a result, we can obtain a high discrimination power and a relatively accurate cut-off value in parent-child and full sibling relationships. However, in the case of pairs of uncle-nephew or cousin, we found a limit of low discrimination power of the likelihood ratio (LR) method. Therefore, we compare the LR ranking method and data mining techniques (e.g., logistic regression, linear discriminant analysis, diagonal linear discriminant analysis, diagonal quadratic discriminant analysis, K-nearest neighbor, classification and regression trees, support vector machines, random forest [RF], and penalized multivariate analysis) that can be applied to identify familial relationships, and provide a guideline for choosing the most appropriate model under a given situation. RF, one of the data mining techniques, was found to be more accurate than other methods. The accuracy of RF is 99.99% for parent-child, 99.44% for full siblings, 90.34% for uncle-nephew, and 79.69% for first cousins.
Subject(s)
Humans , Classification , Data Mining , Discrimination, Psychological , Forests , Logistic Models , Methods , Microsatellite Repeats , Siblings , Support Vector Machine , TreesABSTRACT
We reviewed past studies on the identification of familial relationships using 22 short tandem repeat markers. As a result, we can obtain a high discrimination power and a relatively accurate cut-off value in parent-child and full sibling relationships. However, in the case of pairs of uncle-nephew or cousin, we found a limit of low discrimination power of the likelihood ratio (LR) method. Therefore, we compare the LR ranking method and data mining techniques (e.g., logistic regression, linear discriminant analysis, diagonal linear discriminant analysis, diagonal quadratic discriminant analysis, K-nearest neighbor, classification and regression trees, support vector machines, random forest [RF], and penalized multivariate analysis) that can be applied to identify familial relationships, and provide a guideline for choosing the most appropriate model under a given situation. RF, one of the data mining techniques, was found to be more accurate than other methods. The accuracy of RF is 99.99% for parent-child, 99.44% for full siblings, 90.34% for uncle-nephew, and 79.69% for first cousins.
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Mitochondrial DNA (mt DNA) and the non-recombining region of the Y chromosome are passed down, unaltered, from generation to generation, matrilineally and patrilineally, respectively. Therefore, the Y-chromosome DNA and mtDNA are known as lineage markers, and they play important roles in studies based on human migration and evolutionary history. Y-chromosome DNA is used in forensic analysis to identify individuals involved in cases of sexual assault. In this paper, we review the methods of statistical evaluation of lineage markers used in forensic identification. We also review the combined approach of autosomal and lineage marker evidence.
Subject(s)
DNA , DNA, Mitochondrial , Human Migration , Y ChromosomeABSTRACT
Human mitochondrial DNA (mtDNA) is generally used to identify highly degraded forensic samples, particularly when the extracted DNA is not sufficient for nuclear DNA analysis. However, direct sequencing, the most widely used mtDNA analysis method, is laborious and time-consuming, and precludes the simultaneous analysis of many samples. Here, we describe a rapid and simple screening method for mtDNA analysis in Koreans using single base extension (SBE) methods. Sixteen highly polymorphic mtDNA SNPs from the control region were selected, and a multiplex SBE system was constructed to analyze them. Because the developed system consists of two duplex PCRs, which produce small amplicons with fewer than 270 bp, it works well with highly degraded samples such as old skeletal remains. Using this multiplex SBE system, 145 different haplotypes were expected to be observed from 593 unrelated Koreans. Seventy-three haplotypes were expected to be observed only once, and the most frequent haplotype was expected to occur 80 times. Since the mean number of pairwise differences was estimated to be 4.55, the developed system could be useful to exclude samples that do not match evidence and reference samples. Therefore, the multiplex SBE system used in this study will be a useful tool to analyze many samples simultaneously and to efficiently screen out non-matching mtDNA sequences in forensic casework.
Subject(s)
Humans , Asian People , DNA , DNA, Mitochondrial , Haplotypes , Mass Screening , Methods , Polymerase Chain Reaction , Polymorphism, Single NucleotideABSTRACT
Kinship testing in forensic casework is largely based on a likelihood ratio (LR) approach with short tandem repeat (STR) markers; however, in order to efficiently identify potential relatives in a specific population, the threshold values for kinship prediction should be determined by analyzing the kinship index distributions of the population in question. In this study, 250,000 DNA profiles were simulated using allele frequencies at 20 autosomal STR loci in Koreans, then the LRs were calculated for true close relatives and unrelated pairs. The LR distributions in related and unrelated pairs under a given relationship were compared in 2 sets of 13 Combined DNA Index System (CODIS) and 20 STR profiles. Using 13 CODIS STRs, true relatives in parent/child and full-sibling relationships were sufficiently discriminated from unrelated pairs with LR thresholds of 1,000 and 100, respectively. However, the CODIS STRs lacked the discriminatory power to differentiate between related and unrelated pairs in uncle/nephew and first cousin relationships due to high false-positive and false-negative rates with a LR threshold of 10. Increasing the number of STR loci to 20 increased discrimination of close relatives, but high false results remained in uncle/nephew and first cousin relationships. The kinship index data from this study will help make decisions on various kinship testing and familial searching in Koreans.
Subject(s)
Humans , Asian People , Discrimination, Psychological , DNA , Gene Frequency , Microsatellite RepeatsABSTRACT
OBJECTIVE: This study was conducted to provide a nationwide analysis on barriers to cervical cancer screening in Korea. METHODS: Data used for this study was obtained in a survey called Korean National Health and Nutrition Examination Survey (KNHANES) 2005, which collected data from 2,590 Korean women aged older than 21 years who had not had a hysterectomy and were eligible for Papanicolaou (Pap) smears. Multivariate analysis was adopted to control each demographic factor and unhealthy behavior variable. Demographic factors included age, education, income, job and region; health-related behavior factors were defined as current smoking, obesity, hormone replacement therapy and disability. RESULTS: The study found that cervical cancer screening rate was significantly positively associated with income (odds ratio [OR], 1.002; 95% confidence interval [CI], 1.001 to 1.002), with education (OR, 1.324; 95% CI, 1.030 to 1.703), with job (OR, 1.420; 95% CI, 1.030 to 1.957), and with hormone replacement therapy (OR, 3.732; 95% CI, 2.354 to 5.916). Meanwhile, the age (OR, 0.977; 95% CI, 0.968 to 0.985), disability (OR, 0.358; 95% CI, 0.143 to 0.894) and smoking (OR, 0.447; 95% CI, 0.280 to 0.715) were significantly negatively associated with one's chances to take cervical cytology. CONCLUSION: In order to increase the rates of Korean women taking Pap test, cervical cancer screening programs will have to pay special attention to the elderly, low-income group, smokers, and the disabled.
Subject(s)
Aged , Female , Humans , Demography , Hormone Replacement Therapy , Hysterectomy , Korea , Mass Screening , Multivariate Analysis , Nutrition Surveys , Obesity , Smoke , Smoking , Uterine Cervical Neoplasms , Vaginal SmearsABSTRACT
The purpose of this study was to investigate the influence of mixed NaCl-KCl salt on sodium intake and urinary excretion of sodium and potassium. In this study, 3-day food records for pre-experimental diet and 24-hr urine collected for 2-days, 6-day experimental diet food and 24-hr urine were used to evaluate the relationship between Na metabolism. In the experimental diet food, mixed NaCl-KCl salt was added. During the pre-experimental diet period, intakes of Na and K were 178.2 mEq and 56.4 mEq, respectively. The urinary excretion of Na and K in 24-hr were 139.6 mEq, 27.7 mEq, respectively and urinary Na/K ratio was 6.6. During the experimental diet period, intakes of Na and K were 130.2 mEq and 120.4 mEq, respectively. The urinary excretion of Na and K in 24-hr were 100.2 mEq, 37.1 mEq, respectively and urinary Na/K ratio was 2.8. According to this study, it is concluded that mixed NaCl-KCl salt diet decreased the intake of Na, and increased the intake of K.
Subject(s)
Diet , Metabolism , Potassium , SodiumABSTRACT
OBJECTIVE: To analyze the clinical characteristic of peripartum cardiomyopathy. METHODS: A retrospective review was undertaken on records of women who were diagnosed with peripartum cardiomyopathy at Yonsei University, Wonju College of Medicine, Wonju Christian Hospital between January 1994 and December 2004. We made criteria for its diagnosis, namely: (1) developement of heart failure in the last month of pregnancy or within 5 months after delivery, (2) absence of a determinable etiology for the cardiac failure, and (3) absence of demonstrable heart disease prior to the last month of pregnancy. (4) ejection fraction less than 45%. RESULTS: During the research period, 8 pregnant women were documented as peripartum cardiomyopathy. All of the women undertook echocardiography. Three women were complicated with pregnancy induced hypertension. One woman was in cardiogenic shock. CONCLUSION: Early diagnosis of the peripartum cardiomyopathy is extremely important. The echocardiography can provide helpful information on disease progression.
Subject(s)
Female , Humans , Pregnancy , Cardiomyopathies , Diagnosis , Disease Progression , Early Diagnosis , Echocardiography , Heart Diseases , Heart Failure , Hypertension, Pregnancy-Induced , Peripartum Period , Pregnant Women , Retrospective Studies , Shock, CardiogenicABSTRACT
In postpartum hemorrhage, many clinicians should often consider hysterectomy after delivery. Many surgeons have suggested conservative surgical procedures such as uterine, ovarian and internal iliac artery ligation for preserving future childbearing potential. Recently, B-Lynch surgical technique and hemostatic multiple square suture technique were suggested to compress the entire uterine walls as another methods. The individual choice between these procedures depend on several factors including the general condition of patient and the experience of surgeon. Here, we introduce a case of the selective hemostatic suturing technique which was used to a patient with placenta previa at 20 weeks' gestation. The suturing technique could be used to a patient with massive bleeding from the placental separation site with normal uterine contraction during cesarean delivery.
Subject(s)
Humans , Pregnancy , Hemorrhage , Hysterectomy , Iliac Artery , Ligation , Placenta Previa , Postpartum Hemorrhage , Suture Techniques , Uterine ContractionABSTRACT
Leiomyomas are very common tumors in the uterus and related adjacent structures but rare in the retroperitoneal space. Retroperitoneal leiomyomas are extremely rare and have a good prognosis. Long-term follow-up reveals no metastasis but small potential for local recurrences cannot be ruled out. We report a 44-years-old woman with retroperitoneal leiomyomas who had undergone total abdominal hysterectomy and left salpingooophorectomy 8 years ago due to uterine leiomyomas. Laparotomy was performed, and mass excision was successful.
Subject(s)
Female , Humans , Follow-Up Studies , Hysterectomy , Laparotomy , Leiomyoma , Neoplasm Metastasis , Prognosis , Recurrence , Retroperitoneal Space , UterusABSTRACT
Placenta percreta is a life-threatening complication of pregnancy, and it is very rarely noted to occur in the first trimester. We present here a case of placenta percreta with a missed abortion that occurred at 12 gestational weeks. During curettage, hysterectomy was required due to the heavy bleeding. On operative finding, hemorrhagic placental tissue in the lower uterine segment. It is extending into the myometrium and periuterine soft tissue. Histological examination revealed features of placenta percreta.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Abortion, Missed , Curettage , Hemorrhage , Hysterectomy , Myometrium , Placenta Accreta , Placenta , Pregnancy Trimester, FirstABSTRACT
No abstract available.