Polycystic ovary syndrome (PCOS) is one of the most common hormonal endocrine disorders in women of reproductive age. It consists of a heterogeneous collection of signs and symptoms that together form a disorder spectrum. The diagnosis of PCOS is principally based on clinical and physical findings. The extent of metabolic abnormalities in women with PCOS varies with phenotype, body weight, age, and ethnicity. For general population, the prevalence of hyperandrogenism and oligomenorrhea decreases with age, while complications such as insulin resistance and other metabolic disturbances increase with age. Obese women with PCOS have a higher risk of developing oligomenorrhea, amenorrhea, hyperandrogenemia, insulin resistance, and lower luteinizing hormone (LH) to follicle stimulation hormone (FSH) ratios than non-obese women with PCOS. The LH to FSH ratio is a valuable diagnostic tool in evaluating Taiwanese women with PCOS, especially in the diagnosis of oligomenorrhea. Overweight/obesity is the major determinant of cardiovascular and metabolic disturbances in women of reproductive age.
The present study was undertaken to evaluate the accuracy of ultrasonography in early pregnancy diagnosis in goats. Ultrasonographic scanning with real time B-mode ultrasound machine having 5 MHz linear array transducer was performed on gravid uterus (n=24) obtained from slaughterhouse (Group I). Crown rump length (CRL) measured by ultrasound was found significantly different (p<0.05) with actual CRL measured after dissection in early pregnancy. However, age predicted by ultrasound through the measurement of CRL was found highly correlated (r=0.92) with age measured after dissection through CRL and the weight of fetus. Ages predicted by ultrasound through the measurement of trunk diameter (TD) and uterine diameter (UD) and ages measured after dissection were found highly and equally correlated (r=0.98) and did not differ significantly. Data from six does synchronized (Group II) with PGF2$\alpha$ (Estrumate) at 11 days apart were collected through ultrasound from 17 to 42 days post breding. The correlation between CRL and gestational age was high (r=0.97) in day 30 to 42 post breeding. A high coefficient of correlation (r=0.98) was also observed between predicated age by ultrasound and actual age calculated after kidding. The correlation between CRL and gestational age by the formula Y=(a+bX) i.e. Y=24.42+0.39 X where Y=gestational age and X=CRL, was recorded very high (r=0.99). Accuracy of ultrasonography was lowest on day 17 to 19 (66%) and reached 100% on day 34. Data from 30 does (group III) randomly subjected to only one time ultrasounds scanning to assess the accuracy of pregnancy diagnosis were also obtained. Ages predicted by TD and UD measurements were observed to be non-significantly different with actual age obtained after kidding and correlation between ages predicted by TD and UD measurement with actual age after kidding was found equally and highly correlated (r=0.98). The operator's accuracy in the whole experiment including all three groups was found to be 92%. The sensitivity was 93% and specificity was 86%. From the present study, it was observed that CRL was the most reliable parameter to find out gestational age in early pregnancy and the new formula derived was found very accurate to find out gestational age. TD and UD were also found to be equally reliable parameter to find out gestational age in mid and late stage of pregnancy through ultrasonography. It was concluded that ultrasonography by real time B mode with 5 MHz transrectal transducer was found to be reliable, safe and accurate and practicable means in diagnosing early pregnancy diagnosis as early as 25 days post breeding.
Purpose: To develop a probability-based differential diagnosis for pediatric acute liver failure (PALF) based on age and socioeconomic status of the country of origin. Methods: Comprehensive literature search using PubMed, EMBASE, and SCOPUS databases was performed. Children 0-22 years of age who met PALF registry criteria were included. Articles included >10 children, and could not be a case report, review article, or editorial. No language filter was utilized, but an English abstract was required. Etiology of PALF, age of child, and country of origin was extracted from included articles. Results: 32 full text articles were reviewed in detail; 2,982 children were included. The top diagnosis of PALF in developed countries was acetaminophen toxicity (9.24%; 95% CredI 7.99-10.6), whereas in developing countries it was Hepatitis A (28.9%; 95% CredI 26.3-31.7). In developed countries, the leading diagnosis of PALF in children aged <1 year was metabolic disorder (17.2%; 95% CredI 10.3-25.5), whereas in developing countries it was unspecified infection (39.3%; CredI 27.6-51.8). In developed countries, the leading diagnosis in children aged >1 year was Non-A-B-C Hepatitis (8.18%; CredI 5.28-11.7), whereas in developing countries it was Hepatitis A (32.4%; CredI 28.6-36.3). Conclusion: The leading causes of PALF in children aged 0-22 years differ depending on the age and developmental status of their country of origin, suggesting that these factors must be considered in the evaluation of children with PALF.
Ko, Duck Sung;Lee, Sun-Hee;Park, Chan Woo;Lim, Chun Kyu
Clinical and Experimental Reproductive Medicine
/
v.46
no.4
/
pp.206-210
/
2019
Mucopolysaccharidosis type II (MPS II) is a rare X-linked recessive lysosomal storage disease caused by mutation of the iduronate-2-sulfatase gene. The mutation results in iduronate-2-sulfatase deficiency, which causes the progressive accumulation of heparan sulfate and dermatan sulfate in cellular lysosomes. The phenotype, age of onset, and symptoms of MPS II vary; accordingly, the disease can be classified into either the early-onset type or the late-onset type, depending on the age of onset and the severity of the symptoms. In patients with severe MPS II, symptoms typically first appear between 2 and 5 years of age. Patients with severe MPS II usually die in the second decade of life although some patients with less severe disease have survived into their fifth or sixth decade. Here, we report the establishment of a preimplantation genetic diagnosis (PGD) strategy using multiplex nested polymerase chain reaction, direct sequencing, and linkage analysis. Unaffected embryos were selected via the diagnosis of a single blastomere, and a healthy boy was delivered by a female carrier of MPS II. This is the first successful application of PGD in a patient with MPS II in Korea.
Lee, Jai Young;Kang, Won Sub;Kim, Jong Woo;Kim, Young Jong
Anxiety and mood
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v.11
no.2
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pp.143-148
/
2015
Objective : This study examined benzodiazepine prescription patterns of outpatients visiting the psychiatry department in a single general hospital in Korea. Methods : A retrospective descriptive analysis of benzodiazepine prescriptions was performed on a database from 2014 in a general hospital in Korea. We analyzed the following factors of adult outpatients: demographic factors such as sex and age, amount of benzodiazepine prescribed, treatment duration, and diagnosis based on the ICD-10. Results : In 2014, benzodiazepines were prescribed to 46.4% of the outpatients. Percentage of benzodiazepine prescription increased with age and was highest in the age group 40-59 years. Prescription was more prevalent in women and the prescription percentage increased by treatment duration. Patients with the F4 diagnosis (neurotic, stress-related and somatoform disorders) were the most highly prescribed group. For all diagnosis groups, prescription was more prevalent in females or similar for both sexes except for patients with F5 diagnosis (behavioral syndromes associated with physiological disturbances and physical factors), with males being more predominant. Conclusion : Despite the concern regarding the rate of benzodiazepine prescription and administration to geriatric patients, long-term prescription and usage among older patients is still prevalent.
Purpose: The American Academy of Pediatrics provides guidelines for managing febrile urinary tract infection (UTI) in infants and children 2-24 months old, but little guidance is offered regarding UTIs in those younger than 8 weeks of age. The definition of UTI is unclear and whether to proceed with micturating cystourethrography (MCUG) or $^{99m}$technetium-dimercaptosuccinic acid (DMSA) scintigraphy scan in this age group is controversial. Methods: We retrospectively analyzed 29 neonates and infants younger than 2 months of age who underwent late DMSA scans 9 months following the first episode of febrile or symptomatic UTI between July 2009 and June 2016. Results: In total, 192 children aged 0-24 months underwent ultrasound and DMSA scans (MCUG in 174/192). Neonates and infants younger than 2 months of age were significantly less likely to develop fever, and had a lower fever peak, shorter duration of fever before admission and after starting antibiotics, longer hospitalization period, lower C-reactive protein, and greater incidence of nonEscherichia coli infection. There was no difference in pyuria response at diagnosis. The prevalence rates of an ultrasound abnormality (28%), vesicoureteral reflux (28%), UTI recurrence (38%), and renal scarring (10%) in infants younger than 8 weeks of age were similar to those in children 2-24 months old. Conclusion: Neonates and infants younger than 2 months of age with UTI warrant special consideration because the fever response used for diagnosis in older children may be absent or blunted. Clinical guideline is needed for the diagnosis and management of UTI in this age group.
The purpose of this study was to estimate occlusal tooth wear and bruxism severity in TMD patients, and evaluate the effectiveness of the present age estimation method by occlusal tooth wear in TMD patients. Takei's age estimation method was applied to 163 subjects(56 controls, 107 TMD patients). The author analyzed the degree of occlusal tooth wear from the difference between estimated age and actual age. The obtained results were as follows: 1. In all age group, occlusal tooth wear in TMD patients is higher than those in asymptomatic controls. In 20's age group, a statistically significant difference was found. 2. In both gender, occlusal tooth wear in TMD patients is higher than those in asymptomatic control. In male, a significant difference was found. 3. Occlusal tooth wear in TMD patients with bruxism is significantly higher than that in control. 4. We found no significant difference in bruxism severity and occlusal tooth wear among the RDC/TMD subgroups. 5. Application of Takei's method would be still useful for age estimation in Korean. In case of age estimation of TMD patients using occlusal tooth wear, evaluation of the bruxism severity and appropriate correction according to age, sex and difference of geographical location should be considered.
Juvenile idiopathic arthritis (JIA) is comprised of a heterogeneous group of several disease subtypes that are characterized by the onset of arthritis before the age of 16 years and has symptoms lasting at least 6 weeks. The previous classification of JIA included seven different categories, whereas its current classification was compiled by the International League of the Association for Rheumatology, and replaced the previous terms of "juvenile chronic arthritis" and "juvenile rheumatoid arthritis," which were used in Europe or North America, respectively, with the single nomenclature of JIA. As mentioned above, JIA is defined as arthritis of unknown etiology that manifests itself before the age of 16 years and persists for at least 6 weeks, while excluding other known conditions. The clinical symptoms of JIA can be quite variable. Several symptoms that are characteristic of arthritis are not necessarily diagnostic of JIA and may have multiple etiologies that can be differentiated with careful examination of patient history. The disease may develop over days or sometimes weeks, thereby making the diagnosis difficult at the time of presentation. To make a clinical diagnosis of JIA, the first step is to exclude arthritis with known etiologies. Of note, late treatment due to excessive delay of diagnosis can cause severe damage to joints and other organs and impair skeletal maturation. Therefore, early detection of JIA is critical to ensure prompt treatment and to prevent long-term complications including the likelihood of disability in childhood.
A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment of LTBI are important for tuberculosis (TB) control in public and private healthcare facilities, particularly in high-risk populations. The updated 2017 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of them can be used for the diagnosis of LTBI, depending on the age and immune status of the patient as well as their TB contact history. For diagnosis of LTBI, exclusion of active TB is essential, and the possibility of healed TB in those without a history of treatment for TB but at risk of its development must be considered. The treatment options for LTBI include isoniazid, rifampicin, isoniazid/rifampicin, and isoniazid/rifapentine. The benefits and risks of these agents based on the age of the patient and their hepatotoxicity must be considered when selecting the appropriate drug. Standardized diagnosis and treatment of LTBI based on the updated 2017 guidelines will contribute to the control of TB in Korea as well as to further revisions of the guidelines.
Choi, Jee Ahn;Park, Won Bin;Kim, Jin Joo;Jo, Jin Sung;Kim, Jae Kwang;Lim, Yong Su;Hyun, Sung Yeol;Jeong, Ho Seong;Yang, Hyuk Jun;Lee, Gun
Journal of Trauma and Injury
/
v.22
no.2
/
pp.212-217
/
2009
Purpose: To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma Methods: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008. Results: The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region. Conclusion: From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.
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