This study was attempted to investigate the prevalence of anemia and to obtain nutritional education data for high school girls by analyzing the factors influencing on anemia. Total fo 113 subjects(21 female high school students in Seoul and 92 female students in Inchon) were participated in this study from July 1 to July 15, 1990. Hb and Hct values were measured to evaluate the iron status. Duncan's multiple range test were performed for the comparison between the mean values of the various group. Correlations among various factors were analyzed by Pearson's correlation coefficient. The results of this study are summarized as follows. 1. The maen Hb and Hct values were 13.2g/dl and 41.3%. The rate of anemia of the subjects was 5.3% by the criteria of Hb concentration and 2.7% by the Hct value according to World Health Organization. 2. Subjects who had an early menarche had significantly higher weight and triceps than the ones ofr the girls with a late menarche. 3. There were positive relationships among Hb and Hct values, ages of memarche and cycle of menstruation. Hb, Hct values were significantly higher in the subjects who had frequent bed time snack, high intakes of meats and fishes group and vitamin A, and low calcium intake. In conculsion, the prevalence of anemia of the subjects was much lower than the previous years. There were positive relationships among Hb and Hct values, age of menarche, night snack, and intakes of meats and fishes and fruits. Therefore, it could be concluded that nutrition education should be emphasized for the high school girls to improve the quality of diet and prevent anemia.
Among many maturation indicators of growing patients, menarche and skeletal maturity are useful to assess growth and development, and the changes of the first and third finger are relatively important in hand-wrist X-rays. The objective of this study was to evaluate the relationship between menarche and the changes of the phalanx of the first and third finger and compare skeletal maturation among different malocclusion types. The sample used in this study was 29 Class 1,27 Class II and 27 Class III females whose hand-wrist X-rays had been taken with 6 month interval before the appearance of ulnar sesamoid ossification till the phalanges of the fingers were almost fused. The results were as follows. 1. There was no skeletal maturity difference among malocclusion types. 2. There was no difference in the mean chronologic age of menarche among different malocclusion types and that was $12.30\pm0.98$ years. 3. The ulnar sesamoid was observed at $10.35\pm1.01$ years, and on distal phalanx of the first finger, epiphyseal capping appeared at $11.26\pm1.04$ years and fusion at $13.12\pm1.06$ years. The epiphyseal capping on middle phalanx of the third finger was observed at $11.57\pm1.02$ years and fusion at $13.72\pm1.04$ years. 4. The timing of menarche occurred around the same time as the fusion process of distal phalanx of the first finger(p<0.001, r=0.82) and the initiation of fusion of middle phalanx of the third finger(p<0.001, r=0.78). Therefore, we can give the aid when we evaluate the growth and development of growing females seeing the changes at phalanx of the first and third finger.
Kang, Bo Young;Kim, Yang Kyong;Hong, Young Jin;Son, Byong Kwan;Chang, Kyung Ja;Kim, Soon Ki
Clinical and Experimental Pediatrics
/
v.48
no.1
/
pp.21-26
/
2005
Purpose : The aim of this study is to find the prevalence of obesity, the serum lipid levels and the age at menarche in adolescent female athletes and to examine the effects of exercise in adolescent stage. Methods : With a questionnaire regarding their age at menarche, physical measurement, body fat, and blood samples of the serum lipid levels to evaluate the hyperlipidemia were obtained from adolescent female athletes(n=107) and general adolescent students(n=650) who didn't exercise at regular intervals, aged 12 to 18 years. Results : The mean weight in the athletes' group was $53.3{\pm}7.3kg$ which was similar with $54.3{\pm}8.0kg$ in the control group. The mean height in the athletes' group was $161.4{\pm}5.4cm$, which was taller than $158.9{\pm}5.3cm$ in the control group. The prevalence of obesity by obesity index, body fat, and BMI in the athletes' group were significantly lower than in control group. There was no significant difference in age at menarche between two groups($12.6{\pm}1.3$, $12.9{\pm}1.2$). The levels of cholesterol, LDL cholesterol, and HDL cholesterol in the athletes' group were higher than in the control group. The levels of triglyceride in the athletes' group was lower than in control group. Conclusion : These data suggest the importance of exercise in adolescents for the prevention of obesity since it may reduce body fat and increase the height. There was no negative effect of exercise on the age at menarche. We think that more controlled assessment of nutrition, diet habit, hormonal effect and height are warranted to find the correlation with hyperlipidemia and exercise at the adolescent stage.
Bone mass accretion during puberty appears to be critical in the development of peak bone mass. Although bone density of females in Korea has been studied, only a few studies have related bone mass with anthropometric patterns or puberty in the pubescent girls. This study was conducted as part of a study of major determinants of bone development during puberty. Subjects were aged 14∼16 yr(mean 14.97), and had no history of disorders or dedication use likely to influence bone or calcium metabolism. Bone mineral density and content were measured by dual energy X-ray absorptiometry using a Lunar DPX+Scanner (Lunar Madison, WI). Also, total body fat, and total lean body mass were assessed using a Lunar DPX dual-energy X-ray absorptiometer, Pubertal status was assessed according to the Marshall and Tanner guidelines. Serum levels of osteocalcin was measured by RIA using a commercial kit assay. Skinfold measurements were taken with a skinfold caliper(Lange Caliper, USA). Data were analyzed using the regression and GLM procedure of the statistical package SAS. The results indicated that the observed means for lumbar spine BMD and femoral BMD correspond to approximately 91% and 96% of the means for young adult females, respec tively. All subjects were menarchal, with the majority being in the middle to end stages of pubertal development. Total body BMD was positively related to fat mass(P<0.001), lean body mass and time since menarche, and negatively related to urine pyridinoline, serum alkaline phosphatase and osteocalcin. The data indicate that girls who reported lower age for menarche had significantly higher bone densities than girls who reported higher age for menarche. Attaining peak skeletal bone mass during puberty may reduce the incidence of osteoporosis in later life. this finding suggests that early menarche may augment peak bone mass, influencing the extent of bone loss later in adulthood. The results suggest that good nutrition in childhood appears to be needed not for growth and development, but possibly also to assure an optimal peak of bone mass and thus greater latitude for the maintenance or skeletal integrity in the face of bone losses. Troeps skinfold thickness was a better predictor of total BMD and total BMC than was any other skinfold thickness. The study did not find a relationship between total BMD and body fat %, but total fat was significantly positively related to total BMD(r=0.49) and total BMC(r=0.60). It supports earlier report that there was a significant correlation between TBMD and body weight. Conclusively, total fat, lean body mass and pubertal development could influence BMD in pubescent girls. Clearly, longitudinal studies are required to assess the effect of puberty on peak bone mass, and to define further the potential determinants of peak bone mass.
Objectives: In many previous studies, endocrine disruptors (EDCs) have been found to affect delays in puberty. Various EDCs have been reported on, but there have been only limited epidemiologic studies on the effects of exposure to environmental heavy metals and pyrethroid pesticides on puberty delay. Therefore, the aim of this study was to investigate the association of exposure to environmental mercury, cadmium, and pyrethroid pesticides with delayed puberty in children based on national survey data that represents Korean children. Methods: We selected 450 children at the ages of 9-11 years old from the third Korean National Environmental Health Survey (3rd KoNEHS). The relations of urinary Hg, Cd, and 3-PBA with pubertal development were evaluated using multiple logistic regression analyses. Results: Urinary Hg levels were significantly associated with delayed puberty in boys [testicle development: OR=0.41 (95% CI: 0.20, 0.84); genitalia development: OR=0.35 (95% CI: 0.15, 0.81)]. Girls with higher Hg levels were more likely to experience delayed menarche [OR=0.23 (95% CI: 0.06, 0.90)]. We observed a significant 49% reduction in odds for menarche per increasing unit of urinary cadmium levels [OR=0.51 (95% CI: 0.24, 1.01)]. In addition, urinary 3-PBA showed a negative association with genitalia development in boys and menarche in girls [genitalia development: OR=0.73 (95% CI: 0.55, 0.96); menarche: OR=0.56 (95% CI: 0.32, 1.00)]. Conclusions: The results of this study support the hypothesis that exposure to environmental mercury, cadmium and pyrethroid pesticides may affect puberty delays. Additional evidence needs to be obtained through further prospective studies.
Purpose: This correlational study was performed to identify the impacts of maternal child rearing attitudes on the menstrual attitudes and the determinants of positive menstrual attitudes in female middle school students. Methods: With convenience sampling, 198 middle school female students were recruited living in one major city and its surrounding areas in Korea. Data was collected using a self administered questionnaire including menstrual attitudes and maternal child rearing attitudes from April 1 to July 15, 2008. Results: Among the Maternal child rearing attitudes, affectionate, achievement oriented and rational attitudes had positive correlations to a positive menstrual attitude, and an autonomous attitude had a negative correlation to a negative menstrual attitude. As determinants of positive menstrual attitudes, feeling of menarche, mother's response at first menstruation, and rational maternal child rearing attitudes were delineated and their explained variance for a positive menstrual attitude was 18.5%. There was no difference on menstrual attitudes by K clustering in terms of maternal child rearing attitudes. Conclusion: These results support the critical role of the mother. Especially desirable maternal child rearing attitudes in relation to a positive menstrual attitude would be affectionate, achievement oriented and rational for early adolescent girls. In further studies, considerations are needed for menstruation related education and research for early adolescents and active involvement of the mother & daughter together.
Background: The objective of this study was to determine a diagnostic classification scheme using a decision tree based model. Materials and Methods: The study was conducted as a retrospective case-control study in Imam Khomeini hospital in Tehran during 2001 to 2009. Data, including demographic and clinical-pathological characteristics, were uniformly collected from 624 females, 312 of them were referred with positive diagnosis of breast cancer (cases) and 312 healthy women (controls). The decision tree was implemented to develop a diagnostic classification scheme using CART 6.0 Software. The AUC (area under curve), was measured as the overall performance of diagnostic classification of the decision tree. Results: Five variables as main risk factors of breast cancer and six subgroups as high risk were identified. The results indicated that increasing age, low age at menarche, single and divorced statues, irregular menarche pattern and family history of breast cancer are the important diagnostic factors in Iranian breast cancer patients. The sensitivity and specificity of the analysis were 66% and 86.9% respectively. The high AUC (0.82) also showed an excellent classification and diagnostic performance of the model. Conclusions: Decision tree based model appears to be suitable for identifying risk factors and high or low risk subgroups. It can also assists clinicians in making a decision, since it can identify underlying prognostic relationships and understanding the model is very explicit.
The purpose of this study is to understand the structure of mothers of mentally handicapped daughters' lived experience, to apprehend the connectedness of the structure of the experience with concept of Parse's human becoming theory, and to provide a foundation for nursing research and education. Data collection was conducted from October 1995 to April 1996. Research participants were eight mothers of mentally handicapped daughters whose ages ranged from 12 to 18 attending special schools located in either Inchon or Seoul. The researcher had interviews with them over their lived experience conducted tape recorded, and made an analysis according to Parse's “human becoming research methodoloy.” The data were collected using the dialogical engagement process “I and You,” the participant researcher and the participant subject. The data were analyzed using the extraction-synthesis and heuristic interpretation. The structural integration is illustrated in the following : 1) Realizing the mother's role of mentally handicapped daughters and admitting situation. 2) Concealing a part of their relationship with others is interpreted as revealing-concealing. 3) Living a life kept moving between separating and connecting. 4) Their flight back voluntarily to improve the situation is interpreted as powering. The conceptual integration which emerged was the lived experience of mothers is powering through the revealing-concealing and connecting-separating of valuing.
The mechanisms by which iron is absorbed are similar to those of divalent metals, particularly manganese, lead, and cadmium. These metals, however, show different toxicokinetics in relation to menarche or menopause, although their interaction with iron is the same. This review focuses on the kinetics of these three toxic metals (manganese, lead, and cadmium) in relation to menarche, pregnancy, and menopause. The iron-manganese interaction is the major factor determining sex-specific differences in blood manganese levels throughout the whole life cycle. The effects of estrogen overshadow the association between iron deficiency and increased blood lead concentrations, explaining why women, despite having lower ferritin concentrations, have lower blood lead concentrations than men. Iron deficiency is associated with elevated cadmium levels in premenopausal women, but not in postmenopausal women or men; these findings indicate that sex-specific differences in cadmium levels at older ages are not due to iron-cadmium interactions, and that further studies are required to identify the source of these differences. In summary, the potential causes of sex-specific differences in the blood levels of manganese, lead, and cadmium differ from each other, although all these three metals are associated with iron deficiency. Therefore, other factors such as estrogen effects, or absorption rate as well as iron deficiency, should be considered when addressing environmental exposure to toxic metals and sex-specific differences in the blood levels of these metals.
Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.
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