성장기 환자의 발육 상태를 나타내는 여러 지표 중 수완부 골성숙도와 초경시기가 유용하게 사용될 수 있으며 수완부 골성숙도에서는 첫째와 셋째 수지의 변화가 비교적 중요한 의미를 가지고 있다. 이에 본 연구에서는 첫째 수지 및 셋째 수지의 지절 변화와 초경 및 부정교합과의 연관성을 조사하기 위해, 성장기 여아 중 I급 부정교합자 29명, II급 부정교합자 27명, III급 부정교합자 27명을 대상으로 약 6개월 간격으로 모지척측 종자골 출현 전부터 수지 지절의 융합이 거의 이루어지는 시기까지 누년적으로 촬영한 수완부골 방사선 사진과 초경시기를 평가하여 다음과 같은 결론을 얻었다. 1. 부정교합에 따른 골성숙도의 차이는 없었다. 2. 부정교합에 따른 초경연령의 차이는 없었으며, 초경의 평균 연령은 $12.30\pm0.98$세였다. 3. 모지척측 종자골 출현은 $10.35\pm1.01$세, 첫째 수지의 원심부 지절에서 Capping단계는 $11.26\pm1.04$세, 융합시기는 $13.12\pm1.06$세이고 셋째 수지의 중간 지절의 capping은 $11.57\pm1.02$세, 융합은 $13.72\pm1.04$세에 일어났다. 4.초경은 첫째 수지 원심부 지절의 융합이 진행되는 시기와(P<0.001, r=0.82),셋째 수지 중간 지절의 융합이 시작되는 시기와(p<0.001, r=0.78) 비슷한 시기에 나타났다. 이상의 결과로 첫째 또는 셋째 수지 지절 변화만으로 성장기 여아에서의 발육상태를 평가할 때 도움을 줄 수 있음을 알 수 있었다.
Background: Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries. The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. Objectives: The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. Materials and Methods: A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Results: Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was $47.8{\pm}12.4years$. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was $5.13{\pm}4.8months$, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. Conclusions: A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding, early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.
Objectives: The purpose of this study was to examine whether Sasang medical constitutional distributions of patients with uterine myoma are significantly different from those of healthy women in Korea. Methods: The subjects for this study were 258 patients who were diagnosed with uterine myoma by ultrasonography and classed through a questionnaire for the Sasang Constitution Classification II (QSCC II) among patients who entered Kyunghee Bogung oriental medical clinic from June 7th, 2011 to March 7th, 2012. Results: 1. The average size of myoma of subjects was $5.16{\pm}2.48$ and the average age was $37.1{\pm}7.2$ years old. The average age of menarche was $13.13{\pm}1.44$ years old and average frequency of abortion was $0.65{\pm}1.07$. There were no significant differences by constitution in size of myoma, age, marital status, age of menarche, history of giving birth or history of abortion. 2. The overall average BMI of all subjects in this study was 21.4. By constitution, average BMIs were $24.2{\pm}3.2$, $20.5{\pm}2.0$ and $20.2{\pm}2.2$ for Taeumin, Soyangin and Soeumin, respectively. There was a significant difference by constitution. 3. Sasang medical constitutional distributions of subjects was as follows: Taeumin 28.3% (73 patients), Soyangin 35.7% (92 patients), Soeumin 36.0% (93 patients). When compared with those of healthy Korean adult females who did not have uterine myoma (44.4%, 14.8% and 40.9%, respectively), the proportion of Soyangin was significantly higher. Conclusions: We found that Sasang medical constitutional distribution of subjects differs from those of healthy Korean women without uterine myoma and in particular, among Soyangin is significantly higher.
This study was conducted with 20 female gymnasts and 23 age-matched controls to examine the relationship of diet, menstrual function and bone mineral density (BMD). The results obtained are summarized as follows : Energy intake of gymnasts was 968.9$\pm$421.4kcal, and energy expenditure was 2091.4$\pm$361kcal showing negative energy balance(-1,122.5$\pm$534.6kcal). The average intakes of calcium, iron, vitamin A, thiamin, riboflavin and niacin did not meet the Recommended Dietary Allowances for their age groups. Mean age at menarche in gymnasts is 15.8$\pm$1.2 years compared with 11.8$\pm$2.8 years in age-matched controls. The profile of estradiol, progesterone, and luteinizing hormone was lower than age-matched controls but not significant. Athletic amenorrheic gymnasts(n=12) have the menstrual irregularity(n=10) and amenorrhea(n=2). A number of variables as such nutritional deficiency in diet, negative energy blasnce and hypogonadotropic hormonal status were included. The bone mineral density (BMD) of female gymnasts were significantly higher than controls for the lumbar neck(p<0.001), trochanter(p<0.01), and Ward's triangle(p<0.001), but there were no significant differences for the lumbar spine and forearm. The lumbar spine BMD had a positive correlation with age and lean body weight. The femoral neck BMD was significantly associated with age, group and lean body mass. The trochanter BMD had significant relationship with group, body mass index, energy expenditure and follicular stimulating hormone. Ward's triangle BMD were related to body mass index and follicular stimulating hormone. The significant association was deterced between forearm BMD and age and lean body weight. The major finding of this investigation is that the BMD of gymnasts were higher than age-matched controls despite the fact that gymnasts as a group had inadequate dietary calcium and a higher propensity to have an interruption of their menstrual cycle. These data indicate that grymnsts involved in sports producing significant impact loading on the skeleton had greater femoral neck, trochanter and Ward's triangle bone density than age-matched controls.
More than one million new patients suffer from breast cancer annually in the world. In developed countries, breast cancer is the most common malignancy diagnosed among women, and in developing regions, it often ranks second to cervical cancer. This study aimed to investigate the relationship between incidence of breast cancer and reproductive factors in North-West of Iran. This retrospective analytical control-case study was conducted with 235 breast cancer patients and 235 women in the control group. Data collection tools included a set of questions with interviews and patient medical records. Data were analyzed using statistical tests: t-test, Chi-square, Fisher, and Pearson correlation coefficient. Significantly increased risks were associated between breast cancer and older age at first pregnancy, age at menopause and history of contraceptive use. A trend for decreasing risk were observed with increasing parity. Findings of this study showed no association between breast cancer and age at menarche. The study results suggested that physiological and reproductive factors may play important roles in the development breast cancer among Iranian women.
Background: Breast cancer is the most prevalent malignancy among women with wide differences in clinical profile from region to region. The present study aimed to describe the profile of breast cancer patients attending a tertiary care hospital in Marathwada region of Western India. Materials and Methods: In this descriptive retrospective study, we reviewed records of pathologically diagnosed patients of breast cancer managed at our center from years 2009 to 2015. Data with respect to demographic status, detailed past, medical, familial and personal history, findings of clinical examination and histological features were obtained. Patients were staged according to the Tumor Node Metastasis (TNM) system. Results: Among 260 cases, mean age of presentation was 52.6, with average age of menarche of 11.3 and menopause of 52.6 years. The majority of patients were from urban regions and were postmenopausal (64.3%). Main clinical features presentation were breast lumps. Most patients were in stage II and had infiltrating duct carcinomas. Conclusions: Most common risk factors for breast cancer observed are increasing age, low parity and obesity. Breast cancer was more prevalent among postmenopausal women presenting in stage II with infiltating duct carcinoma in our region of India.
The purpose of this study was to investigate the natural menopause age of middle-aged women in Korea and to analyse various factors affecting them. For the collection of date, 1,140 women aged between 45-54 were selected through stratified sampling technics in Seoul and at a rual area in Kyong KiProvince. They were interviewed from Nov. 1 through Dec. 31,1987 by use of questionnaires made after pilot study had been performed twice. Among them the final subjects for analysis were restricted to only those who had experienced menopause or irregular menstruation during the past one year, the number of which was total 410:206 in urban and 204 in rural area. For the analysis, menopause age was used as dependent variables while fertility variables, socio-economic variables, bio-physical varibles, and insight of life variables were classified as independent variables. Dependent variables such as menopause was tested and analysed by descriptive statistical methods(e.g., frequency, percentage, mean, $X^2-test.$ t-test, ANOVA). The relation between menopause age and independent variables was analysed by use of Pearson's correlation coefficients. For the analysis of various factors affecting menopause age, multiple stepwise regression method was used. The obtained results are summarized as follows: 1. The natural menopause age of Korean women were 47.2 mean age: it was 47.7 and 46.7 mean age in urban and rural area respectively, which revealed that the former was later then the latter by one year. And the recollective error on menopause starting age between the menopause group and the group who had experienced irregular menstruation during the past one year was 0.4-0.7 year. 2. The main factors affecting the menopause age were (1) the duration of marital life, (2) the duration of oral pill use, (3) insight of life and economic status, (4) educational background. (5) menarche, (6) usual menstruation amount, (7) electic charge. and (8) area. These factors. altogether, could explain $18.4\%$ of factors related with menopause, and they took the high percentage in the order mentioned.
This study's purpose is to clarify the growth pattern of Down Syndrome cases -particulary centering on the adolescent growth pattern - and to draw up a standard growth chart on body height and weight which is one estimation of physical growth for the effective caring of their health. I sampled 269 Down syndrome cases (Male 151, Female 118) whose ages ranged from 6 years of age to adulthood and 348 normal control cases (Male 175, Female 173) who were in same age group with Down Syndrome. We also picked 124 Down syndromes cases(Male 70, Female 54) and gathered 8 year longitudinal data on their body height and weight. The results were that, I found Down syndrome cases' height to be short and their weight to be overweight. As far as age at peak height velocity was concerned, boys were at 11-12 years of age and girls were at 10-11 years of age, showing that girls were about one year faster. Peak height velocity was 6.8cm/yr for boys and 5.4cm/yr for girls. The age at peak weight velocity were 12-13 years for age for boys and 10-11 years of age for girls. Peak weight velocity was 5.7kg/yr for boys and 4.3kg/yr for girls. The menarche age of girls with Down syndrome was anticipated to come about 2 years after peak height velocity and peak weight velocity. Finally, we drew up a standard growth chart and compared it with that of the NCHS, which caused us to come to the conclusion that the Standard Growth Chart for Down syndrome cases in Korea that came out of this study was appropriate for the growth-assesment of Down syndrome.
Objectives : It has been suggested that obesity in childhood may lead early menarche and rapid bony maturation. The purpose of this study is to investigate correlation between bone maturation and obese degree in childhood in Korea. Methods : Height, body weight, BMI, percent body fat were taken 138 patients. Ultrasonic scan was taken through calcaneous of the right foot to evaluate bone age. $DA({\Delta}age)$ was calculated from the difference of bone age and chronological age, and it was used in correlation with obese degree. Results : 1. The average age of patients was $11.91{\pm}2.86$ years old in boys, $11.44{\pm}2.27$ years old in girls. 2. The average BMI was $20.92{\pm}4.53kg/m2$ in boys, $19.76{\pm}4.05kg/m2in$ girls, and average percent body fat was $25.13{\pm}8.23%$ in boys, $27.66{\pm}5.95%$ in girls. 3. The average OI(osteo index) was 37.88 in boys, 36.64 in girls, and average bone age was $12.00{\pm}2.61$ years old in boys, $11.81{\pm}2.11$ years old in girls. 4. There was significant correlation between $DA({\Delta}age)$ and PBF in boys, but no significant correlation with BMI(p<0.05). 5. There was significant correlation between $DA({\Delta}age)$ and PBF, BMI in girls(p<0.01). 6. There was significant correlation between RA and OI(p<0.01). Conclusion : It is suggested that obese degree may have an impact on early bony maturation especially in case of girls.
We, Ji Sun;Han, Kyungdo;Kwon, Hyuk-Sang;Kil, Kicheol
Journal of Korean Medical Science
/
제33권48호
/
pp.311.1-311.10
/
2018
Background: In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. Methods: We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. Results: The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ${\geq}4$ compared to those with lower parity levels. Conclusion: Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.
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