PurposeThis study examined the relationships between early menarche and sexual behaviors among Korean female adolescents.MethodsWe analyzed data from the eighth Korea Youth Risk Behavior Web-based survey that was conducted on female high school students in grades 10-12. The survey included 17,867 students, and 974 students were assigned to the early menarche group because they had experienced menarche when they were in grade four or below, and 16,893 students were assigned to the normal menarche group because they had experienced menarche during or after grade five. The characteristics of the sexual behaviors in the early menarche and normal menarche group were analyzed.ResultsThe early menarche group was at a higher risk of intersexual kissing or petting (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.28-1.87), intersexual intercourse (OR, 2.35; 95% CI, 1.65-3.36), homosexual kissing or petting (OR, 3.53; 95% CI, 2.22-5.59), homosexual intercourse (OR, 7.70; 95% CI, 4.04-14.66), being the victim (OR, 2.89; 95% CI, 1.98-4.22) or the assailant (OR, 13.55; 95% CI, 6.61-27.78) of sexual assaults, intercourse without any contraception (OR, 1.92; 95% CI, 1.06-3.46), and pregnancy (OR, 5.72; 95% CI, 2.31-14.15) than the normal menarche group.ConclusionEarly menarche is associated with risky sexual behaviors among adolescent females; therefore, developing comprehensive sexual health education programs and tools for early intervention are required for children who are expected to experience early menarche.

Congenital central hypoventilation syndrome (CCHS) is a life-threatening disorder with apnea and cyanosis during sleep requiring immediate endotracheal intubation during the first day of life. The PHOX2B gene has been identified as the major gene involved in CCHS. This is the first report of a Korean neonate with CCHS confirmed to have a PHOX2B mutation with expanded alleles containing 20 polyalanine repeats that is a relatively small number compared to previous cases. The patient required intermittent ventilator support during sleep only and did not suffer from any other disorders of the autonomic nerve system. He consistently needs ventilator support during sleep and remains alive. Analysis of PHOX2B gene is useful for diagnosis and appropriate therapeutic intervention of CCHS patients.

PurposeThis study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD.MethodsThe clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of patients with NAFLD were also compared based on the status of ALT levels after lifestyle intervention.ResultsPatients with elevated ALT had significantly higher body mass index (BMI) scores than those with normal ALT (P<0.05). Of all the patients with elevated ALT, 89% exhibited moderate or severe degree of fatty change in the liver on ultrasonographic examination, whereas most patients with normal ALT exhibited mild or moderate degree changes. Liver biopsy was performed in 15 children with elevated ALT and all showed mild histological changes. Of all patients with elevated ALT, 49% achieved normal ALT levels after lifestyle intervention. Those with more severe histological changes tended to have continuously increasing ALT levels. There was no correlation between the normalization of posttreatment ALT level and BMI, as well as ultrasonographic findings at diagnosis.ConclusionALT elevation in NAFLD is highly associated with higher BMI scores and more severe degree of fatty changes on ultrasonographic examination. Lifestyle intervention can significantly improve ALT in children with NAFLD. The degree of histologic changes appears to be a predictor of the treatment response to NAFLD.

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Purpose: The objective of this study was to investigate physicians' attitudes toward ethical end-of-life decision making about dying newborns. Methods: Between October and December 2015, we surveyed 185 neonatal staff members working at 6 neonatal intensive care units to investigate their attitudes toward ethical end-of-life decision making about dying newborns. Results:The respondents generally agreed with using sedatives/analgesics to suppress pain despite the risk of fatality (80%), continuing current treatment without using other treatment methods (56.2%), and withholding emergency treatment in the form of cardiac arrest resuscitation (48.1%). In contrast, most respondents disagre ed with administering drugs for the purpose of ending life, withholding neonatal intensive care, and withholding mechanical ventilation. Although the respondents believed that it is necessary to suggest that the parents of dying neonates sign do-notresuscitate (DNR) orders (62.7%), most of them found it difficult to talk to parents/ families about DNR orders (90.8%), or wanted to refrain from obtaining families' consent in person (84.9%). Conclusion: Korean neonatal staff members believed that withholding or withdrawal of treatment is necessary when making ethical decisions about dying neonates; however, they preferred to use conservative, rather than active interventions.