Brain metastases are a leading cause of morbidity and mortality for patients with systemic cancer and are among the most common intracranial tumors in adults. Its incidence increases as cancer therapies improve, and patients live longer, providing new challenges to the multidisciplinary teams that manage these patients. The contemporary neurosurgical treatment of intracranial metastases has become gradually more complex as the available therapeutic options increase. For the past 50 years, whole brain radiotherapy and systemic corticosteroids have been considered as the standard of care for patients with brain metastases. However, in recent years, stereotactic radiosurgery is spotlighted as an alternative therapeutic modality for these patients because of its relatively short, convenient, and non-invasive treatment course. Stereotactic radiosurgery is a radiation therapy technique in which multiple focused radiation beams intersect over a target, which results in the delivery of highly conformal, high-dose of radiation to the target and minimal radiation to surrounding normal parenchyma. The purpose of this review is to provide an overview of stereotactic radiosurgery as a treatment modality for patients with brain metastases.
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Growth represents a sentinel for general health state in children and adolescent. Linear growth in children and adolescent is a complex process influenced by numerous factors including genetic, prenatal, postnatal, and environmental factors. When children less than 2 standard deviation score below the average height for age and sex, they are considered as short stature. Accurate measurement of body profile and determination of height velocity over time are fundamental step. Whether the growth pattern is appropriate or deviated from standardized growth chart is a key point in approaching to short stature in children. Evaluation includes a detailed past medical and family history, physical examination, laboratory test and radiologic evaluation. Recent advances in genetic approaches are allowing for improved diagnosis for idiopathic short stature and various genetic syndromes. Growth hormone is the main treatment option for short stature. It is generally safe but has potential side effects. Individualized growth hormone treatment should be initiated under consideration of both efficacy and safety by pediatric endocrinologists. Early diagnosis and prompt initiation of treatment result in a good prognosis. This article reviews an overview of the diagnostic approach to children and adolescents with short stature, and summarizes etiologies and growth hormone treatment.
A notable secular trend in early puberty onset has been described over the past few decades. Also, the prevalence and incidence of precocious puberty is increasing not only in Korea, but also around the world. The manifestation of secondary sex characteristics before 8 years in girls and 9 years in boys is defined as precious puberty. The causes of precocious puberty can be classified as gonadotropin releasing hormone (GnRH)-dependent, also known as central precocious puberty (CPP), or GnRH-independent. Evaluation of patient with precocity requires detailed examination of the clinical manifestation, GnRH stimulation test, and imaging of the central nervous system if indicated. The standard treatment for CPP is GnRH agonist, which is beneficial for adequate pubertal development and preservation of final adult height. In this paper, we investigate the diagnosis and adequate treatment of CPP.
Colonoscopy is commonly used to screen for and diagnose colorectal disease, and adequate bowel preparation is crucial to its quality. As bowel preparation regimens vary, it is important that clinicians understand each and select the proper one for each patient. Accordingly, here we investigated recent studies and describe how to choose the optimal bowel preparation regimen. We detail composition, dosages, efficacy, contraindications, and precautions of commonly used regimens including 4 L polyethylene glycol (PEG), 2 L PEG+ascorbic acid, 1 L PEG+ascorbic acid, trisulfate (oral sulfate solution/tablets), and sodium picosulfate/magnesium citrate. Here we describe that the most recently introduced 1 L PEG and oral sulfate tablets, which were developed to improve convenience and compliance, differ in composition and efficacy between South Korea and foreign countries. This review presents new evidence of and differences among products to increase clinician understanding.
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, Kyunghee Jung-Choi, Bo Young Kim, Kyoung Ae Kong This study aimed to investigate the prevalence of unhealthy dietary habits by maternal educational level and how the effect of maternal education changed between 2009 and 2019.
Using data from the Korea Youth Risk Behavior Survey conducted between 2009 and 2019, we assessed the prevalence of each unhealthy dietary habit (insufficient consumption of milk and fruit/vegetable, breakfast-skipping, and frequent consumption of fast food, soft drinks, and instant noodles) and the prevalence difference between maternal middle/high school and college graduate groups in four periods. The models included maternal educational level, four periods and the interaction between them, sex, and grade. In addition, we estimated the ORs of unhealthy dietary habits between the two maternal educational groups at each period.
Throughout the study period, unhealthy dietary habits were consistently more prevalent among mothers with lower education levels. Between 2009–2010 and 2017–2019, the prevalence of unhealthy dietary habits increased, with a particular increase in that of frequent consumption of fast food and soft drink. The prevalence differentials between the middle school and college graduate group decreased or did not differ, while those between the high school and college graduate groups increased over time. A similar trend was observed in the relative scale.
Considering the increase in the prevalence of unhealthy dietary habits and the prevalence differentials by maternal educational level, targeted efforts are needed not only for all adolescents and their parents but also for those with low socioeconomic status to improve the dietary habits of adolescents.
, Rosa Kim, Min Young Lee, You Won Choi, Hae Young Choi 
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