Apgar Score ; Autopsy ; Fatal Outcome ; Heart Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Heart Ventricles ; diagnostic imaging ; Humans ; Infant, Newborn ; Male ; Myxoma ; complications ; diagnosis ; diagnostic imaging ; pathology ; Rare Diseases ; Ultrasonography

No abstract available.
Child* ; Humans ; Hypertension*

No abstract available.
Family Practice* ; Humans ; Internship and Residency*

The school health services target the students and teachers who attend the schools in their community. They provide many programs such as health assessment, medical service, environmental management and health education. The former two are mainly conducted by the primary care physicians in each community. In this article, the sentences in the School Health Act and the other laws governing the physician's roles in community school health programs are reviewed. In addition, the main issues on the recent attempts to reform the Act are discussed, and the most satisfying plan, 'primary care physician-centered health examination program', is suggested. As other health care programs, school health programs need more active and organized physician's participation.
Delivery of Health Care ; Health Education ; Humans ; Jurisprudence ; Physician's Role ; Physicians, Primary Care ; School Health Services*

We performed a retrospective analysis of the results of surgical treatment of sixteen patient with comminuted fracture of the distal femur from September 1993 to August 1995 and evaluated the efficacy of the angled blade plate as one of the fixation devices used. The fractures were limited to C2 and C3 fracture classifed according to the AO classification. After an average follow-up of 13 months (range, 9 to 24 months), all of the fractures had healed. Postoperatively, the arc of flexion was limited between 90degrees and 125degrees in eight, normal arc in five, and severely restricted arc of joint motion was present unexceptionally in three patients with deep infection. In angular deformity, average 5.8degrees of valgus and 2.4degrees posterior angulation were showed. The functional results by Sanders-Swiontkowski-Rosen-Helfet rating system were showed excellent in 3, good in 7, fair in 3, and poor in 3 cases. The overall results were seen to be excellent to good in ten cases (62.5%) but in twelve patients using the angled blade plate, excellent to good results were showed 10 patients (83.3%). We attribute the favorable results in our series to restoration of the articular surface through the modified extensile approach, sufficient stable fixation using the angled blade plate with conforming to the concept of bridge plate, routinely performing the bone graft for medial buttress and bone healing, and early mobilization of the extremity.
Classification ; Congenital Abnormalities ; Early Ambulation ; Extremities ; Femur* ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Joints ; Retrospective Studies ; Transplants

BACKGROUND: Recentry, the prevalence of HBsAg in children has been gradually decreased in Korea may be due to extensive vaccination. The object of this study is to identify the HbsAg positive rate in 6 to 7 year-old school children in Seoul and to outline the surveilance status of the HBsAg positive subjects. METHODS: We analyzed HBV mass screening results of 120,106 6 to 7-year-old school children in Seoul. For 188 HBsAg positive children who complied with the follow up visit, we tested HBeAg, LFT and interviewed their parents. We also compared the questionnaire results of HbsAg positive group with those of 694 random-sampled HBsAg negative controls. RESULTS: The overall HBsAg positive rate was 0.79%(0.81% in boys and 0.76% in girls). Children in poverty area showed significantly higher rate(1.04%) of HBsAg positivity than those in non-poverty area(0.77%). Among HbsAg positive children, 86.7% was also HBeAg positive and had higher ALT levels than those with negative HBeAg. More than 70% of parents of HBsAg positive children was not aware of their children's HBsAg status before the screening and 28.7% of mothers did not know their own HbsAg status. The complete vaccination rate of the HBsAg positive and HBsAg negative group were 75.5% and 77.4% respectively, which shows no significant difference. Having family history of HBV infection was significantly associated with HBsAg positive status(OR=32. 8). CONCLUSIONS: The HBsAg positive rate in 6- to 7-year-old school children has decreased in Korea compared to the data from previous studies. However in the aspects of public awareness and health care compliance, there are much room for quality improvement. Above all, more rigorous and continuous surveilance system is required for antenatal and postpartum care.
Child* ; Compliance ; Delivery of Health Care ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis* ; Humans ; Korea ; Mass Screening ; Mothers ; Parents ; Pilot Projects* ; Postnatal Care ; Poverty Areas ; Prevalence ; Quality Improvement ; Seoul* ; Vaccination ; Surveys and Questionnaires

BACKGROUND: The purpose of this study is to obtain the accurate information on the obesity indices, such as body mass index(BMI), relative weight and waist-hip ratio(WHR) and to investigate their relationship in order to assess the childhood and adolescent obesity more appropriately. METHODS: In May, 1995, a total of 6943(male; 3469, female; 3474) students from primary, middle and high schools in Seoul were selected and each students height, weight, waist and hip circumference data were collected. RESULTS: The BMI increased with age in both sexes. From age 12 to 16, values of BMI 50th percentiles for females exceeded those for males. And the BMI 95th percentiles at the age of 13 to 14 years were higher for females than for males. The prevalence of obesity by relative weight was higher in males than in females(male ; 17.9%, female ; 13.1%). The WHR was higher in males than females in all age group and decreased with age in both sexes, showing more sharp reduction in females. Strong correlations were observed between the BMI and the relative weight, and the BMI and the relative weight correlated closely with WHR. The WHR was significanly higher in obese group' than in non-obese group. In the female obese group aged 6 to 11 years, no significant correlation was found between the relative weight and the WHR. CONCLUSIONS: There were significant relationships between the indices of obesity and body fat distribution. This study suggests that WHR as well as BMI and relative weight might be useful in assessing the childhood and adolescent obesity.
Adolescent* ; Body Fat Distribution ; Body Mass Index* ; Child* ; Female ; Hip ; Humans ; Male ; Obesity ; Pediatric Obesity ; Prevalence ; Seoul* ; Waist-Hip Ratio*

OBJECTIVES: This study evaluated the effectiveness of school-based mental health screening and treatment linkage programs, focusing on attention-deficit hyperactivity disorder (ADHD) and adolescent depression. METHODS: All 11,158 children and adolescents aged 8-14 years in Seoul received a school-based mental health screening, consisting of the Korean versions of the ADHD rating scale and the Child Behavior Checklist (CBCL), for ADHD, and the Center for Epidemiological Studies Depression Scale (CES-DS) and the Suicidal Ideation Questionnaire-Junior (SIQ-JR), for depression. The high-risk children's and adolescents' diagnoses were confirmed using the Diagnostic Interview Schedule for Children-IV (DISC-IV). Treatment linkage programs were managed by the Seoul Metropolitan Community Mental Health Center (Program 1), the Seoul Metropolitan Office of Education (Program 2), or the Dongjak District Office of Education (Program 3). We estimated and compared the referral rates of the three programs. RESULTS: Program 1 screened and referred 22.9% of ADHD youths to mental health services, Program 2, 68.8%, and Program 3, 40.0%. Program 1 screened and referred 22.8% of depressed youths to mental health services, Program 2, 53.8%, and Program 3, 88.9%. Key elements for successful screening and referral programs were an effective school/community mental health center/Office of Education network, the parents' financial support and perception of their child's mental health status as being problematic, and the teachers' active engagement. CONCLUSION: This is the first study investigating the effectiveness of school-based mental health screenings' linkage to treatment for primary and middle school students in Korea. An effective network for community mental health and improvements in parents' and teachers' perceptions regarding mental health are needed for more successful treatment linkage.
Adolescent ; Aged ; Appointments and Schedules ; Checklist ; Child ; Child Behavior ; Depression ; Epidemiologic Studies ; Financial Support ; Humans ; Korea ; Mass Screening ; Mental Health ; Mental Health Services ; Referral and Consultation ; Suicidal Ideation

PURPOSE: The purpose of this study was to look at prevalences of abnormal serum aminotransferase levels and abnormal serum total cholesterol levels among adolescents with obesity in Seoul area. METHODS: Body mass index[BMI(kg/m2)], serum aspartate aminotransferase(AST) alanine aminotransferase(ALT), and total cholesterol levels were measured in 26,876 adolescents(male : 13,287, female : 13,589) of first grade of high school in Seoul between the ages of 15 and 16 years, enrolled in a large health examination survey by Seoul School Health Center(SSHC) in 2001. Obesity was defined as BMI more than 95th percentile for age and sex and normal weight was defined as BMI between 25th percentile and 75th percentile for age and sex. Abnormal levels of AST, ALT and total cholesterol were defined as more than 95th percentile for age and sex. RESULTS: The BMI at 95th percentile was 28.7 in males and 26.9 in females. The prevalence of abnormal AST levels was higher in obesity group than in normal weight group. In males, those were 23.7% and 3.7%, respectively(P<0.01, x2-value : 529.2). In females, those were 11.8% and 4.9 %, respectively(P<0.01, x2-value : 56.3). The prevalence of abnormal ALT levels was significantly higher in the obesity group compared with the normal weight group. In males, those were 33.9% and 1.7%, respectively(P<0.01, chi2-value : 1,693.4). In females, those were 22.3% and 3.9%, repectively(P<0.01, x2-value : 397.6). The prevalence of abnormal total cholesterol levels was higher in the obesity group than in the normal weight group. In males, those were 16.8% and 3.5%, respectively(P<0.01, x2-value : 268.3). In females, those were 9.0% and 5.4%, respectively(P<0.01, x2- value : 14.2). CONCLUSIONS: This study revealed that the prevalences of abnormal AST, ALT and total cholesterol level were higher in the obese group than in the normal weight group.
Adolescent* ; Alanine ; Aspartic Acid ; Cholesterol* ; Female ; Humans ; Male ; Obesity* ; Prevalence ; School Health Services ; Seoul

Interscalene bracheal plexus block has became a popular method of anesthesia for surgical operation on the upper extremities. Possible complications are subarachnoid block, epidural block, phrenic nerve block, vagus or recurrent laryngeal nerve block, sympathetic nerve block, intravascular injection. But reported complications has been few and generally without prolonged effects. The following describes a patient who developed signs and symptoms suggestive of inadvertent phrenic nerve block and epidural anesthesia as complications of interscalene bracheal plexus block The complications were attributed to using of inferomedially directed 5 cm needle and then additional blind block of the brachial plexus with 5 or 6 times. We emphasize that if the appropriate length of needle and technique are not used, phrenic nerve paralysis and serious complications including total spinal or epidural block can occur as a result of a medially misdirected needle.
Anesthesia ; Anesthesia, Epidural ; Autonomic Nerve Block ; Brachial Plexus ; Humans ; Needles ; Paralysis* ; Phrenic Nerve* ; Recurrent Laryngeal Nerve ; Upper Extremity