The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program / 소아과

PURPOSE: Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. METHODS: We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. RESULTS: Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. CONCLUSION: We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors.for example, good mental health, balanced nutrition, and more exercise.

One-year evaluation of the national health screening program for infants and children in Korea / 소아과

PURPOSE: Results of the Korea National Health Screening Program for Infants and Children, which was launched in November 2007, were evaluated for future research and policy development. METHODS: Data from a total of 2,729,340 cases were analyzed. Five visiting ages, such as 4, 9, 18, 30, and 60 months, were included. Several parameters such as stunting, obesity, and positive rate of developmental screening were also analyzed. Telephone survey was performed in 1,035 users. For the provider survey, 262 doctors participated in our study. RESULTS: The overall participation rate of users was 35.3%. This participation rate showed a decrement tendency to old age and low income. Only 6.9% of users participated in oral screening. Health screening was performed mainly in private clinics (82.6%). The recall rate of 4 months program users at the age of 9 months was 57.3%. The positive rate of screening was 3.1%, and was higher in the low-income group. By telephone survey, users reported that questionnaires were not difficult (94%) and overall satisfaction was good (73%). Longer duration of counseling was related with more satisfied users. Counseling and health education were helpful to users (73.2%). Doctors agreed that this program was helpful to children (98.5%). CONCLUSION: Korea National Health Screening Program for Infants and Children was launched successfully. Participation rate should be improved, and a quality control program needs to be developed. More intensive support following this program for children of low-income families may lead to effective interventions in controlling health inequality. Periodic update of guidelines is also needed.

Analysis of Prognostic Factors in 1,435 Surgically Treated Patients with Gastric Cancer

PURPOSE: Gastric cancer is prevalent in Korea, therefore the purpose of this study was to determine the clinicopathologic characteristics, 5-year survival rate, and prognostic factors for gastric patients who underwent gastrectomy by a single surgeon. MATERIALS AND METHODS: A total of 1,435 patients diagnosed with gastric cancer who underwent gastrectomy in the Department of Korean Gastric Cancer Center at Seoul Paik Hospital between September 1998 and August 2003, and the gender, age, location and size of the tumor, visual and histologic analysis, depth of invasion, lymph node metastasis, invasion (perineural, venous, and lymphatic), and surgical method were examined retrospectively. RESULTS: The ratio between males and females was 2.29:1, and the average age was 56.7 years. Based on the UICC TNM classification, the patients were distributed as follows: IA 35.4%, IB 14.1%, II 12.6%, IIIA 12.3%, IIIB 8.3% and IV 17.3%. The 5-year survival rate was 69.6%. The results of univariate analysis showed that there were significant differences in the survival rate by age, location and size of tumor, Borrmann type, level of differentiation, Lauren's classification, depth of invasion, metastasis in lymph nodes, UICC TNM stage, invasion (perineural, venous, and lymphatic), and surgical method. Based on multivariate analysis, only the depth of invasion and lymph node metastasis were independent prognostic factors. CONCLUSION: Although various clinicopathologic characteristics affect the prognostic factors of the patients with gastric cancer, the results of this study showed that the stage of disease, such as depth of invasion and metastasis in lymph nodes, are the most critical factors. There is a need to establish the diagnosis of gastric cancer early and to study and develop various treatment methods based on the diagnostic factors in order to improve the survival of patients with gastric cancer.

Overview of the national health screening program for infant and children / 소아과

The mission of National Health Screening Program for Infant and Children is to promote and improve the health, education, and well-being of infants, children, families, and communities. Although the term 'diagnosis' usually relates to pathology, a similar diagnostic approach applies to the child seen primarily for health supervision. In the case of health, diagnosis determines the selection of appropriate health promoting and preventive interventions, whether medical, dental, nutritional, educational, or psychosocial. Components of the diagnostic process in health supervision include the health 'interview'; assessment of physiological, emotional, cognitive, and social development (including critical developmental milestones); physical examination; screening procedures; and evaluation of strengths and issues. Open and informed communication between the health professional and the family remains the most significant component of both health diagnosis and health promotion. Families complete medical history forms at their health supervision visit. Family-friendly questionnaires, checklists, and surveys that are appropriate for the child''s age are additional tools to improve and update data gathering. This type of information helps initiate and inform discussions between the family and the health professional. This article provides a comprehensive review of current National Health Screening Program for Infant and Children in Korea.

Introduction of National Health Screening Program for Infant and Children / 대한소아신경학회지

No abstract available.

Report about the health status of Korean adolescents: A comprehensive overview of the Korean adolescent health through demographics / 소아과

This is to determine current status and historical trends of the health of Korean adolescents. Adolescence is not only a time of health and well-being, but also a time of experimentation and of being at risk of significant threats by health-damaging behaviors. A comprehensive overview through a review of major national demographic data on health-related issues would give health professionals chances to deal with Korean adolescents' unique needs to improve their health.

Interviewing and Physical Examination of the Adolescent

No abstract available.

A Case of mixed Form of Congenital Cystic Adenomatoid Malformation(Type III) and Extralobar Pulmonary Sequestration of the Lung Detected by Prenatal Ultrasonography / 대한주산의학회잡지

No abstract available.

A Case of Septic Arthritis due to Haemophilus influenzae associated with Atypical Kawasaki Disease

We report a case of septic arthritis due to H. influenzae associated with atypical Kawasaki disease. A 2-year-old boy was admitted to our orthopedic department due to limping gait of the right leg. CT finding of right hip joint revealed fluid collection. He was diagnosed as transient synovitis and septic arthritis. He was treated with antibiotics, but no incision nor drainage was performed. During the antibiotics therapy, limping gait subsided, but high fever, skin rash and lip fissure developed. Echocardiographic finding showed both coronary artery aneurysms. We diagnosed the boy's condition as atypical Kawasaki disease, and treated it with intravenous immunoglobulin(IVIG) and aspirin. Even, with the use of IVIG, fever was persistent. A second IVIG was tried, but fever did not subside. An MRI of right hip joint was followed up. The finding was consistent with septic arthritis associated with osteomyelitis of the right femur head. An incision and drainage was performed on the right hip joint, and the pus culture revealed beta-lactamase negative H. influenzae.

A Case of Fetal Alcohol Syndrome

Fetal alcohol syndrome is characterized by distinctive facial appearance, prenatal onset growth deficiency, an increased frequency of development and mental retardation, cardiac anomaly and genitourinary anomaly. Complete abstinence during pregnancy is recommended, since alcohol consumption in each trimester has been associated with abnormalities. We experienced a case of fetal alcohol syndrome in a 11-month-old female infant. Her mother had drunk as much as 500cc of alcohol every day from 1st trimester to 3rd trimester of pregnancy. The child was small for gestational age, other distinctive features were microcephaly, thin upper lip, short palpebral fissure, hypertelorism, low nasal bridge, hypoplasia of philtrum, dysplastic ear, developmental and mental retardation, mild pulmonary stenosis and ovarian cysts. On the basis of maternal history and clinical features mentioned above, we diagnosed the case as fetal alcohol syndrome.

A Case of Fetal Alcohol Syndrome

Fetal alcohol syndrome is characterized by distinctive facial appearance, prenatal onset growth deficiency, an increased frequency of development and mental retardation, cardiac anomaly and genitourinary anomaly. Complete abstinence during pregnancy is recommended, since alcohol consumption in each trimester has been associated with abnormalities. We experienced a case of fetal alcohol syndrome in a 11-month-old female infant. Her mother had drunk as much as 500cc of alcohol every day from 1st trimester to 3rd trimester of pregnancy. The child was small for gestational age, other distinctive features were microcephaly, thin upper lip, short palpebral fissure, hypertelorism, low nasal bridge, hypoplasia of philtrum, dysplastic ear, developmental and mental retardation, mild pulmonary stenosis and ovarian cysts. On the basis of maternal history and clinical features mentioned above, we diagnosed the case as fetal alcohol syndrome.

The Effect of Bundling on Neonatal Body Temperature

PURPOSE: Fever in newborn might be an indicator of serious bacterial infection. Differentiating environmental from disease-related temperature elevations in newborn is clinically important, because neonate with environment-related temperature elevation might be subjected to an unnecessary work-up to detect occult disease. But there are exists no consistent conclusions about environmental effect in previous literatures. We prospectively evaluated the effect of bundling on body temperature. METHODS: Twenty-five well, full-term newborns within 1 week old were assigned to the control group (one blanket) or to the study group (five blankets and hat). Rectal and axillary temperatures and arousal states were measured at 15-minute interval for 2 hours. RESULTS: There were 13 control and 12 study newborns. The mean axillary temperature of contol group increased by 0.21 degrees C; mean rectal temperature increased by 0.23 degrees C. The mean axillary temperature of study group increased by 0.63degrees C; mean rectal temperature increased by 0.56 degrees C. Comparing study newborns to controls, there were significant rises in both axillary temperature and rectal temperature. One newborn of the study group reached 38.3 degrees C in rectal temperature. CONCLUSION: Bundling can cause significant elevations in axillary and rectal temperature in newborn within 1 week old. Therefore, physicians treating neonates with elevated temperature should question whether to use bundling to differentiate endogenous from exogenous causes.

Two Cases of Total Colon Aganglionosis Involving Small Bowel in Triplet

Total or mostly total intestinal aganglionosis is rare and invariably fatal. All patients with aganglionosis involving more than half of the small bowel have died with persistent intestinal obstruction and secondary malnutrition and infection. Recently, we experienced two cases of total colon aganglionosis extending to the middle of the jejunum in triplet. We report the cases with brief review of literatures.

A Case of Double Outlet Left Ventricle with subaortic Ventricular Septal Defect and Pulmonary Atresia

No abstract available.