Adolescent Depression in a Provincial City

PURPOSE: Most studies of depression in adolescents, have been conducted in western countries. Accordingly, we took a survey in the city of Ansan to discover the actual state of depression in adolescents and found a solution. METHODS: Twelve questions of modified diagnostic criteria for DSM-IV(Diagonstic and Statistical Mannual of Mental Disorders, 4th ed.) major depressive disorder were filled out by 1,158 middle and high school students in Asan. The diagnosis of depression was made when more than six of 12 items were positive and the diagnosis of depressed mood, irritable mood, or loss of interest or pleasure was made when at least one of them was positive. RESULTS: There were 71 students(6.2%) who had major depression. Depressed mood was highly prevalent among Ansan teenagers(12.3%). Girls showed(20.8%) more symptoms than boys(16.7%). One hundred-five students(9.1%) thought seriously about attempting suicide. CONCLUSION: Depression and depressed moods are more highly prevalent among Ansan adolescents than American adolescents. So we point to the importance of broad screening of depression in this vulnerable population.

A Case of Dexamethasone induced Hypertrophic Cardiomyopathy in Neonate with Bronchopulmonary Dysplasia

Although hypertrophic cardiomyopathy is uncommon in infant and children, we have experienced a case of dexamethasone induced hypertrophic cardiomyopathy in preterm baby who had bronchopulmonary dysplasia. This patient had hyaline membrane disease. Therefore, he received prolonged mechanical ventilation that resulted in bronchopulmonary dysplasia. After we carried out dexamethasone therapy for 7 days, hypertrophic cardiomyopathy appeared in his echocardiographic finding. We discontinued dexamethasone and then, hypertrophic cardiomyopathy improved. We report this case with the review of the associated literatures.

Clinical Manifestations and Hematologic Complications of Epstein-Barr Virus Infection in Korean Children

PURPOSE: Epstein-Barr virus (EBV) is associated with various diseases and complications caused by the host's immune reactions. This study focuses on various clinical findings and hematologic complications in childhood EBV infection. METHODS: The study group was thirty-eight EBV infected children (Anti-EBV VCA IgM; positive) who were admitted to the Department of Pediatrics, Korea University from January 1996 to July 1997. Patients were evaluated by clinical and laboratory findings. RESULTS: The mean age was 5.1 years old and the male-female ratio was 1.2:1. Fever was the most common clinical manifestation, which was present in 30 (79%) cases. Lymphadenopathy was present in 22 (58%) cases, throat injection in 18 (47%) cases, nausea and vomiting were in 13 (34%) cases, cough in 13 (34%) cases, skin rashes in 11 (29%) cases, hepatomegaly in 10 (26%) cases. AST and/or ALT levels were elevated in 18 (45%) cases and Bilirubin level was elevated in 9 (24%) cases. Twenty cases had hematologic complications. Neutropenia was present in 6 (16%) cases, thrombocytopenia in 1 (3%) case, both anemia and neutropenia in 3 (8%) cases, both anemia and thrombocytopenia in 2 (5%) cases, both neutropenia and thrombocytopenia in 1 (3%) case, pancytopenia in 7 (18%) cases. CONCLUSION: A presumptive diagnosis of EBV infection may be made by the presence of clinical symptoms such as fever, pharyngitis, lymphadenopathy, and hematologic complications such as unknown neutropenia, anemia, thrombocytopenia, and pancytopenia. In such conditions, specific serologic studies for EBV should be performed and confirmed by specific serologic studies.

Obesity in elementary school children

Obesity has been implicated as a significant risk factor for multiple medical condition including hypertention, glucose intolerance, hyperlipidemia, hyperinsulinemia and fatty liver. Furthermore, obesity in childhood is believed to be a reliable predictor of a similar condition in adulthood. During the recent years, there has been a rapid rise in the incidence of childhood obesity in Korea due to increased dietary intake rich in caloric content. This study was undertaken to investigate the epidemiology and potential health complications of obesity observed in elmentary school students. A total of 3,103 children (1630 boys and 1,473 girls), ages ranging from 6 to 12, were studied with personal interview, physical examination, and laboratory evaluation. The results were as follows: 1) The prevalence of obesity was 13.44% with approximately equal distribution among boys (14.42%) and girls (12.36%). 2) The prevalence of childhood obesity in Seoul was significantly higher (18.62%) than that in Suwon (7.85%) and in Hongchon (6.02%). 3) A higher incidence of hypertension was dectected in obese subjects and this was more obvious in girls. 4) Hyperlipidemia and elevated Atherogenic Index were more frequently observed in obese group. 5) although fasting blood glucose levels were similar in both groups. AST and ALT abnormalities were much more prevalent in obese group. It is concluded that hypertension and other metabolic abnormalities are much more frequently observed in obese children and that our effects should be focused on the earliest dection, prevention and management of childhood obesity.

A clinical survey of prolonged Q-T syndrome among Korean children with congenital deafness

The clinical symptom complex characterized by syncopal attacks and sudden death in patients with electrocardiographic anomalies, especially a prolonged Q-T interval is known as the Romano-Ward syndrome. When a similar symptom complex is accompanied by congenital deafness, it is called Jervell and Lange-Nieisen syndrome. This study was undertaken to investigate the investigate the incidence of the latter syndrome in the Seoul area. A total of 1,013 children with congenital deafness who attend schools for the deaf were studied by analyzing their electrocardiograms. A corrected Q-T interval of> or =0.44 seconds was defined as a prolonged Q-T interval. The overall incidence of long Q-T syndrome observed in the deaf in the Seoul area was 0.49% as compared to 0.25% reported from elsewhere in the world. The mean age of patients with long Q-T syndrome was 11.3+/-5.9 years and the first syncopal attacks was 4.6+/-1.1 per patient. A valsalva maneuver and exercise tests in the test group were associated with significant changes in T wave configuration and prolonged Q-T intervals while similar changes were not observed in the control group. A larger survey is needed to derive more statistically significant conclusions.

Acute hemodynamic effects of increasing hemoglobin concentration in children with congenital heart disease and relative anemia

No abstract available.