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Clinical Characteristics of Fever without Localizing Sign in Infants Younger than 100 Days of Age in a Single Center (단일기관에서 시행한 생후 100일 미만 영아에서 발생한 국소 증상 없는 발열에 대한 임상적인 특징에 관한 연구)

  • Lee, Hyun Suk;Lee, Kye Hyang
    • Pediatric Infection and Vaccine
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    • v.23 no.2
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    • pp.128-136
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    • 2016
  • Purpose: This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future. Methods: We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI. Results: Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93, 95% CI 1.60-15.24) and pyuria (OR 18.88, 95% CI 6.76-52.76) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group. Conclusions: Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.

Effects of Farming on Soil Contamination and Water Quality in Keum River Districts (금강유역 농업지대의 토양 및 수질오염)

  • Han, Kang-Wan;Cho, Jae-Young;Kim, Seong-Jo
    • Korean Journal of Environmental Agriculture
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    • v.16 no.1
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    • pp.19-24
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    • 1997
  • This studies was carried out to investigate the soil contamination and water quality affected by agricultural activities in the Keum river Districts. Soil pH of the Keum river districts were $5.56{\sim}7.09$ in Keum river headwater and Namdae-cheon but that of Keumgang-lake were $5.07{\sim}7.21$ because of the cattle shed and industrial complex around. Total nitrogen contents of soils were found difference as period of fertilizer application. Total phosphorous content of soils no difference were found between the headwater and Keumgang-lake. Heavy metal contents of soils were natural background level. Water pH of the Keum river districts ranged from 6.59 to 7.80 and COD was maintain below 1.0 mg/L. Total nitrogen content affected by a livestock wastes and sewage water were the higher than that of others and total phosphorous content showed below 0.5 mg/L. Nitrate nitrogen and ortho-phosphate contents were very high according to the influence a livestock waste and sewage water in headwater region of the Keum river partly. Chlorine and sulfate contents were high according to the influence of sea water invasion. Heavy metal contents of waters were natural background level.

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Studies on Bacterial Contamination of Domestic Chicken Breeding Farm (국내 종계장에 있어서 미생물 오염에 관한 연구)

  • 김기석;이희수;김상희;박근식
    • Korean Journal of Poultry Science
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    • v.18 no.3
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    • pp.151-159
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    • 1991
  • As a part of investigation on causes of drop in egg production in domestic chicken breeding farm, bacteriological contamination on air, feed, drinking water and artificial insemination instruments of randomly selected three farms was surveyed. Total bacterial population in the air was very high in all of the chicken houses tested and was not significantly different among these farms . However, total bacterial counts in the air of the problem house having egg drop problem and colibacillosis was higher than normal house within the problem farm. Bacterial population in the assorted feed was low before or after administration on the normal farm while it was much more increased after administration than before administration on the problem farm. Bacterial population of the drinking water in the source of water supply was very low and has no differences among farms tested. Also, bacterial population in the normal farm was not significantly different between source of water supply and after administration. However, population of total bacteria and coliform bacteria after administration was increased. Bacterial population was much higher in the artificial insemination instrument of problem farm than normal farm. However, this bacterial population in the problem farm was decreased to those of normal farm after these instruments were sanitized.

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Comparison among Known Severity Scoring Scales in the Evaluation of Acute Gastroenteritis in Children (소아 급성 위장관염의 중증도 평가를 위한 기존 중증도 점수척도들의 비교)

  • Choi, Jee-Hyun;Jung, Tae Woong;Kim, Seong Joon;Chung, Ju-Young;Kim, Min-Sung;Han, Seung Beom;Kang, Jin-Han;Kim, Sang Yong;Rhim, Jung Woo;Kim, Hwang-Min;Park, Jae Hong;Jo, Dae Sun;Ma, Sang Hyuk;Jeong, Hye-Sook;Cheon, Doo-Sung;Koh, Dae Kyun;Kim, Jong-Hyun
    • Pediatric Infection and Vaccine
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    • v.21 no.1
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    • pp.43-52
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    • 2014
  • Purpose: This study aimed to evaluate the disease severity of children suffering from gastroenteritis using different scales. The results are compared and subsequently classified on the basis of the type of virus causing the disease in order to investigate the differences in clinical characteristics and disease severity according to pathogen. Method: This study was conducted prospectively with patients under 5 years of age diagnosed with acute gastroenteritis and hospitalized at 9 medical institutions in 8 regions across the Republic of Korea. Disease severity was evaluated using the Vesikari Scale, the Clark Scale, and the modified Flores Scale. Fecal samples collected from patients were used to detect rotavirus and enteric adenovirus by enzyme immunoassay, and for RT-PCR of norovirus, astrovirus, and sapovirus. Results: There were a total of 214 patients with a male : female ratio of 1.58 : 1, of which 35 were under the age of 6 months (16.4%), 105 were aged 6-23 months (49.1%), and 74 were aged 24-59 months (34.5%). The rate of concordance between the Vesikari and Clark Scales was 0.521 (P<0.001) and, in severe cases, the Vesikari Scale was 60.7% and Clark Scale was 2.3%, indicating that the Clark Scale was stricter in the evaluation of severe cases. Conclusions: In children with gastroenteritis, there were differences in disease severity based on the scale used. Therefore, to achieve consistent results among researchers, either only a single scale or a measure of all scales should be used to determine disease severity.

A Clinical Study of Aseptic Meningitis in the Busan Area in 2002 (2002년 부산 지역에서 유행한 무균성 뇌막염에 대한 임상적 고찰)

  • Park, Ji Hyun;Lee, Na Young;Kim, Gil Hyun;Jung, Jin Hwa;Cho, Kyung Soon;Kim, Sung Mi
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.858-864
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    • 2003
  • Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.

Analysis of Etiology and Prognosis of Pulmonary Complications in Children with Hematological or Oncological Disorders in Pediatric Intensive Care Unit (소아 중환자실에 입원한 혈액-종양 환아에서 발생한 폐 합병증의 원인과 예후에 대한 분석)

  • Jung, Jin Young;Hong, Soo-Jong;An, Young Jun;Kim, Ja Hyung;Seo, Jong Jin;Moon, Hyung Nam;Ghim, Thad
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1000-1006
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    • 2002
  • Purpose : In the course of treatment, patients with hematological or oncological disorders often develop pulmonary complication. The patients who develop a severe pulmonary complication have a poor outlook. The causes of pulmonary complication are either infectious or non-infectious in origin. We have analyzed the etiology and outcome of these patients admitted to the pediatric intensive care unit of Asan Medical Center. Methods : Medical records of 95 patients on Pediatric oncology service who were admitted to pediatric intensive care unit(PICU) of Asan Medical Center from Jan 1997 to May 2000 were retrospectively reviewed. Results : The mean age of the patients was 8.5 years(2 months-18 years). The underlying malignancies of these 95 patients were as following; acute lymphoblastic leukemia(31 cases), lymphoma (11 cases), acute myeloid leukemia(nine cases), brain tumor(eight cases) and other solid tumors(25 cases). Pulmonary complications included pneumonia, acute respiratory failure, pneumothorax and pleural effusion. The most common cause of pulmonary complication was infection(88%) in etiology. The overall mortality rate was 56.8%. Pulmonary complications in these patients carried high rates of mortality regardless of whether they were immune compromised(76%) or not(69%). Even without pulmonary complications, the hematological or oncological patients admitted to PICU had high mortality rates of 43%. Conclusion : Pulmonary complications are frequent finding in the hematological or oncological patients admitted to Intensive Care Unit. The main etiology of these pulmonary complications was infection, which carried a high mortality rate regardless of their immune status at the time when they were admitted to PICU.

Serotypes and Antimicrobial Susceptibility of Streptococcus pneumoniae (폐구균의 혈청형 분포와 항생제 감수성에 관한 연구)

  • Choi, Kyoung-Min;Kim, Jeong-Hyun;Shin, Kyoung-Mi;Yeon, Soo-In;Shin, Jeon-Soo;Yong, Dong-Eun;Lee, Kyoung-Won;Kim, Dong-Soo
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.159-166
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    • 2003
  • Purpose : Streptococcus pneumoniae is part of the normal flora but is also responsible for causing many invasive diseases such as pneumonia, meningitis, and sepsis in addition to noninvasive diseases such as otitis in children. Multi-drug resistant strains has raised a lot of concern worldwide and thus the importance of prevention has been emphasized. We have analyzed the current serotypes and antibiotic sensitivity of each serotype as a baseline study to estimate the efficacy of the pneumococcal vaccine in Korean children. Methods : One hundred sixteen cases of pneumococcus cultured at Yonsei Medical Center from September 2001 to January 2003 were analyzed. The serotyping was done with the Quellung reaction and penicillin resistance was tested using the oxacillin disc diffusion method. Results : Pneumococcus were cultured from the sputum in 76 cases(65.5%), from the blood in 13 cases(11.2%), from the ear discharge in 12 cases(10.3%), from the throat in 7 cases(6.0%), from the nasal cavity in 2 cases(1.7%), and one case(0.9%) each from the cerebrospinal fluid, eye discharge, peritoneal fluid, post-operational wound, brain abscess, and catheter tip. Serotyping was possible with 98 cases and the following serotypes were found; 15 cases of type 19F(15.3%), 11 cases of 19A(11.2%), 8 cases of 11A(8.2%), 7 cases each of 6A, 14 and 3(7.1%), 6 cases each of 35, 6B and 23F(6.1%). Eighty two cases(70.7%) out of 116 cases were penicillin resistant and serotypes 19F, 19A, 11A, 23F, 6A, 9V constituted the majority, 48 cases(59.8%). These serotypes showed resistance to cotrimoxazole (74.4%), tetracycline(69.5%), and erythromycin(90.3%) as well. In the 22 cases cultured from children, 19A and 19F were found in 25.0%, 6A, 6B, and 23F in 10.0%, 11A, 14, 19, and 29 in 5.0%. Fifty percent(10/20) of the clinical isolates were represented in the current 7-valent pneumococcal protein conjugate vaccine, and 85%(17/20) when the cross-reacting serotypes were included. Penicillin resistance was found in 86.4%(19/22). Conclusion : The percentage of serotypes included in the 7 valent pneumococcal protein conjugate vaccine found in our study was 40.8% which was less than other prior studies. In anticipation of a change of pneumococcal serotypes, a nationwide multicenter study is needed before the initiation of pneumococcal vaccines in Korea.

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Investigation on the Cause of Bad Natural Seed Collection of the Pacific Oyster, Crassostrea gigas: Relationships between the Conditions of Mother Shell and the Viability of the Released Eggs and Larvae Based on the Pathological and Embryological Survey (참굴 채묘 부진 원인 구명에 관한 연구 -병리 발생학적 조사를 통한 참굴 모패의 건강도와 난 및 유생의 생존율과의 상관관계 구명 -)

  • PARK Mi Seon;LYU Ho Young;LEE Tae Seek
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.1
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    • pp.62-67
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    • 1999
  • Infection rates of oyster ovarian parasite, Marteiliodes chungmuensis and productivity of the oyster shellstock infected with the parasite were investigated at the main seed collection areas in the southern coast of Korea where the extreme bad seed collection of oyster occurred in 1992 and 1993 to evaluate the cause of the bad seed collection. Additionally, the bacterial flora of the sea water and oyster lana were examined to identify the shellfish larva pathogenic bacteria like Vibrio sp. and Pseueomonas sp. In August 1992 to September 1993, infection rate of oyster ovarian parasite, M. chungmuensis at Tongyong, Kyongsangnam province, and Yosu, Chollanam province where the bad seed collection occurred, were $11.8\~100\%$ and $14.3\~100\%$, respectively. But the parasite was not detected in the shellstock collected at Daechon, Chungchongnam province. While a virus-like particle was identified in the cytoplasm of the egg infected by the parasite. The parasite infected egg was not able to fertilize completely. Uninfected egg in the gonad contaminated by the parasite could be able to fertilize but showed an abnormal development till D-shaped larva and then, died of necrosis after D-shaped lana. And some lana developed from low lipid content egg could not develop to the spat and died after the early umbo stage. The predominant bacteria in the oyster lana collected at bad seed collection areas were Pseudomonas sp. and Pseudomonas like bacteria and the occupancy rates were $53.3\~87.1\%$.

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Studies on Reaction Parameters for Composting of Paper Mill Sludge in a Small-Scale Reactor and Static Piles (제지슬럿지의 퇴비화를 위한 반응변수 연구)

  • Han, Shin Ho;Chung, Young Ryun;Cho, Cheon Hee;Kang, Moon Hee;Oh, Say Kyun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.2 no.2
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    • pp.19-29
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    • 1994
  • A large volume of paper mill sludge(PMS) is produced every day from paper industries after treatments of waste water and it costs too much to dispose of the sludge. Since PMS consists mostly of biodegradable organic matter, cellulose, it is desirable to recycle it by proper treatments such as composting. In this study, experiments were conducted using a small scale reactor(12l) to establish optimum conditions for efficient composting of PMS of which initial pH, C/N ratio, and moisture content were 7.1, 28~30, and 60~65%, respectively. No heavy metals such as mercury, cadmimum, and lead were not detected in the PMS. Various levels of forced aeration, 1 minute aeration per every 30, 60, 120, 240, and 480 minutes were applied and 1 minute aeration per 60 and 120 minutes found to be proper for composting of 8l PMS in this system. Relationship between $CO_2$ production and temperatures was positively correlated with r> 0.82 suggesting that the normal decomposition of PMS by microorganisms occurred. However, under the condition of aeration interval over than 240 minutes, a negative relationship between two parameters was found indicating the occurrence of abnormal(maybe anaerobic) degradation. The amount of added nitrogen also affected composting of PMS resulting in the increase of $CO_2$ production and temperature. Semi-field tests using 100kg PMS in a static pile sysem showed that PMS could be composted efficiently under optimal environmental conditions. The parameters determining efficiency of composting such as C/N ratio, aeration, moisture content, and pH need to be monitored.

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A Study on the Efficiency of Hand-Knee Position in GB Stone Ultrasonography (담낭결석 초음파검사에서 Hand-Knee position의 효율성에 관한 연구)

  • Park, Soung-Ock;Do, Yun-Su
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.267-274
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    • 2006
  • The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

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