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Clinical Review of Pulmonary Tuberculosis in Teenagers According to the Involved Lung (소아청소년기 폐결핵의 방사선상 침범위치에 따른 배양 양성률과 임상양상에 대한 연구)

  • Im, Bong Chil;Kim, Young;Kim, Kyoung Sim;Kim, Yong Wook;Kim, Eun Young;You, Eun Jung;You, Ju Hee;Cho, Hyoung Min
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.148-155
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    • 2010
  • Purpose : The purpose of this study was to investigate clinical features and culture-positive rates according to the involved lung in adolescent pulmonary tuberculosis (TB). Methods : We retrospectively reviewed the medical records of adolescents who ranged in age from 10 to 20 years and who had been hospitalized with a diagnosis of TB at Kwangju Christian Hospital from 2000 to 2008. Results : Sixty-six patients were identified with pulmonary TB: median age 16.82 years; 48.5% males. Among them, 90.9% of patients were between 15 and 20 years of age. Most patients presented with multiple symptoms, and the most common included cough (74.2%), sputum (60.6%), fever (39.5%), and night sweating (18.2%). Sputum samples were smear-positive in 28 (42.4%), culture-positive in 40 (60.6%), and PCR-positive in 46 (69.7%). The most common radiological patterns included cavitation in 18 (27.3%), pleural effusion in 18 (27.3%), lymphadenopathy in 10 (15.2%), and tuberculoma in 5 (7.6%). The prevalence of smear, culture, and PCR positive rates increased as the number of involved lobes increased (P<0.05, P<0.01, P<0.05). The median treatment duration was 7 months. Twelve patients (18.2%) had lower lung field TB (Group A) and forty-four patients (66.7%) had other areas involving TB, except for Group A (Group B), and ten patients (15.1%) had only TB pleurisy (Group C). The difference of clinical characteristics and culture rates between group A and group B was not significant. Conclusion : Pulmonary TB toward late adolescence is increasing. We need to pay more attention to lower lung field TB, which is difficult to detect with specific radiographic findings.

Human Parechovirus: an Emerging Cause of Sepsis-Like Syndrome in Infants Aged under 3 Months

  • Roh, Da Eun;Kwon, Jung Eun;Kim, Yeo Hyang
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.102-110
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    • 2020
  • Purpose: This study aimed to investigate the clinical characteristics of human parechovirus (HPeV) infection in sepsis-like syndrome in infants aged under 3 months. Methods: Medical records of infants aged under 3 months with sepsis-like symptoms who were admitted between July 1, 2018 and August 31, 2018 were reviewed. A multiplex reverse transcription-polymerase chain reaction panel test was performed on the cerebrospinal fluid (CSF). Thirty-nine enrolled infants were categorized into three groups: 11 in group 1 (HPeV detected in the CSF), 13 in group 2 (enterovirus detected in the CSF), and 15 in group 3 (no virus detected in the CSF). Results: Compared with groups 2 and 3, a higher proportion of group 1 had tachycardia, tachypnea, apnea, and hypotension (P<0.05). A significantly lower white blood cell (WBC) count was noted in group 1 than in groups 2 and 3 (5,622±2,355/μL, 9,397±2,282/μL, and 12,312±7,452/μL, respectively; P=0.005). The CSF WBC count was lower in group 1 than in groups 2 and 3 (0.9±1.7/μL, 85.1±163.6/μL, and 3.7±6.9/μL, respectively; P=0.068). The proportion of patients requiring inotrope support (36.6% vs. 0% and 6.6%), mechanical ventilation (18.1% vs. 0% and 0%), and high flow nasal cannula (45.4% vs. 15.3% and 6.6%) was higher in group 1 than in groups 2 and 3. All patients recovered completely without complications. Conclusions: HPeV infection shows a severe clinical course and can cause a severe sepsis-like syndrome in infants aged under 3 months. Early diagnosis and proper treatment of HPeV infection are required.

Sick Building Syndrome in 130 Underground Workers (지하상가 근무자의 건강 장애에 관한 실태조사)

  • Joo, Ree;SaKong, Joon;Chung, Jong-Hak;Park, Sang-Whan;Kim, Dong-Hee;Kim, Dong-Min;Choi, Eun-Kyong;Cho, Hyun-Geon
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.325-340
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    • 1998
  • A cross-sectional study was conducted to evaluate the relationship between sick building syndrome(SBS) and the environmental factors affecting SBS on 130 underground workers and 60 controls. The study consisted of 1) a review of environmental condition 2) measurement of temperature, $O_2$, $CO_2$, CO, and formaldehyde and 3) a questionnaire survey of symptom prevalence and perception of environmental conditions using indoor Air Quality questionnaire recommended by National Institute for Occupational Safety and Health. Bronchitis and dust allergy were more prevalent in underground workers significantly(p < 0.05). Among the 18 symptoms related to the indoor air pollution, the experience rate of dry, itching or irritated eyes, sore or dry throat, chest tightness, tired or strained eyes and dry or itchy skin symptom was significantly different between the underground workers and controls. The diagnostic criteria of SBS was defined as at least 1 symptom is experienced 1-3 times a week during the last 1 month among 18 indoor air pollution related symptoms which can be relieved by moving out of the underground. Applying the criteria, the mean symptom score was significant higher in underground workers than controls significantly (p < 0.05). These resalts indicated that underground workers are under inappropriate ergonomic and physical condition and inadequate ventilation. Their experience rate of symptoms related to indoor air pollution and prevalence of SBS was significantly higher than controls. To reduce the prevalence of SBS of underground workers, the surveillance system of indoor air quality, restriction of using fuel in underground and legislative regulations for the environment are needed to establish a better indoor air quality. Early detection, treatment and prevention of SBS through medical attention is also needed.

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A STUDY ON COMORBID DISORDERS AND ASSOCIATED SYMPTOMS OF PERVASIVE DEVELOPMENTAL DISORDER CHILDREN (전반적 발달장애 아동들의 공존질환 및 동반증상에 대한 연구)

  • Kwak, Young-Sook;Kang, Kyung-Mee;Cho, Seong-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.64-75
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    • 1999
  • Objective:The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method:The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result:The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion:These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

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Survey on the Hospice Care Needs of Hospice Volunteers (호스피스 자원봉사자의 호스피스 케어 요구도 분석)

  • Cho, Hyun;Kang, Hee-Sook;Kim, Jeoung-Hee
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.155-162
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    • 2002
  • Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.

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A Clinical Study on Factors affecting Spontaneous Resolution of Vesicoureteral ,Reflux in Children (방광요관역류의 완해에 영향을 미치는 인자에 관한 연구)

  • Song, Byung-Ho;Oh, Chang-Weon;Kim, Ki-Bok
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.152-160
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    • 1998
  • Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically. Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed. Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{\pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$\%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50\%$, each. 4) Resolution rates in relation to the age at diagnosis were $100\%$ for below 1 mo, $48\%$ between 1 mo to 1 yr, $56\%$ between 1 to 6 yr, and $13\%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93\%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32\%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up. Conclusion: The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.

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The Correlation of Sonographic Finding of Fatty Liver with Hematologic Examination and Body Fat Percentage (초음파상 지방간과 혈액학적 검사 및 체지방률과의 상관관계)

  • Cheon, Hae-Kyung;Lee, Tae-Yong;Kim, Young-Ran
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.437-444
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    • 2009
  • Ultrasonography has been used as a basic examination of a medical check up for prevention and diagnostics of diseases. Even the person who has no particular subjective symptoms can have a variety of diseases. Especially fatty liver is found in many cases. In this study, we tested 3582 persons who are in between the ages of 15 to 81 and observed that 1390 persons had fatty liver while 2192 persons are normal. We classified the grade of fatty liver and compared their life styles with the results of liver function test and BMI. The results are as follows. Ratio of the subjects who had a fatty liver is 38.8%. Male and female ratio was 46.2% and 24.2%. On the correlation among the fatty liver, the body mass index and the body fat%, the average value of body mass index and body fat% were significantly higher in the group of the fatty liver than in those of the normal liver. The influence of the related factor and the correlation on the fatty liver was shown that it was more related with the order of age, body mass index, triglyceride, ALT, body fat%, sex, HDL-Cholesterol, LDL-Cholesterol, and GGT. The result of the ultrasonography carried out for the purpose of regular health check up indicates that even the 38.8% of those who was diagnosed as normal condition could have the fatty liver and have possibility of other diseases. Therefore, if there are any troubles related to liver function and lipid through hematologic examination or when practicing follow-up study with ultrasonography concerning the correlation relation between the body fat% and dietary preference, alcohol consumption and exercise, the ultrasonography is definitely useful for prevention and treatment of diseases.

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A Study of Acute Gastroenteritis in Neonates Transfered from Postpartum Care Centers (산후조리원에서 전원되어 입원한 신생아 급성 장염 환자들에 대한 임상적 고찰)

  • Kim, Jong Suh;Lee, Hae Sung;Choi, Jung Hwan;Shin, Yoon Jung;Koo, Mi Lim;Kim, Sung Sin;Kim, Heui Suck;Kim, Eun Ah;Yoon, Sin Won;Kwon, Jae Hoon;Yoon, Sin Won;Kim, Jong Hoon;Sin, Sun Heui;Koo, Sung Kyung;Yang, Sung;Yoo, Sin;Ahn, Young Min;Kim, Eun Mi;Lee, Dong Hwan
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.186-192
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    • 2003
  • Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.

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Analytical studies of bovine mastitis management by standard plate counts(SPC) and somatic cell counts(SCC) (젖소 유방염 관리에 따른 세균 및 체세포수 등급 실태 조사 분석)

  • 허정호;정명호;박영호;조명희;이주홍
    • Korean Journal of Veterinary Service
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    • v.21 no.3
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    • pp.285-300
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    • 1998
  • 1. The number of average milking cows, clinical forms of mastitis, mastitis-developing cows, and cows killed by mastitis a year were 25.7, 1.8(7%), 6.3(26%), and 2.7(10.1%)heads, respectively. The annual grade changes of standard plate counts(SPC) and somatic cell counts(SCC) showed the grade 1A of SPC diminished sharply from April to August, we think it was due to the lack of proper management in farming season and the grade 3 of SCC indirectly influenced increased in huge during August. 2. The average number of parturitions of farms was 2.3, but 50% of below 1 parturition were 22 farms(31%), 50% of above 3 parturitions were 16(23%) out of 71 farms. According to grades of the number of parturitions of milking cows per each farm, the farms' grades recording 3 parturitions and 50% were little bit excellent. 3. The actual situation research of foremilking CMT revealed 35 out of 74 farmer didn't do CMT Among them(35 out of 74 farmers), 80% did not test thanks to the troublesome process of the CMT. SCC grade 3, among farms who did foremilking CMT once or twice a month and who did not were 29% and 40% respectively and SPC grade 1A were 55% and 9%, respectively. 4. The research of actual situation on milking management let us know 29 farms(39%) did not do lastmilking, 37 farms(49%) usually did overmilking, and 34 farms(46%) did milking for 4 or 5 minutes. Grades according to average requiring times of milking showed SCC grade 1 of farms milking within 7 minutes was 11% and SPC grade 1A was 34%, on the other side, farms milking more than 7 minutes were 0% in SCC grade 1 and 13% in SPC grade 1A. Grades according to the starting time of milking after rubbing teats showed SPC grade 1A of farms starting milking at about 1 minute and over 2 minutes were 50% and 20%, respectively. 5. The research of actual situation on hygienic milking management uncovered 65 farms(88%) were using one towel which was used in washing teats and udders to wash more than 3 to 4 cows, and 53 farms(72%) were using one dried towel to dry udders not for each cow but for more than 3 to 4 cows after washing. Also, on milking turns disclosed 30 farms(40%) were milking cows in the order of incoming without isolation of a dominant group. According to grades of towels used in washing teats and udders, farms using a towel for each cow were 56% and a towel for over 3 cows were 31% in SPC grade 1A. According to using-or-not grades of dried towels after washing udders, farms using a towel for each cow were 79% and a towel for over 3 cows were 21% in SPC grade 1A. 6. Farms doing teat-dipping before milking were 7(10%), not doing teat-dipping after milking, or doing sometimes were 9(12%), and doing right after milking were 57(77%). And farms doing teat-dipping after dry cows and before delivery were 21(28a ). Farms using bethadine as an antiseptic solution were 70(95%), 40 farms(59%) diluted it with water as weak as 5 to 10 times, and on drying cows 64 farms(87%) slowly did it more than 2 days. Grade 1A of SPC of farms doing teat-dipping at every milking was 38%, farms doing occasionally or not was 33%, and farms doing it right after milking was 37% and doing after milking more than 5 cows was 20%. Grade 1A of SPC among farms diluting bethadine 5 times and diluting 5 to 10 times with water were 36% and 33%, respectively, and Grade 3 of SCC were 35% and 32%, respectively. 7. Studies on nonlactating period medical treatment, as the cows were on dry, 54 farms treated with their own hands.73 farms(98%) had bovine mastitis treated for themselves. And on applying medicines against mastitis, 55 farmers chose them on the basis of their own experience, 42 farms(57%) were treated more than 3 days. 41 farms(55%) dumped away the mastitis infected milk separately, 24 farms(32%) were feeding and milking at the same time. 8. Fifty-six farms(76%) always washed and disinfected milking machines after milking. Farms using the milking machines at low, or variable vacuum pressures, or at the vacuum pressure, set at the moment of its installation were 31(42%), and farms that did not know pulsation ratio were 27(37%). Farms changing liners when they were torn 8(11%), 58 farms(78%) said they checked milking system when there were wrong with them, 31 farms(42%) changed milking hoses when they found out problems, and 42 farms(57%) cleaned vacuum and milking systems when they felt dirty. The SPC grade 1A of farms washing and sterilizing milking machines was 38% and farms only washing was 28%.

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The actual conditions on drug abuse among High school students in Busan city (고등학생(高等學生)의 약물(藥物) 남용(濫用) 실태(實態))

  • Cho, Yeon-Sook
    • Journal of the Korean Society of School Health
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    • v.3 no.1
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    • pp.101-118
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    • 1990
  • This study was intended to investigate actual conditions and problems relating to a variety of substance which have been used by students. A Questionnaire survey was carried out with the subject of 2411 students in an academic boys' high school, academic girls' high school, technical boys' high school and technical girls' high school in Pusan, from the 15th day to 29th day of March, 1989. The summarized results were as follows. There was not a remarkable difference in distribution of these subjects in boys' & girls' high school. The common and good health condition of subjects accounted for 90 percent or higher. 24.4 percent of them also had smoking experience, 11.6 percent of which continues to smoking. The understanding rate of these substances name other than sedative, psychostimulants and antihypnotic accounted for 90 percent or higher. The experience rate taking these substances for one year showed that anodyne, digestive and nutritive tonic accounted for 70 percent, antihypnotic for 15.6 percent, sedative for 1.4 percent, respectively, and psychostimulants for 0.5 percent. Moreover. it was shown that drugs accounted for 1.5 percent, bond for 1.4 percent, and thinner for 0.5 percent. The rate of the daily experiencers who took anodyne, digestive, nutritive tonic, sedatives, and psychostimulants and so on was 7.7 percent, 6.2 percent, 5.2 percent, 5.9 percent, and 5.0 percent respectively. This fact implied that there was a serious problem in high school students' non - narcotic abuse. The usage rate of these substances for treatment purpose showed that anodyme accounted for 90 percent or higher, and digestive for 70-80 percent, respectively, where girl students showed higher rate than one of boy students. Additionally, there was higher the usage rate for other purposes. The usage rate of drugs was highest when these students felt melancholy and curiousity. Their obtaining place appeared that these students mainly obtained these drugs, bonds and thinners from a small shop or peddler and their friend while they usually obtained other substance from the pharmacy and medical institute. The first usage time of these substances appeared during the middle school (the age of 14-15) which was the highest rate. The smoker of all subjects used remarkly large substances as compared with one of no-smoker. Particularly, it appeared that the usage of drugs was very closely related to smoking. The large number of students did not use these substances for oesrable purposes even though they understood the name of these substances. For this reason, from primasy schools it is required to teach the students dependence and harmful effects caused by these substances abuse. Moreover, it was shown that these students firstly used these substances during the middle school (the age of 14-15)due to curiosity. As a result, it is very urgent to give the students health education suitabale for prevention of these substance abuse, when considering harmful effects of these substances. And so health education for no-smoking. Finally, considering that it is very easy to obtain these substances from a small shop and pharmacy, the regulation of these substances control should be considered and completed in the future.

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