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Clinical Manifestations of PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) Syndrome from a Single Center (단일기관에서 진단한 PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis) 증후군의 임상양상)

  • Shin, Minsoo;Choi, Eun Hwa;Han, Mi Seon
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.179-187
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    • 2019
  • Purpose: Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a leading cause of periodic fever in children. This study describes the clinical characteristics of PFAPA syndrome in patients from a single center. Methods: Thirteen children diagnosed with PFAPA syndrome at Seoul National University Children's Hospital were included in this study. Retrospective medical chart reviews were performed. Results: Among the 13 patients, 8 (61.5%) were male. The median follow-up duration was 3.3 years (range, 10 months-8.3 years). The median age of periodic fever onset was 3 years (range, 1-6 years). All patients had at least 5 episodes of periodic fever and pharyngitis, managed with oral antibiotics, before diagnosis. The median occurrence of fever was every 3.9 weeks and lasted for 4.2 days. All patients had pharyngitis and 12 (92.3%) had cervical lymphadenitis. Blood tests were performed for 12 patients, and no patients had neutropenia. Both the C-reactive protein and erythrocyte sedimentation rate were elevated at medians of 4.5 mg/dL (range, 0.4-13.2 mg/dL) and 29 mm/hr (range, 16-49 mm/hr), respectively. Throat swab cultures and rapid streptococcal antigen tests were negative. Nine (69.2%) patients received oral prednisolone at a median dose of 0.8 mg/kg, and in 6 (66.7%) patients, fever resolved within a few hours. Three (23.1%) patients received tonsillectomy and adenoidectomy. Conclusions: PFAPA syndrome should be considered when a child presents with periodic fever along with aphthous stomatitis, pharyngitis, or cervical lymphadenitis. Glucocorticoid administration is effective for fever resolution and can reduce unnecessary use of antibiotics.

A Cohort Study of Incidence Rate and Causes of School Accidents in a Boys' Middle School in Taegu (남자중학교 학생의 학교사고 발생률과 사고원인에 관한 코호트 연구)

  • Park, Jung-Han;Park, Mi-Wha
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.2 s.22
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    • pp.331-340
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    • 1987
  • To determine the incidence rate of school accidents and its associated factors, a cohort observation was carried out in a boys' high school of a total of 2,324 students for an academic year from March 1986 to February 1987. Data for accidents were collected by the author (school nurse) as students came to the school health station for treatment of accidental injury. Data for school activities were obtained from the diary of academic affairs. A total of 603 students made 1,126 visits to the station for accidental injury during the study period that gave an average 1.9 accidents per student. The average number of visits for accidental injury per day was 5.1 and the incidence rate of accidental injury was 2.2 per 1,000 student days. Each class had about 30 accidents on the average in a year. However there were two classes that had exceptionally high incidence rate of accidents; 54 accidents in one class where 10 athletes were assigned and 58 accidents in the other class where the teacher in charge was On vacation for two months. The highest incidence rate of accident was observed in June (3.4 per 1,000 student days) and the lowest rates were in December and February (1.5 and 0.7 per 1,000 student days, respectively) and there were no appreciable difference by day of week. Accidents were caused by mischief or carelessness of students in 62.2% and by the inappropriate tools and facilities of school in 18.6% . The accidents caused by tools and facilities were mainly due to the antiquated chairs and tables. Referral rate to hospital for severe injury was three times higher in cloudy days and five times higher in rainy days than in clear days. There was almost no accident during the examination period but increased after the examination. Based on these findings, following measures are recommended to prevent school accident: disperse the athletes throughout the classes: should the teacher in charge leave the class for a long period, replace with another teacher who is familiar with the class to keep order; replace or repair the inappropriate tools and facilities; and warn the students for the risk of accident or broadcast music or let the students have light physical exercise to relieve the tension in cloudy or rainy day and after examination.

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Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.

Preliminary Results of 3-Dimensional Conformal Radiotherapy for Primary Unresectable Hepatocellular Carcinoma (절제 불가능한 원발성 간암의 입체조형 방사선치료의 초기 임상 결과)

  • Keum Ki Chang;Park Hee Chul;Seong Jinsil;Chang Sei Kyoung;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.123-129
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    • 2002
  • Purpose : The purpose of this study 띤as to determine the potential role of three-dimensional conformal radiotherapy (3D-CRT) in the treatment of primary unresectable hepatocellular carcinoma. The preliminary results on the efficacy and the toxicity of 3D-CRT are reported. Materials and Methods : Seventeen patients were enrolled in this study, which was conducted prospectively from January 1995 to June 1997. The exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child-Pugh classification C, tumors occupying more than two thirds of the entire liver, and a performance status of more than 3 on the ECOG scale. Two patients were treated with radiotherapy only while the remaining 15 were treated with combined transcatheter arterial chemoembolization. Radiotherapy was given to the field including the tumor plus a 1.5 cm margin using a 3D-CRT technique. The radiation dose ranged from $36\~60\;Gy$ (median; 59.4 Gy). Tumor response was based on a radiological examination such as the CT scan, MR imaging, and hepatic artery angiography at $4\~8$ weeks following the completion of treatment. The acute and subacute toxicities were monitored. Results : An objective response was observed in 11 out of 17 patients, giving a response rate of $64.7\%$. The actuarial survival rate at 2 years was $21.2\%$ from the start of radiotherapy (median survival; 19 months). Six patients developed a distant metastasis consisting of a lung metastasis in 5 patients and bone metastasis in one. The complications related to 30-CRT were gastro-duodenitis $(\geq\;grade\;2)$ in 2 patients. There were no treatment related deaths and radiation induced hepatitis. Conclusion : The preliminary results show that 3D-CRT is a reliable and effective treatment modality for primary unresectable hepatocellular carcinoma compared to other conventional modalities. Further studies to evaluate the definitive role of the 3D-CRT technique in the treatment of primary unresectable hepatocellular carcinoma are needed.

Effects of Boostin-250 Supplementation on Milk Production and Health of Dairy Cows (재조합 Bovine Somatotropin 250 mg 제제의 투여가 젖소의 산유량 및 건강에 미치는 영향)

  • Kim, Yo-Han;Kim, Doo
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.213-219
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    • 2012
  • The recombinant bovine somatotropin (rbST) has been used for increasing milk production of dairy cows without adverse health effects. This study was conducted to compare effects of supplementation with $Boostin^{(R)}$-250 containing 250 mg of rbST on milk production with those of $Posilac^{(R)}$ and $Boostin^{(R)}$-S. And safety of rbST supplementation on target animals was also observed. Each twenty-five lactating dairy cows were assigned randomly to one of four groups. $Boostin^{(R)}$-250 and vehicle (control) were administered weekly. $Boostin^{(R)}$-S and $Posilac^{(R)}$ were administered two week intervals. Milk yield, milk components, milk somatic cell count, health status, and body condition score of cows were examined. Supplementation with $Posilac^{(R)}$, $Boostin^{(R)}$-S, and $Boostin^{(R)}$-250 induced more milk yield than control group by 2.9 kg/day (12.3%), 4.2 kg/day (17.9%), and 4.1 kg/day (17.4%), respectively. There was a significant difference in milk yield among three rbST treatment groups and control group (${\alpha}$ = 0.05). The rbST supplementation did not increase the incidence of clinical mastitis and milk somatic cell counts. Supplementation with rbST did not significantly affect milk components (milk fat, protein, and solid not fat). The rbST supplementation of the dairy cows after peak milk yield did not cause negative effect on BCS. However, some cows less than 100 days in milking had decreased BCSs after rbST supplementation. In conclusion, milk production in 250 mg of rbST administered cows every week was similar to that of 500 mg of rbST administered cows every 2 weeks. And supplementation of 250 mg of rbST every week could reduce metabolic stress in cows.

Studies on hematologic values and types of blood protein in Jindo dogs I. Hematologic values of Jindo dogs (진도견(珍島犬)의 혈액상(血液像)과 혈액단백질형(血液蛋白質型)에 관(關)한 연구(硏究) I. 진도견(珍島犬)의 혈액상(血液像))

  • Kim, Woo-kwon;Han, Bang-keun;Kim, Ja-suk
    • Korean Journal of Veterinary Research
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    • v.28 no.2
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    • pp.285-297
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    • 1988
  • The present study was conducted in order to get the normal hematologic values of Korean Jindo dogs. Blood samples were taken from 328(♂ 92, ♂ 236) healthy Jindo dogs in Jindo area. The results obtained in this study were summarized as follows: 1. The mean values of red blood cell(RBC) count, hemoglobin(Hb) content and packed cell volume(PCV) in the age group of less than one year were 6.77(♂ 6.80, ♂ 6.76)${\times}10^6/{\mu}l$, 13.14 (♂ 13.53, ♂ 12.99)g/100ml and 43.28(♂ 44.47, ♂ 42.79)ml/100ml, respectively, whereas the RBC count, Hb content and PCV in the age group of one year and more were 7.42(♂ 7.44, ♂ 7.42)${\times}10^6/{\mu}l$, 14.98(♂ 15.56, ♂ 14.76)g/100ml and 47.18 (♂ 48.43, ♂ 46.71)ml/100ml, respectively. The values of RBC count, Hb content and PCV appeared to be higher in the male than in the female and it increased with aging in the age group of less than one year. 2. The mean values of mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH) and mean corpuscular hemoglobin content(MCHC) in the age group of less than one year were 63.93(♂ 65.40, ♂ 63.30)fl, 19.41(♂ 19.90, ♂ 19.22) pg and 30.36(♂ 30.43, ♂ 30.36)g/100ml respectively, whereas the MCV, MCH and MCHC in the age group of one year and more were 63.58(♂ 65.09, ♂ 62.95)fl, 20. 19(♂ 20.91, ♂ 19.89) pg and 31.75(♂ 32.13, ♂ 31.60)g/100ml respectively. The values of MCV, MCH and MCHC appeared to be higher in the male than in the female. No differences were found in the MCV and MCH between age groups. The MCHC appeared to be higher in older age group. 3. The mean values of white blood cell(WBC) count in the age group of less than one year were 14,356(♂ 13,878, ♂ 14,551)/${\mu}l$, whereas the values of WBC count in the age group of one year and more were 13,394(♂ 12,656, ♂ 13,672)/${\mu}l$. The WBC count appeared to be higher in the female than in the male. No differences were found between age groups in the WBC count. 4. In WBC differential count the mean percentage of lymphocyte, monocyte, neutrophil and eosinophil of the age group less than one year were 33.45(♂ 31. 64, ♂ 34.18), 2.77(♂ 3.00, ♂ 2.68), 57.40(♂ 58.18, ♂ 57.08) and 6.38(♂ 7.18, ♂ 6.06)% respectively, while those of the age group one year and more were 30. 22(♂ 28.38, ♂ 30.90), 3.03(♂ 3.23, ♂ 2.95), 60.93(♂ 63.34, ♂ 60.03) and 5.82(♂ 5.04, ♂ 6.11)% respectively. Lymphocyte count appeared to be higher in the female and in the age group below one year than in the male and in the age group of one year and more, whereas the reverse was the case with neutrophil and monocyte counts. 5. Mean platelet count in the age group of less than one year was 377,391(♂ 398,778, ♂ 368,721)/${\mu}l$, whereas mean platelet count in the age group of one year and more was 354,657 (♂ 373,660, ♂ 347,512)/${\mu}l$. The platelet count appeared to be higher in the male than in the female and especially lower in the age group of three years and more($305,513/{\mu}l$) than in the other age groups.

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Surface Tension-Water Saturation Relationship as the Function of Soil Particle Size and Aquifer Depth During Groundwater Air Sparging (대수층 폭기공정에서 토양입경 및 지하수 깊이에 따른 표면장력과 함수율의 상관관계)

  • Kim, Heon-Ki;Kwon, Han-Joon
    • Journal of Soil and Groundwater Environment
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    • v.14 no.6
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    • pp.65-70
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    • 2009
  • Reduction of groundwater surface tension prior to air sparging (SEAS, surfactant-enhanced air sparging) was known to increase air saturation in the aquifer under influence, possibly enhancing the removal rates of volatile contaminants. Although SEAS was known to be efficient for increasing air saturation, little information is available for different hydrogeological settings including soil particle sizes and the depth of aquifer. We investigated water saturations in the sparging influence zone during SEAS using one-dimensional column packed with sands of different particle sizes and different aquifer depths. An anionic surfactant was used to suppress the surface tension of water. Two different sands were used; the air entry pressures of the sands were measured to be $15.0\;cmH_2O$, and $36.3\;cmH_2O$, respectively. No significant difference was observed in the water saturation-surface tension relationship for sands with different particle sizes. As the surface tension decreased, the water saturation decreased to a lowest point and then it increased with further decrease in the surface tension. Both sands reached their lowest water saturations when the surface tension was set approximately at 42 dyne/cm. SEAS was conducted at three different aquifer depths; 41 cm, 81 cm, and 160 cm. Water saturation-surface tension relationship was consistent regardless of the aquifer depth. The size of sparging influence zone during SEAS, measured using two-dimensional model, was found to be similar to the changes in air saturation, measured using one-dimensional model. Considering diverse hydrogeological settings where SEAS to be applied, the results here may provide useful information for designing SEAS process.

Study on Temporal Decay Characteristics of Naturally Occurring Radionuclides in Groudwater in Two Mica Granite Area (복운모화강암지역 지하수 중 자연방사성 물질의 경시적 붕괴특성 연구)

  • Kim, Moon Su;Kim, Tae Seung;Kim, Hyun Koo;Kim, Dong Su;Jeong, Do Hwan;Ju, Byoung Kyu;Hong, Jung Ki;Kim, Hye Jin;Park, Sun Hwa;Jeong, Chan Ho;Cho, Byong Wook;Han, Jin Seok
    • Journal of Soil and Groundwater Environment
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    • v.18 no.4
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    • pp.19-31
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    • 2013
  • To figure out the decay characteristics of naturally occurring radionuclides, eight sampled groundwaters from a monitoring borehole having high levels of uranium and radon concentrations in a two mica granitic area have analyzed by liquid scintillation counters (LSC) for over 1 year. In December 2011, three groundwater samples (DJ1, DJ2, DJ3) were obtained from each aquifer system located at -20 m, -40 m, -60 m of the monitoring borehole below the ground surface, respectively. Five samples (DJ4, DJ5, DJ6, DJ7, DJ8) were additionally gained from each aquifer positioned -20 m, -40 m, -60 m, -100 m, -105 m of the borehole in February 2012, respectively. Temporal variation characteristics of uranium and radon concentrations have showed over maximum 2.1 times and 1.4 times fluctuations of the values in the same sampling intervals over time, respectively. The intervals of -40 m and -105 m in the borehole have the highest values of uranium and radon concentrations, respectively. This may imply that the concentrations of naturally occurring radionuclides such as uranium and radon in groundwater have been changed over time and indicate that the qualities of groundwaters from the aquifers developed at each interval in the borehole are different each other. This discrepancy, moreover, could be caused by behaviour differences between uranium which is in ionic status having a half life of 4.6 billion years and is transported along with the flowing groundwater, and radon which is in gaseous status having a 3.82 day's half life in the aquifer systems. Physicochemical characteristics of groundwaters from the aquifer systems could be identified by the results of the on-situ measuring items such as pH and Eh, and the major ionic contents. The CPM values of eight groundwater samples analysed by LSC over one year have shown not to follow the theoretical decay curve of the radon. The CPM values of the samples have ranged from 2 to 7.5 after it had passed two months when the theoretical CPM values of the radon started zero since the initial analysis. Alpha and beta particle spectrums have shown the peaks of radium-226, however they have not revealed any peaks of radon and it's daughter products such as polonium-218 and 214, bismuth-214 for the late stage of the analysis. This implies that the groundwater from the borehole may contain radium-226 having a half life of 1,600 years which decays continuously.

Growth and Root Characteristics and P, K Uptake by Soybean under Different Soil Water Conditions (토양(土壤) 수분(水分)의 상태(狀態)가 대두(大豆)의 생육(生育) 및 근계발달(根系發達) 특성(特性)과 P, K 흡수(吸收)에 미치는 영향(影響))

  • Jung, Yeong-Sang;Lim, Hyung-Sik;Ha, Sang-Geun;Han, Seong
    • Korean Journal of Soil Science and Fertilizer
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    • v.25 no.1
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    • pp.8-15
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    • 1992
  • An experiment was conducted to find out effect of soil water condition on shoot and root growth and P, K uptake by soybean plants. Soybean plants were grown under different soil water table levels, 20cm, 40cm and 60cm below the soil surface using minirhizotron with 20cm in diameter, and well irrigated and water stressed conditions using 1/2000a Waganer pots. Three soybean plants, Paldal culfivar, were grown and sampled at the early growing period, 37 days after planting, and at the harvesing period, 115 days after planting. Shoot and root growth were restricted by water stresed condition and by excessive soil water condition with the 20cm water table. Little difference in shoot and root growth were found between well irrigated condition and 40cm or 60cm water table conditions. The P and K contents in shoot under water stressed condition were higher than well irrigated condition at the early growing period but reversed at later harvesting period. The dry weight and length of roots were more severely restricted by water stress than those of shoots. Root morphological difference was found by anatomical observation. Normal cortex was developed under the well irrigated condition, while abnormal cortex with aerenchyma formed by lysis under excessive water conditions of 20 or 40cm water talbes. Aerenchyma was formed at outer skirt of pericycle. Role of formation of aerenchyma of soybean roots might be an adaptation to excessive soil water condition and possibly related to survival of soybean roots growing under near flooding condition on dikes of paddy lands.

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CT Measurement of Diameter and Dimension of the Trachea in Normal Korean Adults (흥부 전산화단층촬영을 이용한 한국성인의 기관내경과 단면적의 측정)

  • Han, Jae-Youl;Kim, Kwang-Ho;Lee, Gun;Kim, Hyung-Jin;Cho, Soon-Koo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.534-538
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    • 2001
  • Background: Knowledge of size and morphology of the normal trachea is important for airway management and tracheal reconstruction. Conventional radiography is a simple method used to measure the tracheal diameter, but it is not accurate because of the artifacts related to image magnification and overlapping by the shoulder. The purpose of this study was to provide the normal values of the tracheal size and anatomy in Korean adults using Computerized Topography. Material and Method: There were 43 men and 34 women included in this study. They were divided into three age groups(group 1, 20-39 years ; group 2, 40-59 yeas , groups 3, $\geq$60 years). The anteroposterior and transverse diameters and cross - sectional areas of the trachea were measured at the level of the thoracic inlet(Level 1) and the aortic arch(Level 2). These values obtained at each level were compared between age groups and sexes. Result: In 43 men, the anteroposterior / transverse diameters(mean SD in millimeters) of the trachea at levels 1 and 2 were 19.95$\pm$2.99 / 17.72$\pm$2.13 and 19.77$\pm$2.57 / 18.02$\pm$2.19, respectively. In 34 women, those values at levels 1 and 2 were 15.56$\pm$2.12 / 14.18$\pm$2.07 and 15.35$\pm$1.82 / 15.00$\pm$1.60, respectively. At both levels, the anteroposterior and transverse diameters were significantly greater in men than in women (p<0.05). The cross-sectional area of the trachea at levels 1 and 2 were 279.14$\pm$61.37 / 281.93$\pm$63.97 $\textrm{mm}^2$ in men and 173.29$\pm$35.81 / 181.88$\pm$34.74 in women, respectively. They also showed significantly greater values in men than in women(P<0.05). There was no significant difference in diameters and cross-sectional areas of the trachea between age groups. Conclusion: There are significant differences in the internal diameter and cross- sectional area of the trachea between men and women in normal Korean adults, while the age difference was insignificant. We believed CT is a relatively accurate and safe way to measure the internal diameter and cross-sectional areas of the trachea.

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