• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.7.1-7
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• 1987

청력장애가 있고 반복성 뇌막염을 앓는 환자에서는 일단 외임파누공을 의심하고 이에 대한 이비인후과 의사의 철저한 진찰 및 검사를 통해 진단 및 치료에 임해야 하겠다. 저자들은 최근에 경험한 재발성 뇌막염 환아에서 외임파누공을 진단하고 치료한 2예를 보고하고자 한다. 선천적으로 청력장애가 있고 수술전 1년동안 5∼6회의 뇌막염을 앓은 환아를 이학적검사, 청력검사 및 전산화 단층촬영을 이용하여 외임파누공을 진단하고 근막을 포함한 연조직으로 누공을 봉쇄하는 수술적 요법을 사용하여 완치시켰기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.139-143
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• 1987

The clinical picture and CSF findings in cryptococcus meningitis may be identical with those of tuberculous meningitis. The differential diagnosis can be made by finding the budding yeast organism in the counting chamber or in stained smear, the detection of cryptococcal antigen in CSF by the latex agglutination test, and by culture of the fungus on Sabouraud agar. We experienced a case of cryptococcal meningitis in the 48 years old woman, which was confirmed by Indian ink preparation and culture.

• 보건세계
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• v.45 no.5 s.501
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• pp.4-7
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• 1998

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.115-120
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• 1998

Purpose : In the summer 1997, there was an outbreak of aseptic meningitis in Pusan area. We report the clinical features and viral studies of aseptic meningitis in Pusan area in 1997. Methods : 265 children with aseptic meningitis who had been admitted to Department of Pediatrics, St. Benedict Hospital between April to October 1997 were included. Results : 1) Male-to-female ratio was 1.7:1. 2) Mean age was $6.2{\pm}3.29$ years. 3) It occured mostly April to October. 4) Clinical manifestations were fever 99.6%, vomiting 99.2%, headache 99.2%, rash 6.0%. 5) The duration of fever was $3.34{\pm}2.21$ days. 6) The duration of admission was $5.3{\pm}3.21$ days. 7) WBC count in peripheral blood were $11,200{\pm}4,163/mm^3$. 8) WBC count in CSF were $156.1{\pm}394.7/mm^3$. 9) Causative agents were coxsackievirus B5, echovius 6, 30, type nonspecific enterovirus. Conclusion : Aseptic meningitis in 1997 compared with that in 1996 had clinical feature of increase in age, decrease in duration of fever and incidende of rash. It occurred mostly April to October in 1997 and May to October in 1996. Causative agents were coxackievirus B5, echovirus 6, 30, type nonespecific enterovirus in 1997, and echovirus 9, coxsackievirus A24, type nonespecific enterovirus in 1996.

• The Korea Swine Journal
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• v.10 no.2 s.102
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• pp.81-83
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• 1988

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.104-114
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• 1998

Purpose : Enteroviruses are the most common cause of aseptic meningitis. The epidemics of aseptic meningitis in 1993 and 1996 were mostly caused by echovirus type 9. Identification of the causative virus of aseptic meningitis in epidemics, is very important not only for diagnosis but also for epidemiologic purpose. The purpose of this study was to identify the causative virus and investigate the relationship between aseptic meningitis, prevailed in Masan and surrounding areas in Kyoungsangnamdo in 1997, and its clinical manifestations. Methods : One hundred twenty eight cerebrospinal fluid(CSF) and 239 stool specimens were obtained from 239 patients(213 children and 26 adult patients) with aseptic meningitis were admitted to Masan Fatima Hospitals from March to October 1997. Viral isolation and serotype identification was performed by cell culture and immunofluorescent test. Enteroviruses not typed by immunofluorescent test was confirmed by reverse transcription-polymerase chain reaction(RT-PCR). Results : 1) The peak incidence was noted in June. 2) The age of 239 patients(pediatrics-213 cases, internal medicine-26 cases) that were diagnosed ranged from neonate to 35 years, the age of the patients of pediatrics ranged from neonate to 15years(mean 4.9 years), the age of the patients of internal medicine (above 16 years) ranged from 16 years to 35 years(mean 24.2 years). 3) Fifty-three(41.4%) of 128 CSF specimens were positive for enteroviruses, and 163(68.2%) of 239 stool specimens were positive for enteroviruses respectively. 4) Serotypes of 53 enteroviruses isolated from CSF were 16(30.2%) of echovirus type 30, 6(11.3%) of echovirus type 6, 1 of echovirus type 4, 4 of untyped echovirus, 1 of coxsackievirus type B5, and 24 isolates of untyped enteroviruses. Of 163 enterovirus isolated from stool were 72(44.2%) of echovirus type 30, 21(12.9%) of echovirus type 6, 1 of echovirus type 4, 17(10.4%) of undetermined subtyped echovirus, 1 of coxsackievirus type B5, 2 of A24, 3 of undetermined subtyped coxsackievirus type B, and 46 isolates of untyped enterovirus. Conclusion : There were epidemics of aseptic meningitis in the central areas of Kyoungsangnamdo from March to October 1997. The main causative organism was thought to be the echovirus type 30, and echovirus type 4, 6, coxsackievirus B5 and A24 were also thought to contribute to the epidemics.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.168-174
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• 2001

Purpose : There was an epidemic of aseptic meningitis in Korea for 3 years from 1996 to 1998. In this study, we reported the time of outbreak, age and sex distribution, clinical manifestations, laboratory data, and complications of the children with aseptic meningitis. Methods : We reviewed clinical records of 192 aseptic meningitis patients who had been admitted to Pohang St. Mary's Hospital from 1996 to 1998. Results : Aseptic meningitis occurred most frequently in July and August. The ratio of male to female was 1.91 : 1, and the most prevalent age was 1 to 5 years of age. The main symptoms were fever, vomiting, headache in this order of frequency. Peripheral blood showed leukocytosis(WBC > $10,000/mm^3$) in 44.3% of the cases. CSF examination showed WBC count were less than $500/mm^3$ in 88.0%, protein levels less than 40 mg/dL in 61.5%, and glucose levels more than 40 mg/dL in 94.3% of the cases. We did not isolate the causative viral agents. Conclusion : Aseptic meningitis was prevalent in children in the Pohang area from 1996 to 1998. Clinical manifestations and CSF profiles of aseptic meningitis patients showed no great difference compared to other reported.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.64-72
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• 1997

Purpose : The incidence of tuberculous meningitis in Korean children has been markedly decreased after 1980s, but this disease has still occurred with low rate. Therefore, it may be suspected that delayed diagnosis and treatment will be happened because of lacking of clinical experiences and indistinguishable other meningitis, so it is important to make early diagnosis and treatment of tuberculous meningitis concerning with the prognosis. In this aspect, we conducted study to concern and investigate sustainly about the diagnostic criteria, clinical characteristics, radiological findings, complications, and prognosis of typical or atypical tuberculous meningitis in children. Methods : Forty four children who were hospitalized and treated due to tuberculous meningitis in pediatric wards of Our Lady of Mercy Hospital, St. Holy Hospital, St. Vincent Hospital and Uijungbu St. Mary Hospital from January 1985 to June 1996 were included in this study. We reviewed medical records of these patients retrospectively. Results : 1) The tuberculous meningitis has occured continuosly since mid-1980s. The highest 2) The diagnosis was made by contact history of active tuberculous patients, positive tuberculin test, responses of antituberculous antibiotics and discovery of Mycobacterium tuberculosis from CSF or other specimens. Among patients, 7 children(16%) were not vaccinated with BCG, and only 18 children(40%) were positive in tuberculin test. 3) The symptoms and signs of our patients on initial examinations were fever, vomiting, headache, lethargy, poor feeding, weight loss, neck stiffness, convulsion, abdominal pain and motor deficits. 4) The findings of initial CSF samples revealed leukocyte $239.5/mm^3$(mean) with lymphocyte predominant, elevated protein levels(mean;259.5mg%) and low sugar level(mean;40.7mg%). And the ratio of CSF/blood sugar was 0.407. But, atypical CSF findings were seen in 31.8% patients. 5) On brain imaging study, 34 out of 39 children had findings of hydrocephalus, basilar meningeal enhancement, infarction and subarachnoidal inflammations etc. On chest X-ray, the findings of miliary tuberculosis(34.1%), normal finding(29.5%), parenchymal infiltrations (11.4%) and calcifications(9.1%) were showed. 6) In neurological clinical stage, there were twenty-six children(59%) in stage 1, fourteen children(32%) in stage 2 and four children(9%) in stage 3. The late sequeles were encountered by 29.5% with mild and 4.6% with severe neurological injury. The most common neurological injury was quadriplegia and the mortality rate was 6.8%. 7) The SIADH was developed in 20 children(45.5%) after the 4th hospital day. Half of all SIADH patients were symptomatic. Conclusion : Tuberculosis meningitis is still an important extrapulmonary disease with high morbidity and mortality. Early diagnosis with clinical contact history of active tuberculosis and radiological imaging examinations and early treatments are essential in order to prevent and decrase the rate of late sequeles and death.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.97-105
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• 1997

Purpose : Aseptic meningitis mainly caused by enterovirus is common in pediatric population especially during summer & fall. Most of pediatric patients restore their health without any complications with proper management. Between May to August of 1996, Masan and surrounding areas of the Kyoungsangnamdo were epidemic areas for the aseptic meningitis. The purpose of this study was to determine causative virus and describe correlation between disease and clinical symptoms in aseptic meningitis patients and those with fever and characteristic rashes without apparent meningitis symptoms. Methods : Between May to August, 1996, 57 patients with high fever and characteristic feature of rashes were reviewed. From 22 cerebrospinal fluid & 57 stool obtained specimens, viral culture and detection of enterovirus RNA were conducted. Collected specimens were kept in $-30^{\circ}C$ environment until sending of specimens to labortory. The virus identified through indirect immunofluorescence. RT-PCR method was used to identify enterovirus RNA in cerebralspinal fluid. Results : 1) One hundred fifty five pediatric patients with viral infection required hospitalization. Disease occurred higher rate in male than female with ratio of 1.94:1. Examined patients' age ranged from 15days old to 15years old. But most of patients(74.8%) were under age of 5years old. The time of occurrence was between May to August of 1996. 2) All patients had high fever and physical symptoms in those patients include headache, vomiting, abdominal pain, diarrhea, and rashes. The rashes observed mainly in patients under age of 4 years and were predominantly commom patients under age of 18 months olds)<0.001). 3) Between sampled patients and non-sampled patients, clinical course was similar. Echovirus type 9 was cultivated in 41 out of 57 cases of collected stool specimens. RT-PCR that used on CSF showed positive results in 10 out of 22 cases. Three cases of positive cultivated of positive results in RT-PCR were echovirus type 9. Conclusions : Echovirus type 9 was thought to be the causative agent of aseptic meningitis that was prevalent throughout mid areas of Kyoungsangnamdo from May to August, 1996. Additionally causative agent that responsible for high fever with rashes without meningitis symptoms also thought to be the same echovirus type 9.

• Pediatric Infection and Vaccine
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• v.10 no.2
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• pp.193-199
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• 2003

Purpose : This study was performed to investigate the epidemiologic feature of aseptic meningitis in Pohang city for 6 years from 1997 to 2002. Methods : We reviewed the clinical records of 1,839(1,138 male and 701 female) aseptic meningitis patients who had been admitted to 3 general hospitals in Pohang city from 1997 to 2002. Results : 1,750 cases(1,078 male and 672 female) were selected as aseptic meningitis by reviewing clinical records. The ratio of male to female was 1.6 : 1. Aseptic meningitis occured in children of all age groups, and the prevalent age group was different by year. The most common developed month was June(31.3%), and 84.2% of cases were focused from May to August. The time from the initial manifestation to hospital admission was $4.19{\pm}2.96$ (median 3 days). Conclusion : We were performed to investigate the epidemiologic feature of clinical records of Aseptic meningitis pediatric patients who had been admitted and treated to 3 General hospitals in Pohang city from 1997 to 2002. We have to keep up Our study for consideration of the basic of Aseptic meningitis epidemiology and long term control is necessary to prevention the impact of Aseptic meningitis because Aseptic meningitis pediatric patients were continuously recorded by Epidemiological annual report in Pohang city.