• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.31-41
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• 1989

Since the first cases of tsutsugamushi disease reported in Korea in 1986. many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are ; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills(88%), myalgia(65%), headache(54%), nausea and vomiting(31%), and abdominal pain(27%). The eschar was detected on lower part of body in most of cases. and more frequently in male(M : F 100 vs 58%). 4. Patients were treated with tetracyclines(TC) and/or chlorampenicol(CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1 days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 cases of shock. and all cases were recovered without any sequlae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

• Tuberculosis and Respiratory Diseases
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• v.61 no.4
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• pp.389-393
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• 2006

Tsutstugamushi disease is a major febrile disease that generally occurs in the fall in Korea with hemorrhagic fever with renal syndrome and leptospirosis. This disease is often accompanied by interstitial pneumonia, acute renal failure and liver failure. The causative agent, namely Orientia tsutsugamushi, is transmitted to humans through the bite of a laval trombiculid mite, which is commonly known as a chigger. A 78 year old man was admitted in October 2004 with intractable fever and a drowsy mentality. Two weeks earlier, he visited a private clinic complaining of a simple skin rash. He was treated with antihistamine and steroid, but his symptoms were aggravated and he was referred to our hospital. His physical examination and laboratory findings showed a septic shock status. The maculopapular rash had spread over his face, chest, abdomen and extremities. Eschar was observed in lower back area but it was too difficult to distinguish it from other skin rashes. His chest X-ray appeared as diffuse nodular patchy consolidations in the bilateral lung parenchyme. He was treated with a mechanical ventilator and doxycycline under th suspicion of Tsutstugamushi disease. However, he suffered multiorgan failure accompanied by acute respiratory distress syndrome, acute renal failure and acute hepatitis. He was treated in the intensive care unit for approximately 12 weeks and his general condition was recovered.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.545-548
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• 2007

쯔쯔가무시병은 추수 시기에 유행하는 대표적인 급성 열성질환으로 여전히 증가 추세에 있다. 의심되는 환자에게 Doxycycline 투여 후 급속한 해열이 질환의 독특한 특징이기도 한데 Doxycycline 투여 96시간 후에도 지속적인 고열과 근육통이 있었던 환자에게 Clarithromycin으로 변경 후 급속한 해열과 함께 증상이 호전된 증례를 보고한다.

• Clinical Pain
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• v.18 no.2
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• pp.111-114
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• 2019

Guillain-Barre syndrome (GBS) is usually characterized by acute areflexic ascending paralysis with minimal sensory involvement. Only a few cases of GBS associated with scrub typhus have been reported. Previous case reports focused on the laboratory findings, pathogenesis, and clinical manifestation. Unlike the previous case, neuropathic pain was a prominent symptom of GBS in our case. We report scrub-typhus-related GBS with a detailed description of the clinical manifestations, especially neuropathic pain, along with results of serial follow-up electrodiagnostic studies.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.84-88
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• 2018

The aim was to evaluate different results from using crude incidence rate (CIR) instead of agestandardized incidence rate (AIR) when comparing groups having different age structures. After selecting a report using CIRs, AIRs and their 95% confidence intervals(CI) was calculated from the raw data. The statistically significant difference between CIR and AIR was decided based on AIR's 95% CI. Comparing with CIRs, AIRs were under-estimated. In addition, there were no statistical significance of annual trends(P=0.59). These findings are an additional evidence using AIR when comparing level of occurring infectious diseases on groups with different age structures.

• The Journal of Korean Oriental Chronic Disease
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• v.10 no.1
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• pp.32-38
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• 2005

Scrub typhus is a acute febrile illness by Orientia tsutsugamushi that is endemic in Asian-Pacific areas. It is characterized by fever, rash, eschar, lymphadenopathy. Therapy with Tetracycline, Doxycycline, Chloramphenicol is currently recommended. Here we report a case of tsutsugamushi disease in a 66 year old man had fever, nausea, vommitting, dyspnea, who was successfully treated with East-West intergrative medicine therapy - Antibiotics therapy and Korean traditional medicine(Sasang medicine and acupuncture treatment) - and symptoms improved.

• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.247-250
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• 2011

The pandemic (H1N1) 2009 influenza outbreak coincided with the typical Scrub typhus season, which can lead to diagnostic difficulties due to their similar and non-specific symptoms. Here we describe a case of laboratory confirmed co-infection of Pandemic (H1N1) 2009 influenza and Scrub typhus and discuss the difficulties in distinguishing the two illnesses clinically.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.101-107
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• 2005

Purpose : We evaluated the C-reactive protein(CRP), white blood cell(WBC) and neutrophil levels in the various infectious diseases in a single hospital. Methods : A total of 640 medical records of children with infectious diseases such as bacterial meningitis(19 cases), acute pyelonephritis(55 cases), measles(253 cases), chicken pox (38 cases), mycoplasma pneumonia(160 cases), tsutsugamushi disease(39 cases) and Kawasaki disease(152 cases) admitted to The Catholic University of Korea, Daejeon St. Mary's hospital from 1996 to 2002 were retrospectively analyzed. Results : The mean CRP level was $17.9{\pm}6.4mg/dL$ in bacterial meningitis, $9.1{\pm}5.6mg/dL$ in Kawasaki disease, and $8.1{\pm}3.3mg/dL$ in acute pyelonephritis. In the mycoplasma pneumonia and tsutsugamush disease group(atypical bacterial group), the CRP level was $3.2{\pm}2.5mg/dL$, and $1.0{\pm}0.8mg/dL$ in the viral diseases group(measles and chicken pox). There were also significant differences for the WBC count and neutrophil differential between the 3 infectious groups with higher level in the bacterial infections group($15,600{\pm}6,100/mm^3$, $62{\pm}21%$) than in the atypical bacterial infections and in the viral infections group($9,600{\pm}3,300mm^3$, $57{\pm}11%$ and $7,300{\pm}2,900/mm^3$, $49{\pm}16%$, respectively). The inflammatory indices in Kawasaki disease were like those of bacterial infections. There was a correlation between CRP level and WBC or neutrophil count in the bacterial infections and Kawasaki disease groups. Conclusion : The CRP, WBC and neutrophil levels showed a clear difference between the infectious diseases according to causative agents. The WBC and neutrophil level was different according to age in measles and mycoplasma pneumonia. There was a correlation between CRP level and WBC or neutrophil count in the bacterial infections and Kawasaki disease groups.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.116-121
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• 2009

Background: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients with acute febrile illnesses. Methods: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi, HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographic images were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission. Results: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and a higher CRP level than that of those patients without pulmonary involvement (p=0.0073). Conclusion: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP level. Identification of this factor on admission might provide useful selection criteria for the patients who need early intensive care.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.1-10
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• 2019

Objectives: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. Methods: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. Results: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit-planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). Conclusions: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.