Processing math: 100%
  • Title/Summary/Keyword: 청소년 절도

Search Result 73, Processing Time 0.024 seconds

The Incidence Rate of Lymphadenitis after Bacille Calmette-Guérin (BCG) Vaccination (Bacille Calmette-Guérin (BCG) 백신 접종 후 림프절염의 발생 빈도)

  • Kim, Jaehong;Lee, Kyujin;Kim, Jong-Hyun;Kim, Seong Joon;Lee, Soo Young;Lee, Hye Jin;Cho, Kyung Soon;Kwon, Young Joo;Lee, Byoung Chan;Jo, Sang Min;Ha, Jeong Hun;Lee, Yoon Kyung;Seung, So Jin
    • Pediatric Infection and Vaccine
    • /
    • v.23 no.1
    • /
    • pp.54-61
    • /
    • 2016
  • Purpose: Bacille Calmette-Guˊerin (BCG) lymphadenitis is a relatively frequent local adverse reactions after BCG vaccination. Its incidence rate is usually <1%. However, this rate may be different according to BCG strain, vaccination method or skill, etc. In the Republic of Korea, two BCG strains are used: intradermal Danish-1331 or percutaneous Tokyo-172. We surveyed the incidence rates of BCG lymphadenitis. Methods: This survey was performed in total 25 centers (5 general hospitals, 20 private pediatric clinics). Immunized type of BCG strain in study subjects was verified by directly observing the scar. The occurrence of BCG lymphadenitis was asked to their parent. In cases of BCG lymphadenitis, location, diameter size, progression of suppuration, and treatment method were investigated, as well. Results: The total number of study subjects was 3,342. Among these, the subjects suitable for enrollment criteria (total 3,222; Tokyo strain 2,501, Danish strain 721) were analyzed. BCG lymphadenitis regardless of its size developed in each five of subjects per strains, therefore, its incidence rate was 0.20% in Tokyo and 0.69% in Danish strain, respectively (P=0.086). However, when applying the WHO criteria - the development of lymph node swelling with diameter 1.5 cm or more, the incidence rate of BCG lymphadenitis was 0.16% (4 cases) in Tokyo and 0.42% (3 cases) in Danish strain, respectively. Conclusions: The incidence rate of lymphadenitis in two BCG types, percutaneous Tokyo and intradermal Danish strain BCG, is 0.20% and 0.69%, respectively. Both rates are acceptable.

A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination (골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰)

  • Park, Jin A;Park, Joo Young;Park, Ji Min;Park, Seat Byoul;Kim, Heung Sik;Jeon, Dong Seok
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.8
    • /
    • pp.1007-1015
    • /
    • 2002
  • Purpose : The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination. Methods : We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells. Results : The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes. Conclusion : Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

Trends of hospitalized tuberculosis at a children's hospital during a 20-year period (1988-2007) (20년간(1988-2007) 1개 대학병원에 입원한 소아결핵 환자의 동향)

  • Yang, Mi Ae;Sung, Ji Yeon;Kim, So Hee;Eun, Byung Wook;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
    • /
    • v.15 no.1
    • /
    • pp.59-67
    • /
    • 2008
  • Purpose : According to the 2008 WHO report, incidence, prevalence, and mortality of tuberculosis are decreasing globally. The 7th National Tuberculosis Survey of 1995 in Korea showed that the prevalence of tuberculosis was also decreasing. This study was performed to review the hospitalized childhood tuberculosis in a children's hospital over a 20 year period. Methods : Medical records of children <16 years of age hospitalized with the diagnosis of tuberculosis at the Seoul National University Children's Hospital between 1988 and 2007 were reviewed retrospectively. Changes in number of patients and involved sites were also analyzed by four 5-year periods. Results : Out of the 186 hospitalized patients, 59.1% were male. Median age at diagnosis was 5.5 years old (range, 10 days-15 years). The main involved sites included the lung (n=54, 29%) or pleura (n=12, 6.5%), central nervous system (n=49, 26.3%), lymph node (n=15, 8.1 %), bone and joint (n=9, 4.8%), gastrointestinal tract (n=5, 2.7%) or peritoneum (n=5, 2.7%), pericardium (n=2, 1.1%) and others (n=3, 1.6%). Total 32 patients (17.2%) showed miliary pattern. The proportion of hospitalization with newly diagnosed tuberculosis among all cause hospitalization decreased from 0.61% to 0.09%, comparing the period of 1988-1992 and 2003-2007 (P<0.001) and the incidence of hospitalized tuberculosis of any involved organs also decreased with a statistical significance. Conclusion : The data from a single children's hospital suggest that the number of hospitalized childhood patients with tuberculosis has decreased over a 20 year period in Korea.

  • PDF

The Existential Mode and Identity of the Qing Literati - Focusing on Zhang Xuecheng(章學誠) (청대 문인(文人)의 존재 방식과 정체성 - 장학성(章學誠)을 중심으로)

  • 최형섭
    • CHINESE LITERATURE
    • /
    • v.96
    • /
    • pp.145-175
    • /
    • 2018
  • This study was made with the purpose of reconsidering the way of existence of literati(文人), the meaning of writing, and the relationship between cultural power and political power, focusing on Zhang Xuecheng(章學誠, 1738-1801) in the middle of the Qing dynasty. Here, 'Wenren(文人)' was used as a concept equivalent to 'the literary intelligentsia', in other words, 'literati' of English rather than the concept of 'the literary man'. Firstly, Zhang Xuecheng was the person who had lived 64 years of life from Qianlong(乾隆) 3 to Jiaqing(嘉慶) 6, in particular, one of the representatives of the Chinese literati and scholar in the mid and late 18th century. He was born in a typical Gangnam gentry family from Kuaiji(會稽) in Zhejiang province. During adolescence he was grown and educated in hometown Shaoxing(紹興) and Yingcheng(應城) in Hubei province, but Beijing was the city that had the greatest influence on him. After he entered Guozijian(imperial capital academy) at the age of 25 in Qianlong 27(1762), he was mainly active in Beijing and had lived a life of wandering in Zhili(直隸), Henam, Anhui, Hubei province etc. He exchanged ideas with many literati and scholars who led the 18th century. He had many patrons Such as Shen Yefu(沈業富), Ou Yangjin(歐陽瑾), Zhu Fenyuan(朱棻元), Zhu Yun(朱筠), Liang Guozhi(梁國治), Bi Yuan(畢沅), Xie Qikun(謝啓崑) etc, who were prominent government officials and scholars of the time. In spite of passing imperial examinations and becoming the jinshi(進士), he gave up being a bureaucrat, and decided to live as a marginal literati out of office. With the help of his patrons, he solved economic problems mainly through non-regular workers such as tutor, the chief of the local academy, muliao(幕僚, provincial official's adviser) etc. Most of non-official literati in the middle of the Qing dynasty resolved their livelihood problems through irregular jobs like Zhang Xuecheng, while they kept maintaining their identity as intellectuals. Secondly, in intellectual discourses of the 18th century, the academic world was largely divided into moral philosophy(義理), philology(考據), literature(文章, or 詞章). The question of how to define and evaluate the value, relation and status of these three was different according to discussants. However, overall, literary texts were valuated as being less meaningful and worthy than the scholarly texts to deal with moral philosophy and philology. The writings of Zhang Xuecheng generally had the character of a scholar rather than of a literary man, and the meaning and value of his writings could be found in scholarly writings rather than in literary writings. As summarized in the words, "moral philosophy could be proved by philology, literature was the tool to express it," he established the scholarly identity he should seek through the way of integrating moral philosophy and philology centering on the historical writings. Thirdly, including Zhang Xuecheng, Quan Zuwang(全祖望), Yuan Mei(袁枚), Wang Mingcheng(王鳴盛), Zhao Yi(趙翼), Quan Daxin(錢大昕), Yao Nai(姚鼐) etc, represented the Chinese literati and scholars in the 18th century. Coincidentally, they all resigned early and left office, or gave up being official despite passing imperial examinations, and engaged in teaching and writing as marginal literati out of institutional power for a very long time. The backgrounds of their abandonment or early resignation were different, but the ambition and desire to leave the endless works for posterity could be said a common part. In addition, it was necessary to consider that it was a matter of choosing one of the two, in which the 18th century literati could hardly combine official and scholar because of specialized scholarships. It also seemed to be related to the situation that cultural power was becoming a part of the individual choice of Han Chinese literati, for the Manchu regime could not create the leading cultural power.

Long term prognosis of patients who had a Fontan operation (폰탄 수술을 받은 환아들의 장기적 예후)

  • Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.1
    • /
    • pp.40-46
    • /
    • 2007
  • Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was 8.3±5.3years (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average 12.8±3.6years after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after 8.4±5.6years. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.1
    • /
    • pp.63-67
    • /
    • 2005
  • Purpose : Henoch-Sch¨onlein purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

Investigation of causes of FUO (fever of unknown origin) in children (소아 불명열 원인에 대한 고찰)

  • Park, Hyun Seok;Im, Sun Ju;Park, Su Eun
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.12
    • /
    • pp.1282-1286
    • /
    • 2006
  • Purpose : The causes of prolonged fever have changed during the years and are influenced by age, geographic location and availability of diagnostic facilities/techniques. The aim of the present study was to determine the causes of prolonged fever, to know the proportion and outcomes of undiagnosed children. Methods : We reviewed patients with fever persisting for more than 2 weeks in duration, with documented temperatures of 38C on several occasions, or uncertain diagnosis after intensive study of 1 week duration in other hospitals who were admitted to Pusan National University Hospital during the period from July 1999 to June 2004. Results : Fifty-four (59.0 percent) were boys and thirty-seven (41 percent) were girls. Forty-six cases were less than 6 years and 45 cases were more than 6 years; the mean age was 6.48±6.56years. In 62 cases (68.1 percent), the fever had persisted for 2 to 3 weeks before admission and in 26 cases (28.6 percent), had lasted longer than a month. Final diagnosis had been reached in 66 of 91 children (72.5 percent). The most common cause was infection (38/91), followed by collagen vascular disease (12/91), immune deficiency (3/91), neoplasia (2/91), and miscellaneous disease. Tuberculosis was the most common infectious cause. The causes of fever were not revealed in 25 cases. Outcome on discharge were as follows; 77 cases (84.6 percent) were improved, 10 cases (11.0 percent) discharged without improvement and 4 cases (4.4 percent) expired. Conclusion : The most common cause of prolonged fever in Korean children remains infection, but the incidence of infection was decreased as compared with previous studies. Tuberculosis is the most common among infectious causes. As Kikuchi disease (subacute necrotizing lymphadenitis) represented a significant cause of prolonged fever, it should be considered if a patient has neutropenia with lymphadenopathy. Undiagnosed patients with prolonged fever (27.5 percent) have increased over previous studies.

Changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis (소아의 전염성 단핵구증에서 사이토카인과 세포자멸사 연관 유전자의 발현의 변화)

  • Jo, Dae Sun;Han, Ji Hye;Kim, Sun Young;Kim, Min Sun;Yi, Ho Keun;Lee, Dae-Yeol;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.12
    • /
    • pp.1348-1357
    • /
    • 2009
  • Purpose:The aims of this study were to identify the clinical characteristics and determine the changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis. Methods:Serological examinations of 15 pediatric patients diagnosed with infectious mononucleosis were performed prospectively. Peripheral blood from the patients was used to compare the composition of T cell subsets, cytokines, Epstein-Barr virus (EBV) DNA, and the expression of apoptosis-related genes with those in 10 healthy children. Results:Mean age of the patient group was 5.7±3.4 (range, 3-9) years, and the male-to-female ratio was 1.5:1. Fever, sore throat, pharyngitis/tonsillitis, and cervical lymph node enlargement were the most common symptoms and signs. The proportions of CD3+ T cells, CD8+ suppressor cells, and CD56+ natural killer (NK) cells were higher in the patient group than in the control group (P<0.01). The IL-2, IL-6, and interferon (INF)γ levels were higher in the early symptomatic period (P<0.01). Mean amount of EBV DNA in the patients was 102.38copies/μg, and the amount was the highest at the beginning of the symptomatic period and normalized during the convalescent phase. Bcl-2 expression increased during the initial phase, while Bax expression increased during the convalescent phase. Further, FasL expression increased 1 week after symptom presentation and decreased during the convalescent phase. There was no significant change in Fas expression. Conclusion:We analyzed the clinical characteristics and changes in the expression ofcytokines and apoptosis-related genes in the patients with infectious mononucleosis.

A study on the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis (알레르기성 직결장염의 임상상과 내시경 및 조직소견)

  • Lee, Joo Hee;Kim, Sung Shin;Park, Jae Ock
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.3
    • /
    • pp.276-285
    • /
    • 2008
  • Purpose : Allergic proctocolitis is a major cause of bloody stool in early infancy. This study was aimed at ascertaining the clinical courses, sigmoidoscopic and histologic findings of allergic proctocolitis. We also analyzed the relationship between peripheral eosinophilia, the age at symptom onset, and sigmoidoscopic and histologic findings. Methods : We reviewed 25 infants retrospectively who had sigmoidoscopy and biopsy performed with a clinical diagnosis of allergic proctocolitis from April 2003 to April 2007. Results : The mean age at symptom onset was 15.2±13.2 weeks. Fourteen infants (56.0%) were breast fed, one (4.0%) was formula fed, six (24.0%) were on combined formula, and four (16.0%) were on a weaning diet. Peripheral eosinophilia (250/mm3) was seen in eighteen infants (75.0%), but total serum IgE was increased only in six (24.0%). Sigmoidoscopic findings were variable from normal (8.0%), erythema or edema (20.0%), lymphoid hyperplasia (8.0%), erosion (12.0%), hemorrhage and ulcer (4.0%) to lymphoid hyperplasia with erosion, hemorrhage, or ulcer (48.0%). Histologic findings showed focal infiltration of eosinophils in lamina propria (96.0%) and crypt epithelium (96.0%). In twenty four infants (96.0%), the number of eosinophils in mucosa was increased by a more than 60/10 high power field. There was a negative correlation between peripheral eosinophilia and the age at symptom onset. Among the twelve breast fed infants, bloody stool disappeared in ten (83.0%) with a maternal elimination diet of major food groups, but two improved spontaneously. Conclusion : Allergic proctocolitis should be considered as one of the major causes of bloody stool in healthy appearing infants. To confirm the diagnosis it is necessary to perform sigmoidoscopy and biopsy but histologic findings are more informative than sigmoidoscopic findings. Peripheral eosinophilia was prominent in the infants with an early onset of symptoms. Most infants experienced benign courses and recovered with the elimination of causative foods but did not need exclusive food restrictions.

Clinical observations of juvenile rheumatoid arthritis (연소성 류마티스 관절염의 임상적 고찰)

  • Lee, Joo Hoon;Ryu, Jeong Min;Park, Young Seo
    • Clinical and Experimental Pediatrics
    • /
    • v.49 no.4
    • /
    • pp.424-430
    • /
    • 2006
  • Purpose : Juvenile rheumatoid arthritis(JRA) is one of the most common rheumatic diseases of childhood and is an important cause of short- and long-term disability. The purpose of this study was to determine the disease course and outcome in childhood patients with JRA. Methods : Fifty nine patients with JRA who were diagnosed and treated in the Department of Pediatrics, Asan Medical Center from August 1990 to November 2004 were enrolled in this study. Sex, age, type, affected joints, extra-articular manifestations, laboratory and radiologic findings, treatments, and outcomes of JRA patients were reviewed retrospectively. Results : Among JRA patients, 32.2 percent had pauciarticular type, 30.5 percent had polyarticular type and 37.3 percent had systemic type. The ratio of boys to girls was 1.7 : 1 and the mean age at onset was 9.3±3.7(1.3-15.9) years. The most commonly affected joints were knee, ankle and wrist. The extra-articular manifestations observed were fever, rash, myalgia and lymph node enlargement, etc. The main laboratory findings observed were leukocytosis, anemia, thrombocytosis, elevated ESR, and elevated CRP. Rheumatoid factor and antinuclear antibody(ANA) were positive in 5.3 percent and 18.0 percent. Nonsteroid anti-inflammatory drugs(NSAID) were used most frequently and methotrexate with or without steroids was added in 27.1 percent of patients unresponsive to NSAID. 88.1 percent of patients were cured without functional disability and only one patient was in functional status IV. One patient, who had pulmonary involvement, died. Conclusion : Our results showed an even distribution in type of onset, male predominance, older age of onset, low incidence of iridocyclitis, and low positivity of ANA in JRA patients; this differs from occidental data. This study may suggest regional differences and variability in disease groups of JRA among different racies, but further multi-center trials and large scale epidemiological studies are needed to confirm our conclusion.