• Title/Summary/Keyword: 치명도

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A Correlation between Pulmonary Involvement of Acute Febrile Illness with High Incidence during the Fall and C-reactive Protein (가을철 유행하는 급성열성질환의 폐침범과 CRP와의 연관관계)

  • Kim, Go Woon;Lee, Woo Jin;Hong, Won Ki;Lee, Sung Hoa;Lee, Chang Youl;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki Suck
    • 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.

Clinical Significance of Enterovirus in Febrile Illness of Young Children (하절기에 발열을 주소로 입원한 3개월 이하의 영아에서 장바이러스 감염)

  • Kwak, Ji-Yeon;Cho, Mi-Hyun;Kim, Sung-Eun;Kang, Suk-Ho;Kim, Mi-Ok;Ma, Sang-Hyuk;Lee, Kyu-Man
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.94-100
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    • 2001
  • Purpose : Enterovirus is a common cause of aseptic meningitis and nonspecific febrile illness in young children. During the summer and fall months, enterovirus-infected young children are frequently admitted and evaluated to rule out bacterial sepsis and/or meningitis. The purpose of this study was to evaluate the relationship between nonpolio enterovirus infection and febrile illness in infants under 3 months of age during the summer, fall months by using a stool culture to identify the presence of enterovirus. Methods : Patients included febrile infants under 3 months of age admitted to Masan Fatima Hospital for sepsis evaluation from May 1999 to September 1999. Cultures were performed from stool and Cerebrospinal fluid samples and then were tested for enterovirus infection. Viral isolation and serotype identification were performed by cell culture and immunofluorescent testing. Enteroviruses not typed by immunofluorescent testing were confirmed by reverse transcription-polymerase chain reaction. Results : A total of 44 febrile infants were enrolled; of those, 20(45%) were positive for enterovirus. Two enterovirus culture-positive infants had concomitant urinary tract infection and one had Kawasaki disease. All infants infected with an enterovirus recovered without complications. Serotype of 20 enteroviruses were isolated from stool, 3 of echovirus type 9, 1 of echovirus type 11, 1 Coxsachievirus type B4, 15 of untyped enteroviruses. One untyped enterovirus was isolated in the CSF. Conclusion : Nonpolio enterovirus infections are associated with nonspecific febrile illnesses in infants under 3 months of age.

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Comparison of Amphotericin B and Itraconazole as Empirical Antifungal Therapy in Children with Acute Leukemia with Neutropenic Fever (발열을 동반한 호중구감소 상태의 급성백혈병 환아에서 경험적 항진균제로 투여한 Amphotericin B와 Itraconazole의 효과와 이상 반응 비교)

  • Lee, Sang-Yun;Park, Jong-Sun;Kim, Sun-Young;Yang, Keum-Jin;Park, Kyung-Deok;Kim, Hack-Ki
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.75-85
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    • 2005
  • Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

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Differences in T Serotypes and emm Genotypes of Group A Streptococci Obtained from Invasive and Non-invasive Streptococcal Infections (침습적 및 비침습적 감염 환자에서 분리된 A군 연구균의 T 혈청형과 emm 유전자형의 비교 연구)

  • Hahn, Wonho;Kim, Sejin;Ko, Hansoek;Jung, Sajun;Cha, Sungho;Lee, Heejoo;Lee, Kyungwon
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.106-114
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    • 2006
  • Purpose : Studying the serotypes and emm genotype of group A streptococci(GAS) hold a key role in the investigation of epidemiology, pathogenesis, and resistance to antibiotics. We planed to find out the possible differences in serotypes and genotypes between the invasive and the non-invasive GAS infection. Methods : We obtained 39 isolates from the patients hospitalized in 2004 with the diagnosis of invasive GAS infectious diseases in the Severance Hospital, Yonsei University. We sent the isolates to the WHO Collaboratory Center in University of Minnesota and analyzed T serotypes and emm genotypes. These results were compared with non-invasive GAS infections in our hospital. Results : Compared this data with the results of 2003 to 2004, T2/28, T3, T5/27/44, T9 and NT were more prevalent. The NT showed statistically significant difference(P=0.019). The emm 3, emm 9, emm 18, emm 44 and emm provision type STG485 were more frequent genotypes compared with the study in 2003~2004, relatively. The emm provision type STG485 had statistically significant difference(P=0.000). The incidence of T12 plus T4, known as erythromycin(EM) resistant serotypes, was as low as 17.9% in this study, compared with those of non-invasive strains. Conclusion : The incidence of EM-resistant strains is supposed not to be higher in invasive GAS infection. We could find out possible higher incidence of rheumatogenic strains in the invasive GAS infections. It seems to be important to have an effort on studying of serotyping and genotyping for the monitoring of strains and to know the epidemiologic characteristics.

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Early Pulmonary Irradiation in Paraquat ($Gramoxone^{(R)}$) Poisoning (Paraquat 중독 환자에서 전폐 방사선치료의 효과)

  • Lee, Chang-Geol;Kim, Gwi-Eon;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.13 no.4
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    • pp.321-330
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    • 1995
  • Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients were managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A : minimal 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using Co-60 teletherapy machine. A total of 10Gy(2Gy/fr. x 5days) was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due to multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients($86{\%}$) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who were received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary change. One patient who refused RT after 2Gy died due to pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggresive supportive treatment appears to decrease Pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.

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Morphological and Anatomical Response of Rice and Barnyardgrass to Herbicides under Various Cropping Patterns - I. Response to Pyrazolate (재배양식(栽培樣式)에 따른 수종(數種) 제초제(除草劑)에 대한 벼와 피의 해부형태적(解剖形態的) 반응차이(反應差異) - I. Pyrazolate에 대한 반응차이(反應差異))

  • Chon, S.U.;Guh, J.O.;Kuk, Y.I.
    • Korean Journal of Weed Science
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    • v.15 no.1
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    • pp.30-38
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    • 1995
  • Soil-applied pre-emergence herbicide, pyrazolate(4-(2, 4-dichlorobenzoyl)-1, 3-dimethyl pyrazol-5-yl-p-toluene sulphonate) induced, twist effect of shoots of barnyardgrass under dry conditions, and etiolated leaf and stem of that under water condition. Plant height and root length of rice broadcast on soil surface were similar to the untreated control, but plant height of rice drilled in soil was more inhibited than root length as compared with the untreated control, while development of barnyardgrass seedling was severely inhibited at 20 days after application. The inhibition rate was much higher under water condition than under dry condition, but difference in rice and barnyardgrass did not abserve. However, growth of transplanted rice shown to increase to the untreated control. Shoot and root fresh weight of rice broadcast on soil surface was increase as compared with the untreated control, and that of rice drilled in soil was not affected whereas that of barnyardgrass was severely inhibited by 42% and 41%, respectively. Under dry condition at 20 days after pyrazolate application while root growth of rice broadcast on soil surface under water condition was deadly inhibited and development of barnyardgrass was almost completely inhibited. On the other hand, microscopic studies showed that constriction of mesophyll cell by destruction of chloroplast of barnyardgrass were occurred only under dry condition, whereas damage of rice and barnyardgrass under water and transplanting condition were not observed. Anatomical change in the meristernatic region of rice and barnyardgrass was not occurred, and similar to intact plant regardless of cropping patterns.

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Effects of Inorganic Nutrients and Heavy Metals on Germination of the Green Alga, Ulva pertusa Kjellman (녹조 구멍갈파래 (Ulva pertusa Kjellman)의 발아에 미치는 무기영양염류 및 중금속의 영향)

  • 김장균;한태준
    • Korean Journal of Environmental Biology
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    • v.19 no.1
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    • pp.7-17
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    • 2001
  • Growth optima and tolerance ranges of marine algae species nay vary greatly during the developmental stage. The establishment stage is clearly of great importance for each generation, affecting the performance of the adult population. The present study was aimed to determine the effect of various concentrations of inorganic nutrients and heavy metals on germination and germlings of Ulva pertusa Kjellman (Chlorophyta). Percent germination increased rapidly as irradiance level increased, reaching the maximum at 100 ${\mu}$mol m$\^$-2/s$\^$-1/ in both east and west seawater. Percent germination in the east seawater was higher than that in the west seawater at irradiances lower than 30 ${\mu}$mol m$\^$-2/s$\^$-1/, and there was no difference in percent germination between the two different seawaters at irradiances higher than 60 ${\mu}$mol m$\^$-2/s$\^$-1/. Germling growth increased in the both cases with increasing irradiances but no growth was found in the dark. Overall germling area was larger in the east seawater than in the west seawater. Number of cell increased with increasing irradiance and became light-saturated at 100 ${\mu}$mol m$\^$-2/s$\^$-1/ in the both cases. Germlings grown in the east seawater had more cells than those cultivated in the west seawater at irradiances lower than 60 ${\mu}$mol m$\^$-2/s$\^$-1/. In various combinations of nitrate and phosphate, percent germination increased with increasing nitrate concentrations irrespective of phosphate concentrations. At 3 days after inoculation, nitrate concentration of 2.5 ppm with all phosphate concentrations promoted germination. Area and number of cell of germlings increased with increasing nitrate concentrations in all phosphate concentrations. In various combinations of copper and lead, germination was delayed as copper concentrations increased in all lead concentrations. Percent germination was severely reduced at 1 ppm Cu$\^$2+/. Area and number of cell of germlings decreased with increasing copper concentrations in all lead concentrations. The highest copper concentration (1 ppm) clearly suppressed the germling growth in U. pertusa.

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The Geochemical Characteristics and Environmental Factors on the Marine Shellfish Farm in Namhae-po Tidal Flat of Taean (태안 남해포 갯벌 패류양식해역의 환경특성)

  • Choi, Yoon Seok;Park, Kwang Jae;Yoon, Sang Pil;Chung, Sang Ok;An, Kyoung Ho;Song, Jae Hee
    • The Korean Journal of Malacology
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    • v.29 no.1
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    • pp.51-63
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    • 2013
  • To assess the effect of environmental factors on the sustainability of cultured production shellfish, we investigated the habitat characteristics of tidal flat (Namhae-po in Taean). We measured the physiochemical parameters (temperature, salanity, pH, dissolved oxygen and nutrients) and the geochemical characteristics (chemical oxygen demand, ignition loss, C/N ratio and C/S ratio). Surface sediments were collected from several site of tidal flat to examine the geochemical characteristics of both the benthic environment and heavy metal pollution. The grain size for research area of tidal flat were similar at the ratio of silt and clay in comparison with the other site of it. The C/N ratio was more than 5.0, reflecting the range arising from the mix of marine organism and organic matter. The C/S ratio (about 2.8) showed that survey area had anoxic or sub-anoxic bottom conditions. The enrichment factor (Ef) and index of accumulation rate (Igeo) of the metals showed that those research areas can be classified as heavily polluted, heavily to moderately polluted, or more or less unpolluted, respectively. Adult surf clam (Mactra veneriformis) density was highest at St. 2 (middle part of the Namhae-po), on the other hand, surf clam spat density was highest at St. 3 (lower part of the Namhae-po). Heavy rain, terrigenous suspended clay with fresh water from neighboring agricultural land, and severe high air temperature during summer could be thought as detrimental causes of spat and adult mortality in Namhae-po tidal flat. We suggested that the growth of shellfish in the tidal flat was effected by the various environmental conditions, so an improvement in the cultured method was needed.

A Comparison on the Characteristics of Cerebrovascular Disease Patients Admitted to Some Western and Oriental Hospitals (일부 양·한방 병원에 입원한 뇌혈관질환 환자의 특성 비교)

  • Yu, Dae-Jin;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.65-79
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    • 2001
  • Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

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Effect of Bronchial Artery Embolization in the Treatment of Massive Hemoptysis (대량객혈의 치료에 있어서 기관지동맥색전술의 효과)

  • Lee, Sang-Kyeong;Chun, Ho-Kee;Yoon, Ki-Heon;Yoo, Jee-Hong;Kang, Hong-Mo;Yoon, Yup
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.677-682
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    • 1993
  • Background: Massive hemoptysis is a major clinical problem with high mortality. Bronchial artery embolization is well accepted and widely used for treatment of massive and recurrent hemoptysis, especially in patients with chronic diffuse pulmonary disease who are poor candidates for surgery. We evaluated the therapeutic effect of transcatheter arterial embolization for immediate control and prevention of recurrent hemoptysis. Method: We reviewed 20 cases(M:F=13:7) of bronchial artery embolization for the management of massive hemoptysis from Jun 1989 to Aug 1992 retrospectively. Results: Underlying causes of hemoptysis were pulmonary tuberculosis(n=14), bronchiectasis(n=3), aspergilloma(n=2) and paragonimiasis(n=1). Embolization material was choosed randomly gelfoam(n=7) or Ivalon(n=11) and in 2 cases both were used simultaneously. Target arteries of embolization were bronchial artery only in 15 cases, non-bronchial systemic arteries with or without bronchial artery in 5 cases. After the arterial embolization, immediate cessation of hemoptysis was achieved in 17 cases(85%) and total recurrence rate including 3 cases of immediate treatment failure was 50%. Among recurrences 3 cases were achieved lobectomy, 1 case was expired by asphyxia due to massive hemoptysis and remained 6 were managed by medical conservative treatment with no further recurrence of hemoptysis during follow up periods. Conclusion: Bronchial artery embolization for treatment of massive or recurrent hemoptysis was effective in immediate bleeding control. Despite high recurrence rate the rebleeding after embolization was less severe and controllable by conservative management. Bronchial artery embolization is valuable as primary trial to massive hemoptysis.

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