• Title/Summary/Keyword: X0/S0 ratio

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Clinical Study of Tuberculous Meningitis in Children (소아 결핵성 뇌막염의 임상적 고찰)

  • Kim, Woo Sik;Kim, Jong Hyun;Kim, Dong Un;Lee, Won Bae;Kang, Jin Han
    • 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.

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Changes in spatial organization of Korea by the construction of Seoul-Pusan railroad (京釜線 鐵道建設에 따른 韓半島 空間組織의 變化)

  • ;Joo, Kyung-Sik
    • Journal of the Korean Geographical Society
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    • v.29 no.3
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    • pp.297-317
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    • 1994
  • This study demonstrates the changes in the spatial organization of Korea by the construction of Seoul-Pusan railroad. This Seoul-Pusan line, which is the most important one in Korea was constructed in 1905. The original plan of the line was selected to cross the main traditional roads to control the entire Korean peninsular and to mobilize the Korean commercial potentials. It was the line to exploit the staples and to expand the Japanese market in Korea. In accordance with the contracts between Japan and Korean government, Korean government had to supply the lands for railroad, office, and service facilities. That was one of the important reasons that Korean government had been broken down. The main findings of this study are as follows: 1. The Seoul-Pusan railroad line was constructed Japanese colonial policy which emphasized three main purposes; the first was to reorganize the economic space and to collapse the traditional Korean markets for Japanese ruling, and the second was to find out the military supply routes, and the third was to search for the transcontinental line for China and Siberia. As the results, the old Korean pedestrian routes, which were the Eastern, the mid, the westren, and the Samnam route lost their functions. 2. Japanese requested for Korean government usually ten times of wider space for the site of stations than the needed one. The land was expropriated, and constructed the new centers aparted from the original Korean towns. In this process Japanese got the most developmental and windfall profits. The newly constructed centers were for Japanese immigration and the town service facilities which would be used to control the Korean financial market. At last, they easily converted the Korean spatial economy into Japanese colonial one, which made to reinforce the sphere of Seoul-Pusan line. 3. Japanese planned the stations as the central points in Korea. So the railroad stations were located apart from the centers of towns, to avoid the Korean resistances, and to maximize their profits. The mean distance from staiton to 'the town center is about 1km while the Japanese case is 0.6km. 4. The pattern of present Korean railroads is not the 'X type'. Because the Honam line is not the trunk one. So, we could call the Korean railroad pattern as the 'Ip(Chinese character 入) type' . The operational effects of Seoul-Pusan line brought out the concentration of the national economy to this line as Japanese planned. And the polorization had occurred between this line and the other parts of Korea. For twenty years (1910-1930), the transported freights were increased about 5 times. In 1930, the total freight of Seoul-Pusan line became 2, 010, 444 metric tons. If we examine this process, the underconstructing Seoul-Pusan express electric railroad should avoid adjacent this line to reduce the regional and ecological imbalance. 5. The forms of centers on the Seoul-Pusan line were classified into six types in relation to station, town center, and built-up area; the compact (integrated) type, the elongated one, the splited (independent) one, the absorbed one, the consolidated one, and the declined one. All types of these towns might be developed in accordance with the centrality, railroad function, and the other transportational functions. 6. The Seoul-Pusan line plays the most important role among Korean railroads but the ratio of passenger and freight become lower because the effiects of other inaugurated railoads the different transportation modes such as trucks and cars would be got more merits in competition. 7. The results of cluster analyses on the cities of railroad stations showed the rudimentary urban systems in 1910 and 1930. In 1930, the cities were classified into three groups; the group of small cites, the intermediate (developing) city-group, and the special city-group. In 1930s the spatial organization and urban system of Korea were similar to the present ones. We call appreciate that these were the effects of the Seoul-Pusan line.

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