• International journal of thyroidology
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• 제10권1호
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• pp.50-55
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• 2017

Sweet's syndrome, or acute febrile neutrophilic dermatosis, occurs in association with autoimmune diseases such as Hashimoto's thyroiditis but is rare in Graves' disease, in which all cases are induced by propylthiouracil (PTU). We report a case of Sweet's syndrome in a patient with Graves' disease treated with methimazole (MMI) during three weeks. A 34-year-old man presented with the acute onset of high fever, skin rashes on the whole body, arthralgia, and acroparesthesia. Laboratory results showed leukocytosis and elevated C-reactive protein. MMI first stopped and antibiotics and antihistamine therapy started, but his symptoms dramatically improved after oral prednisolone. Graves' disease has again been treated by MMI because of his aggravated ophthalmopathy. After one year of retreatment with MMI, there has been no recurrence of Sweet's syndrome, supporting that Sweet's syndrome in this case was not related to MMI exposure. To our knowledge, this is the first report of Sweet's syndrome associated with Graves' disease per se but not PTU or MMI use.

• 대한한의학원전학회지
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• 제23권3호
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• pp.23-48
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• 2010

Onbyeong(溫病) is called an acute epidemic febrile disease caused by warm pathogen, a major symptom of Onbyeong is high fever. Doctrine of Onbyeong is a study of an occurrence, progress and treatments of an acute epidemic febrile disease. Doctrine of Onbyeong is valid in the Cheong Dynasty at China. Now, a theory of doctrine of Onbyeong at China and Korea is being applied in not only an acute febrile disease but also many other lifestyle diseases. Onbyeongjobyeon is a book written by Oguktong(吳鞠通). Oguktong was influenced by Jangjung-gyeong(張仲景) "Sanghanron(傷寒論)". Oguktong had organized Seopcheonsa(葉天士)'s medical thoughts and Oguktong's medical experiences. A Samcho(三焦) deteriorated case is divided into three groups - Upper, Middle and Lower-energizer - that is discussed of a vertical progress of Onbyeong. And a Wigiyeonghyeol(衛氣營血) deteriorated case is divided into four groups - Wi, Gi, Yeong and Hyeol - that is discussed of a horizontal progress of Onbyeong. In Korean medicine, there are four types of diagnosis which are watching, listening, asking and taking. Informations, got by four types diagnosis are synthesized and classified for medical treatments. A pulse diagnosis belongs to a method by taking a wrist among four diagnosis. A Korean Medicine doctor makes a conclusion of cause, region and condition of disease by taking a pulse. Because all organs in human body are connected by a meridian system. organs conditions are reflected in a meridian system. So by taking a pulse, a progress and a prognosis of disease is diagnosed In this thesis, by taking a pulse on "Onbyeongjobyeon(溫病條辨)", a location and a feature of disease's cause with weakness and strength of a vital force are examined, and a character of a pulse diagnosis of Onbyeong is examined.

• Clinical and Experimental Pediatrics
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• 제49권8호
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• pp.839-844
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• 2006

목 적 : 발열을 주소로 소아응급실에 내원한 소아의 임상적 특성에 대하여 조사를 하고자 연구를 시행하였다. 방 법 : 2004년 9월부터 2005년 8월까지 일산백병원 소아응급실에 내원한 8,881명의 환아와 이 중 $38.3^{\circ}C$이상의 발열을 주소로 내원한 1,764명의 환아를 대상으로 발열 환아의 발생 빈도, 월별 분포, 연령별 분포, 진단명을 조사 분석하였다. 결 과 : 조사 기간동안 소아응급실에 내원한 8,881명 중 1,764명이 발열로 내원하여 발열환자의 빈도는 19.9%이었고, 1,764명 중 26.4%가 입원하였다. 내원 발열 환아가 가장 많았던 연령군은 12-23개월 군이었고, 4-11개월 군과 2세 군이 뒤를 이었다. 가장 많은 진단명은 급성 인두염이었고, 급성 장염, 폐렴도 흔한 진단이었다. 연중 발열 환자가 가장 많았던 시기는 4-7월이었고, 이 중 5월에 발열 환자가 가장 많았다. 발열환자의 빈도는 8월이 가장 높았으나 통계적 의미는 없었으며, '봄 여름군', '가을 겨울군'으로 나눠서 비교한 발열환자의 빈도는 통계적으로 의미 있는 차이가 있었다. 결 론 : 소아 응급실에서 발열 환아의 연중 발생빈도는 19.9%이었고, 12-23개월의 환아가 빈도가 높았으며, 5월에 발열 환아가 가장 많았다. 본 연구에서도 급성 인두염, 급성 장염, 급성 비인두염, 급성 기관지염과 같은 비응급 질환의 비율이 높았다. 응급실에 내원하는 비응급 질환을 줄이기 위해 의료체계 개선과 보호자 교육이 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.378-381
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• 2007

Tsutsugamushi disease (Scrub typhus) is an acute, febrile illness caused by Orientia tsutsugamushi, which is transmitted to humans through chigger bites. Leptospirosis, a febrile disease caused by various pathogenic Leptospira, and is acquired by exposure to contaminated water and soil. Both diseases have been the most common acute febrile diseases in the autumn in Korea for many years. Concomitant leptospirosis and scrub typhus is quite rare. We report a case of a coinfection with leptospirosis and scrub typhus in a 51-year-old male who presented with fever, abdominal pain and acute dyspnea. The patient was diagnosed with as acalculous cholecystitis, acute respiratory distress syndrome, and septic shock caused by the infection. This is the first case report of a coinfection with leptospirosis and scrub typhus in Korea.

• Clinical and Experimental Pediatrics
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• 제54권4호
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• pp.157-162
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• 2011

Purpose: Exaggerated pro-inflammatory reactions during the acute phase of Kawasaki disease (KD) suggest the role of immune dysregulation in the pathogenesis of KD. We investigated the profiles of T regulatory cells and their correlation with the clinical course of KD. Methods: Peripheral blood mononuclear cells were collected from 17 KD patients during acute febrile and subacute afebrile phases. T cells expressing CD4, CD25, and Foxp3 were analyzed using flow cytometry, and the results were correlated with the clinical course of KD. Results: The percentage of circulating $CD4^+CD25^{high}Foxp3^+$ T cells among $CD4^+$ T cells was Significantly higher during the subacute afebrile phase than during the acute febrile phase ($1.10%{\pm}1.22%$ vs. $0.55%{\pm}0.53%$, P=0.049). Although levels of $CD4^+CD25^{low}Foxp3^+$ T cells and $CD4^+CD25^-Foxp3^+$ T cells were only slightly altered, the percentage of $CD4^+CD25^+Foxp3^-$ T cells among $CD4^+$ T cells was significantly lower during the subacute afebrile phase than during the acute febrile phase ($2.96%{\pm}1.95%$ vs. $5.64%{\pm}5.69%$, P=0.036). Consequently, the ratio of $CD25^{high}Foxp3^+$ T cells to $CD25^+Foxp3^-$ T cells was higher during the subacute afebrile phase than during the acute febrile phase ($0.45%{\pm}0.57%$ vs. $0.13%{\pm}0.13%$, P=0.038). Conclusion: Decreased $CD4^+CD25^{high}Foxp3^+$ T cells and/or an imbalanced ratio of $CD4^+CD25^{high}Foxp3^+$ T cells to $CD4^+CD25^+Foxp3^-$ T cells might playa role in KD development. Considering that all KD patients were treated with intravenous immunoglobulin (IVIG), recovery of $CD4^+CD25^{high}Foxp3^+$ T cells during the subacute afebrile phase could be a mechanism of IVIG.

• Journal of Yeungnam Medical Science
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• 제17권2호
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• pp.99-107
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• 2000

Kawasaki disease, an acute febrile illness which primarily affects in children under the age of six, was first described by Tomisaku Kawasaki in 1967. It has been reported that Kawasaki disease is probable driven by abnormalities of the immune system after an infectious insult, but this has not been confirmed. It mainly affects small and medium-sized arteries, particularly the coronary arteries. Deaths may occur at any time with cardiovascular complications. The early recognition and treatment with follow-up evaluation for the coronary arterial lesion is very important in a case of Kawasaki disease.

• Clinical and Experimental Pediatrics
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• 제46권2호
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• pp.207-209
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• 2003

가와사끼병은 주로 심혈관계를 침범하는 전신적인 염증 질환이다. 8세 이상의 나이가 많은 소아에서 가와사끼병은 발생률이 낮고 비정형적인 다양한 임상양상을 보이기 때문에 진단이 늦어질 수 있다. 저자들은 10세 남아에서 급성 신부전과 근염을 비롯하여 여러 가지 비정형적인 증상을 보임으로써 진단이 늦어진 가와사끼병을 경험하였기에 보고하는 바이다.

• 대한한의학원전학회지
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• 제28권4호
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• pp.139-154
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• 2015

Objectives : Zheng Zhi Xin Chuan(證治心傳) is a compact compilation of 14 discussions on medicine, written by Yuan Ban(袁班) in the late Ming-early Qing period. Methods : To survey the scholarly position of Yuan Ban(袁班) in the history of Wenbing by systematically analyzing and organizing Wenbing related theories in Zheng Zhi Xin Chuan (證治心傳). Results & Conclusions : In his book, YB suggests concepts such as 'mainly attack upper heater(多犯上焦)', 'transmission to the nutrient phase(轉入營分)', 'sequential transmission(順傳)', 'abnormal transmission(逆傳)', 'dryness invasion of human body in autumn(秋傷於燥)'. In the history of Wenbing, it has been widely acknowledged that the concept of weiqiyingxiebianzheng(衛氣營血辨證) and abnormal transmission to the pericardium(逆傳心包) were originally suggested by Ye Tianshi(葉天士). However, according to the findings of this study, these concepts are traced back to the contents of YB's publication, nearly a century before Ye's time. In addition, YB's discussion on '秋燥' was highly advanced than any other scholar of his time, hinting his influence on medicine thereafter.

• 보건행정학회지
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• 제28권4호
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• pp.402-410
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• 2018

Background: Monitoring appropriate medication categories can provide early warning of certain disease outbreaks. This study aimed to present a methodology for selecting and monitoring medications relevant to the surveillance of acute respiratory tract infections, such as influenza. Methods: To estimate correlations between acute febrile respiratory tract infection and some medication categories, the cross-correlation coefficient (CCC) was used and established. Two databases were used: real-time prescription trend of antivirals, anti-inflammatory drugs, antibiotics using Drug Utilization Review Program between 2012 and 2015 and physicians' number of encounters with acute febrile respiratory tract infections such as influenza outbreaks using the national level health insurance claims data. The seasonality was also evaluated using the CCC. Results: After selecting six candidate diseases that require extensive monitoring, influenza with highly specific medical treatment according to the health insurance claims data and its medications were chosen as final candidates based on a data-driven approach. Antiviral medications and influenza were significantly correlated. Conclusion: An annual correlation was observed between influenza and antiviral medications, anti-inflammatory drugs. Suitable models should be established for syndromic surveillance of influenza.

• 농촌의학ㆍ지역보건
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• 제29권1호
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• pp.177-184
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• 2004

Objectives: Tsutsugamushi disease is one of the most significant acute febrile illnesses, increasing in frequency of occurrence during the late autumn in rural areas of Korea. Methods: I have conducted a case-control study on 30 cases who had the fever as a chief complaint, then had been ruled out as having the Tsutsugamushi disease. Data was collected retrospectively by review of chart regarding their general characteristics, clinical and laboratory findings, then was analysed by chi-test. Results: Of 30 cases, 16 cases were seropositive and 14 cases were seronegative against O. tsutsugamushi. Of seropositive for tsutsugamushi disease, 56.3% were female; 37.5% were in their seventies; 50.0% were farmers; 62,6% had chances of exposure to fields or mountains. And 75.0% occurred in November. The main symptoms and signs were fever and chill(100.0%), headache(75.0%). weakness and fatigue(93.8%), and eschar(68.8%). The characteristic laboratory findings were elevated AST(50.0%), ALT(62.5%), and abnormal urinalysis(56.3%). On the other hand, of seronegative cases, 57.1% were male; 50.0% were in their fifties; 42.9% were farmers; 57.2% had chances of exposure to fields or mountains. And 71.4% occurred in November. The symptoms and signs were fever and chill(100.0%), headache(85.7%), eschar(64.3%). weakness, fatigue and skin(57.1%). The laboratory findings were elevated AST(71.4%) and ALT(64.3%), and abnormal urinalysis(42.9%). However, there were no significant differences between the seropositive and seronegative cases(P>.05). Conclusions: Acute febrile community inhabitants who have the epidemiological, clinical as well as laboratory features should be focused upon for the early diagnosis and treatment for tsutsugamushi disease whether or not possessing the serological antibody against O. tsutsugamushi.