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Tuberculosis in Infants (영아의 결핵)

  • Kim, Ee-Kyung;Nah, Song-Yi;Park, Jin-Young;Choi, Eun-Hwa;Lee, Hoan-Jong
    • Pediatric Infection and Vaccine
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    • v.5 no.1
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    • pp.69-78
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    • 1998
  • Purpose : The risk of severe tuberculous disease such as meningitis or miliary tuberculosis increases as younger is the child at the time of infection. Therefore, the early diagnosis and prompt treatment is mandatory for infants with tuberculosis. This study was undertaken to describe the epidemiology, clinical and radiographic manifestations, and response to therapy in infants with tuberculous disease. Methods : Medical records of 29 infants with tuberculosis diagnosed at the Seoul National University Children's Hospital from July, 1985, to April, 1997, were reviewed, retrospectively. A case of tuberculosis was confirmed if M. tuberculosis was isolated from any body site or if there was histologic proof of tuberculosis. Otherwise, the diagnoses were individualized considering history of contact with contagious adult case, clinical manifestations, chest X-ray findings, result of a Mantoux test reaction with 5 tuberculin unit of PPD, and the response to therapy. Results : The mean age at diagnosis was $7.00{\pm}2.65$ months (range, 3 to 12 months). Twelve cases had isolated pulmonary diseases, and the rest had pulmonary disease and meningitis, 5 cases; pulmonary disease and cervical lymphadenitis, 3; isolated meningitis, 3; and miliary tuberculosis, 6. Source case was identified in 19 cases, 7 of which were detected with retrograde manner. Twenty seven of 29 were symptomatic at their initial visit. The presenting symptoms were mainly respiratory or neurologic, and respiratory difficulty was accompanied in 7 cases. Physical examination revealed wheezing in 7 cases and decreased breath sounds in 9. Hepatomegaly or hepatosplenomegaly were frequent. Chest radiographs showed lung parenchymal disease with hilar lymphadenopathy in 18 cases, and focal or generalized emphysematous change in 7 cases. Conclusion : Most of the infants with tuberculosis are symptomatic at diagnosis, and many of infants with intrathoracic tuberculosis presented with symptoms of bronchial obstruction. When tuberculosis is suspected in an infant, the adult source case should be vigorously investigated to aid in diagnosis and for the prevention of further transmission of tuberculous disease. Almost half of infant tuberculosis are preventable if prophylaxis were given when adult cases were diagnosed.

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The Effects of Wearing Protective Devices among Residents and Volunteers Participating in the Cleanup of the Hebei Spirit Oil Spill (허베이스피릿호 유류유출사고 방제작업 참여자의 보호장비착용 효과)

  • Lee, Seung-Min;Ha, Mi-Na;Kim, Eun-Jung;Jeong, Woo-Chul;Hur, Jong-Il;Park, Seok-Gun;Kwon, Ho-Jang;Hong, Yun-Chul;Ha, Eun-Hee;Lee, Jong-Seung;Chung, Bong-Chul;Lee, Jeong-Ae;Im, Ho-Sub;Choi, Ye-Yong;Cho, Yong-Min;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.2
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    • pp.89-95
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    • 2009
  • Objectives : To assess the protective effects of wearing protective devices among the residents and volunteers who participated in the cleanup of the Hebei Spirit oil spill. Methods : A total of 288 residents and 724 volunteers were surveyed about symptoms, whether they were wearing protective devices and potential confounding variables. The questionnaires were administered from the second to the sixth week following the accident. Spot urine samples were collected and analyzed for metabolites of 4 volatile organic compounds(VOCs), 2 polycyclic aromatic hydrocarbons(PAHs), and 6 heavy metals. The association between the wearing of protective devices and various symptoms was assessed using a multiple logistic regression adjusted for confounding variables. A multiple generalized linear regression model adjusted for the covariates was used to test for a difference in least-square mean concentration of urinary biomarkers between residents who wore protective devices and those who did not. Results : Thirty nine to 98% of the residents and 62-98% of volunteers wore protective devices. Levels of fatigue and fever were higher among residents not wearing masks than among those who did wear masks(odds ratio 4.5; 95% confidence interval 1.23-19.86). Urinary mercury levels were found to be significantly higher among residents not wearing work clothes or boots(p<0.05). Conclusions : Because the survey was not performed during the initial high-exposure period, no significant difference was found in metabolite levels between people who wore protective devices and those who did not, except for mercury, whose biological half-life is more than 6 weeks.

Hemolytic-uremic Syndyome Associated with Bloody Diarrhea (혈변을 동반한 용혈성 요독 증후군 5례)

  • Kim Jung-Sim;Park Eun-Jung;Chung So-Hee;Ko See-Hwan;Uhm Mee-Ryung;Park Moon-Su;Lee Heung-Jea;Jin Dong-Kyu
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.170-175
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    • 1997
  • Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

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Cost-Benefit Analysis on Rubella Vaccination Policy (풍진 예방접종사업의 비용-편익분석)

  • Shin, Young-Jeon;Choi, Bo-Youl;Park, Hung-Bae;Moon, Ok-Ryun;Yoon, Bae-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.337-365
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    • 1994
  • Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

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The Analysis of Cost Structure and Productivity in the Korea and Japan Railroad Industry (한국과 일본 철도산업의 비용구조와 생산성 분석)

  • Park, Jin-Gyeong;Kim, Seong-Su
    • Journal of Korean Society of Transportation
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    • v.24 no.2 s.88
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    • pp.65-78
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    • 2006
  • This paper investigates the cost structure ot the Korea and Japan railroad industry with respect to density, scale and scope economies as well as productivity growth rate using a generalized trans)og multiproduct cost function model. The paper then assumes that the Korea and Japan railway companies pi·educe three outputs (incumbent railway passenger-kilometers. Shinkansen passenger-kilometers, ton-kilometers of freight) using four input factors (labor, fuel, maintenance, rolling stock and capital). The specified cost function includes foul other independent variables: track lengths to reflect network effects, two dummies to reflect nation and ownership effects, and time trend as a proxy for technical change. The simultaneous equation system consisting of a cost function and three input share equations is estimated with the Zellner's iterative seemingly unrelated regression. The unbalanced panel data used in the paper, a total of 154 observations. are collected from the annual records of the Korea National Railroad (KNR) for the yews $1977{\sim}2003$, Japan National Railways (JNR) for the years $1977{\sim}1984$. seven Japan Railways (JR's) for the years $1987{\sim}2003$. The findings show that the Korean and Japanese railways exhibit product-specific and overall economies of density but product-specific diseconomies of scale with respect to incumbent railway passenger-kilometers, Shinkansen-kilometers and ton-kilometers. However, the railways experience mild overall economies of scale which result from economies of scope associated with the joint production of incumbent railway/Shinkansen and feight, freight/incumbent railway and Shinkansen except Shinkansen/incumbent railway and freight. In addition, the economies of density and scale in the KNR, JR east, JR central, and JR west companies at the point of the years $1990{\sim}2003$ average is generally analogous to the above results at the point of sample average. There also appear to be economies of ssope associated with the joint Production of the incumbent railway and Shinkansen in JR central but diseconomies of scope in JR East and JR West. The findings also indicate that the productivity growth rate of the privately-owned JR's is larger than that of the government-owned KNR.

Characteristics of stormwter runoff from highways with unit traffic volume (고속도로 자동차 통행량에 따른 강우유출수 유출 특성 분석)

  • Choi, Jiyeon;Hong, Jungsun;Kang, Heeman;Kim, Lee-Hyung
    • Journal of Wetlands Research
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    • v.18 no.3
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    • pp.275-281
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    • 2016
  • This study was conducted to analyze the runoff characteristics of the highway depending on the number of vehicles and to provide the installation proposal of an NPS pollution reduction facility. There were a total of 5 monitoring sites used for the study namely, Gyeongbu, Seohaean, Honam and Tongyeoung Dageon highway. Monitoring events started from 2006 until 2015 having a total of 44 storm events. According to monitoring statistics, the average antecedent dry days (ADD) and rainfall was 6.2 days and 19.2 mm, respectively. The Gyeongbu Highway (H-4) was recorded having the highest Average Daily Traffic and Catchment Area (ADT/CA) with $49.4car/day{\cdot}m^2$ while other site were less than $10car/day{\cdot}m^2$. The average concentration of the NPS pollutants generated from monitoring sites were 63.5 mg/L(TSS), 24.9 mg/L(BOD), 3.35 mg/L(TN), 0.63 mg/L(TP) and 298 ug/L(Total Zn). This exhibited lower values in comparison to the remarks of highway related runoff EMC values published in Korea. Moreover, through the results of the correlation analysis between the contaminant concentration and ADT/CA, $R^2$ value of SS showed the highest correlation with 585. Through the correlation equation between ADT/CA and EMC of TSS, when there is 73.7 mg/L of TSS EMC found from a domestic highway, ADT/CA ratio is normally $13car/day{\cdot}m^2$. Therefore, in a case of more than 13 cars passing through a certain area, the area can be considered and present as the point of generation of nonpoint source pollutants. Also, in this study, since it considered a unit area ADT indicated in previous studies, it was determined that it has a high applicability and utilization in generalized units than conventional study which were conventionally done.

Regional Analysis of Forest Eire Occurrence Factors in Kangwon Province (강원도 지역 산불발생인자의 지역별 유형화)

  • 이시영;한상열;안상현;오정수;조명희;김명수
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.3 no.3
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    • pp.135-142
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    • 2001
  • This study attempts to categorizes the factors of forest fire occurrences based on regional meteorologic data and general forest no characteristics of 18 cities and guns in Kangwon province. lo accomplish this goal, some statistical analyses such as analysis of variance, correspondence analysis and multidimensional scaling were adopted. To reveal the forest fires pattern of study region, a categorization process was conducted by employing the quantification approach which modified and quantified the metric-data of fire occurrence dates. Also, The fire occurrence similarity was compared by using multidimensional scaling for each study region. The major results are summarized as follows: It was found that the meteorological factors emerged as different to each region are average and maximum temperature, minimum dew point temperature and average and maximum wind speed. In the result of correspondence analysis representing relationships between fire causes and study regions, Kangrung is caused by arsonist, Chulwon, Hwachen and Yanggu caused by military factor, Sokcho and Chunchen caused by the debris burning, and Samchuk caused by general man-caused fires, respectively. Finally, the forest fire occurrence pattern of this study regions were divided into five areas such as, group I including Samchuk, Kangryung, Chunchen, Wonju, Hongchen and Hhoingsung, group II including Donghae, Taebaek, Yangyang and Pyongchang, group III including Jungsun, Chulwon and Whachen, group Ⅵ including Gosung, Injae and Yanggu, and group V including Shokcho and Youngwol.

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Spaciotemporal Distributions of PM10 Concentration and Their Correlation with Local Temperature Changes : a Case Study of Busan Metropolitan City (PM10 농도의 시공간적 분포 특징과 국지적 기온 변화 간의 상관관계: 부산광역시 사례 분석)

  • Park, Sunyurp
    • Journal of the Korean association of regional geographers
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    • v.23 no.1
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    • pp.151-167
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    • 2017
  • The main objective of this study was to investigate the climatic impact of $PM_{10}$ concentration on the temperature change pattern in Busan Metropolitan City(BMC), Korea during 2001~2015. Mean $PM_{10}$ concentration of BMC has gradually declined over the past 15 years. While the highest $PM_{10}$ concentration was observed in spring followed by winter, summer, and fall on average, the seasonal variations of $PM_{10}$ concentration differed from place to place within the city. Frequency analysis showed that the most frequently observed $PM_{10}$ concentration ranged from $20{\mu}g/m^3$ to $60{\mu}g/m^3$, which accounted for 64.6% of all daily observations. Overall, the west-high and east-low pattern of $PM_{10}$ concentration was relatively strong during the winter when the effect of yellow-dust events on the air quality was weak. Comparative analyses between $PM_{10}$ concentration and monthly temperature slope derived from generalized temperature curves indicated that the decreasing trend of $PM_{10}$ concentration was associated with increases of annual temperature range, and $PM_{10}$ concentration had a negative relationship with the temperature slope of warming months. Overall, $PM_{10}$ concentration had a weak correlation with the annual mean temperature, but it had a significant, positive correlation with the winter season, which had a dominant influence on the annual mean temperature. In terms of energy budget, it has been known that the change in $PM_{10}$ concentration contributes to the warming or cooling effect by affecting the radiative forcing due to the reflection and absorption of radiant energy. The correlation between $PM_{10}$ concentration and temperature changes in the study area was not seasonally and spatially consistent, and its significance was statistically limited partly due to the number of observations and the lack of potential socioeconomic factors relevant to urban air quality.

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A Historical Study on Fruits in Korea (우리나라 과실류(果實類)의 역사적(歷史的) 고찰(考察))

  • Kang, Choon-Ki
    • Journal of the Korean Society of Food Culture
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    • v.5 no.3
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    • pp.301-311
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    • 1990
  • The agriculture of Korea was begun in the neolithic era partly and generalized around 4,000 B.C. Discovery of acorn and stoneworks used in agriculture in neolithic era in 8,000 B.C to 6,000 B.C suggests that prehistoric ancestors of Korean night use acorn, hazel-nuts, and haws, etc. as foods. Cultivation of chestnuts, peaches, plums, pears, and japanese apricots was found in Mahan, the tribal states, and in the period of three kingdoms and Balhae dynasty too. In the period of Koryo, pears, plums, japanese apricots, pine nuts, apricots, grapes, jujubes, gingko nuts, oranges, and citrons were cultivated and used in diet. Sejongsilrokjiriji(1454), a geography of the early chosun, and Sinjungtonggukyojisungnam(1492) show that they cultivated almost all fruits we are now cultivating such as hazel-nuts, haws, nutmeg nut, and so on. Loquats seem to be brought in the early chosun era and figs around 16th century. Pecans, sweet cherries were brought around 1,900 and recently tropical fruits like kiwis were brought in and used in a large scale. In addition, Some fruits were used in medical treatments. Fruits increase the pleasure of the diet and sometimes they are used as a measure of a standard of living. Fruits have been improved and used for a long time, their status in our diet will be maintained resolutly.

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A Bibliographical Research of the Correlation Among Sasang Constitutional Disease(사상체질병증) and the Pulse Diagnosis(맥진) (사상체질병증(四象體質病症)과 맥진(脈診)의 상관성(相關性)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Kim, Dong-Jun;Kim, Jung-Ryul;Kim, Dal-Rae
    • Journal of Pharmacopuncture
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    • v.6 no.3
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    • pp.23-37
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    • 2003
  • The purpose of this research was to investigate the correlation Among Sasang Constitutional Disease and Examination of the pulse. I have gone over literatures of mainly ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ and the others Oriental Medical book was studied about the Pulse Diagnosis. And then I came to get some conclusion as follows. 1. Soeumin(소음인) the initial-stage symptoms of wulkwang disease(울광증) ; when the Superficial Pulse and the Superficial+ Moderate Pulse is made a diagnosis, Ceongunggyegitang(천궁계지탕) and Gunggyuhyangsosan(궁귀향소산) can be used. 2. Soeumin(소음인) the initial-stage blood disease symptoms of wulkwang disease(울광증) ; when the Minute+deep Pulse is made a diagnosis, Palmulgnnjatang(팔물군자탕) and Guakhyanggeonggisan(곽향정기산) can be used. 3. Soeumin(소음인) the initial-stage symptoms of mangyang disease(망양증) ; when the Yang region Superficial Pulse and the Yin region Weak Pulse is made a diagnosis, Hwanggigyegitang(황기계지탕), Bojungikgitang(보증익기탕) and Sengyangikgitang(승양익기탕) can be used. 4. Soeumin(소음인) the symptoms of taeum disease(태음증) ; when the Minute Pulse and Deep+Thin Pulse is made a diagnosis, Sasang Prescription can be used. 5. Soeumin(소음인) the symptoms of soeum disease(소음증) ; when the Minute+Thin Pulse, Deep Pulse and Thin+Deep+Rapid Pulse is made a diagnosis, Sasang Prescription can be used. 6. Soyangin(소양인) Wind of soyang disease(소양상풍증) ; when the Superficial+Tight Pulse is made a diagnosis, Hungbangpaedogsan(형방패독산) can be used. And when the Deep+Full with strong power Pulse is made a diagnosis, Hyungbangdojeoksan(형방도적산) can be used. 7. Soyangin(소양인) the symptoms of mangyeum disease(망음증) ; when the Superficial+Large+Rapid Pulse and Flood+Large Pulse is made a diagnosis, Hungbangsabaeksan(형방사백산) can be used. And when the Wiry+Thin Pulse is made a diagnosis, Hungbanggiwhangtang(형방지황탕) can be used. 8. Soyangin(소양인) the chest-phrenic fever syndrome(흉격열증) ; when the Superficial Pulse, Flood+Full+Rapid Pulse and Flood+Large Pulse is made a diagnosis, Sasang Prescription can be used. 9. Soyangin(소양인) the after fever syndrome(음허오열증) ; when the Empty+Soft+Rapid Pulse is made a diagnosis, Sasang Prescription can be used. 10. Taeumin(태음인) the upper neck exterior disease caused by Cold(배추표병) ; when the Superficial and Superficial+Tight Pulse is made a diagnosis, Mawhangbalpoytang(마황발표탕) can be used, And when the Superficial and Superficial+Tight with strong power on left hand Pulse is made a diagnosis, Ungdamsan(웅담산) and Handayulsotang(한다열소탕) can be used. 11. Taeumin(태음인) the Coldness syndrome in esophagus(위완한증) ; when the Superficial+Tight Pulse with weak power on left hand Pulse is made a diagnosis, Taeumjowetang(태음조위탕) can be used. 12. Taeumin(태음인) the Dryness-Heat syndrome(조열증) ; when the Flood+Large Pulse, Long Pulse and Long+Large Pulse is made a diagnosis, Galgeunhaegitang(갈근해기탕) can be used. And when the Tight+Full+Rapid Pulse with deep region is made a diagnosis, Yuldahansotang(열다한소탕) can be used. And when the Superficial+Slippery Pulse is made a diagnosis, Chungsimyunjatang(청심연자탕) can be used. 13. Taeumin(태음인) the symptoms of Yin-blood Exhaustion(음혈모갈증) ; when the Superficial with weak power Pulse is made a diagnosis, Nokyongdaebotang(녹용대보탕) can be used. And when the Deep with weak power Pulse is made a diagnosis, Gongjinheukwondan(공진흑원단) can be used. 14. Taeyangin(태양인) a slight Lumbar vertebrae disease(외감경증) ; when the Superficial+Hollow Pulse is made a diagnosis, Gunshitang(건시탕) can be used. 15. Taeyangin(태양인) the Generalized and Fatigue syndrome(해역증) ; when the Moderate+Choppy Pulse with left hand chi region(척맥) is made a diagnosis, Ogapijangchuktang(오가피장척탕) can be used. 16. Taeyangin(태양인) a slight Small Intestine disease(내촉경증)