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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
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    • v.49 no.12
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    • pp.1282-1286
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    • 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 $38^{\circ}C$ 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 $6.48{\pm}6.56years$. 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.

A Study of Epstein-Barr Virus, and Human Leukocyte Antigen Typing in Children with Acute Infectious Mononucleosis (급성 전염성 단핵구증 환아에서 Epstein-Barr 바이러스의 감염형과 사람 백혈구 항원형 연구)

  • Hahn, Seung-Hoon;Shin, Wan-Shik;Han, Hoon;Kang, Jin-Han
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.467-473
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    • 2003
  • Purpose : The Epstein-Barr virus(EBV), gamma herpesvirus, is an important pathogen that is widespread around the world. The EBV causes various diseases depending on the geographic location, and on the immunity or the premorbid condition of the person exposed to EBV. To evaluate EBV typing may be the most important step to figure out the pathogenesis of EBV associated diseases, and we need to re-evaluate the pathologic role of human leukocyte antigen(HLA) in developing Epstein- Barr virus associated acute infectious mononucleosis by using newly developed methods. Methods : This study included 24 children(age range : 6 to 13 years), serologically confirmed with acute infectious mononucleosis. The control group for the HLA type consisted of 200 age-matched healthy children. To classify HLA I, modified ARMs-PCR was used, while modified PCR-SSOP was utilized in typing of HLA II. Also, we performed EBV typing in study patients by using a one-step PCR. Results : The results of HLA types : In HLA class I, HLA-A24 was positive in 69 of 200 healthy children and positive in 14 of 24 patients in the study group(relative risk : 3.5724, chi-square; 5.26, P<0.05). In HLA class II, HLA-DRB1*07 was detected in 18 of 200 healthy children, and eight of 24 patients in the study group(relative risk; 506173, chi-square; 9.73, P<0.01). The results of EBV types : In the research group, 20(83.8%) of 24 patients were shedding type A virus, while 4(16.7%) were type B. Conclusion : We conclude that development of infectious mononucleosis may be associated with HLA types, and these results suggest that acute infectious mononucleosis could have hereditary traits. And we confirm that type A EBV is highly prevalent in patients with acute infectious mononucleosis in Korea. Also, our results suggest that further large scale studies, including adult groups, regarding the association between pathogenesis of EBV with HLA-DP or HLA-DQ will be warranted.

Collection of Adult and Larval Mosquitoes in U.S. Army Compounds in the Republic of Korea During 1979~1983 (한국에 주둔한 미군지역내에서의 모기 성충과 유충 채집(1979~1983))

  • ;R.K
    • Parasites, Hosts and Diseases
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    • v.22 no.1
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    • pp.102-108
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    • 1984
  • This paper is the result of adult female mosquito and larval collection in U.S. Army Installations in Korea from 1979 to 1983. New Jersey light traps were operated for adult collection from May to October. The primary concern of this surveillance is to determine when to recommend insecticide spraying for mosquito control in the Army areas. The 5th Preventive Medicine Unit have developed an "index" level of female mosquitoes in a light trap similar to other U.S. Army Agencies in other parts of the world. When 10 female mosquitoes are reached on two consecutive trap-night, or 5 known vector females are collected, fogging is recommended in the trap areas. 1. Mosquito collections were conducted in 12 U.S. Army areas by operating 39 New Jersey light traps. Mosquitoes collected from the areas were identified to be 17 species comprising 3 genera. Anopheles sinensis (40%), Culex tritaeniorhynchus (31%), Aedes vexans nipponii (19 %) and Culex pipiens pallens (10%) appeared to be the most common species in the areas. 2. The species, population density and monthly appearance of adult mosquitoes were found to be almost the same in the all provinces involved. And Japanese Encephalitis vector mosquitoes, Culex tritaeniorhynchus, showed their seasonal fluctuation from July to September with a peak in August each year. 3. Larval habitats confirmed in the Army areas were categorized into 16 types as shown in Table 3. The mosquito larvae collected in those habitats were identified to be 15 species representing 4 genera. Most breeding sites in the Army areas were those which are activated during the wet season. 4. More mosquitoes were collected from the Kyungki Province than from the other Provinces. The reason for more collection of mosquitoes from military installations in the Kyungki Province appears to be the geographic characteristics surrounded by rice fields, marshes and other stagnant water areas.

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The propriety of Spatial Arrangement Condition of 119 Emergency Medical Service - Mainly Around H Town Area, Countrysid of Y city - (119지역대의 공간적 배치 현황의 적절성 -Y시 H면 지역을 중심으로-)

  • Yun, Jong-Geun;Choi, Kyu-Chul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.374-380
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    • 2017
  • In this study, we analyzed the situation of the 119 emergency medical service zone of H town, countryside of Y city from January 1st, 2015 to December 31st, 2016 and then, on the basis of this analysis, we investigated the present condition of the patient-transportation service of the 119 emergency medical service to provide the basic data in order for patients to use the emergency medical service more efficiently. We analyzed the data with SPSS 21.0 using frequency analysis and, after positioning the virtual 119 emergency medical service, we analyzed the data of the transportation time and transportation distance by using GIS. The results of this study show that the use of the 119 emergency medical service for people over 65 years old represents approximately 57% of the total number of patients transported, The average distance and time of the real moving reaction are 6.41 km and 11.86 min, respectively. The distance and time from the pick-up location to the hospital are 18.24 km and 21.52 min, respectively. Given the present position of the 119 emergency medical service, the results of this analysis using GPS show that the (average) distance and time from the 119 emergency medical service to Jang * Ri town are 9.12 km and 12 min, and the (average) total distance and time to arrive at the hospital after the emergency medical service picks up the patient are 36.83 km and 62 min, respectively. In the case of the virtual emergency medical service, the total distance and time required to arrive at the hospital after the emergency medical service picks up the patient are 27.71km and 50min, respectively. The results of this study showed that the present position of the 119 emergency service does not provide the optimum distance and time from the patient's location to the hospital. Therefore, we consider that the repositioning of the 119 emergency medical center is necessary, in order to reduce the time required for the emergency medical service to move to the patient's location and then bring the patient to the hospital.

Koreanized Analysis System Development for Groundwater Flow Interpretation (지하수유동해석을 위한 한국형 분석시스템의 개발)

  • Choi, Yun-Yeong
    • Journal of the Korean Society of Hazard Mitigation
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    • v.3 no.3 s.10
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    • pp.151-163
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    • 2003
  • In this study, the algorithm of groundwater flow process was established for koreanized groundwater program development dealing with the geographic and geologic conditions of the aquifer have dynamic behaviour in groundwater flow system. All the input data settings of the 3-DFM model which is developed in this study are organized in Korean, and the model contains help function for each input data. Thus, it is designed to get detailed information about each input parameter when the mouse pointer is placed on the corresponding input parameter. This model also is designed to easily specify the geologic boundary condition for each stratum or initial head data in the work sheet. In addition, this model is designed to display boxes for input parameter writing for each analysis condition so that the setting for each parameter is not so complicated as existing MODFLOW is when steady and unsteady flow analysis are performed as well as the analysis for the characteristics of each stratum. Descriptions for input data are displayed on the right side of the window while the analysis results are displayed on the left side as well as the TXT file for this results is available to see. The model developed in this study is a numerical model using finite differential method, and the applicability of the model was examined by comparing and analyzing observed and simulated groundwater heads computed by the application of real recharge amount and the estimation of parameters. The 3-DFM model is applied in this study to Sehwa-ri, and Songdang-ri area, Jeju, Korea for analysis of groundwater flow system according to pumping, and obtained the results that the observed and computed groundwater head were almost in accordance with each other showing the range of 0.03 - 0.07 error percent. It is analyzed that the groundwater flow distributed evenly from Nopen-orum and Munseogi-orum to Wolang-bong, Yongnuni-orum, and Songja-bong through the computation of equipotentials and velocity vector using the analysis result of simulation which was performed before the pumping started in the study area. These analysis results show the accordance with MODFLOW's.

A Study on an Estimated Location of Seongjae Ryu, Junggyo's Okgye Gugok in GaPyeong-Gun (성재 유중교의 가평 옥계구곡 위치추정 연구)

  • Kang, Kee-Rae;Lee, Hae-Ju;Lee, Hyun-Chae;Kim, Hee-Chae;Kim, Dong-Phil;Ha, Seung Kun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.3
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    • pp.32-40
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    • 2017
  • The introduction of neo-Confucianism as the ideological foundation of Joseon, and its root Confucianism have become the origin of the life, scholarship and ideology of the Korean people. Additionally, it was considered the best to follow the teachings of the discipline's advocates including Confucius (孔子), Mencius (孟子), Zisi (子思), ZhuXi (朱子). Among these teachers, ZhuXi was the one who overtly presented the way of self-discipline, of which goal lies in attaining the character by the manifestation of vitality (氣 ki) and rationality (理 i) and contemplating on them. As he regarded natural places with mountains and waters as stages and tools for practicing toward the enlightenment, Confucian scholars in Joseon also followed his example in the spirit of honoring and studying ZhuXi (尊朱子, 學朱子), which became the basic thoughts and practical philosophy among them. Ryu, Junggyo, the neo-Confucian dogmatist, was no exception to applaud the nature, as he designated and ruled Okgye Gugok. On the basis of these backgrounds, this study aims to estimate the geographic places of Okgye Gugok, which was set by Ryu, Junggyo, a Confucian scholar in late-Joseon period, by collecting and analyzing the basic data, starting from Gareung-gun Okgye Sansugi(嘉陵郡玉溪山水記) which is the primary text authored by Seongjae Ryu, Junggyo. The literature study is followed by ten field trips to the estimated locations of Okgye Gugok, and verification of the estimations by three locals who were born and raised in Okgye Gugok. Coordinates and photographs were obtained as spatial data for each location of nine Gok(曲) estimated through this study. They will serve as a primary and critical data for story-telling and tourism resource in Okgye Gugok. The significance of this study is that it provides the primary data for designating the locations of Gok(曲) in Okgyeo Gugok.

Study On the Geographic Locations of Gugoks and Dongcheons in Seoul, Gyeonggi-Do and Gangwon-Do (서울시·경기도·강원도지역 구곡·동천 위치연구)

  • Kang, Kee-Rae;Lee, Hae-Ju;Kim, Hee-Chae;Lee, Hyun-Chae;Kim, Dong-Phil
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.3
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    • pp.67-75
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    • 2017
  • The culture of Gugok (九曲) and Dongcheon (洞天), which tries to reach the ideological culmination in Confucianism, was widespread throughout the Joseon dynasty. This was an extension of the spirit of studying and honoring Zhu Xi (學朱子, 尊朱子); thereby, Confucian scholars in Joseon expressed the will to follow the teachings of Zhu Xi (朱子) and comforted themselves that they were in the course of attaining the truth. As a realization of this expression of will, scholars designated and operated various scenic sites as Gugoks, following the example of Zhu Xi's Mui Gugok (武夷九曲), and Dongcheons, as a representation of the utopia. These designations are widespread nationwide, with around sixty Gugok locations that have now been reported in academia. However, the actual number of Gugoks exceeds this number, and many of them are currently not identified concerning the exact locations. Therefore, the purpose of this study is to identify the locations of Gugoks and Dongcheons scattered around Seoul, Gyeonggi and Gangwon regions. For the coordinates of Gugoks and Dongcheons, this study referred to the literature, web search and the books published by local cultural institutes. Based on the collected information, the researchers conducted field trips to investigate whether the record exists as a real location and, if so, acquired their coordinates. This study also provides the tables of Gugok or Dongcheon that only exists in the imagination, existed before but now are lost, or are inaccessible. Eight locations in Seoul, Gyeonggi, and Gangwon regions are understood as Gugok. Among them, Gogun Gugok and Okgye Gugok have relatively clear locations and records. Byeokgye Gugok and Suhoe Gugok, on the other hand, has many locations and titles overlapped, and their established time and managers are unclear. As for Ui Gugok in Seoul, it is known to be set by Hong Yangho, but some parts of its locations are confirmed, others are in dispute, and many locations are damaged. Thirty-eight locations in Seoul, Gyeonggi, and Gangwon regions are understood as Dongcheon. There are sixteen Dongcheons in Seoul area. Among them, those including Dohwa Dongcheon, Yangsan Dongcheon, and Ssangnyu Dongcheon actually exist but are forbidden to be accessed. There are thirteen Dongcheons in Gyeonggi area. The exact location of Onsu Dongcheon cannot be confirmed because of the development; Gwirae Dongcheon has historical records, but the actual existence cannot be confirmed. There are nine Dongcheons in Gangwon area. The researcher judged that Hwaeum Dongcheon is the misspelled record of Hwaeumdong Jeongsaji (華陰洞精舍址), which is located at the upstream of Gogun Gugok.

Soil Loss and Pollutant Load Estimation in Sacheon River Watershed using a Geographic Information System (GIS를 이용한 동해안 하천유역의 토양유실량과 오염부하량 평가 -사천천을 중심으로-)

  • Cho, Jae-Heon;Yeon, Je-Chul
    • Journal of Korean Society of Environmental Engineers
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    • v.22 no.7
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    • pp.1331-1343
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    • 2000
  • Through the integration of USLE and GIS, the methodology to estimate the soil loss was developed, and applicated to the Sacheon river in Gangrung. Using GIS, spatial analysis such as watershed boundary determination, flow routing. slope steepness calculation was done. Spatial information from the GIS application was given for each grid. With soil and land use map, information about soil classification and land use was given for each grid too. Based upon these data, thematic maps about the factors of USLE were made. We estimated the soil loss by overlaying the thematic maps. In this manner, we can assess the degree of soil loss for each grid using GIS. Annual average soil loss of Sacheon river watershed is 1.36 ton/ha/yr. Soil loss in forest, dry field, and paddy field is 0.15 ton/ha/yr, 27.04 ton/ha/yr, 0.78 ton/ha/yr respectively. The area of dry field, which is 4% of total area, is $2.4km^2$. But total soil loss of dry field is 6561 ton/yr, and it occupies 84.9 % of total soil loss eroded in Sacheon river watershed. Comparing with the 11.2 ton/ha/yr of an average soil loss tolerance for cropland, provision for the soil loss in dry field is necessary. Run-off and water quality of Sacheon river were measured two times in flood season: from July 24, 1998 to July 28 and from September 29 to October 1. As the run-off of the river increased, SS, TN, TP concentrations and pollutant loadings increased. SS, TN, TP loads of Sacheon river discharged during the 2 heavy rains were 21%, 39%, and 19% of the total pollutant loadings generated in the Sacheon river watershed for one year. We can see that much pollutants are discharged in short period of flood season.

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Genetic Differences and Variation in Two Largehead Hairtail (Trichiurus lepturus) Populations Determined by RAPD-PCR Analysis (RAPD-PCR 분석에 의해 결정된 갈치 (Trichiurus lepturus) 2 집단의 유전적 차이와 변이)

  • Park, Chang-Yi;Yoon, Jong-Man
    • Korean Journal of Ichthyology
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    • v.17 no.3
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    • pp.173-186
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    • 2005
  • Genomic DNA was isolated from two geographic populations of largehead hairtail (Trichiurus lepturus) in Korea and the Atlantic Ocean. The eight arbitrarily selected primers were found to generate common, polymorphic, and specific fragments. The complexity of the banding patterns varied dramatically between primers from the two locations. The size of the DNA fragments also varied widely, from 150 bp (base pairs) to 3,000 bp. Here, 947 fragments were identified in the largehead hairtail population from Korea, and 642 in the largehead hairtail population from the Atlantic Ocean: 148 specific fragments (15.6%) in the Korean population, and 61 (9.5%) in the Atlantic population. In the Korean population, 638 common fragments with an average of 79.8 per primer were observed.; 429 common fragments, with an average of 53.6 per primer, were identified in the Atlantic population. The number of polymorphic fragments in the largehead hairtail population from Korea and the Atlantic Ocean was 76 and 27, respectively. Based on the average bandsharing values of all samples, the similarity matrix ranged from 0.784 to 0.922 in the Korean population, and from 0.833 to 0.990 in the Atlantic population. The bandsharing value of individuals within the Atlantic population was much higher than in the Korean population. The dendrogram obtained by the eight primers indicated two genetic clusters: cluster 1 (KOREAN 01~KOREAN 11), and cluster 2 (ATLANTIC 12~ATLANTIC 22). Individual KOREAN no. 10 from Korea was genetically most closely related to KOREAN no. 11 in the Korean population (genetic distance = 0.038). Ultimately, individual KOREAN no. 01 of the Korean population was most distantly related to ATLANTIC no. 16 of the Atlantic population (genetic distance = 0.708).

Study of Rainfall-Runoff Variation by Grid Size and Critical Area (격자크기와 임계면적에 따른 홍수유출특성 변화)

  • Ahn, Seung-Seop;Lee, Jeung-Seok;Jung, Do-Joon;Han, Ho-Chul
    • Journal of Environmental Science International
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    • v.16 no.4
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    • pp.523-532
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    • 2007
  • This study utilized the 1/25,000 topographic map of the upper area from the Geum-ho watermark located at the middle of Geum-ho river from the National Geographic Information Institute. For the analysis, first, the influence of the size of critical area to the hydro topographic factors was examined changing grid size to $10m{\times}10m,\;30m{\times}30m\;and\;50m{\times}50m$, and the critical area for the formation of a river to $0.01km^2{\sim}0.50km^2$. It is known from the examination result of watershed morphology according to the grid size that the smaller grid size, the better resolution and accuracy. And it is found, from the analysis result of the degree of the river according to the minimum critical area for each grid size, that the grid size does not affect on the degree of the river, and the number of rivers with 2nd and higher degree does not show remarkable difference while there is big difference in the number of 1st degree rivers. From the results above, it is thought that the critical area of $0.15km^2{\sim}0.20km^2$ is appropriate for formation of a river being irrelevant to the grid size in extraction of hydro topographic parameters that are used in the runoff analysis model using topographic maps. Therefore, the GIUH model applied analysis results by use of the river level difference law proposed in this study for the explanation on the outflow response-changing characters according to the decision of a critical value of a minimum level difference river, showed that, since an ogival occurrence time and an ogival flow volume are very significant in a flood occurrence in case of not undertow facilities, the researcher could obtain a good result for the forecast of river outflow when considering a convenient application of the model and an easy acquisition of data, so it's judged that this model is proper as an algorism for the decision of a critical value of a river basin.