• Title/Summary/Keyword: time-frequency characteristics

Search Result 2,661, Processing Time 0.039 seconds

Flowering Patterns of Miscanthus Germplasms in Korea (국내 수집 억새 유전자원의 출수 특성)

  • An, Gi-Hong;Um, Kyoung-Ran;Lee, Jun-Hee;Jang, Yun-Hui;Lee, Ji-Eun;Yu, Gyeong-Dan;Cha, Young-Lok;Moon, Yun-Ho;Ahn, Jong-Woong
    • KOREAN JOURNAL OF CROP SCIENCE
    • /
    • v.60 no.4
    • /
    • pp.510-517
    • /
    • 2015
  • Miscanthus has been considered as the most promising bioenergy crop for lignocellulosic biomass production. In Korea, M. sacchariflorus and M. sinensis can be found easily in all regions. It is a great advantage to utilize as important species with respect to genetic and cross-breeding programs materials for creation of novel hybrids. For successful breeding programs, it is important to precisely understand the variability of flowering traits among Miscanthus species as breeding parents materials. In this study, flowering traits were observed daily in 960 germplasms of two Miscanthus species (M. sacchariflorus and M. sinensis) for growing seasons over 2 years. The flowering process was divided into three stages. ST (sprouting time) was recorded when first leaf of the plant emerged on soil. FS1 (flowering stage 1) and FS2 (flowering stage 2) were recorded when flag leaf was firstly observed, and 1 cm of panicle was showing on at least one stem, respectively. For 2013 and 2014, the latest germplasms exerted flag leaf, i.e. September 30 (DOY of FS1 164.1) and September 4 (DOY of FS1 141.0) occurred M. sacchariflorus cv. Geodae 1 and M. sacchariflorus cv. Uram collected from Southern Korea (Jeollanam-do), while Miscanthus germplasms collected from northern Korea (Gyeonggi-do) which emerged the earliest flag leaf in July and August, significantly decreased DOY. For DOY from ST to FS2, M. sacchriflorus germplasms ranged from 140 to 190 days, and 110 to 170 days for 2013 and 2014. The highest frequency showed to 160 days for 2013, and 150 days for 2014. In M. sinensis germplasms, the highest frequency showed to 180 days for 2013, and 170 days for 2014. In the results of correlation between the day of years from ST to FS2 for 2013 and 2014, M. sacchriflorus and M. sinensis showed high coefficient of correlation (0.70 and 0.89). It can be supposed that flowering characteristics of Miscanthus are largely affected by the unique phenotypic characteristic of native habitat than environmental factors of the current planted site. This study for flowering traits of Miscanthus may provides an important information in order to expedite the introduction as breeding materials for creation of new hybrid.

National Survey of Injury and Poisoning on a Representative Sample Population of Koreans (우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性))

  • Kim, Joung-Soon;Kim, Sung-Soo;Chang, Sung-Chill
    • Journal of Preventive Medicine and Public Health
    • /
    • v.27 no.3 s.47
    • /
    • pp.447-463
    • /
    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

  • PDF

A Study for establishment of soil moisture station in mountain terrain (1): the representative analysis of soil moisture for construction of Cosmic-ray verification system (산악 지형에서의 토양수분 관측소 구축을 위한 연구(1): Cosmic-ray 검증시스템 구축을 위한 토양수분량 대표성 분석 연구)

  • Kim, Kiyoung;Jung, Sungwon;Lee, Yeongil
    • Journal of Korea Water Resources Association
    • /
    • v.52 no.1
    • /
    • pp.51-60
    • /
    • 2019
  • The major purpose of this study is to construct an in-situ soil moisture verification network employing Frequency Domain Reflectometry (FDR) sensors for Cosmic-ray soil moisture observation system operation as well as long-term field-scale soil moisture monitoring. The test bed of Cosmic-ray and FDR verification network system was established at the Sulma Catchment, in connection with the existing instrumentations for integrated data provision of various hydrologic variables. This test bed includes one Cosmic-ray Neutron Probe (CRNP) and ten FDR stations with four different measurement depths (10 cm, 20 cm, 30 cm, and 40 cm) at each station, and has been operating since July 2018. Furthermore, to assess the reliability of the in-situ verification network, the volumetric water content data measured by FDR sensors were compared to those calculated through the core sampling method. The evaluation results of FDR sensors- measured soil moisture against sampling method during the study period indicated a reasonable agreement, with average values of $bias=-0.03m^3/m^3$ and RMSE $0.03m^3/m^3$, revealing that this FDR network is adequate to provide long-term reliable field-scale soil moisture monitoring at Sulmacheon basin. In addition, soil moisture time series observed at all FDR stations during the study period generally respond well to the rainfall events; and at some locations, the characteristics of rainfall water intercepted by canopy were also identified. The Temporal Stability Analysis (TSA) was performed for all FDR stations located within the CRNP footprint at each measurement depth to determine the representative locations for field-average soil moisture at different soil profiles of the verification network. The TSA results showed that superior performances were obtained at FDR 5 for 10 cm depth, FDR 8 for 20 cm depth, FDR2 for 30 cm depth, and FDR1 for 40 cm depth, respectively; demonstrating that those aforementioned stations can be regarded as temporal stable locations to represent field mean soil moisture measurements at their corresponding measurement depths. Although the limit on study duration has been presented, the analysis results of this study can provide useful knowledge on soil moisture variability and stability at the test bed, as well as supporting the utilization of the Cosmic-ray observation system for long-term field-scale soil moisture monitoring.

Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.4
    • /
    • pp.420-425
    • /
    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

THE RELATIONSHIP BETWEEN PARTICLE INJECTION RATE OBSERVED AT GEOSYNCHRONOUS ORBIT AND DST INDEX DURING GEOMAGNETIC STORMS (자기폭풍 기간 중 정지궤도 공간에서의 입자 유입률과 Dst 지수 사이의 상관관계)

  • 문가희;안병호
    • Journal of Astronomy and Space Sciences
    • /
    • v.20 no.2
    • /
    • pp.109-122
    • /
    • 2003
  • To examine the causal relationship between geomagnetic storm and substorm, we investigate the correlation between dispersionless particle injection rate of proton flux observed from geosynchronous satellites, which is known to be a typical indicator of the substorm expansion activity, and Dst index during magnetic storms. We utilize geomagnetic storms occurred during the period of 1996 ~ 2000 and categorize them into three classes in terms of the minimum value of the Dst index ($Dst_{min}$); intense ($-200nT{$\leq$}Dst_{min}{$\leq$}-100nT$), moderate($-100nT{\leq}Dst_{min}{\leq}-50nT$), and small ($-50nT{\leq}Dst_{min}{\leq}-30nT$) -30nT)storms. We use the proton flux of the energy range from 50 keV to 670 keV, the major constituents of the ring current particles, observed from the LANL geosynchronous satellites located within the local time sector from 18:00 MLT to 04:00 MLT. We also examine the flux ratio ($f_{max}/f_{ave}$) to estimate particle energy injection rate into the inner magnetosphere, with $f_{ave}$ and $f_{max}$ being the flux levels during quiet and onset levels, respectively. The total energy injection rate into the inner magnetosphere can not be estimated from particle measurements by one or two satellites. However, the total energy injection rate should be at least proportional to the flux ratio and the injection frequency. Thus we propose a quantity, “total energy injection parameter (TEIP)”, defined by the product of the flux ratio and the injection frequency as an indicator of the injected energy into the inner magnetosphere. To investigate the phase dependence of the substorm contribution to the development of magnetic storm, we examine the correlations during the two intervals, main and recovery phase of storm separately. Several interesting tendencies are noted particularly during the main phase of storm. First, the average particle injection frequency tends to increase with the storm size with the correlation coefficient being 0.83. Second, the flux ratio ($f_{max}/f_{ave}$) tends to be higher during large storms. The correlation coefficient between $Dst_{min}$ and the flux ratio is generally high, for example, 0.74 for the 75~113 keV energy channel. Third, it is also worth mentioning that there is a high correlation between the TEIP and $Dst_{min}$ with the highest coefficient (0.80) being recorded for the energy channel of 75~113 keV, the typical particle energies of the ring current belt. Fourth, the particle injection during the recovery phase tends to make the storms longer. It is particularly the case for intense storms. These characteristics observed during the main phase of the magnetic storm indicate that substorm expansion activity is closely associated with the development of mangetic storm.

Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
    • /
    • v.15 no.3
    • /
    • pp.31-44
    • /
    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

Ecological Characteristics of Mulberry Longicorn Beetle, Apriona germari Hope, at the Hibernation Stage in Mulberry Fields (뽕밭에서 월동하는 뽕나무하늘소(Apriona germari Hope)의 생태적 특성)

  • 윤형주;박인균;마영일;이상범;양성열
    • Korean journal of applied entomology
    • /
    • v.36 no.1
    • /
    • pp.67-72
    • /
    • 1997
  • To study the ecological characteristics of the mulberry longicorn beetle, Apriona germari Hope, Mulberry branches with egg-laid scar were regionally collected from ten mulberry fields during the hibernation. It showed that its distribution was highest in Kyunggi province with 3.05% and lowest in Kyungnam province with 0.28%. The number of the egg-laid scar per branch was single with 87.7% of high frequency and its average size was 2.38 L$\times$1.45 W$\times$0.34D cm. The average diameter of scarred branch was 1.7 cm, ranging from 1.3 to 1.9 cm. the shape of egg was long elliptical with width of $2.32\pm$0.33 mm and with length of $6.606.60\pm$0.55 mm. the weight of egg was $16.6\pm$2.94 mg and the color of the just-oviposited egg was milky white, changing into thick brown with time. The weight and length of the just-hatched larva was $16.6\pm$2.4 mg and $6.36\pm$0.66 mm. respectively. Most of the larvae moved downward inside the branch, showing that 94.2% of larvae for outdoor rearing and 87.9% of larvae for indoor rearing moved downward in the branch. As a result, it was found that it hibernated at egg stage with a higher rate than at larval stage by two or three folds in Kyunggi and Kyungbuk province and contrarily at larval stage with higher rate than at egg stage in Chunbuk, Chunnam and Kyungnam provinces. The survival rate for the egg after hibernation was significantly low with 6.6% and contrarily for the larva after hibernation remarkably high with 91.2%. Although the survival rate of the egg in this survey was relatively low, the result indicated that there were two types of hibernation of A. germari in Korea; egg and larval stage.

  • PDF

Freshwater Fish Utilization of Fishway Installed in the Jangheung Dam (장흥댐에 설치되어 있는 어도와 담수어류의 이용 분석)

  • Yoon, Ju-Duk;Kim, Jeong-Hui;Joo, Gea-Jae;Seo, Jin-Won;Pak, Hubert;Jang, Min-Ho
    • Korean Journal of Ecology and Environment
    • /
    • v.44 no.3
    • /
    • pp.264-271
    • /
    • 2011
  • At the Jangheung multipurpose dam, which is on the Tamjin River, a trapping and trucking operation was established to maintain continuous upstream migration of fish,. To facilitate fish gathering, installation of an effective fishing trap was required. In this study, we evaluated the fish trap, established at the Jangheung dam, using PIT (Passive Integrated Transponder) telemetry. A total of 254 individuals from 15 species were monitored. Among these tagged species, 36 individuals from 6 species (Carassius auratus, C. cuvieri, Zacco temminckii, Z. platypus, Pungtungia herzi, and Pseudobagrus koreanus) were detected; a 14.2% detection rate. C. auratus recorded the highest detection rate of 44.2% while P. herzi was 14.3%. Z. temminckii and Z. platypus showed relatively low detection, 5% and 7.7% respectively. Some of individuals from C. auratus and Z. platypus did not pass through the antenna at the first attempt but were continuously detected on multiple days. There were no statistical differences in body size (total length, standard length and body weight) of individuals that did or did not swim into the trap (Mann-Whitney U test, p>0.05). Fish mainly swam into the trap during outflow of water from the dam (Mann-Whitney U test, p<0.001) and showed a higher detection frequency in daytime than nighttime (Mann-Whitney U test, p<0.001). Thus, for fish movement into the trap, external factors such as outflow from dam and time of day have important roles. Based on detection rate, not all fishes showed upstream migration but represented selective migration. Consequently, the establishment of flexible outflow strategies that take into consideration ecological characteristics of fishes should required for improving the efficiency of fishway.

Temporal and Spatial Characteristics of Surface Winds over the Adjacent Seas of the Korean Peninsula (한국 주변해역에서의 해상풍의 시공간적 특성)

  • Han, Sang-Kyu;Lee, Heung-Jae;Na, Jung-Yul
    • 한국해양학회지
    • /
    • v.30 no.6
    • /
    • pp.550-564
    • /
    • 1995
  • The temporal and spatial characteristics of wind fields over the neighbouring seas of the Korean peninsula are investigated using 10-years daily wind data during 1978${\sim}$1987 which have been spatially smoothed and low-pass filtered. Long term annual and monthly means are examined for synoptic patterns and spectral analyses are made for temporal variability and spatial coherence. Spatial patterns of the annual mean wind stress and curl have a strong resemblance with those of monthly means during the winter season. Two outstanding periodicities are observed at 1 and 2 cycles per year. The synoptic winds over the study area are highly coherent at both the annual and semi-annual periodicities. However, each basin has its own characteristic spatial pattern. For instance, the prevailing wind during the winter season is northerIy over the northern East Sea (ES), Yellow Sea (YS), and northern East China Sea (ECS), while it is northwesterly over the southern ES and northesterly over the northern ES and southern ECS. At the same time, the wind stress curl is positive over the northern ES and southern ECS, while it is negative over the southern ES, YS and northern ECS. On the other hand, the wind field during the summer season, with its strength being much reduced, is completely different from that during the winter season, and frequent passage of tropical storms provokes large temporal variability over ECS. One remarkable point is that the annual cycle, dominated by the Siberian High, tends to propagate from northeast to southwest, i.e., from northern 25 toward southern ES, YS and ECS, while the semi-annual cycle propagates in the opposite direction, from southwest to northeast. The semi-annual periodicity may reflect development of extratropical cyclones in spring and fall which frequently cross the Korean peninsula. In higher frequencies, there are no dominant periodicities, but local winds over YS and ES are highly correlated for frequencies larger than 0.1 cycles per day and phase difference increases linearly with frequency. This linear increase of phase corresponds to phase speed of 550 and 730 km/d at 0.1 and 0.3 cpd, respectively, The phase speed is apparently coincident with moving speed of extratropical cyclones across the Korean peninsula in the west-east direction.

  • PDF

Clinical Characteristics, Prognostic Factors and Influence of Prophylaxis in Children with Pneumocystis jirovecii Pneumonia (소아 주폐포자충 폐렴의 임상양상, 위험인자 및 예방요법의 효과 연구)

  • Kim, Seohee;Yoo, Reenar;Sung, Hungseop;Lee, Jina
    • Pediatric Infection and Vaccine
    • /
    • v.23 no.1
    • /
    • pp.31-39
    • /
    • 2016
  • Purpose: The aim of this study was to investigate the prognostic factors for Pneumocystis jirovecii pneumonia (PCP) and to evaluate the influence of PCP prophylaxis in pediatric patients. Methods: From January 2002 to April 2015, patients aged <18 years with a diagnosis of confirmed PCP at our institute were reviewed retrospectively. Clinical characteristics and outcomes were compared according to the groups with or without PCP prophylaxis. Risk factors associated with PCP-related death were analyzed by logistic regression analysis. Results: During study period, a total of 24 patients were diagnosed with PCP by immunofluorescence assay and/or PCR. The median age of the patients was 5 years (range, 3 months-18 years) and 23 (96%) had immunocompromised conditions including hematologic disorders with or without hematopoietic stem cell transplantation (n=15), solid organ transplantation (n=4), and primary immune deficiency (n=4). Most common presenting symptoms were tachypnea and cough (92%, each). At the time of diagnosis, 79% (19/24) and 25% (6/24) suffered from respiratory failure and multi-organ dysfunction syndrome (MODS), respectively. Mechanical ventilation was required in 8 (33%) patients and 5 (21%) patients died of PCP. Multivariate analysis showed that MODS at initial presentation was an indicator of poor prognosis (OR, 17.1 [95% CI 1.13-257.67]; P=0.04). Compared to the patients without PCP prophylaxis, the frequency of MODS at diagnosis, need for mechanical ventilation and length of hospital days were significantly less common in the children who received PCP prophylaxis. Conclusions: MODS at presentation was a significant predictor for poor outcome and PCP prophylaxis could alleviate the clinical courses of pediatric PCP. Prospective study will be mandatory to determine the risk factors for development and deterioration of PCP in children.