• Title/Summary/Keyword: under 40 years old

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A Descriptive Study on the Tuberculosis Mortality in a Tuberculosis-Centered Hospital (한 결핵전문병원의 입원 결핵환자 사망에 대한 기술통계학적 고찰)

  • Kim, Soo-Young;Byun, Joo-Nam;Choi, Jin-Su
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.595-601
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    • 1993
  • Background: Today, tuberculosis continues as an important cause of death in Korea despite the effective treatment and prevention. So we have studied charicteristic distribution of death by pulmonary tuberculosis through epidemiologic survey. Subjects and Method: The mortality data were obtained from 684 pulmonary tuberculosis cases who died in a tuberculosis-centered hospital in Seoul during the period of 5 years from 1986 to 1990. In order to estimate the distribution of death by tuberculosis, t-test and $x^2$-text were performed on the data. Results: 1) 19.9% of patients died among the total 3,441 hospitalized pulmonary tuberculosis cases during 5 years. 2) In distribution of sex and age, male death occupies 81% of total death. Significantly high proportions of younger female death (under 40 years-old) were also observed. 3) In terms of medical security status, medical assistance group occupies 42.3% of medical insurance group while the non-security group also occupies 11.8% of total death. 4) Treatment interruption was observed in 78% of total death. Conclusion: Special attention should be given to the identification, management and follow up of high risk group in nationwide tuberculosis control program.

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Evaluation of the Dietary Diversity and Nutrient Intakes in Obese Adults (비만성인의 영양소 섭취량 및 식사 다양성 평가)

  • Kim, So-Hye;Kim, Ju-Young;Ryu, Kyoung-A;Sohn, Cheong-Min
    • Korean Journal of Community Nutrition
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    • v.12 no.5
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    • pp.583-591
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    • 2007
  • The purpose of this study was to assess the diet diversity, food habit and nutrient intake of obese adults who were visiting the health promotion center. This study was accomplished with the 138 obese adults (men = 103, women= 35) aged over 20 years old whose BMI were above $25 kg/m^2$. Nutrient adequacy ratio (NAR), the number of foods (Dietary Variety Score DVS), and food group consumed (Dietary Diversity Score, DDS) by using the data from the three days record were analyzed and the food habit and lifestyle were assessed by self reporting questionnaire. The average enemy intake of men was 2150.2 kcal which was significantly higher than that of women (p < 0.05). The intake ratio of carbohydrate, protein and fat over total energy was 54.8% : 19.3% : 25.8% in men, 59.5% : 17.8% : 22.6% in women respectively. Frequency of the breakfast in a week above 4, $2{\sim}3$ time and under one time was 75.7% 10.7% and 9.7% in men 77.1%, 5.7% and 14.3% in women respectively. frequency of eating between meals in a day under one time was 73.8% in men, 57.1% in women (p < 0.05). The average DDS and DVS was $3.63{\pm}0.07$ and $14.10 {\pm}3.45$, respectively which was significantly correlated with MAR (r=0.40 in DDS, r=0.64 in DVS, p < 0.01). The most frequent style of food pattern was DMGFV = 01101 in 35% of men, and DMGFV= 01111 in 37.1% of women. Our results show that dietary diversity and variety are useful parameters far evaluating nutrient intakes in obese adults. These findings suggest that nutritional education based on obese persons' eating behavior and eating diversity may be required to increase educational efficiency of weight control programs.

The Efficacy of Sclerotherapy for Conservative Treatment of Ovarian Pseudocyst (난소의 가성 낭종의 보존적 치료로서 경화술의 효용성)

  • Ahn, Sung-Hee;Yoo, Seung-Chul;Jo, Mi-Yeong;Kim, Mi-Ran;Hwang, Kyung-Joo;Ryu, Hee-Suk
    • Clinical and Experimental Reproductive Medicine
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    • v.29 no.4
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    • pp.245-250
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    • 2002
  • Objective: To evaluate the efficacy of sclerotherapy for conservative treatment of ovarian pseudocyst. Methods: Patients with ovarian pseudocyst who had undergone sclerotherapy at Ajou University Hospital from February, 1997 to March, 2002 were included in this study. Sclerotherapy was performed as follows: Under intravenous analgesia, the cyst was irrigated with dehydrated alcohol after aspiration under transvaginal sonography. The aspirated contents and alcohol irrigated contents were sent for cytologic examination. Results: 71 patients with ovarian pseudocyst were performed sclerotherapy. All but 2 patients were followed up for 0.5 to 33 months with transvaginal sonography and pelvic examination. Mean age of the patients was 40 years old. Mean size of the pseudocyst was 8.0 cm, mean amount of aspiration fluid was 179.8 ml, and average follow-up duration was 6.0 months. All had abdominal or pelvic surgical history and 38 patients (58.9%) of them had undergone hysterectomy. 44 of 71 patients (62.0%) were performed sclerotherapy only one time. 27 patients (38.0%) recurred and were undergone more than one time. Complication was not occurred in all cases. Conclusions: We concluded that although pseudocyst after sclerotherapy has high recurrence rate, sclerotherapy was an safe and effective method for conservative treatment of ovarian pseudocyst.

CLINICOSTASTICAL STUDY OF INPATIENTS OF ABSCESS IN FASCIAL SPACES FOR THE LAST 5 YEARS (최근 5년간 치성감염으로 인한 구강악안면부 근막간극에 발생한 농양환자의 임상 통계학적 검토)

  • Lee, Won-Hyuk;Ahn, Kyung-Mi;Jang, Bo-Young;Ahn, Mi-Ra;Lee, Jung-Yub;Sohn, Dong-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.497-503
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    • 2004
  • One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral & Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.

Depositional Environment and Formation Ages of Eurimji Lake Sediments in Jaechon City, Korea (제천 의림지 호저퇴적물 퇴적환경과 형성시기 고찰)

  • 김주용;양동윤;이진영;김정호;이상헌
    • The Korean Journal of Quaternary Research
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    • v.14 no.1
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    • pp.7-31
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    • 2000
  • Quaternary Geological and geophysical investigation was performed at the Eurimji reservoir of Jaechon City in order to interprete depositional environment and genesis of lake sediments. For this purpose, echo sounding, bottom sampling and columnar sampling by drilling on board and GPR survey were employed for a proper field investigation. Laboratory tests cover grain size population analysis, pollen analysis and $^{14}C$ datings for the lake sediments. The some parts of lake bottom sediments anthropogenically tubated and filled several times to date, indicating several mounds on the bottom surface which is difficult to explain by bottom current. Majority of natural sediments were accumulated both as rolling and suspended loads during seasonal flooding regime, when flash flow and current flow are relatively strong not only at bridge area of the western part of Eurimji, connected to stream valley, but at the several conduit or sewage system surrounding the lake. Most of uniform suspend sediments are accumulated at the lake center and lower bank area. Some parts of bottom sediments indicate the existence of turbid flow and mudflow probably due to piezometric overflowing from the lake bottom, the existence of which are proved by CM patterns of the lake bottom sediments. The columnar samples of the lake sediments in ER-1 and ER-3-1 boreholes indicate good condition without any human tubation. The grain size character of borehole samples shows poorly sorted population, predominantly composed of fine sand and muds, varying skewness and kurtosis, which indicate multi-processed lake deposits, very similar to lake bottom sediments. Borehole columnar section, echo sounding and GPR survey profilings, as well as processed data, indicate that organic mud layers of Eurimji lake deposits are deeper and thicker towards lower bank area, especially west of profile line-9. In addition the columnar sediments indicate plant coverage of the Eurimji area were divided into two pollen zones. Arboreal pollen ( AP) is predominant in the lower pollen zone, whreas non-aboreal pollen(NAP) is rich in the upper pollen zone. Both of the pollen zones are related to the vegetation coverage frequently found in coniferous and deciduous broad-leaved trees(mixed forest) surrounded by mountains and hilly areas and prevailing by aquatic or aquatic margin under the wet temperate climate. The $^{14}C$ age of the dark gray organic muds, ER1-12 sample, is 950$\pm$40 years B.P. As the sediments are anthropogenetically undisturbed, it is assumed that the reliability of age is high. Three $^{14}C$ ages of the dark gray organic muds, including ER3-1-8, ER3-1-10, ER3-1-11 samples, are 600$\pm$30 years B.P., 650$\pm$30 years B.P., 800$\pm$40 years B.P. in the descending order of stratigraphic columnar section. Based on the interpretation of depositional environments and formation ages, it is proved that Eurimji reservoir were constructed at least 950$\pm$40 years B.P., the calibrated ages of which ranges from 827 years, B.P. to 866 years B.P. Ancient people utilize the natural environment of the stream valley to meet the need of water irrigation for agriculture in the local valley center and old alluvium fan area.

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Epidemiological Studies of Clonorchiasis - II. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Goyang Gun, a Low Endemic Area in Korea (간흡충증(肝吸虫症) 역학(疫學) - II. 저도유행지(低度流行地) 고양지방(高陽地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移))

  • Kim, D.C.;Lee, O.Y.;Lee, J.S.;Ahn, J.S.;Chang, Y.M.;Son, S.C.;See, S.H.
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.66-80
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis in Korea, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Goyang Gun a low endemic area in recent years, prior to the introduction of praziquantel which will eventually influence to the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author (Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The current prevalence rate of Clonorchis infection among the inhabitants was 7.5% on the average out of a total of 479 persons examined. The prevalence rate was 9.0% in the riverside area and 4.2% in the inland area. Among the schoolchildren, the prevalence rate was 1.1% out of a total of 1 319 examined. By area, it was 1.4% in the riverside area and 0.7% in the inland area. By sex, the prevalence rate was 13.3% in the male and 1.3% in the female in the inhabitants and no difference was seen in the schoolchildren. 2) In the natural transition of the infection, the prevalence rate in the inhabitants has decreased from 22.5% in 1967 to 7.5% in 1983, and in the schoolchildren, from 9.5% in 1967 to 1.1% in 1983. The reduction rate was higher in the riverside area than in the inland area. 3) In the prevalence rate by age, 1.2% was seen in the 10-14 age group and gradually increased to 8.1% in the 30-39 age group and reached peak 18.1% in the 40-49 age group. By sex, in the male, the prevalence rates have increased to 31.9% and 33.3% in the 40-49 and 50-59 age groups, respectively and decreased thereafter. In the female, the prevalence rate less than 5% was seen only in between the 10-14 and 30-39 age groups. 4) In the natural transition of the prevalence rate by age, sharp decrease was seen in the male from around 50% in 1967 between 15-19 and 30-39 age groups. The generation over 40s showed less decrease. In the female, the prevalence rate has decreased from 13% in 1967 to 5% in 1983 in the middle age groups and dropped to 0% in the rest of the age groups. 5) The intensity of the infection among clonorchiasis cases by mean EPmg (number of eggs per mg feces) value was 1.4. In the inhabitants, the value was 2.0 in the riverside area and 0.4 in the inland area. While in the schoolchildren, the value was 0.2 in both riverside and inland areas. 6) In the transition of the intensity of the infection, EPmg among the inhabitants has decreased from 3.9 in 1967 to 2.0 in 1983 in the riverside area, and from 2.9 to 0.4 in the inland area. In the schoolchildren, the reduction was similar in both riverside and inland areas resulting from 1.0-1.1 in 1967 to 0.2 in 1983. 7) In the intensity of the infection by age, EPmg 3.4 was peak at the 40-49 age group and 0.2-1.0 was seen in the rest of the age groups. The mean value was 1.5 in the male and 0.6 in the female. 8) In the natural transition of the intensity of the infection, the EPmg has decreased from 2.7 in 1967 to 1.4 in 1983. By age, reduction was seen in all of the age groups, particularly in the young and the old age groups of 50s and over, except in the 40-49 age group in which reverse phenomenon was seen. By sex, it has decreased from 3.5 in 1967 to 1.5 in 1983 in the male and from 1.0 to 0.6 in the female. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 70.3% of the cases were placed in the range of 0.1-0.9 as the most and 16.2% in 1.0-4.9 as the next. With such figures, those included in the range less than 0.9 as light infection were 78.4% and under 5.0-9.9 up to moderate infection 99.3% of the cases were covered. The cases were distributed up to 20.0-39.9 in the male and to 1.0-4.9 in the female. 10) In the transition of the distribution of the clonorchiasis cases by EPmg, the highest intensity reached up to 60.0-79.9 in 1967 and to 20.0-39.9 in 1983. In the range of light infection, under 0.1-0.9, the distribution in rate was 64.5% in 1967 and 78.4% in 1983. Up to the range of moderate infection, under 5.0-9.9, 91.7% in 1967 and 97.3% in 1983 were seen respectively. 11) In a survey for raw freshwater fish consumption among the local inhabitants,78.3 of the clonorchiasis cases interviewed admitted their experience of the raw consumption. However, those who practised in the past two years were 34.8% 55.6% of those who have such experience in the past professed that they did not practise raw freshwater fish consumption in the past two years. 12) The major cause of the reduction of the raw freshwater fish consumption among the inhabitants were the wide spread water pollution in the locality. The most common reason professed for stopping raw freshwater fish consumption among the inhabitants was the risk of the fluke infection. 13) In animal survey, 3.1% of dogs were found infected with Clonorchis, decreasing from 21.6% in 1967. 14) The distribution of the first intermediate host, Parafossarulus manchouricus has greatly diminished in this locality and found only in two localized ponds. No Clonorchis infection was found from the snails examined. 15) The second intermediate freshwater fish host has been further limited by extended water pollution. No susceptible fish host could be examined. 16) In conclusion, the endemicity of Clonorchis infection in Croyang Gun, low endemic area, has significantly decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the freshwater system of this locality. This has upset the ecosystems of the intermediate host of Clonorchis sinensis in many areas of waterbodies and further discouraged to a significant extent the local inhabitants from raw freshwater fish consumption.

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A Statistical Analysis of the Fereign Bodies in the Food and air Passages (식도 및 기도이물의 임상통계학적 고찰)

  • 정해영;권평중;박성준;민양기;김중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.4.1-4
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    • 1978
  • The foreign bodies in the food and air passages are frequently observed in the field of otolaryngology, and the foreign bodies in the air passages have much significance in clinical practice because they may cause sudden death. A statistical study was done on 95 cases of foreign bodies in the food and air passages who had visited department of otolaryngology, Chung-Ang university from June, 1968 to April, 1978. The results were as follows; 1. The total cases of foreign bodies in the food and air passages was 95; 89 cases (93.7%) were in the food passage and the remaining (6.3%) were in the air passage. The ratio between the food passage and air passage was about 14. 8 to 1.0. 2. In distribution by sex, 64 cases (67.4%) were in male patients and the remaining 31 cases (32.6%) were in female patients. The ratio between male and female was 2.1 to 1.0. 3. The kinds of foreign bodies in the food in the order of their frequency, were coin, gogame stone and pebble. In the air passages, the peanut and bean were most frequently found. 4. In distribution by age, 64 cases (67.4%) of all foreign bodies were found in children under 5 year old, and coin was the most common kind of foreign body. Except for meat, almost all of foreign bodies were found in children under 10 year old. 5. There was chronologically no significant tendency in incidence; the incidence, however, had decreased during recent 2 years. 6. In the location of foreign bodies in the food passage, 70 cases (78.7%) were found at the first esophageal narrowing. Meat was more frequently found at second esophageal narrowing associated with cicatrical stenosis. Almost all of foreign bodies in the air passage was found in bronchi; 3 cases were in the right side of bronchi, and 2 cases were in the left side of bronchi and 1 case was in glottic region. 7. In duration of lodgement, 50 cases (52.6%) visited our hospital within 24 hours, and 3 cases after 30 days. 8. Under topical anesthesia, 83 cases (93.3%) of the foreign bodies in the food passage were removed by esophagoscopy, by 6 cases (6.7%) failed to be removed. All of the foreign bodies of the air passages (6 cases) were removed by bronchoscopy. Among them, 5 cases under 5 years old were removed by inferior bronchoscopy through tracheostomy site.

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A Study on Mother's Feeding Practice in a Urban Apartment Area (일부도시(一部都市) 아파트지역(地域) 어머니의 수유(授乳)에 관(關)한 조사연구(調査硏究))

  • Lee, Sung-Shoe
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.167-177
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    • 1982
  • This study was undertaken to observe relationships between patterns of feeding, supplementary-feeding and various maternal, family, and socioeconomic charactereistics in Hae Cheog Apartment area in Cheongdam-dong, Kangnamku, Seoul on July 2 to 12 in 1982. The results were based on a questionnaire from 179 mothers who have the last-born child under two years old. Results were as follows: 1) In socio-demographic characteristics, most of mothers were 25 to 30 years old and 52.0% of index children were under 6 months old. About 56.0% of families were the salaries and 47.0% of them earn over 500,000 won a month. 40.8% of mothers were college graduates and 81.6% of mothers had no occupation. 2) 89.4% of mothers received prenatal care in pregnancy of the index children and mothers who have delivered the child in medical institute were 88.3%. Mothers who recieved education of breast care and feeding technique through prenatal care were 22.4%, 31.8% respectively. 3) In the feeding method, 44.1% of mothers took the breast feeding, 24.0% of them chose the artificial feeding, and 20.7% of them chose the mixed feeding. Mothers who changed the-method from breast feeding to artificial feeding were 10.6% and only 0.6% of mothers changed from artificial feeding to breast feeding. 4) According to the questionnaire, 37 mothers have already finished lactation (no relation with. the beginning of weaning food). In breast feeding, one mother has lactated for $4{\sim}6$ months, one has lactated for $7{\sim}9$ months, four have lactated for $10{\sim}12$ months, and seven have. continued the lactation over 12 months. In artificial and mixed feeding, as the same phenomenon, most of mothers have lactated for more than 12 months. 5) The reasons for feeding method were as follows: In breast feeding, 64.6% of them took the method because they thought the breast milk nutrious, in artificial feeding, 34.9% of them chose it because they had occupation and in the mixed feeding, 67.6% of mothers took the method because of lack of their breast milk. In the case of changing the method from breast feeding to artificial feeding, 42.1% of them answered that they had to change the method because of lack of breast milk. 6) In most of cases, the 4th month was the proper period to begin the weaning food and 32.5% of breast feeding children and 27.6% of artificial feeding children began the weaning food in 4th month. After 4th month, there was no difference between breast feeding and artificial feeding in the beginning of weaning food. 7) In the matter of menstruation, 29.8% of mothers who had breast feeding started their menstruations in 3 months and the rest of them delayed until 12 months. 40% of mothers who had artificial feeding began to menstruate after 2 months and all the rest started within 5 months. 8) The birth interval between the index child and next new child (would-be-born): In breast feeding, the interval of $18{\sim}24$ months had a majority as 50.0%, and in the artificial feeding, the interval of over 24 months marked 66.7% of them. It was analyzed that the birth interval of artificial feeding was wider than that of breast feeding. 9) In the desirable number of children, the mothers who had breast feeding wanted two sons and two daughters as proper children. Those who want two children in disregard of the sex (son or daughter) were 89.3% of breast feeding, and 80.0% of artificial feeding respectively. Mothers who had breast feeding wanted two children rather than one child. 10) In the family planning practice, the rate of practice were 41.9% in breast feeding, and 58.1% in artificial feeding respectively. In the case of breast feeding, the using rate of family planning practice in men was higher than in women.

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Ecological Studies on Several Forest Communities in Kwangnung. A Study of the Site Index and the ground vegetation of Larch (광릉삼림의 생태학적 연구 낙엽송의 Site Index와 임상식생에 관하여)

  • 차종환
    • Journal of Plant Biology
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    • v.9 no.1_2
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    • pp.7-16
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    • 1966
  • In order to determine the factors related to site quality, 13 areas of Larch growing in the Kwangung and its vicinity forest as sample plots, were examined. Sample plots included various site classes as well as age classes. Three were divided into two groups (major and minor trees). Average height of dominant trees was determined through messurement of 5 to 6 dominant tree in each sample plots. Average height of dominant 30 year-old trees was the basis for site index. A Standard Yield Table for the larch produced in Kwangnung forest was made by various data, which included age class 5, ranging from 10 to 45 years. The relationship of the height of the trees, the site conditions, and ground vegetation are investigated in this paper. The site indexes of 40 forest class age in 28-B and 28-G forest classes of the larch associations for ground vegetation had comparatively rarge differences due to the sampled areas. The relation of the direction of forest communities to the height and the diameter of the tree shwoed that its communiteis of northest and northwest parts appeared higher valueof the height and the diameter. The diameter and the height of trees were closely realted to each other. The samller the occupied area per tree and the smaller the average distance among trees, the more density was increased. The larger the density was the lower height of the trees. In the ground vegetation of the larch communities, there seems to be a definite correlation between the height of trees and the occupied area per tree or the average distance among the trees. The height of trees and site index of two larch communities were as follow: 28-B forest class site index 20.8, height 24.0m, 28-G forest class site index 18.4, height 20.9m. The ground layer was analyzed by the method of Quadrat(20/20sq. cm) with an interval of 1M. It set up 40 Quadrats of the larch communiteis. The community structure of the ground vegetation of two larch was analyzed, and important value was calculated and then evaluated. The ground vegetation under the larch had developed Burmannii Beauv stratal society below the 28-B and 28-G the forest class. Accordingly, the first important value of Burmannii Beauv was found in two ground vegetation below the larch. Therefore, this species could be quantitatively considered as the forest indicator species. Common species of each community appeared 18 species out of 34 species in the ground vegetation under two larch communities. The ground vegetation of the 28-B forest class showed more than that of the 28-G forest class. the similarity of the ground vegetation was measrued by the Frequency Index Community Coefficient. The differences between the associations were lcearly manifested by the ground vegetation tested by Gleason's Frequency Index of Community Coefficient for the analysis of each stratal society of all associations. According to F.I.C.C. the ground vegetation under two larch(28-B and 28-G) forest classes showed higher value. An investigation into the relationship of physical and chemical properties of soil and site was considered the next step to be taken in the study of the larch site classification.

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Clinical Presentations and Causative Organisms in Children and Adolescents with Osteoarticular Infections: A Retrospective Study (소아청소년기에 발생한 골관절염의 임상 양상 및 원인균에 대한 고찰)

  • Lee, Soyoung;Kim, Han Wool;Cho, Hye-Kyung;Yun, Yoe Hon;Ryu, Kyung Ha;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.154-163
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    • 2015
  • Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.