Baek Seung Lee | 3 Articles |
Background
: Aseptic meningits is caused, for the most part, from viruses. Reports say that over 85% of its cause is from enterovirus and some of the rest from arbovirus, mumpsvirus, herpes simplexvirus, etc. Due to well-developed antibiotics, most recently, the proportion of aseptic meningitis to all meningitis has showed a rise trend, so that high contrat rate still has been proved epidemic in accrdence with causative viruses. Thereupon, we experienced 120 cases diagnosed aseptic meningitis among the patients who were hospitalized at the pediatric deparment, Jeong Eup Hospital, Asan Foundation, Jeon Ra Peuk Do in the middle of 1993, so we report the clinical observation and the literature on the subject. Methods : While working as the pediatric chief physician, We wrote examination reports and medical affairs records about the 120 cases diagnosed aseptic meningitis based on clinical findings and negative fidings on CSF Gram & AFB stain & culture with sensitive test among the patients hospitalized numerously in this area. Age and sex distribution, attack frequency in date, duration between onset of symptom and admission, duration of fever and admission, laboratory findings, clinical prognosis, and therapeutic result were analized based on the above mentioned examination reports and medical affairs records. Results : Aseptic meningitis in this area broke out numerously to be bimodel during the middle third and the last third of May and during the middle third and the last third of June. The rate of concurrent attack in family was 8 famillies among 112 families(7.1%). The rate of male to female was 1.7:1, so male was found to be vulnerable. Most common age was 1~5 years(46.7%h, main clinical ymtom was fever(98.3%), headache(47.5%), nausea(46.7%), pain on lower extremity(24.2%), pain on neck(22.5%), and skin rash(17.5%) in order. With peripheral blood laboratory findings, 52% of 120 cases had 10,000/mm³ or more of WBC which is called leukocytosis. 50% were found to keep 60% or more of neutrophils on percentage of WBC, 54.2% kept 40% or less of lympocytes, 74.2% showed 20 mm/hr or more of ESR, and 27.5% showed positive in CRP. In addition, with CSF, 44.2% showed 500/mm³ or more of WBC, to our suprise, 17.5% showed 1,000/mm³ or more of WBC, 90% of former example showed lymphocytosis. 15% showed 40mg/dl or more of protein which was increased level, only 2.5% showed 40mg/dl or less of sugar with which almost all were normal. The average duration between onset of initial symptom in which fever is primary symptom and admission was 3.8days. Becasuse the average duration of hospitalization was 13.5 days, we estimated that the average febile duration of aseptic meningitis is about 8 dyas and therapeutic duration is about 17 days. Conclusion : Almost all aseptic meningitis patients who had clinical symptom of fever, headache, vomiting, abdominal pain, etc and showed WBC(especially lymphocyte) increment on CSF, proved normal in sugar, but protein was increased with 15%, With fluid replacement and bed rest using symptomatic care, antipyretics and antibiotics to prevent secondary infection, the patients were cured completely without complication.
Background
: The number of the aged in rural community is recently increasing according to the development of social, economical and medical field has contributed to prolong life expectancy and the younger nowadays are moving into urban areas. This team study aims to focus on the influence of family resources upon family function through their family APGAR score by examining their family backgrounds : whether their spouses are alive or not, of what type their family is, whether they live together with their children or not, now many they are living with, if any, and much living expenses is, etc. Methods : This research is based on the questionnaires for 129 inpatients over 65 year old in Jung-Up and Bo-Sung Hospital of Asan Foundation during the period from Nov.1, 1993 to Feb. 28, 1994 and 100 healthy old people living near the above hospitals in the same villages. We have examined their influence on the family function by comparing the mean scores of each item of the family APGAR questionnaires with that of those concerning the type and affinity of family resources. The investigation has been made simultaneously by the attending physicians for the inpatients and by our team for the ordinary healthy group. Results : Mean family APGAR scores for each group show a meaningful difference as follows : the inpatients' 4.25±2.85 family APGAR was, the healthy's family APGAR was 5.66±1.78(P<0.001). The amount of living costs does not affect the family APGAR score between inpatient and healthy groups. In comparison between the old with their spouse and the spouseless, the result shows a significantly high old one whose spouse is alive(Inpatient;P<0.001, Healthy ; P<0.05), and we got the lower score in a single one whose duration of being single is longer(Inpatient ; P<0.01, Healthy ; P<0.001). In view of the existence of any family member, the old who live alone(single family show a low score than who live with their spouse, child or both(P<0.001). But the old who live with their spouse, with children or with both does not show any meaningful difference in the Family APGAR score among them(Inpatient; P>0.05, Healthy ; P>0.05). Conclusion : Through this study, the amount of living expenses reflects little influence upon the family APGAR score, but whether live with(regardless spouse, their child or both) or without, whether their spouse are allive or not, and in case if widower or widow(spouseless), the duration of being single reflect much more influence upon the family function. The spouse group shows better family function(P<0.05) than the spouseless group and family function lessens when the death of one's spouse marks a longer period and the living alone(single family) comparatively convey lower family function.
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