An epidemiological and clinical study of leptospirosis acquired by twelves combat policemen in september, 2000 / 대한내과학회지

BACKGROUND: There were two occurrences of typhoon and the floods in Korea from early to late September, 2000. The Korean Combat Police and policemen participated in cleaning activities at the flooded area. Leptospirosis broke out among these participants. This study describes the epidemiological and clinical characteristics of leptospirosis patients among policemen. METHODS: Of 16,750 individuals involved, 3,752 subjected to passive hemagglutination antibody (PHA) test at the Regional Health Care Units or the National Police Hospital. With 1 case of dead plus 12 cases which were turned out to be seropositive by PHA test and confirmed by microagglutination (MA) test, epidemiological and clinical characteristics were studied by questionnaire survey, laboratory test, and history of treatment while being hospitalized. RESULTS: The seropositive rate of leptospira antibody was 0.3% (12/3,752). All 12 seropositives were bare-footed while working at the flooded area and of these, 8 patients (67%) were noticed abrasions either on hand or feet. However, no statistically significant correlation was found between the duration of outdoor activity and the seropositive rate (r=-0.46, p=0.36). There were clinical difference among patients who has the same serotype of leptospirosis, physical conditions, circumstance and the same work area. Two abnormal EKG results are present, the one who complained of chest pain is myocardial ischemia and the other who didn't complain of any symptoms is sinus pause. Correlation between the febrile period before and the duration of fever after the use of antibiotics was estimated as; febrile period after antibiotics use = 0.102804 + 0.995327 x febrile period before antibiotics use (p=0.058). CONCLUSION: When leptospirosis is related to group activities, it is possible to educate in advance and to manage systematically afterwards, it may prevent the occurrence of leptospirosis or the related complications.

A Case of Alport's Syndrome in an Adult / 대한신장학회잡지

Alport's syndrome is a hereditary disorder whose incidence is 1 in 10,000 in general population, and, majority are developed in childhood, so it is rare to develop in adults. This syndrome consists of hematuria, sensorineural hearing loss, and lenticonus, in classic form. However, there are many atypical forms which have not all clinical manifestations. Although most asymptomatic hematuria in adults results from IgA nephropathy(Berger's disease) or thin basement disease(benign hematuria), Alport's syndrome should be considered as a cause of hematuria. The authors experienced a case of Alport's syndrome in a 21-year-old man who showed only hematuria and proteinuria, and who was diagnosed by history, family history, audiogram, and kidney needle biopsy. So, we report this case with a review of literature.