• 보건세계
• /
• v.56 no.6
• /
• pp.19-23
• /
• 2009

외래에서 흔히 이용하는 결핵 진단법으로는 객담 도말과 배양검사, 엑스선 검사가 있다. 일단 활동성 결핵으로 진단되면 환자의 과거력 등을 참조하여 치료를 하게 되는데, 초치료인 경우 아이나, 리팜핀, 에탐부톨, 피라진아마이드를 이용한 6개월 단기 초치료 처방으로 치료를 한다. 4제 처방의 효과는 강력하여 규칙적으로 약을 복용한다면 대부분 완치되며, 완치 판정은 치료 중 추구 객담검사를 이용한다. 대부분의 환자들은 진단, 치료에 어려움이 없지만 실제 외래 치료시에는 진단, 치료에서 어려운 문제가 발생하기도 한다. 이에 외래에서 부닥칠 수 있는 상황과 적절한 대처법을 알아보기로 한다.

• 보건세계
• /
• v.50 no.3 s.559
• /
• pp.38-41
• /
• 2003

• 전기의세계
• /
• v.1 no.12
• /
• pp.1-2
• /
• 1958

• 전기의세계
• /
• v.1 no.7
• /
• pp.1-2
• /
• 1958

• 전기의세계
• /
• v.1 no.8
• /
• pp.1-4
• /
• 1958

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.5
• /
• pp.709-719
• /
• 2000

Background : The different features of high-resolution CT(HRCT) findings of active pulmonary tuberculosis(TB) were studied between acid fast bacilli(AFB) smear or culture positive and negative group. Methods : We prospectively evaluated 36 patients who had been confirmed for active pulmonary tuberculosis by the smear or culture of AFB in sputum(n=25), and changes on serial chest radiographs(n=11). The patients were divided into 3 groups by the results of sputum AFB stain and culture. Group 1(n= 11) is negative in both AFB stain and culture; group 2(n=13) is negative in AFB stain but positive in culture ; and group 3(n=12) is positive in both AFB stain and culture. We evaluated the findings of HRCT in each group randomly. Result : On the HRCT scans, acinar nodule(100%), macronodule(75%), and cavity(75%) in group 3 were more frequently found than group 1(63%. 18%, 9%) and group 2(46%, 15%, 23%)(p<0.05). The centrilobular nodule and branching structure were more frequently observed in group 3(92%) than in group 1(54%)(p<0.05), but were similarly observed in group 2(77%)(p>0.05). AFB positive group was statistically different than the negative group in the HRCT findings with to acinar nodule(100% vs 54%), macronodule(75% vs 17%), and cavity(75% vs 17%)(p<0.05). TB culture positive group was statistically different than the negative group in the HRCT findings with respect to acinar nodule(72% vs 45%) and cavity(48% vs 9%)(p<0.05). Conclusions : HRCT scans are helpful in determining disease acitivity in sputum AFB stain-negative pulmonary tuberculosis. When HRCT shows centrilobular nodule and branching structure, acinar nodule, macronodule, cavity, further studies as sputum induction and bronchoscopy can be performed to determine the presence of bacilli in patients of AFB stain-negative tuberculosis.

• Journal of Biomedical Engineering Research
• /
• v.23 no.3
• /
• pp.235-241
• /
• 2002

The detection of tubercle bacilli (TB) from sputum smear is one of the fast and inexpensive methods for diagnosis of tuberculosis. For this method. sputum smears are usually flexed by heating and stained by acid-fast staining method, and then examined under an optical microscope. Two Procedures are commonly used fur TB staining. One is hot staining and the other is cold staining method. The Ziehl-Neelsen method which is a hot staining method is widely used in Korea because its stained color is more vivid However, the conventional automated stainer has to fix the sputum smear on a slide manually and the stain is not so vivid because it has not heating function. In an effort to save labor and minimize variations in manual staining Procedure. we developed an automated stainer with heating function. The entire staining process is fully automated. from fixation to final washing and drying. With the automated methods, five slides can be flexed and stained in 21 minutes at consistent high quality We compared the concordance rate between the two methods for 91 sputum samples to validate the stain quality of the developed automated stainer. As the results, the concordant rate between the two methods was 95% and there was no significant difference (p>0.05)

• The Korean Journal of Nuclear Medicine
• /
• v.34 no.2
• /
• pp.129-134
• /
• 2000

Purpose: It is difficult to determine the activity of tuberculosis radiologically. Therefore there have been efforts to assess the activity using radiopharmaceuticals such as $^{67}Ga,\;^{99m}Tc-tetrofosmin,\;and\;^{99m}Tc-MIBI$. But there may be some discrepancy in defining the term 'activity' between clinicians and nuclear physicians. While negative conversion of sputum acid fast bacilli (AFB) is defined as 'disappearance of activity' by clinicians, a loss of uptake in previously positive lesion is accepted as 'disappearance of activity' by nuclear physicians. We designed a prospective study to see if the negative conversion of sputum AFB could directly match the disappearance of radioactivity of the lesion. Materials and Methods: Fifteen patients with bacteriologically confirmed active localized pulmonary tuberculosis were scanned 10 and 60 min after intravenous injection of 550 MBq $^{99m}Tc$-MIBI. In 6 patients, who showed negative conversion of sputum AFB after 3-7 months of chemotherapy, $^{99m}Tc$-MIBI scan was repeated. For the purpose of comparison, target/nontarget ratios of the lesions were determined. Results: 12/15 (80%) patients with active pulmonary tuberculosis showed increased uptake of $^{99m}Tc$-MIBI in tuberculous lesion. After negative conversion of sputum AFB, 5/6 (83%) patients still showed increased uptake, although the intensity of uptake decreased. Conclusion: Uptake of radioactivity decreased but did not disappear after negative conversion of sputum AFB. $^{99m}Tc$-MIBI scan may be useful to address the degree of inflammation of pulmonary tuberculous lesion, but the uptake did not directly match the activity defined by positivity of sputum AFB. We nuclear physicians might have used the term 'activity' somewhat differently from clinicians who treat patients with tuberculosis.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.2
• /
• pp.151-159
• /
• 2006

Background : Excision repair cross complementing gene 1 (ERCC1) not only has a protective role against carcinogens, but plays an important role in cisplatin-resistance via the repair of cisplatin-DNA adducts. This study investigated the association between the ERCC1 expression levels in sputum and survival after cisplatin-based chemotherapy in patients with inoperable non-small cell lung cancer (NSCLC). Methods : Using the sputum collected from 67 inoperable (stage IIIa-IV) NSCLC patients treated with either taxanes (33 cases) or gemcitabine (34 cases) plus cisplatin, the relative expression levels of ERCC1 and the expression of the tumor specific antigen, MAGE, were examined by the quantitative RT-PCR and RT-PCR, respectively. The response and survival were compared with the relative level of ERCC1 or MAGE expression and the treatment modality. Results : In the sputum, ERCC1 and MAGE was detected in 74.6% and 40.2% of patients, respectively. Using the median ERCC1 level, the patients were classified as having high or low ERCC1 expression. The median overall survival (MST) was significantly longer in patients with a high ERCC1 expression level than those with a low expression level (84 weeks vs. 44 weeks respectively, P=0.017). In the taxene-based treatment group, the MST was longer than the gemcitabine group (79 weeks vs. 47 weeks, respectively, P=0.03). The levels of ERCC1 were significantly higher in patients who were MAGE-positive (P=0.003). In the MAGE-negative patients, the MST was longer in the high ERCC1 group (103 weeks vs. 43 weeks, P=0.008), but not in the MAGE-positive patients (62 weeks vs. 44 weeks, P=0.348). Conclusion : ERCC1 expression in the sputum can be a prognostic factor for survival after chemotherapy in patients with inoperable NSCLC.

• Tuberculosis and Respiratory Diseases
• /
• v.56 no.4
• /
• pp.348-355
• /
• 2004