• Title/Summary/Keyword: 객담

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Relation between Capacity Change of Ephedrae Herba and Sputum Secretion In Two Stroke Patients with High Levels of Sputum (객담을 동반한 중풍 환자에 마황량과 객담 배출 변화에 관한 보고 -정천탕, 해표이진탕을 이용하여-)

  • 노기환;강경숙;조기호;김영석
    • The Journal of Korean Medicine
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    • v.22 no.1
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    • pp.96-103
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    • 2001
  • Clinical symptoms of stroke patients vary widely, and include headache, dizziness, vomiting, dysphagia, dysphasia, incontinence, confusion, chest discomfort, dyspnea etc. Stroke patients who had chronic respiratory disease or had tracheostomy cannula usually have high levels of sputum, but there have been rare clinical reports about treatment of oriental medicine. High levels of sputum in stroke patients can cause pneumonia and dyspnea, and so can delay rehabilitation. By use of Haepyoleejin-tang.Jungchun-tang with change of Ephedrae Herba capacity, we could improve sputum secretion and respiratory function of two stroke patients, and so we report on the clinical course of two stroke patients with high levels of sputum.

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기생충 관리-기생충, 무검사 투약은 이래서 무섭다

  • Lee, Jun-Sang
    • 건강소식
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    • v.11 no.9 s.106
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    • pp.30-32
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    • 1987
  • 디스토마증을 확진하려면 우선 피내반응검사를 실시하여 양성 반응이 나오면 대변이나 객담검사에서 충란을 발견하고 투약토록 되어 있는데 무조건 독한 약만 복용한다면...

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Report of Four Cases of Pulmonary Pseudallescheriasis from Korea (폐(肺) Pseudallerscheria증(症) 4례(例))

  • Kim, Sang-Jae;Hong, Young-Pyo;Kim, Sin-Ok;Yoon, Young-Ja
    • The Journal of the Korean Society for Microbiology
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    • v.18 no.1
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    • pp.99-110
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    • 1983
  • Four cases of pulmonary pseudallescheriasis in patients with healed pulmonary tuberculosis are described. All four patients had a long history of antituberculous chemotherapy for pulmonary tuberculosis, but continuous sputum negativity for acid fast bacilli indicated apparent recovery from tuberculosis. They, however, complained continued intermittent hemoptysis and chronic cough. Although their chest roentgenograms did not show a clearcut mycetomal shadows in preformed cavitary lung lesions, Pseudallescheria boydii or Scedosporium apiospermum was repeatedly isolated from serial sputum specimens collected at different days for a period of over half an year or two years and their serial serum specimens produced precipitin bands with home-made antigen from 8-week old culture filtrate of P. boydii. Second fungus was isolated from sputum specimens of two patients and one was Candida albicans and the other was Aspergillus fumigatus. Sera from both patients reacted with antigens of those second fungi. Unfortunately pulmonary function of three patients did not allow surgical excision of the infected area and one patient refused surgery.

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Nuclear Factor-κB(NF-κB) Activity and Levels of IL-6, IL-8 and TNF-α in Induced Sputum in the Exacerbation and Recovery of COPD Patients (만성폐쇄성폐질환의 급성악화와 회복기에서 유도객담 내 Nuclear Factor-κB(NF-κB)의 활성도와 IL-6, IL-8 및 TNF-α의 농도 변화)

  • Song, So Hyang;Kim, Chi Hong;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.152-159
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    • 2005
  • Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the $NF-{\kappa}B$ is known to be an indicator of cellular activation and of inflammatory mediator production. This study was undertaken to investigate the change of cytokine characteristics and $NF-{\kappa}B$ activity in induced sputum of COPD patients during exacerbation and recovery of the disease. Methods : Sputum induction was performed in 37 patients with COPD during exacerbation and during recovery and in 15 healthy subjects. Cell counts, levels of IL-6, IL-8 and $TNF-{\alpha}$ in induced sputum and NF-kB activity in macrophage of induced sputum were measured. Results : Patients with COPD showed significantly increased levels of IL-6, IL-8 and $TNF-{\alpha}$(p<0.01) and increased $NF-{\kappa}B$ activity in induced sputum(p<0.05) as compared with control subjects. Level of IL-8 during exacerbation of COPD decreased significantly during recovery(p<0.05). $NF-{\kappa}B$ activity and levels of IL-6 and $TNF-{\alpha}$ tended to be decreased during recovery, but not siginificantly. Conclusion : Activation of $NF-{\kappa}B$ and increased levels of IL-6, IL-8 and $TNF-{\alpha}$ were thought to be associated with pathogenesis and exacerbations of COPD.

CT Findings Related to Negative Results of Sputum Smear in Patients with Active Pulmonary Tuberculosis having Multiple Cavities (여러 개의 공동이 있는 활동성폐결핵 환자에서 객담도말검사 음성과 관련된 CT 소견)

  • Lee, Hwa Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.374-381
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    • 2007
  • Background: This study evaluated which CT findings could be used to predict the negative results of a sputum smear in patients with active pulmonary tuberculosis and multiple cavities. Methods: Thirty-eight patients with active pulmonary tuberculosis and multiple cavities on CT were classified into 2 groups: smear-positive (n = 30) and -negative (n = 8). The CT findings were reviewed retrospectively. The maximum internal diameter of the largest cavity, the number of the cavities and lobes with cavities, and the characteristics of the associated findings such as consolidation, ground glass opacity, micronodules and nodule were accessed. The number of cavities above 20 mm in the maximum internal diameter and a necrotizing pneumonia-like pattern were also evaluated. Result: The maximum internal diameter and number of cavities was $32.23{\pm}17.66mm$ and $15.50{\pm}11.12mm$ (p = 0.0042), and $5.53{\pm}3.17$ and $2.43{\pm}1.13$ (p = 0.0002) in the smear-positive and -negative group, respectively. Three or more cavities were observed at 76.7% and 12.5% in the smear-positive and -negative group, respectively (p < 0.005). There were $2.00{\pm}1.34$ and $0.25{\pm}0.46$ (p = 0.001), and $1.5{\pm}1.50$ and $0.38{\pm}0.52$ (p =0.0016) lobes with consolidation and ground glass opacity in the smear-positive and -negative group, respectively. A necrotizing pneumonia-like pattern was observed in 43.3% of the smear-positive group only. The other findings were similar in both two groups. The sensitivity, specificity, positive and negative predictive value for the presence of at least a finding of consolidation, more than 3 cavities or the largest cavity > 20 mm in the maximum internal diameter were 100%, 62.5%, 90.9%, and 100%, respectively. Conclusion: Two cavities 20 mm or less in the maximum internal diameter without consolidation on CT might be associated with a negative result of the sputum smear in patients with active pulmonary tuberculosis and multiple cavities.

The Usefulness of PCR Study in AFB Smear Negative Patients on Admission (내원시 항산균도말검사상 음성인 환자에서 실시한 PCR검사방법의 유용성에 대한 연구)

  • Kim, C.S.;Son, H.D.;Park, M.R.;Seo, J.Y.;Cho, M.D.;Rheu, N.S.
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1001-1010
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    • 1997
  • Background : PCR technique is useful in diagnosis of pulmonary tuberculosis. But, its sensitivity and specificity is some different among several studies. Our aim is compare our PCR results with other's previous PCR results in AFB smear negative patients. Methods : PCR were performed in patients that their disease were suspected as active pulmonary tuberculosis and that their initial serial sputum AFB smear results were negative. Total number of patients studied by PCR technique was 177. Also, we analyzed the data only in patients whose bronchial washing fluid AFB smear was negative. And the primer had been used was IS 6110. Results : In our retrograde study, the number of patients who are diagnosed as having active pulmonary tuberculosis, inactive pulmonary tuberculosis and nontuberculous pulmonary disease was 99, 28, 50, respectively. In the sputum study, the sensitivity of PCR is 41.5% (27 PCR positive cases/65 active TBc cases). And the sensitivity of TB culture is 53.8% (35 TB culture positive cases/65 active TBc cases). In the bronchial washing specimen study, the sensitivity of PCR is 53.8% (21 PCR positive cases/39 active TBc cases). And the sensitivity of TB culture is 43.6% (17 TB culture Positive cases/39 active TBc cases). The specificity of PCR in our study is 94.9%. (74 PCR negative cases/78 inactive TBc or nontubereulous cases) In the cases of patients who were never takened anti-TBc medication, the sensitivity of PCR (45.6%--25 positive cases/55 cases) is some lower than culture (58.2%--32 positive cases/55 cases). In the cases of patients who had been takened anti-TBC medication. the sensitivity of PCR (60%--18 positive cases/30 cases) is some superior than culture (50%--15 positive cases/30 cases). Conclusion : We think that PCR results in cases of sputum AFB smear negative patients is nearly same as culture. And PCR is especially useful in patients who had been takened anti-TBc medication on admission.

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Evaluation of Peptide Nucleic Acid Probe-Based Fluorescence In Situ Hybridization for the Detection of Mycobacterium tuberculosis Complex and Nontuberculous Mycobacteria in Clinical Respiratory Specimens (임상 객담검체에서 Peptide Nucleic Acid Probe를 이용한 결핵과 비결핵 항산균의 구분)

  • Lee, Seung Hee;Kim, Shine Young;Kim, Hyung Hoi;Lee, Eun Yup;Chang, Chulhun L.
    • Annals of Clinical Microbiology
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    • v.18 no.2
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    • pp.37-43
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    • 2015
  • Background: Tuberculosis is globally the most important cause of death from single pathogen. Rapid and accurate identification of mycobacteria is essential for the control of tuberculosis. We evaluated a fluorescence in situ hybridization (FISH) method using peptide nucleic acid (PNA) probes for the differentiation of Mycobacterium tuberculosis complex (MTB) and nontuberculous mycobacteria (NTM) in direct smears of sputum specimens. Methods: The cross-reactivity of MTB- and NTM-specific PNA probes was examined with reference strains of M. tuberculosis ATCC 13950, Mycobacterium kansasii ATCC 12479, Mycobacterium fortuitum ATCC 6841, several clinical isolates of mycobacteria (Mycobacterium abscessus, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium gordonae and Mycobacterium chelonae), and 11 frequently isolated respiratory bacterial species other than mycobacteria. A series of 128 sputa (89 MTB culture positive, 29 NTM culture positive, and 10 under treatment culture negative) with grades of trace to 4+ were used to evaluate the performance of the method. Results: The MTB- and NTM-specific PNA probes showed specific reactions with the reference strains of MTB and M. kansasii and clinical isolates of mycobacteria except M. fortuitum ATCC 6841, and no cross-reactivity with other tested bacteria. The PNA probe-based FISH assay for detection of MTB had a sensitivity and specificity of 100%, respectively. The sensitivity and specificity of the NTM-specific PNA probe was 100%. The smear grades of the PNA FISH test were same as with those of the fluorescence AFB stain in 2+ or higher grade. Conclusion: Detection and differentiation based on PNA FISH is sensitive and accurate for detecting mycobacteria and for differentiating MTB from NTM in clinical sputum smears.

Fungal Complications in Patients with Pulmonary Tuberculosis or Other Lung Diseases (폐결핵(肺結核)이나 기타 폐질환환자(肺疾患患者)에서의 진균(眞菌) 합병증(合倂症))

  • Kim, Sang-Jae;Hong, Young-Pyo;Kim, Sin-Ok
    • The Korean Journal of Mycology
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    • v.16 no.1
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    • pp.26-32
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    • 1988
  • A total of 1,192 patients, who complained a continued chronic cough, suptum or occasional hemoptysis, in spite of successful completion of antituberculous chemotherapy or had some suspected fungal infection, were included. Serum specimens were collected from all the patients studied and sputum or other specimens collected and cultured from the most of the patients. 405(34.0%) cases of the total patients studied showed a positive precipitin reaction to the one or more of the fungal antigens on immunodiffusion tests and 303 cases of them were found to have been infected with Aspergilli, of which Aspergillus fumigatus was involved in 287 cases, followed by Aspergillus flavus(1.7%), Aspergillus nidulans(0.3%), Aspergillus niger(0.3%) and Aspergillus nidulans var. latus(0.1%). pricipitin antibodies were produced to Candida al­bicans(8.1%) and Pseudallerscheria boydii(0.8%). In the chest radiographs of 186 precipitin positive patients, distinct fungus ball shadows were seen in 47 cases and 45 cases of them were formed by A. fumigatus. The isolates from sputum specimens of 724 patients were aspergilli which were consisted of the 46.4% of the total fungal isolates. Identification of 137 yeast like fungi from the sputum specimens of 413 patients revealed that C. albicans(64.2%) was a commonest yeast flora.

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Evaluation of Liquid Culture System in Sputum Culture and Drug Susceptibility of Mycobacterium tuberculosis (고위험병원체 결핵균의 신속진단을 위한 액체배양시스템 평가)

  • Kim, Jin-Sook;Kim, Seung-Cheol;Jeon, Bo-Young;Park, Seung-Kyu
    • Korean Journal of Microbiology
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    • v.45 no.3
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    • pp.281-285
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    • 2009
  • In this study, we compared the BacT/Alert liquid culture system with Ogawa and $L\ddot{o}wenstein$-Jensen (L-J) media for sputum culture and drug susceptibility test (DST) of Mycobacterium tuberculosis. Rapid liquid culture systems have been widely employed both for primary cultures of M. tuberculosis from clinical specimens and for drug susceptibility test because of its greater sensitivity and faster turn-around time than the conventional egg-based culture methods (Ogawa, $L\ddot{o}wenstein$-Jensen media). Sputum specimens were decontaminated with N-acetyl-L-cysteine (NALC)-4% NaOH and inoculated into the BacT/Alert culture bottles and Ogawa media. 95 from among 135 sputa were smear-positive, 97 (71.9%) were culture-positive by the BacT/Alert culture system, while 89 (65.9%) were positive by Ogawa media. The mean time to culture-positive by the BacT/Alert process system was about 11.3 days, which was significantly shorter than that by Ogawa media (22.4 days). Of 32 M. tuberculosis cultures examined for drug sensitivity, the concordant rate between the two methods (BacT/ Alert liquid culture system, $L\ddot{o}wenstein$-Jensen media) ranged from 87.5% for isoniazid and 90.6% for rifampicin.