• Title/Summary/Keyword: 결핵관리

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Factors Affecting on the Work-related Performance Level of TB Control Manpower (결핵관리전담요원의 업무수행정도와 영향요인)

  • Lee, Jin Beom;Kim, Young Im;Choi, Sook Ja;Choi, Young
    • Korean Journal of Occupational Health Nursing
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    • v.23 no.4
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    • pp.254-261
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    • 2014
  • Purpose: The purpose of this study was to investigate the degree of performance of TB control manpower in Korea and to identify the affecting factors associated with it. Methods: This study employed a quantitative observational with cross-sectional design and the subjects were consisted of 189 TB (Tuberculosis) control manpower who were working in both community health centers and private hospitals. Variables included in this study were demographic, social, work-related characteristics, aqhnd self-efficacy. A reliability of the instrument for the performance was Cronbach's ${\alpha}$=.91. Data were analyzed by t-test, ANOVA and multiple regression using SPSS (19th version). Results: The mean value of the degree of work-related performance of TB control manpower was $4.4{\pm}0.49$9 and it was higher than those of general nurses working in any other health care departments. The mean differences in the degree of work-related performance were in self-efficacy, workplace, the number of full charge manpower in TB, the number of participation in in-depth education, and the willingness to job maintenance. In multiple regression analysis, factors associated with TB control manpower' work-related performance were self-efficacy (${\beta}$=.164, p=.025), workplace (${\beta}$=-.186, p=.023), the number of participation in in-depth education(${\beta}$=.339, p<.002), and the willingness to job maintenance (${\beta}$=-.157, p=.036). Conclusion: Results of this study showed that work-related performances of manpower working in private hospital were higher than those of manpower in public health centers. So, it is necessary to enhance nation's active intervention to improve effectiveness and reduction of risk factors in TB policy.

The Analysis of Risk Factors of Pulmonary Tuberculosis Patients Failed in Retreatment (재치료실패 폐결핵 환자의 위험인자 분석)

  • Kim, Hyoung-Soo;Lee, Won-Jin;Kong, Seok-Jun;Shon, Mal-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.684-690
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    • 2000
  • Background : The most common cause of treatment failure of pulmonary tuberculosis is early stoppage of treatment or irregular medication. The most important aspect of a retreatment is regular medication provided over a long period. Inadequate treatment may cause drug resistance and prolong the duration of chemotherapy. This study analyzed the risk factors of pulmonary tuberculosis patients, who failed in retreatment, and to use the results as basic data in the management of intractable tuberculosis patients with improving the rate of retreatment success. Methods : We performed a retroactive study of 62 pulmonary tuberculosis patients in retreatment at National Mokpo Tuberculosis Hospital from Jan. 1994 to Dec. 1995. The patients were separated into two groups: group I was retreatment failure and group II was retreatrnent success. For the analysis of risk factors in retreatment failure, we compared the difference between the two groups and tested the confidence limit about results of the results by independent t-test, ${\chi}^2$ test and Fisher's exact test. Results : The treatment failure rate of retreatment patients was 13(21%), and treatment success 49(79%). No significant difference (p>0.05)in age, sex, number of treatment, irregular rate of treatment, extent of the disease & cavitary lesion on the chest X-ray, number of resistance drugs, number of used drugs to medication, number of sensitive bactericidal drugs to medication, rate of sensitive drugs to medication and resisiance to INH & RFP had not significant difference. was found. However, the number of treatment was $2.4{\pm}0.8$ in group I and $1.6{\pm}0.9$ in group II, and had showing a significant difference(p<0.05) between the two groups. Conclusion : The risk factor of retreatment failure was more irregular previous treatment the irregularity of the previous treatment. For reducing the retreatment failure of pulmonary tuberculosis, greater efforts are needed more need to be done to prevent failure of first treatment.

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A Study on the Characteristics of Tuberculosis Control System Using Markov Processes (마르코프 과정을 이용한 결핵 관리 특성에 관한 연구)

  • Chong, Hyeng-Hwan;Joo, Soo-Won;Kim, Hae-Jae
    • Journal of Biomedical Engineering Research
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    • v.9 no.2
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    • pp.159-164
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    • 1988
  • This thesis investigates the Quantitative aspect of epidemic phenomena utilizing the analytical method of discrete time systeMs based on the theory of Markov processes. In particular, the pattern on the epidemic character of turberculosis controlled by prophylaxis and BCG vaccinatioll was analyzed by the markovian model of tuberculosis system which is derived according to the ecologic relationship between nine epidemiologic states of individuals. The quantitative aspects of the model were characterized by digital computer simulations.

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Rapid Drug Susceptibility Testing for Isoniazid and Rifampicin by Reverse Hybridization Assay (역교잡반응법을 이용한 아이소니아지드 및 리팜피신 신속감수성검사)

  • Park, Young Kil;Yu, Hee Kyoung;Ryu, Sung Weon;Bai, Gill Han
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.440-448
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    • 2003
  • Background : Development of rapid drug susceptibility testing provides the opportunity for rapid identification of individuals with drug resistant tubercle bacilli, allowing selection of appropriate therapeutic regimens. Methods : A total of 502 drug resistant isolates were subjected to reverse blot hybridization assay to detect mutations within genes (rpoB, katG, inhA, and ahpC) associated with rifampicin (RMP) and isoniazid (INH) resistance. Results : Among the 264 RMP resistant strains ($RMP^R$) tested, the most prevalent mutation was the Ser531Leu seen in 121 strains (46%). The second common mutation occurred in 84 strains (32%) at codon 526. And 27 strains (10%) showed the mutation at codon 516. Among all 469 INH resistant strains ($INH^R$), the katG mutation was responsible for INH. The inhA mutation was present in 88 strains (19%). In 11 isolates (2%), coexisting of the katG and inhA mutations were identified. Reverse hybridization assay successfully detected over 80% of $INH^R$ and over 92% of $RMP^R$ among Korean isolates. CONCLUSION: Reverse hybridization was useful for rapid detection of $INH^R$ and $RMP^R$.

The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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The Status of Infection for Infectious Diseases and Status of Infection Control in Occupational Therapy - Focusing on Busan (작업치료실의 감염 실태와 감염예방 관리 실태 : 부산지역을 중심으로)

  • Jung, Nam-Hae;Bae, Won-Jin
    • The Journal of Korean society of community based occupational therapy
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    • v.6 no.2
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    • pp.39-49
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    • 2016
  • Objective : The aim of this study was to investigate the status of infection for infectious diseases and infection control in occupational therapy. Methods : This study was implemented through the survey composed of the status of infection for infectious disease and the infection control and awareness of the infection control. The duration of survey was a month, June, 2016. 111 occupational therapists in 23 room of occupational therapy completed a survey. Results : 34.8% of occupational therapy room experienced the infectious diseases. This study showed the occupational therapists have high performance in almost items of infection control. But the occupational therapist showed the low performance in the items including 'Washing hands over than 15 seconds', 'Washing hands before and after wearing gloves', 'Wearing mask during treatment', 'Throwing away mask after using' and 'Washing your uniform separate from other cloths'. Almost occupational therapists think infection control is important and the education for infection control is needed in occupational therapy. But most of the education is implemented in only medical institution. Conclusion : To improve performance in infection control, individual effort of occupational therapists and institutional strategies are needed. This study will use as basic data for the education about infection control aimed at the occupational therapists.

Development of Model Linking Pilot System (WaterRing) for IWRM (통합수자원 모델 연계 파일럿 시스템 (WaterRing) 개발)

  • Lee, Sung-Hack;Kim, Sung;Kang, Jae-Won;Lee, Mi-Yeon
    • Proceedings of the Korea Water Resources Association Conference
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    • 2007.05a
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    • pp.2024-2028
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    • 2007
  • 우리나라의 물관련 이슈는 수자원뿐만 아니라 사회, 경제 환경 등의 범위까지 확대되어 복합적이며, 기존 방법론과 기술만으로는 해결에 어려움이 있다. 따라서 새로운 기술적/방법론적 도구 개발의 필요성에 따라 통합수자원관리가 하나의 방법으로 받아들여지고 있다. 통합수자원관리는 지속가능한 수자원관리를 목표로하며, 물과 이와 관련 다양한 요소를 고려하는 통합적인 방법론이다. 그러므로 의사결정에 있어 전체론적인 접근이 필요하며, 세부적인 요소와 요소간의 연관관계를 파악하는 것이 중요하다. 이를 위하여 본 연구에서는 통합수자원관리의 기반 도구 중의 하나인 통합수자원관리 모델링 환경인 WaterRing 시범시스템을 개발하였다. WaterRing은 모델연계에 있어 필수적인 표준성, 사용편의성 및 모델공유를 제공하며, 모델코드 자체보다 모델의 개발에 많은 노력을 기울일 수 있도록 설계되었다. 따라서 수자원분야 및 다양한 분야의 모델을 연계할 수 있다. 모델의 연계를 위하여 기본모델단위를 설정하고 각각의 기본모델단위의 결합을 통하여 보다 큰 시스템으로 구성할 수 있도록 하였다. 기본모델단위는 입력/상태/출력의 세 가지 기본요소와 내부수행 루틴으로 구성되어 있다. 기본모델단위 사이의 결합을 정의하기 위하여 BPM(Business Process Management)(Arkin, 2002)와 STELLA의 모델 결합방식을 활용하였다. 기본모델단위는 독립적인 수행단위로 표준적인 입력과 출력을 수행한다. 따라서 입력과 출력의 속성이 같은 기본모델단위는 결합할 수 있다. 본 연구에서 시범적으로 개발된 수자원통합모델링환경 WaterRing은 통합수자원관리의 실현에 있어 평가, 계획에 이용될 수 있다. 그러므로 향후 시스템의 개발이 완료되면 우리나라의 통합수자원관리의 실현을 위한 기반도구로서 많은 역할이 기대된다. 홍수기에 측정된 성과를 바탕으로 고수위대의 수위-유량관계 곡선식을 개발하여야 할 것으로 판단된다. 본 연구를 통해 일부 확인된 바와 같이, 일반적인 자연하천이 아닌 감조하천의 경우는, 각각의 수위대별 유량 값의 변화가 발생하는 바 기간별 혹은 간조와 만조부를 포함하여 유량측정을 하여야 할 것으로 판단된다. 청폐화담탕(淸肺化痰湯)은 LPS로 유도된 macrophage에서 NO와 염증Cytokine 생성량을 억제하였고 murine macrophage에서 NF-${\kappa}$B 활성을 억제함으로써 iNOS와 염증Cytokine 유전자 발현을 하향조절 하였다. 이러한 청폐화담탕(淸肺化痰湯)의 항염작용으로 천식, 기관지염, 폐렴, 결핵, 산후감모 등의 호흡기 질환에 응용할 수 있으리라 사료된다.im}$5개월), 9.44${\pm}$1.05 6${\sim}$ll개월)으로 개월에 관계없이 전반적으로 유사한 비율을 나타내었다. 분획물(첨가농도 15.6 ${\mu}$g/ml)은 60%의 저해효과를 나타내면서 농도 의존적으로 그 저해효과가 컸으며 250 ${\mu}$g/ml 농도에서는 80%의 저해효과를 관찰 할 수가 있었다. 에틸아세테이트분회물의 경우 디글로로메탄 분회물에 비해 다소 낮은 저해효과를 나타내었지만 250 ${\mu}$g/ml 농도에서 약 60%의 세포독성 효과를 나타내었다. 디클로로메탄 분획물과 에틸아세테이트 분획물에 의한 면역 활성 증진 효과를 검토한 결과, 디글로로메탄 분획물은 첨가농도 1 ${\mu}$g/ml에서 94%로 Yac-1표적세포를 사멸시켰으며 에틸아세테이트 분획물도 동일 농도에서 96%의 억제효과를 나타내었다. CTLL세포를 이용

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Comparative Study on the Regimens with Pyrazinamide or Ofloxacin in the retreatment of pulmonary tuberculosis (폐결핵 재치료에서 Pyrazinamide 복합처방과 Ofloxacin 복합처방의 효과에 관한 비교 연구)

  • Choi, In Hwan;Park, Seung Kyu;Kim, Kyeong Ho;Kim, Jin Ho;Kim, Cheon Tae;Song, Sun Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.871-881
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    • 1996
  • Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

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A Study on Awareness and Degree of Practice about Infection Control by Dental Hygienics Student's in Some Ares (일부지역 치위생과 학생의 감염관리 인식 및 실천도에 관한 조사)

  • Han, Ok-Sung;Lee, Jae-Ra
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.410-417
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    • 2013
  • This research surveyed 324 college students majored dental hygiene in Gwangju and Chonnam province to analyze their awareness and degree of practice about infection control. Through the study for recognition about infectious disease related with the grade, the sophomore students are the group who is the most aware. In addition, the study shows students who experienced teeth cleaning have high degree of awareness (p<0.05). The research of perception about infectious disease based on experiences for vaccinations and education about infection prevention says hepatitis B has the highest rate when it comes to level of occurrence risk and tuberculosis and acquired immune deficiency syndrome are the lowest (p<0.05). According to the research, the group who had vaccination, knowledge about infection prevention and experience for scaling shows high practice rate for hand washing according to whether students receive protective inoculation or not. Depending on what the result were, since student learned about infection control has high degree of recognition and practice about infection management if we could emphasize the importance to students through regulative education about infection control and then increase the degree of practice, it would make big contributions to the effective infection control.

Clinical Characteristics and Treatment Outcomes of Patients with Pulmonary tuberculosis at a Private General Hospital (한 민간종합병원에서 진단된 폐결핵 환자의 특성과 치료성적)

  • Koh, Won-Jung;Kwon, O Jung;Kim, Cheol Hong;Ahn, Young Mee;Lim, Seong Yong;Yun, Jong Wook;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Jung Wook;Suh, Jin Sook
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.154-164
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    • 2003
  • Background : Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. Materials and Methods : The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. Results : Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. Conclusions : To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.