• Title/Summary/Keyword: Pulmonary Tuberculosis

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A Dual Lung Scan for the Evaluation of Pulmonary Function in Patients with Pulmonary Tuberculosis before and after Treatment (폐결핵치료전후(肺結核治療前後) 방사성동위원소(放射性同位元素)스캔에 의(依)한 폐기능(肺機能)의 비교(比較))

  • Rhee, Chong-Heon
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.2
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    • pp.1-25
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    • 1967
  • In 20 normal cases and 39 pulmonary tuberculosis cases, regional pulmonary arterial blood flow measurements and lung perfusion scans by $^{131}I$-Macroaggregated albumin, lung inhalation scans by colloidal $^{198}Au$ and spirometries by respirometer were done at the Radiological Research Institute. The measured lung function tests were compared and the results were as the following: 1. The normal distribution of pulmonary blood flow was found to be $54.5{\pm}2.82%$ to the right lung and $45.5{\pm}2.39%$ to the left lung. The difference between the right and left pulmonary arterial blood flow was significant statistically (p<0.01). In the minimal pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be $52.5{\pm}5.3%$ to the right lung and $47.5{\pm}1.0%$ to the left lung when the tuberculous lesion was in the right lung, and $56.2{\pm}4.4%$ to the right lung and $43.8{\pm}3.1%$ to the left lung when the tuberculous lesion was in the left lung. The difference of pulmonary arterial blood flow between the right and left lung was statistically not significant compared with the normal distribution. In the moderately advanced pulmonary tuberculosis, the average distripution of pulmonary arterial blood flow was found to be $26.9{\pm}13.9%$ to the right lung and $73.1{\pm}13.9%$ to the left lung when the tuberculous lesion was more severe in the right lung, and $79.6{\pm}12.8%$ to the right lung and $20.4{\pm}13.0%$ to the left lung when the tuberculous lesion was more severe in the left lung. These were found to be highly significant statistically compared with the normal distribution of pulmonary arterial blood flow (p<0.01). When both lungs were evenly involved, the average distribution of pulmonary arterial blood flow was found to be $49.5{\pm}8.01%$ to the right lung and $50.5{\pm}8.01%$ to the left lung. In the far advanced pulmonary tuberculosis, the average distribution of pulmonary arterial blood flow was found to be $18.5{\pm}11.6%$ to the right lung and $81.5{\pm}9.9%$ to the left lung when the tuberculous lesion was more severe in the right lung, and $78.2{\pm}8.9%$ to the right lung and $21.8{\pm}10.5%$ to the left lung when the tuberculous lesion was more severe in the left lung. These were found to be highly significant statistically compared with the normal distribution of pulmonary arterial blood flow (p<0.01). When both lungs were evenly involved the average distribution of pulmonary arterial blood flow was found to be $56.0{\pm}3.6%$ to the right lung and $44.0{\pm}3.2%$ to the left lung. 2. Lung perfusion scan by $^{131}I$-MAA in patients with pulmonary tuberculosis was as follows: a) In the pretreated minimal pulmonary tuberculosis, the decreased area of pulmonary arterial blood flow was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive than had been expected from the chest roentgenogram in the apparently healed minimal pulmonary tuberculosis. b) In the pretreated moderately advanced pulmonary tuberculosis, the decrease of pulmonary arterial blood flow to the diseased area was corresponding to the chest roentgenogram, but the decrease of pulmonary arterial blood flow was more extensive in the treated moderately advanced pulmonary tuberculosis as in the treated minimal pulmonary tuberculosis. c) Pulmonary arterial blood flow in the patients with far advanced pulmonary tuberculosis both before and after chemotherapy were almost similar to the chest roentgenogram. Especially the decrease of pulmonary arterial blood flow to the cavity was usually greater than had been expected from the chest roentgenogram. 3. Lung inhalation scan by colloidal $^{198}Au$ in patients with pulmonary tuberculosis was as follows: a) In the minimal pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram. b) In the moderately advanced pulmonary tuberculosis the decrease of radioactivity in the diseased area was partly corresponding to the chest roentgenogram in one hand and on the other hand the radioactivity was found to be normally distributed in stead of tuberculous lesion in the chest roentgenogram. c) In the far advanced pulmonary tuberculosis, lung inhalation scan showed almost similar decrease of radioactivity corresponding to the chest roentgenogram as in the minimal pulmonary tuberculosis. 4. From all these results, it was found that the characteristic finding in pulmonary tuberculosis was a decrease in pulmonary arterial blood flow to the diseased area and in general decrease of pulmonary arterial blood flow to the diseased area was more extensive than had been expected from the chest roentgenogram, especially in the treated group. Lung inhalation scan showed almost similar distribution of radioactivity corresponding to the chest roentgenogram in minimal and far advanced pulmonary tuberculosis, but there was a variability in the moderately advanced pulmonary tuberculosis. The measured values obtained from spirometry were parallel to the tuberculous lesion in chest roentgenogram.

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Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.

Association of Serum Vitamin D Levels with Bacterial Load in Pulmonary Tuberculosis Patients

  • Yuvaraj, B.;Sridhar, M.G.;Kumar, S. Vinod;Kadhiravan, T.
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.3
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    • pp.153-157
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    • 2016
  • Background: Vitamin D is known to have diverse effects on various systems in the body. There is evidence to suggest that a link exists between the serum vitamin D status and tuberculosis. The present study was designed to assess the alterations in serum 25-hydroxyvitamin D levels in newly diagnosed sputum acid fast bacilli (AFB) positive pulmonary tuberculosis patients and to study the association, if any, between serum vitamin D levels and different levels of sputum smear positivity. Methods: Serum 25-hydroxyvitamin D levels were estimated in 65 sputum AFB positive pulmonary tuberculosis patients and 65 age and gender-matched healthy controls. Results: The levels of serum 25 hydroxy-vitamin D in tuberculosis patients were not statistically different from the levels of serum 25 hydroxy-vitamin D in healthy controls. However, among patients with pulmonary tuberculosis, there was a significant negative correlation between the levels of serum 25 hydroxy-vitamin D and levels of sputum positivity. Conclusion: Serum vitamin D levels negatively correlates with bacterial load in patients with active pulmonary tuberculosis.

Acquired pulmonary stenosis secondary to tuberculosis -A case report- (결핵성 폐동맥 협착증 치험 1 례)

  • 조광조;우종수;성시찬;최필조;손춘희
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1140-1143
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    • 1999
  • Acquired pulmonary artery stenosis which is secondary to tuberculosis is so rare that only a few scattered cases have been reported. We report one case of pulmonary stenosis caused by pulmonary tuberculosis.l A 50 year old man who gradually developed dyspnea was diagnosed as bilateral pulmonary stenosis, he underwent bypass surgery between the main diagnosed as bilateral pulmonary stenosis. he underwent bypass surgery between the main pulmonary artery and the right pulomonary artery with a 13mm Gortex ringed straight graft. The left pulmonary artery was too small to restore the perfusion. The patient was discharged on the 33rd day after the operation. Acquired pulmonary stenosis could be treated successfully with one-side pulmonary arery reconstruction.

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Studies on the anti-pulmonary tuberculosis of Inonotus obliquus (차가버섯의 항결핵 활성에 대한 연구)

  • Song, Ho-Yeon;Lee, Dae-Jin;Lee, Byung-Eui
    • Journal of Mushroom
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    • v.9 no.4
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    • pp.190-193
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    • 2011
  • Inonotus obliquus is a traditional medicine mushroom that was developed from traditional medicine originating in ancient. It has been applied for cancer or immunotherapy, but its effect on pulmonary tuberculosis is not reported. Therefore, we measured the pulmonary tuberculosis therapeutic effect of methyl alcohol extract from MGIT 960 system with fluorescent indicator. Inonotus obliquus extract showed 14 day more inhibitory activity than the positive control. In addition, the anti-pulmonary tuberculosis activity of Inonotus obliquus was $50{\mu}m$. These results suggest that Inonotus obliquus methyl alcohol extracts could contribute to inhibition of pulmonary tuberculosis.

A Study on Support by Families of Patients with pulmonary Tuberculosis and Compliance with Sick Role Behavior (결핵 환자의 가족 지지와 환자 역할 행위에 관한 연구)

  • 서숭미
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.555-568
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    • 1993
  • The purposed of this study was to identify compliance with sick role behavoir and support by families of patients with pulmonary tuberculosis and to identify factors affecting these variables md factors that increase compiance with sick role behavoior This study was a survey design done in K. general hospital from 1992. 7 1 to 1992. 7. 20. The data were collected through personal interviews with 70 subjects who had pulmonary tuberculosis. A questionnaire was used to collect the data. 1. Demographic characteristics of the subjects The factor causing the tuberculosis for 28.6% of the subjects was that they lived with another family member who had pulmonary tuberculosis, 11.4% of the subjects had a family member who died of tuberculosis, 24.3% of the subjects had experienced an adverse reaction to medication. Gastroenteric disorders(28.6%) had the highest rate for this kind of adverse reaction to medication. 2. Support by families for patients with pulmonary tuberculosis The items which showed high support for compliance were taking medicine regularly(80.0% ) eat-ing a balanced diet(80.0%), loving them(84.3%), taking care of them(82.8%), getting the support from people for being sick(81.1%) The items which showed low support for compliance were meeting relatives or clergymen(20%), talking with the people suffering from pulmenary tuberculosis to relieve frustrated because they were not recovering. 3. General characteristics and family support The degree of family support showed that 75 was highest score and 30, the lowest score with 55.5(74. 1%)the average score. The degree of family support appeared similar in cases where the person was married and where the person did not have a family member with pulmonary tuberculosis(P〈.01) 4. The degree of compliance with sick role behavior by patients with pulmonary tuberculosis The degree of compliance with sick role behavior showed that 100 was the highest scoure47, the low-est score and 76.4, the average score out of a Possible score of 100. 5. Correlation between compliance with sick role behavior and family support The compliance with sick role behavior and family support showed a positive correlation(r=.2094 p〈.5) So for patients with pulmonary tuberculosis. compliance with sick role behavior is related to the sup-port given by their families.

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A Case of Intestinal Tuberculosis Complicated with Pulmonary Tuberculosis in a Young Aldolescent with Cerebral Palsy (뇌성마비 소아에서 진단된 폐결핵에 병발된 결핵성 장염 1례)

  • Choi, Sung Yun;Kim, Young Min;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.102-107
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    • 2004
  • About 20% of intestinal tuberculosis have active pulmonary tuberculosis. Intestinal tuberculosis can develop by swallowing sputum which have active pulmonary tuberculosis and by ingestion of contagious milk. We report a case of intestinal tuberculosis complicated with pulmonary tuberculosis in a 15-year old aldelescent who could not cough out sputum because of known cerebral palsy. He was admitted because of 3 day history of fever and bloody stool. Chest PA showed both upper lobe consolidation. AFB stain and AFB PCR was positive for tuberculosis. Colon study showed abscence of haustral marking and lead pipe appearance due to stenosis of ascending colon and mucosal edema. Abdominal CT scan showed mild wall thickening in ascending colon. Despite the anti-tuberculosis therapy with first line drugs, fever accompanying pleural effusion developed. Second line drug with Isoniazid and Rifampin improved clinical manifestation. After the report on sensitivity, we readjusted the regimen, and clinical manifestations improved gradually.

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The Value of Submitting Multiple Sputum Specimens for Accurate Diagnosis of Pulmonary Tuberculosis

  • Kisa, Ozgul;Albay, Ali;Baylan, Orhan;Doganci, Levent
    • Journal of Microbiology
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    • v.40 no.4
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    • pp.301-304
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    • 2002
  • Is a multiple number of sputum specimens necessary for the diagnosis of pulmonary tuberculosis? To answer this question, 6844 respiratory specimens obtained from previously untreated patients suspected of having pulmonary tuberculosis between 1998 and 2001 were evaluated retrospectively. All of the specimens were evaluated by acid fast bacilli smear and BACTEC 460 TB culture system. A total of 785 (11%) specimens from 353 patients were positive for Mycobacterium tuberculosis complex. For 76% (270/353) of these patients the organism was detected from sputum specimens collected sequentially for daily basis. Mycobacterium tuberculosis was isolated in the first, second and third samples of the majority (98%,195/199) of patients who had three or more sputum samples sent to the laboratory. Our results indicate that, we could carry out Mycobacterium tuberculosis isolation in the first, second and third sputum samples of the overwhelming majority of the patients and the diagnostic value of four or more sputum specimens submitted to the laboratory was very low (2%). We recommend that, for definitive and cost-effective diagnosis of pulmonary tuberculosis at least three sequential sputum specimens be collected for all patients suspected pulmonary tuberculosis.

The Clinical Report on the Pulmonary Tuberculosis, Tuberculosis Meningitis (Pulmonary Tuberculosis, Tuberculous Meningitis의 임상치험 3례)

  • Son, Yun-Jung;Lim, Joong-Hwa;Lee, Do-Hyoung
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.352-360
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    • 2004
  • Tuberculosis, one of the oldest diseases known to affect humans, is caused by bacteria belonging to the Mycobacterium luberculosis complex. The diseases usually affects the lungs, although in up to one-third of cases other organs are affected. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within 5 years in more than half of cases. Transmission usually takes place through the airborne spread of droplets of nuclei produced by patients with infectious pulmonary tuberculosis. Two patients with Pulmonary Tuberculosis and one with Tuberculous Meningitis were recently examined. The changes in these patient's symptoms through both western medical treatment and oriental medical treatment are reported.

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