• Tuberculosis and Respiratory Diseases
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• 제55권2호
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• pp.154-164
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• 2003

연구배경 : 1990년대 초반까지 민간 병의원에서의 폐결핵환자 치료효율은 보건소에 비해 낮았다. 보건소에 비해 민간 병의원에서 치료받는 결핵환자의 비율이 최근 계속 증가하고 있지만, 민간부문에서 치료 받는 환자들의 특성과 치료효율은 정확히 파악되지 못하고 있다. 본 연구는 서울에 소재한 한 민간 종합병원에서 최근 진단되고 치료한 폐결핵환자의 특성과 치료효율을 조사하고자 하였다. 방 법 : 2000년 8월 1일부터 2001년 1월 31일까지 6개월간 삼성서울병원에서 진단되어 관할 보건소로 신고된 232명의 성인 폐결핵 환자를 대상으로 진단 시 연령과 성별, 입원여부, 과거 폐결핵 치료력, 객담 항산균 도발과 배양 검사 결과, 약제감수성검사 결과, 치료약제의 종류 및 치료 기간, 치료 결과 그리고 도말 양성 환자에서의 치료성적 등을 조사하였다. 결 과 : 232명의 폐결핵 환자의 평균 연령은 47세(범위 16-86세)이고 남자 136명(58.6%), 여자 96명(41.4%)이었다. 82명(35.3%)의 환자는 진단 당시 입원치료를 받았고, 13명(5.6%)이 치료 도중 사망하였다. 과거 치료력이 없는 신환이 166명(71.6%), 재발이 32명(13.8%)이었다. 도말 양성 환자가 83명(35.8%), 도말 음성 배양 양성 환자가 27명(11.6%)으로 균 양성 환자가 110명(47.4%)이었다. 47명(20.3%)에서는 객담 검사가 시행되지 않았다. 초치료 환자 188명 중 130명(69.1%)에서 INH, RFP, EMB, PZA가 처방되었고, 21명(11.2%)에서 INH, RFP, EMB가 사용되었다. 전체 폐결핵 환자 232명 중 26명(11.2%)과 도말 양성 환자 83명 중 11명(13.3%)이 치료를 중단하였다. 도말 양성 초치료 환자 68명 중 29명(42.6%)가 완치되었고, 18명(26.5%)은 치료를 종결하였으나 균 음전을 확인할 수 없었다. 결 론 : 민간 병의원에서 진단된 폐결핵 환자의 치료효율을 높이고 치료 중단률을 낮추기 위해서는 폐결핵 환자의 진단과 치료에서 대한 결핵 및 호흡기학회의 진료기준을 충실히 따르려는 보다 적극적인 노력과 함께 우리나라 실정에 맞는 적절한 공공-민간 협력체계의 국가결핵관리모델의 개발이 필요하리라 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.449-469
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• 1997

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.167-170
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• 2021

• Tuberculosis and Respiratory Diseases
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• 제86권1호
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• pp.61-62
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• 2023

• Tuberculosis and Respiratory Diseases
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• 제70권5호
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• pp.433-437
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• 2011

Sarcoidosis is a multisystemic disorder characterized by the presence of non-caseating granulomas in the involved organ. Tuberculosis is an infectious disease caused by $Mycobacterium$ $tuberculosis$ and is characterized by granuloma with caseous necrosis. The clinical and histological similarity between sarcoidosis and tuberculosis has stimulated research searching for an association between mycobacterium and sarcoidosis. We report a case of a 38-year-old male with sarcoidosis that developed soon after treatment of tuberculous lymphadenitis. He was diagnosed as tuberculous lymphadenitis by microbiological confirmation. He showed clinical improvement after treatment for tuberculosis. One year later, his chest radiography showed bilateral hilar enlargement with diffuse bilateral nodules. A noncaseating granuloma was confirmed by endobronchial ultrasound guided transbronchial needle aspiration and he was diagnosed with sarcoidosis. To our knowledge, this is the first report describing sarcoidosis after treatment of tuberculosis in South Korea.

• Tuberculosis and Respiratory Diseases
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• 제57권6호
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• pp.528-534
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• 2004

배 경 : 객담 항산균 도말 검사는 저렴하고 간편한 검사이며, 검사 결과를 빨리 얻을 수 있다는 장점이 있지만, 결핵균과 NTM을 구별하지 못한다는 제한점이 있다. 외국에서는 도말 양성 환자에서 폐결핵과 NTM 폐질환을 구별하기 위하여 TB-PCR 검사가 권장되고 있다. 본 연구는 국내에서도 객담 도말 양성 환자에서 객담 또는 기관지 세척액의 TB-PCR 검사가 폐결핵과 NTM 감염의 감별 진단에 유용한가를 알아보고자 하였다. 대상 및 방법 : 2003년 1월 1일부터 2003년 12월 31일까지 1년간 진단검사의학과 임상미생물검사실로 항산균 도말 및 배양검사가 의뢰된 객담 검체 중 도말과 배양이 모두 양성인 826건의 객담 검체를 연구대상으로 하였고, 이 검체가 분리된 환자 299명의 의무기록과 방사선학적 소견을 후향적으로 조사하였다. 결 과 : 결핵균이 분리된 객담은 606건(73.4%)이었고 NTM이 분리된 객담은 220건(26.6%)이었다. 299명의 환자 중 결핵균이 분리된 폐결핵 환자는 229명(76.6%)이었고, NTM이 분리된 환자는 70명(23.4%)이었으며 모두 임상적 의의가 있는 NTM 폐질환 환자였으며, 원인균은 M. avium complex 38명(54.3%), M. abscessus 26명(37.1%), 기타 6명 등이었다. 폐결핵 환자 229명 중 112명(48.9%)와 NTM 폐질환 환자 70명 중 51명 (72.9%)에서 객담 또는 기관지 세척액을 이용한 TB-PCR 검사가 시행되었다. 검사를 시행한 폐결핵 환자 112명 중 99명(88.4%)에서 TB-PCR 검사가 양성을 보였고, NTM 폐질환 환자는 모두 음성을 보였다 (p<0.001). 객담 도말 양성 환자에서 객담 또는 기관지 세척액의 TB-PCR 검사 양성 반응이 폐결핵을 예측하는 민감도와 특이도는 각각 88.4%(99/112)와 100%(51/51)였고, 양성 예측치는 100%(99/99) 그리고 음성 예측치는 79.7%(51/64)였다. 결 론 : 객담 항산균 도말 양성을 보이는 환자에서 객담 또는 기관지 세척액 TB-PCR 검사는 국내에서도 폐결핵과 NTM 폐질환을 구별하는데 임상적 유용성이 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제6권1호
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• pp.23-28
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• 1973

This is a report of pulmonary actinomycosis which has been treated with long chemotherapy under the misdiagnosis of pulmonary tuberculosis for 14 years and has finally diagnosed by the specimens of excised lung. Pulmonary actinomycosis is very few in recent report by the use of penicillin and sulfonamide, but for the difficult differential diagnosis with pulmonary tuberculosis and carcinoma, It is a choice of treatment for resect for the localized lesions.

• Tuberculosis and Respiratory Diseases
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• 제38권3호
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• pp.245-249
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• 1991

Surgical intervention for pumlmonary tuberculosis has been controverted for last several decades. Although it is widely held that the chemotherapy is the best modality for treatment of pulmonary tuberculosis, surgical intervention has still some roles in well elected circumstance. At the National Kongju Tuberculosis Hospital in Korea, we performed a retrospective case Cohort study through the regular follow-up of 463 cases, who underwent the surgical intervention for pulmonary tuberculosis between January 1986 and April 1990. The results were as follows: 1) The male to female ratio was 1.8:1 and 84.4% of the patients were between 20 and 49 years of age. 2) According to the NAT classification, 6 cases (1.3%) were minimal, 216 (46.7%) moderately advanced and 241 (52%) far advanced. 3) One hundred and thirty four cases (28.9%) had the treatment history of 5 to 10 years and 129 cases (27.9%) of 3 to 4 years. 4) As for the pathologic entities, 172 cases (37.1%) had the totally destroyed lung and 137 (29.6%) destroyed lobe or segment. 5) A total of 238 cases (51.4%) underwent pneumonectomy and 153 (33.0%) lobectomy. 6) As the post-operative complications, 21 cases (4.5%) had empyema and 11 (2.4%) bleeding. The rate of complication after pneumonectomy and lobectomy was 5.8% and 3.2%, respectively. 7) Six cases (1.3%) died post-operatively. 8) Out of 238 cases with pre-operative positivity for AFB, 212 achieved the negative conversion, its rate being 89.1%. It follows from these results that although it has a limit, surgical intervention may play an important role in treating some patients with pulmonary tuberculosis.

• Journal of Korean Biological Nursing Science
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• 제22권4호
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• pp.288-296
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• 2020

Purpose: The purpose of this descriptive study was to identify factors influencing pulmonary tuberculosis patients' self-care behaviors. Methods: The patients were 125 adults over the age of 19 who were diagnosed with pulmonary tuberculosis, receiving care at the National tuberculosis hospital. The survey questions measured family support, multidimensional scale of perceived social support (MSPSS), stigma and self-care behaviors. Results: The average score for self-care behaviors was 3.91, ranging from 2.22 to 5.00. There was a significant positive correlation between self-care behaviors and support system. There was a significant negative correlation between self-care behaviors and stigma. The significant variables influencing self-care behaviors were family support (β = .33, P< .001), smoking (β= -.23, p= .002), age (β= .22, p= .005) and experience of stopping treatment (β= -.17, p= .040). These factors explain 36% of pulmonary tuberculosis patients' self-care behaviors. Conclusion: Family support is very important to improve selfcare for tuberculosis patients. However, those in their fifties, men, and those who do not have a job and have underlying diseases have low family support, so they need active support at the national level. The study results suggest that a educational and nursing programs must be designed to reduce stigma and promote support system in order to enhance self-care behaviors.

• Journal of Chest Surgery
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• 제24권10호
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• pp.1011-1018
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• 1991

From September, 1985 to March, 1991, 33 patients under went thoracotomy for treatment of pulmonary aspergilloma with Pulmonary tuberculosis on the department of Thoracic and Cardiovascular Surgery, National Kongju Hospital. 1. There were 25 male and 8 female patients ranging from 19 to 57 years old [mean age, 36.2 years]. 2. Hemoptysis was the most common symptom [recurrent minor hemoptysis: 24cases, severe hemoptysis [200cc /day]: 4 cases, massive hemoptysis [600/day]: 4 cases]. 3. In the chest X-ray films, intracavitary fungus balls [air meniscus sign] were noted in 20 cases [61%] and upper lobe involvements were 29 cases [88%]. 4. All cases had a history of treatment with antituberculosis drugs under diagnosis of pulmonary tuberculosis for an average of 10 years and 2 months. 5. The most common indication for operation was hemoptysis [32 cases] - hemoptysis with total destroyed lung or lobe: 12cases, hemoptysis with open AFB [t-] cavity: 6cases, recurrent or massive hemoptysis: 14 cases. 6. The operative procedures was as follows - - - lobectomy . 16 cases, pneumonectomy: 8 cases, bilobectomy, segmentectomy, cavernoplasty and lobectomy with segmentectomy: each 2 cases, lobectomy with cavernoplasty: 1 case. 7. 6 complications appeared postoperatively which included empyema with BPF [2 cases], empyema [2 cases] and wound infection [2 cases]. In conclusion, surgical resection is the treatment of choice in the management of pulmonary aspergilloma associated pulmonary tuberculosis.