• 제목/요약/키워드: Treatment Tuberculosis

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다제내성 폐결핵 치료실패의 위험인자 분석 (The Analysis of Risk Factors of Treatment Failure in MDR-TB)

  • 김형수;최광민
    • Tuberculosis and Respiratory Diseases
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    • 제50권6호
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    • pp.686-692
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    • 2001
  • 배 경 : 다제내성 폐결핵의 발생은 약제선택의 제한성과장기간의 항결핵제의 복용으로 인한 부작용 등으로 인하여 치료 성공율을 감소시킨다. 본 연구는 치료 실패인자들을 알아내어 다제내성 폐결핵의 치료 성공율을 향상시키는데 기초자료로 삼고자 하였다. 대상 및 방법 : 1996년 1월부터 1998년 12월까지 입원치료를 시행한 다제내성 폐결핵 환자 111명을 대상으로 하였다. 다제내성 폐결핵 치료의 실패에 관계되는 인자들을 분석하기 위하여 치료에 성공한 군(I군)과 실패한 군(II군)으로 나누어 각 인자들을 독립표본 T-검정, $X^2$ 검정 그리고 Fisher의 정확확률 검정으로 비교 분석하였다. 결 과 : I군과 II군을 비교한 결과, 폐결핵 과거력의 유무, 흉부방사선 검사상 공동이 있는 경우와 과거의 치료 횟수, 내성 약제의 개수 그리고 치료약제의 개수에서 통계적 유의성을 관찰할 수 있었다(p<0.05). 결 론 : 다제내성 폐결핵 치료 실패의 위험인자는 과거의 치료력, 흉부방사선상 공동이 있는 경우, 내성약제의 개수가 많은 것임을 알 수 있었다. 따라서 다제내성 폐결핵의 치료 효과를 향상시키기 위하여 초치료 폐결핵관리를 보다 철저히 하여 항결핵제에 대한 약제 내성발생을 억제하는데 노력을 하여야 할 것으로 생각된다.

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원인불명의 고열 및 흉수 이후 악화된 폐결핵후유증 소양인환자 치험 1례 보고 (A Case Report of a Soyangin Patient with Aftereffects of the Tuberculosis Aggravated after a Pleural Effusion and a High Fever of Unknown Origin)

  • 이재욱;허한솔;조혜원;임은철
    • 사상체질의학회지
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    • 제28권2호
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    • pp.163-175
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    • 2016
  • Objectives It is important to care aftereffects of the tuberculosis such as cough and sputum especially for the old. The purpose of this study is to report a case which showed symptoms improvement after treatment with Hyungbangjihwang-tang.Methods To evaluate the results of this treatment, Decrease of cough and sputum was assessed by Visual Analogue Scale(VAS). The patient`s oral intake and body weight were measured.Results The patient who suffered with cough and sputum after tuberculosis developed high fever and pleural effusion of unknown origin. After treatment with western and oriental medicine, high fever and pleural effusion were subsided but cough and sputum got worse and body weight was decreased after high fever and pleural effusion. So we prescribed Hyungbangjihwang-tang and then the symptoms of the patient were improved.Conclusions This study suggests that using Sasang constitutuional medical treatment is effective for Soyangin patient with afftereffects of the tuberculosis such as cough and sputum.

시보건소 결핵등록관리환자들의 치료충실도에 미치는 요인에 관한 조사 -서울특별시 일개 구보건소 등록환자 중심- (A Study on the Factors which Influenced the Faithfulness to Treatment Among the Pulmonary Tuberculosis Patients Registered in a City Health Center)

  • 이영우
    • Journal of Preventive Medicine and Public Health
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    • 제17권1호
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    • pp.127-135
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    • 1984
  • Personal and social characteristics, disease status, reason of delay of receiving drug from City Health Center and knowledge and attitude on the pulmonary tuberculosis were compared between the faithful group in treatment and the unfaithful group among the patients for pulmonary tuberculosis registered in a City Health Center in order to analyze the factors which influenced the faithfulness to treatment. Record as well as interview survey was done toward all patients of 247 who were registered and being cared during over 6 months in a City Health Center from April 1, 1982 to March 31, 1983, and results were as follows; 1. There was no statistically significant difference in sex and age distribution between the faithful group in treatment and the unfaithful group. 2. There was no statistically significant difference in marital status distribution between the faithful group and unfaithful group in treatment. 3. The lower education group comprised higher proportion than the higher education group among the faithful group in treatment. 4. The proportion of the emlployed was higher than unemlpoyed among the unfaithful group in treatment. 5. The proportion of mild case was higher than severe case among the unfaithful group in treatment. 6. As for the onset of delay of receiving drug, 'less than 3 month after starting treatment' was 59.5% among the unfaithful group in treatment. 7. The reasons of delay of receiving drug were 'no time' (42.2%). 'being away from home' (25.0%), 'being sick' (13.8%), and 'forgot the appointed date' (12.0%). 8. There was no statistically significant difference in the knowledge on the communicability of the tuberculosis between the faithful groups in treatment and the unfaithful group. 9. There was no statistically significant difference in the knowlege on B.C.G. as vaccination drug of tuberculosis between the faithful group and the unfaithful group in treatment. 10. There was no statistically significant difference in the satisfaction on the treatment of health center between the group of faithful and unfaithful in treatment. 11. There was no statistically significant difference in the belief on the complete recovery of tuberculosis between the faithful group and the unfaithful group in treatment. 12. The rate of consulting on tuberculosis treatment with life partner was higher among the faithful group in treatment than the unfaithful group.

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전국 결핵 신환자 의료빅데이터를 이용한 경쟁위험모형 적합 (Fitting competing risks models using medical big data from tuberculosis patients)

  • 김경대;노맹석;김창훈;하일도
    • 응용통계연구
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    • 제31권4호
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    • pp.529-538
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    • 2018
  • 결핵은 높은 이환과 사망을 일으키는 질병으로 현대의학의 발달에 따라 발생률과 사망률은 감소하고 있다. 그러나 한국은 아직까지 OECD 국가 중 결핵 발생률과 사망률이 가장 높다. 이에 따라 한국은 결핵의 예방 및 통제를 위해 여러 정책 사업을 실시하고 있다. 본 연구에서는 공공민간협력(public-private mix) 결핵관리사업이 치료결과에 미치는 영향을 분석하고 결핵환자의 치료 성공에 영향을 미치는 요인을 확인하고자 한다. 질병관리본부에서 관리하는 결핵환자 신고 자료를 이용하여 2012-2015년 전국 결핵 신환자 코호트 약 13만명을 대상으로 분석하였다. 누적 발생 함수(cumulative incidence function)를 이용하여 요인별로 누적 치료 성공률을 비교하였으며. 주 관심사건(치료성공) 및 경쟁사건(사망)을 고려한 두 가지 경쟁위험모형(cause-specific Cox's proportional hazards model and subdistribution hazard model)을 사용하여 분석 결과를 비교하였다.

The Rapid Drug Susceptibility Testing of Mycobacterium tuberculosis by GenoType$^{(R)}$ MTBDRplus in Contaminated Specimen

  • Heo, Reun;Kim, Yoon-Sik
    • 대한의생명과학회지
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    • 제19권4호
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    • pp.330-337
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    • 2013
  • There are several methods currently being used to diagnose tuberculosis in patients, such as smear, PCR, tuberculosis culture and X-ray. For a proper medical treatment, antimicrobial susceptibility test and rapid drug susceptibility testing have been operated. Tuberculosis bacilli usually need 3~8 weeks of culture period because of delay in RNA synthesis and require 15~22 hours for generation. After a germ raises in culture, we initiated antimicrobial susceptibility test for a proper treatment. It has some difficulties to give a proper prescription for a tuberculosis patient because antimicrobial susceptibility test requires 4 weeks. To supplement this, we are practicing drug susceptibility testing which allow us to know the sensibility of RMP and INH after 2 or 3 days. But this is only possible when more than 2 positive germ. Therefore, we should practice rapid drug susceptibility testing with culture test. But if media is contaminated by other germs except Mycobacterium tuberculosis, it's hard to interpret result about culture test and to practice antimicrobial susceptibility test and rapid drug susceptibility testing. Because we have to practice again smear, culture test after extracting specimen from the patient, time is consumed and proper patient treatment is postponed. To address these problems and quick patient treatment, rapid drug susceptibility testing is practiced by using GenoType$^{(R)}$ MTDRplus method. As a result of this method we detected sensibility 10 and 7 cases and resistance 0 and 3 cases using RIM and INH respectively with other 1 case toward medicals out of the total 11 test. In conclusion rapid drug susceptibility testing can be used from the contaminated specimen after elimination of contaminated source from culture and proved that it can be practiced for rapid examination of a tuberculosis patient.