• Tuberculosis and Respiratory Diseases
• /
• 제38권2호
• /
• pp.119-127
• /
• 1991

This study was designed to observe the problems in performing the screening for early detection of lung cancer, and the degree to which regular radiographic and cytologic screening contributes to the early detection of lung cancer in asymptomatic volunteers. Through mass media campaign, 346 male volunteers had registered to receive radiographic and sputum cytologic screening every four months. Initial chest x-ray examination showed 83 cases of lesions suggesting tuberculosis. Among them, two cases were proved to be active tuberculosis. The rate of long-term follw-up over two years was about 15%. The screening tests detected two cases of lung cancer, one prevalent lung cancer by sputum cytologic examination, and the other by sputum cytologic examination during follow-up. So the prevalence rate of lung cancer was 0.28% and the incidence rate was 3.1/1,000 person·years. Both were localized lesions; ie, American Joint Committee on Cancer (AJCC) stage I and occult lung cancer, respectively. With these results, we suggest that the maintenance of long-term follow-up seems to be the most important problem to evaluate the effect of early detection of lung cancer. It would require thorough explanation of the risk of smoking in lung cancer and the wide public education on the government's base. It should be done at several hospitals simultaneously to include a large population in the study. Although we couldn't determine the effect of screening for the early detection of lung cancer in this report, new diagnostic procedure other than chest x-ray and sputum cytologic examination would be required, according to the literature, to reduce the mortality of lung cancer by the screening program for the early detection of lung cancer.

• Tuberculosis and Respiratory Diseases
• /
• 제77권2호
• /
• pp.55-59
• /
• 2014

The US National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality and a 6.7% decrease in all-cause mortality. The NLST is the only trial showing positive results in a high-risk population, such as in patients with old age and heavy ever smokers. Lung cancer screening using a low-dose chest computed tomography might be beneficial for the high-risk group. However, there may also be potential adverse outcomes in terms of over diagnosis, bias and cost-effectiveness. Until now, lung cancer screening remains controversial. In this review, we wish to discuss the evolution of lung cancer screening and summarize existing evidences and recommendations.

• Tuberculosis and Respiratory Diseases
• /
• 제57권2호
• /
• pp.118-124
• /
• 2004

Lung cancer is the leading cause of cancer death for men and women in the industrialized world. It is desirable to detect disease at a stage when it is not causing symptoms and when control or cure is possible. If the screening test detects patients with the disease at an early stage, they can be examined to confirm the diagnosis and intervention can alter the natural history of the disease. The results of screening programs designed to detect early lung cancer using either conventional chest radiograph or sputum cytology are disappointing for a diagnostic screening test. Because of advances in helical CT imaging techniques, screening for lung cancer has been suggested as a possible method of improving outcome. Findings in recent publications suggest that substantial dose reduction is possible in chest CT. The advantages of low-dose CT are more sensitive than chest radiograph for detecting small pulmonary nodules that may be lung cancers, shorter scanning time than conventional chest CT scan without intravenous contrast injection, cheaper cost than standard CT, low radiation dose. However, the true clinical significance of the small tumors found by screening is still unknown, and their effect on mortality awaits future investigation. Furthermore, in addition to detecting an increased number of lung cancers, low-dose CT found at least one indeterminate nodule in many of all screened patients. The majority should be benign but evaluation of all these indeterminate nodules is not a trivial problem in routine practice. In conclusion, lung cancer screening with low-dose CT is a complex subject. The true effectiveness of lung cancer screening (a reduction in mortality from lung cancer) with low-dose CT can be determined through well-designed randomized control trials with enrolment of appropriate subjects.

• 한국방사선학회논문지
• /
• 제15권7호
• /
• pp.1021-1030
• /
• 2021

국내 결핵 환자 관리의 방안을 모색하고 결핵 정책의 기초자료를 제공하고자 2010년부터 2018년까지 통계청과 질병관리본부의 결핵 환자 통계 연보와 세계보건기구(WHO; World Health Organization)의 GLOBAL Tuberculosis Report 등의 자료를 수집하여, 국내 결핵 환자 현황을 분석하였다. 결과는 다음과 같다. 첫째, 국내 결핵 환자 발생 현황 결과는, 2018년 33,796명(65.9%), 신환자는 2018년 26,433명(51.5%)으로 약 21.3% 감소한 것으로 나타났다. 둘째, 국내 결핵 환자치료 현황은 과거 치료결과 불명확은 2018년 655명으로 2014년 대비 약 160% 증가한 것으로 나타났다. 셋째, 청소년 결핵환자 발생률은 10에서 14세는 2018년 1.8%, 15세에서 19세는 15.0%로 고등학생의 결핵 발생률이 높았다. 넷째, 나이별 결핵 환자 발생률을 보면 60대 이상의 대상자가 60% 이상의 결핵 유병률을 보였으며 특히 80세 이상의 노인결핵 환자가 증가하였다. 다섯째, 성별 결핵 환자발생률 현황은 2010년 대비 2018년에 남성이 여성보다 1.4배가 많은 것으로 나타났다. 여섯째, 전국적으로 결핵 유병률은 전남 1,419명(75.6%)이 가장 높았고, 세종 99명(33.4%)이 가장 낮았다. 일곱째, 국내 외국인 환자 수는 2012년 1,510명으로 지속적으로 늘어나 2016년에는 2,569명으로 증가한 것으로 나타났다. 이상의 결과에 따라 결핵 재발자, 고등학생, 60세 이상의 연령층, 80세 이상의 노인, 군대 등의 남성 집단, 외국인 대상의 신속하고 정확한 결핵 조기 검진정책과 관리가 필요하다.

• Tuberculosis and Respiratory Diseases
• /
• 제87권2호
• /
• pp.115-122
• /
• 2024

Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

• 한국건강관리협회지
• /
• 제2권3호
• /
• pp.73-96
• /
• 2004

Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea Most of the health screening programmes focused upon detection of risk factors and diagnosis of life - style related diseases (diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers (stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus) , infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites) , chronic obstructive respiratory diseases, chronic renal diseases (bacteriuria hematuria, proteinuria) , anemia, glaucoma, hearing loss, Alzheimer disease, stress, early psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests (CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests (HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray (chest PA, CT) , endoscopy (gastroscopy, colonoscopy) , sonography(abdomen, thyroid, pelvis, breast) ,cytology (cervix) , bone density, tumor markets (NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MRI, MRT/Angio, molecular testings) were widely used in hospital health screening programmes .In summary, a variety of tests were utilized in health screening in Korea. Those tests were utilized by stages or according to sex and age in most of health screening programmes, however a few program used tests to excess disregarding health screening subjects.

• 한국건강관리협회지
• /
• 제2권2호
• /
• pp.215-230
• /
• 2004

Along with a development of medical technology, a variety of tests, such as laboratory tests, x-ray and endoscopies are being used in health screening tests. As the tests determine the quality of health screening, test items and methods should be carefully selected. This study was to get hold of the test items of major health screening programs in Korea. Most of the health screening programmes focused upon detection of risk factors and diagnosis of life-style related diseases(diabetes, hypertension, cardiovascular diseases, hypercholesterolemia, overweight, drinking, smoking, cerebrovascular diseases, osteoporosis) ,cancers(stomach, cervix, lung, breast, liver, colon, prostate, ovary, pancreas, thyroid, esophagus), infectious diseases (hepatitis, tuberculosis, sexually-transmitted diseases, parasites),chronic obstructive respiratory diseases, chronic renal diseases(bacteriuria, hematuria, proteinuria), anemia, glaucoma, hearing loss, Alzheimer disease, stress, early Psychiatric diseases. The health screening tests were basic physical examination, basic laboratory tests(CBC, urinalysis, liver function tests, lipid tests, glucose, HbAlc, uric acid, electrolytes, serological tests(HBsAg, HBs-Ab, HCV-Ab, HIV-Ab, VDRL) EKG, x-ray(chest PA, CT), endoscopy (gastroscopy, colonoscopy) , sonography(abdormen, thyroid, pelvis, breast) , cytology(cervix) ,bone density, tumor markers(NMP22, alpha-FP, CEA, CA-19-9, CA12S, PSA) and eye tests. Advanced technologies, like CT, PET, MIRI, MIRI/Angio, molecular testings) were widely usedin hospital health screening programmes. In summary, a variety of were utilized by stages or programmes, however a few subjects. tests were utilized in health screening in Korea. Those tests according to sex and age in most of health screening program used tests to excess disregarding health screening subject.

• Tuberculosis and Respiratory Diseases
• /
• 제86권4호
• /
• pp.284-293
• /
• 2023

Background: Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. Methods: A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCO_m2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. Results: A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. Conclusion: Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.

• Pediatric Infection and Vaccine
• /
• 제26권1호
• /
• pp.32-41
• /
• 2019

목적: 결핵 전파를 조기에 차단하기 위해서는, 활동성 결핵 환자와 접촉한 사람들을 조사하여 결핵 질환 및 잠복결핵감염을 진단하고 치료하는 것이 매우 중요하며, 국내에서는 민간-공공협력 결핵관리사업을 통해 적극적인 접촉자 조사 활동을 지원하고있다. 본연구에서는최근 3년간단일기관에서이루어진소아청소년연령에서의접촉자검진과소아잠복결핵감염치료 현황에 대해 조사하였다. 방법: 2014년 7월 1일부터 2017년 6월 30일까지 충남대학교병원에서 활동성 결핵 환자로 진단받은 환자들을 대상으로 가족 내 소아청소년 접촉자에 대한 검진을 시행하여 접촉자 검진 완료율 및 결과를 분석하였고, 이와 함께 동일 기간 동안 잠복결핵감염으로 치료 받은 소아청소년 환자들의 치료 현황을 후향적으로 검토하였다. 결과: 연구 기간 동안 본 기관에서 활동성 결핵 환자는 총 1,002명 진단되었고, 그 중 소아청소년 가족접촉자가 있는 환자는 171명이었다. 소아청소년 접촉자 269명 중 20명(7.4%)은 검진을 전혀 받지 않았다. 1차 검진을 받은 249명 중 폐결핵이 1명(0.4%) 진단되었고, 7명(2.8%)은 과거의 결핵 감염 병력이 있었으며, 42명(16.9%)이 잠복결핵감염으로 진단되었다. 2차 검진 시 29명(11.6%)이 추가로 잠복결핵감염으로 진단되었으며, 2차 검진까지 필요하였으나 검진을 완료하지 않은 사람이 61명으로 총 접촉자 269명 중 188명(69.9%)만이 필요한 검진을 완료하였다. 잠복결핵감염으로 치료받은 소아청소년 환자는 90명이었으며 83명(92.2%)이 치료를 완료하였고, 이 중 18명이 발진(8명), 피로(5명), 위장장애(5명) 등의 부작용을 호소하였으나 치료 중단이 필요한 심각한 부작용은 없었다. 결론: 민간-공공협력 결핵관리사업 도입 및 보편화 후에도 소아청소년 연령에서의 결핵 접촉자 검진 완료율은 낮았으며, 잠복결핵감염으로 진단받은 소아의 항결핵제 치료 시 심각한 부작용의 발생 없이 투약 완료율이 높게 나타났다. 향후 결핵 전파의 예방 및 관리를 위해 더욱 적극적인 민관 협동 노력 및 환자, 보호자 교육이 필요하겠다.

• Tuberculosis and Respiratory Diseases
• /
• 제59권4호
• /
• pp.356-360
• /
• 2005

연구배경 : 징병검사에서 집단 흉부 간접 방사선 촬영의 폐결핵에 관련한 임상적 유용성을 평가하고자 하였다. 방 법 : 2003년 4월부터 11월까지 서울 지방병무청 제 2 징병검사장에서 징병검사를 시행한 25386명을 대상으로 하였다. 모두 흉부 간접 방사선 촬영을 시행하였고 이상소견자는 직접 방사선 촬영으로 확인하였다. 흉부 간접 방사선 촬영과 직접 방사선 촬영과의 양성 예측율을 알아보았다. 폐결핵을 중심으로 추적검사를 통해 활동성 폐결핵 유병율, 침윤정도와 임상경과를 알아보았다. 결 과 : 총 25386명중 328명에서 흉부 간접 방사선 촬영상 이상소견이 발견되어 직접 방사선 촬영으로 재검사하였다. 재검사 중 302명(1.19%)에서 이상소견이 확인되었다. 폐결핵을 포함한 폐실질병변이 109예였고, 종격동 병변이 6예, 심혈관계 이상이 45예, 흉막병변이 49예, 측만증을 포함한 골격계 이상이 90예 그리고 기타 7예였다. 흉부 간접 방사선 촬영상 폐결핵은 99예 였으며, 이중 활동성 폐결핵이 67예로 활동성 폐결핵의 유병율은 0.26%였다. 활동성 폐결핵 환자의 42예, 폐렴 1예, 종격동 종양 1예, 늑골골절 2예 그리고 기흉 4예가 최초 진단되었다. 활동성 폐결핵 환자의 폐침윤 정도는 경증이 52예 였으며, 60예에서 추적검사상 호전되었다. 결 론 : 징병검사에서 집단검사로서 흉부 간접 방사선 촬영은 한계와 문제점이 있으나, 특히 활동성 폐결핵을 포함한 병의 최초 조기발견에 있어 유용한 검사로 의미가 있을 것으로 사료된다.