• Title/Summary/Keyword: sputum

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Study of the Indicators of Dampness-Phlegm Pattern Identification Based on Tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke (한국형 중풍 변증 표준시안의 습담 변증 지표에 대한 연구)

  • Jo, Hyun-Kyung;Kim, Joong-Kil;Kang, Byeong-Kab;Yu, Byeong-Chan;Baek, Kyung-Min;Lee, In;Choi, Sun-Mi;Seol, In-Chan
    • The Journal of Internal Korean Medicine
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    • v.27 no.1
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    • pp.237-252
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    • 2006
  • Objectives : This study was done to investigate clinical frequency and correlation among the indicators of dampness-phlegm pattern identification settled by tentative Korean Standard Differentiation of the Symptoms and Signs for Stroke. Methods : The subjects were 147 hospitalized patients with stroke, and a list of registry was made for each of them. Among the five types of pattern identification, fire-heat, dampness-phlegm, blood-stasis and deficiency of Qi and of Yin, those that have shown a high frequency in dampness-phlegm type were categorized as the dampness-phlegm pattern group. Frequency of dampness-phlegm indicators was compared with those from the non-dampness-phlegm pattern group. Correlations among dampness-phlegm indicators were also studied. Results : 1. Dampness-phlegm pattern group included 26 patients out of 147. 2. Among the indicators of dampness-phlegm pattern. those, in order of highest frequency, were 'tiredness or sluggishness', 'white Coated tongue' and 'sputum'. 3. In comparing dampness-phlegm pattern group with non-dampness-phlegml group, the indicators such as 'lightheadedness', 'nigrescence', 'sputum', 'dermatic dysaesthesia' showed significantly high frequency. 4. Among the indicators, 'sputum' and 'tiredness or sluggishness', 'sputum' and 'yellow coated tongue', and 'white coated tongue' and 'yellow coated tongue' showed significant correlation. 5. In investigation of the correlation of scale in symptoms, various results such as positive correlation and negative correlation were obtained. Conclusion : In this study, more sensitive indicators of dampness-phlegm pattern identification were found. Based on these results, it is suggested that a more practical Korean Standard Differentiation of the Symptoms and Signs of Stroke would be established through continuous clinical studies by giving weight on each specific type of pattern identification.

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Development and Evaluation of an Automated Stainer for Mycobacterium Tuberculosis (결핵균 자동염색기의 개발 및 평가)

  • Kim, S. C.;Kang, S. I.;Kim, S. C.;Hwang, J. H.;Kim, S. Y.;Kim, Y.;Song, S. D.;Cho, S. N.;Kim, D. W.
    • Journal of Biomedical Engineering Research
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    • v.23 no.3
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    • pp.235-241
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    • 2002
  • The detection of tubercle bacilli (TB) from sputum smear is one of the fast and inexpensive methods for diagnosis of tuberculosis. For this method. sputum smears are usually flexed by heating and stained by acid-fast staining method, and then examined under an optical microscope. Two Procedures are commonly used fur TB staining. One is hot staining and the other is cold staining method. The Ziehl-Neelsen method which is a hot staining method is widely used in Korea because its stained color is more vivid However, the conventional automated stainer has to fix the sputum smear on a slide manually and the stain is not so vivid because it has not heating function. In an effort to save labor and minimize variations in manual staining Procedure. we developed an automated stainer with heating function. The entire staining process is fully automated. from fixation to final washing and drying. With the automated methods, five slides can be flexed and stained in 21 minutes at consistent high quality We compared the concordance rate between the two methods for 91 sputum samples to validate the stain quality of the developed automated stainer. As the results, the concordant rate between the two methods was 95% and there was no significant difference (p>0.05)

Drug Sensitivity and Relapsed Period of Relapsed Pulmonary Tuberculous Patients registered in Some Public Health Offices, in Seoul (폐결핵 재발 환자의 약제 감수성과 재발 간격에 관한 단면 연구 - 서울시 일부 보건소 등록 환자를 중심으로)

  • Park, Hye-Sook;Ha, Eun-Hee;Wie, Cha-Hyung;Kang, Ji-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.67-78
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    • 1996
  • The purpose of this study was examine the general characteristics of relapsed pulmonary tuberculous patients (i.e. age, sex, weight, occupation, previous forms of treatment, drug sensitivity, and the frequency of relapse) in order to improve future treatments of tuberculosis as well as to perpetuate health education. The data was obtained from the medical records of 186 relapsed pulmonary tuberculosis patients who were registered for treatment at various public health offices in Seoul during the year of 1994. The major findings obtained from the study were as follows; 1) The male to female ratio of relapsed pulmonary tuberculous patients was about 7:3, more specifically 23.7% of the men and 30.9% of the women were between 20 and 29 years of age. 2) Comparing initial less aggravated states to relapsed states, patients with minimal X-ray findings later proved moderately advanced X-ray findings. Furthermore, patients with negative sputum AFB findings later proved positive sputum AFB findings. 3) Of the 186 patients studied, 91.9% suffered, relapse and 8.1% suffered 2 or more relapses. Of the patients who suffered at least 1 relapse, 54.8% received short-term treatment, 26.9% received long-term treatment, and 18.3% received treatment of an unknown during their initial tuberculosis treatment periods. 4) fifty five point four percent of the patients had no reaction to the drug treatment(not available), 25.9% of the patients had sensitive reaction to the drug treatment, 18.7% of the patients had resistant reaction to the- drug treatment. Drug resistance was higher in patients that exhibited positive X-ray findings as well as in patients that exhibited positive sputum AFB findings. furthermore, patients receiving treatment of an unknown nature(35.5%) exhibited higher drug resistance than those receiving short-term treatment(13.6%) and long-term treatment(17.0%). 5) Of the 160 patients who suffered relapses, 8.8% suffered a relapse within 1 year after treatment and 91.2% suffered a relapse at least 1 year after treatment. Furthermore, our study showed that women, under 30, who received short-term treatment and encounterd complications during their primary treatment suffered relapses faster than any other groups studied. In addition, minimal X-ray findings and sputum AFB findings were not correlated to the time relapse occured. Therefore, the seater efforts are needed to prevent relapsed pulmonary tuberculosis.

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Evaluation of Liquid Culture System in Sputum Culture and Drug Susceptibility of Mycobacterium tuberculosis (고위험병원체 결핵균의 신속진단을 위한 액체배양시스템 평가)

  • Kim, Jin-Sook;Kim, Seung-Cheol;Jeon, Bo-Young;Park, Seung-Kyu
    • Korean Journal of Microbiology
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    • v.45 no.3
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    • pp.281-285
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    • 2009
  • In this study, we compared the BacT/Alert liquid culture system with Ogawa and $L\ddot{o}wenstein$-Jensen (L-J) media for sputum culture and drug susceptibility test (DST) of Mycobacterium tuberculosis. Rapid liquid culture systems have been widely employed both for primary cultures of M. tuberculosis from clinical specimens and for drug susceptibility test because of its greater sensitivity and faster turn-around time than the conventional egg-based culture methods (Ogawa, $L\ddot{o}wenstein$-Jensen media). Sputum specimens were decontaminated with N-acetyl-L-cysteine (NALC)-4% NaOH and inoculated into the BacT/Alert culture bottles and Ogawa media. 95 from among 135 sputa were smear-positive, 97 (71.9%) were culture-positive by the BacT/Alert culture system, while 89 (65.9%) were positive by Ogawa media. The mean time to culture-positive by the BacT/Alert process system was about 11.3 days, which was significantly shorter than that by Ogawa media (22.4 days). Of 32 M. tuberculosis cultures examined for drug sensitivity, the concordant rate between the two methods (BacT/ Alert liquid culture system, $L\ddot{o}wenstein$-Jensen media) ranged from 87.5% for isoniazid and 90.6% for rifampicin.

Viability Change of Mycobacterium Tuberculosis in the Sputum Specimens Stored at Different Temperatures with or without Preservatives (객담보관온도별 결핵균의 생활력 변화와 오염방지를 위한 방부제에 관한 연구)

  • Kim, Sang-Jae;Hwang, Hae-Do
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.4
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    • pp.435-439
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    • 1986
  • The viability of tubercle bacilli in the sputum specimens has been investigated after different periods of storage at diffeent temperatures and in the presence of different preservatives. No loss of culture positives was observed for one week storage at $4^{\circ}C$, but 9.8% 19.5%C, and 26.8% of sputums failed to yield positives on 2, 3, and 4 weeks of storage respectively. At $25^{\circ}C$ even one week storage made 19.5% of sputums fail to yield positive culture and 2, 3, and 4 weeks of storage made 36.6% 70.7%, and 90.2% of sputums fail to yield positive culture respectively. And contamination was unacceptably high beyond one week of storage at $25^{\circ}C$. Contamination of sputum specimens could be protected fairly well by 0.5% boric acid, by 5% trisodium phosphate or by 0.5% cetylpyridium chloride, but, except CP, the former two had no advantage at all to protect viability of tubercle bacilli over the specimens without preservative. The CP was much less harmful to the viability of tubercle bacilli than BA, yielding 61.0% and 31.7% of culture positives on 3 and 4 weeks of storage in the presence of CP, while BA yielded 34.1% and 4.9% of positives on the same respective periods of storage. Therefore CP may be useful to preserve sputums if it takes more than 2 weeks to transport them at the temperature of over $25^{\circ}C$.

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The Effectiveness of Real-Time PCR Assay, Compared with Microbiologic Results for the Diagnosis of Pulmonary Tuberculosis

  • Kim, Seo Woo;Kim, Sae In;Lee, Seok Jeong;Lee, Jin Hwa;Ryu, Yun Ju;Shim, Sung Shine;Kim, Yookyoung;Lee, Mi Ae;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.1-7
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    • 2015
  • Background: The incidence of tuberculosis (TB) in Korea is relatively high compared to the other Organisation for Economic Co-operation and Development (OECD) countries, with a prevalence of 71 per 100,000 in 2012, although the incidence is declining. Real-time polymerase chain reaction (PCR) has been introduced for the rapid diagnosis of TB. Recently, its advantage lies in higher sensitivity and specificity for the diagnosis of TB. This study evaluated the clinical accuracy of real-time PCR using respiratory specimens in a clinical setting. Methods: Real-time PCR assays using sputum specimens and/or bronchoscopic aspirates from 2,877 subjects were reviewed retrospectively; 2,859 subjects were enrolled. The diagnosis of TB was determined by positive microbiology, pathological findings of TB in the lung and pleura, or clinical suspicion of active TB following anti-TB medication for more than 6 months with a favorable response. Results: Sensitivity, specificity, and accuracy were 44%, 99%, and 86% from sputum, and 65%, 97%, and 87% from bronchoscopic aspirates, respectively. For overall respiratory specimens, sensitivity was 59%, specificity was 98%, and accuracy increased to 89%. Conclusion: Positivity in real-time PCR using any respiratory specimens suggests the possibility of active TB in clinically suspected cases, guiding to start anti-TB medication. Real-time PCR from selective bronchoscopic aspirates enhances the diagnostic yield much more when added to sputum examination.

Open Lung Biopsy for Diffuse Infiltrative Lung Disease (미만성 폐질환에 대한 폐생검의 의의)

  • 김해균
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.903-906
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    • 1991
  • Retrospective review of 26 patients undergoing open lung biopsy at the Yonsei University during 10 years period was conducted to evaluate open lung biopsy for DILD. From January 1980 to August 1990, open lung biopsy was performed in 26 patients through a limited thoracotomy incision[a limited anterior or a posterolateral thoracotomy]. Open lung biopsy was indicated for diffuse interstitial pulmonary diseases undiagnosed by indirect clinical and radiological diagnostic methods. The types of incision were limited anterior[11] and limited posterolateral[15]. Preoperative evaluation of the lung disease included sputum culture[26], sputum cytology [19], bronchoscopy[9] and TBLB[7]. In 23 patients the histologic appearances after open lung biopsy were sufficiently specific histologic pictures to confirm diagnosis. The results of the biopsies changed usual therapeutic plan in 17 patients among them. The complications were resp. insufficiency[3], pulmonary ed6ma[3], sepsis[2], and others[3] in 6 patients. Diagnosis from the open lung biopsy was included respiratory pneumonia[7], fibrosis[7], infection[5], malignancy[2], others[5]. 4 patients died of respiratory insufficiency. The causes of the other three death were not due to direct result of the biopsy itself. Open lung biopsy in the patient with a diffuse infiltrative lung disease is an one of the accurate diagnostic method and frequently leads to change of the therapeutic plans. So we conclude that open lung biopsy remains our diagnostic method of choice in diffuse infiltrative lung disease undetermined etiology.

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A Case Report of a Patient with Chronic Thoracic Empyema Treated with a Combination of East-West Medicine (한양방 병용치료를 통한 만성적 농흉의 완화 치험 1례)

  • Jeong, Yeong-eun;Kim, Jong-dea
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.252-258
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    • 2017
  • Objectives: The purpose of this case report is to describe the clinical effectiveness of Korean medicine, especially Jungcheonwhadam-tang and Bopyeoyangyeong-jun, in a patient with chronic thoracic empyema while receiving treatment for this condition. Methods: The patient who had been diagnosed with empyema complained of a cough, with sputum. The patient was diagnosed with pe-ong (肺癰) based on his symptoms and x-ray findings. He was treated with a range of Korean medicines, including a herbal decoction, acupuncture, moxibustion, and cupping. A visual analogue scale and percentage pain reduction scale were administered after treatment. Results: After 20 days of the treatment, the patient's cough decreased by 80%, and sputum decreased by 50%. Conclusion: According to this study, Korean medicine, including Jungcheonwhadam-tang and Bopyeoyangyeong-jun, is effective in the treatment of chronic thoracic empyema.

A Case of Welder's Lung Disease and Concurred Non-Tuberculotic Mycobacterial Infection Confirmed with Thoracoscopic Lung Biopsy (흉강경하 폐생검을 통하여 확진된 용접공폐질환에 병발된 비결핵성 항산균감염증 1예)

  • Kim, Jung-Ho;Park, Yun-Jung;Park, Ki-Hoon;Kwon, Soon-Seog;Kim, Yong-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.223-227
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    • 2012
  • Pulmonary siderosis, or Welder's lung disease is an occupational lung disease caused by iron-inhalation. Diagnosis of pulmonary siderosis is based on occupational history of the patient, radiologic findings, and pathologic findings of iron-laden macrophages within lung tissue or broncho-alveolar lavage fluid. We observed a case of a 43 years-old welder diagnosed with pulmonary siderosis via thoracoscopic lung biopsy. Sputum culture along with pathology also identified a non-tuberculotic mycobacterial infection with a sputum culture and the pathologic findings. The patient was treated with anti-tubercular medication and cessation of iron-exposure. And his condition improved within a few months.

Recurrent Pseudomonas aeruginosa Infection in Chronic Lung Diseases: Relapse or Reinfection?

  • Yum, Ho-Kee;Park, I-Nae;Shin, Bo-Mun;Choi, Soo-Jeon
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.172-177
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    • 2014
  • Background: Pseudomonas aeruginosa infection is particularly associated with progressive and ultimately chronic recurrent respiratory infections in chronic obstructive pulmonary disease, bronchiectasis, chronic destroyed lung disease, and cystic fibrosis. Its treatment is also very complex because of drug resistance and recurrence. Methods: Forty eight cultures from 18 patients with recurrent P. aeruginosa pneumonia from 1998 to 2002 were included in this study. Two or more pairs of sputum cultures were performed during 2 or more different periods of recurrences. The comparison of strains was made according to the phenotypic patterns of antibiotic resistance and chromosomal fingerprinting by pulsed field gel electrophoresis (PFGE) using the genomic DNA of P. aeruginosa from the sputum culture. Results: Phenotypic patterns of antibiotic resistance of P. aeruginosa were not correlated with their prior antibiotic exposition. Fifteen of 18 patients (83.3%) had recurrent P. aeruginosa pneumonia caused by the strains with same PFGE pattern. Conclusion: These data suggest that the most of the recurrent P. aeruginosa infections in chronic lung disease occurred due to the relapse of prior infections. Further investigations should be performed for assessing the molecular mechanisms of the persistent colonization and for determining how to eradicate clonal persistence of P. aeruginosa.