• Title/Summary/Keyword: 결핵 예방

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Assessment of Renal Function in Silicobis with Urinary N-acetyl-$\beta$-D-glucosaminidase Activity (규폐증환자의 신기능 평가를 위한 요중 N-acetyl-$\beta$-D-glucosaminidase활성치 측정의 의의)

  • Lee, Hoo-Rak;Kim, Don-Kyoun;Lee, Su-Il;Cho, Byung-Mann;Kim, Wha-Jo
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.49-64
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    • 1993
  • To provide the basic data for assessment of renal dysfunction related to silicosis, urinary N-acetyl-$\beta$-D-giucobarninidase(NAG) activity known as a sensitive markers for early renal damage were measured in 58 silicosis patients, and control subjects of 40 pulmonary tuberculosis Patients and 51 official workers. The results were summarized as fellows. 1. The values of blood urea nitrogen and serum creatinine in all subjects were within reference limits. But the mean value of urinary NAG activity($7.25{\pm}7.31U/g\;creatinine$) was beyond reference value and more sensitive test than others. 2. The mean value of urinary NAG activity in silicosis group was $11.98{\pm}9.05U/g\;creatinine$ and significantly higher than in tuberculosis and healthy group(p<0.01), but the mean values of NAG activity in tuberculosis and healthy group were not different(p>0.05). 3. The value of NAG activity in tuberculosis had a tendency to be increased according to severity of disease, but that was not significant(p>0.05). The value of NAG activity was increased significantly by use of nephrotoxic antituberculosis drugs(p<0.05). 4. The value of NAG activity in silicosis had a tendecy to be increased according to the size of nodule, use of nephrotoxic antituberculosis drugs and shortness of onset duration, but the increase was not significant(p>0.05). 5. After excluding the users of nephrotoxic antituberculosis drugs, the mean values of NAG activity in healthy control and in tuberculosis control were same as 3.63 U/g creatinine and 3.60 U/g creatinine, respectively. But the mean value of NAG activity in silicosis group was remarkably increased as 10.90 U/g creatinine(p<0.01). As above results, even though there are no abnormal finding in screening renal function test, silicosis can be related with renal dysfunction. And it will be very useful to apply urinary NAG activity in health management of workers exposed to dust.

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An Assessment of the Protective Efficacy of BCG against Plmounary Tuberculosis (폐결핵 예방에 대한 BCG의 효과 분석)

  • No, Sung-Chan
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.5-11
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    • 1983
  • The BCG vaccination has been employed as the main control measure for pulmonary tuberculosis in Korea since 1952. However, the protective efficacy of BCG against tuberculosis has been controversial worldwide. This study was conducted to evaluate the protective efficacy of BCG against pulmonary tuberculosis by a case-cotrol study. The study subjects included all the pulmonary tuberculous patients under 20 years of age who were registered in six health centers in Taegu City between May 1 and September 30, 1982. The controls were randomly selected among non-tuberculous out-patients matched by the age, sex and residence of the cases. The history of BCG vaccination was confirmed by the scar of 400 cases and 659 controls. The relative risk of the BCG recipients for pulmonary tuberculosis were 0.5 and the protective efficacy of the BCG was. 51.5%. It appears that the BCG vaccination is an efficient preventive measure in Korea where tuberculosis is prevalent. Thus the routine BCG vaccination should be continued.

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Factors Affecting Clinical Course of BCG Lymphadenitis (BCG 림파선염의 경과에 영향을 미치는 인자들에 대한 연구)

  • Na, Kyong Hee;Rim, Sung Soo;Kim, Eun Yong;Kim, Kyoung Sim;Kim, Yong Wook
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.181-190
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    • 2001
  • Purpose : Lymphadenitis is the most common complication of BCG vaccination and has various clinical course and prognosis, but there are no accurate guidelines for management of BCG lymphadenitis. We performed this study to reveal the clinical course of BCG lymphadenitis and provide guidelines for its management. Methods : From January, 1997, to May, 2000, 73 patients in the 3~24 months were enrolled. We investigated retrospectively the size, site, and number of lymphadenitis, tuberculin skin test induration, used BCG strains, vaccination age, injection site, treatment and clinical course. The effects of various variables on clinical course were evaluated. Results : 1) There were no statistically significant difference between lymphadenitis size and tuberculin test induration diameter, spontaneous resolution rate, and suppuration rate. 2) Later vaccination(${\geq}1$ mo) and supraclavicular lymphadenitis increased suppuration rate. Using domestic BCG product increased surgical treatment rate. 3) According to treatment(observation vs antituberculous medication), medication did not affect the prevention of suppuration and ironically increased the rate of suppuration and surgical treatment. 4) Suppurative lymphadenitis required more surgical treatment than non-supurative one. Conclusions : Clinical course of BCG lymphadenitis is affected by vaccination age, used BCG strains, site of lymphadenitis, antituberculous medication and suppuration, but not affected by size and number of lymphadenitis. For management of BCG lymphadenitis, systemic antituberculous medicaion is not recommended and regular follow up with observation should be the mainstay. But for suppuration, active surgical en bloc resection should be the treatment of choice.

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The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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A Case of Disseminated Mycobacterium bovis Infection after BCG Vaccination (Tokyo strain) in an Apparently Immunocompetent Infant (면역기능이 정상인 영아에서 동경주 BCG 백신 접종 후 발생한 파종성 Mycobacterium bovis 감염 1예)

  • Paik, Ji Yeun;Choi, Jae Hong;Kim, Min Kyung;Choi, Eun Hwa;Lee, Hoan Jong;Park, Kyoung Un
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.91-96
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    • 2011
  • Bacille Calmette-Gu$\acute{e}$rin (BCG) vaccine is a live attenuated vaccine derived from Mycobacterium bovis. Frequent complications after BCG vaccination are localized ulcer formation and regional lymphadenitis, but there could be rarely severe systemic reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection. Although disseminated BCG infection can be complicated in infants with underlying immunodeficiency after BCG vaccination, it is very unlikely to develop in immunocompetent infants or children. We report a 13-month-old infant who presented with fever, skin nodules, and multiple enlarged lymph nodes 5 months following BCG vaccination. She was diagnosed with disseminated BCG infection by PCRconfirmed M. bovis BCG infection at ${\geq}$2 anatomical sites beyond the region of vaccination. The patient showed no obvious evidence of immunodeficiency as judged on the basis of previous disease history, plasma immunoglobulin levels, B and T lymphocytes counts in peripheral blood, DHR (dihydrorhodamine 123 fluorescence) test and HIV test. She started antituberculous treatment with isoniazid and rifampin, and now, apparently her symptoms have been improved.

The Reactivity to 2TU PPD Tuberculin Skin Test after Percutaneous Multiple Puncture BCG Vaccination (건강한 영아에서 경피다자법 BCG 접종후 2TU 투베르쿨린 검사의 반응성)

  • Roh, Hye Ok;Lee, Woo Gill
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.101-106
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    • 1999
  • Purpose : Tuberculosis, a major public health problem, is an important cause of childhood infectious diseases. To decrease the tuberculosis morbidity rate, BCG vaccination and chemoprophylaxis are performed. Recently 2TU PPD skin test was introduced as a diagnostic method for tuberculous infection. We studied the positive conversion rate of 2TU PPD test after percutaneous multiple puncture BCG vaccination. Methods : Four hundred seventy six infants from well baby clinic of Samsung Cheil Hospital were enrolled. They were immunized with percutaneous multiple puncture technique BCG(Japan BCG laboratory, Japan) at 1 month of age. Approximately 6 months later, tuberculin skin test using RT23 2TU PPD was performed. Induration size, family history of tuberculosis and number of BCG scars were evaluated. Induration greater than or equal to 5mm was defined as positive conversion. Results : Among 476 infants, 248(52.1%) were male and 228(47.9%) were female. PPD skin tests were performed $6.2{\pm}0.5$($mean{\pm}S.D.$) months after BCG vaccination. Mean induration size was $7.3{\pm}3.2mm$ and positive conversion rate was 85.5%. Total number of BCG scars was $15.5{\pm}3.2$. Conclusion : The seroconversion rate by 2TU PPD test after percutaneous multiple puncture BCG vaccination was high. But, more comparative studies with various age groups may be needed for 2TU PPD test used as diagnostic method of tuberculosis in the hospitals.

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Factors Influencing Compliance with Anti-Tuberculosis Therapy (폐결핵 환자의 치료 순응과 관련된 요인)

  • Kim, Cheon-Tae;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.79-90
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    • 1996
  • The purpose of the study was to determine factors influencing compliance with anti-tuberculosis therapy. The study subjects were 104 tuberculosis patients who have received the initial treatment in 3 health centers of Kyongju-City, Dalseong-Gun in Teagu and Kumi-City. Data were collected between September and October 1995. The patients were classified into the improved group and the non-improved group according to outcomes of 3 month treatment with short-term therapeutic regimen. To find factors influencing compliance with anti-tuberculosis therapy, multiple logistic regression was made. There was no significant differences between the improved group and the non-improved group in sex, age, education level, occupation, family pattern, and habitual change regarding smoking and drinking. The level of knowledge about anti-tuberculosis therapy in the improved group was significantly higher than the non-improved group(p<0.01). Multiple logistic regression analysis revealed that family support for not forgetting medication (p<0.05) wis a predictor of improvement and knowledge about anti-tuberculosis therapy(p=0.054), regularity of medication(p=0.062), and consultation to family, doctor and nurse(p=0.075) were marginal predictors of improvement. Treatment must be given to every patient confirmed as having tuberculosis and must be given free of charge to the patients. The requirements for adequate chemotherapy are prescribed in the correct dosage and taken regularly by the patient for a sufficient period to prevent relapse of the disease after cure. It is suggested that education to the patients should be reinforced and connectedness between patients and tuberculosis control workers and family should be solidated.

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Respiratory Vaccination (호흡기 예방접종)

  • Park, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.457-461
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    • 2011
  • Vaccination in adults is recommended according to the age group and underlying diseases or risks of exposure. Patients with chronic diseases including chronic obstructive pulmonary diseases are susceptible to infectious diseases and related serious complications. They need risk-related vaccination along with age-related vaccination. Both influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary diseases. They are additive if administered simultaneously. Pertussis vaccination is also needed in adolescents and adults. Although there is strong need for these vaccinations, the actual vaccination rate is low. Measures to effectively enhance the vaccination rate are needed.

성인병 뉴스 제310호

  • The Korea Association of Chronic Disease
    • The Korean Chronic Disease News
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    • no.310
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    • pp.1-18
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    • 2006
  • 강원도 인제군 보건소 권장원 소장/‘만성질환관리사업지원단’설치.운영/경기도립노인전문병원 2008년 건립/전통 한의약 세계적 브랜드로 육성/인터넷 이용 결핵환자 원격판독/“간호조무사 대체 법적 근거 마련”/건보-자보 일원화 추진 논란/“아시아 당뇨 대란 심각하다”/2010년 세계뇌졸중학회 서울 유치/“성분명처방, 시간 필요하다”/생동성 관련 품목허가취소 가처분 수용/KGMP“ 의약품 품목별로 평가한다”/식약청, 11번째 국산 신약 시판 허가/내년부터 의약품 설명서 알기 쉽게 교체/군부대장병 금연환경조성을 위한 이동금연클리닉 사업/외래환자 1위는‘서울아산병원’/‘대한네트워크병의원협회’발족/뇌혈관질환 50대 이후 사망원인 1위 차지/건강한 생활습관이 심혈관질환 예방의 첩경/

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The Effects of Knowledge and Attitudes related to Tuberculosis on Tuberculosis Prevention Behaviors in North Korea Refugee Adolescents (북한이탈청소년의 결핵에 대한 지식 및 태도가 결핵예방행위에 미치는 영향)

  • Kim, Seon Hwa;Shin, Juh Hyun
    • Journal of the Korean Society of School Health
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    • v.33 no.3
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    • pp.164-174
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    • 2020
  • Purpose: The purpose of this study was to identify the factors affecting tuberculosis prevention behaviors in North Korean adolescent refugees. Methods: From September 16 to October 8, 2019, a survey was conducted to collect data from 143 North Korean adolescent refugees aged 13 to <25 at alternative and general schools in Seoul and Gyeonggi Province. The scale developed by Park (2008) and adapted by Cha (2012) was used to rate tuberculosis prevention behaviors in daily life with the aim of preventing high school students from getting infected with tuberculosis. The collected data were processed through frequency analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression, using SPSS 25.0. Results: The mean score was 13.65 for knowledge of tuberculosis, 44.23 for attitudes towards tuberculosis, and 41.33 for tuberculosis prevention behaviors. Significant differences were found according to gender, country of origin, duration of stay in South Korea, tuberculosis examination, pre-entry chest x-ray, education about tuberculosis, alcohol intake, and subjective health status. A positive correlation was found between knowledge, attitudes, and prevention behaviors. The factors affecting tuberculosis prevention behaviors were attitudes (β=.38, p<001) and subjective health status (β=.26, p<.001). Conclusion: It is necessary to provide attitude-based education that can reinforce positive attitudes in order to improve North Korean adolescent refugees' tuberculosis prevention behaviors. This is expected to help them pay more attention to health care and become better at prevention behaviors. It is, therefore, necessary to develop a tuberculosis prevention education program with the aim of making them more knowledgeable about tuberculosis and providing them with systematic and sustainable education.