• Title/Summary/Keyword: 결핵 조기 검진

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우리나라 학생 신체검사의 현황, 문제점 개선방향

  • Choe, Yu-Jin
    • Journal of the Korean Society of School Health
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    • v.5 no.1
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    • pp.20-23
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    • 1992
  • 충치등의 구강질병은 예방이 가능하며 일단 발생하면 자연치유란 없고 질병의 진행만 있는 질병으로서 조기발견과 조기치료가 필요하다. 특히 학교연령층에서 폭발적으로 발생되고 있 기 때문에 학교구강보건관리가 중요하지만 선진국처럼 학교구강건강 관리실을 운영하고 전문인력을 상주 배치할 수 없는 현시점에서 예방교육과 조기발견, 조기치료를 위한 정기구강검사 제도는 필수적이다. 현행학교정기구강검사는 결핵, 간염, AIDS 등 질병의 전염문제와 검진비가 현실적이지 못하며 치과의사의 봉사강요형태로 진행되고 있는 문제 등이 있다. 그러므로 래원검진제 같은 의견도 있으나 현행 정기구강검진제를 개선하여 실시하는 것이 현실적이라고 본다. 기수소독문제는 치과의사 1인당 50개 정도의 기구가 준비되고 화학소독제로서 Glutal-dehyde(와이멕스)사용으로 해결될 수 있으며 기타 문제는 검진수가의 현실적 인상과 연계되어 근본적으로 해결될 수 있다.

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Childhood Tuberculosis Contact Investigation and Treatment of Latent Tuberculosis Infection: a Single Center Study, 2014-2017 (소아청소년 결핵 접촉자 검진 및 잠복결핵감염의 치료 현황: 2014-2017 단일 기관 연구)

  • Hwang, Woo Jin;Lee, Go Un;Kim, So Hyun;Cho, Eun Young
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.32-41
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    • 2019
  • Purpose: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. Methods: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. Results: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. Conclusions: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.

`98 국가결핵관리사업 추진방향

  • 서상곤
    • 보건세계
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    • v.45 no.3 s.499
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    • pp.4-7
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    • 1998
  • 지난 1997년은 결핵관리부분에도 많은 어려움이 있었던 해였다. 특히 국가결핵관리사업의 핵심사항인 영유아 결핵예방접종에 있어 민간의 병$\cdot$의원 경피 비시지 사용이 늘어 결핵예방사업에 지장을 주었고 결핵진단용약(PPD)의 공급차질 그리고 교육부와 학생 검진문제에 대한 의견상충 등으로 결핵관리사업편람을 재검토하는 계기가 되었다. 그러한 중에도 현재 마지막 정리단계에 있는 '2000년대 국가결핵관리 발전방안 모색을 위한 작업반'의 활동결과는 지난 1년간 각계의 전문가들이 여러차례의 진지한 토의를 거쳐 얻은 귀중한 결실이었다. 동 활동내용은 민간 병$\cdot$의원과 함께 결핵의 현실을 정확하게 재조명하고 해결방안을 찾고자 하는데 의미가 컸다고 할 수 있으며 우리나라의 중$\cdot$장기 결핵관리사업 계획수립에 기초가 되어 결핵의 조기퇴치에 크게 기여할 것이라고 확신한다. 1998년은 그 작업결과를 바탕으로 단기적으로 그동안 해결하지 못했던 문제점의 해결에 최선을 다하여 국가결핵관리의 체계를 재정립하고 장기적으로는 다가오는 2000년대에 대비하여 보다 발전된 국가결핵관리 사업의 초석을 다지고자 한다.

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A Study on the Current Status of Tuberculosis Patients in Korea(2010-2018) (국내 결핵환자 발생 현황 고찰(2010-2018))

  • Kim, Won-Soon;Park, Chang-Su
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.1021-1030
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    • 2021
  • This study analyzed the status of tuberculosis patients in Korea by collecting data from the Statistics Korea and the KDCA's GLOBAL Tuberculosis Report from 2010 to 2018 to find ways to manage tuberculosis patients in Korea and provide basic data on tuberculosis policies. The results are as follows. First, the results of tuberculosis patients in Korea decreased by about 21.3% to 33,796 (65.9%) in 2018 and 26,433 (51.5%) in 2018. Second, the status of tuberculosis patient treatment in Korea was found to be 655 in 2018, an increase of about 160% compared to 2014. Third, the incidence of tuberculosis among adolescents was 1.8% in 2018 for those aged 10 to 14 and 15.0% for those aged 15 to 19, the highest rate of tuberculosis among high school students, Fourth, looking at the incidence of tuberculosis patients by age, subjects in their 60s or older showed a prevalence of tuberculosis by 60% or more, especially elderly tuberculosis patients over 80 years of age. Fifth, the status of the incidence of tuberculosis patients by gender was found to be 1.4 times higher in men than in women in 2018 compared to 2010. Sixth, 1,419 people (75.6%) in Jeollanam-do had the highest prevalence of tuberculosis nationwide, and 99 people (33.4%) in Sejong had the lowest prevalence. Seventh, the number of foreign patients in Korea continued to increase to 1,510 in 2012, increasing to 2,569 in 2016. The results this study indicate the need for rapid and accurate early tuberculosis screening policies and management for tuberculosis relapse patients, high school student, age groups over 60, a group of men such as the military, the elderly over 80, and foreigners.

A Study on Clinical Manifestations of Pulmonary Tuberculosis and Tuberculosis Contact Investigation in School-Age Children and Adolescents at Two Centers (두 개 대학병원에서 진단된 학동기 소아 및 청소년 폐결핵의 임상 양상과 접촉자 검진의 실태)

  • Bae, Mi-Hye;Song, Bo Kyung;Kim, Kyung-Min;Son, Seung Kook;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.191-198
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    • 2014
  • Purpose: The aim of this study was to evaluate the clinical manifestations, contact history, and status of tuberculosis contact investigations in school-age children and adolescents with pulmonary tuberculosis (TB) at two centers. Methods: This study was conducted with 54 patients in the age ranging from 10 to 18 years, who were diagnosed with pulmonary TB at the Pusan National University Hospital and Pusan National University Children's Hospital, January 2008 to December 2012. We retrospectively reviewed the medical records of the patients. Results: The median age of the patients was 16 years old; 11 patients were aged 10 to 14 and 43 patients were aged 15 to 18. Among 54 patients, 19 had history of contact with pulmonary TB, 10 had contact with house members (household), and remaining 9 had contact with classmates (non-household). One out of 10 patients who had household contacts and 6 out of 9 patients who had non-household contacts were evaluated with contact investigation after the exposure to pulmonary TB. Among 7 patients who were evaluated with contact investigation, 3 were diagnosed with active pulmonary TB, 1 had latent tuberculosis infection (LTBI), and 3 had no evidence of TB or LTBI. The median period of diagnosis after the exposure to active pulmonary TB was 2 years in patients with household contacts and 0.23 years in patients with non-household contacts. Conclusion: This study suggested that if the contact investigation conducted properly, it would be helpful for early diagnosis and prevention of pulmonary TB.

Lung Cancer Screening (폐암 조기 진단)

  • Kim, Ju Ock
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.207-213
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    • 2006
  • 기존의 폐암 발생의 고위험군(나이. 흡연력, $FEV_1$, 가족력, 직업적 발암물질의 노출력, 기존의 폐암 및 두경부 종양)에 대한 저선량 나선식 CT와 기관지 내시경 검사로 선별 검사 시 폐암의 유병률은 높아야 2%내외이고 대부분 그보다 낮은 것으로 알려져 있다. 특이도는 49-90%, 양성예측률은 10%이하로 선별검사 시 불필요한 검사를 초래하고 그에 따른 이환률과 사망률을 증가시키며 비용적인 문제를 야기하는 것으로 알려져 있다. 이에 기존의 고위험군에 대해 대상 환자를 더욱 더 좁힐 필요가 있으며, 이는 실제 임상적으로 이용 가능한 생물학적 표지자의 개발의 필요성이 있다고 하겠다. 그러나 현재까지 알려진 폐암조기검진에 대한 각종 진단 수기 중애서 상기의 3가지 방법(저선량 MDCT, 자가형광기관지경 및 객담내 MAGE)을 한꺼번에 시행하는 program은 비용적인 문제는 있지만 시도해 볼 만한 방법이라고 생각된다.

Factors Influencing Treatment Result in Inpatients with Tuberculosis (결핵입원환자의 치료결과에 영향을 미치는 요인)

  • Lee, Hyun-Sook;Hwang, Seul-Ki;Kim, Sang-Mi
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.196-205
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    • 2016
  • The purpose of this study is to identify factors influencing treatment result in patients with Tuberculosis by patient characteristic, admission and disease characteristic, and hospital characteristic from 2006 to 2012. Survey data was using Korean national hospital discharge in-depth survey data produced by KCDC(Korea Center for Disease Control and Prevention). Study subjects were 8,305 inpatients with TB(A15.0~A19.9) and analyzed frequency, chi-square test, and logistic regression by using SPSS 20(Statistical Package for the Science). The results of this study show that influencing factors of treatment result were ages (20-39, 40-64, and over 65 years), type of insurance(medical aid), disease code (A16, A17, A18, A19), LOS (31-90, and 91-180 days), beds of hospital (300-499, 500-999, over 1,000 beds) and hospital district (non-metropolitan). These findings implied that it is necessary to support successful prevention and management for high risk TB groups and to build middle and long-term policies as well as short -term policy.

Clinical Characteristics of Tuberculosis in North Korean Refugees (북한이탈주민에서의 결핵의 임상적 고찰)

  • Choi, Chang-Min;Jeong, Woo-Kyoung;Kang, Cheol-In;Kim, Doh-Hyung;Kim, Young-Keun;Heo, Sang-Taek;Kim, Hee-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.285-289
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    • 2006
  • Background : North Korea's economic and public health problems began in the early 1990s as a result of the gradual loss of economic support from its communist allies, combined with an inordinate number of natural disasters. The decline in public health has increased the incidence of tuberculosis in North Koreans and refugees. This study investigated tuberculosis situation in North Korean refugees in order to prepare for the future impact of tuberculosis control in Korea. Material and Methods : From 2001 to 2005, tuberculosis patients among North Korean refugees who were diagnosed before or after arriving in South Korea, based on the official records of OO hospital, were enrolled in this study. The demographic and clinical data of the cases were evaluated retrospectively. Results : A total of 42 TB cases were reviewed during the study period. Of these, 37 (88.1%) cases were pulmonary TB. based on the cases identified among the number of North Korean refugees' arriving each year, the annual incidence of pulmonary TB were 900 per 100,000 in 2004, 700 in 2003, The number of smear-positive patients was 20 (47.6%) and the number of culture-positive patients was 18 (42.9%). Of the M. tuberculosis isolates, 2 cases were found to be susceptible to all anti-TB drugs available, 4 were resistant to isoniazid, and 3 were multi-drug resistant. Conclusion : The prevalence of pulmonary TB in North Korean Refugees is high. In addition, North Korean refugees suffer from more severe tuberculosis in bacteriological and radiological aspects.

Predictors on In-hospital Mortality Following In-hospital Diagnosis of Tuberculosis (결핵으로 입원한 환자의 병원내 사망과 관련된 인자)

  • Shin, Su Rin;Kim, Chang Hwan;Kim, Sung Eun;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung;Kim, Cheol Hong;Eom, Kwang Seok;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Gu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.233-238
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    • 2006
  • Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

The Application of Impulse Oscillometry(IOS) in the Detection of Smoking Induced Early Airway Obstruction (Impulse Oscillometry(IOS)를 이용한 흡연자에서의 조기 기도폐쇄의 연구)

  • Kim, Youn-Seup;Kweon, Suk-Hoe;Song, Mi-Young;Yoo, Sun-Mi;Park, Jae-Seuk;Jee, Young-Koo;Lee, Kye-Young;Kim, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1030-1039
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    • 1997
  • Background : Impulse Oscillometry is a noninvasive and effort-independent test used to characterize the mechanical impedance of the respiratory system. The clinical potential of the IOS is rapid and demands only passive cooperation which makes it especially appealing for children, for epidemiologic surveys and for conditions in which quiet breathig instead of forced expiratory maneuvers are preferred. However, several studies have shown conflicting results that the role of IOS about detection of smoking induced small airway diseases or early airway obstruction Methods : Study was to evaluate the clinical ability of the IOS to detect about smoking induced early airway obstruction in persons with normal spirometry test. Respiratory asymptomatic study groups were formed that one is non-smoking group, another is smoking group. Results : The parameters of spirometry were not significantly differences between non-smoking group and smoking group. Among the parameters of IOS, total resistance(non-smoking group : smoking group=$2.22{\pm}1.20$ : $2.58{\pm}1.71$), peripheral resistance($1.25{\pm}0.62$ : $1.47{\pm}0.10$), bronchial compliance($0.44{\pm}0.12$ : $0.47{\pm}0.16$) were not statistically significant different (p<0.05), but central resistance and lung compliance were not statistically significant different (unit ; resistance=hPa/l/s, compliance=l/hPa). Resistance(Rrs) was not statistically significant different with changes of frequences(5, 10, 15, 20, 25, 30, 35Hz), but Reactance(Xrs) was statistically significant different with low frequences that X5(non-smoking group : smoking group=$-0.62{\pm}0.28$ : $-0.76{\pm}0.48$, p<0.001) and X10($-0.06{\pm}0.19$ : $-0.15{\pm}0.33$, p<0.013) (unit; hPall/s, $hPa{\cong}cmH_2O$). Conclusion : Impulse oocillometer(IOS) is clinically available method to detect about smoking induced early airway obstruction. And clinically potential parameters of IOS were considers that total resistance, peripheral resistance, bronchial resistance, and reactance of low frequency at 5Hz, 10Hz.

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