• Title/Summary/Keyword: Combined Therapy

Search Result 1,536, Processing Time 0.023 seconds

Clinical Observations of the Drug Induced Hepatitis during Antituberculosis Medication (항결핵제 투여 중 나타난 간기능 장애의 임상적 고찰)

  • Park, Moon-Hwan;Yun, Sang-Won;Kim, Kung-Ho;Lee, Mung-Sun;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.41 no.4
    • /
    • pp.405-412
    • /
    • 1994
  • Background: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. Method: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. Results: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to fema1e ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significant1y different. 4) Drug induced hepatitis was most common in the case of moderate advanced pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significant1y different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant tenderness in order. 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occured within the first month. 7) The duration of abnormal liver function was $28{\pm}5$(Mean${\pm}$SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. Conclusion: There are no dicided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as well as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.

  • PDF

Cancinoma of Uterine Cervix Treated wvith High Dose Rate Intracavitary Irradiation : 1 Patterns of Failure (자궁경부암의 고선량율 강내치료후 실패양상에 대한 고찰)

  • Kim Ok Bae;Choi Tee Jin;Kim Jin Hee;Lee Ho Jun;Kim Yung Ae;Suh Young Wook;Lee Tae Sung;Cha Soon Do
    • Radiation Oncology Journal
    • /
    • v.11 no.2
    • /
    • pp.369-376
    • /
    • 1993
  • 226 patients with carcinoma of the uterine cervix treated with curative radiation therapy at the Department of Therapeutic Radiology, Dongsan hospital, Keimyung university, School of medicine, from July,1988 to May,1991 were evaluated. The patients with all stages of the disease were included in this study. The maximum and mean follow up durations were 60 and 43 months. The radiation therapy consisted of external irradiation to the whole pelvis (2700~4500 cGy) and boost parametrial doses (for a total of 4500~6300 cGy)with midline shild $(4{\times}10\;cm),$ and combined with intracavitary irradiation (5700~7500 cGy to point A). The distribution of patients according to the stage was as follows: stage IB 37 $(16.4\%),$ stage IIA 91 $(40.3\%),$ stage IIB 58 $(25.7\%),$ stage III 32 $(13.8\%),$ stage IV 8 $(3.5\%).$ The overall failure rate was $23.9\%$ (54 patients). The failure rate increased as a function of stage from $13.5\%$ in stage IB to $15.4\%$ in stage IIA, $25.9\%$ in stage IIB, $46.9\%$ in stage III, and $62.5\%$ in stage UV. The pelvic failure alone were 32 patients and 11 patients were as a components of other failure, and remaining 11 patients had distant metastasis only. Among the 43 patients of locoregional failure,28 patients were not controlled initially and in other words nearly half of total failures were due to residual tumor. The mean medial paracervical (point A) doses were 6700 cGy in stage IIB,7200 cGy in stage IIA,7450 cGy in stage IIB,7600 cGy in stage III and 8100 cGy in stage IV. The medial paracervical doses showed some correlation with tumor control rate in early stage of disease (stage Ib, IIA), but there were higher central failure rate in advanced stage in spite of higher paracervical doses. In advanced stage, failure were not reduced by simple increment of paracervical doses. To improve a locoregional control rate in advanced stages, it is necessary to give additional treatment such as concomitant chemoradiation.

  • PDF

The Results of Postoperative Radiotherapy for Endometrial Carcinoma (자궁 내막암의 수술 후 방사선치료 결과)

  • Noh, O-Kyu;Lee, Sang-Wook;Ahn, Seung-Do;Choi, Eun-Kyung;Kim, Jong-Hyeok;Kim, Yong-Man;Nam, Joo-Hyun;Mok, Jung-Eun;Kim, Jong-Hoon;Shin, Seong-Soo
    • Radiation Oncology Journal
    • /
    • v.25 no.2
    • /
    • pp.93-100
    • /
    • 2007
  • [ $\underline{Purpose}$ ]: To evaluate the outcome and prognostic factors of postoperative radiotherapy in endometrial carcinoma. $\underline{Materials\;and\;Methods}$: From September 1991 to August 2003, 76 patients with endometrial carcinoma received postoperative adjuvant radiotherapy after hysterectomy at Asan Medical Center. Stage was classified as FIGO I in 41 (53.9%), II in 12 (53.9%), and III in 23 (30.3%). Histologic grade 1, 2 and 3 were in 29 (38.2%), 20 (26.3%), and 27 (35.5%) respectively. Forty two patients received both external beam radiation therapy (EBRT) and intracavitary radiation (ICR), 34 patients were treated with EBRT or ICR alone. EBRT dose was 50.4 Gy, ICR was performed in $4{\sim}6$ fractions with $4{\sim}5\;Gy$ per fraction. Median follow-up period was 51 (range $5{\sim}121$) months. $\underline{Results}$: Five-year overall survival was 89.6%. In univariate analysis, statistically significant factors to overall survival were FIGO stage, lymph node metastasis and histologic grade. In disease free survival, FIGO stage, lymph node metastasis and lymphovascular invasion were significant prognostic factors. Recurrence was seen in 11 patients. Of these, systemic failure was in 10 patients. There were no moderate to severe complications after radiation therapy. $\underline{Conclusion}$: The outcome of postoperative adjuvant radiotherapy in endometrial carcinoma was good. Main pattern of failure after postoperative radiotherapy was distant metastasis. So, adjuvant chemotherapy may help in improving outcome. Further study on chemotherapy in combined with postoperative radiotherapy will be needed, especially for patients with high risk factors such as high FIGO stage, lymphovascular invasion, and high histologic grade.

Comparison of I-131 Scintigraphy, T1-201 Scintigraphy, and Serum Thyroglobulin in the Postoperative Follow-Up of Differentiated Thyroid Cancer (분화된 갑상선암의 수술후 경과관찰에서 I-131 스캔, T1-201 스캔 및 혈청 갑상선 글로불린 농도의 비교)

  • Lee, Hyun-Kyung;Song, Jae-Soon;Shinn, Joon-Jae;You, Kye-Hwa;Cha, Wang-Ki;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.31 no.3
    • /
    • pp.346-355
    • /
    • 1997
  • To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation ($TSH>50{\mu}U/ml$). Total 41 cases of I-131 and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/m1 were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group). Of 17 studies before the I-131 ablation therapy(preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.

  • PDF

Optimum Dose Combination of External Radiation and High Dose Rate ICR in FIGO IB Uterine Cervical Cancer (병기 IB 자궁경부암의 방사선치료에서 외부방사선치료와 고선량율 강내치료의 최적선량 배합)

  • Lee Sang Wook;Suh Chang Ok;Chung Eun Ji;Kim Woo Cheol;Chang Sei Kyung;Keum Ki Chang;Kim Gwi Eon
    • Radiation Oncology Journal
    • /
    • v.14 no.3
    • /
    • pp.201-209
    • /
    • 1996
  • Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

  • PDF

A Clinical Study of Tinnitus (耳鳴에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.14 no.2
    • /
    • pp.134-145
    • /
    • 2001
  • Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.

  • PDF

Adenocarcinoma of the Uterine Cervix (자궁경부선암의 방사선 치료)

  • Chung Eun Ji;Shin Hyun Soo;Lee Hyung Sik;Kim Gwi Eon;Loh John Juhn-Kyu;Suh Chang Ok
    • Radiation Oncology Journal
    • /
    • v.9 no.2
    • /
    • pp.277-284
    • /
    • 1991
  • Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents $4.1\%$ of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49 years (range, $27\~79$ years) and the peak incidence was in the group 50 to 59 years of age. More half of the patients were postmenopausal (46/76= $60.5\%$). Most patients ($76\%$) had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage IIb was $43.4\%$. There were 4 major histologic subtypes: pure adenocarcinoma (48/76=$63.2\%$), adenosquamous carcinoma (20/76=$26.3\%$), papillary (5/76=$6.6\%$) and clear cell carcinoma (3/76=$3.9\%$). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was $68\%$, and the 5-year survival rates for stage Ib, II and III were $90\%,\;66\%\;and\;54\%$, respectively. Control of pelvic tumors was achieved in $93.8\%,\;90.2\%\;and\;50.0\%$ of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

  • PDF

Postoperative Radiation Therapy for Chest Wall Invading pT3N0 Non-small Cell Lung Cancer: Elective Lymphatic Irradiation May Not Be Necessary (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 후 방사선치료)

  • Park, Young-Je;Ahn, Yong-Chan;Lim, Do-Hoon;Park, Won;Kim, Kwan-Min;Kim, Jhingook;Shim, Young-Mog;Kim, Kyoung-Ju;Lee, Jeung-Eun;Kang, Min-Kyu;Nam, Hee-Rim;Huh, Seung-Jae
    • Radiation Oncology Journal
    • /
    • v.21 no.4
    • /
    • pp.253-260
    • /
    • 2003
  • Purpose: No general consensus has been reached regarding the necessity of postoperative radiation therapy (PORT) and the optimal techniques of its application for patients with chest wall invasion (pT3cw) and node negative (NO) non-small cell lung cancer (NSCLC). We retrospectively analyzed the PT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. Materials and Methods: From Aug. 1994 till June 2000, 21 pT3cwN0 NSCLC patients received PORT at Samsung Medical Center; all of whom underwent curative on-bloc resection of the primary tumor plus the chest wall and regional lymph node dissection. PORT was typically stalled 3 to 4 weeks after operation using 6 or 10 MV X-rays from a linear accelerator. The radiation target volume was confined to the tumor bed plus the immediate adjacent tissue, and no regional lymphatics were included. The planned radiation dose was 54 Gy by conventional fractionation schedule. The survival rates were calculated and the failure patterns analyzed. Results: Overall survival, disease-free survival, loco-regional recurrence-free survival, and distant metastases-free survival rates at 5 years were 38.8$\%$, 45.5$\%$, 90.2$\%$, and 48.1$\%$, respectively. Eleven patients experienced treatment failure: six with distant metastases, three with intra-thoracic failures, and two with combined distant and intra-thoracic failures. Among the five patients with intra-thoracic failures, two had pleural seeding, two had in-field local failures, and only one had regional lymphatic failure in the mediastinum. No patients suffered from acute and late radiation side effects of RTOG grade 3 or higher. Conclusion: The strategy of adding PORT to surgery to improve the probability, not only of local control but also of survival, was justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. The incidence and the severity of the acute and late side effects of PORT were markedly reduced, which contributed to improving the patients' qualify of life both during and after PORT, without increasing the risk of regional failures by eliminating the regional lymphatics from the radiation target volume.

The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.47 no.5
    • /
    • pp.601-608
    • /
    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

  • PDF

Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.2
    • /
    • pp.241-250
    • /
    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

  • PDF