• Tuberculosis and Respiratory Diseases
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• 제68권3호
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• pp.146-154
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• 2010

Background: The increasing incidence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has become a serious worldwide problem. However, there is insufficient data regarding the current status of MDR-TB and XDR-TB in Korea. This study examined the recent status of MDR- and XDR-TB using the data from 7 laboratories, in which almost all drug susceptibility tests (DST) for Mycobacterium tuberculosis were performed. Methods: The patients' identification data and DST results were collected from all 7 laboratories from 2001 to 2006 and the number of patients with MDR-TB and XDR-TB were calculated. Results: The number of DSTs was 140,638 for 6 years with an increasing incidence each year (p<0.001). The number of DST with MDR results was 18,510 and personal identifying information was obtained in 16,640 (89.9%) tests. The number of MDR-TB patients from 2001 to 2006 was 2,329, 2,496, 2,374, 2,300, 2,354, and 2,178, respectively, when counting the duplications in a year as one patient. The number of MDR-TB patients when counting the duplications in 6 years as one patient was 2,281, 1,977, 1,620, 1,446, 1,512, and 1,373, respectively. When the same method was adopted, the number of XDR-TB patients was 191, 238, 282, 260, 272, and 264, respectively, and 189, 150, 130, 90, 122, and 110 patients, respectively. Conclusion: Despite the national efforts to control TB, there are still a large number of MDR- and XDR-TB patients in Korea.

• Tuberculosis and Respiratory Diseases
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• 제80권4호
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• pp.392-400
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• 2017

Background: Most patients with influenza recover spontaneously or following treatment with an anti-viral agent, but some patients experience pneumonia requiring hospitalization. We conducted a retrospective review to determine the incidence and risk factors of pneumonia in hospitalized patients with influenza A or B. Methods: A total of 213 patients aged 18 years or older and hospitalized with influenza between January 2012 and January 2015 were included in this study. A reverse-transcriptase polymerase chain reaction assay was used to detect the influenza A or B virus in the patients' sputum samples. We collected demographic and laboratory data, combined coexisting diseases, and radiologic findings. Results: The incidence of pneumonia was higher in patients in the influenza A group compared to those in the influenza B group (68.6% vs. 56.9%), but this difference was not statistically significant. The presence of underlying respiratory disease was significantly associated with pneumonia in the influenza A group (adjusted odds ratio [OR], 3.975; 95% confidence interval [CI], 1.312-12.043; p=0.015). In the influenza B group, the white blood cell count (adjusted OR, 1.413; 95% CI, 1.053-1.896; p=0.021), platelet count (adjusted OR, 0.988; 95% CI, 0.978-0.999; p=0.027), and existence of an underlying medical disease (adjusted OR, 15.858; 95% CI, 1.757-143.088; p=0.014) were all significantly associated with pneumonia in multivariate analyses. Conclusion: The incidence of pneumonia was 65.7% in hospitalized patients with influenza A or B. The risk factors of pneumonia differed in hospitalized patients with influenza A or B.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.127-130
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• 2006

The incidence of the tuberculosis infection has decreased worldwide, but it is still easy to find the patients in some areas or some races. And it is very difficult to diagnose and treat the patients who are infected by the atypical tuberculosis. Facial skin infection by atypical tuberculosis has not been reported. We report the case of a 62-year-old woman who developed facial skin and soft tissue necrosis caused by Mycobacterium abscessus after receiving liquid silicone injections and face lift operation. We cultured the pathogenic organism and treated the wound with radical curettage, debridement, skin graft and tuberculosis medication.

• 대한미생물학회지
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• 제18권1호
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• pp.47-52
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• 1983

During the last three years, it has become evident that patients with tuberculosis-like diseases due to the Mycobacterium avium-intracellulare complex(referred to M. avium complex; MAC) in Korea are more frequently observed than were assumed earlier. However, the incidence of various serotypes of the MAC isolated from patients with tuberculosis-like diseases has not been clarified. In this study, the serotypes of 16 strains of the MAC isolated from sputa of persons who had radiographic abnormalities of the lungs were determined by bacterial agglutination test with reference sera. The serotypable strains belonged to 7 serotypes, i.e., M. avium 13 were 4 strains(25.0%), M. avium 8 and 14 each 3 strains(18.8%), M. avium 5, 7, 12 and 18 one strain(6.3%), respectively. Two strains(12.5%) were not typable.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.161-167
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• 2015

Tuberculosis (TB) remains a major global health problem, and the incidence of TB cases has not significantly decreased over the past decade in Korea. The standard short course regimen is highly effective against TB, but requires multiple TB-specific drugs and a long treatment duration. Recent studies using late-generation fluoroquinolones and/or high-dose rifapentine-containing regimens to shorten the duration of TB treatment showed negative results. Extending the treatment duration may be considered in patients with cavitation on the initial chest radiograph and positivity in sputum culture at 2 months of treatment for preventing TB relapse. Current evidence does not support the use of fixed-dose combinations compared to separate drugs for the purpose of improving treatment outcomes. All patients receiving TB treatment should be monitored regularly for response to therapy, facilitation of treatment completion, and management of adverse drug reactions. Mild adverse effects can be managed with symptomatic therapy and changing the timing of the drug administration, but severe adverse effects require a discontinuation of the offending drugs.

• Tuberculosis and Respiratory Diseases
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• 제64권4호
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• pp.259-265
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• 2008

연구배경: 당뇨병 환자는 결핵을 비롯한 감염에 일반인들에 비해서 더 민감하고 당뇨병의 유병기간이 길수록 결핵 유병률이 높은 것으로 알려져 있다. 당뇨병 환자와 정상 혈당을 가진 폐결핵 환자들에서 임상 양상 및 방사선학적 차이및 결핵약제의 내성정도에 대한 임상의들의 많은 관심 및 연구가 이루어져왔고 이에 차이점 유무에 대해서 조사를 하였다. 방법: 203년 1월부터 205년 12월까지 청주 성모병원에 내원한 환자 중 객담 도말 양성이나 배양 양성 조직학적으로 폐결핵으로 진단된 159명의 환자를 대상으로 하였다. 결과: 당뇨병을 동반한 폐결핵 환자는 30명이었고 정상 혈당 폐결핵 환자는 129명이었다. 양 군의 기초적 특성 및 임상 양상에서 차이점은 없었다. 흉부 사진에서 증등도로 진행된 환자들이 가장 흔하였으나 당뇨병 유무와 결핵 중증도와는 관계가 없었다. 당뇨병이 있는 폐결핵 환자군 에서는 정상 혈당 폐결핵 환자 군에 비해 통계적으로 의미 있게 공동이 더 많이 있었으나 공동의 수나 크기는 차이가 없었다. 한편 무기폐는 정상 혈당 폐결핵 환자 군에서 더 많이 발생하였다. 그 이외에 하엽 침범 유무, 침범된 폐엽 수, 치료 기간에 차이가 없었다. 결론: 당뇨병을 동반한 폐결핵 환자는 공동을 더 많이 동반하였고 무기폐는 의미 있게 적게 발생하였다.

• Journal of Chest Surgery
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• 제4권2호
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• pp.95-100
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• 1971

The incidence of empyema has been drastically reduced with the advent of antimicrobial drugs,however,there is still complicated and difficult problems of management of empyema remaining. During the period of December, 1958 to December, 1962, 90 patients nf empyema thoracis were managed in the Department of Thoracic Surgery of the National Medical Center, and this series deals with the incidence,etiologic consideration, bacteriology and management of empyema with its result. 1] Male predominates with the ratio of 3.1: 1, and peak age incidence lies in 3rd decade. 2] Most common etiologic factor is bronchorespiratory infection among which tuberculosis remains highest incidence. 3] 56.7% of patients shows positive result of bacteriologic study and about half of positive culture series shows mixed infection or changing pattern of bacteriological strains during serial examinations. 4] Complete cure is obtained in 84.4% of patients with 5 deaths.

• Journal of Chest Surgery
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• 제16권3호
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• pp.356-361
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• 1983

Pulmonary tuberculosis is still one of unsolved problems in Korea due to increased number of far-advanced and drug-resistant patients, who have poor pulmonary function. We have analyzed 1332 operated Gases during the period of 1958-1981. Annual incidence of the disease decreased from 110 [1960] to 21 [1980]. The ratio between male and female was 7:3 and the age of peak incidence was in the 3rd and 4th decades. Recently, patients below the age of 20 years were slightly decreased, but above 50 years were slightly increased. The patients consisted of far-advanced case in 60% and moderately-advanced in 39% in 1980, as compared with 40% and 59% correspondingly in 1965. Preoperative sputum positively decreased from 91% [1958-1963] to 43.8% [ 1974-1981 ]. Medically treated patients for more than 3 years increased from 16% [1958-1963] to 51% [1974-1981]. From the view of surgical indication, totally destroyed hung increased from 27% [1958-1963] to 4396 [1974-1981 ]. Therefore, pneumonectomy occupied 53.8% of total surgical management recently. Mode of surgical treatment showed that thoracoplasty [33%], resection [57%] in 1958-1963 and thoracoplasty [2%], resection [98%] in 1974-1981. As Semb`s thoracoplasty was the first choice of treatment until 1960, thereafter resection became the choice. Postoperative mortality increased from 1.6-2.096 to 396 recently as well as morbidity. It was mainly due to increased number of poor pulmonary function and postoperative spread of disease. On the basis of our experience, far-advanced and drug-resistant patients increased in number recently, whose pulmonary function was poor. So postoperative mortality and morbidity increased. Proper surgical intervention should be considered before the appearance of resistance for all chemotherapeutic drugs.

• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.313-319
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• 2022

Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM_2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO₂) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.158-164
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• 2016

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.