• Tuberculosis and Respiratory Diseases
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• 제67권4호
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• pp.331-337
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• 2009

Background: The whole-blood interferon-gamma release assay (QuantiFERON-TB Gold [QFT-G]: Cellestis, Carnegie, Victoria, Australia) has been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. In the present study, the usefulness of QFT-G was evaluated for the diagnosis of extra-pulmonary tuberculosis (EP-TB). Methods: From June 2006 to February 2009, we evaluated the usefulness of QFT-G in patients (n=65) suspected with EP-TB, retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the QFT-G assay were analyzed. Results: EP-TB was diagnosed in 33 (51%) participants. The overall sensitivity, specificity, PPV, and NPV of the QFT-G assay for EP-TB were 78%, 79%, 81%, and 77%, respectively. Of the 33 with EP-TB, 14 (42%) were diagnosed with TB pleurisy, 7 (21%) with TB lymphadenitis, 7 (21%) with intestinal TB, and 5 (15%) with EP-TB in other sites. In subgroup analyses according by site of infection, the QFT-G showed 86% sensitivity, 64% specificity, and 78% NPV in TB pleurisy. On the other hand, the sensitivity, specificity, and NPV of the assay were 71%, 83% and 71%, respectively in TB lymphadenitis, and 86%, 100% and 88%, respectively in intestinal TB. Among the patients with suspected alternative site EP-TB, the sensitivity, specificity, and NPV of the assay were 50%, 80% and 67%, respectively. Conclusion: The QFT-G assay showed moderate diagnostic accuracy in EP-TB. However, negative QFT-G assay does not exclude EP-TB because of the low NPV of this assay.

• Tuberculosis and Respiratory Diseases
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• 제38권4호
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• pp.384-388
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• 1991

Parenchymal pulmonary endometriosis is the likely cause in patients with hemoptysis, dyspnea, or chest pain during menstruation. Embolization of endometrial tissue from the uterus to the lungs via the pulmonary arteries has been proposed for the mechanism of the development of parenchymal pulmonary endometriosis. This is a report of a woman with catamenial hemoptysis which was responded successfully to danazol therapy; however, hemoptysis resumed after cessation of therapy. The patient was subsequently treated with danazol again because she refused surgical treatments.

• Tuberculosis and Respiratory Diseases
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• 제86권4호
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• pp.319-321
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• 2023

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.27-34
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• 2017

Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days). Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.

• Tuberculosis and Respiratory Diseases
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• 제43권2호
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• pp.128-137
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• 1996

연구배경: 폐결핵은 고전적인 방법인 객담 도말 검사 및 배양검사로 전단할 수 있지만 객담 도말 민감도가 낮고 배양검사는 시일이 오래걸리는 단점이 있고 효과적인 객담배출이 되지 않는 환자에서는 검사가 불가능하기도 하다. 또한 최근에 개발된 PCR법은 신속하기는 하지만 위양성과 위음성이 문제가 되고 있다. 그래서 기관지내시경을 통한 기관지폐포세척액을 이용하여 세균학적 검사 및 PCR을 시행하여 폐결핵진단에 있어서 민감도와 예민도를 높이고 보다 신속한 진단을 할 수 있는지 연구하였다. 방법: 폐결핵 67예와 폐결핵이외의 폐질환을 가진 43예를 대상으로 객담 도말검사 및 배양검사를 시행하고, 기관지내시경을 시행하여 흉부 X-선상 병변이 보이는 엽상기관지에 기관지내시경을 위치하고 생리식염수 5cc로 3-5회에 걸쳐서 세척을 시행하여 세척액을 채취한 후 세균학적검사 및 PCR을 시행하였다. 결과: 1) 폐결핵환자의 기관지폐포세척액 결핵균 도말 검사 및 배양검사의 민감도는 각각 47.8% 및 80.6%로서, 객담 도말검사 및 배양검사의 민감도인 32.8% 및 57.4%보다 유의하게 높았다. 2) 폐결핵환자의 기관지폐포세척액 PCR의 민감도는 80.6%로서 배양검사의 민감도와 같았고, PCR의 배양검사에 대한 양성예측율은 81.5%였다. 3) 객담 도말검사 및 배양검사상 음성을 보인 폐결핵환자에서 시행한 기관지내시경을 통한 기관지폐포세척액 도말검사의 민감도는 23.1%였으며, 배양검사의 민감도는 100%였고, PCR의 민감도는 88.5%였으며, PCR의 배양검사에 대한 양성예측율 82.4%였다. 4) 기관지폐포세척액 PCR의 특이도는 77.0%였다. 5) 폐결핵의 최초 진단 후 치료시작까지의 기간은 객담 도말검사로 최초 진단이 된 경우가 평균 5일로 가장 빨랐고, 기관지폐포세척액 도말검사가 평균 9일, 기관지폐포세척액 PCR이 평균 26일이었으며, 객담배양검사는 평균 32일이었고, 기관지 폐포세척액 배양검사는 평균 56일로 가장 길었다. 결론: 폐결핵환자에서 기관지내시경을 통한 기관지폐포세척액의 결핵균 도말검사 및 배양검사는 객담을 이용한 검사보다 민감도가 높다. 그러므로, 객담을 배출하지 못하는 환자나 객담의 세균학적 검사가 음성인 환자에서 기관지내시경이 고려되어야 하며, 기관지폐포세척액의 PCR법까지 병행할 때에는 보다 신속하고 높은 진단율을 나타내므로, 조기에 적절한 항결핵제 투여에 도움이 될 것으로 기대된다.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.331-336
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• 2007

연구배경: 결핵은 호흡기를 통한 전염성 질환이지만 말초혈액에서 결핵균 PCR이 양성이거나 결핵균이 배양된 보고가 일부 있었다. 이는 결핵의 진단에 있어서의 유용성과 헌혈을 통한 결핵의 전염 가능성의 두 가지 문제를 제기하게 되었고, 저자들은 상기 문제들에 대한 향후 연구방향의 기초자료로 사용하고자 연구를 시행하여 보았다. 방법: 속립성 결핵이 아닌 폐결핵, 비결핵항산균 폐질환, 폐암 및 폐렴 환자 69명을 대상으로 말초혈액에서 결핵균 PCR을 시행하였고, 결핵균이 많을 것으로 추정되는 10명의 폐결핵 환자의 말초혈액을 대상으로 결핵균 배양을 시행하였다. 결핵균 PCR은 nested PCR을 이용한 TB-taq (M&D, Korea)을 이용하였고 혈액배양에는 BACTEC Myco/F Lytic 혈액배양병(Becton Dickinson, Sparks, Md)을 사용하였다. 결과: 결핵균 PCR을 시행한 환자는 69명으로 각각 폐결핵 35명, 비결핵항산균 폐질환 6명, 폐암 20명, 폐렴 8명이었다. 폐렴이나 폐암 환자 28명 모두에서 PCR은 음성이었고, 비결핵항산균 폐질환 6명 중 1명(16.7%), 폐결핵 35명 중 8명(22.8%)에서 양성이었다. 혈액 배양은 폐결핵 10명 모두에서 음성이었다. 결론: 미만성 결핵이 동반되지 않은 폐결핵 환자의 말초혈액에서 결핵균의 DNA가 검출됨을 확인할 수 있었으나 균배양이 되지 않는 것으로 보아 살아있는 균이 존재하기 보다는 균의 일부 성분만 존재할 가능성을 제시하였다.

• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.105-110
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• 2000

저자들은 객담, 기침, 발열과 호흡곤란을 보이고 단순 흉부촬영상 다발성 공동과 경변을 보이며 흉부 전산화 촬영과 폐동맥 혈관조영술상 폐 동맥류가 확인된 환자에서 폐 절제술후 만성 괴사성 침입성 폐 국균증으로 진단된 1예를 경험하였기에 이에 보고하는 바이다.

• Journal of Chest Surgery
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• 제17권2호
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• pp.269-274
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• 1984

Since tuberculosis was a common pulmonary disease in Korea, Aspergillosis was easily misdiagnosed as tuberculosis and an acute form of Aspergillosis was misinterpreted as pneumonia because of their similarities in the X-ray findings. This investigation is designed to illustrate the clinical features and preoperative diagnosis and surgical role in the management of this disease. In a retrospective review of operative cases from Jan. 1963 through Dec. 1983, 36 cases were analyzed. Peak age incidence lies in the 3rd decade [41.7%]. All cases had a history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis and the most common chief complaint was hemoptysis [69.5%]. Only nine cases [25%] showed cavitary lesions with mycetoma and preoperative sputum study for fungus showed low positive valve [42.3%]. Anatomical location of lesion was located mainly upper lobe [66.7%] and most of cases were managed by lobectomy. We experienced 7 cases of complication; they were postoperative empyema, hepatic failure, esophageal varix bleeding. Postoperative pathologic findings showed that 29 cases [80.5%] were combined with tuberculosis 3 cases were combined with bronchiectasis and 4 cases were not combined with other disease. In conclusion, when the patient has a longstanding history of pulmonary tuberculosis and has a hemoptysis, he must be suspected fungus super infection. Resectional surgery is the treatment of choice for symptomatic localized disease and needed resection in asymptomatic patient to prevent possible fatal sequelae in the future.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.77-81
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• 2012

Blastomyces dermatitidis is a dimorphic fungus that causes the systemic pyogranulomatous disease known as blastomycosis. Blastomycosis most often involves the lungs, skin, and may involve nearly every organ in the body. It is difficult, however, to diagnose blastomycosis in the early stage of pulmonary disease because clinical manifestations are varied from subclinical infection to acute respiratory distress syndrome. Since blastomycosis is often accompanied by granulomatous inflammation in histopathologic findings, differentiation from other etiologic diseases is important. We report a case of a 45-year-old male with pulmonary blastomycosis who had been misdiagnosed with tuberculosis for 3 months.

• 대한한의학방제학회지
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• 제16권2호
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• pp.255-261
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• 2008

Hemoptysis is a common clinical symptom responsible for about 10% of the patients who has the pulmonary disease. In Korea, pulmonary tuberculosis is still the most common cause of the hemoptysis. This study is a chlinical report of Korean Traditional Medical Therapy for the patient of hemopysis with old pulmonary tuberculosis. The patient was suffering from hemoptysis, headache, sweating, feeling of uneasiness and fatigue. After administration of herbal medicines (Bokryungbosim-tang, Yukmijihwangwon-gagambang) and acupunture treatment for 34days, these symptoms of the patient were improved. Thus, we concluded that Oriental Medical Treatment can improve the symptoms of the patient who is suffering from hemoptysis.