• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.595-601
• /
• 1993

Background: Today, tuberculosis continues as an important cause of death in Korea despite the effective treatment and prevention. So we have studied charicteristic distribution of death by pulmonary tuberculosis through epidemiologic survey. Subjects and Method: The mortality data were obtained from 684 pulmonary tuberculosis cases who died in a tuberculosis-centered hospital in Seoul during the period of 5 years from 1986 to 1990. In order to estimate the distribution of death by tuberculosis, t-test and $x^2$-text were performed on the data. Results: 1) 19.9% of patients died among the total 3,441 hospitalized pulmonary tuberculosis cases during 5 years. 2) In distribution of sex and age, male death occupies 81% of total death. Significantly high proportions of younger female death (under 40 years-old) were also observed. 3) In terms of medical security status, medical assistance group occupies 42.3% of medical insurance group while the non-security group also occupies 11.8% of total death. 4) Treatment interruption was observed in 78% of total death. Conclusion: Special attention should be given to the identification, management and follow up of high risk group in nationwide tuberculosis control program.

• The Korean Journal of Nuclear Medicine
• /
• v.26 no.1
• /
• pp.111-115
• /
• 1992

Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse "miliary" infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body $^{67}Ga-citrate$ scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga?scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.5
• /
• pp.669-676
• /
• 1995

Background: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prostaglandin(PG), especially PG $E_2$, is involved in cellular immunosuppression. It is known that the PG $E_2$ is suppressed by indomethacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG $E_2$ levels. Method: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG $E_2$, levels with radioimmunoassay. Results: 1) There was no significant difference in the plasma PG $E_2$ levels among A group(far advanced and positive TST reaction cases, n=10, $11.22{\pm}2.86\;pg/ml$), B group(minimal and negative TST reaction cases, n=9, $11.35{\pm}2.20$) and C group(far advanced and positive TST reaction cases, n=7, $11.11{\pm}2.30$) in the new cases(p>0.05). 2) There was no significant difference in the plasma PG $E_2$ levels between positive(n=10, $9.25{\pm}2.21$) and negative(n=10, $8.25{\pm}1.13$) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG $E_2$ levels between new(n=26, $11.35{\pm}2.41$) and intractable(n=20, $8.75{\pm}1.78$) groups, the intractable group had significi- andy lower plasma PG $E_2$ levels(p<0.05). 4) There was no significant difference in the plasma PG $E_2$ levels between negative(n=19, $9.88{\pm}2.43$) and positive(n=27, $10.46{\pm}2.56$) groups by TST(p>0.05). 5) There was no significant difference in the plasma PG $E_2$ levels between male(n=32, $10.07{\pm}2.44$) and female(n=14, $10.56{\pm}2.70$)(p>0.05). 6) There was no significant difference in the plasma PG $E_2$ levels among 2nd(n=5, $10.21{\pm}2.86$), 3rd(n=9, $9.97{\pm}2.47$), 4th(n=13, $11.35{\pm}2.33$) and 5th(n=19, $9.57{\pm}2.48$) decades(p>0.05). 7) There was no significant correlation between the induration sizes of the TST and the plasma PG $E_2$ levels(r=0.054, p>0.05). Conclusion: From the above results, the plasma PG $E_2$ levels of intractable group are not higher as the authors had expected. There was no significant difference in the plasma PG $E_2$ levels by the lesion sizes of plain chest roentgenogram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary tuberculosis patients.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.4
• /
• pp.317-325
• /
• 2007

Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.

• The Journal of Internal Korean Medicine
• /
• v.14 no.1
• /
• pp.71-81
• /
• 1993

Clinical observation was done on 372 Cheon-Jeung patients more than 65 years of age in Department of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from December 1990 to November 1991. The results were as follows; 1. The ratio of male to female was 1.2:1. The age distribution showed the large number in the 65-69 year group, the female more than the male in 8th decade. 2. The peak age in the on set was 7th decade(44.4%). 3. The ratio of the season distribution was as follows, everytime 62.6%, fall and winter 25.5%. 4. Duration from on set, the most frequence was $5{\sim}10$ years(29.6%). 5. Chief complaints were represented cough, laryngeal stridorand, dyspnea. 6. In past illness, Pulmonary. The was most predominent(29.7%) followed by allergic disease(8.1%), bronchitis(7.2%) in turn. 7. In complication, Pul. Tbc was most predominent(21.1%) followed by ronchiectasis (12.7), cardiac disease(11.3%). 8. Predisposing factors in the Geriatric athma were represented chiefly exercising(41.8%), the others is Pung-Han-Neng(27.6%), respiratory infection(12.7%) etc. 9. The recipe which used in treatment were Gamigeumsuyukgun-jeon, Gamimahwangyunpai-tang, Gamiyunpai-tang, Sojaganggi-tang, Cheongsangboha-tang etc. 10. Duration of treatment was noted within 10 days was 39.2%, $11{\sim}30$ days was 40.6%, over 60 days was 7.3%. 11. About 77.3% patients were improved.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.1
• /
• pp.19-24
• /
• 1995

Background: Although pulmonary tuberculosis is effectively controlled with 6 months or 9 months short course standard regimens, comparable numbers of treatment failures ensued because of inadequate treatment mainly due to patient's poor compliance. Indequate treatment with standard regimens during initial treatment may cause emergence of drug resistance and prolong the duration of chemotherapy. Also it may make the patient lesser compliant and finally increase the morbidity and the mortality. Methods: A clinical study was done to evaluate clinical and bacteriological characteristics of 94 patients who were retreated for pulmonary tuberculosis. Results: 1) 62 of the 94 patients were male and 32 patients were female. Mean age is 51 years old in male and 45 years old in female. 2) The extent of the disease on the chest radiograph was minimal in 10(11.1%) patients, moderate in 31(33.3%) patients, and far advanced in 52(55.6%) patients. 3) On sputum bacteriologic examination, 73(77.7%) patients were positive in sputum AFB smear and/or culture for Mycobacterium tuberculosis. 4) Results of drug sensitivity test performed in 42 patients showed that the resistance to one drug is in 9(20.5%) patients, two drugs in 18(40.8%) patients, and more than three drugs in 14(31.8%) patients. 5) Poor patient's compliance was the leading cause of the retreatment of pulmonary tuberculosis(43.6%) 6) Only 24(25.5%) patients of the 94 retreatment patients were successfully treated and 39(41.6%) patients were dropped out during follow-up. Conclusion: We concluded that poor patient's compliance was the most important cause of treatment failure not only in primary treatment patients but also in retreatment patients. Primary treatment of pulmonary tuberculosis should be completed under strict monitoring of the patient because significant number of retreatment patients had multiple drug resistance and poor outcome.