• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.274-280
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• 2018

Background: The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods: This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results: In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20-67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion: Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.

• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.151-157
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• 2019

Background: Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. Methods: This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. Results: Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per $10^5$ of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per $10^5$ of the population), two of whom had multidrug-resistance (5.6 per $10^5$ of the population). Conclusion: The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.

• Clinical and Experimental Reproductive Medicine
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• 제43권2호
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• pp.90-96
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• 2016

Objective: Diabetes mellitus (DM) is known to cause many systemic complications as well as male infertility. Astaxanthin (ASTX) is a powerful antioxidant that is involved in a variety of biologically active processes, including those with anti-diabetes effects. The present study investigates the effect of ASTX on the spermatozoa function in streptozotocin (STZ)-induced diabetic rats. Methods: We divided 30 adult rats into three groups (10 rats per group), with a control group that received corn oil mixed with chow. DM was induced by intra-peritoneal injection of STZ. Eight weeks after the STZ injection, half of the diabetic animals were used as diabetic controls, and the rest were treated with ASTX for 56 days. Then the parameters and chromatin integrity of the epididymal sperm were analyzed using chromomycin A3, toluidine blue (TB), and acridine orange (AO) staining. Results: The count, viability, and motility of the epididymal sperm were decreased significantly in the STZ group in comparison with the control group (count and viability, p<0.001; motility, p<0.01). ASTX increased normal morphology and viable spermatozoa compared to the STZ group (morphology, p=0.001; viability, p<0.05). The percentage of abnormal chromatins in TB and AO staining was higher in the STZ group compared to the control group (p<0.001). The mean percentage of TB and AO positive spermatozoa in STZ rats was significantly lower in the STZ+ASTX group (TB, p=0.001; AO, p<0.05). Conclusion: This study observed that in vivo ASTX treatment partially attenuates some detrimental effect of diabetes. Conversely, ASTX improved sperm viability, normal morphology, and DNA integrity.

• Tuberculosis and Respiratory Diseases
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• 제62권1호
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• pp.5-10
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• 2007

배 경: 국내 결핵관리지침은 결핵 집단발병시 접촉자에 대하여 투베르쿨린 검사와 흉부단순촬영을 이용하여 활동성 결핵을 찾아내고 나머지 접촉자 중 HIV 양성자와 투베르쿨린 검사 양성인 6세 미만의 소아에 한하여 잠복결핵 치료를 시행하도록 되어있다. 국내외 연구에서 20대 초반의 젊은 연령층은 다른 연령대에 비하여 결핵 발병률과 잠복결핵으로 진행시 추후 활동성 결핵 발병률이 높다고 알려져 있어 이 집단에서의 결핵 집단발병시 현재의 지침이 적절한지는 의문이다. 본 연구는 한 부대에서 일어난 결핵유행에 대하여 국내 결핵관리지침에 따라 대응하고 잠복결핵이 포함된 나머지 접촉자들을 6개월간 추적 관찰한 결과이다. 방 법: 2005년 12월 총원 464명인 경기도 한 부대에서 결핵유행이 발생하여 연구 대상으로 선정하였다. 간접 흉부엑스레이촬영은 전 인원에 대하여 실시하여 활동성 여부를 판정하였고 투베르쿨린 검사는 408명에 시행하여 48-72시간 사이에 판독하였다. 투베르쿨린 검사는 환자당 1회 실시하였고 간접 흉부엑스레이촬영이나 투베르쿨린 검사가 음성이라도 결핵에 합당한 증상이 있으면 직접 흉부엑스선촬영과 객담 도말검사를 시행하였다. 결 과: 간접 흉부엑스레이촬영을 통하여 2명의 활동성 결핵환자를 발견하여 치료를 시작하였으나 2006년 4월에 신환 1명이 발생하고 이후 2006년 8월까지 3명의 환자가 추가로 발생하여 2005년 12월부터 8개월 동안 총 9명의 환자가 발병하였으며 이들은 모두 활동성 폐결핵이나 결핵성 흉막염 형태를 보였다. 밀접 접촉자와 기타 접촉자 사이의 투베르쿨린 검사결과를 비교할 때 경결의 절대적인 크기와 ($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p= <0.001) 각각 10mm(50.0% vs. 32.0%, p= <0.001), 15mm(33.2% vs. 20.9%, p= 0.005) 이상인 환자 비율에서 의미 있는 차이를 보였다. 결 론: 20대 젊은 연령층이 집단으로 생활하는 공간에서 결핵유행이 발생하여 이를 국가 결핵관리지침에 따라 대응 하였지만 계속되는 환자 발생이 인지되어 현재의 국내지침 외에 추가적인 대책이 필요하리라 생각된다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제16권7호
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• pp.2131-2153
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• 2022

To achieve accurate detection of tuberculosis (TB) areas in chest radiographs, we design a chest X-ray TB area detection algorithm. The algorithm consists of two stages: the chest X-ray TB classification network (CXTCNet) and the chest X-ray TB area detection network (CXTDNet). CXTCNet is used to judge the presence or absence of TB areas in chest X-ray images, thereby excluding the influence of other lung diseases on the detection of TB areas. It can reduce false positives in the detection network and improve the accuracy of detection results. In CXTCNet, we propose a channel attention mechanism (CAM) module and combine it with DenseNet. This module enables the network to learn more spatial and channel features information about chest X-ray images, thereby improving network performance. CXTDNet is a design based on a sparse object detection algorithm (Sparse R-CNN). A group of fixed learnable proposal boxes and learnable proposal features are using for classification and location. The predictions of the algorithm are output directly without non-maximal suppression post-processing. Furthermore, we use CLAHE to reduce image noise and improve image quality for data preprocessing. Experiments on dataset TBX11K show that the accuracy of the proposed CXTCNet is up to 99.10%, which is better than most current TB classification algorithms. Finally, our proposed chest X-ray TB detection algorithm could achieve AP of 45.35% and AP50 of 74.20%. We also establish a chest X-ray TB dataset with 304 sheets. And experiments on this dataset showed that the accuracy of the diagnosis was comparable to that of radiologists. We hope that our proposed algorithm and established dataset will advance the field of TB detection.

• Journal of Preventive Medicine and Public Health
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• 제54권6호
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• pp.471-480
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• 2021

Objectives: Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population. Methods: In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index. Results: The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively. Conclusions: Chronic exposure to cadmium showed positive associations with liver damage.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.113-119
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• 2024

Background: Missing isoniazid (INH) resistance during tuberculosis (TB) diagnosis can worsen the outcomes of INH-resistant TB. The BD MAX MDR-TB assay (BD MAX) facilitates the rapid detection of TB and INH and rifampin (RIF) resistance; however, data related to its performance in clinical setting remain limited. Moreover, its effect on treatment outcomes has not yet been studied. Methods: We compared the performance of BD MAX for the detection of INH/RIF resistances to that of the line probe assay (LPA) in patients with pulmonary TB (PTB), using the results of a phenotypic drug sensitivity test as a reference standard. The treatment outcomes of patients who used BD MAX were compared with those of patients who did not. Results: Of the 83 patients included in the study, the BD MAX was used for an initial PTB diagnosis in 39 patients. The sensitivity of BD MAX for detecting PTB was 79.5%. The sensitivity and specificity of BD MAX for INH resistance were both 100%, whereas these were 50.0% and 95.8%, respectively, for RIF resistance. The sensitivity and specificity of BD MAX were comparable to those of LPA. The BD MAX group had a shorter time interval from specimen request to the initiation of anti-TB drugs (2.0 days vs. 5.5 days, p=0.001). Conclusion: BD MAX showed comparable performance to conventional tests for detecting PTB and INH/RIF resistances. The implementation of BD MAX as a diagnostic tool for PTB resulted in a shorter turnaround time for the initiation of PTB treatment.

• 한국환경농학회지
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• 제25권3호
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• pp.262-267
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• 2006

Increased application of glyphosate (Gly) in glyphosate-resistant (GR) soybean cropping systems may affect rhizospheric microorganisms including IAA-producing rhizobacteria (IPR) and their effect on the growth of soybean. This field experiment was conducted to assess IPR populations in the rhizosphere of GR soybean ('Roundup-Ready' DeKalb DKB38-52) treated with glyphosate and foliar amendment treatments such as $PT21^{(R)}$ (urea solution with N 21 %) and $Grozyme^{(R)}$ (Biostimulant: mixtures of micro nutrients and enzymes). Effects of herbicide, sampling date, and their interaction on total bacterial numbers were significant (P < 0.001, 0.001, 0.013, respectively). Total bacteria (TB) numbers were increased with glyphosate treatment at 20 d after application and highest TB populations were associated with $Grozyme^{(R)}$ application, possibly due to the additional substrate from this product. The IPR of the soybean rhizosphere was significantly affected by herbicide, sampling date, and the herbicide*foliar amendment interaction. The ratios of numbers of IPR to TB ranged from 0.79 to 0.99 across the sampling dates irrespective of treatments. IPR numbers were slightly hindered by glyphosate application regardless of foliar amendment.

• 근관절건강학회지
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• 제26권2호
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• pp.120-130
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• 2019

Purpose: The purpose of this study was to investigate the predictors of tuberculosis (TB) drugs in health care workers diagnosed with latent tuberculosis Infection (LTBI). Methods: This study was a descriptive correlation study. Data were collected by using a self-report questionnaire. The collected data were analyzed by -test, t-test, and logistic regression analysis. Results: There were involved 160 participants, 35 (21.9%) who took the TB drugs, and 125 (73.8%) who did not take the TB drugs. The predictors on taking TB drugs in health care workers with LTBI were subjective norms (OR=3.33, p<.001), perceived sensitivity (OR=2.67, p=.026), perceived barrier (OR=0.14, p=.014), and unmarried (OR=4.69, p=.006) than married, health care worker category 2 group (OR=5.84, p=.015) and 1 group (OR=4.25, p=.022) than 3, 4 group, sleep over 7 hours (OR=4.11, p=.022) than less 7 hours sleep. Conclusion: In order to promote the use of TB drugs in health care workers with LTBI, it is necessary that take intervention strategies to increase the subjective norms and perceived sensitivity and to decrease the perceived barriers.

• Clinical and Experimental Pediatrics
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• 제52권1호
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• pp.61-67
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• 2009

목 적 : 소아에서의 항결핵제 내성률은 지역 사회에서의 결핵 관리의 효율성을 파악하는 척도가 되나 국내외의 보고가 많지 않다. 이에 저자들은 소아청소년 결핵에서의 약제 내성률과 변화 경향을 조사하여 결핵 치료 및 예방적 화학요법 처방 선정에 도움을 얻고자 하였다. 방 법 : 1999년 1월부터 2007년 7월까지 대한결핵협회 결핵 연구원 미생물부(세계보건기구 지정 국제자문검사소)에 배양 및 감수성 검사가 의뢰되어 M. tuberculosis가 분리되어 항결핵제에 대한 감수성 검사가 실시된 예 중 19세 이하를 대상으로 항결핵제에 대한 감수성 검사를 실시하였다. 결 과 : 소아청소년에서 한 가지 이상의 약제에 대해 내성을 보인 균주는 607균주(16.6%)였고, IHN에 대해 내성을 보인 균주는 503균주(13.8%), RFP에 대해서는 326균주(8.9%), PZA에 대해서는 155균주(4.2%), SM에 대해서는 134균주(3.7%), EMB에 대해서는 215균주(5.9%), PAS에 대해서는 70균주(1.9%)였다. 다제내성결핵균은 276균주(7.6%)였고 광범위약제내성결핵균은 5균주(0.2%)였다. 15세 이하에서보다(20.5%) 15세 이상에서의 한 가지 이상의 약제에 대한 내성률(16.1%)이 유의하게 낮았고(P=0.016), 다제내성결핵이 차지하는 비율도 낮았으나(각각 8.7 %, 7.4%) 통계적으로 유의하지는 않았다. 본 조사 기간 동안 한 가지 이상의 결핵 약제에 대한 내성률과 다제내성결핵이 차지하는 비율은 유의하게 감소하였다(P<0.001). 이전 1987년부터 1995년까지의 조사와 비교해 보면, 한 가지 이상의 결핵 약제에 대한 내성률은 37.5%에서 20.5%로 유의하게 감소하였고(P=0.007), INH, EMB, PAS에 대한 내성률의 감소는 통계적으로 유의하였으며(P<0.05), 다제내성결핵이 차지하는 비율도 감소하였으나 통계적으로 유의하지는 않았다. 결 론 : 소아청소년 결핵에서의 약제 내성률은 과거에 비해 점차로 감소하는 양상을 보이고 있으나, 아직은 다른 나라보다 높고 다제내성결핵과 광범위약제내성결핵이 새로운 문제로 대두되고 있어 약제 감수성 검사와 내성균 감염 위험 요인 파악을 통한 효율적인 치료 약제 선정으로 치료 성공률을 높이면서 항결핵제 내성균의 증가를 막아야 할 것으로 사료된다.