• Journal of Chest Surgery
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• 제50권1호
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• pp.50-53
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• 2017

A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.

• Tuberculosis and Respiratory Diseases
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• 제75권5호
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• pp.218-221
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• 2013

This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.140-147
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• 2021

Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.

• 한국콘텐츠학회논문지
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• 제18권5호
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• pp.432-445
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• 2018

예비보건의료인들을 포함한 보건 의료인들은 결핵에 노출될 위험이 상대적으로 높기 때문에 이들이 적절한 수준의 지식과 예방행위를 구비하는 것이 중요하다. 예비보건의료인들을 위한 결핵 교육 모형을 구축함에 있어서 문헌고찰을 실시함과 동시에 129명의 예비 보건 의료인과 14인의 의료인들을 대상으로 설문조사와 전화 인터뷰를 실시하였다. 그 결과는 다음과 같다.; 첫째, 문헌 고찰에 근거하여 결핵의 역학, 결핵의 전파 및 병태생리, 검사와 진단, 잠복결핵, 결핵의 치료, 그리고 결핵의 예방 등을 포함한 총 6개의 교육 주제가 파악되었다. 둘째, 예비보건의료인들은 결핵의 역학, 전파 및 병태생리, 잠복결핵 분야에 대해 상대적으로 낮은 지식수준을 보였다. 그러므로 교육과정을 계획할 때, 이러한 지식이 낮은 영역에 더 많은 시간이 할애되어야 할 것이다. 셋째, 의료인들은 결핵역학 교육 시, 결핵의 정의와 유형이 잘 포함되어야 한다고 강조하였으며, 결핵의 전파와 병태생리를 교육할 때에는 병원감염과 감염회로에 관한 내용이 포함되어야 된다고 답변하였다. 이에 덧붙여, 의료인들은 결핵의 진단과 집단검진을 강조하였으며, 잠복결핵 교육 시에는 개인보호장구 착용에 관한 내용이 포함되어야 한다고 반응하였다. 또한, 결핵의 치료에 대한 교육 시, 환자 교육 및 결핵약의 부작용에 대한 내용이 포함되어야 하며, 덧붙여 예비보건의료인들의 자기건강증진 행위 및 체계적인 결핵 교육이 결핵 예방의 중요한 수단이라고 정의하였다. 이러한 결과는 제한된 수의 응답자들과 표집 오차를 포함하고 있기에 결과를 일반화하는데 신중을 기해야 한다. 그러므로 더 큰 연구집단을 이용한 후속 연구를 통해 결핵 교육 모형을 개발하는 것이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제55권5호
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• pp.428-435
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• 2022

Objectives: The Indonesian Ministry of Health launched isoniazid preventive therapy (IPT) in 2016, with general practitioners (GPs) at the frontline of this program. However, the extent to which GPs have internalized this program remains uncertain. The aim of this study was to identify the knowledge and attitudes of GPs towards the IPT program in Indonesia. Methods: This study used an online, self-administered questionnaire distributed via e-mail and social messaging services. A logistic regression model was employed to identify the explanatory variables influencing the level of knowledge and attitudes toward IPT among GPs in Indonesia. An empirical analysis was conducted separately for each response variable (knowledge and attitudes). Results: Of the 418 respondents, 128 (30.6%) had a good knowledge of IPT. Working at a public hospital was the only variable associated with good knowledge, with an adjusted odds ratio (aOR) of 1.69 (95% confidence interval [CI], 1.02 to 2.81). Furthermore, 279 respondents (66.7%) had favorable attitudes toward IPT. In the adjusted logistic regression analysis, good knowledge (aOR, 0.55; 95% CI, 0.34 to 0.89), 1-5 years of work experience (aOR, 2.09; 95% CI, 1.21 to 3.60), and having experienced IPT training (aOR, 0.48; 95% CI, 0.25 to 0.93), were significantly associated with favorable attitudes. Conclusions: In general, GPs in Indonesia had favorable attitudes toward IPT. However, their knowledge of IPT was limited. GPs are an essential element of the IPT program in the country, and therefore, adequate information dissemination to improve their understanding is critical for the long-term viability and quality of the IPT program in Indonesia.

• International Journal of Advanced Culture Technology
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• 제12권1호
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• pp.190-201
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• 2024

This study examined the effect of the distance Infection Control Education Program (ICEP), developed based on the ADDIE model, on infection control knowledge, attitude, and performance among care workers in long-term care facilities nationwide. The program, developed based on the ADDIE model, was applied to 173 care workers directly responsible for nursing care of elderly residents in lomg-term care facilities. The distance ICEP for care workers was conducted through the website and lasted 30 minutes for each of the eight topics. To determine the effectiveness of the education, infection control knowledge, attitude, performance, and satisfaction were surveyed before and four weeks after the program. Differences in infection control knowledge, attitude, and performance before and after the distance ICEP were assessed by a t-test. A significant difference was observed in knowledge and infection control performance after the distance ICEP was administered to care workers. In the sub-domains of infection control performance, overall understanding of infection, regular infection control education, infection control by special pathogen (multidrug-resistant bacteria, tuberculosis, tick-borne infectious diseases), and detailed infection control education by infection site (pressure ulcers and urinary tract infections) were significantly improved. Infection control knowledge and performance improved through the distance ICEP applied to care workers. Satisfaction also displayed high scores on most items and indicated that it was helpful for infection control in facilities, confirming the effectiveness of infection control education. Based on the survey of care workers nationwide, the infection education program can be effectively used for care workers in the future.

• Tuberculosis and Respiratory Diseases
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• 제54권4호
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• pp.459-466
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• 2003

M. kansasii는 M. avium complex에 이어 NTM 폐질환의 원인균 중 두 번째로 흔하다고 외국에서는 보고되었다. M. kansasii는 M. avium complex와 마찬가지로 과거부터 잘 알려진 상엽공동형의 형태와 함께 기관지확장증에 다발성 결절이 동반된 형태가 새롭게 알려지고 있다. 다른 NTM 폐질환과 달리 M. kansasii 폐질환은 INH, RFP, EMB 등 항결핵제에 치료반응이 매우 좋기 때문에 정확한 진단과 함께 적절한 약제와 치료기간의 선택이 중요하다. 국내에서는 임상검체에서 M. kansasii가 분리되는 빈도가 매우 낮으며, 아직까지 정상면역을 가진 성인에서 M. kansasii 폐질환으로 진단된 증례가 보고되지 않았다. 저자들은 1997년 미국흉부학회의 NTM 폐질환 진단기준에 따라 M. kansasii 폐질환을 진단하고 치료한 3명의 환자를 경험하여 이를 보고하는 바이다.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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• pp.79-90
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• 1996

항결핵치료 시작 후 3개월간의 치료 경과와 치료 순응과의 관련성을 조사하기 위하여 3개 보건소(대구시 달성군, 경주시, 구미시)에 1995년 10월 15일 현재 단기 6개월 표준처방으로 치료 시작 후 3개월 이상 경과된 초치료 결핵환자 중 계속적인 추적관찰에서 누락된 10명을 제외하고 104명의 자료를 분석한 결과는 다음과 같다. 연구 대상자 104명 중 호전군은 80.8%였고, 비호전군은 19.2%였다. 호전군과 비호전군간에 성, 연령, 교육 수준, 직업, 동반 가족유무, 흡연 및 음주습관의 변화 등에 유의한 차이는 없었고, 평균 연령은 비호전군이 51세로 호전군 42세보다 많았으나 유의 한 차이는 아니었다. 호전군에서는 약제의 복용을 식전과 식후 30분에 복용하는 경우(p<0.05), 약의 복용을 잊지 않도록 가족들이 챙겨 주는 경우(p<0.05), 약을 규칙적으로 복용하는 경우(p<0.01), 항결핵치료 도중 의문점을 가족이나 결핵담당자와 상의하는 경우(p<0.01) 등이 유의하게 많았다. 비호전군에서는 당뇨병이나 위장 질환 등을 않고 있는 경우가 유의하게 많았다(p<0.01). 결핵에 대한 지식점수는 호전군이 12.9로 비호전군 10.6보다 유의하게 높았고(p<0.01), 지식정도의 문항에 대한 신뢰도 검증 결과 신뢰성$(Cronbach'\alpha:0.703)$이 있었다. 치료경과를 호전군과 비호전군으로 나누어 종속변수로 놓고 시행한 다중 지수형 회귀분석에서는 약의 복용을 잊지 않도록 가족들이 챙겨주는 경우(p<0.05)가 유의한 변수로 채택되었고, 결핵에 대한 지식이 높은 경우(p=0.054), 약을 규칙적으로 복용하는 경우(p=0.062), 항결핵치료 도중 의문점을 가족이나 결핵담당자와 상의하는 경우(p=0.075)는 경계역의 변수로 채택되었다. 결론적으로 약을 규칙적으로 복용할 수 있도록 항결핵치료에 대한 신념을 불어넣고 경각심을 높임으로써 환자의 치료 결과를 향상시킬 수 있을 것으로 생각되며, 향후 단기 6개월 표준요법에 의한 치료에 있어서 치료시작 후 3개월간의 치료 경과로 치료 결과를 예측하고 환자의 치료순응을 평가하기 위한 변수로 사용하기 위해서는 보다 많은 결핵환자를 대상으로 한 연구가 필요할 것으로 생각된다. 또한 환자의 치료 순응을 높이기 위하여 환자에 대한 교육과 의사 또는 결핵관리자와 환자, 조력자간의 강한 유대 관계의 형성에 도움을 줄 수 있는 방안의 모색이 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.416-418
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• 2015

Mycobacterium shinjukuense is a novel species of nontuberculous mycobacteria (NTM) that was first reported in Japan in 2011. It is a slow-growing NTM pathogen that can cause chronic pulmonary infections. There are only a few reported cases of M. shinjukuense infections, all of which are from Japan. We reported a case of chronic lung disease caused by M. shinjukuense. The organism was identified by 16S rRNA, rpoB, and hsp65 gene sequencing. To the best of our knowledge, this was the first confirmed case of lung disease caused by M. shinjukuense outside of Japan.

• Tuberculosis and Respiratory Diseases
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• 제70권5호
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• pp.433-437
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• 2011

Sarcoidosis is a multisystemic disorder characterized by the presence of non-caseating granulomas in the involved organ. Tuberculosis is an infectious disease caused by $Mycobacterium$ $tuberculosis$ and is characterized by granuloma with caseous necrosis. The clinical and histological similarity between sarcoidosis and tuberculosis has stimulated research searching for an association between mycobacterium and sarcoidosis. We report a case of a 38-year-old male with sarcoidosis that developed soon after treatment of tuberculous lymphadenitis. He was diagnosed as tuberculous lymphadenitis by microbiological confirmation. He showed clinical improvement after treatment for tuberculosis. One year later, his chest radiography showed bilateral hilar enlargement with diffuse bilateral nodules. A noncaseating granuloma was confirmed by endobronchial ultrasound guided transbronchial needle aspiration and he was diagnosed with sarcoidosis. To our knowledge, this is the first report describing sarcoidosis after treatment of tuberculosis in South Korea.