• IMMUNE NETWORK
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• v.11 no.5
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• pp.253-257
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• 2011

Background: The active metabolite (1, 25- dihydroxycholecalciferol) of vitamin D (25-hydroxycholecalciferol) leads to activation of macrophages and deficiency of vitamin D seems to be involved in the risk of tuberculosis. The effects of vitamin D are exerted by interaction with the vitamin D receptor (VDR) and may be influenced by polymorphism in the VDR gene. In this study, variation in the VDR gene was investigated in Korean population with tuberculosis. Methods: We typed three VDR polymorphisms of restriction endonuclease sites for TaqI, BsmI and FokI in 155 patients with tuberculosis and 105 healthy volunteers. Results: The frequencies of FokI genotypes determined from TB patients were 29.13% for FF, 56.31% for Ff, and 14.56% for ff. We observed 1.4-fold increased prevalence of the Ff genotype in TB patients compared with normal healthy groups (p=0.0857). However, there was no significant association between the genotype groups, TB patient and normal control, for FokI polymorphism. There was also no significant association between VDR gene and tuberculosis in another polymorphism (BsmI and TaqI). Conclusion: Three polymorphisms (TaqI, BsmI and FokI) in the VDR gene do not appear to be responsible for host susceptibility to human tuberculosis in Korean population.

• Clinical and Experimental Reproductive Medicine
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• v.16 no.1
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• pp.81-91
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• 1989

It has been suggested that the prognosis for fertility of the infertile patients with healed pelvic tuberculosis is very poor. Total 60 patients(77 cycles) with previous history of pelvic tuberculosis who underwent IVF-ET from January 1988 to March 1989 at SNUH were classified into three groups according to the principal histopathological lesions : tuberculous endometritis group(N=20, 28 cycles), tuberculous salpingitis group(N=32, 37 cycles) and pelvic peritoneal tuberculosis group(N=8, 12 cycles). To evaluate the effects of previous pelvic tuberculous lesions on ovarian follicular growth and development in controlled ovarian hyperstimulation for IVF-ET and its final outcome, serum E2 levels on the day of hCG administration(Day 0) and the day after hCG administration(Day +1), the number of ovarian follicles with mean diamete ${\geqq}$ 12 mm on Day 0, the number of oocytes retrieved by transvaginal aspiration, and pregnancy rate per cycle were measured and compared with control group(N=123, 161 cycles). There were no significant differences in cancellation rate during controlled ovarian hyperstimulation, total dosage of FSH and hMG administrated, menstrual cycle date(MCD) of hCG injection, serum E2 levels, the number of ovarian follicles with mean diameter ${\geqq}$ 15 mm, and the number of oocytes retrieved between pelvic tuberculosis group and control group. But in pelvic tuberculosis group, the number of ovarian follicles with mean diameter 12-14 mm, total number of ovarian follicles(${\geqq}$ 12 mm), and pregnancy rate per cycle were significantly decreased. These data suggest that previous pelvic tuberculous lesions have no significant adverse effects on the ovarian response to gonadotropin stimulation. IVF-ET proved to be an useful treatment modality for infertile patients with previous history of pelvic tuberculosis in spite of its relatively lowered pregnancy rate.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.416-425
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• 2012

Background: The sensitivities and specificities of interferon-gamma release assays (IGRAs) vary among different population studies, and the data on the routine use of IGRAs are limited. The aim of this study was to evaluate the role of QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of active tuberculosis. Methods: We conducted a prospective study, enrolling 77 patients with suspected pulmonary tuberculosis (TB), at a secondary care teaching hospital in Seoul. Results: In total, 12 (15.6%) patients showed indeterminate results due to positive control failure on the QFT-GIT test. Indeterminate results were significantly associated with the elderly, history of the intensive care unit stay, lymphocytopenia, especially low CD4 count, increased C-reactive protein and decreased protein levels. Of the 77 patients, 44 (57.1%) were diagnosed with active pulmonary tuberculosis, and the percentage of false negative results of the QFT-GIT was 36.4% (vs. 31.8% with TST). In the TB group with >65 years old (n=12), the proportions of the indeterminate (33.3% vs. 3.1%) and the false negative results (58.3% vs. 25.0%) of the QFT-GIT were significantly higher than in the younger TB group (n=32). Conclusion: Indeterminate and false negative results of QFT-GIT test were not infrequent in tuberculosis, especially in the elderly. Care should be considered for the interpretation with the elderly, immunocompromised, chronic and severely diseased patients.

• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.78-84
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• 2015

Background: Reports of therapeutic drug monitoring (TDM) for second-line medications to treat multidrug-resistant tuberculosis (MDR-TB) remain limited. Methods: A retrospective cohort from the Virginia state tuberculosis (TB) registry, 2009-2014, was analyzed for TDM usage in MDR-TB. Drug concentrations, measured at time of estimated peak ($C_{max}$), were compared to expected ranges. Results: Of 10 patients with MDR-TB, 8 (80%) had TDM for at least one drug (maximum 6 drugs). Second-line drugs tested were cycloserine in seven patients (mean $C_{2hr}$, $16.6{\pm}10.2{\mu}g/mL$; 4 [57%] below expected range); moxifloxacin in five (mean $C_{2hr}$, $3.2{\pm}1.5{\mu}g/mL$; 1 [20%] below); capreomycin in five (mean $C_{2hr}$, $21.5{\pm}14.0{\mu}g/mL$; 3 [60%] below); para-aminosalicylic acid in five (mean $C_{6hr}$, $65.0{\pm}29.1{\mu}g/mL$; all within or above); linezolid in three (mean $C_{2hr}$, $11.4{\pm}4.1{\mu}g/mL$, 1 [33%] below); amikacin in two (mean $C_{2hr}$, $35.3{\pm}3.7{\mu}g/mL$; 1 [50%] below); ethionamide in one ($C_{2hr}$, $1.49{\mu}g/mL$, within expected). Two patients died: a 38-year-old woman with human immunodeficiency virus/acquired immune deficiency syndrome and TB meningitis without TDM, and a 76-year-old man with fluoroquinolone-resistant (pre-extensively drug-resistant) pulmonary TB and low linezolid and capreomycin concentrations. Conclusion: Individual pharmacokinetic variability was common. A more standardized approach to TDM for MDR-TB may limit over-testing and maximize therapeutic gain.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.103-108
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• 2022

In 2021,the incidence of newly notified tuberculosis in Jeju Province decreased by 23.0% compared to that in the previous year. This was the largest decline among the 18 municipalities studied. This study aimed to examine trends in the incidence of tuberculosis among different age and sex groups in Jeju Province between 2017 and 2021. This study observed the number of new cases in the annual report from 2017 to 2021, published by the Jeju Center for Infectious Diseases Control and Prevention. The average annual percentage change (AAPC; %) was calculated to determine the trend in crude incidence rates over the past 5 years by sex and age. While a P-value of <0.1 was considered marginally significant, aP-value of <0.05 was considered statistically significant. The AAPC of all age groups in Jeju Province had negative values. In men,there was a statistically significant decrease in ages 30-34, 40-44, 45-49, and 50-54 years and a marginally significant decrease in ages 35-59, 55-59, 60-64, 65-69, 75-79, and ≥80 years. In women, a statistically significant decrease was observed among patients aged 30-34, 35-39, and ≥80 years, and a marginally significant decrease was observed among patients aged 45-49, 50-54, 60-64, 65-69, and 75-79 years. A statistically significant decrease in tuberculosis was observed among patients in their 30s and 40s, and elderly patients aged ≥80 years comprised the group vulnerable to tuberculosis. Based on these findings, tuberculosis prevention and screening programs conducted in Jeju Province were effective.

• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.686-692
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• 2001

Background : Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. Methods : Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into two groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk factors for treatment failure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test. chi-square test and a Fisher's exact test. Results : The treatment failure rate of MDR-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatment regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). Conclusion : The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.38-47
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• 2012

Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1049-1055
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• 1989

We have reviewed 73 patients who experienced hemoptysis with pulmonary tuberculosis to analyze the factors contributing hemoptysis and its management The result are; 1. The age group between 30 * 50 years old was major prevalent group [59%]. 2. Sexual ratio was 3.9 to 1, as 58 men and 15 women. 3. In 58 patients [79.5 %], the number of hemoptysis in frequency was less than 5 times. 4. The quantity of hemoptysis was ranged from less than 50 ml to more than 600 ml and 20 patients [27.4%] experienced bleeding more than 600 ml at once. 5. There was no seasonal difference in hemoptysis. 6. The common prodromal symptoms of hemoptysis were coughing, fatigability, hot foreign sensation of throat in order of frequency. 7. In chest roentgenographic finding, the cavitary lesion was the most common finding, 67% [51 cases], and the multiple cavity was 19.2%[14 cases]. 8. 23 patients [31.37%] were operated for control of hemoptysis and pulmonary tuberculosis itself, 7[30.43 %] of them suffered from complication of empyema, respiratory failure, empyema with bronchopulmonary fistula. 9. One patient [4%] was died due to respiratory failure after left thoracoplasty.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.532-539
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• 2006

Background : The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions. Methods : From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis. Results : 458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months. Conclusion : Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

• Korean Journal of Adult Nursing
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• v.16 no.4
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• pp.575-584
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• 2004

Purpose: To describe the performance in the health-promoting lifestyle and to identify the major factors affecting the health-promoting relationships between self care behaviors and health promoting lifestyle profile in patients with pulmonary tuberculosis. Method: A convenience sample for this study was 172 pulmonary tuberculosis patients who have taken TB medications in urban city. The HPLP-II was selected to measure the concept of health-promoting lifestyle because of the number of research studies conducted using both the original HPLP and the revised HPLP-II. The statistical methods used in this study were t-test, ANOVA, Pearson correlations, and multiple regression. Result: The differences of the HPLP-II were found to have a significance of age, marital status, education level, and health service center. The level of self care behaviors was related positively to the level of health promoting lifestyle and their subcategories. Based on stepwise multiple regression analysis, the model that predicted factors included self care behaviors, age, health service center and education. Conclusion: After decades of decreasing rates, TB has reemerged as a serious national problem in Korea. The careful clinical management and more national concern of TB may help to improve the outcomes of many patients. The findings of this study suggest that TB patients who are more fulfilled in health-promoting lifestyles and self-care behaviors may be able to make better decisions regarding positive health-promoting behaviors.