• Title/Summary/Keyword: Tuberculosis test

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Treatment of Latent Tuberculosis Infection and Its Clinical Efficacy

  • Kim, Hyung Woo;Kim, Ju Sang
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.1
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    • pp.6-12
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    • 2018
  • The role of the treatment for latent tuberculosis infection (LTBI) has been underscored in the intermediate tuberculosis (TB) burden countries like South Korea. LTBI treatment is recommended only for patients at risk for progression to active TB-those with frequent exposure to active TB cases, and those with clinical risk factors (e.g., immunocompromised patients). Recently revised National Institute for Health and Care Excellence (NICE) guideline recommended that close contacts of individuals with active pulmonary or laryngeal TB, aged between 18 and 65 years, should undergo LTBI treatment. Various regimens for LTBI treatment were recommended in NICE, World Health Organization (WHO), and Centers for Disease Control and Prevention guidelines, and superiority of one recommended regimen over another was not yet established. Traditional 6 to 9 months of isoniazid (6H or 9H) regimen has an advantage of the most abundant evidence for clinical efficacy-60%-90% of estimated protective effect. However, 6H or 9H regimen is related with hepatotoxicity and low compliance. Four months of rifampin regimen is characterized by less hepatotoxicity and better compliance than 9H, but has few evidence of clinical efficacy. Three months of isoniazid plus rifampin was proved equivalence with 6H or 9H regimen in terms of efficacy and safety, which was recommended in NICE and WHO guidelines. The clinical efficacy of isoniazid plus rifapentine once-weekly regimen for 3 months was demonstrated recently, which is not yet introduced into South Korea.

Relationships of Stigma, Family Support, and Quality of Life in Tuberculosis Patients (결핵환자의 스티그마, 가족지지와 삶의 질의 관계)

  • Park, Su-Jung;An, Minjeong;So, Hyang-Sook
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.285-294
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    • 2015
  • Purpose: The purpose of this study was to identify the relationships between stigma, family support, and quality of life in tuberculosis patients. Methods: The participants were 122 who completed a questionnaire. The data were analyzed using descriptive statistics, t-test, and ANOVA. Results: The score of stigma I(community perspectives) was $18.67{\pm}7.48$ and the score of stigma II(patients perspectives) was $14.84{\pm}6.93$. The score of those with family support was $30.81{\pm}4.16$. The score of QOL was $102.22{\pm}13.72$. The findings showed significant positive relationships between stigma I and stigma II and between family support and QOL(r = .753, p < .001; r = .314, p < .001, respectively) and negative relationship between stigma II and QOL(r = -.250, p = .005). Conclusion: Further studies are needed to develop and evaluate the nursing interventions to support patients with tuberculosis, reducing their level of stigma and improving their quality of life.

Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children

  • Yun, Ki Wook;Kim, Young Kwang;Kim, Hae Ryun;Lee, Mi Kyung;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • v.59 no.6
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    • pp.256-261
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    • 2016
  • Purpose: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-${\gamma}$ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. Methods: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015. Blood samples for IGRA were collected, processed, and interpreted according to manufacturer protocol. Results: Among 149 children, 31 (20.8%) and 10 (6.7%) were diagnosed with LTBI and active pulmonary TB, respectively. In subjects lacking contact history with active TB patients, TST and IGRA results were positive in 41.4% (29 of 70) and 12.9% (9 of 70) subjects, respectively. The agreement (kappa) of TST and IGRA was 0.123. The control group, consisting of non-TB-infected subjects, showed no correlation between age and changes in interferon-${\gamma}$ concentration after nil antigen, TB-specific antigen, or mitogen stimulation in IGRAs (P=0.384, P=0.176, and P=0.077, respectively). In serial IGRAs, interferon-${\gamma}$ response to TB antigen increased in IGRA-positive LTBI subjects, but did not change considerably in initially IGRA-negative LTBI or control subjects. Conclusion: The lack of decrease in interferon-${\gamma}$ response in young children indicates that IGRA could be considered for this age group. Serial IGRA tests might accurately diagnose LTBI in children lacking contact history with active TB patients.

Microplate hybridization assay for detection of isoniazid resistance in Mycobacterium tuberculosis

  • Han, Hye-Eun;Lee, In-Soo;Hwang, Joo-Hwan;Bang, Hye-Eun;Kim, Yeun;Cho, Sang-Nae;Kim, Tae-Ue;Lee, Hye-Young
    • BMB Reports
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    • v.42 no.2
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    • pp.81-85
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    • 2009
  • Early and accurate detection of drug resistant Mycobacterium tuberculosis can improve both the treatment outcome and public health control of tuberculosis. A number of molecular-based techniques have been developed including ones using probe molecules that target drug resistance-related mutations. Although these techniques are highly specific and sensitive, mixed signals can be obtained when the drug resistant isolates are mixed with drug susceptible isolates. In order to overcome this problem, we developed a new drug susceptibility test (DST) for one of the most effective anti-tuberculosis drug, isoniazid. This technique employed a microplate hybridization assay that quantified signals from each probe molecule, and was evaluated using clinical isolates. The evaluation analysis clearly showed that the microplate hybridization assay was an accurate and rapid method that overcame the limitations of DST based on conventional molecular techniques.

The Factors Affecting Health Promoting Lifestyle in Patients with Pulmonary Tuberculosis (폐결핵 환자의 건강증진 생활양식과 그 영향 요인)

  • Chon, Mi-Young;Ryu, Eunjung
    • 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.

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TUBERCULOUS OSTEOMYELITIS SIMULTANEOUSLY OCCURED ON THE MAXILLA AND MANDIBLE (상악골과 하악골 동시에 발생한 결핵성 골수염)

  • Kim, Il-Kyu;Ryu, Mun-Kwang;Kim, Dong-Soo;Ku, Je-Hoon;Choi, Jin-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.164-169
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    • 2005
  • Tuberculosis is a systemic disease with a world-wide distribution, and its occurance in the oral cavity is well documented in the literature. Disease of oral cavity and jaw caused by Mycobacterium tuberculosis is very rare, so it is often difficult to diagnose tuberculosis in the oral cavity. When granulomatous and ulcerative lesion persists in the oral cavity for a long time, it may be considered a tuberculosis. When differential diagnosis is needed, the most reliable indicators of mycobacterial infection are careful clinical evaluation, skin test, acid-fast staining, biopsy and culture. We report a case of tuberculous osteomyelitis which simultaneously occurred on the maxilla and mandible in a 85 years old man that proved diagnosis difficult, but which responded very well to surgical treatment and chemotherapy.

A CASE OF FOREIGN BODY ASPIRATION CONFUSED WITH ENDOBRONCHIAL TUBERCULOSIS (기관지 결핵으로 오인된 틀니조각 흡인 1례)

  • 김치홍;김보경;문진성;김선명
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.238-243
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    • 1996
  • Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

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Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis (폐결핵 입원환자의 건강관련 삶의 질 예측모형)

  • Jang, Kwang-Sim;Jeon, Gyeong-Suk
    • Journal of Korean Academy of Nursing
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    • v.47 no.1
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    • pp.60-70
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    • 2017
  • Purpose: This study was conducted to construct and test a structural equation model of health-related quality of life (HRQoL) among hospitalized patients with pulmonary tuberculosis (PTB). Methods: Participants were 256 patients with PTB who were 20 years or older and admitted in two national tuberculosis hospitals. The patients participated in pulmonary function testing and responded to structured questionaries. Results: The goodness-of-fit statistics of the final hypothetical model were as follows: ${\chi}^2/df=2.19$, RMSEA=.07, SRMR=.05, GFI=.95, NFI=.95, CFI=.96, TLI=.92, and PCFI=.52. Symptoms and general health perception had significant direct effects, and subjective economic status, social support and stigma had significant indirect effect on HRQoL of hospitalized patients with PTB. These variables explained 64% of variance in the prediction model. Conclusion: Findings suggest that strategies and intervention for physical symptoms and depressive symptoms are crucial to improve the quality of life in hospitalized patients with PTB. The development of various social support programs is also recommended.

Differentiation of four Mycobacterium Species using DNA-DNA Hybridization Method using Specific Probes

  • Kweon, Tae-Dong;Bai, Sun-Joon;Hong, Seong-Karp
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2013.05a
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    • pp.1012-1014
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    • 2013
  • DNA-DNA hybridization method with four oligonucleotide-specific probes was used simultaneously for differentiation and identification of four Mycobacterium species (Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii). This DNA-DNA hybridization method with 4 oligonucleotide-specific probes, which targets in the rpoB region of 4 Mycobacteria species, respectively, was tested on 322 clinical isolates. Using DNA-DNA hybridization method, we detected M. tuberculosis (282 strains), M. avim (7 strains), M. intracellulare (9 strains), and M. kansasii (3 strain) from 322 clinical isolates. This result was compared with conventional biochemical test and rpoB DNA sequence analysis of this clinical isolates. We confirmed identification of Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii with high sensitivity (100 %) and specificity (100 %). This DNA-DNA hybridization method could be performed within 4 hours at least. Therefore, we suggest that DNA- DNA hybridization method using 4 rpoB DNA probes of Mycobacteria could be used for accurate, rapid, convenient detection and identification of Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii in clinical samples.

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Tc-99m-MIBI Uptake in Active Pulmonary Tuberculosis : A Case Report (활동성 폐 결핵에서의 Tc-99m-MIBI 섭취 : 1예 보고)

  • Lee, Chang-Ho;Park, Chan-Hee;Hwang, Hee-Sung;Bae, Moon-Sun
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.379-381
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    • 1996
  • Technetium-99m MIBI was developed as a myocardiac perfusion imagine agent and has been used effectively in the detection and post-therapeutic evaluation of various neoplasm such as thyroid, lung, bone and breast tumors. As an infrequent findings, Tc-99m MIBI agent has shown in non-neoplastic pulmonary conditions Including fibrosing alveolitis, pulmonary actinomycosis, active pulmonary sarcoidosis, pulmonary interstitial fibrosis in progressive systemic sclerosis and active osteomyelitis. In a recent report conducted by Cetin Oncel, Tc-99m MIBI imaging is an effective method in the detection and follow-up of pulmonary tuberculosis We have also experienced Tc-99m MIBI uptake in active pulmonary tuberculosis incidentally found in a patient with suspected proliferative villonodular synovitis of the left ankle.

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