• Journal of Chest Surgery
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• 제41권1호
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• pp.137-140
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• 2008

폐 랑거한스 세포 조직구증은 랑거한스 세포 조직구증의 제한적 인 형태로 매우 드문 질환이다. 특히, 폐 랑거한스 세포 조직구증이 폐결핵과 동반되어 보고된 경우는 극히 드물다. 극심한 호흡곤란으로 입원한 환자가 객담 AFB 도말 검사로 활동성 폐결핵으로 진단되었다. 입원 후 시행한 고해상도 컴퓨터 단층 촬영에서 다수의 미세 결절과 작은 낭종들이 관찰되었다. 개흉 폐생검을 시행하였고 폐 랑거한스 세포 조직구증의 동반이 확인되었다.

• 대한핵의학회지
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• 제30권3호
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• pp.379-381
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• 1996

Tc-99m-MIBI는 비특이적 반응으로 양성 비종양성 질환의 일종인 활동성 폐결핵에 섭취가 증가되며, 이의 치료 후 추적 관찰에도 유용할 것으로 생각된다. 특히 만성 폐결핵 환자에 있어 방사선학적으로나 객담검사는 음성이었으나 재발이 의심될 때, tuberculin skin test 상 양성이나 단순 흉부 검사상 확실치 않을 때 유용하게 이용되리라 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.102-107
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• 2004

저자들은 객담을 뱉지 못하는 뇌성마비 환아에서 객담 검사와 방사선학적 검사, 대장 조영술과 복부전산화단층촬영 검사를 통해, 폐결핵에 동반되어 상행 결장을 침범한 장결핵을 진단하고 항결핵제를 투여하여 임상적 호전을 가져온 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.43-46
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• 2008

Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.283-288
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• 2020

Background: Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients. Methods: Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment. Results: In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time. Conclusion: The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.

• Tuberculosis and Respiratory Diseases
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• 제59권4호
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• pp.356-360
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• 2005

연구배경 : 징병검사에서 집단 흉부 간접 방사선 촬영의 폐결핵에 관련한 임상적 유용성을 평가하고자 하였다. 방 법 : 2003년 4월부터 11월까지 서울 지방병무청 제 2 징병검사장에서 징병검사를 시행한 25386명을 대상으로 하였다. 모두 흉부 간접 방사선 촬영을 시행하였고 이상소견자는 직접 방사선 촬영으로 확인하였다. 흉부 간접 방사선 촬영과 직접 방사선 촬영과의 양성 예측율을 알아보았다. 폐결핵을 중심으로 추적검사를 통해 활동성 폐결핵 유병율, 침윤정도와 임상경과를 알아보았다. 결 과 : 총 25386명중 328명에서 흉부 간접 방사선 촬영상 이상소견이 발견되어 직접 방사선 촬영으로 재검사하였다. 재검사 중 302명(1.19%)에서 이상소견이 확인되었다. 폐결핵을 포함한 폐실질병변이 109예였고, 종격동 병변이 6예, 심혈관계 이상이 45예, 흉막병변이 49예, 측만증을 포함한 골격계 이상이 90예 그리고 기타 7예였다. 흉부 간접 방사선 촬영상 폐결핵은 99예 였으며, 이중 활동성 폐결핵이 67예로 활동성 폐결핵의 유병율은 0.26%였다. 활동성 폐결핵 환자의 42예, 폐렴 1예, 종격동 종양 1예, 늑골골절 2예 그리고 기흉 4예가 최초 진단되었다. 활동성 폐결핵 환자의 폐침윤 정도는 경증이 52예 였으며, 60예에서 추적검사상 호전되었다. 결 론 : 징병검사에서 집단검사로서 흉부 간접 방사선 촬영은 한계와 문제점이 있으나, 특히 활동성 폐결핵을 포함한 병의 최초 조기발견에 있어 유용한 검사로 의미가 있을 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.311-320
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• 1999

연구 배경 : 최근 전세계적으로 결핵이 증가하며 새로운 문제로 대두되고 있으며, 특히 결핵의 유병률이 높은 우리나라의 경우에는 민감도가 높으며 간편한 검사방법 이 필요하다. M. tuberculosis 항원을 사용한 rapid membrane based assay 검사 방법으로 최근에 폐결핵 환자의 결핵항원 특이 항체를 검출한다고 알려진 상용화된 2 가지 kit를 이용하여 폐결핵의 혈청학적 진단 가능성을 알아보고자 하였다. 방법 : 1998년 3월부터 9월까지 충남대학교 병원에서 입원 치료를 받은 호흡기 환자 총 45예를 대상으로 하였다. 객담 도말 양성의 활동성 폐결핵 22예와 비활동성 폐결핵 14예 그리고 대조군으로 비결핵성 호흡기 질환 9예를 대상으로 하여 STAT-PAK ULTRA FAST$^{(R)}$ 및 ICT tuberculosis$^{(R)}$ 검사를 실시하여 결핵 혈청 검사의 유용성을 알아보고 자하였다. 결과: STAT-PAK ULTRA FAST$^{(R)}$의 경우에는 폐결핵과 비활동성 폐결핵의 비교에서 민감도는 77.3%, 28.6%, 양성 63.0%, 음성 예측도는 44.4%, 위양성률은 71.4%, 위음성률은 22.7% 이었고, 활동성 폐결핵과 비결핵성 호흡기 질환의 비교에서는 민감도는 77.3%, 특이도는 33.3%, 양성 예측도는 73.9%, 음성 에측도는 37.5%, 위양성률은 66.7%, 위음성률은 22.7% 이었다. ICT tuberculosis$^{(R)}$의 경우에는 활동성 폐결핵과 비활동성 폐결핵의 비교에서는 민감도는 54.5%. 특이도는 57%, 양성 예측도는 66.7%, 음성 예측도는 44.4%, 위양성률은 42.9%, 위음성률은 45.4 %이었고, 활동성 폐결핵과 비결핵성 호흡기 질환에서는 민감도는 54.5%, 특이도는 100%, 양성 예측도는 100%, 음성 예측도는 47.4%. 위양성률은 0%, 위음성률은 45.4%이었다. 폐결핵의 중증정도(extent) 와 양성율은 상기 2가지 kit에서 큰 차이가 없었다. 결론: 따라서 상기 2가지의 kit는 항체 반응이 다양하여 임상적으로 폐결핵의 진단에 이용하는 것에는 문제가 있다고 생각되며, 일단 양성반응을 보인 환자의 경우, 항결핵제 투여에 따른 추적 검사에서 항체가의 변화가 있는지에 대한 연구가 필요하리라 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.153-157
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• 2016

Background: Vitamin D is known to have diverse effects on various systems in the body. There is evidence to suggest that a link exists between the serum vitamin D status and tuberculosis. The present study was designed to assess the alterations in serum 25-hydroxyvitamin D levels in newly diagnosed sputum acid fast bacilli (AFB) positive pulmonary tuberculosis patients and to study the association, if any, between serum vitamin D levels and different levels of sputum smear positivity. Methods: Serum 25-hydroxyvitamin D levels were estimated in 65 sputum AFB positive pulmonary tuberculosis patients and 65 age and gender-matched healthy controls. Results: The levels of serum 25 hydroxy-vitamin D in tuberculosis patients were not statistically different from the levels of serum 25 hydroxy-vitamin D in healthy controls. However, among patients with pulmonary tuberculosis, there was a significant negative correlation between the levels of serum 25 hydroxy-vitamin D and levels of sputum positivity. Conclusion: Serum vitamin D levels negatively correlates with bacterial load in patients with active pulmonary tuberculosis.

• 한국산업보건학회지
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• 제33권2호
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• pp.134-144
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• 2023

Objectives: Active pulmonary tuberculosis (active PTB) is manifested in one of the complications of pneumoconiosis, but statistics are not available. The objective of the present study was to identify the incidence of active PTB among dusty workers who were diagnosed with pneumoconiosis by year. Methods: The present study was performed using the results of the Pneumoconiosis Examination Council's assessment from the Korea Workers' Compensation and Welfare Service (KCOMWEL) database between January 1, 1984, and December 31, 2017. Pneumoconiosis is defined as Category 1 or more. Active PTB was defined as a positive result for active PTB in the result of the Pneumoconiosis Examination Council's assessment. The annual incidence rate of pneumoconiosis and active PTB were analyzed by age standardization. Results: The number of retired dusty workers who received the health examination for work-related pneumoconiosis increased every year. However, the incidence of pneumoconiosis among retired dusty workers and active PTB among patients with pneumoconiosis decreased every year. Conclusions: To effectively manage pneumoconiosis and active PTB among patients with pneumoconiosis, the annual status of them in retired dusty workers who received the health examination for work-related pneumoconiosis was required.

• 대한의생명과학회지
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• 제20권3호
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• pp.162-167
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• 2014

Tuberculosis (TB) is one of the major global health problems and it has been estimated that in 5~10% of Mycobacterium tuberculosis (MTB)-infected individuals, the infection progresses to an active disease. Numerous cytokines and chemokines regulate immunological responses at cellular level including stimulation and recruitment of wide range of cells in immunity and inflammation. In the present study, the mRNA expression levels of eight host immune markers containing of IFN-${\gamma}$, TNF-${\alpha}$, IL-2R, IL-4, IL-10, CXCL9, CXCL10, and CXCL11 in whole blood cells from active pulmonary TB patients were measured after T-cell mitogen (PHA) and MTB specific antigens (ESAT-6, CFP-10, and TB7.7). Among the TH1-type factors, IFN-${\gamma}$ mRNA expression was peaked at 4 h, TNF-${\alpha}$ and IL-2R mRNA expression was significantly high at the late time points (24 h) in active TB patients, TH2-type cytokine (IL4 and IL10) mRNA expression levels in both active TB and healthy controls samples did not changed significantly, and the mRNA expression of the three IFN-${\gamma}$-induced chemokines (CXCL9, CXCL10, and CXCL11) were peaked at the late time points (24 h) in active TB patients after MTB specific antigen stimulation. In conclusion, the mRNA expression patterns of the TB-related immune markers in response to the T-cell mitogen (PHA) differed from those in response to MTB specific antigens and these findings may helpful for understanding the relationship between MTB infection and host immune markers in a transcripts level.