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일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005~2009
윤늘봄 ( Neul Bom Yoon ),이성우 ( Sung Woo Lee ),박수민 ( Su Min Park ),정일환 ( Il Hwan Jeong ),박소영 ( So Young Park ),한송이 ( Song Yee Han ),이유림 ( Yu Rim Lee ),정진규 ( Jin Kyu Jung ),김준모 ( Joon Mo Kim ),김수영 ( Su You 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.71 No.2
Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~ 26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.
( Mi Ran Park ),( Su Min Park ),( Il Hwan Jeong ),( Neul Bom Yoon ),( Sung Woo Lee ),( Soo Jung Um ),( Soo Keol Lee ),( Choon Hee Son ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
Cysticercosis is a infection with Cysticercus, the larval form of the various tapeworms of the genus Taenia (usually T. solium in man). In humans they penetrate the intestinal wall and invade subcutaneous tissue, brain, eye, muscle, heart, liver, lung, and peritoneum. Brain involvement results in neurocysticercosis. Here we present a case of cysticercosis presenting peripheral and pulmonary eosinophilia with similar radiologic pattern of hypersensitivity pneumonitis. A 22-year-old male was referred to our department due to 6 month history of cough, sputum. Physical examination revealed bilateral rales on his both lung fields. Peripheral blood examination showed leukocytosis and marked eosinophlia (total white blood cells; 23,950/μL, eosinophils; 61.3%). Pulmonary function test revealed moderate obstructive ventilator pattern. Serum total IgE by CAP system was more than 5,000 kU/L. Chest x-ray film showed multiple nodular increased opacities in both lung fiedls. High resolution chest computed tomography (HRCT) showed multiple centrilobular nodule with diffuse involvement of both lung compatible to hypersensitivity pneumonitis. Bronchoalveolar lavage fluid analysis showed 64% of total cells were eosinophils. Serum IgG antibody to Cysticercus showd strong positive response. After treatment with Pyraziquantel and prednisolone 0.5 mg/kg of body weight, patient`s subjective symptoms and abnormal radiologic findings were disappeared.
Serum vitamin D levels in patients with obstructive airway diseases in real clinical practice
( Mi Ran Park ),( Il Hwan Jeong ),( Su Min Park ),( Sung Woo Lee ),( Neul Bom Yoon ),( Soo Jung Um ),( Soo Keol Lee ),( Choon Hee Son ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
Background and objective: Some published data suggest that 25(OH) vitamin D (vitamin D) may participate in the airway inflammation of obstructive airway diseases. This study was performed to evaluate the relationship between serum vitamin D levels and lung functions in patients with obstructive airway disease including COPD and bronchial asthma in real clinical practice. Methods: COPD was defined by pulmonary function, FEV1/FVC of ≤ 70 % and FEV1 of ≤ 80% of predicted value. Bronchial asthma was diagnosed by positive airway hyperresponsiveness or bronchodilator responsiveness. Serum vitamin D was measured by chemoluminescence immunoassay. All values are expressed as mean± SD. Results; 29 patients (48.3%) were compatible with COPD, vitamin D level were 25.83±13.06 ng/ml and 31 patients (51.7%) were compatible with bronchial asthma, their vitamin D level were 35.47±31.19 ng/ml. However, there was no significant difference in serum vitamin D levels between two groups (p>0.05). Vitamin D insufficiency (≤ 20 mg/ml) was observed in 10 patients (34.48%) of COPD and 10 patients (32.35%) of asthma (p>0.05). COPD with reversible component in pulmonary function was demonstrated in 6 patients (10.9%), their mean vitamin D level was 29.73±13.57 ng/ml. There was no significant difference in the serum level of vitamin D between copd with or without reversible airway obstruction (p>0.05) Serum vitamin D level and lung function showed some trend of positive correlation, however, we could not find statistical significance (r=0.18, p>0.05) Conclusions: Reduced vitamin D levels seem to be associated with impaired lung function. Further studies are required to evaluate the relationship between reduced vitamin D level and impaired lung function in patients with obstructive airway diseases.