ABSTRACT
Background: Multidrug-resistant tuberculosis(MDR-Tb) has been increased not only in Asia but also in Western society, which may cause public health problems and reduce the efficacy of treatment of tuberculosis. In Western society HIV infection is believed to do a central role in increasing incidence of MDR tuberculosis, but MDR-Tb in Korea may be somewhat different about clinical features, underlying disorders, and prognosis. Goble et al reported that overall treatment failure rate in MDR-Tb including resistance to isoniazid(INH) and rifampin(RFP) was 44%. The aim of this study is to find the treatment result in Korea and the factors determining the prognosis. Methods: A retrospective study of pulmonary tuberculosis cultured M. tuberculosis from sputum or bronchial washing fluid between 1986 through 1992 was conducted in the Seoul Paik Hospital, Inje University. We reviewed clinical courses of 141 patients, who had a tuberculosis with resistance to 2 or more drugs including isoniazid(INH) and rifampin(RFP). One hundred and 4 patients of 141 patients had completed treatment and followed up for more than one year. Results: Of 104 (mean age 43.6+/-16.7, M: F=63: 41) patients with sufficient follow-up data, 73(84.6%) patients responded which is defined as negative sputum cultures for at least 3 consecutive months. Seven patients(6.7%) had a failure in negative conversion and 9(8.7%) of the patients who initially responded relapsed. Overall treatment failure rate was 15.4%. Patients who were treated for less than 12 months had a higher relapse rate(12.3%) than 18 months(4.9%). And there was a statistically significant correlation between the relapse rate and the number of drugs to which isolates wera resistant(p<0.05). Conclusion: The treatment failure rate of MDR-Tb in Korea was lower than previous studies in western country and the major determining factor of prognosis was the number of resistant drugs to M. tuberculosis at drug sensitivity test. For reducing the relapse rate, we recommend more than 12 months of treatment for MDR tuberculosis.
Subject(s)
Humans , Asia , Follow-Up Studies , HIV Infections , Incidence , Korea , Prognosis , Public Health , Recurrence , Retrospective Studies , Seoul , Sputum , Treatment Failure , Tuberculosis , Tuberculosis, Multidrug-Resistant , Tuberculosis, PulmonaryABSTRACT
Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behcet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocyto- clastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.
Subject(s)
Humans , Male , Aneurysm , Angiography , Biopsy , Cyclophosphamide , Embolization, Therapeutic , Erythema , Exanthema , Fever , Hemoptysis , Korea , Lower Extremity , Lung , Rupture , Stomatitis, Aphthous , Strikes, Employee , Vasculitis , Venous ThrombosisABSTRACT
BACKGROUND: In case of tuberculous pneumonia, differentiation from bacterial lobar pneumonia is sometimes very difficult because clinical symptoms, signs and radiological images are very similar. So we investigated the usefulness of CA125, which is known to increase in tuberculous diseases, in differential diagnosis between tuberculous pneumonia (TBPN) and community acquired bacterial lobar pneumonia (LP). METHODS: Serum CA125 level was measured in 20 patients with TBPN (female 12 male 8: mean age 36.1 years) and 14 patients with LP (female 5 male 9: mean age 45.1 years) by radioimmunoassay (Centocor(R) CA125 RIA kit). RESULTS: 1) The serum CA125 level in TBPN (333.7 283.5 u/ml) was higher than in LP (60.9 66.2 u/ml). (P 0.05) 4) Following up of serum CA125 level after initiation of antituberculosis treatment showed rapid decline and approach to near normal range in 6 months. CONCLUSION: High serum CA125 level (> 195 u/ml) was useful in differential diagnosis of TBPN from LP.
Subject(s)
Humans , Male , Diagnosis , Diagnosis, Differential , Pneumonia , Radioimmunoassay , Reference Values , Sensitivity and SpecificityABSTRACT
The obstruction of inferior vena cava(IVC) is uncommon condition. The classification is based on the obstructive sites of major anatomic segments of IVC. The main collateral pathways of interruption of IVC were central channels through ascending lumbar veins, intervertebral veins and azygos-hemiazygos complex. However, the complete obstruction of mid-portion of IVC, accompanying collateral cirulation with pericardiacophrenic vein was rarely reported. We had experienced a case of complete obstruction of mid-portion of IVC with lobulated left cardiac border, which was unforgettable characteristic finding on chest radiograph. It was confirmed by venographic examination that the lobulated left cardiac shadow was a collateral circulation of pericardiacophrenic vein.
Subject(s)
Classification , Collateral Circulation , Radiography, Thoracic , Veins , Vena Cava, InferiorABSTRACT
No abstract available.