Tuberculosis (TB) and diabetes mellitus (DM) are major global health problem. The link between DM and TB has been recognized for centuries. And, there are growing evidences that diabetes is a risk factor for tuberculosis. However, the risk varies according to races and regional prevalence, but limited data is available in South Korea. The report of Park et al. showed that the relative odds ratio was 2.220 (95% CI 1.090~4.523) in diabetic group, compared with hypertensive group. Although this study has some limitations, it is a meaningful data. A large-scale multi-center prospective study is needed in Korean population.
Aluminum Hydroxide ; Carbonates ; Continental Population Groups ; Diabetes Mellitus ; Humans ; Odds Ratio ; Prevalence ; Republic of Korea ; Risk Factors ; Tuberculosis

Tuberculosis (TB) is still an important cause of morbidity and mortality worldwide. Nearly one-third of the world's population is latently infected with Mycobacterium tuberculosis, and 10% of them will develop active TB during their lifetime. The tuberculin skin test or interferon-gamma release assay (IGRA) is the method for diagnosis of latent TB infection. Although commercially available IGRAs have limitations in serial testing, and testing children and immunosuppressive patients, IGRAs have superior sensitivity and specificity compared with conventional tuberculin skin testing, especially in Bacillus Calmette-Guerin vaccinated populations. For the treatment of latent TB infection, 9 months isoniazid is the standard treatment in Republic of Korea. However, shorter treatment regimens, including 4 months of rifampin, 3 months of isoniazid/rifampin, and once weekly isoniazid/rifapentine are currently alternatives. Identification and treatment of latent TB infection has lowered the TB incidence in developed countries. Therefore, for TB control, diagnosis and treatment of latent TB infection is important. However, there is lack of research on latent TB infection in South Korea. To revise the guideline, a large prospective trial on the treatment of latent TB infection is needed.
Bacillus ; Child ; Developed Countries ; Diagnosis* ; Humans ; Incidence ; Interferon-gamma Release Tests ; Isoniazid ; Latent Tuberculosis* ; Mortality ; Mycobacterium tuberculosis ; Republic of Korea ; Rifampin ; Sensitivity and Specificity ; Skin Tests ; Tuberculin ; Tuberculin Test ; Tuberculosis

BACKGROUND: Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate (VO2) compared to non-obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. METHODS: Maximal exercise capacity was represented by maximam maximum oxygen uptake and VO2 max in the cardiopulmonary test. Obesity, total fat content and abdominal obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers(male 22, female 20) were evaluated. RESULTS: 1) Weight to height ratio(mean±SD) was 110%±14.9% in men and 100±11.1% in women. 2) Fat ratio(mean±SD) was 23.3±5.2% in men and 27.55±3.9% in woman. 3) Waist to hip ratio(mean±SD) was 0.85±0.04 in men and 0.8±0.03 in woman. 4) In men, VO2max/min/Kg was negatively correlate with obesity, fat ratio, and abdominal fat distribution. 5) In woman, VO2max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. CONCLUSION: Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.
Abdominal Fat ; Exercise Test* ; Female ; Hip ; Humans ; Male ; Obesity ; Obesity, Abdominal ; Oxygen ; Respiratory System

BACKGROUND: pH measurement is an important test in assessing the etiology of pleurisy and in identifying complicated parapneumonic effusion. Although the blood gas analyzer is the' gold standard method' for pleural pH measurement, pH meter & pH strip methods are also used for this purpose interchangably. However, the correlation among the pH data measured by the three different methods needs to be evaluated. In this study, we measured the pH of pleural fluid with the three different methods respectively and evaluated the correlation among the measured data. METHODS: From August 1999 to March 2000, were measured the pleural fluid pH in 34 clinical samples with three methods-blood gas analyzer, pH meter, and pH strip. In the blood gas analyzer and pH meter methods, the temperature of plerual fluid was maintained around 0℃ in air-tight condition before analysis and measurement was performed within 30 minutes after collection. As for the pH strip method, the pleural fluid pH was checked in the ward immediately after tapping and in the clinical laboratory of our hospital. This part is unclear. RESULTS: The causes of pleural effusion were tuberculosis pleurisy in 16 cases, malignant pleural effusion 5 cases, parapneumonic effusion 9 cases, empyema 3 cases, and congestive heart failure 1 case. The pH of pleural fluid (mean±SD) was 7.34±0.12 with blood gas analyser, 7.52±0.25 with pH meter, 7.37±0.16 with pH strip of immediate measurement and 6.93±0.201 with pH strip of delayed measurement. The pH measured by delayed pH strip measurement was lower than those of other methods(p<0.05). The correlation of the results between the blood gas analyzer and pH meter(p=0.002, r=0.518) and the blood gas analyzer and pH strip of immediate measurement(p<0.001, r=0.607). CONCLUSION: In the determination of pH of pleural fluid, pH strip method could be a simple and reliable method under immediate measurement conditions after fluid tapping.
Empyema ; Heart Failure ; Hydrogen-Ion Concentration* ; Methods* ; Pleural Effusion ; Pleural Effusion, Malignant ; Pleurisy ; Tuberculosis

Complex Regional Pain Syndromes (CRPS) type I and type II are neuropathic pain conditions that are being increasingly recognized in children and adolescents. The special distinctive features of pediatric CRPS are the milder course, the better response to treatment and the higher recurrence rate than that of adults and the lower extremity is commonly affected. We report here on a case of pediatric CRPS that was derived from ankle trauma and long term splint application at the left ankle. The final diagnoses were CRPS type I in the right upper limb, CRPS type II in the left lower limb and unclassified neuropathy in the head, neck and precordium. The results of various treatments such as medication, physical therapy and nerve blocks, including lumbar sympathetic ganglion blocks, were not effective, so implantation of a spinal cord stimulator was performed. In order to control the pain in his left lower limb, one electrode tip was located at the 7th thoracic vertebral level and two electrode tips were located at the 7th and 2nd cervical vertebral levels for pain control in right upper limb, head, neck and right precordium. After the permanent insertion of the stimulator, the patient's pain was significantly resolved and his disabilities were restored without recurrence. The patient's pain worsened irregularly, which might have been caused by psychological stress. But the patient has been treated with medicine at our pain clinic and he is being followed up by a psychiatrist.
Adolescent ; Adult ; Ankle ; Causalgia ; Child ; Complex Regional Pain Syndromes ; Diagnosis ; Electrodes ; Ganglia, Sympathetic ; Head ; Humans ; Lower Extremity ; Neck ; Nerve Block ; Neuralgia ; Pain Clinics ; Psychiatry ; Recurrence ; Spinal Cord Stimulation* ; Spinal Cord* ; Splints ; Stress, Psychological ; Upper Extremity

No abstract available.
Head* ; Killer Cells, Natural* ; Lymphocytes* ; Neck*

Background/Aims: Few real-world studies explored factors associated with latent tuberculosis infection (LTBI) treatment-related adverse drug reactions (ADRs). This study evaluate ADRs that lead to the discontinuation of LTBI treatment and identify the associated factors, including age groups and drug regimens. Methods: Using the Korean national tuberculosis registry and HHC investigation database linked to the National Health Insurance Service claims database, we examined treatment discontinuation due to ADRs among HHCs on LTBI treatment from January 2015 to December 2018. Multivariable logistic regression analysis was conducted to examine factors associated with ADRs, including demographics, LTBI treatment, comorbidities, and steroid use. Results: Among 11,913 participants initiated LTBI treatment, 633 participants (5.3%) discontinued treatment due to ADRs. The primary contributors to discontinuation were adverse skin reactions (2.0%) and abnormal liver function (1.9%). Risk associated with ADRs and abnormal liver function showed age-related increase, except for the age group 66–75 (adjusted odds ratio [AOR] 3.82, 95% confidence interval [CI] 2.31–6.31) which reported lower OR to that of age group 36–65 (AOR 4.38, 95% CI 3.09–6.21). Three months isoniazid/rifampin and 4 months rifampin exhibited a lower odds of ADRs and abnormal liver function when compared to 6–9 months isoniazid. Conclusions We discovered the real-world prevalence of LTBI treatment discontinuation due to ADRs among HHCs. Our findings suggest a notably increased odds of ADRs resulting in discontinuation with age of 76 years or above, emphasizing careful attention when prescribing LTBI treatment in this population. Further studies are warranted to validate these results.

Background/Aims: Few real-world studies explored factors associated with latent tuberculosis infection (LTBI) treatment-related adverse drug reactions (ADRs). This study evaluate ADRs that lead to the discontinuation of LTBI treatment and identify the associated factors, including age groups and drug regimens. Methods: Using the Korean national tuberculosis registry and HHC investigation database linked to the National Health Insurance Service claims database, we examined treatment discontinuation due to ADRs among HHCs on LTBI treatment from January 2015 to December 2018. Multivariable logistic regression analysis was conducted to examine factors associated with ADRs, including demographics, LTBI treatment, comorbidities, and steroid use. Results: Among 11,913 participants initiated LTBI treatment, 633 participants (5.3%) discontinued treatment due to ADRs. The primary contributors to discontinuation were adverse skin reactions (2.0%) and abnormal liver function (1.9%). Risk associated with ADRs and abnormal liver function showed age-related increase, except for the age group 66–75 (adjusted odds ratio [AOR] 3.82, 95% confidence interval [CI] 2.31–6.31) which reported lower OR to that of age group 36–65 (AOR 4.38, 95% CI 3.09–6.21). Three months isoniazid/rifampin and 4 months rifampin exhibited a lower odds of ADRs and abnormal liver function when compared to 6–9 months isoniazid. Conclusions We discovered the real-world prevalence of LTBI treatment discontinuation due to ADRs among HHCs. Our findings suggest a notably increased odds of ADRs resulting in discontinuation with age of 76 years or above, emphasizing careful attention when prescribing LTBI treatment in this population. Further studies are warranted to validate these results.

Background/Aims: Few real-world studies explored factors associated with latent tuberculosis infection (LTBI) treatment-related adverse drug reactions (ADRs). This study evaluate ADRs that lead to the discontinuation of LTBI treatment and identify the associated factors, including age groups and drug regimens. Methods: Using the Korean national tuberculosis registry and HHC investigation database linked to the National Health Insurance Service claims database, we examined treatment discontinuation due to ADRs among HHCs on LTBI treatment from January 2015 to December 2018. Multivariable logistic regression analysis was conducted to examine factors associated with ADRs, including demographics, LTBI treatment, comorbidities, and steroid use. Results: Among 11,913 participants initiated LTBI treatment, 633 participants (5.3%) discontinued treatment due to ADRs. The primary contributors to discontinuation were adverse skin reactions (2.0%) and abnormal liver function (1.9%). Risk associated with ADRs and abnormal liver function showed age-related increase, except for the age group 66–75 (adjusted odds ratio [AOR] 3.82, 95% confidence interval [CI] 2.31–6.31) which reported lower OR to that of age group 36–65 (AOR 4.38, 95% CI 3.09–6.21). Three months isoniazid/rifampin and 4 months rifampin exhibited a lower odds of ADRs and abnormal liver function when compared to 6–9 months isoniazid. Conclusions We discovered the real-world prevalence of LTBI treatment discontinuation due to ADRs among HHCs. Our findings suggest a notably increased odds of ADRs resulting in discontinuation with age of 76 years or above, emphasizing careful attention when prescribing LTBI treatment in this population. Further studies are warranted to validate these results.

Background/Aims: Few real-world studies explored factors associated with latent tuberculosis infection (LTBI) treatment-related adverse drug reactions (ADRs). This study evaluate ADRs that lead to the discontinuation of LTBI treatment and identify the associated factors, including age groups and drug regimens. Methods: Using the Korean national tuberculosis registry and HHC investigation database linked to the National Health Insurance Service claims database, we examined treatment discontinuation due to ADRs among HHCs on LTBI treatment from January 2015 to December 2018. Multivariable logistic regression analysis was conducted to examine factors associated with ADRs, including demographics, LTBI treatment, comorbidities, and steroid use. Results: Among 11,913 participants initiated LTBI treatment, 633 participants (5.3%) discontinued treatment due to ADRs. The primary contributors to discontinuation were adverse skin reactions (2.0%) and abnormal liver function (1.9%). Risk associated with ADRs and abnormal liver function showed age-related increase, except for the age group 66–75 (adjusted odds ratio [AOR] 3.82, 95% confidence interval [CI] 2.31–6.31) which reported lower OR to that of age group 36–65 (AOR 4.38, 95% CI 3.09–6.21). Three months isoniazid/rifampin and 4 months rifampin exhibited a lower odds of ADRs and abnormal liver function when compared to 6–9 months isoniazid. Conclusions We discovered the real-world prevalence of LTBI treatment discontinuation due to ADRs among HHCs. Our findings suggest a notably increased odds of ADRs resulting in discontinuation with age of 76 years or above, emphasizing careful attention when prescribing LTBI treatment in this population. Further studies are warranted to validate these results.