Clinical Investigation of Tuberculous Pneumonia / 결핵및호흡기질환

BACKGROUND: It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. METHODS: We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. RESULT: The male to female ratio was 1:1 and the mean age at diagnosis was 54.5+/-18.6 years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). CONCLUSION: We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.

The Prevalence and Awareness of Hypertension and the Relationship between Hypertension and Snoring in the Korean Population

BACKGROUND: Hypertension is the most important, and yet modifiable, risk factor for cardiovascular diseases. But in many countries, hypertension remains poorly controlled. Moreover, sleep apnea syndrome has shown that it is correlated with hypertension. The purpose of this study was to investigate the prevalence, awareness and control of hypertension among the Korean people and to evaluate the relationship between hypertension and snoring. METHODS: A total of 640 subjects living in Ansan, a regional city in Korea, were selected randomly, and trained nursing students investigated their age, sex, medical history, blood pressure, body mass index (BMI) and snoring score. Blood pressures were measured three times with a 10 - minute interval and then averaged. The degree of snoring was estimated using a questionnaire. We divided the subjects into hypertensive (BP> OR =140/90 mmHg) versus normotensive group and snorer versus non-snorer group, and correlated hypertension with snoring. RESULTS: Of 640 subjects, 311 were male. The mean age was 39.7+/-14.6 years (18-77 years), the mean BMI (body mass index) was 22.4+/-3.0 kg/m2. The mean systolic and diastolic blood pressure was 121+/-15.7 mmHg and 79.5+/-11.6 mmHg. The prevalence and awareness of hypertension were 22.2% and 16.9%, respectively, and the prevalence of snoring was 35.2%. With the increment of age, in the male, the prevalence of hypertension and snoring were higher, and the snorer group showed a higher risk of hypertension than the non-snorer group (Odds ratio 2.32, CI=1.56-3.39, p=0.0001). CONCLUSION: In Korea, the prevalence of hypertension was similar to that in the western countries, but the awareness of hypertension was much lower compared with western countries. The prevalence of hypertension was higher in the snorer group, so more research on the correlation between the two conditions should be advanced in the future.