INTERNAL MEDICINE CENTER

Zion Women셲 Hospital, Serving with Love

Tuberculosis is an infectious disease caused by infection of mycobacterium tuberculosis. Since the bacteria are infected through the respiratory organs, the most affected organ is the lungs and the bacteria spread from the lungs to other various organs through the blood or the lymph. The bacteria can also go up the neck, nose or ears through the bronchus or spread to the entire body from the stomach with food.
The mycobacterium tuberculosis produces fibrous tissue and sometimes causes calcification.
TB, which used to be responsible for 1/4 of human deaths, has decreased significantly but is an important disease that is still one of the top 10 causes of deaths in Korea.
Although the incidence rate for pulmonary TB is decreasing in developed countries, the rate for other types of TB (TB of other organs) is not decreasing.
TB is named according to the originating organ such as pulmonary TB, pleural TB, joint TB, TB meningitis, lymph node TB, bone TB, spinal TB (caries), kidney TB, intestinal TB, and tuberculous peritonitis. TB that is spread through the whole body due to blood circulation is miliary TB.

TB is an infectious disease caused by infection of mycobacterium tuberculosis
The escape of the mycobacterium tuberculosis, which occurs in open TB patients, takes place through the sputum for pulmonary TB, the urine for renal TB and the stool for intestinal TB.
Pulmonary TB, which takes up the majority of TB incidences, starts to develop when a patient with TB coughs, sneezes or talks loudly and the mycobacterium tuberculosis floats out into the air and is then inhaled into the alveoli of another person.
Although when a healthy person inhales the mycobacterium tuberculosis, in most cases the immune system heals naturally against the bacteria, a part of the bacteria may form a lesion in the lungs, spread to the lymph nodes, cause pleurisy, or cause infection across the whole body, such as miliary TB, TB meningitis, bone TB, and intestinal TB. Infants are particularly prone to develop progressive TB such as miliary TB and TB meningitis and the elderly are also prone to develop active TB. People with severe malnutrition, experience of gastrectomy, liver conditions, diabetes, silicosis or malignant tumors have a high chance of catching TB.

The incubation period for TB is 4~6 weeks and there are no subjective symptoms in the early stage since it is a chronic disease which worsens gradually. There are many cases in which no particular symptom appears, even when the condition has progressed considerably, and even the symptoms that do appear are spread all over the body without any particular feature, such as fatigue, slight fever, loss of appetite, weight loss, and abnormal menstruation.
Respiratory symptoms include coughing, which is most common, chronic suppurative sputum or no sputum, chest pains, hemoptysis and difficulty breathing.
Other symptoms include neurological symptoms, such as vomiting, renal and urological symptoms, such as pain in the joints and spine and hematuria, and gastrointestinal symptoms, such as diarrhea and stomach pain.

The treatment of TB is the same, regardless of the originating area.
The key of the treatment is what medication to combine in order to prevent antimicrobial resistance and how long the treatment should last. Also, it must be acknowledged that the only fundamental treatment is through a continuous medication method.
Patients should be confident until the condition is completely cured since the recent developments in anti-TB agents have led to an extremely high cure rate for TB.

Most cases of pneumonia occur due to acute pathogenic bacteria such as bacteria or viruses. Fungi or parasites may also cause pneumonia. Other allergies may cause pneumonia while wrong intake of powder medicine etc. may cause aspiration pneumonia. Recent cases of pneumonia are also caused by a pathogenic bacterium called mycoplasma. Although there are many substances in the air we breathe that can cause pneumonia, such substances do not all cause pneumonia when they enter the lungs. The lungs have the ability to release those substances outside and deal with them so as to defend against the development of a disease and those with weakened defense abilities are prone to suffer from pneumonia. It is mostly the elderly or children who develop pneumonia due to weak defense capabilities and it is uncommon for young healthy people to catch pneumonia.

Most cases of pneumonia occur due to acute pathogenic bacteria such as bacteria or viruses. Fungi or parasites may also cause pneumonia. Other allergies may cause pneumonia while wrong intake of powder medicine etc. may cause aspiration pneumonia. Recent cases of pneumonia are also caused by a pathogenic bacterium called mycoplasma. Although there are many substances in the air we breathe that can cause pneumonia, such substances do not all cause pneumonia when they enter the lungs. The lungs have the ability to release those substances outside and deal with them so as to defend against the development of a disease and those with weakened defense abilities are prone to suffer from pneumonia. It is mostly the elderly or children who develop pneumonia due to weak defense capabilities and it is uncommon for young healthy people to catch pneumonia.

While only light symptoms like those associated with the common cold appear for the early stage of pneumonia, respiratory symptoms such as a fever, coughing, chest pains, difficulty breathing and greenish sputum appear as the condition rapidly progresses, and sometimes the situation can turn serious when the infection is a combination of viral pneumonia and bacterial pneumonia.
Children and elderly patients must see a doctor and receive treatment in the early phase of the condition since they can suffer from severe symptoms such as difficulty in breathing and cyanosis if they come down with pneumonia.
Symptoms of the common cold generally last for 3~4 days, then 80% of patients suffer from a fever, phlegm develops and the respiration rate exceeds 20 times per minute.
When the fever is high, the face reddens, breathing becomes harsh, and some patients suffer from chest pains. Moreover, the mind can become cloudy and the lips can turn purple due to the lack of oxygen that is supplied to the lungs. In addition, the area around the anticardium may sink in every time the patient breathes.
Symptoms of diarrhea, vomiting, convulsions, and cyanosis may appear according to the bacteria that caused the condition. The condition may occur in newborns or premature babies without a fever (afebrile pneumonia).
Special attention is needed since similar symptoms may occur in bronchitis, acute sinusitis and other various infectious diseases.

Pleuritis may occur as a complication of pneumonia.
Pleurisy refers to the condition where inflammatory discharge is accumulated between the two thin sheets of pleura surrounding the lungs.
When pleurisy becomes severe, suppuration occurs and pus fills in between the two sheets of pleura, and this condition is called empyema.
Severe pneumonia can cause the infection to spread to the brain or the meninges or the pathogenic bacteria to enter the blood and develop a sepsis.

The diagnosis of pneumonia requires a doctor셲 scientific opinion and an X-ray.
The patient셲 symptoms are examined through scientific observation, including the use of a stethoscope, and the range and changes of the lesions can be determined through an X-ray imaging. The X-ray can be used to diagnose pneumonia and other similar conditions.
Furthermore, the bacteria that caused the conditioned can be identified through a blood and secretion test, the results of which can be used for the diagnosis and treatment.
New diagnostic methods, such as a serum test, can also be used.
A CT scan can be taken for a more detailed diagnosis and a thoracentesis can be performed if there is fluid in the pleura.
A sputum examination or a bronchoscope may be necessary to identify the bacteria that caused the condition.

Treatment of pneumonia is different according to the bacteria that caused the condition the doctor셲 orders must be followed since most cases of pneumonia require hospital admission.

Lifestyle Precautions

01. Rough exercise or overwork is prohibited and stability should be maintained on the day of the vaccination and the day after.
02. Baths and swimming is prohibited on the day of the vaccination.
03. The area of vaccination should not be scratched or touched.
04. Contact or visit the hospital if there is a fever, convulsion, or a severe headache after the vaccination.

It is important to keep the body healthy and improve the body셲 resistance through these precautions.
The elderly and children must be careful not to catch an infectious respiratory disease such as acute upper respiratory infection, especially in-between seasons or in winter. When a respiratory infection occurs, it is best to receive treatment from a specialist and to be vaccinated for pneumonia and the flu.
Vaccination for pneumonia is performed in cases where the risk is high if infected with streptococcus pneumonia, such as when the patient is over 65, or suffers from chronic heart conditions, chronic lung conditions, chronic liver conditions, chronic renal failure, alcohol addiction, diabetes or hematomas, etc.
Getting vaccinated for the flu every year helps to prevent secondary bacterial complications of the bronchus and pneumonia.

Asthma is an airway disease in which the response of the bronchus increases due to various stimulations. Thus, since a chronic inflammation develops in the airway, through which air passes through, the airway wall becomes swollen, and mucus is secreted in abundance, various stimulants in the atmosphere will easily cause a hypersensitive reaction and make the airway close up and convulse.

One of the greatest asthma inducers, which cause asthma attacks, is the common cold while exercises such as running, pollen, dust mites, dog or cat fur and excretion, environmental factors such as molds, pungent smells, cigarette smoke, and weather changes are also asthma inducers.
Agitation, stress or excitement can aggravate the condition and drug side effects can also cause asthma.

The 3 major symptoms of asthma are coughing, stridor (a high-pitched breath sound) and difficulty breathing. Mucus increases due to an inflammation of the airway, the bronchus becomes narrower due to various stimulants and it becomes difficult to breathe since air is hindered from fully passing through.
Therefore, the most common symptom is difficulty breathing, which is accompanied with coughs. If the contraction of the bronchus is weak, the patient may complain of chest pressure (suffocating sensation or discomfort of the chest) rather than difficulty breathing. The patient can also suffocate if airway convulsions are severe enough to cause the bronchus to close in completely.
The extent of these symptoms varies, some people normally showing no symptoms but having difficulty breathing and developing stridor when they catch a cold and some showing signs of asthma when they exercise. In addition, many patients with asthma also have rhinitis, and experience an increase in nasal mucus and a stuffy nose due to the interior of the nose becoming swollen.
Asthma attacks generally occur at night and subside early in the morning. Asthma attacks are most common in children and occur more frequently in men than in women. Children who live with a smoker are more prone to the condition.

The methods of treatment for asthma consist of the avoidance method, in which the cause substance or stimulant is removed or avoided, drug therapy, in which drugs are used to bring minimum side effects and maximum drug effects, and the immune effect, in which a small dosage of allergen is injected for immunity when the cause substance has been found but cannot be avoided.
The most important is the avoidance method. The cause of the asthma must be removed from the patient. Asthma medication, which opens up the airway that is closed up when there is an asthma attack and alleviates the symptoms, include bronchodilators, antiflammatory drugs (steroids), and anti-allergic agents, and the inhaler is used most in the administration of the treatment drugs.

Bedclothes and pillows should be regularly dried in the sun to prevent dust mites and use of carpets should be avoided. The house should be frequently ventilated and cleaned to remove ticks, pet fur, and smoke etc.
Excessive exercise should be avoided. The patient should rest if an asthma attack occurs due to too much exercise. Frequently drinking warm water is recommended. No particular diet is necessary but food that can cause asthma attacks should beavoided .

沅곴툑븯떊 궡슜쓣 寃깋빐二쇱꽭슂!