• Journal of Chest Surgery
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• v.11 no.2
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• pp.147-152
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• 1978

Six patients with pulmonary tuberculosis with cavity had cavernoplasty at Seoul National University Hospital during the last 4 years and 9 months, from October 1973 to April 1978, were studied in order to assess the clinical values of cavernoplasty. 2] All the cases were male, and the mean age was 31.5 years. 2] All the patients had combined therapy with more than two antituberculosis drugs preoperatively, its minimum duration being 8 months and maximum duration 5 years. 2] Nonspecific symptoms were predominant just prior to admission, weight loss being in 50% and loss of appetite in 50% of cases, respectively. The preoperative cavity size on plain film was minimum 2.5cm by 3.5cm and maximum 6.0cm by 4.0cm with the mean of 4. 4cm by 3.4cm. The cavity size was reduced postoperatively to 1/3-1/4 of preoperative size with the mean of 1.15cm by 1.59cm. 2] Sputum smear for acid fast bacilli was converted to negative postoperatively in two cases. 2] Complications occurred in two cases. One was postoperative pleural effusion and the other was recurrence of symptoms 2 years after surgery. 2] Of the 3 cases able to follow, 2 stopped antituberculous medication after one year. The third case was still on medication because of bronchiectasis due to tuberculous infection.

• The Journal of the Korean Society for Microbiology
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• v.6 no.1
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• pp.41-60
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• 1971

The author prepared a tuberculin sample using synthetic medium for the test material in this experiment. For the test animals, guinea pigs, healthy calf sensitized with heat killed tubercle bacilli, naturally infected dairy cattle, goat, and calf were used. A reduced reactivity to tuberculin was observed when the second tuberculin test was done within 28 days after the first. The results obtained are summarized as follows. 1. The experimental HCSM tuberculin was shown the similar activities as the control products of standard tuberculin. 2. The potency of the experimental tuberculin preserved at $5^{\circ}C$ in refrigerator maintained the activity for three years. 3. By the intradermal test, the experimental tuberculin was proved to be specific to detect tuberculous dairy cattles and goats. 4. The appearance of skin reaction to tuberculin in naturally infected dairy cattles, goat and beef cattles was soft and diffuse swellings or circumscribed swellings accompanied by induration. 5. In the case of observing tuberculous dairy cattles, goats and beef cattles, as the criterion of the reaction to the caudal fold test, results were taken as positive when findings are either hard and circumscribed or soft and diffuse swellings of 3 mm at least in size. 6. The acid fast organisms isolated from tuberculin positive animals were identified mostly as M. tuberculosis var. bovis. 7. When the tuberculin test was repeated in the tuberculin positive animals, the reactivity decreased rapidly, lasting 4 weeks at least.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.238-243
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• 1996

Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.203-209
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• 2015

Background: Induced sputum (IS) has been used to collect airway secretions in subjects who have inadequate sputum production. The aim of this study was to investigate the efficacy of IS for the diagnosis of pulmonary tuberculosis (PTB) in adults unable to expectorate sputum. Methods: Medical records of 39 PTB patients who underwent IS due to absence of spontaneous sputum production between January 2011 and March 2014 at a tertiary hospital in South Korea were reviewed. Results of acid fast bacilli smear, Mycobacterium tuberculosis culture and polymerase chain reaction assay for M. tuberculosis (TB-PCR) of IS specimens from these patients were analyzed. Clinical and high-resolution computed tomography (HRCT) characteristics were also analyzed to find characteristics associated with IS culture positivity. Results: Of the 39 IS specimens from PTB patients, 7 (17.9%) were smear positive and 31 (79.5%) were culture positive. Twenty-four IS specimens were tested for TB-PCR and 13 (54.2%) were positive on TB-PCR. Multivariate analysis showed that younger age (p=0.04) and presence of tree-in-bud appearance on HRCT (p=0.03) were independent predictors of IS culture positivity. Conclusion: IS is useful for the diagnosis of PTB in adults unable to expectorate sputum. Younger age and tree-in-bud appearance on HRCT were associated with IS culture positivity in these patients.

• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.153-157
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• 2016

Background: Vitamin D is known to have diverse effects on various systems in the body. There is evidence to suggest that a link exists between the serum vitamin D status and tuberculosis. The present study was designed to assess the alterations in serum 25-hydroxyvitamin D levels in newly diagnosed sputum acid fast bacilli (AFB) positive pulmonary tuberculosis patients and to study the association, if any, between serum vitamin D levels and different levels of sputum smear positivity. Methods: Serum 25-hydroxyvitamin D levels were estimated in 65 sputum AFB positive pulmonary tuberculosis patients and 65 age and gender-matched healthy controls. Results: The levels of serum 25 hydroxy-vitamin D in tuberculosis patients were not statistically different from the levels of serum 25 hydroxy-vitamin D in healthy controls. However, among patients with pulmonary tuberculosis, there was a significant negative correlation between the levels of serum 25 hydroxy-vitamin D and levels of sputum positivity. Conclusion: Serum vitamin D levels negatively correlates with bacterial load in patients with active pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.74 no.5
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• pp.215-221
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• 2013

Background: Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. Methods: Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. Results: A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. Conclusion: The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.529-537
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• 2009

Drug-resistant tuberculosis in children has important implications for both the patients and tuberculosis control programs. In Korea, among all new patients, the isoniazid resistance rate was 9.9% and multidrug-resistant tuberculosis rate was 2.7% in 2004 (in patients aged 10-19 yr, the multidrug-resistant tuberculosis rate reached 2.1%). Tuberculosis in pediatric patients is difficult to diagnose because many children have nonspecific clinical signs and the detection rates of acid-fast bacilli smears and cultures are low. Therefore, every effort should be made to identify adult sources and obtain information on drug susceptibility because symptomatic adult patients have a higher chance of culture positivity and drug-susceptibility patterns are the same in most adult-child pair patients. Korean children are at significant risk of drug-resistant tuberculosis. As the isoniazid resistance rate is greater than 4% among the new cases in Korea, a four-drug regimen should be considered for initial treatment of children with active tuberculosis, unless drug-susceptibility test results are available. Treatment of drug-resistant tuberculosis in children is challenging and there are only few available data. Tuberculosis control programs should be continuous with specific focus on pediatric populations because they can serve as reservoirs for future active cases. Further studies are needed regarding treatment of drug-resistant tuberculosis in children.

• Journal of Korean Neurosurgical Society
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• v.50 no.5
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• pp.460-463
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• 2011

There are few reported cases of post-operative spondylitis caused by $Mycobacterium$ $Intracellulare$. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, $Mycobacterium$ $Intracellulare$ was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.

• Biomedical Science Letters
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• v.6 no.1
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• pp.55-63
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• 2000

This study has been carried out to investigate the sensitivity of polymerase chain reaction (PCR) method over conventional acid-fast bacilli (AFB) staining and/culture methods for the detection of Mycobacterium tuberculosis from trace body fluid and paraffin-embedded tissues (PET) specimens. A total of 65 cases were employed for the AFB staining and culture test, and a total of 50 cases were subjected to PCR and histopathological analysis. Among the specimen showing negative reaction to AFB staining, 12.1% were positive to PCR and 3.7% of the specimen representing negative result to culture test showed positive reaction to PCR. In addition, 20.0% of the specimen with AFB negative showed positive reaction to PCR. From these results, it could be concluded that PCR method overwhelms AFB staining and culture tests in sensitivity and specificity to M tuberculosis detection.

• Fisheries and Aquatic Sciences
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• v.16 no.3
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• pp.165-169
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• 2013

We report on mycobacteriosis in an imported tropical ornamental fish Macropodus opercularis commonly known as the paradise fish. Mass mortality occurred in paradise fish imported to Korea from Southeast Asia in 2008. The affected fish did not show any outward clinical signs, but enlargement of the spleen, kidneys, and liver was observed on dissection. Histopathological examination revealed numerous granulomas in the spleen, and acid-fast bacilli were observed in the centers of the granulomas. About 65% of spleen DNA samples were PCR positive using mycobacteria-specific primers targeting the 16S rRNA and hsp65 genes. The nucleotide identities of the 16S rRNA and hsp65 genes with those of Mycobacterium marinum were 99.5% and 99.4%, respectively. Although the bacterium was not cultured, the molecular diagnosis and histopathological findings were consistent with mycobacteriosis in paradise fish.