• Title/Summary/Keyword: Anti-tuberculosis medicine

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Treatment Guidelines for Community-acquired Pneumonia in Korea: An Evidence-based Approach to Appropriate Antimicrobial Therapy (지역사회획득 폐렴의 치료지침 권고안)

  • Song, Jae-Hoon;Jung, Ki-Suck;Kang, Moon Won;Kim, Do Jin;Pai, Hyunjoo;Suh, Gee Young;Shim, Tae Sun;Ahn, Joong Hyun;Ahn, Chul Min;Woo, Jun Hee;Lee, Nam Yong;Lee, Dong-Gun;Lee, Mi Suk;Lee, Sang Moo;Lee, Yeong Seon;Lee, Hyukmin;Chung, Doo Ryeon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.281-302
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    • 2009
  • The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy. The etiology and antimicrobial susceptibility of major pneumonia pathogens can differ by country. Therefore, the ideal treatment guidelines for community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia for immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

CD40-CD40 Ligand Interactions in the Production of IL-12 and IFN-γ by Tuberculous Pleural Mononuclear Cells

  • Song, Chang-Hwa;Nam, Hyun-Hee;An, Jeun-Ok;Lee, Ji-Sook;Kim, Hwa-Jung;Park, Jeong-Kyu;Suhr, Ji-Won;Jung, Sung-Soo;Na, Moon-Jun;Paik, Tae-Hyun;Jo, Eun-Kyeong
    • IMMUNE NETWORK
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    • v.2 no.3
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    • pp.142-149
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    • 2002
  • Background: Our previous study showed that purified protein derivative (PPD)-stimulated pleural mononuclear cells (PMC) from tuberculous pleurisy (Tbp) produced significantly more $IFN-{\gamma}$ (10- to 70-fold) after in vitro PPD stimulation than freshly isolated pleural cells from malignant pleurisy. The present study was designed to determine whether blocking the CD40-CD40 ligand (CD40L) interaction decreases $IFN-{\gamma}$ production by altering IL-12 levels. Methods: IL-12 and $IFN-{\gamma}$ production after neutralizing anti-CD40L antibody treatment was compared to the efficacy of anti-CD80, anti-CD86, and a combination of anti-CD80 and CD86 (CD80+86) monoclonal antibodies (mAb). These activities were measured by enzyme-linked immunosorbent assays (ELISAs) and reverse transcription-polymerase chain reaction (RT-PCR), after in vitro stimulation with PPO antigen (Ag). Results: Neutralization of CD80, CD86 and CD80+86 did not decrease $IFN-{\gamma}$ and IL-12 production in Tbp-PMC, whereas neutralization of CD40L significantly depressed IL-12 p40 and $IFN-{\gamma}$. In addition, neutralization of CD40L completely inhibited IL-12 p40 and $IFN-{\gamma}$ mRNA expression. Conclusion: The CD40-CD40L interaction might play a major role in IL-12 and $IFN-{\gamma}$ production in Tbp-PMC, thus contributing to protective immunity in human tuberculosis.

Detection of Specific Antibody to Mycobacterium tuberculosis in Anti-Complementary Human, Rabbit and Bovine Serum by Supplementation with Procomplementary Porcine Serum (친보체성(親補體性) 돼지혈청의 보강(補强)에 의한 항보체성(抗補體性) 사람, 토끼 및 소혈청속의 인결핵균(人結核菌)(Mycobacterium tuberculosis)에 대한 특이항체검출(特異抗體檢出))

  • Choi, Chul-Soon;Yang, Yong-Tae
    • The Journal of the Korean Society for Microbiology
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    • v.16 no.1
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    • pp.39-48
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    • 1981
  • A direct complement fixation test supplemented with procomplementary porcine serum was studied using anticomplementary human, rabbit and bovine serum against Mycobacterium tuberculosis. Procomplementary activity of porcine serum varied with porcine individual and affected by anticomplementary antiserum. The procomplementary titre of porcine serum against rabbit, human and bovine serum ranged from 1:5 to 1:40. By means of complement fixation test supplemented by porcine serum, the specific complement-fixing antibody to both tuberculopolysaccharide and/or tuberculoprotein antigen was readily differentiated from the anticomplementary antibody titre.

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Drug resistance of Mycobacterium tuberculosis in children (소아 결핵 환자에서의 항결핵제 내성 II)

  • Lee, Soo Jin;Ahn, Young Min;Kim, Hee Jin
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.61-67
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    • 2009
  • Purpose : The rate of drug-resistant tuberculosis (DR-TB) in children is an indicator of the effectiveness of TB control programs in the community. This study aimed to assess the prevalence of DR-TB in children and evaluate TB management. Methods : Between January 1999 and July 2007, drug susceptibility tests for anti-TB drugs were employed for patients aged less than 19 years with culture-positive TB. Results : A total of 607 cases (16.6%) were resistant to at least one anti-TB drug as follows: isoniazid (INH; 13.8%), rifampin (8.9%), pyrazinamide (4.2%), streptomycin (3.7%), ethambutol (EMB; 5.9%), and para-aminosalicylic acid (PAS; 1.9%). Multidrug-resistant (MDR) TB was found in 276 cases (7.6%); extensive drug resistant (XDR) TB, in 5 cases (0.2%). The rate of resistance to at least one anti-TB drug in children aged >15 years (16.1%) was significantly lower than that in children aged <15 years (20.5%) (P=0.016). The rate of resistance to at least one anti-TB drug and multidrug-resistance in this survey decreased significantly (P<0.001) as compared to the previous survey (1987-1995). The rate of resistance to INH, EMB, and PAS also significantly decreased (P<0.05). Conclusion : The rate of DR-TB in children in Korea has decreased over time; however, it remains higher than that in other countries. MDR-TB and XDR-TB are the emerging problems in Korean children. Therefore, the selection of effective drugs through drug susceptibility tests and evaluating risk factors of resistant TB is essential to successful therapy and a decreased incidence of DR-TB.

Post-traumatic Back Pain Revealed as Tuberculous Spondylitis -A Case Report-

  • Kim, Bum-Suk;Shin, Jeong-Hee;Moon, Ho-Sik;Chon, Jin-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.74-77
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    • 2010
  • Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.

Plasma Activity of Lysosomal Enzymes in Active Pulmonary Tuberculosis (활동성 폐결핵 환자에서 혈중 리소솜 효소의 활성도)

  • Koh, Youn-Suck;Choi, Jeong-Eun;Kim, Mi-Kyung;Lim, Chae-Man;Kim, Woo-Sung;Chi, Hyun-Sook;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.646-653
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    • 1995
  • Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

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Selecting marker substances of main producing area of Codonopsis lanceolata in Korea using UPLC-QTOF-MS analysis (UPLC-QTOF-MS분석를 이용한 국내산 더덕 주산지의 표지물질 선정)

  • An, Young Min;Jang, Hyun-Jae;Kim, Doo-Young;Baek, Nam-In;Oh, Sei-Ryang;Lee, Dae Young;Ryu, Hyung Won
    • Journal of Applied Biological Chemistry
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    • v.64 no.3
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    • pp.245-251
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    • 2021
  • Codonopsis lanceolata (Deoduk) was grown in East Asia, including Korea, China, Japan, and Russia, and the roots of C. lanceolata have been used as functional foods and traditional medicine to treat symptoms of cough, bronchitis, asthma, tuberculosis, and dyspepsia. The phytochemicals of C. lanceolata have been reported such as phenylpropanoids, polyacetylenes, saponins, and flavonoids that are involved in pharmacological effects such as anti-obesity, anti-inflammation, anti-tumor, anti-oxidant, and anti-microbial activities. Selecting marker substances of the main producing area by MS-based metabolomics analysis is important to ensure the beneficial effect of C. lanceolata without side-effects because differences in cultivated areas of plants were related not only to the safety of medicinal plants but also to changes in chemical composition and biological efficacy. In our present study, ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry combined with multivariate statistical analysis was applied to recognize the main producing area of C. lanceolata in South Korea. As a result of Principal Component Analysis and loading plot analysis of three groups, Inje (Kangwon-do), Hoengseong (Kangwon-do), and Muju (Jeonlabuk-do), several secondary metabolites of C. lanceolata including tangshenoside I, lancemaside A, and lancemaside G, were suggested as potential marker substances to distinguish the place of main producing area of C. lanceolata.

A Study on Major Health Components of National Health Examination Survey in Korea (국민건강진단조사(National Health Examination Survey) 내용선정에 관한 연구)

  • Lee, Soon-Young;Kim, Hae-Kyung;Park, Ju-Won;Shin, Seung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.167-182
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    • 1998
  • The purpose of this study was to identify the major health components and measurements to be conducted in National Health Examination Survey(KNHES). The prevalence and severity of disease, acceptability of population and the possibility of standardization of measurement were considered as guideline for selecting the components. On the base of magnitude and severity of disease, chronic liver disease, hepatic cancer, gastric ulcer, stomach cancer, essential hypertension, cerebrovascular disease, ischemic heart disease, pulmonary tuberculosis, lung cancer, DM, breast cancer, cervical cancer, arthritis and intervertebral disc disorder were selected as the preliminary target diseases. Questionnaire survey for 648 persons in 'K' city and medical specialists in five clinical societies were conducted for evaluation the acceptability of general population for the measurements and the possibility of standardization for the procedures. In conclusion, the major target diseases were chronic liver disease, hypertension and DM and the total cholesterol, high density lipoprotein, triglyceride, total protein, albumin, hemoglobulin, hematocrit, platlet count, anti-HBs, HBsAg, height and weight were selected for basic physical components.

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Anti-inflammatory Activities of Cheongpyehwadam-tang

  • Kwak Sang-Ho;Kim Ji-Young;Han Eun-Hee;Oh Kyo-Nyeo;Kim Dong-Hee;Jeong Hye-Gwang;Yoo Dong-Youl
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1399-1404
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    • 2005
  • In oriental medicine, Cheongpyehwadam-tang (CHT) has long been used for the cure of inflammatory diseases in the lung and bronchus such as bronchitis, bronchial asthma, pneumonia and tuberculosis. It's use is currently further extended for the treatment of allergic asthma. To investigate the anti-inflammatory effects of CHT, we investigated the effects of CHT on the lipopolysaccharide (LPS)-induced nitric oxide (NO) and pro-inflammatory cytokines ($TNF-{\alpha}$, IL-6, and $IL-1{\beta}$) production, and on the level of inducible nitric oxide synthase (iNOS) and proinflammatory cytokines expression in murine macrophage RAW 264.7 cells. CHT alone did not affect NO or pro-inflammatory cytokines production. In contrast, CHT inhibited LPS-induced NO and proinflammatory cytokines and the levels of LPS-induced iNOS and proinflarnmatory cytokine mRNA in a dose-dependent manner. CHT also inhibited the nuclear factor-kappa B (NF-kB) activation. Taken together, these results suggested that CHT inhibits the production of NO and pro-inflammatory cytokines in RAW 264.7 cells through blockade of NF-kB activation.

Sputum Inflammometry to Manage Chronic Obstructive Pulmonary Disease Exacerbations: Beyond Guidelines

  • Venegas, Carmen;Zhao, Nan;Ho, Terence;Nair, Parameswaran
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.3
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    • pp.175-184
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    • 2020
  • Quantitative sputum cytometry facilitates in assessing the nature of bronchitis associated with exacerbations of chronic obstructive pulmonary disease (COPD). This is not assessed in most clinical trials that evaluate the effectiveness of strategies to prevent or to treat exacerbations. While up to a quarter of exacerbations may be associated with raised eosinophil numbers, the vast majority of exacerbations are associated with neutrophilic bronchitis that may indicate airway infections. While eosinophilia may be a predictor of response to corticosteroids (oral and inhaled), the limited efficacy of anti-interleukin 5 therapies would suggest that eosinophils may not directly contribute to those exacerbations. However, they may contribute to airspace enlargement in patients with COPD through various mechanisms involving the interleukin 13 and matrix metalloprotease pathways. The absence of eosinophils may facilitate in limiting the unnecessary use of corticosteroids. The presence of neutrophiia could prompt an investigation for the specific pathogens in the airway. Additionally, sputum measurements may also provide insight into the mechanisms of susceptibility to airway infections. Iron within sputum macrophages, identified by hemosiderin staining (and by more direct quantification) may impair macrophage functions while the low levels of immunoglobulins in sputum may also contribute to airway infections. The assessment of sputum at the time of exacerbations thus would facilitate in customizing treatment and treat current exacerbations and reduce future risk of exacerbations.