• Title/Summary/Keyword: Atypical

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Clinical and Radiographic Characteristics of 12 Patients with Mycobacterium abscessus Pulmonary Disease (Mycobacterium abscessus 폐질환 환자 12명의 임상적, 방사선학적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.45-56
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    • 2003
  • Background : Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus. Materials and Methods : Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively. Results : The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%). Conclusions : M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.

Recovery Rate of Nontuberculous Mycobacteria from Acid-Fast-Bacilli Smear-Positive Sputum Specimens (항산균 도말양성 객담에서 비결핵성 마이코박테리아의 분리 비율)

  • Koh, Won-Jung;Kwon, O Jung;Yu, Chang Min;Jeon, Kyeongman;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Sang Won;Park, Sun Young;Lee, Nam Yong
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.22-32
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    • 2003
  • Background : Sputum smears for acid-fast bacilli(AFB) examined microscopically is the most important diagnostic test for pulmonary tuberculosis. However, the AFB observed on the smear may represent either M. tuberculosis or nontuberculous mycobacteria (NTM). This study examined the recovery rate of NTM from the AFB smear-positive sputum specimens in a tertiary hospital in Korea. Materials and Methods : This study analyzed the results for the 1,889 AFB smear-positive and culture-positive sputum specimens collected from 844 patients from July, 1997 to December, 2001. Results : The 1,889 sputum specimens collected from 844 patients tested positive on both microscopy and culture during the 4.5 years. The NTM were recovered from 10.3% (195/1,889) of the smear-positive sputum specimens and 11.0% (93/844) of patients with smear-positive sputum. The NTM were isolated more than two times in 44.1% (41/93) of the patients from whom the NTM was recovered. Trends of the recovery rate of the NTM from the AFB smear-positive sputum specimens were increasing from 6.5%(17/262) in the latter half of 1997 to 17.8%(36/202) in the latter half of 2001 (p<0.001, test for trend). Conclusions : These results suggest that some patients with AFB smear-positive sputum have NTM pulmonary disease rather than pulmonary tuberculosis in Korea.

Growth Performance, Immune Response and Carcass Characteristics of Finishing Pigs by Feeding Stevia and Charcoal (스테비아와 숯이 급여된 비육돈의 사양성적, 면역력 및 도체특성)

  • Choi, Jung-Soek;Jung, Dong-Soon;Lee, Ju-Ho;Choi, Yang-Il;Lee, Jae-Joon
    • Food Science of Animal Resources
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    • v.32 no.2
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    • pp.228-233
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    • 2012
  • This study was conducted to determine the effects of stevia (Stevia rebaudiana bertoni) and charcoal supplementation on growth performance, immune response and carcass characteristics of finishing pigs. A total of 420 pigs (LYD) were randomly allocated into 7 treatments with 3 replications. Dietary treatments were 1) T1 (basal diet), 2) T2 (basal diet+0.3% stevia), 3) T3 (basal diet+0.6% stevia), 4) T4 (basal diet+0.3% charcoal), 5) T5 (basal diet+0.6% charcoal), 6) T6 (basal diet+0.3% stevia+0.3% charcoal) and 7) T7 (basal diet+0.6% stevia+0.6% charcoal). During the experimental period, average daily gain (ADG) was higher in T2 and T6 groups than the other treatments (p<0.05). Feed conversion ratio (FCR) was higher in T6 group compared to the others (p<0.05). There were no significant differences in total cholesterol level and glutamic pyruvic transaminase (GPT) activity of blood among treatments. In glutamic oxaloacetic transaminase (GOT) activity, T3, T5, T6 and T7 groups showed lower values (p<0.05) compared to T1. Insulin-like growth factor-1 concentration was higher in T2 and T6 groups than the others (p<0.05), but there were no significant differences in immunoglobulin G, lymphocyte, eosinophil, basophil and atypical lymph levels among treatments. In neutrophil, T6 showed higher level compared to the others (p<0.05). In the carcass characteristics, T6 showed higher level of a carcass grade compared to the other treatments. However, carcass length did not show any significant difference among treatments. As a result, dietary supplementation of 0.3% stevia and 0.3% charcoal showed higher ADG, higher FCR and better immune response resulting in better growth performance and carcass characteristics of finishing pigs.

Clinical Investigation of Recurrent Pneumonia in Adults - Analysis of Patients From Hallym University Medical Center - (성인 재발성 폐렴에 대한 임상적 고찰 - 한림대학교 의료원 내원 환자를 대상으로 -)

  • Eom, Kwang-Seok;Jeon, Gang;Shin, Taerim;Jang, Seung Hun;Bahn, Joon-Woo;Lee, Jae Young;Park, Yong Bum;Kim, Cheol Hong;Jeon, Man-Jo;Park, Sang Myeon;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.47-54
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    • 2004
  • Background : Recurrent pneumonia in adults is not uncommon. However, there is no domestic data about recurrent pneumonia in adults. Therefore, we investigated the associated diseases and clinical findings of recurrent pneumonia in adults. Methods : Among 5513 patients who were treated in five teaching hospitals of Hallym medical center?over a 5-year period, we retrospectively reviewed the medical records of the 58 who were compatible with diagnostic criteria of recurrent pneumonia. Results : The number of patients with recurrent pneumonia was 58 (1.05%, 58/5513) during the 5 years. Thirtyseven patients were male and 21 were female. Mean age was 66.4 (${\pm}14.9$) years. Median interval between each pneumonic episode was 18.5 months. Associated diseases were 25 cases of respiratory diseases, 13 of heart diseases, 13 of diabetes mellitus, 7 of lung malignancies, 11 of malignancies other than lung, 7 of neurologic disease, and 8 of miscellaneous diseases. Three cases had no underlying illness. Of the 8 cases with 2 or more times of recurrence, 4 were associated with respiratory diseases, 2 with aspiration pneumonia due to neurologic diseases, 1 with heart disease and 1 with no underlying illness. Recurrent pneumonic episodes affecting the same location were 30 of the total recurrent pneumonic episodes (30/67, 47.8%) and common associated diseases were respiratory diseases including lung malignancies. The etiology of recurrent pneumonia was Streptococcus pneumoniae, methicillinresistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, atypical organisms, etc. Conclusion : Recurrent pneumonia in adults had a low incidence rate compared with children, but most cases had associated illness. Respiratory diseases including lung cancer were the most common associated illness of recurrent pneumonia.

The Relationship between the Therapeutic Response to Antipsychotic Drugs and the Dopamine D2, D3, and D4 Receptor Gene Polymorphisms in Korean Schizophrenic Patients (한국인 정신분열병 환자에서 항정신병 약물의 치료 반응과 도파민 D2, D3 및 D4 수용체 유전자 다형성)

  • Kim, Hee-Cheol;Jung, Sung-Won;Kim, Dae-Kwang;Jung, Chul-Ho
    • Korean Journal of Biological Psychiatry
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    • v.14 no.3
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    • pp.167-176
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    • 2007
  • Objectives:A considerable number of pharmacogenetic studies have been performed in recent years to define the association of antipsychotic drug response with dopamine receptor polymorphisms. The purpose of this study was to investigate the relationship between the therapeutic response to antipsychotic drugs and the polymorphisms of the dopamine D2, D3, and D4 receptor genes(DRD2, DRD3 and DRD4, respectively). Methods:We conducted retrospective chart review of 200 consecutively hospitalized patients with the diagnosis of schizophrenia(DSM-IV) who were treated with various antipsychotics(94% atypical antipsychotics) at Bugok National Hospital, Korea. The patients were divided into two groups, responders and non-responders, by responsiveness to antipsychotic drugs according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. We analyzed the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48 bp repeat polymorphism in the DRD4. Results:Among the total patients of 200, 141(70.5%) were categorized as responders. There were no significant differences in the frequencies of the DRD2, DRD3, and DRD4 alleles and genotypes between responders and non-responders. Conclusion:These results suggest that the Ser311Cys polymorphism in the DRD2, the Ser9Gly polym- orphism in the DRD3, and the exon III 48bp repeat polymorphism in the DRD4 are not associated with the therapeutic response to antipsychotic drugs in Korean schizophrenic patients. A larger prospective study is needed to elucidate the association between antipsychotic response and dopamine receptor gene polymorphism.

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A Comparative Analysis of Blood and Urine Luteinizing Hormone Surge According to Different Regimens of Induced Ovulatory Agens in Superovulated Menstrual Cycles (배란유도방법에 의한 과배란주기에서 혈중및 요중 황체화호르몬 Surge에 관한 연구)

  • Park, Won-Jong;Suh, Byung-Hee;Lee, Jae-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.15 no.2
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    • pp.103-117
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    • 1988
  • Ovulation induction was done with 3 different regimens as clomid combined with HMG, HMG only, and FSH combined with HMG in 28 menstrual cycles for IVF-ET and GIFT program. The appearance of endogenous LH surge, estradiol plateau, atypical LH surge, and time from initiation to peak of LH surge in serum and urine were observed and compared in 3 groups. 1. The estradiol concentration of serum LH surge day was similar in three groups but 1st group (Clomiphene Citrate+Sequential HMG) was slightly higher at $1924.0{\pm}865.1\;pg/ml$. In regards to the existence of serum estradiol plateau, 3rd group (FSH+Sequential HMG) was highest at 60%, and 1st group and 2nd group (HMG only) were similar at 33% and 44% respectively. 2. The number of ovarian of ovarian follicle which was more than 18mm in diameter was $4.1{\pm}2.0$, $4.2{\pm}2.1$ respectibely for 2nd group and 3rd group. Although the numbers were slightly higher thean 1st group for each ovarian follicle, serum estradiol value per follicle was higher for 1st group at $583.0{\pm}261.2pg/ml$. 3. When measuring the urine LH surge according to Hi-Gonavi and according to the standard set by three different types of surge, simultameous satisfaction for 1st group, 2nd group, 3rd group was two cases, five cases, four cases respectively at 40%, and the remained cases were composed of numorous type combination which satisfied the two definition, simultaneously in this study, the LH surge starting time was determined only in the cases tow combination were satisfied simultaneously at first, but there are something to study more. In one case of the 3rd group. 4. The concentration of LH surge start in urine and serum of 2nd group was highest at306. $0{\pm}287.2IU/l$ and $34.0{\pm}9.9mIU/ml$ and 1st group was low at $116.6{\pm}66.1IU/l$ and 7.4mIU/ml. The urine and serum value of LH was highest at $1644.4{\pm}988.8IU/l$, $65.9{\pm}15.0mIU/ml$ for 2nd group, 1st group was low at urine, and 3rd group was low of serum. With pregnancy established, the LH concentration of urine was relatively high but on the contrary the LH concentration of serum was low compared to urine concentration. 5. Time from LH surge start to the maximun of urine and serum value was highest at 15. $7{\pm}9.1$ hrs and $10.8{\pm}4.9$ hrs for 1st group and 3rd group. With pregnancy established, time was shortened for urine but on the contrary serum showed an increase in time. 6. The concentration of LH which increases with time on urine was highest at 2nd group ($194.6{\pm}76.8\;IU/hour$). The lowest increase for serum was at 3rd group (2.1mIU/hour). With pregnancy established, urine showed more increase than control group ($266.5{\pm}47.4\;IU/hour$) and for serum there was similar increase ($3.4{\pm}0.8\;mIU/hour$). 7. There were two examples of non-typical surge from 1st group and 3rd group each. Among these three cases showed a reestablishment of LH surge after 10-24 hours. 8. Endogenous spontaneous Lh surge occurs once for each 2nd group and 3rd group.

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Comparison of Thinprep (Liquid-Based Cytology) and Conventional Cytology : Abnormal Lesion on Bronchoscopy (기관기내시경상 이상병변을 보이는 환자에게 있어 Thinprep검사법과 기존세포검사법의 효율성 및 유용성에 대한 비교)

  • Lee, Jung Ho;Yang, Jung Kyung;Jung, In Bum;Lee, Jung Hea;Sul, Hae Jung;Kim, Yoon Mi;Kim, Bum Kyeng;Choi, Yue Jin;Na, Moon Joon;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.547-553
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    • 2006
  • Background: Liquid-based cytology is currently known as an effective method, and cervical cytology has been shown to be especially effective from of malignancy detection. In our study, the cytological detection rates of the Thinprep (Liquid-based cytology) and conventional cytology (bronchial washing & brushing) for endobronchial lesions were compared. Methods: Between July 2005 and September 2005, the data from 30 patients with respiration symptom, who had shown abnormal lesion on bronchoscopy, were collected. Results: The bronchoscopic biopsy group was consisted of 30 cytodiagnosis specimens, 24 of which were confirmed to be malignant. The others were tuberculosis (4), bronchiectasis and bronchopulmonary fistula (1 each). Of the 24 malignant case, cancer or atypical cells were detected in 19, 17 and 12 of the Thinprep, brushing cytology and washing cytology cases, respectively. None one of the methods detected cancer cells in the non-malignant specimens. Washing cytology has shown sensitivity, specificity, and positive and negative predictive values of 50, 100, 100 and 33.3% respectively. Brushing cytology has shown sensitivity, specificity, and positive and negative predictive values of 70.8, 100, 100 and 46.2%, respectively. Thinprep has shown sensitivity, specificity, and positive and negative predictive values of 79.2, 100, 100 and 54%, respectively. Conclusions: Thinprep (liquid-based cytology) showed better sensitivity and negative predictive values for the evaluation of lung cancer than conventional cytology. However a large-scale study will be needed in the future.

Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.

Abnormal Perfusion on Myocardial Perfusion SPECT in Patients with Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군 환자의 심근 관류 이상)

  • Kang, Do-Young;Cha, Kwang-Soo;Han, Seung-Ho;Park, Tae-Ho;Kim, Moo-Hyun;Kim, Young-Dae
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.9-14
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    • 2005
  • Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome. Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients (mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent ($11.0{\pm}8.5%$, range:$3{\sim}35%$) and mild to moderate severity ($-71{\pm}42.7%$, range:$-2l7{\sim}-39%$) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

A. Artaud or the Prisoner of Language (앙토냉 아르토 혹은 언어의 수형자)

  • Park, Hyung-Sub
    • Cross-Cultural Studies
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    • v.45
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    • pp.219-243
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    • 2016
  • The life of Antonin Artaud exactly reproduces a very cruel drama. He lived in constant anguish and suffered from severe mental pain. This research will trace his thoughts in his writings while he was a prisoner of language. Artaud was a poet filled with anxiety about language, things, being, and thought. Whenever he tried to explain the mystery of being by means of mundane language, he experienced psychological agony. His poetic thoughts began to break down, because of his identity loss. Nevertheless, he was destined to grasp the world through language. Artaud had suffered from mental illness during his youth. His mental illness was associated with his difficulty in creating poetry. In this research, the letter, Correspondance avec Jacques $Rivi{\grave{e}}re$, is analyzed. The poet refers to "the collapse of the spirit's core, and the erosion of the fundamental thought that slips away" to convey his linguistic incompetence. Hereafter, he constantly demonstrated anxious mental symptoms. Even though he became mentally deranged, he maintained his consciousness, as is apparent in his writings. Also, his spiritual belief is reflected in his mental uneasiness. While he was traveling through the Tarahumaras area in Mexico, he was obsessed with its primitive belief in the Peyote rituals, and he immersed himself in performing them. His unchristian belief was the product of his mystical personality. Until his last breath, he did not give up writing. Artaud's mental derangement does not mean lunacy, but if one insists in calling it so, that is a metaphor. His derangement comes from his refusal to accept his limitations and from his aspiring to regard his body in the same light as his intellectual perceptions. His intellect could manifest more easily when his mind was elevated to the extreme. Artaud's lunacy is no different from that of a profound philosopher. The lives of poets who suffer from mental derangement are more poetic than the lives of those who do not. Artaud's atypical emotions provide a way of to measure our own limitations, helplessness, and resignation. His scream is nonsegmental but different from that of a mental patient. That difference is why people are interested in his works and wish to delve into his writings.