• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.430-434
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• 2023

Intravesical bacillus Calmette-Guérin (BCG) instillation is an adjuvant treatment for non-muscle-invasive urinary bladder cancer. Although most complications associated with BCG immunotherapy are mild and self-limiting, rare albeit serious complications have been reported. Only a few cases of BCG-related rhabdomyolysis have been reported. In this study, we present the case of a 72-year-old woman who developed severe weakness and hyperCKemia following intravesical BCG instillation. A muscle biopsy was performed, and a diagnosis of drug-induced myopathy was made.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.1-5
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• 1997

Regional lymphadenitis is the most common complication following BCG vaccination in this country. The literature describes controversial results with medical, surgical and combined therpy. The purpose of this study is to clarify the therapeutic effect of isoniazid(INH) after surgical procedures. The early and late postoperative complications of 136 children with lymphadenitis following BCG vaccination at the Taegu Fatima Hospital between March 1985 and February 1996 were reviewed. In 90 children, INH was given for 3-4 days before operation and for 3 months after surgery. In the other 46 cases, INH was not given during the pre- or postoperative period. Surgical procedures were excision or incision and currettage according to the states of lesions. Postoperative complications were fluid accumulation, wound infection, sinus formation and others. Complication rates were 14.4 % in INH-treated group and 13.0% of INH-nontreated group. The difference was not significant. There was no recurrence or other late complication in either groups. The result suggest that surgical excision or incision and currettage are sufficient for the treatment of regional lymphadenitis following BCG vaccination and postoperative INH therapy is not necessary.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.54-61
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• 2016

Purpose: Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) lymphadenitis is a relatively frequent local adverse reactions after BCG vaccination. Its incidence rate is usually <1%. However, this rate may be different according to BCG strain, vaccination method or skill, etc. In the Republic of Korea, two BCG strains are used: intradermal Danish-1331 or percutaneous Tokyo-172. We surveyed the incidence rates of BCG lymphadenitis. Methods: This survey was performed in total 25 centers (5 general hospitals, 20 private pediatric clinics). Immunized type of BCG strain in study subjects was verified by directly observing the scar. The occurrence of BCG lymphadenitis was asked to their parent. In cases of BCG lymphadenitis, location, diameter size, progression of suppuration, and treatment method were investigated, as well. Results: The total number of study subjects was 3,342. Among these, the subjects suitable for enrollment criteria (total 3,222; Tokyo strain 2,501, Danish strain 721) were analyzed. BCG lymphadenitis regardless of its size developed in each five of subjects per strains, therefore, its incidence rate was 0.20% in Tokyo and 0.69% in Danish strain, respectively (P=0.086). However, when applying the WHO criteria - the development of lymph node swelling with diameter 1.5 cm or more, the incidence rate of BCG lymphadenitis was 0.16% (4 cases) in Tokyo and 0.42% (3 cases) in Danish strain, respectively. Conclusions: The incidence rate of lymphadenitis in two BCG types, percutaneous Tokyo and intradermal Danish strain BCG, is 0.20% and 0.69%, respectively. Both rates are acceptable.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.80-86
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• 2009

Purpose : This study was performed to determine the clinical course of BCG lymphadenitis. Methods : Between May 2005 and April 2009, the medical records of 33 patients with BCG lymphadenitis were retrospectively reviewed. If needed, needle aspiration was recommended without surgical resection or antituberculous medication. Results : Of the 33 patients who were identified, 21 were males and 12 were females. Among the 33 patients, 32 were full-term babies. The mean age was 6 months (range, 2-35 months) and the most prevalent site of the lesion was the left axilla. BCG lymphadenitis was observed 1-34 months after BCG vaccination, mostly 1-6 months after vaccination. The size of the enlargement was generally 1-3 cm. The strains were identified as French (n=14), Danish (n=7), and Tokyo (n=12). BCG lymphadenitis regressed spontaneously in 19 patients. After 1-5 needle aspirations, 14 patients recovered completely. Complete regression of lymphadenitis was recorded over an average period of 4 months. Conclusion : Clinicians need to be aware of the clinical features of BCG lymphadenitis. For management of BCG lymphadenitis, regular follow-up with observation should be the mainstay. Needle aspiration is a safe and easy treatment for suppurative BCG lymphadenitis.

• Journal of agricultural medicine and community health
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• v.32 no.3
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• pp.125-138
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• 2007

Objectives: This retrospective study is to identify related factors of treatment success of patients with tuberculosis at community health centers. Methods: The subjects of this study were 1,417 patients with tuberculosis treated in 28 community health centers. The predictors of tuberculosis treatment success were analyzed in terms of 2 areas, which were characteristics of patients and health centers(TB control program). The characteristics of patients consist of 2 factors, such as demographic & diagnosis and treatment. The present conditions of health centers consist of 3 factors, location of centers, resources, and community activities. Data were analysed using X2- test and logistic regression methods. Results: The significant differences between success group and failure group were sex(p=0.003), age(p=0.013), job(p=0.000), type of patients(p=0.001), past history(p=0.029), BCG injection(p=0.009), sputum culture examination(p=0.017), period of treatment(p=0.000), location of center(p=0.001), population per staff(p=0.015), FTE(p=0.027), education days of staff(p=0.005), BCG injection rate(p=0.001), case detection rate (p=0.003), and health education provision rate(p=0.044). Then these variables were analysed using logistic regression analysis. Significant positive factors of treatment success were occupation(95% CI:1.3-6.1), periods of treatment(95% CI:1.5-2.2), center in large city(95% CI:1.2-16.7), center in middle city(95% CI:2.1-24.3), job education related TB(95% CI:1.02-1.3), and BCG injection rate(95% CI:1.1-303.4). Significant negative factors of treatment success were male(95% CI:0.1-0.5) and treatment after default(95% CI:0.005-0.5). Conclusions: Tuberculosis is still one of serious diseases in Korea, because it causes highest mortality rate among OECD countries. This study may provide information to improve treatment effectiveness of tuberculosis at community health centers.

• Biomedical Science Letters
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• v.24 no.2
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• pp.138-142
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• 2018

The incidence of tuberculosis (TB) in the Republic of Korea remains high when compared to the incidence in other Organization for Economic Cooperation and Development (OECD) countries. The prompt diagnosis and effective treatment of latent TB infection (LTBI) are very important in terms of controlling the burden of TB. The tuberculin skin test (TST) has long been the "gold standard" assay for the diagnosis of LTBI. However, it can show false positive results due to Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) vaccination and infection with many environmental nontuberculous mycobacteria (NTM). The interferon gamma release assay (IGRA) using Mycobacterium tuberculosis (MTB)-specific antigens, was developed for the detection of LTBI. The QuantiFERON-TB Gold In-Tube assay is one of the most commonly used forms of the IGRA. In order to compare the diagnostic efficacy of the TST and IGRA in relation to LTBI among BCG-vaccinated healthy donors, whole blood samples were collected from 51 participants, and the results of the TST and IGRA were compared. Of the 51 cases, 18 cases (35.3%) were positive and 33 cases (64.7%) were negative when using the TST, while four cases (7.8%) were positive and 47 cases (92.2%) negative when using the IGRA. There was no correlation between the size of the induration in the TST and the $IFN-{\gamma}$ protein level. In conclusion, the TST showed higher cross-reactivity among the BCG-vaccinated healthy participants, therefore, the IGRA might be the most suitable assay for the rapid screening of LTBI in BCG-vaccinated healthy population, or for TB contact investigation.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.250-256
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• 2000

The incidence of tuberculosis has been decreased, and especially the incidence of severe complicated tuberculosis has been markedly decreased as the result of widely used BCG vaccines. But tuberculosis is still an important community accquired infectiouse disease in the world despite continued worldwide efforts to control the disease. Miliary tuberculosis, the most serious complicated tuberculosis, can be occurred by lymphohematogenous dissemination of tuberculosis, and intracranial tuberculoma with or without tuberculosis meningitis can be developed in case of miliary tuberculosis. In general, serious tuberculosis infections such as miliary tuberculosis and CNS tuberculosis are developed especially in young infants and children in cases of delayed diagnosis and treatment despite receiving BCG vaccination, and usually those patients have contact sources. Intrcranial tuberculoma in children are usually found near infratentorial site at the base of cerebellum, and clinically symptoms and signs of increased intracranial pressure developed before treatment. Serial brain CT or MRI is a good non-invasive diagnostic modality of intracranial tuberculoma. Although surgical intervention was initially advocated as the mainstay of intracranial tuberculoma therapy, but many recent clinical studies indicate that intracranial tuberculoma can be cured with medical treatment alone. We experienced a case of 3 months old male patient, who was diagnosed as having miliary tuberculosis associated with multiple intracranial tuberculoma. He received BCG vaccination at 4 weeks after birth, and his father was confirmed as active pulmonary tuberculosis patient after this patient's admission. We report this case with a review of related literatures.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10813-10817
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• 2015

Background: Possible roles of nestin expression in terms of predicting intravesical BCG therapy response in T1 high grade bladder cancer patients were investigated. Materials and Methods: T1 high grade bladder cancer patients who were treated with intravesical BCG between 1990-2009 were included. Immunohistochemical staining for nestin expression was performed. Nestin(+) and nestin(-) patients were compared in terms of recurrence and progression rates. Results: Sixty-three patients were included and median follow-up time was twenty-five months. After staining; 33 patients (52.4%) were classified as nestin (+) and 30 (47.6%) as (-). Nestin (+) patients were more likely to recur compared to nestin (-) patients (60.6% vs. 30%, p<0.05). Progression rates were also higher in nestin (+) patients, although this result did not reach statistical significance (15.2 % vs. 10 %, p=0.710). Conclusions: Nestin expression, which seems effective in predicting recurrence, appears to have a potential role in the urothelial carcinoma tumorigenesis. Patients with high grade bladder cancer and positive nestin expression need close follow-up and might be informed about more tendency to recur. Further comprehensive studies including larger patient cohorts may clarify the role of nestin in bladder cancer.

• The Korean Journal of Zoology
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• v.34 no.2
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• pp.173-180
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• 1991

The objective of this experiment was to examine the effect of polyamine depletion by polyamine biosynthesis inhibitors on microbicidal activity and tumoricidal activity in mouse mac-rophages. $\alpha$ -Difluoromethylomithine (DFMO), inhibitor of putrescine and spernidine biosynthesis, treatment in vivo for 6-8 days reduced chemiluminescence levels in thioglycollate-, lipo-polysaccharide (LPS), and BCG-treated mouse macrophages. An DFMO treatment in vitro inhibited production of tumor necrosis factor (TNF), in dose-dependent manner, and tumoricidal activity by macrophages. The effect of polyamine depletion by MO on ThF production and tumoricidal activity could be reversed by the addition of exogenous putrescine. These result indicated that the obserbed effect of DFMO on macrophage activities were mediated through inhibition of polyamines are, must be, required for optimal activities of macrophages.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2935-2941
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• 2012

Biological response modifiers (BRMs) can alter interactions between the immune system and cancer cells to boost, direct, or restore the body's ability to fight disease. Mice with ethylnitrosourea- (ENU) induced leukemia were here used to monitor the therapeutic efficacy of lipopolysaccaride (LPS), Bacillus Calmette Guerin (BCG) and sheep erythrocytes (SRBC). Flow cytometry based CD34+ positivity analysis, clonogenicity, proliferation and ultrastructure studies using scanning electron microscopy (SEM) of stem cells in ENU induced animals with and without BRMs treatment were performed. BRMs improved the stem-stromal relationship structurally and functionally and might have potential for use as an adjunct in human stem cell therapy.