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Clinical Study on Thoracic Actinomycosis (흉부 방선균종의 임상적 고찰)

  • Hong, Sang-Bum;Kim, Woo-Sung;Lee, Jae-Hwan;Bang, Sung-Jo;Shim, Tae-Son;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Lee, In-Chul;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1058-1066
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    • 1998
  • Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

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Analysis of HBeAg and HBV DNA Detection in Hepatitis B Patients Treated with Antiviral Therapy (항 바이러스 치료중인 B형 간염환자에서 HBeAg 및 HBV DNA 검출에 관한 분석)

  • Cheon, Jun Hong;Chae, Hong Ju;Park, Mi Sun;Lim, Soo Yeon;Yoo, Seon Hee;Lee, Sun Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.35-39
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    • 2019
  • Purpose Hepatitis B virus (hepatitis B virus, HBV) infection is a worldwide major public health problem and it is known as a major cause of chronic hepatitis, liver cirrhosis and liver cancer. And serologic tests of hepatitis B virus is essential for diagnosing and treating these diseases. In addition, with the development of molecular diagnostics, the detection of HBV DNA in serum diagnoses HBV infection and is recognized as an important indicator for the antiviral agent treatment response assessment. We performed HBeAg assay using Immunoradiometric assay (IRMA) and Chemiluminescent Microparticle Immunoassay (CMIA) in hepatitis B patients treated with antiviral agents. The detection rate of HBV DNA in serum was measured and compared by RT-PCR (Real Time - Polymerase Chain Reaction) method Materials and Methods HBeAg serum examination and HBV DNA quantification test were conducted on 270 hepatitis B patients undergoing anti-virus treatment after diagnosis of hepatitis B virus infection. Two serologic tests (IRMA, CMIA) with different detection principles were applied for the HBeAg serum test. Serum HBV DNA was quantitatively measured by real-time polymerase chain reaction (RT-PCR) using the Abbott m2000 System. Results The detection rate of HBeAg was 24.1% (65/270) for IRMA and 82.2% (222/270) for CMIA. Detection rate of serum HBV DNA by real-time RT-PCR is 29.3% (79/270). The measured amount of serum HBV DNA concentration is $4.8{\times}10^7{\pm}1.9{\times}10^8IU/mL$($mean{\pm}SD$). The minimum value is 16IU/mL, the maximum value is $1.0{\times}10^9IU/mL$, and the reference value for quantitative detection limit is 15IU/mL. The detection rates and concentrations of HBV DNA by group according to the results of HBeAg serological (IRMA, CMIA)tests were as follows. 1) Group I (IRMA negative, CMIA positive, N = 169), HBV DNA detection rate of 17.7% (30/169), $6.8{\times}10^5{\pm}1.9{\times}10^6IU/mL$ 2) Group II (IRMA positive, CMIA positive, N = 53), HBV DNA detection rate 62.3% (33/53), $1.1{\times}10^8{\pm}2.8{\times}10^8IU/mL$ 3) Group III (IRMA negative, CMIA negative, N = 36), HBV DNA detection rate 36.1% (13/36), $3.0{\times}10^5{\pm}1.1{\times}10^6IU/mL$ 4) Group IV(IRMA positive, CMIA negative, N = 12), HBV DNA detection rate 25% (3/12), $1.3{\times}10^3{\pm}1.1{\times}10^3IU/mL$ Conclusion HBeAg detection rate according to the serological test showed a large difference. This difference is considered for a number of reasons such as characteristics of the Ab used for assay kit and epitope, HBV of genotype. Detection rate and the concentration of the group-specific HBV DNA classified serologic results confirmed the high detection rate and the concentration in Group II (IRMA-positive, CMIA positive, N = 53).

A Morphological Study of Bamboos by Vascular Bundle Sheath (대나무류(類)의 유관속초(維管束鞘)에 의(依)한 형태학적(形態學的) 연구(硏究))

  • Kim, Jai Saing
    • Journal of Korean Society of Forest Science
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    • v.25 no.1
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    • pp.13-47
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    • 1975
  • Among the many species of bamboo, it is well known that the dwarf-type is widely distributed in the tropical regions, and the slender type in temperated zone. In the temperated zone the trees have extensively differentiated into one hundred species in 50 genera. In many oriental countries, the bamboo wood is being used as a material for construction and for the manufacture of technical instruments. The bamboo shoot is also regarded as a good and delicious edible resource. Moreover, recent medical investigation verifies that the sap of certain species of the bamboo is an antibiotic effect against cancer. Fortunately, it is very easy to propagate the bamboo trees by using cutting from southeastern Asian countries. This important resource can further be used as a significant source of pulp, which is becoming increasingly important. The classification system of this significant resource has not been completely established to date, even though its importance has been emphasized. Initiated by Canlevon Linne in the 18th century, a classification method concerning the morphological characteristics of flowers was the first step in developing a classification. But it was not an easy task to accomplish, because this type of classification system is based on the sexual organs in bamboo trees. Because the bamboo has a long life cycle of 60-120 years and classification according to this method was very difficult as the materials for the classification are not abundant and some species have changed, even though many references related to the morphological classification of bamboo trees are available nowadays. So, the certification of bamboo trees according to the morphological classification system is not reasonable for us. Consequently, the classification system of bamboo trees on the basis of endomorphological characteristics was initiated by Chinese-born Liese. And classification method based on the morphological characteristics of the vascular bundle was developed by Grosser. These classification methods are fundamentally related to Holltum's classification method, which stressed the morphology of the ovary. The author investigated to re-establish a new classification method based on the vascular sheath. Twenty-six species in 11 genera which originated from Formosa where used in the study. The results obtained from the investigation were somewhat coordinated with those of Crosser. Many difficulties were found in distinguishing the species of Bambusa and Dendrocalamus. These two species were critically differentiated under the new classification system, which is based on the existence of a separated vascular bundle sheath in the bamboo. According to these results, it is recommended that Babusa divided into two groups by placing it into either subspecies or the lower categories. This recommendation is supported by the observation that the evolutional pattern of the bamboo thunk which is from outward to inward. It is also supported by the viewpoint that the fundamental hypothesis in evolution is from simple to complex. There remained many problems to be solved through more critical examination by comparing the results to those of the classification based on the sexual organs method. The author observed the figure of the cross-sectional area of vascular trunk of bamboo tree and compared the results with those of Grosser and Liese, i.e. A, $B_1$, $B_2$, C, and D groups in classification. Group A and $B_2$ were in accordance with the results of those scholars, while group D showed many differences, Grosser and Liese divided bamboo into "g" type and "h" type according to the vascular bundle type; and they included Dendrocalamus and Bambusa in Group D without considering the type of vascular bundle sheath. However, the results obtained by the author showed that Dendrocalamus and Bambusa are differentiated from each other. By considering another group, "i" identified according to the existence of separated vascular bundle sheath. Bambusa showed to have a separated vascular bundle sheath while Dendrocalamus does not have a separated vascular bundle sheath. Moreover, Bambusa showed peculiar characteristics in the figure of vascular development, i.e., one with an inward vascular bundle sheath and the other with a bivascular bundle sheath (inward and outward). In conclusion, the bamboo species used in this experiment were classified in group D, without any separated vascular bundle sheath, and in group E, with a vascular bundle sheath. Group E was divided into two groups, i.e., and group $E_1$, with bivascular sheath, and group $E_2$, with only an inward vascular sheath. Therefore, the Bambusa in group D as described by Grosser and Liese was included in group E. Dendrocalamus seemed to be the middle group between group $E_l$ and group $E_2$ under this classification system which is summarized as follows: Phyllostachys-type: Group A - Phyllostachys, Chymonobambus, Arundinaria, Pseudosasa, Pleioblastus, Yashania Pome-type: Group $B_2$ - Schizostachyum, Melocanna Hemp-type: Group D - Dendrocalamu Bambu-type: Group $E_1$ - Bambusa ghi.

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