• Title/Summary/Keyword: Healthy volunteers

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Automated Measurement of Native T1 and Extracellular Volume Fraction in Cardiac Magnetic Resonance Imaging Using a Commercially Available Deep Learning Algorithm

  • Suyon Chang;Kyunghwa Han;Suji Lee;Young Joong Yang;Pan Ki Kim;Byoung Wook Choi;Young Joo Suh
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1251-1259
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    • 2022
  • Objective: T1 mapping provides valuable information regarding cardiomyopathies. Manual drawing is time consuming and prone to subjective errors. Therefore, this study aimed to test a DL algorithm for the automated measurement of native T1 and extracellular volume (ECV) fractions in cardiac magnetic resonance (CMR) imaging with a temporally separated dataset. Materials and Methods: CMR images obtained for 95 participants (mean age ± standard deviation, 54.5 ± 15.2 years), including 36 left ventricular hypertrophy (12 hypertrophic cardiomyopathy, 12 Fabry disease, and 12 amyloidosis), 32 dilated cardiomyopathy, and 27 healthy volunteers, were included. A commercial deep learning (DL) algorithm based on 2D U-net (Myomics-T1 software, version 1.0.0) was used for the automated analysis of T1 maps. Four radiologists, as study readers, performed manual analysis. The reference standard was the consensus result of the manual analysis by two additional expert readers. The segmentation performance of the DL algorithm and the correlation and agreement between the automated measurement and the reference standard were assessed. Interobserver agreement among the four radiologists was analyzed. Results: DL successfully segmented the myocardium in 99.3% of slices in the native T1 map and 89.8% of slices in the post-T1 map with Dice similarity coefficients of 0.86 ± 0.05 and 0.74 ± 0.17, respectively. Native T1 and ECV showed strong correlation and agreement between DL and the reference: for T1, r = 0.967 (95% confidence interval [CI], 0.951-0.978) and bias of 9.5 msec (95% limits of agreement [LOA], -23.6-42.6 msec); for ECV, r = 0.987 (95% CI, 0.980-0.991) and bias of 0.7% (95% LOA, -2.8%-4.2%) on per-subject basis. Agreements between DL and each of the four radiologists were excellent (intraclass correlation coefficient [ICC] of 0.98-0.99 for both native T1 and ECV), comparable to the pairwise agreement between the radiologists (ICC of 0.97-1.00 and 0.99-1.00 for native T1 and ECV, respectively). Conclusion: The DL algorithm allowed automated T1 and ECV measurements comparable to those of radiologists.

COVID-19 Vaccination Alters NK Cell Dynamics and Transiently Reduces HBsAg Titers Among Patients With Chronic Hepatitis B

  • Hyunjae Shin;Ha Seok Lee;Ji Yun Noh;June-Young Koh;So-Young Kim;Jeayeon Park;Sung Won Chung;Moon Haeng Hur;Min Kyung Park;Yun Bin Lee;Yoon Jun Kim;Jung-Hwan Yoon;Jae-Hoon Ko;Kyong Ran Peck;Joon Young Song;Eui-Cheol Shin;Jeong-Hoon Lee
    • IMMUNE NETWORK
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    • v.23 no.5
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    • pp.39.1-39.15
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    • 2023
  • Coronavirus disease 2019 (COVID-19) vaccination may non-specifically alter the host immune system. This study aimed to evaluate the effect of COVID-19 vaccination on hepatitis B surface Ag (HBsAg) titer and host immunity in chronic hepatitis B (CHB) patients. Consecutive 2,797 CHB patients who had serial HBsAg measurements during antiviral treatment were included in this study. Changes in the HBsAg levels after COVID-19 vaccination were analyzed. The dynamics of NK cells following COVID-19 vaccination were also examined using serial blood samples collected prospectively from 25 healthy volunteers. Vaccinated CHB patients (n=2,329) had significantly lower HBsAg levels 1-30 days post-vaccination compared to baseline (median, -21.4 IU/ml from baseline), but the levels reverted to baseline by 91-180 days (median, -3.8 IU/ml). The velocity of the HBsAg decline was transiently accelerated within 30 days after vaccination (median velocity: -0.06, -0.39, and -0.04 log10 IU/ml/year in pre-vaccination period, days 1-30, and days 31-90, respectively). In contrast, unvaccinated patients (n=468) had no change in HBsAg levels. Flow cytometric analysis showed that the frequency of NK cells expressing NKG2A, an NK inhibitory receptor, significantly decreased within 7 days after the first dose of COVID-19 vaccine (median, -13.1% from baseline; p<0.001). The decrease in the frequency of NKG2A+ NK cells was observed in the CD56dimCD16+ NK cell population regardless of type of COVID-19 vaccine. COVID-19 vaccination leads to a rapid, transient decline in HBsAg titer and a decrease in the frequency of NKG2A+ NK cells.

Comparative Analysis of Two Pedobarography Systems (두 족저압 측정장비의 비교 분석)

  • Ho Won Kang;Soomin Pyeun;Dae-Yoo Kim;Yun Jae Cho;Min Gyu Kyung;Dong Yeon Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.21-26
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    • 2024
  • Purpose: Foot pressure measurement devices are used widely in clinical settings for plantar pressure assessments. Despite the availability of various devices, studies evaluating the inter-device reliability are limited. This study compared plantar pressure measurements obtained from HR Mat (Tekscan Inc.) and EMED-n50 (Novel GmbH). Materials and Methods: The study involved 38 healthy male volunteers. The participants were categorized into two groups based on the Meary's angle in standing foot lateral radiographs: those with normal feet (angles ranging from -4° to 4°) and those with mild flatfeet (angles from -8° to -15°). The static and dynamic plantar pressures of the participants were measured using HR Mat and EMED-n50. The reliability of the contact area and mean force was assessed using the interclass correlation coefficient (ICC). Furthermore, the differences in measurements between the two devices were examined, considering the presence of mild flatfoot. Results: The ICC values for the contact area and mean force ranged from 0.703 to 0.947, indicating good-to-excellent reliability across all areas. EMED-n50 tended to record higher contact areas than HR Mat. The mean force was significantly higher in the forefoot region when measured with EMED-n50, whereas, in the hindfoot region, this difference was observed only during static measurements with HR Mat. Participants with mild flatfeet exhibited significantly higher contact areas in the midfoot region for both devices, with no consistent differences in the other parameters. Conclusion: The contact area and mean force measurements of the HR Mat and EMED-n50 showed high reliability. On the other hand, EMED-n50 tended to record higher contact areas than HR Mat. In cases of mild flatfoot, an increase in contact area within the midfoot region was observed, but no consistent impact on the differences between the two devices was evident.

Effect of Waxy Barley Bread with Trans Fat on the Lipid Profile and Fatty Acid Composition in Healthy Korean Adults (Trans 지방을 첨가한 찹쌀보리빵의 섭취가 건강한 성인의 혈장 지질수준과 지방산 조성에 미치는 영향)

  • Noh, Kyung-Hee;Huh, Young;Jang, Ji-Hyun;Shin, Jin-Hyuk;Lee, Mi-Ock;Lee, Kyung-Sik;Lee, Seong-Hwan;Kim, Do-Hoon;Park, Yong-Kyu;Cho, Kyung-Hwan;Song, Young-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.10
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    • pp.1353-1361
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    • 2009
  • This study investigated the effect of waxy barley on the incorporation trans fat (tFA) into plasma lipid and lipid profile through 6 weeks trial. 39 healthy volunteers were divided into 2 groups and fed waxy barley bread (WBG) or wheat bread (WG) containing equivalent amounts of tFA (elaidic acid rich, 3.75 g/day), respectively. Plasma lipid profiles and fatty acid composition at 0, 2, 4, 6 weeks after a respective bread were studied. Plasma lipid was extracted by the method of Folch, esterified by acid transmethylation and analyzed by gas chromatography. The fatty acid composition reflected the fatty acid proportion of the test fat. However, consumption of waxy barley bread with tFA for 6 weeks affected plasma fatty acid composition including tFA. Incorporation of tFA into plasma lipid was significantly lowered compared to WBG than in WG after 6 weeks of consumption. Furthermore, saturated fatty acids such as C16:0 and C18:0 levels were also significantly lowered in WBG than in WG. Furthermore, plasma total cholesterol level and TG/HDL-cholesterol ratio were also significantly lowered in WBG compared to WG at 2, 4 and 6 weeks. These results suggest that waxy barley bread with high $\beta$-glucan lowered plasma trans, saturated fatty acid and total cholesterol levels though the inhibition of lipid absorption.

Effect of Breads Containing Trans Fat, Soybean or Rice on Plasma Lipid and Fatty Acid Composition in Healthy Korean Adults (Trans 지방과 쌀, 콩을 첨가한 빵의 섭취가 건강한 성인 남녀의 혈장 지질 및 지방산 조성에 미치는 영향)

  • Noh, Kyung-Hee;Huh, Young;Jang, Ji-Hyun;Kim, Soo-Hee;Shin, Jin-Hyuk;Kim, Do-Hoon;Lee, Seong-Hwan;Lee, Kyung-Sik;Park, Yong-Kyu;Cho, Kyung-Hwan;Song, Young-Sun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.8
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    • pp.1042-1049
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    • 2009
  • It has been reported that trans fat (tFA) may have adverse or beneficial effect depending upon the position and number of double bonds. The presence of tFA in human tissues and fluids is related to dietary intake, intestinal absorption, metabolism and storage, exchanges among compartments. This study investigated the effect of breads containing tFA, soybean or rice on postprandial plasma fatty acid and lipid composition. 33 healthy volunteers were divided into 3 groups and fed soybean bread, rice bread or wheat bread groups containing equivalent amounts of tFA (elaidic acid rich, 3.75 g/day), respectively. Postprandial lipid profiles at 0, 1, 2, 3 and 4 hours after a respective meal were studied. Plasma fatty acid was extracted by the method of Folch and methyl ester of fatty and prepared by acid transmethylation and analyzed by Gas Chromatography. Peaks were identified using pure reference compounds and quantified. Postprandial data indicated that consumption of soybean and rice breads with 3.75 g tFA retarded the appearance of C18:1 and C18:2 tFA in plasma lipid compared to that of wheat bread. Futhermore, soybean and rice bread groups showed lower plasma saturated fatty acid levels than wheat bread group. Postprandial TG level was significantly lowered in soybean bread group compared to that of rice and wheat bread groups. These results imply that soybean bread with high dietary fiber content and biologically active substances may inhibit or delay lipid absorption.

Comparison of Brain Activation Images Associated with Sexual Arousal Induced by Visual Stimulation and SP6 Acupuncture : fMRI at 3 Tesla (시각자극과 삼음교 자침으로 유발된 성적 흥분의 대뇌 활성화 영상의 비교 : 3 테슬라 기능적 자기공명영상법)

  • Choi, Nam-Gil;Han, Jae-Bok;Jang, Seong-Joo
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.183-194
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    • 2009
  • Purpose : This study was performed not only to compare the brain activation regions associated with sexual arousal induced by visual stimulation and SP6 acupuncture, but also to evaluate its differential neuro-anatomical mechanism in healthy women using functional magnetic resonance imaging (fMRI) at 3 Tesla (T). Subjects and methods : A total of 21 healthy right-handed female volunteers (mean age 22 years, range 19 to 32) underwent fMRI on a 3T MR scanner. The stimulation paradigm for sexual arousal consisted of two alternating periods of rest and activation. It began with a 1-minute rest period, 3 minutes of stimulation with either of an erotic video film or SP6 acupuncture, followed by 1-minute rest. In addition, a comparative study on the brain activation patterns between an acupoint and a shampoint nearby GB37 was performed. The fMRI data were obtained from 20 slices parallel to the AC-PC line on an axial plane, giving a total of 2,000 images. The mean activation maps were constructed and analyzed by using the statistical parametric mapping (SPM99) software. Results : As comparison with the shampoint, the acupoint showed 5 times and 2 times higher activities in the neocortex and limbic system, respectively. Note that brain activation in response to stimulation with the shampoint was not observed in the regions including the HTHL in the diencephalon, GLO and AMYG in the basal ganglia, and SMG in the parietal lobe. In the comparative study of visual stimulation vs. SP6 acupuncture, the mean activation ratio of stimulus was not significantly different to each other in both the neocortex and the limbic system (p < 0.05). The mean activities induced by both stimuli were not significantly different in the neocortex, whereas the acupunctural stimulation showed higher activity in the limbic system (p < 0.05). Conclusions : This study compared the differential brain activation patterns and the neural mechanisms for sexual arousal, which were induced by visual stimulation and SP6 acupuncture by using 3T fMRI. These findings will be useful to understand the theory of traditional acupuncture and acupoint channel in scientific point of view.

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Effect of Saengshik on Blood Glucose Response in Healthy Subjects (생식조성이 정상성인의 혈당반응에 미치는 영향)

  • Kim, Hwa-Young;Hong, Seong-Gil;Hwang, Sung-Ju;Mok, Chul-Kyoon;Park, Mi-Hyoun;Lee, Ju-Yeon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.12
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    • pp.1553-1559
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    • 2007
  • The purposes of this study were to investigate the effect of Saengshik on blood glucose level of normal subject and to explore the marketing possibility of four kinds of Saengshik (ES, HS, BS, SS) as alternative diabetic meals. Blood glucose levels of healthy volunteers was measured at 15, 30, 45, 60, 75, 90, 105 and 120 minutes after taking Saengshik and 50 g glucose. Blood glucose response areas, glycemic index (GI) and glycemic load (GL) were calculated from the glucose response. The Saengshik showed a significantly lower glucose level than the glucose. The glycemic index (GI) of ES showed $43.1{\pm}12.6$, which belonged to low GI foods (GI of 55 or less). Other samples (HS, BS, SS) could be classified as intermediate GI foods ranging $56{\sim}69$ of GI. Saengshik showed a gentle rising and falling pattern showing moderate left area ratio and right area ratio on blood glucose curve. The GL of ES showed 14.1 while HS, BS and SS did $19.2{\sim}19.5$. The results indicated that Saengshik may have a beneficial effect on a diabetic.

The Relationship between Cell-mediated Immunity and Subtypes of Lymphocyte in BAL Fluid and Peripheral Blood in Patients with Pulmonary Tuberculosis (폐결핵 환자의 말초 혈액 및 기관지 폐포세척액내의 임파구 아형과 세포성 매개면역과의 관계)

  • Uh, Soo-Taek;Cha, Mi-Kyung;Lee, Sang-Moo;Kim, Hyun-Tae;Chung, Yeon-Tae;Woo, Jun-Hee;Kim, Yong-Hun;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.4
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    • pp.334-342
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    • 1992
  • Background: The activated T lymphocyte by inhalaed mycobacterial antigen may evoke cell-mediated immunity in patients with active pulmonary tuberculosis. These activated lymphocyte may influence the response of tuberculin-purified protein derivative (PPD) in skin test. But occasionally, anergy to PPD appear in patients with pulmonary tuberculosis in spite of active stage. Thus we evaluated the effect of change of subtypes of lymphocyte in bronchoalveolar lavage fluid (BAL) and peripheral blood on anergy to PPD in patients with active pulmonary tuberculosis. Method: We performed tuberculin skin test and flow-cytometry analysis of lymphocytes obtained from BAL fluid and peripheral blood in 11 healthy normal volunteers and 20 patients with active pulmonary tuberculosis. Results: 1) The composition of lymphocyte significantly increased in patients with active pulmonary tuberculosis when compared with that in healthy control ($25.2{\pm}4.8$ vs $6.5{\pm}1.3%$, p<0.01), but composition of monocyte significantly decreased ($69.6{\pm}5.7$ vs $89.2{\pm}1.4%$, p<0.05) in analysis of BAL fluid. 2) There were no differences in compositions of cells in BAL fluid between responders and no-responders to PPD. 3) The compositions of CD3 (+), CD4 (+), CD3 (+) IL-2R (+), CD3 (+) HLA-DR (+) significantly increased in BAL fluid when compared with those in peripheral blood in patients with active pulmonary tuberculosis. But the composition of CDS (+), CD4/CDS were not different between BAL fluid and peripheral blood. 4) There were no correlations between response to PPD and compositions of cells and lymphocyte subtypes in BAL fluid and peripheral blood in all patients with tuberculosis, responders, and no-responders, respectively. Conclusion: From these results, we suggest no direct relationship between compositions of inflammatory cells in bronchoalveolar lavage fluid and we could not rule out the possibility of compartmentalization of activated lymphocyte involving in anergy to PPD in skin test in patients with active pulmonary tuberculosis.

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Prevention of thromboembolism with ticlopidine and aspirin after cardiac valve replacement (심장변막치환후 Ticlopidine과 Aspirin의 혈전방지 효과)

  • Kim, Gwang-Taek;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.35-42
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    • 1986
  • Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

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Pharmacokinetic Study of Isoniazid and Rifampicin in Healthy Korean Volunteers (정상 한국인에서의 Isoniazid와 Rifampicin 약동학 연구)

  • Chung, Man-Pyo;Kim, Ho-Cheol;Suh, Gee-Young;Park, Jeong-Woong;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Park, Hyo-Jung;Kim, Myoung-Min;Choi, Kyung-Eob
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.479-492
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    • 1997
  • Background : Isoniazid(INH) and rifampicin(RFP) are potent antituberculous drugs which have made tuberculous disease become decreasing. In Korea, prescribed doses of INH and RFP have been different from those recommended by American Thoracic Society. In fact they were determined by clinical experience rather than by scientific basis. Even there has been. few reports about pharmacokintic parameters of INH and RFP in healthy Koreans. Method : Oral pharmacokinetics of INH were studied in 22 healthy native Koreans after administration of 300 mg and 400mg of INH to each same person successively at least 2 weeks apart. After an overnight fast, subjects received medication and blood samples were drawn at scheduled times over a 24-hour period. Urine collection was also done for 24 hours. Pharmacokinetics of RFP were studied in 20 subjects in a same fashion with 450mg and 600mg of RFP. Plasma and urinary concentrations of INH and RFP were determined by high-performance liquid chromatography(HPLC). Results : Time to reach peak serum concentration (Tmax) of INH was $1.05{\pm}0.34\;hrs$ at 300mg dose and $0.98{\pm}0.59\;hrs$ at 400mg dose. Half-life was $2.49{\pm}0.88\;hrs$ and $2.80{\pm}0.75\;hrs$, respectively. They were not different significantly(p > 0.05). Peak serum concentration(Cmax) after administration of 400mg of INH was $7.14{\pm}1.95mcg/mL$ which was significantly higher than Cmax ($4.37{\pm}1.28mcg/mL$) by 300mg of INH(p < 0.01). Total clearance(CLtot) of INH at 300mg dose was $26.76{\pm}11.80mL/hr$. At 400mg dose it was $21.09{\pm}8.31mL/hr$ which was significantly lower(p < 0.01) than by 300mg dose. While renal clearance(CLr) was not different among two groups, nonrenal clearance(CLnr) at 400mg dose ($18.18{\pm}8.36mL/hr$) was significantly lower than CLnr ($23.71{\pm}11.52mL/hr$) by 300mg dose(p < 0.01). Tmax of RFP was $1.11{\pm}0.41\;hrs$ at 450mg dose and $1.15{\pm}0.43\;hrs$ at 600mg dose. Half-life was $4.20{\pm}0.73\;hrs$ and $4.95{\pm}2.25\;hrs$, respectively. They were not different significantly(p > 0.05). Cmax after administration of 600mg of RFP was $13.61{\pm}3.43mcg/mL$ which was significantly higher than Cmax($10.12{\pm}2.25mcg/mL$) by 450mg of RFP(p < 0.01). CLtot of RFP at 450mg dose was $7.60{\pm}1.34mL/hr$. At 600mg dose it was $7.05{\pm}1.20mL/hr$ which was significantly lower(p < 0.05) than by 450mg dose. While CLr was not different among two groups, CLnr at 600 mg dose($5.36{\pm}1.20mL/hr$) was significantly lower than CLnr($6.19{\pm}1.56mL/hr$) by 450mg dose(p < 0.01). Conclusion : Considering Cmax and CLnr, 300mg, of INH and 450mg RFP might be sufficient doses for the treatment of tuberculosis in Koreans. But it remains to be clarified in the patients with tuberculosis.

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