• Title/Summary/Keyword: Miliary pattern

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$^{67}Gallium$ Scan Findings in Miliary Tuberculosis (속립성 결핵의 $^{67}Gallium$ Scan 소견)

  • Lee, Myeong-Seob;Kim, Eung-Jo;Hong, In-Soo;Sung, Ki-Jun;Park, Hyun-Ju
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.111-115
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    • 1992
  • Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse "miliary" infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body $^{67}Ga-citrate$ scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga?scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

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A Case of Miliary Tuberculosis Mimicking ARDS due to Bilateral Severe Pneumonia (양측성 중증 폐렴으로 인한 ARDS로 오진된 속립성 결핵)

  • Han, Koon Hee;Jung, Bock Hyun;Kim, Young Don;Hwang, Jung Won;Hong, Hyun Il;Yoon, Sung Kyu;Kim, Mi Hye;Ryu, Dae Sik;Kang, Gil Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.109-113
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    • 2005
  • Miliary tuberculosis is the most serious form of tuberculous disease, but is rarely complicated with acute respiratory distress syndrome (ARDS). When a patient with miliary tuberculosis initially presents with ARDS, the mortality is much higher. Therefore, the early detection of miliary tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. The diagnosis of miliary tuberculosis may be easy if the patient presents typical clinical manifestations associated with the characteristic pattern of miliary nodules on chest radiology. However, the diagnosis of miliary tuberculosis when complicated with ARDS can be difficult due to the nonspecific radiologic patterns, such as diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. However, these nonspecific patterns are known as less likely findings of miliary tuberculosis. We experienced a pregnant woman with miliary tuberculosis, mimicking ARDS due to bilateral severe pneumonia. She was admitted, via the emergency room, with sudden onset of fever, chill, cough and dyspnea. The initial chest PA and HRCT showed diffuse bilateral consolidation and ground glass opacity, without miliary nodular infiltration. All bacteriological studies, including blood and sputum cultures, tuberculosis-PCR and serologic study for infectious disease were negative. However, the definite diagnosis of unusual miliary tuberculosis as the underlying cause of ARDS was confirmed from the radiological finding and transbronchial fiberoptic lung biopsy. We report this case, with a review of the literature.

Hematologic Studies of Peripheral Blood and Bone Marrow in Miliary Tuberculosis (속립성결핵환자에서 말초혈액 및 골수의 혈액학적 소견에 대한 연구)

  • Jeong, Jae-Man;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.654-659
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    • 1995
  • Background: Tuberculosis has commonly been associated with various hematologic changes. A difference between the changes found in pulmonary tuberculosis and those found in miliary tuberculosis has been discussed. Up to now some worker were investigated hematological changes associated with pulmonary tuberculosis but was not investigated those associated with miliary tuberculosis in korea. Therefore we examimed the peripheral blood and bone marrow findings in miliary tuberculosis patients to determine hematologic changes. Methods: We performed blood sample at admission and bone marrow biopsy within 7days after admission. For evaluation of the hematologic findings, full blood counts and marrow differential counts were defined by the criteria outlined by Dacie and Lewis. Results: 1) Peripheral blood findings: Pancytopenia in 10% of patients, anemia in all patients, leukocytosis in 10% of patients, leukopenia in 20% of patients, thrombocytopenia in 30% of patients, lymphocytopenia in 90% of patients, monocytosis in 40% of patients and neutrophilia in 10% of patients were found at peripheral blood. 2) Bone marrow findings: Lymphocytopenia in 30% of patients, lymphocytosis in 20% of patients, plasmacytosis in 40% of patients, monocytosis in 100% of patients, and hypocellularity in 30% of patients were found at bone marrow. Erythropoiesis was decreased in 30% of patients. Granulopoiesis was decreased in 20% of patients and increased in 20% of patients. Bone morrow granuloma occured in 25% of patients. Conclusion: Hematologic changes of miliary tuberculosis were seen tendency of cytopenic pattern but monocyte was increased at peripheral blood and bone morrow. This findings would provide additional information for the differential diagnosis of miliary tuberculosis.

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A Case of Miliary Tuberculosis Misdiagnosed as Pneumonia and ARDS Due to the Transient Improvement after Intravenous Injection of Levofloxacin (폐렴, 급성호흡곤란증후군으로 오인되어 Levofloxacin 투여 후 호전되어 진단이 지연된 속립성 결핵 1예)

  • Lee, Go Eun;Cho, Young Jun;Cho, Hyun Min;Son, Ji Woong;Choi, Eu Gene;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.236-240
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    • 2009
  • Miliary tuberculosis is quite a rare but serious cause of acute respiratory distress syndrome (ARDS). Therefore, the early detection of military tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. We report a case of military tuberculosis mimicking ARDS. A female patient was admitted due to repeated fever and dyspnea. The initial chest CT scan showed diffuse ground glass opacity, without a miliary pattern. The case was considered to be ARDS caused by pneumonia. She showed improvement after being treated with levofloxacin. However, she was re-admitted with fever seven days after discharge. The follow up chest CT scan showed micronodules in both lungs. An open lung biopsy confirmed the diagnosis of military tuberculosis.

Congenital miliary tuberculosis in an 18-day-old boy

  • Lee, Jue Seong;Lim, Chang Hoon;Kim, Eunji;Lim, Hyunwook;Lee, Yoon;Choung, Ji Tae;Yoo, Young
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.64-67
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    • 2016
  • Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day. Chest X-ray showed diffuse fine bilateral infiltration. Clinically, pneumonia or sepsis was suspected. Respiratory symptoms and chest X-ray findings worsened despite empirical antibiotic therapy. The lungs showed miliary infiltration suggestive of TB. Gastric aspirates were positive for M. tuberculosis. Respiratory distress and fever were gradually improved after anti-TB medication. Congenital TB is difficult to detect because of minimal or no symptoms during pregnancy and nonspecific symptoms in neonates. Hence, clinicians should suspect the possibility of TB infection even if neonates have non-specific symptoms. Early diagnosis and meticulous treatment are required for the survival of neonates with TB.

A case of bullous lung disease disappeared spontaneously (자연소실의 경과를 보안 기포성 폐질환 1예)

  • Kim, Chong-Ju;Yong, Suk-Joong;Gang, Sin-Gu;Song, Gwang-Seon;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.455-460
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    • 1996
  • In general, a bulla of the lung is large, air contained sac and it is more than 1cm in diameter, and its wall is well defined and less than 2mm thick. The natural course of bulla of the lung is said to follow a pattern of progressive deterioration. It is a progressive disease, and spontaneous resolution of bulla is very unusual. In the world only two cases of spontaneous resolution of bulla have been reported. We experienced a case of bullous lung disease complicated from miliary tuberculosis in which the bulla was disappeared spontaneously following bulla infection.

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Two Cases of Mycotic Pneumonia in Dogs (개에서 곰팡이성 폐렴 2례)

  • Han Sung-young;Chun Hyeyoung;Lee Sook-jin;Na Ki-jeong;Yang Mhan-pyo;Lee Hee-chun;Chang Dong-woo
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.65-69
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    • 2005
  • A two-year-old male Laika weighing 19 kg and a two-year-old female Rottweiler dog weighing 33 kg were presented to the Veterinary Medical Center, Chungbuk National University. Chest radiographs showed miliary interstitial lung pattern in the overall lung fields and the ill-defined mass in the perihilar area, which is consistent with lymphadenopathy in both cases. In the tracheal wash fluid smears in two cases, 90% of cells were eosinophils. Also, Aspergillus fumigatus was isolated from the tracheal wash fluid in Czapek's agar in one case. Ketoconazol (10 mg/kg, PO, ql2hr) alleviated the clinical signs in two dogs. Follow up radiographs showed marked reduction of lung lesions in one case.

A Study on Punggi Rayon (풍기인견에 관한 연구)

  • Lee, Yeon;Park, Yoonmee
    • Journal of the Korean Society of Clothing and Textiles
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    • v.43 no.6
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    • pp.891-909
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    • 2019
  • This study uses a documentary survey, field survey and textile's characteristics to understand the history of the Punggi Viscose Rayon. Punggi's textile industry grew as people migrated from Pyeongan Province in the 1900s. Little is known regarding early production conditions, but documents show cottage industries in the 1940s made union cloth using silk and rayon. The Punggi weaving industry peaked after the Korean War and declined in the late 1950s. Punggi rayon at that time was mainly used for lingerie or lining, with miliary or polka dot patterns. The industry regained momentum when the power loom was introduced in the 1960s. Manufacturers also started weaving union cloth with synthetic fibers and rayon. In the 1990s, jacquard looms enabled the weaving of elaborately colored and patterned textiles for outer fabric that made Punggi rayon famous. Most Punggi rayon looms have developed in the order of manual handlooms, semiautomatic looms, Jokdapgi, to power looms. Looms equipped with dobbies or jacquard devices also changed from wooden dobby looms to wooden jacquard looms and then to iron jacquard looms. Punggi Rayon currently has its own trademark and tag, but lacks specific regulations on the blending of fibers.

Two Cases of Pulmonary Complications Following Intravesical Bacillus Calmette-Guerin Immunotherapy in Patients with Superficial Bladder Cancer (표재성 방광암 환자에서 방광내 BCG 주업치료 후 발생한 폐합병증 2예)

  • Lee, Gyeoi-Seong;Lee, Gi-Yong;Yoon, Jae-Cheol;Na, Dong-Jib;Jeong, Seong-Su;Sul, Chong-Koo;Kim, Sun-Young;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.869-878
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    • 1999
  • Intravesical instillation of the bacillus Calmentte-Gu$\acute{e}$rin(BCG), an attenuated strain of Mycobacterium bovis, is an approved method for the treatment of superficial bladder cancer. Because BCG is a living organism, the potential for infection exists. BCG is generally well tolerated, with complications in less than 5% of those treated with use of current practices. The most frequent symptoms of toxicity associated with intravesical BCG immunotherapy include bladder irritation, frequency, and dysuria. Systemic reactions are less common but more serious than local side effects, and include fever, chills, malaise, rash, hepatitis, pneumonitis, arthritis and sepsis. In rare cases, BCG treatment can result in a systemic infection that requires antituberculous therapy. The pulmonary toxicity that results from intravesical BCG treatment is generally characterized by one of two types : systemic allergic reaction with pulmonary reticulonodular opacities depicted on chest radiographs with cellular findings consisting of activated lymphocytes, and actual BCG mycobacteremia with a miliary pattern depicted on chest radiographs and granuloma formation which rarely results in positive acid-fast stain or culture results. Recently we experienced two types of pulmonary complications following intravesical BCG immunotherapy in patients with superficial bladder cancer. We report two cases with a review of literatures.

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Trends of hospitalized tuberculosis at a children's hospital during a 20-year period (1988-2007) (20년간(1988-2007) 1개 대학병원에 입원한 소아결핵 환자의 동향)

  • Yang, Mi Ae;Sung, Ji Yeon;Kim, So Hee;Eun, Byung Wook;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.59-67
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    • 2008
  • Purpose : According to the 2008 WHO report, incidence, prevalence, and mortality of tuberculosis are decreasing globally. The 7th National Tuberculosis Survey of 1995 in Korea showed that the prevalence of tuberculosis was also decreasing. This study was performed to review the hospitalized childhood tuberculosis in a children's hospital over a 20 year period. Methods : Medical records of children <16 years of age hospitalized with the diagnosis of tuberculosis at the Seoul National University Children's Hospital between 1988 and 2007 were reviewed retrospectively. Changes in number of patients and involved sites were also analyzed by four 5-year periods. Results : Out of the 186 hospitalized patients, 59.1% were male. Median age at diagnosis was 5.5 years old (range, 10 days-15 years). The main involved sites included the lung (n=54, 29%) or pleura (n=12, 6.5%), central nervous system (n=49, 26.3%), lymph node (n=15, 8.1 %), bone and joint (n=9, 4.8%), gastrointestinal tract (n=5, 2.7%) or peritoneum (n=5, 2.7%), pericardium (n=2, 1.1%) and others (n=3, 1.6%). Total 32 patients (17.2%) showed miliary pattern. The proportion of hospitalization with newly diagnosed tuberculosis among all cause hospitalization decreased from 0.61% to 0.09%, comparing the period of 1988-1992 and 2003-2007 (P<0.001) and the incidence of hospitalized tuberculosis of any involved organs also decreased with a statistical significance. Conclusion : The data from a single children's hospital suggest that the number of hospitalized childhood patients with tuberculosis has decreased over a 20 year period in Korea.

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