• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.452-456
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• 2012

Disseminated Mycobacterium avium complex (MAC) infection can occur in immunocompromised patients, and rarely in immunocompetent subjects. Due to the extensive distribution of the disease, clinical presentation of disseminated MAC may mimic malignancies, and thorough examinations are required in order to make accurate diagnosis. We report a case of disseminated Mycobacterium intracellulare disease in an immunocompetent patient, which involved the lung, lymph nodes, spleen, and multiple bones. F-18 fluorodeoxyglucose positron-emission tomography imaging showed multiple hypermetabolic lesions, which are suggestive of typical hematogenous metastasis. However, there was no evidence of malignancy in serial biopsies, and M. intracellulare was repeatedly cultured from respiratory specimens and bones. Herein, we should know that disseminated infection can occur in the immunocompetent subjects, and it can mimic malignancies.

• Tuberculosis and Respiratory Diseases
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• 제59권6호
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• pp.606-612
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• 2005

배 경: 최근 국내의 연구에 의하면 객담 항산균 도말검사에 양성을 보인 환자들 중 NTM 분리비율이 약 10%정도로 NTM 폐질환의 중요성이 증가하고 있다. 국립 마산 결핵 병원의 경우 타 병원에 비해 초치료 환자 보다 재치료 및 다제 내성 결핵 환자의 비율이 높고 이런 환자들에 있어서 NTM 폐질환의 여부 및 원인균에 대한 연구가 필요할 것으로 생각된다. 대상 및 방법 : 2002년 8월부터 2003년 7월까지 본원에서 객담 및 기관지 세척액 등 호흡기 검체를 통해 항상균 도말 및 배양검사가 의뢰된 검체에서 NTM이 분리된 환자들을 대상으로 하였다. NTM 폐질환의 진단은 미국흉부학회 진단 기준을 이용하였으며 환자들의 원인균, 임상적 및 방사선적 특징과 NTM 폐질환 발생과 치료성공에 연관된 인자에 대하여 후향적으로 조사하였다. 결 과 : 57명의 환자로부터 의뢰된 100개의 호흡기 검체에서 NTM균이 분리되었다. 미국 흉부학회의 NTM 폐질환 진단 기준에 따라 57명의 환자 중 26명(45.6%)가 NTM 폐질환을 가지고 있었으며 원인균은 M. intracellulare 19명(73.1%), M. abscessus 5명(19.2%), M. fortuitum 1명(3.8%), M. chelonae 1명(3.8%)의 순이었다. 균종에 따른 발병력은 M. intracellulare 67.9%(19/28명), M. abscessus 41.7%(5/12명)로 높았으며 M. fortuitum 14.3%(1/7명), M. chelonae 25%(1/4명)였다. NTM 폐질환 발생과 연관된 인자는 객담 도말양성(odds ratio=6.3, p=0.02), 분리된 균이 MAC 또는 M. abscessus인 경우(odds ratio=6.9, p=0.007)와 관련되어 있었다. NTM 폐질환 환자의 치료성공률은 57.7%(15/26명)이었으며 치료성공과 관련된 인자는 관찰할 수 없었다. 결 론 : 본원의 NTM이 분리된 환자 중 NTM 폐질환 비율은 높았으며 원인균에 있어서 MAC, M. abscessuss순이었다. 그리고 NTM 폐질환 발생과 연관된 인자는 객담 도말양성, 분리된 균이 MAC 또는 M. abscessus인 경우와 관련되어 있었다.

• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.242-249
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• 2004

연구배경 : 기관지확장증을 가진 환자의 객담에서 NTM이 분리되는 경우 집락상태와 폐침범을 구별하는 것은 쉽지 않다. 본 연구는 기관지확장증과 다발성 결절이 관찰되는 환자에서 NTM 폐질환을 진단하는데 기관지 내시경술의 유용성을 알아보고자 하였다. 대상 및 방법 : 2002년 4월부터 2003년 6월까지 흉부 전산화단층촬영에서 기관지확장증과 동반된 다발성 결절로 NTM 폐질환이 의심되어, 기관지내시경을 통해 기관지폐포세척술과 경기관지폐생검을 시행한 48명의 환자를 대상으로 후향적 조사를 시행하였다. 결 과 : 48명의 환자 중 여자가 34명(71%)이었고, 연령은 중앙값 60세(범위 21-80세)였다. 최종진단은 NTM 폐질환 26명(54%; M. abscessus 14명, MAC 12명), 기관지 확장증에 동반된 비특이적 세기관지염 15명(31%), 폐결핵 3명(6%) 등이었다. 기관지내시경 시행 전 객담에서 3회 이상 NTM이 분리된 환자 21명 중 6명(29%)에서 경기관지폐생검 조직 도말 양성, 14명(67%)에서 조직 배양 양성, 5명(24%)에서 육아종이 관찰되어 전체적으로 16명(76%)에서 NTM 폐 침범의 소견을 확인하였다. 객담검사만으로 NTM 폐질환을 진단하지 못한 27명의 환자 중 3명의 폐결핵 환자를 제외한 24명의 환자 중 5명(21%)에서 기관지내시경 검사를 통해서 NTM 폐질환을 진단할 수 있었다. 시술 후 발열이 25명(52%), 기흉이 1명(2%)에서 발생하였다. 결 론 : 흉부 전산화단층촬영에서 기관지확장증과 동반된 다발성 결절이 관찰되면서 객담에서 NTM이 여러 차례 분리되는 환자에서 기관지내시경술은 NTM의 폐조직침범을 확인하는데 도움이 될 수 있으며, NTM 폐질환이 의심되지만 객담검사만으로 NTM 폐질환 진단기준을 만족하지 못하는 환자에서 기관지내시경술은 NTM 폐질환의 진단에 도움이 될 수 있을 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제40권5호
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• pp.483-494
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• 1993

석탄산으로 사멸한 균으로 감작시켜 얻은 토끼 항혈청으로 주요 병원성 mycobacteria의 세포 표면항원간의 항원적 상관관계를 효소결합면역분석법으로 관찰하였다. M, avium-intracellulare(MAI) 항혈청을 이용한 동종 및 이종반응 분석결과를 보면 동종내 항원적 상관관계는 매우 가깝고 M. scrofulaceum(MG)을 포함하면 MAIS군내 종간 항원적 관계도 가까웠다. MAI 혈청이 M. chelonei(MC), fortuitum(MF), nonchromogenicum(MNC), terrae(MTR) 및 triviale(MTV)와는 반응하지 않거나 미약하게 반응하지만 M. kansasii(MK)와 결핵균과는 강하게 반응했다. 그러나 후자의 두균종으로 흡수해도 MAI 혈청의 동종반응은 감소되지 않았다. M. avium(MA) (K40004) 항혈청은 M. intracellulare(MI) 균주를 제외한 다른 균들과는 미약하게 반응했고 항원적 상관관계가 가까운 MI와 MG로 흡수하면 동종반응의 50~89%가 감소했다. MI 혈청의 종내반응이 종간반응보다 물론 더 강하지만 공유항원량의 크기에 따라 달랐다. MI균주 중 N-260D, N-260R, N-260T 및 K41014간의 항원적 상관관계가 N-242D, N257T, N281D 및 N275T와의 관계보다 더 가깝게 나타났다. MNC 항혈청은 MC와 MTV를 제외하고는 강한 교차반응을 보여주었다. 종내 항원적 상관관계 다음으로는 MTR와 MG(K30003)과 가까웠다. NC-3 혈청은 MA, MC 및 MF와 상당한 반응력을 나타내지만 NC-11은 그렇지 않았다. MTR 항혈청은 MI와 강하게 반응하지만 MI로 흡수한다고 해서 그들의 동종반응이 감소하지 않는 것으로 보아 MTR 표면에 공유항원이 많지 않음을 보여주었다. MTR과 MNC, MC 및 MF 사이에도 상당량의 공유항원이 있음이 알려졌다. MTR 가운데 T-8 혈청과는 달리 T-13 항혈청은 MA, MG, MK 및 MTB와 강하게 교차반응하였다. 이상의 실험으로 밝혀진 mycobacteria의 항원적 상관관계가 각종 생물학적 및 생화학적 방법으로 갈라놓은 분류군과 잘 일치하고 있었다.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.71-79
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• 2015

Background: Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. Methods: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. Results: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. Conclusion: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

• 대한수의학회지
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• 제16권2호
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• pp.151-158
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• 1976

The tuberculin test have been widely utilized to diagnose tuberculosis of the dairy cattle. It was reported that approximately 70% of the dairy cattle with positive tuberculin reaction in Korea had been non-pathogenic lesion. So the studies on the specific method to diagnose tuberculosis of them is really need in Korea. Therefore this study investigated upon the diagnostic method for cattle tuberculosis in the aspect of cellular-immunology. The results obtained in this investigation are summarized as follows: 1. All the tuberculin tests to the swine inoculated with BCG.(B group), Mycobacterium avium (A group) and Mycobacterium smegmatis (S group), respectively, were represented high positive reaction and were no differences in the species of inoculated bacteria. 2. In the migration inhibition test using Iymphocyte in circulating blood of the swine inoculated with three species of acid-fast bacteria respectively, the test to A group was represented slight positive for migration in the presence of $15{\mu}g/ml$-PPD and the other reaction were clear and total positive for migration inhibition in the presence of $25{\mu}g/ml$-PPD or more, and the test to B group was the same results as to A group approximately. The test to S group was represented slight positive for migration inhibition in the presence of $15{\mu}g/ml$-PPD, but the results were the same in the presence of $25{\mu}g/ml$-PPD and $35{\mu}g/ml$-PPD. These results showed that there were remarkable differences between group A, B and group S in the presence of $25{\mu}g/ml$-PPD and $35{\mu}g/ml$-PPD. 3. The transformation rates of lymphocyte in PPD treated tissue culture had no significance without any relation between PPD treatment and non-treatment but A group and B group showed significance. And A group and B group showed high significance in comparison with N group and S group in the LSD examination. 4. The infection rated in lymphocyte of BCG inoculated after 3 days tissue culturing were represented those of high infection but its cellular degeneration rates almost did not change. The infection rates in bacilli in N group and S group were low but after 3 days inoculation it shewed higher cellular degeneration.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.141-146
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• 2020

Background: The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). Methods: The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. Conclusion: NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.

• 한국동물위생학회지
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• 제45권2호
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• pp.117-124
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• 2022

In the event of an outbreak of a livestock epidemic, it has been considered that the existing burial-centered carcass disposal method should be improved ecofriendly for prevention of leachate and odors from burial basically in regard of pathogen inactivation. Therefore, the aim of this study is whether it was possible to treat the carcass of cattle and chickens using the chemical carcass treatment method. It was conducted to establish detailed treatment standards for the chemical treatment method of cattle and chicken carcasses based on the results of the proof of the absence of infectious diseases in cattle chickens. After inoculating cattle carcass with 10 pathogens (foot and mouth disease virus, bovine viral diarrhea virus, Mycobacterium bovis, Mycobacterium avium subsp. Paratuberculosis, Brucella abortus, Bacillus anthracis, Clostridium chauvoei, Clostridium perfringens, Escherichia coli, and Salmonella Typhimurium) and chicken carcasses with low pathogenic avian influenza virus, Clostridium perfringens type C, E. coli and Salmonella Typhimurium, these were treated at 90℃ for 5 hours in a potassium hydroxide liquid solution corresponding to 15% of the body weight. This method liquefies all cadaveric components and inactivates all inoculated pathogens by PCR and culture. Based on these results, it was possible to prove that chemical treatment of cattle and chicken carcasses is effective in killing pathogens and is a safe method without the risk of disease transmission. The chemical treatment method of livestock carcasses can be suggested as an alternative to the current domestic burial-centered livestock carcass treatment method, preventing environmental pollution, and contributing to public health.

• 한국동물위생학회지
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• 제36권1호
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• pp.31-36
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• 2013

Mycobacterium avium subsp. paratuberculosis is the pathogen of paratuberculosis called Johne's disease. Johne's disease is hardly eliminated because of its long latent period and continuous dissemination, so it is found in ruminants worldwide and can cause substantial economic losses in cattle. It has been reported in many studies on the distribution of Johne's disease in some provinces of Korea that not many, but noticeable numbers of infected cows have been detected since the first detection in 1984. The aims of this study was to investigate the prevalence of Johne's disease obtained from slaughtered cattle in central area of Gyeongnam province, Korea. In this study, the ELISA serum antibody test and PCR were employed on a total of 240 blood and ileac substrate samples from slaughtered cattle in two slaughtering and wholesale centers in Gyeongsangnam-do Livestock Veterinary Research Institute Central Branch. Out of the entire 240 blood samples, three (1.3%) were positive by ELISA, while five (2.1%) were suspected cattle. But ileac substrate samples, eight (3.3%) were positive by PCR. By breeds, positive rates of ELISA and PCR in Korean native cattle were 1.3% and 3.5%, respectively, but no positive cows were found in dairy cattle. By provinces, sero-positive rates of Gyeongnam and Gyeongbuk were 1.6% and 1.3%, respectively. And PCR positive rates of Gyeongnam, Gyeongbuk and other provinces were 2.4%, 5.0% and 2.8%, respectively. These results indicate that it requires the nationwide monitoring test and measure to deal with subclinically infected slaughtering cows.

• 한국동물위생학회지
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• 제34권4호
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• pp.303-311
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• 2011

Prevalence of infectious agents, including Brucella abortus (BA), Mycobacterium bovis (MB), bovine leukemia virus (BLV), M. avium subsp. paratuberculosis (MP), Neospora caninum (NC) and Toxoplasma gondii (TG), was investigated in all the cattle raised in Ulleung island during 2007~2010. For BA, the prevalences in head and farm were 8.1% (44/545) and 5.5% (4/73) in 2007, all negative in 2008~2009, and 0.5% (4/774) and 1.7% (1/58) in 2010, respectively. For MB, no sample was positive by PPD or ELISA in 2007~2010. For BLV and MP, no sample was positive by ELISA in 2007~2009. For NC, seroprevalences in head and farm were 0.2% (1/545) and 1.4% (1/73), respectively, in 2007 and all negative in 2008~2009. For TG, seroprevalences in head and farm were 17.6% (97/552) and 54.8% (34/62) by ELISA in 2009. By regions, the seroprevalences of TG in Ulleung-eup, Seo-myeon and Buk-myeon were 26.0%, 9.8% and 16.7%, respectively, which had significant differences (P<0.0001). Tiger cattle were more resistant to TG infection than Hanwoo. The seroprevalence of TG in summer was higher than in autumn. The seroprevalence of TG in cows was higher than in oxen. The seroprevalence of TG in cattle was increased with age. In conclusion, this study indicates that the prevalences of six infectious diseases, except for TG which are widely spread, are relatively low in cattle reared in Ulleung island.