• IMMUNE NETWORK
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• 제22권3호
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• pp.27.1-27.13
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• 2022

Little is known of the lung cellular immunophenotypes in patients with non-tuberculous mycobacterial lung disease (NTM-LD). Flow-cytometric analyses for the major myeloid and lymphoid cell subsets were performed in less- and more-diseased areas of surgically resected lungs from six patients with NTM-LD and two with Pseudomonas aeruginosa lung disease (PsA-LD). Lymphocytes, comprised mainly of NK cells, CD4⁺ and CD8⁺ T cells, and B cells, accounted for ~60% of all leukocytes, with greater prevalence of T and B cells in more-diseased areas. In contrast, fewer neutrophils were found with decreased number in more-diseased areas. Compared to NTM-LD, lung tissues from patients with PsA-LD demonstrated relatively lower numbers of T and B lymphocytes but similar numbers of NK cells. While this study demonstrated a large influx of lymphocytes into the lungs of patients with chronic NTM-LD, further analyses of their phenotypes are necessary to determine the significance of these findings.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.191-196
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• 2012

While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.

• Archives of Plastic Surgery
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• 제50권6호
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• pp.557-562
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• 2023

Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

• Tuberculosis and Respiratory Diseases
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• 제56권3호
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• pp.268-279
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• 2004

연구배경 : 결핵균 감염을 확인하는 방법으로 투베르쿨린 검사가 사용되고 있으나, 폐결핵을 진단하거나 배제하는데 유용성이 있는 지에 대해서는 아직까지 잘 알려져 있지 않았다. 본 연구는 폐결핵이 의심되지만 객담 도말 음성인 환자에서 투베르쿨린 검사가 폐결핵을 진단하거나 배제하는 것에 도움이 되는지와, 객담 도말 양성 환자에서 폐결핵과 NTM 폐질환을 감별하고자 할 때 도움이 되는 지를 알아보고자 하였다. 방 법 : 2002년 10월부터 2003년 8월까지 삼성서울병원 호흡기내과에 입원한 성인 환자 중 폐결핵이 감별진단에 포함된 환자 258명을 대상으로 투베르쿨린검사를 시행하여 그 결과를 분석하였다. 결 과 : 남자가 156명, 여자가 102명이었고 평균 연령은57.5세였다. 최종진단은 폐암 89명(34.5%), 폐결핵59명(22.9%), 폐렴 33명(12.8%), NTM 폐질환 24명(9.3%) 등이었다. 투베르쿨린 검사는 폐결핵 환자의 81.4%(48/59)와 비결핵성 폐질환 환자의 42.2%(84/199)에서 양성을 보였다(p<0.001). 객담 도말음성 환자 208명 중 결핵 환자의 69.4%(25/36)와 비결해성 폐질환 환자의 44.8%(77/172)에서 양성을 보여(p=0.007), 투베르쿨린 검사 양성이 폐결핵을 예측하는 민감도와 특이도는 각각 69.4%(25/36)와 55.2%(95/172)였고, 양성 예측치와 음성 예측치는 각각 24.5%(25/102)와 89.6%(95/106)였다. 폐결핵환자 31명과 NTM 폐질환 환자 19명 등 객담 도말 양성 환자 50명에서는 폐결핵 환자의 83.9%(26/31)와 NTM 폐질환 환자의 21.1%(4/15)에서 양성을 보여(p<0.001), 민감도와 특이도는 각각 83.9%(26/31)와 78.9%(15/19), 양성 예측치와 음성 예측치는 각각 86.7%(26/30)와 75.0%(15/20)였다. 결 론 : 투베르쿨린 검사는 폐결핵이 의심되지만 객담 도말 음성인 환자에서 폐결핵을 배제하는 데 그리고 도말 양성 환자에서는 폐결핵과 NTM 폐질환을 감별하는 데 임상적 유용성이 있을 것으로 사료된다.

• 항공우주의학회지
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• 제31권3호
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• pp.77-81
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• 2021

Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P<0.001). The positive ratio of NTM and abnormal chest X-ray (CXR) which required sputum tests among the applicants over 15 years old has trends to increase with age. The age groups of over 70 years showed high positive rate in NTM and abnormal CXR (4.10%, 20.51%). However, ages 15 to 49 years groups showed 0.00% to 0.30% in NTM and 1.08% to 3.91% in abnormal CXR. In the study population, the positive rates of STIs were 0.03%, 0.08%, and 0.74% in gonorrhea, syphilis, and chlamydia, respectively. Among the participants who underwent sputum smears and cultures were just 1 case of active tuberculosis (0.03%) and 25 cases of NTM infection (0.66%). Conclusion: This study found that rate of positivity in tuberculosis and STIs screening among South Korean applicants for US visa in 2016 to 2020. Regarding tuberculosis, the positivity of CXR among the aged 15 to 59 years applicants was lower than that among over 60 years old. Among 2 to 14 years, positivity of IGRA was very low. And IGRA test can reduce effort of further evaluation compared to TST test in South Korea, so IGRA test among young adults can be useful. High positive rates in STI among young adult could result in high active sexuality, especially chlamydia infection is most common. Therefore Chlamydia polymerase chain reaction should be considered formal protocol among the Korean applicant for US visa.

• 한국방사선학회논문지
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• 제15권1호
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• pp.55-61
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• 2021

방사선 촬영실은 감염원을 지닌 환자와 간접적인 접촉이 빈번하게 일어나 2차 감염에 노출될 위험성이 높다. 따라서 본 연구는 흉부 X선 촬영을 대상으로 방사선사와 환자가 빈번하게 접촉하는 부위를 4급 암모늄세정제 중 하나인 에니오설프(ANIOS, ANIOSURF Premium NPC)를 이용하여 소독 전, 후의 미생물을 채z취한 후 비교하였다. 2020년 9월 1일부터 9월 7일까지 대구광역시 P병원을 대상으로 X-ray tube handle, Chin rsgion, Chest region, Palm region을 수송배지(TransystemTM, Copan Diagnostics Inc., Murrieta, CA, USA) 내의 멸균면봉을 사용하여 10×10㎠ 크기로 채취한 후 비색법을 통해 소독 전, 후 동정결과를 획득하였다. 그 결과 X-ray tube handle의 경우 Proteus mirabilis, Staphylococcus epidermidis, Bacillus spp., Candida spp이 검출되었고, Chin region의 경우 Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, NTM이 검출되었고, Chest region의 경우 Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa이 검출되었고, Palm region의 경우 NTM, Candida spp.이 검출되었으며 공통적으로 103 CFU(Colony Forming Unit) 이상이 측정되었다. 소독 후 Chest region, Palm region에서는 미생물이 검출되지 않았고 X-ray tube handle에서만 Bacillus spp.이 검출되었으며 102 CFU 이상이 측정되었다. 소독 전 검출된 미생물은 대부분 기회감염균의 일종으로 소독 후 이러한 미생물의 수가 줄어들거나 제거되는 것을 통해 에니오설프(0.25%)는 에탄올(ethanol, 70~90%)와 이소프로필 알코올(Isopropyl alcohol, 70~90%)과 비교하였을 때 우수한 경제성과 유사한 소독효율을 보였다. 하지만 소독 후 Bacillus spp.가 검출됨에 따라 아포균에 대한 심화된 연구가 필요하다고 생각된다. 본 연구는 방사선 검사실 내 감염관리의 중요성을 재고하였으며 병원 내 2차 감염을 예방하기 위한 유용한 기초자료로 사용될 것으로 사료된다.

• 한국항공우주학회지
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• 제44권5호
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• pp.391-398
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• 2016

본 연구에서는 난류 유입조건을 갖는 수평축 풍력터빈 블레이드의 공력 하중에 대해 초점을 맞추어 연구하였다. 난류모델은 풍속과 방향에 대한 변동을 포함하며, 그 특성은 난류 강도와 표준편차로 표현된다. IEC61400-1에서는 정상 난류 모델과 정상 풍속 측면도에 대해서 피로해석을 수행하도록 규정하고 있다. 이를 위해 공력 최적설계 절차를 통해 얻어낸 MW급 수평축 풍력터빈 블레이드 허브와 저속 회전축에 대한 공력하중 해석을 수행한다. 공력하중 성분은 수치적인 절차를 통해 얻어내며 이를 블레이드 회전 특성을 고려하여 해석적으로 검토하였다. 난류 조건을 고려했을 때의 최대 추력과 토크의 변동치는 난류 조건을 고려하지 않았을 때의 값들에 비해 5~8 배 더 큰 값을 보였다. 따라서 난류 조건을 반영한 하중 해석은 풍력터빈 블레이드의 구조설계에 있어서 필수적임을 확인하였다.

• 한국산업보건학회지
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• 제33권3호
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• pp.355-364
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• 2023

Objectives: The objective of the present study was to identify mycobacterial infection in retired dusty workers who were ineligible for medical care benefits for work-related pneumoconiosis. Methods: Sputum samples were collected from 170 retired dusty workers living in Gangwon-do. The mycobacterial culture was grown in 2% Ogawa medium and Mycobacteria Growth Indicator Tube(MGIT). Mycobacterial species were identified using MolecuTech REBA Myco-ID^Ⓡ. Results: Thirty-one(18.2%) out of 170 sputum samples were identified as positive for culture. Among the positive culture samples, eleven(6.5%) were identified as mycobacterial species. The proportion of mycobacteria was M. avium 2.3%(4/170), M. fortuitum complex 1.2%(2/170), M. intracellulare 1.2%(2/170), M. abscessus 0.6%(1/170), M. tuberculosis(MTB) complex 0.6%(1/170), and MYC(NTM except 19 species) 0.6%(1/170). Conclusions: In comparison with previous studies, the incidence rate of tuberculosis(TB) in retired dusty workers who were ineligible for medical care benefits for work-related pneumoconiosis was higher than in close contact with TB patients, workers exposed to silica, and patients with silicosis. And the proportion of non-tuberculosis mycobacteria(NTM) was higher than that of MTB.

• Journal of Korean Neurosurgical Society
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• 제50권5호
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• pp.460-463
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• 2011

There are few reported cases of post-operative spondylitis caused by $Mycobacterium$ $Intracellulare$. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, $Mycobacterium$ $Intracellulare$ was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.

• Tuberculosis and Respiratory Diseases
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• 제58권5호
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• pp.452-458
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• 2005

연구 배경 : 결핵의 유병률이 낮고 상대적으로 비결핵항산균증의 유병률이 높은 미국에서는 항산균 도말 양성 호흡기 검체에서 결핵의 진단 목적으로 결핵균 PCR 검사가 공인되었다. 최근 국내에서도 비결핵항산균증이 증가하고 있는 추세로 객담 도말 양성 환자에서 결핵균과 비결핵항산균의 신속 감별이 중요할 것으로 사료된다. 객담 항산균 도말 양성이지만 임상적으로 결핵균과 비결핵항산균과의 감별이 필요한 경우에 결핵균 PCR의 시행이 배양 결과 전 신속한 감별에 도움이 되는지 알아보고자 본 후향적 연구를 시행하였다. 방 법 : 항산균 도말 양성이지만 비결핵항산균과의 감별을 위해 결핵균 PCR 검사가 시행된 56명의 의무기록을 조사하여 결핵균 PCR 결과, 배양 결과 및 최종진단을 확인하여 결핵균 PCR의 유용성을 검증하였다. 결 과 : 총 56명의 환자에서 62회의 PCR이 시행되었다. 환자의 평균 나이는 58.7세(범위 22-83세)이었다. 최종진단은 결핵 23명(41.0%), 비결핵항산균 폐질환 9명(16.0%), 기타 폐질환 24명(42.8%)이었다. 배양 양성을 기준으로 PCR 검사의 결핵 진단의 민감도, 특이도, 양성예측도, 음성예측도는 각각 88.8%, 86.8%, 76.1%, 94.3%이었고, 최종 임상진단을 기준으로는 각각 91.3%, 100%, 100%, 94.3%이었다. 비결핵항산균이 배양된 15명(26.7%)은 모두 PCR 음성이었다. 결 론 : 결핵의 발병률이 중등도인 국내에서도 항산균 도말양성이지만 비결핵항상균과의 감별이 필요한 경우에 결핵균 PCR검사는 배양검사 전 신속한 감별에 유용하였다.