• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.517-525
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• 1992

Background: Since its development by Saiki et al, polymerase chain reaction (PCR) has been very useful in various fields of molecular biology. PCR can be used for the detection of a very small amount of microbial agent, and is especially useful in those patients who are difficult to diagnose microbiologically or serologically. Mycobacterium tuberculosis is a very slowly growing organism and AFB staining frequently shows false negative results, and therefore PCR would be a very rapid, easy, and sensitive diagnostic method for the diagnosis of Mycobacterium tuberculosis. Method: To compare PCR with conventional methods in diagnosing Mycobacterium tuberculosis in sputum, we used sputa of patients who visited or were admitted to Seoul National University Hospital. The amplification targets were 383 base pair DNA, a part of 2520 base pair DNA encoding 65 kD Mycobacterium tuberculosis specific protein (the primers are TB-1, -2), and 123 base pair DNA, a part of IS6110 fragment, which multiple copies are known to exsist PCR one genome (the primers are Sal I-1, -2). We also requested AFB staing and culture to the lab of Seoul National University Hospital with the same sample and compared the results. Results: 1) Using TB-1, -2 primers, PCR was positive in 73.1% (19/26) of culture positive sputa, in 12.5% (1/8) of culture negative. but clinically diagnosed tuberculous sputa, and was negative in all sputa of patients who were clinically diagnosed as non-tuberculous etiology. 2) Using Sal I-I, -2 primers, PCR was positive in 94.1% (32/34) of culture positive sputa, in 23.1% (6/26) of culture negative, but clinically diagnosed tuberculous sputa, and was negative in 87.5% (14/16) of sputa from patients who were clinically diagnosed as non-tuberculous etiology. Conclusion: PCR could be a very rapid, sensitive and specific method for the diagnosis of Mycobacterium tuberculosis in sputa, and further studies should be followed for the development of easier method.

• Tuberculosis and Respiratory Diseases
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• v.74 no.2
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• pp.79-81
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• 2013

Few recent reports have indicated that Mycobacterium massiliense causes various infections including respiratory infection. However, there is scarce information on the clinical significance, natural history of the infection, and therapeutic strategy. This report describes a case of an immunocompetent old man infected by M. massiliense that causes acute respiratory failure. In light of the general courses of non-tuberculous mycobacterium infections, rapid progression and fatality are very rare and odd. In addition, we discuss the biological and pathological properties of M. massiliense with the review of cases reported previously including our fatal one.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.863-870
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• 1988

Many varieties of space-occupying lesions can occur in the mediastinum. During the twenty-three-year period 1966-1988, we had experienced the 151 cases of primary mediastinal tumors and cysts at the Thoracic k Cardiovascular Dept., CUMC. The most common histologic types were thymomas and germ cell tumors, followed by neurogenic tumors and lymphomas. Most non-neoplastic lesions were granulomatous lesions and cysts. The mediastinal tumors were often asymptomatic, the malignant tumors in 35.4%, the benign tumors and cysts in 72.8% of the cases. The most common symptom was pain, which occurred in one-fourth of the patients. The most useful diagnostic method was X-ray examination of the chest. However, a final diagnosis could usually be made only at operation. Nine malignant tumors[30.0%] were excised radically, 17[56.7%] palliatively and 4[13.3%] were only biopsied. Almost all benign tumors except tuberculous lymphadenitis were radically excised. Fourteen patients received postoperative radiation therapy and 17 received chemotherapy. The postoperative complications were developed in 15[11.7%] and hospital mortality was 0.8%.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.958-961
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• 1999

A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.3
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• pp.158-165
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• 2006

Although Mycobacterium tuberculosis complex strains remain responsible for the majority of diseases caused by mycobacterial infections worldwide, the increase in HIV infections has allowed for the emergence of other non-tuberculous mycobacteria as clinically significant pathogens. However, Mycobacterium species has a long period of incubation, and requires serious biochemical tests such as niacin, catalase, and nitrate test that are often tedious. The development of rapid and accurate diagnostics can aid in the early diagnosis of disease caused by Mycobacterium. The current DNA amplification and hybridization methods that have been developed target several genes for the detection of mycobacterial species such as hps65, 16S rDNA, rpoB, and dnaj. These methods produce rapid and accurate results. In this study, PCR-restriction fragment length polymorphism analysis(PCR-RFLP) based on the region of the rpoB gene was used to verify the identification of non-tuburculosis Mycobacterium species. A total of 8 mycobacterial reference strains and 13 clinical isolates were digested with restriction enzymes such as Msp I in this study. The results of using this process clearly demonstrated that all 13 specimens were identified by rpoB gene PRA method. The PCR-RFLP method based on the rpoB gene is a simple, rapid, and accurate test for the identification of Mycobacterium.

• Tuberculosis and Respiratory Diseases
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• v.63 no.2
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• pp.139-144
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• 2007

Background: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. Methods: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary's hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. Results: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. Conclusion: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.3
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• pp.225-232
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• 2021

This study sought to investigate the distribution, antimicrobial resistance rate, and bacterial co-infection frequency of non-tuberculous mycobacteria (NTM) in a single center in Incheon, South Korea. A total of 8,258 specimens submitted for tuberculosis (TB)/NTM real-time PCR tests during the years 2015 to 2020 were retrospectively reviewed. In total, 296 specimens (3.6%) were NTM positive, and the positivity increased from 2.5% (30/1,209) in 2015 to 3.8% (66/1,740) in 2020. Of 296 NTM specimens, 54.7% (162/296) were identified as the Mycobacterium avium complex (MAC) followed by the Mycobacterium abscessus complex (MABC) 20.9% (62/296), M. fortuitum 6.4% (19/296) and M. flavescens 3.4% (10/296). Of the NTM-positive specimens, 76.7% (227/296) were tested for drug resistance. The results showed multidrug-resistant NTM in 40.1% (91/227) and extensively drug-resistant NTM in 59.9% (136/227) of these specimens. Of the 145 isolates taken for bacterial culture, bacteria/fungi co-infection with NTM accounted for 43.4% (63/145), in which the most common bacterial species was Klebsiella pneumonia (23.8%, 15/63). This study is the first report on the distribution and antimicrobial resistance of NTM in Incheon. As the proportion of NTM infections increases, active treatment and thorough infection control are required for effective management.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.2
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• pp.83-89
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• 2015

Although Mycobacterium tuberculosis complex strains remain responsible for the majority of diseases caused by mycobacterial infections worldwide, the increase in HIV (human immuno deficiency virus) infections has allowed for the emergence of other non-tuberculous mycobacteria as clinically significant pathogens. M. tuberculosis was detected by two-tube nested polymerase chain reaction (PCR) and non-tuberculous mycobacteria was detected by PCR-restriction fragment length polymorphism (RFLP) with Msp I. Result of niacin test is equal to result of two-tube nested PCR after culture for M. tuberculosis. In this study, acid fast bacilli stain (AFB. stain) >2+ case, Detection of Mycobacteria is similar to result before culture and after culture. AFB. stain <1+ case, result of mycobacteria is distinguished. Conclusionly, these results suggest that identification of mycobacteria must go side by side both culture and PCR for more fast and accuracy.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.20-28
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• 2018

Tuberculosis (TB) is a bacterial infection disease caused by members of the species Mycobacterium tuberculosis (MTB) complex. Approximately one third of the world's population is infected with TB. In Korea, approximately 40,000 new patients are identified each year. Moreover, infections from non-tuberculous mycobacteria (NTM) have also increased. In the diagnosis of TB and NTM, traditional bacterial cultures are required for 3 to 4 weeks. Therefore, rapid and accurate diagnostic tests for TB and NTM are needed. To distinguish between TB and NTM, a range of diagnostic methods have been developed worldwide. In vitro diagnostic assays are constantly being developed to meet the increasing need for the rapid and accurate identification for TB and NTM. On the other hand, the performance evaluations of in vitro diagnostic reagents for TB and NTM are lacking. Recently, the Korea Food and Drug Administration (KFDA) issued a guideline for in vitro diagnostic reagents for MTB and NTM. Here, this study analyzed the performance of currently developed in vitro diagnostic reagents for TB and NTM in the US FDA. This analysis of US FDA approved molecular assays could serve as a useful reference for an evaluation of the reagent performance of TB and NTM.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.19-28
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• 1975

The thoracoscopic study was reported on 21 cases of spontaneous pneumothorax requiring surgical management, and clinical values of thoracoscopic examination on spontaneous pneumothorax were also discussed. patients were treated in the Department of .Thoracic Surgery, Hanyang University Hospital for the period of two Years from May 1972 to April 1974. For exact detection of etiologic factors on spontaneous pneumothorax, the thoracoscopic examination in the intrapleural space was performed in parallel with X-ray study. this study, the difference of diagnostic and therapeutic significance between radiological and thoracoscopic findings were observed and compared simultaneously. The results are summerized as follows: Patients age was distributed between 3 and 70 years old with highest incidence in the age group of sixty decade [33. 3%], and sex ratio of male to female was 5:2. The tuberculous processes which developed superficial subpleural layer in the lung parenchyme, on the pulmonary surface could be observed by thoracoscopic examination in a characteristic picture. detection ratio of pulmonary tuberculosis by the radiologic study to that by thoracoscopy was 8:2. The adhesion between the visceral and the parietal pleura which could possibly make a rupture of the alveola and the visceral pleura was found to be localized in a small area of the lung surface. The other part of the lung surface was free of the adhesion and, therefore, the movement of the lung took place completely without any difficulty. The ruptured orifice of the pleura and pathological changes surrounding the orifice can be detected by thoracoscopy, but not by other means such as radiologic examination. A single tuberculous bleb and multiple emphysematous blebs were found on 6 cases out of 21 cases of spontaneous pneumothorax. Among these cases, radiologic Study revealed the bleb only in one patient. On the other hand, the blebs were found in all the six patients by means of thoracoscopic examination. It gives the detection ratio of bleb by radiologic study to that by thoracoscopy was 1:6. By thoracoscopy, the rupture on the lung surface were visualized on the 10 patients out of a total of 21 patients [10 patients of visual rupture]. However, the rupture of the pleura was not observed on the rest of 11 patients even by thoracoscopic examination [11 patients of non visual rupture]. Five patients [50%] out of ten who had the visual rupture on the lung surface was required a surgical operation to remove pneumothorax. For the patients who were detected to have the visual rupture of the pleura by thoracoscopy, be considered in the early stage of closed thoracostomy. of 21 patients, 16 patients [11 patients of non visual rupture of the pleura and 5 patients of visual rupture of the pleura] who received no surgical management, were treated with closed thoracostomy with continuous suction, and the` pneumothorax was healed completely up in each cases. Therapeutic measures for the remaining 5 patients of visual rupture of the pleura who were subjected to surgical approach for radical treatment of spontaneous pneumothorax were accordingly complicated, and the following different procedures were properly indicated case by case, that is, rib resection thoracostomy, simple closure of ruptured visceral pleura, wedged resection of the lung, and lobectomy.