• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.93-98
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• 1995

Cryptococcosis is a systemic infection caused by the yeast-like fungus Cryptococcus neoformans. Respiratory tract is the usual portal of infection but relatively few cases of pulmonary cryptococcosis have been reported. Recently the incidence of the disease are increasing because the perception to seek the disease is increasing and immunocompromised hosts are more widespread with introduction of immune-suppressants, steroids and advent of AIDS. Because of nonspecific pattern of clinical manifestation, radiologic findings, differentiating the other diseases is essential and it needs fungal culture and biopsy. We describe a patient in the state of bilateral adrenalectomy due to bilateral ACTH-independent macronodular hyperplasia who developed pulmonary cryptococcosis and was later infected with pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.283-288
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• 2020

Background: Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients. Methods: Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment. Results: In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time. Conclusion: The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.143-152
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• 2017

Background: Fluoroquinolones are considered important substitutes for the treatment of tuberculosis. This study investigates the current status of fluoroquinolone for the treatment of tuberculosis. Methods: In 2009, a retrospective analysis was performed at one tertiary referral center for 953 patients diagnosed with tuberculosis. Results: A total of 226 patients (23.6%), who received fluoroquinolone at any time during treatment for tuberculosis, were enrolled in this study. The most common reasons for fluoroquinolone use were adverse events due to other anti-tuberculosis drugs (52.7%), drug resistance (23.5%), and underlying diseases (16.8%). Moxifloxacin (54.0%, 122/226) was the most commonly administered fluoroquinolone, followed by levofloxacin (36.3%, 82/226) and ofloxacin (9.7%, 22/226). The frequency of total adverse events from fluoroquinolone-containing anti-tuberculosis medication was 22.6%, whereas fluoroquinolone-related adverse events were estimated to be 2.2% (5/226). The most common fluoroquinolone-related adverse events were gastrointestinal problems (3.5%, 8/226). There were no significant differences in the treatment success rate between the fluoroquinolone and fluoroquinolone-$na{\ddot{i}}ve$ groups (78.3% vs. 78.4%, respectively). Conclusion: At our institution, fluoroquinolones are commonly used for the treatment of both multidrug-resistant tuberculosis and susceptible tuberculosis, especially as a substitute for adverse event-related drugs. Considering the low adverse event rates and the comparable treatment success rates, fluoroquinolones seem to be an invaluable drug for the treatment of tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.430-434
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• 2007

Massive and untreated hemoptysis is associated with a >50% mortality rate. Since bleeding has a bronchial arterial origin in most patients, bronchial artery embolization (BAE) has become an accepted treatment in massive hemoptysis. The possibility of bleeding from pulmonary artery should be considered in patients in whom the bleeding focus cannot be found by Bronchial angiogram. Indeed, the bleeding occurs from a pulmonary artery in approximately 10% of patients with massive hemoptysis. The most common causes of bleeding from the pulmonary artery are pulmonary artery rupture associated with a Swan-Ganz catheter, infectious diseases and vasculitis. We report a rare case of a fistula between the right upper lobar pulmonary artery and the right upper lobar bronchus in a 71-year-old woman who presented with massive hemoptysis.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.229-233
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• 2001

The incidence of complications of measles is about 4% and most of the chief complications are in the respiratory system, such as pneumonia, bronchitis. One of other potential dangers of measles is exacerbation of an existing pulmonary tuberculosis. We report a case of exacerbated pulmonary tuberculosis in 15-year old male child after contracting measles during epidemic in year 2001.

• Annals of Clinical Neurophysiology
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• v.22 no.2
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• pp.117-120
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• 2020

Miller Fisher syndrome (MFS) is characterized by the acute ophthalmoparesis, ataxia and areflexia. We describe the case of 70-year-old man with cardinal symptom of MFS and active pulmonary tuberculosis (Tb). A thorough evaluation led to the diagnosis of MFS and treatment with intravenous immunoglobulin (IVIg) was started. The complete resolution of ophthalmoparesis and ataxia was observed from the fourth day of IVIg treatment. This is the first report to describe a case of MFS that developed in patient pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.554-558
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• 1992

A 38 years old man had been treated as a pulmonary tuberculosis by the positive result of acid fast stain of bronchial washing from the focal infiltrative lesion at left lower lobe. On radiologic examination after one year treatment, there was an aggravation of lesion at left lower lobe with moderate amount of pleural effusion at the same side. After 11 weeks, follow up chest film disclosed bilateral pleural effusion. The pleural fluid of both side was pus in gross appearance with low pH, high LDH, low glucose and high protein. Pleurodectomy was performed to remove the loculated empyema with the thickened pleura of right thorax. This pleuro-pulmonary lesion can be easily misdiagnosed as a tuberculous lesion if it is not taken into consideration as a possible diagnosis.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.53-58
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• 1977

There are many procedures which treat pulmonary tuberculosis. Pneumoperitoneum of those which was begun by Banyai in 1934 is considered effective collapse therapy economically and socially in Korea. The author had studied 30 patients receiving pneumoperitoneum and/or chemotherapy who were moderatedly advanced pulmonary tuberculosis with positive sputum to AFB stain between Apt. 1, 1976 and Oct. 1, 1976. An attempt is to clarify the effects of pneumoperitoneum with chemotherapy [A group: 20 patients] in contrast with chemotherapy alone [B group: 10 patients] for 6 months. The results obtained were as follows: 1] All both groups showed the diminished pulmonary cavity size, but the effect of A group is prominent as 74% rather than 39% of B group. 2] Sputum conversion ratio is 55% in A group, and 20% in B group. 3] In Korea, the moderate amount of air is 1500cc in men, 1000cc in women. 4] Although pneumoperitoneum is in old hands, it is a relatively safe procedure, well tolerated, free from serious complications. 5] The advantages of pneumoperitoneum are evident in the treatment of bilateral lesion, with or without cavity, not too far advanced.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.452-458
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• 2005

Background : In Korea, polymerase chain reaction (PCR) test for M. tuberculosis has been used for the diagnosis of acid-fast bacilli (AFB) smear-negative tuberculosis in order to increase diagnostic sensitivity. However, there have been no data dealing with the clinical utility of PCR in AFB smear-positive patients to differentiate between M. tuberculosis and nontuberculous mycobacteria. Method : We retrospectively analyzed the PCR test results which have been performed in patients who had AFB smear-positive sputum but had ambiguous clinical manifestations of active tuberculosis. PCR test was done using $AMPLICOR^{\hat{a}}$ M. tuberculosis kit. The sensitivity, specificity, and positive and negative predictive values of the PCR test were calculated based on culture and final clinical diagnosis result. Results : Fifty-six consecutive patients (62 PCR tests) were included in the study. Active tuberculosis was diagnosed in 23 patients (41.0%), while 9 patients had NTM infection (16.0%). The sensitivity, specificity, positive- and negative-predictive value of PCR test were 88.8%, 86.8%, 76.1% and 94.3%, respectively, according to the culture result. In comparison, they were 91.3%, 100%, 100%, 94.3%, respectively, according to the final clinical diagnosis. All 15 patients with NTM isolates, including 6 patients who had other lung diseases but expectorated NTM isolate, were negative for PCR test. Conclusion : Even though tuberculosis is still prevalent in Korea, PCR test is useful to differentiate between M. tuberculosis and NTM in patients with AFB-smear positive sputum but with ambiguous clinical manifestations of active tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.823-830
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• 1995

Background: It has been found that Helper T cells in the peripheral blood are decreased in the cell mediated immunity in the pulmonary tuberculosis. But it has not been confirmed yet that only decrease in number of cells which has phenotype in the peripheral blood is defined to decrease in cell mediated immunity. The immunocytochemical study was performed to observe the change of the percentage of T-lymphocytes with their subsets and activated T cells in the peripheral blood of pulmonary tuberculosis and to know how many T cells would be activated, relative to resting cells in the peripheral blood. Methods: The peripheral blood obtained from twenty two patients and ten healthy controls were smeared on the gelatin coated slide glass prepared for of mononuclear cells. The double bridge technique of alkaline phosphatase-antialkaline phosphatase(APAAP) method was used. As the primary antibodies, $T_1$(anti-human T cell), $T_4$(anti-human helper/inducer T cells) and $T_8$(anti-human supressor/cytotoxic T cell) antibodies and interleukin-2 receptor (for early activated T cell), very late activation antigen (for activated cytotoxic T cell), T cell lineage specific activation antigen monoclonal actibodies were used. Results: 1) There were significantly decrease in the absolute number of $T_4$(+) cells but significantly increase of $T_8$(+) cells in the peripheral blood of pulmonary tuberculosis (p<0.05). 2) The percentage of $T_4$(+) cells showed significantly decrease in pulmonary tuberculosis but $T_8$(+)cells significantly increase(p<0.05). $T_4(+)/T_8(+)$ ratio showed significantly decrease in the peripheral blood of the pulmonary tuberculosis(p<0.05). 3) There were significantly increase in the absolute number of variable stages of activated T cells in the peripheral blood of the pulmonary tuberculosis(p<0.05). 4) The percentage of IL-2R, VLA-1, TLiSA were 6.45+1.56%, $7.64+1.34^*$, 10.45+1.16% in order which showed significantly increase in the peripheral blood of the pulmonary tuberculosis(p<0.05). Conclusion: We speculate that only a few percentage of T lymphocyte is activated in cell mediated immunity in pulmonary tuberculosis.