• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.36-39
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• 2008

Although tuberculosis of the central nervous system is well known, the incidence of intramedullary tuberculomas is low and a combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of disseminated tuberculoma involving brain and spine with miliary pulmonary tuberculosis in a 66-year-old woman initially presenting with fever, general weakness, back pain and motor weakness of both lower extremities. Despite medical therapy, she developed progressive motor weakness of both lower extremities with muscle strength 1/5 in both lower extremities. Urgent surgical intervention was followed and her muscle power and motor functions were improved gradually. The anti-tuberculous drugs were continued and the follow-up magnetic resonance imaging (MRI) of brain and spine showed that the lesions had become smaller or disappeared.

• 대한미생물학회지
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• 제20권1호
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• pp.79-89
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• 1985

It is important to discriminate between tuberculosis and tuberculosis-like disease by Mycobacteria other than tuberculosis in the serodiagnosis of tuberculosis. But because common antigens share among Mycobacteria, their antigenicities to human are similar. Therefore degree of cross-reactivity of antibody in the sera of patients with tuberculosis between M. tuberculosis and Mycobacteria other than tuberculosis should be checked to increase the specificity in the serodiagnosis of tuberculosis. The activity levels of IgG antibody in the sera of 106 patients confirmed as active pulmonary tuberculosis and 30 normal healthy control person to the pressate extract antigen (TE, BE, AE, and FE antigen) from M. tuberculosis, M. bovis, M. avium, and M. fortuitum were measured by enzyme-linked immunosorbent assay and the crossreactivity of IgG antibody with mycobacterial species was analysed. The results were as follows; 1. The activity level(O.D. at 492nm) of IgG to TE antigen in sera of patients with pulmonary tuberculosis was $0.228{\pm}0.167$ in minimal tuberculosis; moderately advanced, $0.556{\pm}0.616$; far advanced, $1.116{\pm}0.651$ and $0.315{\pm}0.245$ in miliary tuberculosis. 2. The activity level (O.D. at 492nm) of IgG to BE antigen in sera of patients with pulmonary tuberculosis was $0.190{\pm}0.162$ in minimal tuberculosis; moderately advanced, $0.337{\pm}0.361$; far advanced, $0.713[\pm}0.460$ and $0.204{\pm}0.162$ in miliary tuberculosis. 3. The activity level (O.D. at 492nm) of IgG to AE antigen in sera of patients with pulmonary tuberculosis was $0.165{\pm}0.114$ in minimal tuberculosis; moderately advanced, $0.392{\pm}0.494$; far advenced, $0.751{\pm}0.512$ and $0.233{\pm}0.191$ in miliary tuberculosis. 4. The activity level (O.D. at 492nm) of IgG to FE antigen in sera of patients with pulmonary tuberculosis was $0.280{\pm}0.227$ in minimal tuberculosis; moderately advanced, $0.460{\pm}0.564$ ; far advanced, $0.845{\pm}0.573$ and $0.257{\pm}0.103$ in miliary tuberculosis. 5. The activity level (O.D. at 492nm) of IgG in sera of healthy control person was $0.126{\pm}0.084$ to TE antigen. $0.105{\pm}0.041$ to BE antigen, $0.103{\pm}0.052$ to AE antigen, and $0.095{\pm}0.061$ to FE antigen. 6. Degree of correlation(r) in activity level of IgG between TE antigen and BE antigen was 0.905 ; between TE antigen and AE antigen, 0.760; between TE antigen and FE antigen, 0.790, and between AE antigen and FE antigen, 0.945. 7. As O.D. above 0.200 was determined positive for the serodiagnosis of pulmonary tuberculosis, the sensitivity and specificity in ELISA using TE antigen were 80% and 87% respectively, whereas in the case of using BE antigen, 66% and 100%; in the case of using AE antigen, 62% and 100%, and in the case of using FE antigen, 72% and 93%, respecitively.

• Clinical and Experimental Pediatrics
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• 제45권12호
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• pp.1596-1600
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• 2002

저자들은 속립성 결핵으로 진단한 23개월된 여아에서 신경학적인 증상이 나타나기 전인 초기의 속립성 뇌결핵에서 뇌자기공명영상 소견 및 치료에 따른 경시적 호전 양상의 변화를 자기공명영상소견으로 얻었기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.455-460
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• 1996

폐기포는 폐 내부에 공기를 포함하는 공간으로 보통 1cm 이상의 크기와 2mm이하의 모발선 모양의 기포벽을 갖는다. 자연경과상 지속적으로 약화되는 양상을 보이고 자연소실 또는 호전되는 경우는 매우 드문 것으로 알려져 있다. 저자들은 임신중 발생한 속립성 결핵 환자에서 성인형 호흡곤란 증후군의 경과 후 발생한 다발성 폐기포가 자연소실된 1예를 관찰하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제49권11호
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• pp.1227-1231
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• 2006

소아에 있어서 복부 및 위장관 결핵은 매우 드문 질환이며 임상증상도 복통, 설사, 체중감소, 발열 등 비특이적이어서 크론병, 맹장염 및 다른 위장관 질환의 증상과 크게 다르지 않아 복부 질환의 진단에 있어 간과하기 쉽다. 특히 결핵성 장염은 사망률이 19-38%에 이르지만 조기에 진단, 치료하면 예후가 좋아 조기 진단의 중요성이 높다. 저자들은 복부팽만, 발열을 주소로 내원한 환아에게 속립성 폐결핵에 합병된 결핵성 장염 1례를 경험하였기에 보고하는 바이며, 아직도 결핵 유병율이 높은 우리나라에서는 위장관 증세를 호소하는 환아에게 위장관 결핵의 가능성을 고려해야 하겠다.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.513-518
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• 2009

In childhood tuberculosis, it is possible to clearly distinguish among three basic stages: exposure, infection, and disease. The incidence of tuberculosis in children is low compared with that in adults, but latent infection is a major concern because children, who are exposed to Mycobacterium tuberculosis especially early in childhood, are at increased risk of developing the disease. Younger children particularly infants have a high relative risk of miliary or meningeal disease. The clinical manifestations of childhood tuberculosis differ noticeably from those of the disease seen in adults. Adolescents with tuberculosis have different demographic and clinical features from those of adults or children. Tuberculosis in adolescents has become relatively more important as the incidence of infection in childhood has decreased.

• Tuberculosis and Respiratory Diseases
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• 제64권2호
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• pp.153-157
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• 2008

항결핵제 치료 도중 병변이 악화되거나 새로 생기는 경우 일시적인 역설적 반응과 치료 실패를 감별하는 것이 중요하다. 역설적인 반응은 폐외 결핵, 특히 림프절과 중추신경계 결핵에서 잘 나타나는데 기존의 약제를 그대로 사용하더라도 일반적으로 잘 치유가 된다. 저자들은 속립성 폐결절이 항결핵제 투여 후 호전되고 있었으나 두개강내 결절은 오히려 악화된 소견을 보였지만 치료 약제를 변경하지 않았음에도 결국 치유된 역설적 반응을 경험하였기에 이를 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제67권5호
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• pp.454-457
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• 2009

Infliximab, a TNF-${\alpha}$ antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and Behcet's disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet's disease and uveitis. We report this case with a review of the relevant literature.

• Investigative Magnetic Resonance Imaging
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• 제20권3호
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• pp.200-205
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• 2016

In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extra-axial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.

• Advances in pediatric surgery
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• 제12권2호
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• pp.244-250
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• 2006

Splenic abscess is a rare clinical condition with a reported incidence of 0.14 % to 0.70 % in various autopsy series. Primary tuberculosis of the spleen as a cause of splenic abscess is even rarer, especially in the antitubercular era. Infants and children have a higher predisposition to extra-pulmonary tuberculosis than adults and tend to develop severe extra-pulmonary disease such as miliary tuberculosis and meningitis. The diagnosis of tuberculosis in infants and children can be difficult because of nonspecific symptoms and clinical findings. Computed tomography establishes the diagnosis of splenic abscess and demonstrates the number and location of abscesses. Splenectomy is the standard of care in most clinical setting. We present a 4-year-old girl who had multiple tuberculosis splenic abscesses and was treated successfully with splenectomy.