• Tuberculosis and Respiratory Diseases
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• v.80 no.1
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• pp.27-34
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• 2017

Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days). Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.315-322
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• 2011

Background: A variety of diagnostic modalities for lung cancer have been developed. To achieve efficient and early detection of lung cancer, we tried to measure the expression rates of the melanoma associated gene (MAGE) and synovial sarcoma on X chromosome (SSX) genes. Methods: We designed primers for the SSX gene. In addition to the pre-developed MAGE A primer, using an SSX gene primer was attempted to increase the detection rate. We obtained cancer tissues and cancer-free lung tissues from resected lung, sputum from lung cancer patients who had not undergone surgery, and sputum from healthy people and patients with benign intrathoracic diseases. Results: The sensitivity of the MAGE or SSX gene RT-PCR to identifying cancer tissue of the 69 lung cancer patients was 95.2% for squamous cell carcinoma (scc), 87.0% for adenocarcinoma, and 100% for small cell carcinoma. The mean sensitivity value was 94.2% (p=0.001). For adenocarcinoma, the additional use of the SSX gene resulted in a higher expression rate than MAGE alone (87% vs. 69.6%). The expression rate for the cancer-free lung tissue was 14.3% in scc, 17.4% in adenocarcinoma, and 25.0% in small cell carcinoma. In the induced sputum of 49 lung cancer patients who had not undergone surgery, the expression rate for one of the two genes was 65.5%. The expression rate for the sputum of healthy people and benign intrathoracic diseases by MAGE or SSX gene reverse transcription polymerase chain reaction (RT-PCR) was 3.8% and 17.7%. Conclusion: Detecting lung cancer using the expression of MAGE and SSX genes in lung cancer tissue has high sensitivity.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.152-159
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• 2005

Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the $NF-{\kappa}B$ is known to be an indicator of cellular activation and of inflammatory mediator production. This study was undertaken to investigate the change of cytokine characteristics and $NF-{\kappa}B$ activity in induced sputum of COPD patients during exacerbation and recovery of the disease. Methods : Sputum induction was performed in 37 patients with COPD during exacerbation and during recovery and in 15 healthy subjects. Cell counts, levels of IL-6, IL-8 and $TNF-{\alpha}$ in induced sputum and NF-kB activity in macrophage of induced sputum were measured. Results : Patients with COPD showed significantly increased levels of IL-6, IL-8 and $TNF-{\alpha}$(p<0.01) and increased $NF-{\kappa}B$ activity in induced sputum(p<0.05) as compared with control subjects. Level of IL-8 during exacerbation of COPD decreased significantly during recovery(p<0.05). $NF-{\kappa}B$ activity and levels of IL-6 and $TNF-{\alpha}$ tended to be decreased during recovery, but not siginificantly. Conclusion : Activation of $NF-{\kappa}B$ and increased levels of IL-6, IL-8 and $TNF-{\alpha}$ were thought to be associated with pathogenesis and exacerbations of COPD.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.670-675
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• 1994

Lipoid pneumonia is a chronic inflammatory reaction of the lungs that results from the aspiration of vegetable, animal, or mineral oils. The most frequently implicated agent is mineral oil used as a laxative and to reduce dysphagia. Lipoid pneumonia is suggested when there is a history of chronic oral or intranasal use of an oil- or lipid-based product. The characteristic findings of lipid materials in CT or MRI are used in the diagnosis of lipoid pneumonia. The presence of lipid-laden macrophages in the sputum, bronchoalveolar larvage or pulmonary parenchymal biopsy confirms the diagnosis. Sputum study is simple and inexpensive. We report a case of lipoid pneumonia of 75 year old male with cough and sputum, confirmed by sputum study, and review the literature.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.158-170
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• 2001

Background : Although an oxidants and antioxidants imbalance has been considered in the pathogenesis of chronic obstructive pulmonary disease (COPD), there is a paucity of reports focussing on the smoking-induced changes of oxidants and antioxidants in COPD. Method : The concentration of antioxidants (ascorbic acid, uric acid, retinol, and $\alpha$- & $\gamma$-tocopherol) was measured in the serum and induced sputum of 30 healthy controls and 34 stable COPD patients using high performance liquid chromatography (HPLC). The inhibition of lipid peroxidation as an index of antioxidant capacity was measured in the serum by a TBA assay. Results : The serum concentration of ascorbic acid, $\alpha$-tocopherol, and retinol were significantly lower in the patients with COPD than in healthy controls ($484.8{\pm}473.3$ vs $1497.8{\pm}819.2\;pmol/L$, $48.38{\pm}17.34$ vs $73.96{\pm}26.29\;pmol/L$, p<0.001, and $9.51{\pm}8.33$ vs $15.01{\pm}5.88\;pmol/L$, p<0.05, respectively, mean$\pm$SD). However, there were little differences in the ascorbic acid and uric acid concentrations in the induced sputum between the COPD patients and the controls. The induced sputum to serum ratio of ascorbic acid was significantly higher in COPD patients compared with healthy control (0.375 vs 0.085, p<0.05). In the normal controls, the serum ascorbic acid concentration was lower in smokers than in nonsmokers ($1073{\pm}536$ vs $1757{\pm}845\;pmol/L$, p<0.05), but the level was still higher than that of the COPD patients (p<0.05). The serum retinol levels were correlated with $FEV_1$ in COPD patients (r=0.58, p<0.05). The products of lipid peroxidation were increased in normal smokers and COPD compared with norma1 nonsmokers ($115.56{\pm}19.93$ vs $120.02{\pm}24.56$ vs $91.87{\pm}20.71\;{\mu}mol/{\mu}mol$ Pi of liposome, p<0.05). Conclusion : Cigarette smoking may induce the dep1etion of serum antioxidants and this depletion of antioxidants is suggested to play a role in the pathogenesis of COPD.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.420-430
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• 2002

Background : Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. Objectives ; The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods : We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results : There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusion : The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.

• Tuberculosis and Respiratory Diseases
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• v.69 no.3
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• pp.196-200
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• 2010

Intussusception primarily occurs in children and is uncommon in adults. Moreover, intussusception caused by intestinal tuberculosis is very rare. We report a case of intussusception induced by intestinal tuberculosis. A 53-year-old man presented to our hospital with complaints of cough and sputum for 2 weeks. We started anti-tuberculosis medication as the patient's sputum acid-fast staining was positive. After 4 days of treatment, the patient developed abdominal cramping pain. Imaging studies showed ileo-ileal type intussusception. The patient underwent segmental resection of the small bowel and intestinal tuberculosis was confirmed on histological examination. He recovered after surgery and was discharged on anti-tuberculosis medication.

• The Journal of Internal Korean Medicine
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• v.24 no.2
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• pp.387-394
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• 2003

Amiodarone is an effective antiarrhythmic agent because of its vasodilator actions. Nowadays it is mostly used to treat patients with severe cardiomyopathy or coronary artery disease complicated by disturbances in the supraventricular or ventricular rhythm. But, some doctors are reluctant to prescribe it because of its many side effects. These include impairment of liver and thyroid fuction and, rarely, damage to the lungs. Most of all, its most serious side effect is amiodarone-induced pulmonary toxicity, which can occur in up to 10% of patients, with mortality rates as high as 50%. We recently experienced one case of the patient with the Amiodarone-induced pulmonary toxicity. The clinical manifestations of the patient was cough, painful breathing, fever, presence of rales, decreased breath sounds, and sputum. We report the change of the patient's symptoms through both western medical treatment and oriental medical treatment.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.4
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• pp.973-979
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• 2006

Cordyceps sinensis has been clinically used for the treatment of recovering fatigue, promoting the production of body fluid and qi, resolving sputum and arresting cough. Recent studies showed that Cordyceps sinensis produced immune-modulatory, anticarcinogenic and antioxidative effects. But, there are lack of studies regarding the effects of Cordyceps sinensis on the asthma. So, this study was performed to investigate the oral administrated effects of this herb against the disease. Asthma was induced to Balb/c mouse by i.p. injection and aerosol immunization with ovalbumin, and the change of the eosinophil number in the bronchoalveolar avage fluid(BALF) was observed. Concentrations of Interleukine-4(IL-4), Interleukine-5(IL-5) in BALF and splenocyte were assessed by ELISA, ImmunoglobinG(IgG) and ImmunoglobinE(IgE) from serum were calculated by same method. We found that the effects of Cordyceps sinensis in asthma mouse was implicated in reductions of IL-4, IL-S released from type2 T helper (Th2) cell, and decreases of IgE from plasma cell. These findings suggest that Cordyceps sinensis can produce anti-asthmatic effect, which may play a role in allergen-induced asthma therapy.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.78-84
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• 1999

Broncholithiasis is defined as a condition in which calcified material is present within the bronchial lumen. It is a rare but troublesome disease that can cause life-threatening complications such as massive fatal hemoptysis. Therefore, pulmonary resection is frequently required to remove the broncholiths and irreversibly damaged parenchyma. We experienced 3 cases of broncholithiasis. In one case, a 36 year old female patient suffered from coughing, massive hemoptysis with lithoptysis caused by intrinsic obstructive broncholiths in the right middle and lower lobe. In the 2nd case, a 41 year old male patient complained of long-standing blood tinged sputum and frequent pneumonic symptoms for 10 months because of extrinsic broncholithiasis where the calcified peribronchial lymph node eroded into the bronchial lumen of the right lower lobe. The remaining case involved a 30 year old female patient who complained of intermittent blood-tinged sputum induced by intrabronchial broncholith in the orifice of the right middle lobe bronchus. Two patients underwent bilobectomy(right middle and lower lobe) for removal of the broncholiths, damaged bronchi and parenchyma. The other patient was treated with right middle lobectomy and stone removal by bronchotomy of bronchus intermedius. In all patients, the post-operative course was uneventful.