• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.201-204
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• 2014

Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that developed pulmonary embolism after percutaneous cannulated screw fixation for a greater tubercle fracture of the proximal humerus with literature review.

• Korean Journal of Veterinary Service
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• v.20 no.2
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• pp.205-215
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• 1997

In this study, homogenized mixture of tubercle and pulmonary lymph node showed up tuberculin(PPD) positive dairy cattle was inoculated in experimental animal, and was cultured on medium(Lowenstein Jensen medium, 3% Ogawa). The results obtained through the survey were sumerized as follows ; 1. In experimental animal, goat and rabbits were decreased body weight(25∼28%) and died in 90 days with severe pathogenicity. Rats are slight pathogenicity. 2. Goat, rabbits and rats showed up severe lesions In lung, rabbits was also lesions other organs (kidney, appendix, ileocecum, and I lymph node). 3. Mycobacterium was grown between 5 weeks and 8 weeks on Lowenstein Jensen medium and 3% Ogawa medium. 4. Biochemical test of Mycobacterium cultured on medium was that niacin, nitrate reduction, tween 80 hydrolysis and catalase test were negative, but that urease test was positive. Therefore it was Mycobacterium bovis (M. bovis).

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.729-741
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• 1997

Background : We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli suggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therefore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. Methods : Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes (PBM) were stimulated with LPS($10{\mu}g/ml$), H37Rv, or H37Ra($5{\times}10^5$ bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of $TNF{\alpha}$ and IL-$1{\beta}$ production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. Results : $TNF{\alpha}$ and IL-$1{\beta}$ productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in $TNF{\alpha}$ and IL-$1{\beta}$ production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. Conclusion : Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.725-729
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• 1993

A case of cavitary pulmonary tuberculosis with persistent positive bacilli due to resistant strain was treated successfully with artificial pneumothorax with antituberculosis chemotherapy. Negative conversion of Tubercle bacilli was noticed by four months on sputum smears and by 11 months on sputum cultures after the starting of artificial pneumothorax. The cavitary lesion was collapsed by 13 months. Artificial pneumothorax is one of the collapse therapies of pulmonary tuberculosis which had been used widely in the early 20th century before the era of antituberculosis chemotherapy. Nowadays, this method is almost neglected due to its inferiority in efficacy as compared to chemotherapy and complications. But we recommend considering this method when no other measure is likely to be useful in open cavitary lesion.

• Tuberculosis and Respiratory Diseases
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• v.41 no.3
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• pp.248-261
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• 1994

Background: Lectins are proteins or glycoproteins of non-immune origin that recognize a specific sequence of sugar residues. The availability of a large number of lectins has provided the capacity to identify selectively glycoconjugates possessing distinctive chemical structure in diverse sites of highly specialized biological activity. The purpose of the present study was to investigate the lectin binding patterns of various components in human pulmonary tubercles. Method: Biopsy specimens of tuberculous lung were obtained from male adult patients who underwent a surgical resection for severe pulmonary tuberculosis. The specimens were processed and stained with 13 kinds of biotinylated lectins according to some modification of Hsu and Raine's methods. Results: 1) In the caseous necrotic lesions, BS $I-B_4$ showed negative reaction and BS I were also negative except some irregularly-shaped cells located in the marginal zone. All other lectins, however, showed a positive reaction with various binding patterns. 2) The epithelioid cells were broadly divided into three groups according to the reaction patterns in the cytoplasms and cell membranes. 3) WGA, ECL, PHA-L, PHA-E and LCA showed strong staining in the lymphocytes. 4) SBA showed a different binding patterns between the endothelial layers located in the region beyond the fibrous layers and those located within the fibrous layers. 5) PNA showed a positive reaction in the outer 1/3 to 1/2 of the fibrous layer, but showed no staining in the inner 1/2 to 2/3 of the fibrous layers. Conclusion: The present lectin histochemical study provided a useful information to assess the characterization and distribution of various glycoconjugates in each constituent of human pulmonary tubercles. The results demonstrate structural differences in the glycoconjugate composition of various components of the tubercles and reveal changes in glycosylation in the components during soft tubercle formation. This study provides a new data useful for the studies on the pathogenesis and pathology of human pulmonary tubercles.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.111-115
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• 1992

Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse "miliary" infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body $^{67}Ga-citrate$ scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga?scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

• Korean Journal of Veterinary Research
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• v.48 no.2
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• pp.181-185
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• 2008

Comparative studies of histopathologic lesions from 23 purified protein derivative (PPD) positive cattle, 21 slaughter cattle found with tuberculosis, and 11 tuberculosis-positive elk (Cervus elaphus) were performed. PPD positive cattle did not show specific histopathologic lesions in all 23 heads that were no visible lesion reactor. Slaughter cattle found with tuberculosis revealed microscopically classical granulomatous lesion (tubercle) with central caseous necrosis surrounded by mantle of epithelioid cells and Langhan's giant cells capsuled by connective tissue in lung. Elk was noted with some different lesion patterns with classical granulomatous lesion and suppurative abscesses that was composed of fibrin, degenerated cells without having connective tissue. In addition, many Langhan's giant cells infiltration in alveoli at peripheral lesion were observed in some cases of classical granulomatous lesion and suppurative abscesses.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.49-58
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• 1984

The differential diagnosis of atypical mycobacteriosis caused by atypical mycobacteria (with the exception of Mycobacterium tuberculosis, Mycobacterium bovis, and Mycobacterium leprae) which are widly distributed in soil and water, from pulmonary tuberculosis is possible only when atypical mycobacteria are isolated and identified. In this investigation, attempts were made to isolate atypical mycobacteria from persons registered as tuberculosis patients in the Anyang Health Center in Anyang City, Kyungki province, Korea. Biological and biochemical tests were performed for the atypical mycobacteria isolated from these patients, also retrospective analysis of clinical and X-ray findings of the patients with bacteriologically confirmed atypical mycobacteriosis were done. The results can be summarized as follows: 1. 103 strains of mycobacteria were isolated among 334 sputum samples from patients. 2. Among the isolated mycobacteria, 10 strains (9.7%) were found to be a atypical mycobacteria and 93 strains (90.3%) were tubercle bacilli of human type. 3. On the basis of Runyon's grouping of atypical mycobacteria, there were 3 strains (30.0 %) of scotochromogen and nonphotochromogen respectively, 4 strains (40.0%) of rapid grower, and no photochromogen. 4. By biochemical tests, 3 strains of scotochromogen were identified as Mycobacterium scrofulaceum (2 strains) and Mycobacterium szulgai (1 strain) 3 strains of nonphotochromogen were Mycobacterium avium-complex (2 strains) and Mycobacterium terriae (1 strain), and 4 strains of rapid grower were Mycobacterium fortuitum (3 strains) and Mycobacterium chelonei. 5. In drug sensitivity tests, all 10 strains isolated atypical mycobacteria showed resistance to various concentration of INH and SM and low concentration (10mcg, 40mcg and 50mcg) of EB, TH, and CS, and were sensitive to only high concentration (20mcg and 100mcg) of EB, TH, CS, and RFP. 6. In analysis of clical findings by the patients with bacteriologically confirmed atypical mycobacteriosis, it was found that clinical symptoms of these patients appeared not to be mild than those of patients with pulmonary tuberculosis. The patients with atypical mycobacteriosis had been treated for pulmonary tuberculosis for a long time and they showed no improvement.

• Tuberculosis and Respiratory Diseases
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• v.38 no.4
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• pp.340-346
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• 1991

Tuberculous tracheobronchitis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus and recognized as one of the most common and serious complication of pulmonary tuberculosis. It had been a diagnostic challenge in prebronchoscopic era and since 1968, fiberoptic bronchoscopy has been accepted as a safe and valuable diagnostic procedure of tuberculous tracheobronchitis. Now, it remains a troublesome therapeutic problem due to its sequelae such as bronchostenosis, bronchiectasis and bronchial deformity. The authors analyzed the clinical features, radiological findings and bronchoscopic findings with pathologic and bacteriologic study on 61 cases of tuberculous tracheobronchitis and following results were obtained. 1) The peak incidence was in the fourth decade and male to female ratio was 1:3.4. 2) The most common symptom was cough (86.9%) and followed by sputum (49.2%), dyspnea (27.9%), fever (19.8%), weight loss (11.5%), hemoptysis (6.6%), hoarseness (6.6%) and chest discomfort (3.3%) and localized wheezing was heard in 18%. 3) In chest X-ray, consolidation with collapse was observed in 70.5%, and followed by consolidation only (18.0%), mediastinal node enlargement (8.2%), cavitary lesion (6.6%), suspicious hilar mass (3.3%) and miliary lesion (1.6%) and there was no abnormal findings in 4.9%. 4) Bronchoscopy showed hyperplastic lesion in 67.2%, mucosal lesion (18.0%), ulcerative lesion (9.8%) and stenotic lesion (4.9%). The most common site of bronchial lesion was right upper bronchus (36.1%) and followed by right main bronchus (34.4%), left main bronchus (29.5%), left upper bronchus (16.4%), right middle bronchus (8.2%), right lower bronchus (6.6%) and left lower bronchus (3.3%). 5) Chronic granulomatous inflammation with or without caseation necrosis on microscopic examination was confirmed in 69.7%, bronchial washing AFB stain was positive in 34.1%, prebronchoscopic sputum AFB stain was positive in 88.1% and postbronchoscopic sputum AFB stain was positive in 30.1%.

• Tuberculosis and Respiratory Diseases
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• v.40 no.1
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• pp.29-34
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• 1993

Background: The development of the flexible fiberoptic broncoscope by Ikeda was an important technologic advance in the diagnosis and management of patients with pulmonary disease. But, cross contamination related to fiberoptic bronchoscope was reported in cases involving tubercle bacilli, MOTT and other agents. Therefore, cleaning and disinfecting of fiberoptic bronchoscope requires careful attention. Methods: From September 1991 to May 1992, medical records of all patients with positive culture for MOTT in bronchial washing specimens were reviewed. Also to evaluate bactericidal effect of 2% glutaraldehyde, culture was performed after inoculum of MOTT, Serratia marsescens and Pseudomonas aeruginosa to the disinfectant solution. Results: In 2% alkaline glutaraldehyde, MOTT was not survived only after 30 minute exposure, but P. aeruginosa and S. marsescens were rapidly inactivated with no survivors after exposure to 2% glutaraldehyde. Since vigorous mechanical cleansing and more than 30 minute of contact time within washing machine, no more outbreak was observed. Conclusions: It is also very important that bronchoscopes must be meticulously cleaned after each procedure and more than 30 minute exposure would be required for eradication of MOTT with 2% glutaraldehyde. However even the most strictly applied infection control measures cannot exclude contamination completly and clinicians have to stay alert to this possibility. Prompt detection of pseudoepidemics is possible if abrupt increase in isolation rates, especially if they involve unusual or generally nonpathogenic organisms, are readily recognized.