• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.151-157
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• 2019

Background: Tuberculosis (TB) is the most important disease screened for upon patient history review during preimmigration medical examinations as performed in South Korea in prospective immigrants to certain Western countries. In 2007, the U.S. Centers for Disease Control and Prevention (CDC) changed the TB screening protocol from a smear-based test to the complete Culture and Directly Observed Therapy Tuberculosis Technical Instructions (CDOT TB TI) for reducing the incidence of TB in foreign-born immigrants. Methods: This study evaluated the effect of the revised (as compared with the old) protocol in South Korea. Results: Of the 40,558 visa applicants, 365 exhibited chest radiographic results suggestive of active or inactive TB, and 351 underwent sputum tests (acid-fast bacilli smear and Mycobacterium tuberculosis culture). To this end, using the CDOT TB TI, 36 subjects (88.8 per $10^5$ of the population) were found to have TB, compared with only seven using the older U.S. CDC technical instruction (TI) (p<0.001). In addition, there were six drug-resistant cases which were identified (16.7 per $10^5$ of the population), two of whom had multidrug-resistance (5.6 per $10^5$ of the population). Conclusion: The culture-based 2007 TI identified a great deal of TB cases current to the individuals tested, as compared to older U.S. CDC TI.

• The Journal of the Korean Society for Microbiology
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• v.21 no.4
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• pp.435-439
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• 1986

The viability of tubercle bacilli in the sputum specimens has been investigated after different periods of storage at diffeent temperatures and in the presence of different preservatives. No loss of culture positives was observed for one week storage at $4^{\circ}C$, but 9.8% 19.5%C, and 26.8% of sputums failed to yield positives on 2, 3, and 4 weeks of storage respectively. At $25^{\circ}C$ even one week storage made 19.5% of sputums fail to yield positive culture and 2, 3, and 4 weeks of storage made 36.6% 70.7%, and 90.2% of sputums fail to yield positive culture respectively. And contamination was unacceptably high beyond one week of storage at $25^{\circ}C$. Contamination of sputum specimens could be protected fairly well by 0.5% boric acid, by 5% trisodium phosphate or by 0.5% cetylpyridium chloride, but, except CP, the former two had no advantage at all to protect viability of tubercle bacilli over the specimens without preservative. The CP was much less harmful to the viability of tubercle bacilli than BA, yielding 61.0% and 31.7% of culture positives on 3 and 4 weeks of storage in the presence of CP, while BA yielded 34.1% and 4.9% of positives on the same respective periods of storage. Therefore CP may be useful to preserve sputums if it takes more than 2 weeks to transport them at the temperature of over $25^{\circ}C$.

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.87-93
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• 1982

Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.

• Korean Journal of Veterinary Research
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• v.1 no.1
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• pp.72.2-72.2
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• 1961

Since April, 1957, 200 White Leghorn and 100 Newhampshire had been brought to the poultry farm of our college from Songwhan National Breeding Station. The looses due to avian tuberculosis were 67 chickens by June, 1959. Thirteen of them were examined histopathologically. Grayish white tuberculous nodules varying in size were recognized in the liver, spleen, bone marrow, and intestine of all affected birds. The heart rind testis were involved in each case, and pulmonary tuberculosis which, unlike in mammals, was kown to be rarely encountered in birds was observed in two cases. One case showed amyloid like degeneration in hepatic cell cords of the liver, glomerular tufts and collecting ducts of the kidney. Lesions in the spleen presented typical Sago spleen. Sections from the liver, spleen, intestine, and lungs were stained by Ziel-Neelsen stain. Acid Fast stained bacilli were found embeded in the cytoplasm of epithlioid cells and foreign-body giant cells.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.408-411
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• 2021

Tuberculosis (TB)-infected giant bullae are rare. A 55-year-old man was referred when an infected bulla did not respond to empirical treatment. Computed tomography showed a giant bulla in the right upper lobe with an air-fluid level and surrounding infiltrate. Sputum culture, acid-fast bacilli (AFB) stain, and polymerase chain reaction (PCR) for TB were negative. Percutaneous drainage of the bullous fluid was performed. AFB stain and PCR were positive in the drained fluid. The patient was given anti-TB drugs and later underwent obliteration of the pulmonary cavity using talc. To summarize, we report a patient with a TB-infected giant bulla that was treated successfully with anti-TB drugs and obliteration of the pulmonary cavity using talc.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.5-16
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• 2002

Background : Though mononuclear phagocytes serve as the final effectors in killing intracellular Mycobacterium tuberculosis, the bacilli readily survive in the intracellular environment of resting cells. The mechanisms through which cellular activation results in the intracellular killing is unclear. In this study, we sought to explore an in vitro model of a low-level infection of human mononuclear phagocytes with MAC and $H_{37}Ra$ and determine the extent of the lymphocyte dependent cytotoxicity of human monocytes and alveolar macrophages. Materials and Methods : The peripheral monocytes were prepared using the Ficoll gradient method from PPD positive healthy people and tuberculosis patients. The alveolar macrophages were prepared from PPD positive healthy people via a bronchoalveolar lavage. The human mononuclear phagocytes were infected at a low infection rate (bacilli:phagocyte 1:10) with MAC(Mycobacterium avium) and Mycobacterium tuberculosis $H_{37}Ra$. Non-adherent cells(lymphocyte) were added at a 10:1 ratio. After 1,4, and 7 days culture in $37^{\circ}C$, 5% CO2 incubator, the cells were harvested and inoculated in a 7H10/OADC agar plate for the CFU assay. The bacilli were calculated with the CFU/$1{\times}10^6$ of the cells and the cytotoxicity was expressed as the log killing ratio. Results : The intracellular killing of MAC and $H_{37}Ra$ within the monocyte was greater in patients with tuberculosis compared to the PPD positive controls (p<0.05). Intracellular killing of MAC and $H_{37}Ra$ within the alveolar macrophage appeared to be greater than that within the monocytes of the PPD positive controls. There was significant lymphocyte dependent inhibition of intracellular growth of the mycobacteria within the monocytes in both the controls and tuberculosis patients and within the macrophages in the controls(p<0.05). There was no specific difference in the virulence between the MAC and the $H_{37}Ra$. Conclusion : This study is an in vitro model of a low-level infection with MAC and $H_{37}Ra$ of human mononuclear phagocytes. The intracellular cytotoxicity of the mycobacteria within the phagocytic cells was significantly lymphocyte dependent. During the 7 days culture after the intracellular phagocytosis, the actual confinement of the mycobacteria was observed within the monocytes of tuberculosis patients and the alveolar macrophages of the controls as in the case of adding lymphocytes.

• 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.

• The Korean Journal of Medicine
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• v.93 no.6
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• pp.509-517
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• 2018

A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment of LTBI are important for tuberculosis (TB) control in public and private healthcare facilities, particularly in high-risk populations. The updated 2017 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of them can be used for the diagnosis of LTBI, depending on the age and immune status of the patient as well as their TB contact history. For diagnosis of LTBI, exclusion of active TB is essential, and the possibility of healed TB in those without a history of treatment for TB but at risk of its development must be considered. The treatment options for LTBI include isoniazid, rifampicin, isoniazid/rifampicin, and isoniazid/rifapentine. The benefits and risks of these agents based on the age of the patient and their hepatotoxicity must be considered when selecting the appropriate drug. Standardized diagnosis and treatment of LTBI based on the updated 2017 guidelines will contribute to the control of TB in Korea as well as to further revisions of the guidelines.

• The Journal of the Korean Society for Microbiology
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• v.18 no.1
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• pp.99-110
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• 1983

Four cases of pulmonary pseudallescheriasis in patients with healed pulmonary tuberculosis are described. All four patients had a long history of antituberculous chemotherapy for pulmonary tuberculosis, but continuous sputum negativity for acid fast bacilli indicated apparent recovery from tuberculosis. They, however, complained continued intermittent hemoptysis and chronic cough. Although their chest roentgenograms did not show a clearcut mycetomal shadows in preformed cavitary lung lesions, Pseudallescheria boydii or Scedosporium apiospermum was repeatedly isolated from serial sputum specimens collected at different days for a period of over half an year or two years and their serial serum specimens produced precipitin bands with home-made antigen from 8-week old culture filtrate of P. boydii. Second fungus was isolated from sputum specimens of two patients and one was Candida albicans and the other was Aspergillus fumigatus. Sera from both patients reacted with antigens of those second fungi. Unfortunately pulmonary function of three patients did not allow surgical excision of the infected area and one patient refused surgery.

• Tuberculosis and Respiratory Diseases
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• v.85 no.3
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• pp.264-272
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• 2022

Background: The current conventional drug susceptibility test (DST) for Mycobacterium tuberculosis (Mtb) takes several weeks of incubation to obtain results. As a rapid method, molecular DST requires only a few days to get the results but does not fully cover the phenotypic resistance. A new rapid method based on the ability of viable Mtb bacilli to hydrolyze fluorescein diacetate to free fluorescein with detection of fluorescent mycobacteria by flow cytometric analysis, was recently developed. Methods: To evaluate this cytometric method, we tested 39 clinical isolates which were susceptible or resistant to isoniazid (INH) or rifampin (RIF), or ethambutol (EMB) by phenotypic or molecular DST methods and compared the results. Results: The susceptibility was determined by measuring the viability rate of Mtb and all the isolates which were tested with INH, RIF, and EMB showed susceptibility results concordant with those by the phenotypic solid and liquid media methods. The isolates having no mutations in the molecular DST but resistance in the conventional phenotypic DST were also resistant in this cytometric method. These results suggest that the flow cytometric DST method is faster than conventional agar phenotypic DST and may complement the results of molecular DST. Conclusion: In conclusion, the cytometric method could provide quick and more accurate information that would help clinicians to choose more effective drugs.