Tuberculosis is a potentially deadly infectious disease caused by the Mycobacterium tuberculosis (M. tuberculosis). Tuberculosis is diagnosed by proving the M. tuberculosis in sputum samples based on the results of acid-resistant staining, culture, and nucleic acid amplification tests. However, there is a report that the detection rate of M. tuberculosis is low in acid-resistant staining using tissue specimens. It has been suspected that the cause is a potential loss of acid resistance by the organic solvents used for tissue specimen preparation. Therefore, this study was pursued to find out if Gram staining and fluorescent staining in addition to acid-resistant staining would be helpful in diagnosing tuberculosis. We used four tissue (lung, small intestine, large intestine, and lymph node) samples with chronic granulomatous inflammation observed in HE staining and positive results in real-time PCR. These detection rates and staining properties were investigated through microscopic examination using the Ziehl-Neelsen, Gram, and Auramin rhodamine staining. In this studies, M. tuberculosis were observed by Ziehl-Neelsen, Gram, and Auramin rhodamine staining in all four samples. In the evaluation of clinical microbiology proficiency testing (CMPT), the Ziehl-Neelsen and Gram staining were the same result, but the Auramin rhodamine staining was relatively low. These data indicated that Gram staining is useful for detecting M. tuberculosis in formalin-fixed tissue specimens. Therefore, if the Ziehl-Neelsen and Gram staining are combined as the M. tuberculosis staining method in tissue specimens, a better direction may be provided for tuberculosis diagnosis.

In this study, we used a choropleth map to explore the spatial variation of the risk of cattle herds being bovine tuberculosis (BTB) positive in Gangwon-do in 2015. The map shows that the risk of being BTB-positive was lower in provinces located in the middle of Gangwon-do (Wonju, Youngwol, Peongchang, and Kangneung) than in other provinces. In addition, one province located in the north (Goseong) had a low risk of BTB. The estimate for the intercept of the spatial lag model was 0.66, and the spatial autocorrelation coefficient (lambda) was 0.20 (Table 1). The Moran’s I was 0.33 with p-value of 0.02. In 2015, provinces located in the North West (Hwacheon) and East (Donghae) of Gangwon-do had a higher BTB risk. We identified some specific provinces at low BTB-positive risk, information that may prove useful for control of BTB in the study area.

한국에서 결핵은 소위 후진국 병으로 인식되어 사라진 질병으로 여겨진다. 그러나 한국은 OECD 가입국 중 결핵 발병률 및 사망률이 가장 높은 국가로 결핵은 여전히 사회적 문제이다. 특히 결핵은 사회적 질병으로서 다양한 사회 ․환경적 요인들이 작용하여 나타나는 질병이기에 이에 대한 연구가 필요하다. 하지만 한국의 결핵 관련 연구는 생의학적 결정 요인 연구에 집중되어, 이외에 발병에 영향을 미칠 수 있는 사회 ․환경적 결정요인 연구는 매우 부족한 실정이다. 이는 결핵 발병의 생의학적 결정 요인과 사회 ․환경적 결정 요인을 통합적으로 분석하고 있는 최근의 세계적 연구 흐름과도 동떨어져 있다. 따라서 본 연구는 2015년 국내 결핵 발병률의 공간적 차이를 확인하고, 아이겐벡터 공간필터링 모형을 이용하여 공간적 차이에 기반한 결핵 발병의 사회 ․환경적 결정요인을 분석해 보고자 한다.

The Ministry of Environment established a data base platform called environmental statistic portal. From there we collected environmental statistics including sulfurous acid gas, fine dust, carbon monoxide, nitrogen dioxide, household waste, domestic waste, construction waste, the number of factories, the amount of waste water, the amount of organic matter, etc. We collected the number of tuberculosis (TB) patients from National Health Service in Korean Statistical Information Service. We consider the number of TB patients and environmental statistics as a dependent variable and predictors, respectively. A multiple regression analysis is performed to find out significant predictors that affect the number of TB patients. A deep analysis is done to discover the relationship between significant predictors and the dependent variable depending on national district areas, i.e. Gu or Goon, by use of a multivariate analysis and a covariance analysis.

This paper describes the epidemiological characteristics of bovine tuberculosis in Korea during January 2000 to September 2004, when the incidence of bovine tuberculosis increased markedly: a total of 1,054 herds (4,197 cattle) were confirmed to be infected with Mycobacterium bovis during this period. Based on the record of epidemiological investigation, introduction of purchased cattle (22.9%, 125/545) into a farm was the most frequent transmission route of M. bovis infection. On 31.7% (335/1,054) of the infected farms, recurrent infection occurred more than once before the disease has been eradicated completely. The highest rate of recurrence was detected around 70 days after the initial test of the infected herd, which seems to be related to current regulation on the test of animals that cohabited with those previously diagnosed with infection in farms, rather than to the characteristic of the disease. Although the current eradication program has been effective in controlling the disease in dairy cattle in Korea, control measures more specific to beef cattle may be needed because infection rate in beef cattle continues to increase in recent years.

Tuberculosis (TB) is a significant disease for both humans and animals worldwide. The genus Mycobacterium includes several species that cause TB disease in humans and other animals. Amongst the members of the Mycobacterium tuberculosis complex (MTC), M. tuberculosis is mainly a human pathogen, whereas M. bovis has a broad host range and is the principal agent responsible for TB in domestic and wild mammals. M. bovis also infects humans, causing zoonotic TB through ingestion, inhalation. M. bovis accounts for only a small percentage of the reported cases of TB in humans. In recent years, TB in farmed deer has become a disease as public health importance in several countries. Nowadays, there has been rapid outbreak of bovine TB in cattle and deer in Korea. Investigations are needed to elucidate the relative importance of M. bovis on TB incidence in humans, especially in Korea where bovine TB remains a problem. Also, the human sources as the cause of animal infection, M. tuberculosis from the farm workers also important for TB control of animals in Korea. Differentiation between the causative organisms may only be achieved by sophisticated laboratory methods involving bacteriological characteristics, biochemical properties, and routine resistance to pyrazinamide (PZA). M. bovis shows inherently resistant to PZA whereas M. tuberculosis is susceptible to PZA. In this study, we developed a multiplex-PCR assay based on a 12.7-kb fragment for the differential detection of M. bovis and M. tuberculosis. A total of 131 M. tuberculosis complex isolates were randomly obtained from cattle and deers that were PPD positive. they all yielded M. bovis. M. tuberculosis was not isolated from animals. and, a total of 25 M. tuberculosis complex isolates which is resistant to PZA were obtained from patient. PZA resistant MTC in humans was caused entirely by M. tuberculosis. The multiplex-PCR protocol was highly species-specific and time saving for identification of M. bovis and M. tuberculosis. This multiplex-PCR assay will be easily used as a routine monitoring tool in veterinary and medical laboratories.

Inonotus obliquus is a traditional medicine mushroom that was developed from traditional medicine originating in ancient. It has been applied for cancer or immunotherapy,but its effect on pulmonary tuberculosis is not reported. Therefore, we measured the pulmonary tuberculosis therapeutic effect of methyl alcohol extract from MGIT 960 system with fluorescent indicator. Inonotus obliquus extract showed 14 day more inhibitory activity than the positive control. In addition, the anti-pulmonary tuberculosis activity of Inonotus obliquus was 50㎛. These results suggest that Inonotus obliquus methyl alcohol extracts could contribute to inhibition of pulmonary tuberculosis.

Tuberculosis (TB) is still a significant public health problem in Korea. In many cases, it is not easy to diagnose TB. A 13-year-old male patient was admitted for left chest pain for 6 months period. Chest radiography done two months ago during the school screening revealed a pleural effusion in the left lung. All cultures were negative, and 3 sputum samples and his pleural fluid sample tested negative for Acid-fast bacilli. There was no evidence of a malignant effusion. A pleural fluid examination revealed features suggestive of an empyema. Thick and yellowish pus was drawn out. Pleural fluid analysis presented White blood cell 5,200/mm3, and neutrophil-dominant with 60% of neutrophil. In an effort to attain a diagnosis, a video-assisted thoracoscopy procedure was performed with pleural drainage and biopsies. Active chronic granulomatous pleuritis was found through pleural biopsies. He was responsive to treatment and received 6 months of anti-TB therapy with complete clinical resolution. If the clinical picture is in confusion, pleural biopsy is occasionally indicated to diagnose TB pleuritis.

A paradoxical response in tuberculosis is defined as clinical and radiological worsening of previous lesions or development of new lesions after initial improvement during the process of anti-tuberculous treatment. The authors report on a patient who developed massive pleural effusion as a paradoxical response after 8 weeks of anti-tuberculous treatment. The patient’s symptoms were improved with thoracostomy without any change of anti-tuberculous medications. If symptoms worsen during the process of anti-tuberculous treatment, drug resistance, non-compliance, or other diseases should be excluded first. If it is regarded as a paradoxical response, the treatment plan need not be changed except for additional conservative treatment.

Gastrointestinal tuberculosis is a commonly presenting ileocecal disease. Appendiceal tuberculosis results from secondary to either ileocecal tuberculosis, or tuberculosis at other sites of the abdomen. "Isolated" form of tuberculosis affecting appendix only, without evidence of disease elsewhere, is very rare. We report on two cases of isolated appendiceal tuberculosis initially presenting as acute appendicitis. Each case was proven as tuberculosis by acid fast bacilli or caseous necrosis in pathology. Colonoscopy and abdominal computed tomography showed neither intestinal nor intra-abdominal disease.

Pulmonary tuberculosis is an important public health problem. Early diagnosis and treatment is necessary for successful patient outcomes. However, diagnosis of pulmonary tuberculosis is difficult in cases with an unusual presentation and often requires a lung biopsy. The tuberculosis polymerase chain reaction results in tissue sample have potential for early diagnosis and treatment initiation for pulmonary tuberculosis. The relatively low sensitivity limit the use of this test in the detection of the pulmonary tuberculosis.

Intussusception in adults is a rare disease entity; its clinical course and etiology are different from its pediatric counterpart. Furthermore, intussusception caused by intestinal tuberculosis is very rare. We report on a case of transient intussusception induced by intestinal tuberculosis. A 29-year-old female visited our hospital with a chief complaint of right lower quadrant abdominal pain. Abdominal computed tomography showed ileo-colic type intussusception. Intussusception was transient and showed spontaneous reduction. Colonoscopy was performed for evaluation of the cause and intestinal tuberculosis was probable on colonoscopic biopsy. Follow up colonoscopy showed improvement after administration of anti-tuberculosis medication and intestinal tuberculosis was then confirmed.