Introduction: Mycobacterium tuberculosis resists rifampicin (RIF) because of mutations in the rpoB (the p subunit of RNA polymerase) gene, mostly in the 81 bp region. \r\n', u'Objectives: Identify the frequency and characteristics relative to drug - resistant rpoB gene mutation in RIF - resistant M. tuberculosis strains. \r\n', u'Subjects and method: 40 M. tuberculosis strains including 11 RIF - sensitive strains and 29 RIF - resistant strains. Some bio molecular techniques were used such as extracting mycobacterial DNA, PCR, cloning, sequencing and analyzing mutation related RIF - resistance on rpoB gene. \r\n', u'Results: No mutation was found on the 81 bp region of rpoB gene of the RIF - sensitive M. tuberculosis strains. The rate of mutation on rpoB gene of 29 RIF - resistant M. tuberculosis strains is 96.6%. We found 12 mutation codon positions on the 81 bp region of the rpoB gene, and the mutation codon positions with high frequency were 531 (51.7%) and 526 (31%). The mutation position found in only one strain is codon 519 (3.4%) but not found in other reports. There are 15 types of drug resistant mutations in which TCG531 TCG is the most common with 50%. Multi - drug resistance was seen in mutable and none mutable cases, with all codon positions and mutable forms. \r\n', u'Conclusion: No mutation was found on the 81 bp region of the rpoB gene of RtF - sensitive M. tuberculosis strains. The rate of mutation on the rpoB gene of RIF - resistant M. tuberculosis strains is 96.6%. The new mutation position found is codon 519. The mutation on the rpoB gene does not determine the multi - drug resistance of M. tuberculosis. \r\n', u'
Mutation ; rpoB gene ; Rifampicin - resistant M. tuberculosis

Background: Recently, microplate almar blue assay has been used commonly in detecting gen related to tuberculosis drug resistance, which provides results after 5-7 days with lower cost compared to traditional methods. Objective: To evaluate the application of microplate almar blue assay for rapid detection of drug resistance of M. tuberculosis strains. Subject and Method: A microplate-based assay which uses Alamar blue reagent - an oxidation reduction dye (MABA), was used for the determination of the anti-tuberculosis drug (isoniazid-INH, rifampicine-RIF, streptomycine-STR and ethabuton=EMB) resistance of 96 M. tuberculosis strains isolated from Vietnamese patients in comparison to those obtained by conversional method. Result: MABA showed to have high sensitivity and specificity in testing the sensitivity to individual anti-tuberculosis drugs (from 82.4% for STR to 93.3% for - INH and from 82.5% for EMB to 98.4% for STR; respectively), as well as for the multi-drug resistant M.tuberculosis (86.4% of sensitivity), highly correlated with the result determined by proportion method. Conclusion: MABA reveals the advantage in shortening test time, in simple performance and lower cost compared with the conversional culture based methods.
Microplate almar blue assay ; M. tuberculosis ; drug resistance

Some of the proteins of mycobacteria are preferentially associated with the cell wall and are powerful immunogens, and humoral antibody responses to these mycobacterial antigens may occur in patients with tuberculosis. In this study, Triton X-100 solubilized protein (TSP) antigen was isolated from Mycobacterium tuberculosis H37Rv by overnight shaking with 1% Triton X- 100/PMSF and 10-90% ammonium sulfate precipitation. IgG and IgM antibody levels against TSP, crude protein from the unheated cultrue filtrate (CF#) and 30 kDa antigens were determined in the sera of 80 patients with pulmonary tuberculosis and 99 healthy controls with PPD (+) and (-). High IgG reactivity to TSP and CF antigen was observed in tuberculosis patients. Mean IgG antibody titers against all of three mycobacterial antigens were differed significantly (P<0.01) between patients and controls but IgM showed no difference. By the cut-off value adding 2 standard deviation to the mean absorbance of controls, the sensitivity and specificity of the IgG antibody to TSP antigen were 93.9% and 77.5%. The specificity to TSP antigen was a litttle higher than those obtained by CF and 30 kDa antigen. From the above results, the TSP antigen may be useful for the serodiagnosis of tuberculosis.
Ammonium Sulfate ; Antibody Formation ; Cell Wall ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune* ; Octoxynol* ; Sensitivity and Specificity ; Serologic Tests ; Tuberculosis ; Tuberculosis, Pulmonary*

Granulomatous mastitis is a rare benign inflammatory disease of the breast with multiple etiologies such as tuberculosis, sarcoidosis, foreign body reaction, and mycotic and parasitic infections. In contrast, idiopathic granulomatous mastitis (IGM) is characterized by the presence of chronic granulomatous lobulitis in the absence of an obvious etiology. Clinically and radiologically it may mimic breast carcinoma and so awareness of surgeons, pathologists, and radiologists is essential to avoid unnecessary mastectomies. Cases of IGM are reported during antidepressant therapy in patients also showing high levels of prolactinemia. In these cases, we believe that surgical excision must be avoided being replaced with a conservative management of the pathological condition based on a corticosteroid treatment.
Breast ; Foreign-Body Reaction ; Granulomatous Mastitis ; Humans ; Hydrazines ; Hyperprolactinemia ; Immunoglobulin M ; Mastectomy ; Sarcoidosis ; Serotonin Uptake Inhibitors ; Tuberculosis

PURPOSE: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The purpose of this study is to develop a new algorithm for the differential diagnosis and treatment of IGM and TM. METHODS: Medical records of 68 patients (58 with IGM and 10 with TM) between July 1999 and February 2009 were retrospectively reviewed. RESULTS: The mean age of the patients was 33.5 (IGM) and 40 (TM) years (p=0.018). The median follow-up was 84 months. Of the total 10 patients with TM, 5 patients had a history of pulmonary tuberculosis. The most common symptoms of the diseases were breast lump and pain. However, axillary lymphadenopathy was more seen in TM (50%) compared to IGM (20.6%) (p=0.048). TM showed more cancer-mimicking findings on radiologic study (p=0.028). In IGM, 48 patients (82.7%) underwent surgical wide excision and 21 patients (36.2%) were managed with corticosteroid therapy and antibiotics. All of the TM patients received anti-tuberculosis medications and 9 patients (90%) underwent wide excision. The mean treatment duration was 2.8 months in IGM and 8.4 months in TM. Recurrence developed in 5 patients (8.6%) in IGM and 1 patient (10%) in TM. CONCLUSION: This study shows different characteristics between IGM and TM. The IGM patients were younger and had more mastalgia symptoms than the TM patients. Axillary lymphadenopathy was seen more often in TM patients. Half of the TM patients had pulmonary tuberculosis or tuberculosis lymphadenitis. Surgical wide excision might be both therapeutic and useful for providing an exact diagnosis.
Anti-Bacterial Agents ; Breast ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Granulomatous Mastitis ; Humans ; Immunoglobulin M ; Lymphadenitis ; Lymphatic Diseases ; Mastitis ; Mastodynia ; Medical Records ; Recurrence ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

Mycobacteria cause diseases which occur the world over and which carry a considerable burden in morbidity, mortality and social problems. A battery of monoclonal antibodies specific for mycobacterial antigens would provide a useful tool for rapid diagnosis of mycobacterial diseases. Fourteen monoclonal antibodies to perchloric acid soluble antigen of M. tuberculosis were produced. Immunoglobulin isotypes of monoclonal antibodies were ten of immunoglobulin G2a, two of IgG3, and two of IgM. By means of Western blotting, monoclonal antibody detected the antigen of 54kD in TB-P. In the immunofluorescence assay, the monoclonal antibody showed a positive reaction with intact M. tuberculosis bacilli, M. tuberculosis in the pulmonary tissue of tuberculous patient and M. bovis BCG.
Antibodies, Monoclonal* ; Blotting, Western ; Diagnosis ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Immunoglobulin Isotypes ; Immunoglobulin M ; Immunoglobulins ; Mortality ; Mycobacterium bovis ; Social Problems ; Tuberculosis

Objectives: To evaluate the immunogenicity of Methods: Protein extracts from Results: Immunization with Conclusion This is the advanced study to investigate the immunogenicity of
Animals ; Antibodies, Bacterial/immunology* ; Antigens, Bacterial/immunology* ; Bacterial Proteins/immunology* ; Cross Reactions ; Cytokines/immunology* ; Female ; Genome, Bacterial ; Immunoglobulin G/immunology* ; Immunoglobulin M/immunology* ; Macrophages/immunology* ; Mice, Inbred BALB C ; Mycobacterium avium Complex/immunology* ; Mycobacterium tuberculosis/immunology* ; Tuberculosis Vaccines/administration & dosage* ; Whole Genome Sequencing

Acute adrenal insufficiency may result from adrenal crisis, hemorrhagic destruction, or the rapid withdrawal of steroids from patient with chronic steroid medication, congenital adrenal hyperplasia or those on other drugs. Acute hemorrhagic destruction of both adrenal glands can occur due to infection, trauma, anticoagulant therapy, antiphospholipid syndrome or a coagulation disorder. However, there have been no reports on acute hemorrhagic adrenal insufficiency due to the Ebstein-Barr virus (EBV). Herein, a case of acute adrenal insufficiency, with bilateral adrenal hemorrhagic infarction, is reported in a patient with asymptomatic chronic adrenal insufficiency. A 42-year-old man presented with general weakness, weight loss and hyperpigmentation of several months duration. He suffered from a sore throat, general myalgia and a headache on admission. The laboratory findings were lymphocytosis, positive EBV IgM antibody, low cortisol level and a high level of adrenocorticotropic hormone (ACTH). Adrenocortical autoantibody and PCR for Mycobacterium tuberculosis showed negative findings. The serologic findings for CMV and HIV were negative. Fine needle aspiration of the adrenal gland revealed a hemorrhagic infarction and positive staining for the anti-EBV antibody. Acute adrenal insufficiency was then diagnosed with a bilateral adrenal hemorrhagic infarction due to the EBV infection in the patient, also with asymptomatic chronic adrenal insufficiency. This is the first case of acute adrenal insufficiency with bilateral hemorrhagic infarction, due to an EBV infection
Adrenal Glands ; Adrenal Hyperplasia, Congenital ; Adrenal Insufficiency* ; Adrenocorticotropic Hormone ; Adult ; Antiphospholipid Syndrome ; Biopsy, Fine-Needle ; Epstein-Barr Virus Infections ; Headache ; Herpesvirus 4, Human ; HIV ; Humans ; Hydrocortisone ; Hyperpigmentation ; Immunoglobulin M ; Infarction* ; Lymphocytosis ; Myalgia ; Mycobacterium tuberculosis ; Pharyngitis ; Polymerase Chain Reaction ; Steroids ; Weight Loss

OBJECTIVETo evaluate of therapeutic efficacy of deoxyribouncleotidum on pulmonary tuberculosis.

METHODSEighty patients with pulmonary tuberculosis sustaining hepatic lesion after treatment with antituberculosis drugs were randomized into therapeutic group and control group. Patients in the control group received regular treatment and those in the therapeutic group had additional deoxyribouncleotidum injection.

RESULTSALT, AST, ALP and TBIL levels were significantly higher in the therapeutic group than in the control group 4 weeks after treatment. IgG, IgA, IgM levels, and CD3(+) and CD8(+) lymphocytes were significantly increased in the therapeutic group after treatment (P<0.05).

CONCLUSIONdeoxyribouncleotidum can improve hepatic function and immunity in patients with pulmonary tuberculosis.

Adjuvants, Immunologic ; administration & dosage ; therapeutic use ; Adult ; Alanine Transaminase ; metabolism ; Antitubercular Agents ; adverse effects ; therapeutic use ; Aspartate Aminotransferases ; metabolism ; CD3 Complex ; immunology ; CD8-Positive T-Lymphocytes ; cytology ; drug effects ; immunology ; Chemical and Drug Induced Liver Injury ; Deoxyribonucleotides ; administration & dosage ; therapeutic use ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Injections ; Liver Diseases ; blood ; drug therapy ; Male ; Middle Aged ; Treatment Outcome ; Tuberculosis, Pulmonary ; blood ; drug therapy