OBJECTIVE: To explore the value of interferon-inducible protein 10 (IP-10) in the auxiliary diagnosis of tuberculosis and the judgment of the severity of disease. METHODS: From February, 2013 to February, 2017, a total of 193 patients with TB admitted in our hospital and 84 healthy control subjects were recruited consecutively. The peripheral blood plasma levels of interferon-γ (IFN-γ) and IP-10 were detected using liquid phase chip (Luminex) technique. According to the number of lung fields affected by TB, the patients were divided into group A (with lesions in 1-2 lung fields), group B (3-4 lung fields) and group C (5-6 lung fields), The expressions of IFN-γ and IP-10 in 3 groups were compared. RESULTS: The plasma levels of IP-10 were significantly higher in TB patients than in the control subjects ( < 0.05), but IFN-γ levels were comparable between the two groups ( > 0.05). Among the TB patients, plasma IP-10 levels was the highest in group C ( < 0.05), and IFN-γ levels did not differ significantly among the 3 groups ( > 0.05). CONCLUSIONS Plasma IP-10 has a certain reference value in the auxiliary diagnosis of active tuberculosis and the judgment of the severity of the disease.
Antigens, Bacterial ; Biomarkers ; blood ; Chemokine CXCL10 ; blood ; Humans ; Tuberculosis, Pulmonary ; blood ; diagnosis

BACKGROUND: An association between diabetes and tuberculosis has long ken implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. METHODS: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics(DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetios (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was undertaken. RESULTS: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMIB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5 -10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderata awl far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenograpflc finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the stverity of pulmonary tuberculosis on chest X-ray. During treatmenu of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was sigrificantly higher than the pcorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). CONCLUISON: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonaiy tuberculosis.
Blood Glucose ; Diabetes Mellitus ; Diagnosis ; Humans ; Incidence ; Lung ; Male ; Prevalence ; Retrospective Studies ; Sex Ratio ; Thorax ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

The Immunological diagnosis of tuberculous meningitis (TBM) requires the presence of de novo synthesis of immunoglobulin in the central nervous system. We investigated the CNS IgG synthetic rate and IgG antibody titers against lipoarabinomanan (LAM) and PPD antigens in the serum and CSF by using ELISA in patients with TBM and patients with only pulmonary tuberculosis (PTB). The CNS IgG synthetic rate was markedly increased in all 11 patients with TB with PTB (56.42+l886 mg/day vs 7.47+435 mg/day). On the other hand, abnormally elevated IgG titers in the CSF against either LAM or PPD antigen were present in all 7 patients with TBM and in 4 of 11 patients with PTB tested. The 4 patients with the false positivity showed markedly elevated IgG antibody titers in the sera suggesting the passive diffusion of IgG antibodies through the intact blood brain barrier from the sera to the CSF. It is likely that the simultaneous measurement of CNS IgG sythesis is an useful addition to the ELISA of IgG antibody titration against the antigens of M. tuberculare in the CSF for the accurate diagnosis of TBM, especially in the endemic area of tuberculosis.
Antibodies ; Blood-Brain Barrier ; Central Nervous System ; Diagnosis ; Diffusion ; Enzyme-Linked Immunosorbent Assay ; Hand ; Humans ; Immunity, Humoral* ; Immunoglobulin G* ; Immunoglobulins* ; Immunologic Tests ; Tuberculosis ; Tuberculosis, Meningeal* ; Tuberculosis, Pulmonary

PURPOSE: Tuberculosis (TB) is a common and possibly fatal infectious disease, and its incidence and prevalence is quite high in Korea compared to other Organization for Economic Co-operation and Development countries. Patients who have active TB can cause latent tuberculosis infection (LTBI) in children, which may progress to reactivated tuberculosis. This study was performed to analyze the risk of adult TB that affects children's LTBI. METHODS: From June 2013 to May 2014, 60 children (32 boys, 28 girls) who came into close contact with adult patients diagnosed with pulmonary TB underwent LTBI tests. The children were divided into the 2 groups: the first group was finally diagnosed to LTBI, and the second group was proven not to have LTBI. We compared the risk of adult patients with pulmonary TB between children with LTBI and those without through a medical record review. RESULTS: The number of adult patients with TB was 36 (father 68%, mother 23%, grandparents 8%). The patients who came into close contact with the LTBI group were older (47.0±12.8 years vs. 41.3±6.6 years) and had higher erythrocyte sedimentation rate (ESR) levels than those of the second group. The rate of negative acid-fast-bacilli smear with positive culture results in patients who came into contact with the LBTI group was higher than in the second group. The cutoff value of ESR for the diagnosis of LTBI was 31 mm/hr with a sensitivity of 0.75 and a specificity of 0.85 (area under curve=0.748). CONCLUSION: Adult pulmonary TB patients who are older and have higher ESR levels may be risk factors for LTBI in children coming into close contact with them.
Adult ; Blood Sedimentation ; Child* ; Communicable Diseases ; Diagnosis ; Family Characteristics* ; Grandparents ; Humans ; Incidence ; Korea ; Latent Tuberculosis* ; Medical Records ; Mothers ; Prevalence ; Risk Factors* ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Pulmonary*

Aged ; Aged, 80 and over ; Antibodies, Bacterial ; blood ; Coal Mining ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; immunology ; Pneumoconiosis ; complications ; Sensitivity and Specificity ; Tuberculosis, Pulmonary ; complications ; diagnosis

BACKGROUND: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). METHODS: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. RESULTS: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. CONCLUSION: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.
Alcoholism ; Anemia ; Blood Sedimentation ; Body Mass Index ; C-Reactive Protein ; Diagnosis ; Humans ; Leukocytosis ; Lithuania* ; Logistic Models ; Male ; Risk Factors ; Sputum* ; Thorax ; Thrombocytosis ; Treatment Outcome ; Tuberculosis* ; Tuberculosis, Pulmonary ; Unemployment

OBJECTIVETo establish a recombinant plasmid of CFP32 of Mycobacterium tuberculosis in E. coli, and to analyze its antigenicity.

METHODSRv0577 gene was amplified by polymerase chain reaction from genome of Mycobacterium tuberculosis, and then cloned into vector pMD18-T followed by the subclone into the expression vector pET21a. Recombinant CFP32 was expressed and purified. The antigenicity of the recombinant protein was analyzed by using Western-blot. The purified recombinant CFP32 protein was used as an antigen to screen the sera of 7 pulmonary TB patients (n = 97), as well as the other pulmonary disease patients (n = 25), and the clinically healthy controls (n = 38) by ELISA.

RESULTSRecombinant plasmid of CFP32 was established, and be expressed efficiently in E. coli BL21 (DE3). The relative molecular mass of the protein was about 300,000 by SDS-PAGE analysis. The protein purified by Ni-NTA was in a purity over 90%, which was confirmed by Western-blot analysis. ELISA analysis showed its sensitivity and specificity were 63.9% (62/97) and 96.8% (2/63) respectively.

CONCLUSIONThe recombinant expression plasmid pET21a CFP32 has been constructed and CFP32 proteins has been successfully expressed and be purified in E. coli and, ELISA analysis has identified the recombinant CFP32 as a candidate antigen for TB serodiagnosis.

Antigens, Bacterial ; blood ; Bacterial Proteins ; genetics ; immunology ; Cloning, Molecular ; Escherichia coli ; Gene Expression ; Humans ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Plasmids ; Recombinant Proteins ; Serologic Tests ; Tuberculosis, Pulmonary ; diagnosis ; microbiology

BACKGROUND/AIMS: We investigated the utility of serum C-reactive protein (CRP) and procalcitonin (PCT) for differentiating pulmonary tuberculosis (TB) from bacterial community-acquired pneumonia (CAP) in South Korea, a country with an intermediate TB burden. METHODS: We conducted a prospective study, enrolling 87 participants with suspected CAP in a community-based referral hospital. A clinical assessment was performed before treatment, and serum CRP and PCT were measured. The test results were compared to the final diagnoses. RESULTS: Of the 87 patients, 57 had bacterial CAP and 30 had pulmonary TB. The median CRP concentration was 14.58 mg/dL (range, 0.30 to 36.61) in patients with bacterial CAP and 5.27 mg/dL (range, 0.24 to 13.22) in those with pulmonary TB (p<0.001). The median PCT level was 0.514 ng/mL (range, 0.01 to 27.75) with bacterial CAP and 0.029 ng/mL (range, 0.01 to 0.87) with pulmonary TB (p<0.001). No difference was detected in the discriminative values of CRP and PCT (p=0.733). CONCLUSIONS: The concentrations of CRP and PCT differed significantly in patients with pulmonary TB and bacterial CAP. The high sensitivity and negative predictive value for differentiating pulmonary TB from bacterial CAP suggest a supplementary role of CRP and PCT in the diagnostic exclusion of pulmonary TB from bacterial CAP in areas with an intermediate prevalence of pulmonary TB.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; C-Reactive Protein/*analysis ; Calcitonin/*blood ; Community-Acquired Infections/blood/*diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Bacterial/blood/*diagnosis ; Prospective Studies ; Protein Precursors/*blood ; Severity of Illness Index ; Tuberculosis, Pulmonary/blood/*diagnosis

OBJECTIVE: To study the clinical value of detecting carcinoembryonic antigen levels in pleural effusion (PCEA) and serum (SCEA) and their ratio (P/S) in the differential diagnosis of pleural effusions resulting from tuberculosis and lung cancer. METHODS: This retrospectively study was conducted among 82 patients with pleural effusion caused by pulmonary tuberculous (TB; control group) and 120 patients with pleural effusion resulting from lung cancer in our hospital between April, 2016 and March, 2018. PCEA, SCEA and P/S were compared between the two groups and among the subgroups of lung cancer patients with squamous cell carcinoma (SqCa), adenocarcinoma (ACA), small cell carcinoma (SCLC). The receiveroperating characteristic curve (ROC) analysis was used to confirm the optimal critical value to evaluate the diagnostic efficiency of different combinations of PCEA, SCEA and P/S. RESULTS: PCEA, SCEA and P/S were significantly higher in the overall cancer patients and in all the 3 subgroups of cancer patients than in the patients with TB ( < 0.05). The areas under the ROC curve of PCEA, SCEA and P/S were 0.925, 0.866 and 0.796, respectively; PCEA had the highest diagnostic value, whose diagnostic sensitivity, specificity, accurate rate, and diagnostic threshold were 83.33%, 96.34, 88.61%, and 3.26 ng/ml, respectively; SCEA had the lowest diagnostic performance; the diagnostic performance of P/S was between that of SCEA and PCEA, but its combination with SCEA greatly improved the diagnostic performance and reduced the rates of misdiagnosis and missed diagnosis. Parallel tests showed that the 3 indexes combined had significantly higher diagnostic sensitivity than each or any two of the single indexes ( < 0.05), but the diagnostic specificity did not differ significantly. The area under the ROC curve of combined detections of the 3 indexes was 0.941 for diagnosis of lung cancer-related pleural effusion, higher than those of any other combinations of the indexes. CONCLUSIONS The combined detection of PCEA, SCEA and P/S has a high sensitivity for diagnosis of lung cancer-related pleural effusion and provides important information for rapid and accurate diagnosis of suspected cases.
Carcinoembryonic Antigen ; analysis ; blood ; Case-Control Studies ; Diagnosis, Differential ; Humans ; Lung Neoplasms ; blood ; complications ; Pleural Effusion ; blood ; diagnosis ; immunology ; Pleural Effusion, Malignant ; blood ; chemistry ; diagnosis ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Tuberculosis, Pulmonary ; complications

We report a 63-years-old woman who developed a nodular lesion in right upper lobe (RUL) of lung after achieving a partial response with salvage chemotherapy for relapsed non-Hodgkin's lymphoma (NHL). Previously, she had been diagnosed as NHL and tuberculous lymphadenitis resulting a complete response with 8 cycles of CHOP regimen and anti-tuberculosis medication for 1 year. CT scan of the chest showed an irregular marginated soft tissue density in RUL with internal punctate calcifications and this lesion was difficult to discriminate between pulmonary tuberculosis and parenchymal involvement of NHL. Because the pulmonary infiltrations progressed despite empirical anti-tuberculosis medication, we performed bronchoscopic biopsy, showing diffuse large B-cell lymphoma. Thereafter, the pulmonary infiltrations were markedly improved with salvage chemotherapy. However, she died of refractory NHL despite high-dose chemotherapy with autologous peripheral blood stem cell transplantation.
Biopsy ; Diagnosis ; Drug Therapy ; Female ; Humans ; Lung ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Pathology ; Peripheral Blood Stem Cell Transplantation ; Thorax ; Tomography, X-Ray Computed ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary