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Analysis of Management Status and Optimum Production Scale of Quarrying Firms in Korea -Comparative Analysis of Aggregate and Building-Stone Quarrying Firms- (산지채석업체(山地採石業體)의 경영실태(經營實態) 및 적정규모설정(適正規模設定) -골재용(骨材用) 채석업체(採石業體)와 건축용(建築用) 채석업체(採石業體)의 비교(比較) 분석(分析)-)

  • Joung, Ha Hyeon;Cho, Eung Hyouk
    • Journal of Korean Society of Forest Science
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    • v.80 no.1
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    • pp.72-81
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    • 1991
  • This study was carried out to provide necessary information for improving quarrying industry management in Korea. The results of the study are summarized as follows : 1. In aggregate and building-stone quarrying firms the managers over 40 years of age are 97% and 89.1%, the ones above education level of high school are 90% and 85% and the ones not more than 10 years of quarrying experience are 70% and 52%, respectively. Accordingly it can be pointed out that most of the managers of two types of firms are relatively old, have high educational background, while quarrying experiences of building-stone firm managers are longer than that of aggregate firm managers. 2. Most of the management forms are social corporation(60%) for aggregate quarry firms and private management(76%) for building-stone firms. Average areas of permitted stone-pits of aggregate and building-stone quarries are about 2.86ha and 1.66ha respectively. That is, aggregate quarrying firms are carried on a larger scale than building-stone quarrying firms. 3. The yearly average product of aggregate quarrying firms has increased steadily from $88.961m^3$ in 1985 to $144.028m^3$ in 1988, while, in case of building-stone quarry firms, it has significantly increased from $4.155m^3$ to $19.462m^3$ from 1985 to 1987, but reduced to $13.400m^3$ in 1988. Unstable production activities of building-stone quarrying firms may require continuous government support. 4. Major cost items are equipment rental, depreciation, salaries, repair, maintenance for aggregate quarrying firms, and salaries, depreciation, fuel, tax for building-stone quarrying firms. The yearly average rate of return is about 9.7% for aggregate quarry firms and 2.6% for building-stone quarry firms. It can be pointed out that aggregate quarrying firms is better managed than building-stone quarrying firms. 5. The production elasticity of salary for aggregate quarrying firms is 0.495, that of employees is 0.559, and that of capital service is 0.513. The sum of the elasticities is 1.257>1. Fur building-stone quarrying firms, that of employees is 0.492, that of variable costs is 0.192, and that of capital service is 0.498. The sum of elasticities is 1.172>1, thus denotes the increasing returns to scale for both types quarrying firms. 6. The ratio of marginal value product to opportunity cost of empolyees is 2.54, that of variable costs is 3.62, and that of capital service is 1.45, in aggregate quarrying firms. That of employees is 2.47, that is variable costs was 2.34, and that of capital service is 19.67 in building-stone quarrying firms. Therefore the critical factors for more expansion of management scale in aggregate quarrying firms are variable cost and employees, and are capital service in building-stone quarry ing firms. 7. The break-even points of stone sales are about 0.587 billion won and 0.22 billion won in aggregate and building-stone quarrying firms respectively. The optimum sales Level for profit maximization are about 2.0 billion and 0.5 billion in aggregate and building-stone quarry firms respectively.

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Tracheal gas insufflation (TGI) in patients with increased deadspace fraction: the effect and its determining factors (사강호흡율이 증가된 환자에서 기관내 가스주입법(Tracheal Gas Imsufflation)이 가스교환에 미치는 효과와 그 결정인자)

  • Lim, Chae Man;Jung, Bok Hyun;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Park, Pyung Hwan;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.136-145
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    • 1997
  • Background : Tracheal Gas Insufflation (TGI) is one of the newer ancillary measures in mechanical ventilation employed to enhance carbon dioxide elimination. TGI exerts its effect through reduction of deadspace ventilation, but the factors determining its effect are not well studied yet. Method : The subjects were seven mechanically-ventilated patients ($58.8{\pm}10.6$ yrs) who showed increased physiologic deadspace greater than 60%. After 30 nun of stabilization with 100% oxygen on pressure control ventilation, continuous flow TGI was administered via the insufflation lumen of Hi-Lo Jet Tracheal Tube (Mallincrodt, USA) for 15 min at 3 L/min and 5 L/min each. Results : $PaCO_2$ was decreased ($51.4{\pm}17.6$ at baseline, $49.1{\pm}18.9$ at TGJ 3 L/min $45.0{\pm}14.9$ mm Hg at TGI 5 L/min, p=0.050), and pH was increased ($7.37{\pm}0.12$, $7.38{\pm}0.13$, $7.39{\pm}0.12$, respectively, p=0.037) while mixed expired $CO_2$ ($P_ECO_2$) was not changed significantly from baseline (p=0.336) by TGI. Physiologic deadspace(Vdphy) was decreased ($73.0{\pm}7.9$% at baseline, $69.8{\pm}10.0$% at TGI 3 L/min, and $67.1{\pm}10.1$% at TGI 5 L/min, p=0.015). $AaDO_2$(p=0.147), Vt(p=0.2140), Pmean(p=0.7788) and mean arterial pressure(p=0.4169) were not changed. The correlation between % maximal decrease of Vdphy were r=0.790 with the ratio of baseline Vdana/Vdphy(p=0.035) and r=-0.754 with baseline Vdalv(p=0.050). Conclusion: TGI was effective in reducing $PaCO_2$ and deadspace, and the deadspace-reducing effect was best correlated with baseline anatomic/physiologic deadspace ratio.

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Ecological Characteristic between the Re-introduction Population and the Original Population (Jojong Stream, Sudong Stream) of Zacco koreanus in the Bongseonsa Stream, Korea (봉선사천의 참갈겨니(Zacco koreanus) 재도입 개체군과 원개체군(조종천, 수동천) 간 생태학적 특징)

  • Wang, Ju-Hyoun;Choi, Jun-Kil;Lee, Hyuk-Je;Lee, Hwang-Goo
    • Korean Journal of Environment and Ecology
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    • v.31 no.6
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    • pp.537-548
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    • 2017
  • The purpose of this study was to investigate the species composition and the aquatic environment of Jojong Stream and Sudong Stream, which were the original habitats of Zacco koreanus population and restored population re-introduced in Bongseonsa Stream. It also compared and analyzed the states of the growth and reproductive ability of Z. koreanus habiting in each of the three streams. The investigation was conducted in June 2016 which was known as the spawning season of Z. koreanus. The results of the physical aquatic environments showed the slight differences in altitude, width and depth of water among three streams, but the bottom structure was found to be quite different in the composition of the boulder, cobble, and pebble among the streams. The result of the physicochemical aquatic environment analysis showed that there were no significant differences in water temperature, pH, DO, BOD, and EC among the three stream. In the fish fauna investigation, 530 individuals of 11 species of 3 families were collected in Bongseonsa Stream, 293 individuals of 12 species of 4 families were collected in Jojong Stream, and 361 individuals of 11 species of 4 families were collected in Sudong Stream. All three streams were dominated by Z. koreanus and Z. platypus. Six Korean endemic species appeared in each of the three streams, showing the high occurrence rate of indigenous species of 50.0% or more. The aggregation index analysis revealed that the mean dominance index ranged from 0.63 (${\pm}0.05$, BS) to 0.72(${\pm}0.01$, JJ), mean diversity index from 1.55 (${\pm}0.06$, JJ) to 1.78 (${\pm}0.11$, BS), mean evenness index from 0.71 (${\pm}0.03$, JJ) to 0.76 (${\pm}0.02$, BS), and mean richness index from 1.61 (${\pm}0.33$, JJ) to 1.73 (${\pm}0.24$, SD). The result indicated that the observed differences between the stream community indices were statistically nonsignificant. The similarity analysis showed that 75.4% similarity was divided into two groups of A and B and that the fish fauna on each analyzed point was similar. The quantitative habitat evaluation index (QHEI) analysis showed that the average value of QHEI was 151.0 (${\pm}46.0$), which means that it was a suboptimal habitat environment. The result of length-weight analysis of Z. koreanus populations showed that the regression coefficient b of the restoration population and the original habitat population were at 3.0 or higher while the condition factor had a positive slope. Moreover, it was found that the slopes of the regression coefficient b and condition factor of the original habitat population were larger than the restored population. The analysis of the length frequency distribution of the Z. koreanus population revealed that all three streams maintained the stable life cycle although it was found that the growth rate of the original habitat population was faster than the restored population in the one-year-old class. The result of the gonadosomatic index (GSI) analysis showed that the GSI median value of the Z. koreanus population in the restored habitat Bongseonsa Stream was higher than the population in the original habitat Jojong Stream and Sudong Stream for both of males and females.

Study on the Thermal Storage Characteristics of Phase Change Materials for Greenhouse Heating (온실보온(溫室保溫)을 위한 상변화(相變化) 물질(物質)의 축열특성연구(蓄熱特性硏究))

  • Song, Hyun-Kap;Ryou, Young-Sun;Kim, Young-Bok
    • Solar Energy
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    • v.13 no.2_3
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    • pp.65-78
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    • 1993
  • An overdose of fossil fuel for greenhouse heating causes not only the high cost and low quality of agricultural products, but also the environmental pollution of farm village. To solve these problems it is desirable to maximize the solar energy utilization for the heating of greenhouse in winter season. In this study phase change materials were selected to store solar energy concentratively for heating the greenhouse and their characteristics of thermal energy storage were analyzed. The results were summarized as follows. The organic $C_{28}H_{58}$, and the inorganic $CH_3COONa{\cdot}3H_2O\;and\;Na_2SO_4{\cdot}10H_2O$ were selected as low temperature latent heat storage materials. The equation of critical radius was derived to define the generating mechanism of the maximum latent heat of phase change materials. The melting point of $C_{28}H_{58}$ was $62^{\circ}C$, and the latent heat was $50.0{\sim}52.0kcal/kg$. The specific heat of liquid and solid phase was $0.54{\sim}0.69kcal/kg^{\circ}C$ and $0.57{\sim}0.75kcal/kg^{\circ}C$ respectively. The melting point of $CH_3COONa{\cdot}3H_2O$ was $61{\sim}62^{\circ}C$, the latent heat was $64.9{\sim}65.8$ kcal/kg and the specific heat of liquid and solid phase was respectively $0.83kcal/kg^{\circ}C$ and $0.51{\sim}0.52kcal/kg^{\circ}C$. The melting point of $Na_2SO_4{\cdot}10H_2O$ was $30{\sim}30.9^{\circ}C$, the latent heat was 53.0 kcal/kg and the specific heat of liquid and solid phase was respectively $0.78{\sim}0.89kcal/kg^{\circ}C$ and $0.50{\sim}0.7kcal/kg^{\circ}C$ When the urea of 21.85% was added to control the melting point of $Na_2SO_4{\cdot}10H_2O$ and the phase change cycles were repeated from 0 to 600, the melting point was $16.7{\sim}16.0^{\circ}C$ and the latent heat was $36.0{\sim}28.0kcal/kg^{\circ}C$.

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The Comparative Study of on Pump CABG during Pulsatile $(T-PLS^{TM})$ and Nonpulsatile $(Bio-pump^{TM})$ Perfusion (관상동맥우회술 시 사용된 박동성펌프$(T-PLS^{TM})$와 비박동성펌프$(Bio-pump^{TM})$의 비교연구)

  • Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.354-358
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    • 2006
  • Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

The Evaluations of Phoria and AC/A Ratio by Watching 3D TV at Near (3D TV 근거리 시청에 따른 사위도와 조절성폭주비 평가)

  • Son, Jeong-Sik;Kim, Dong-Su;Kim, Jung-Ho;Kim, Jae-Do;Hamacher, Alaric;Yu, Dong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.319-324
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    • 2015
  • Purpose: This study was designed to evaluate the changes of phoria and calculated AC/A ratio, and their recovery time points by watching 3D television (3D TV). Methods: 50 subjects (male 30, female 20) of 20s to 40s ages who can watch 3D, were measured phoria using a Howell phoria card at 3 m for distance and 40 cm for near. The phoria was evaluated before watching 3D TV and every 10 minutes from starting of watching 3D TV for 30 minutes, and every 5 minutes after finishing of watching 3D TV for 30 minutes again. Results: For the distance phoria during and after watching 3D TV, it was increased to more exophoria $-0.98{\pm}1.37{\Delta}$ (prism diopters) after 10 minutes from starting of 3D TV watching (p=0.063) and increased to more exophoria $-1.00{\pm}1.28{\Delta}$ after 30 minutes (p=0.024), and started to decrease after finishing of watching 3D TV and recovered to the level of before 3D TV watching ($-0.78{\pm}1.11{\Delta}$) after 20 minutes (p=0.32) with comparing to phoria of before watching 3D TV ($-0.80{\pm}1.12{\Delta}$). For the near phoria, it was also increased to more exophoria $-5.71{\pm}4.45{\Delta}$ after 10 minutes from starting of watching 3D TV (p=0.000) and $-6.58{\pm}4.36{\Delta}$ after 30 minutes (p=0.000), and started to decrease after finishing of watching 3D TV and recovered to the level of before watching 3D TV after 20 minutes ($-4.34{\pm}3.67{\Delta}$) (p=0.32) with comparing to the phoria of before watching 3D TV ($-4.36{\pm}3.66{\Delta}$). AC/A ratio was decreased from $4.92{\pm}1.17{\Delta}/D$ for before 3D TV watching to $4.11{\pm}1.50{\Delta}/D$ for after 30 minutes from starting of watching 3D TV (p=0.000), and increased after the end of watching 3D TV and recovered to the level of before 3D TV watching ($4.93{\pm}1.18{\Delta}/D$) after 25 minutes (p=0.598). Conclusions: During watching 3D TV at near, it showed a tendency of convergence insufficiency by decrease of calculated AC/A ratio as result that exophoria at near was higher increased than exophoria at distance. However, the increased exophoria at both near and distance was recovered to the level of base line after 25 minutes from the end of watching 3D TV. Through this study, it seems to need rational proposals of advice for watching 3D TV.

Minimally Invasive Coronary Artery Bypass Grafting (소침습적 관상동맥우회술)

  • Na, Chan-Young;Lee, Young-Tak;Park. Joong-Won;Chung, Do-Hyun;Jung, Ill-Sang;Jung, Yoon-Seup;Kim, Ok-Sung;Bang, Jung-Hyun;Lee, Sub;Chung, Chul-Hyun;KIM, Woong-Han;Park, Young-Kwan;Kim, Chong-Whan;Hong, Sung-Nok;Han, Jae-Jin;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.118-124
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    • 1998
  • Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.

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The Studies on Growth Characteristics and Dry Matter Yield of Hybrid Corn Varieties in Daegwallyeong Region (대관령에서 옥수수 품종별 생육특성과 건물수량에 기후변화의 영향)

  • Kim, Meing Jooung;Seo, Sung;Choi, Ki Choon;Kim, Jong Geun;Lee, Sang Hack;Jung, Jeong Sung;Yoon, Sei Hyung;Ji, Hee Chung;Kim, Myeong Hwa
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.33 no.2
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    • pp.123-130
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    • 2013
  • This study was conducted to investigate the effects of climate change on the growth characteristics and dry matter yields of silage corn hybrids in fields of forage crops of Hanwoo Experiment Station, National Institute of Animal Science, RDA, from Apr. 2009 to Sep. 2011. Corn hybrids were cultivated in Daegwallyeong of Gangwon Province, at an altitude of 760 m. Corn varieties used in this study consisted of 5 domestic varieties and 5 foreign varieties. Differences of silk days according to years occurred at an average of 5.5 days. The silk periods of domestic varieties occurred from Aug. 8 to 12, while that of overseas varieties was from Aug. 5 to 11. Silk days of domestic varieties occurred approximately 3 to 4 days earlier than those of oversea varieties. Silk days of Kwangpyeongok and P3156 belonging to the early varieties were Aug. 8 and 5, respectively. Kwangpyeongok and P3156 were Aug. 8 and 5, respectively. Pyeonganok and DK729 belonged to late varieties. The mean plant height of corn was approximately 231 cm, while those of Kwangpyeongok and Pyeonganok were 236 cm and 237 cm, respectively. The mean stem diameter and ear height of corn were approximately 23.2 mm and 94 cm, respectively. In the case of stem diameters, those of Cheonganok and 33J56 were 86 cm and 80 cm, respectively, while Gangdaok grew to a greater height (enter height) than other varieties. Dry matter yields of Kwangpyeongok and Pyeonganok were higher than those of other varieties. The mean leaf ratio of corn was 39.3%, while that of domestic varieties increased as compared to foreign varieties. The average DM yield of corn was 16,653 kg/ha, while those of 32P75, P3156, Pyeonganok, P3394 and Kwangpyeongok were 18,901, 17,997, 17,675, 17,194, 17,188 kg/ha, respectively. Total digestible nutrient (TDN) yields of 32P75, P3156, P3394, Pyeonganok and Kwangpyeongok were 13,381, 12,590, 12,532, 12,140 and 12,036 kg/ha, respectively. Corn crude protein (CP), in vitro dry matter digestibility (IVDMD), neutral detergent fiber (NDF), acid detergent fiber (ADF) and TDN were 7.8%, 74.2%, 42.4%, 23.5% and 70.3%, respectively. In the case of nutritive values of corn, there was no significant difference between of corn varieties of domestic and foreign origin.

Difference in Patient's Work of Breathing Between Pressure-Controlled Ventilation with Decelerating Flow and Volume-Controlled Ventilation with Constant Flow during Assisted Ventilation (보조환기양식으로서 감속형유량의 압력-조절환기와 일정형유량의 용적-조절환기에서 환자의 호흡일의 차이)

  • Kim, Ho-Cheol;Park, Sang-Jun;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.803-810
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    • 1999
  • Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

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Lymphocyte Proportion and Cytokines from the Bone Marrow of Patients with Far-Advanced Pulmonary Tuberculosis with Peripheral Lymphocytopenia (말초혈액의 림프구감소증을 동반한 중증폐결핵 환자들에서 골수 내의 림프구 분획과 사이토카인 소견)

  • An, Chang Hyeok;Kyung, Sun Yong;Lim, Young Hee;Park, Gye Young;Park, Jung Woong;Jeong, Sung Hwan;Ahn, Jeong Yeal
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.449-458
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    • 2003
  • Background : The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)(< $1,000/mm^3$) and $T_4$-cell count ${\leq}500/mm^3$. However, the cause of PB lymphocytopenia in FAPTB is unclear. The aim of this study was to analyze the lymphocyte proportion and cytokines of the bone marrow(BM) in FAPTB patients with peripheral lymphocytopenia in order to clarify whether the limiting step of the lymphocytopenia occurs in production, differentiation, or circulation. Methods : This study included patients with FAPTB between August 1999 and August 2002 who visited Gachon Medical School Gil Medical Center. The exclusion criteria were old age(${\geq}65years$), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-${\alpha}$, Interferon-${\gamma}$, and TGF-${\beta}$ levels in the BM were measured by ELISA. Result : Thirteen patients(male : female=9:4) were included and the mean age was $42{\pm}12$years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group ($7.4{\pm}3.0%$, $694{\pm}255/mm^3$ vs. $17.5{\pm}5.8%$, $1,377{\pm}436/mm^3$, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group($9{\pm}4%$ vs. $12{\pm}3%$, p=0.138). The IL-2($26.0{\pm}29.1$ vs. $112.2{\pm}42.4pg/mL$, p=0.001) and IL-10($3.4{\pm}4.7$ vs. $12.0{\pm}8.0pg/mL$, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. Conclusion : These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.