• 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.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.303-314
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• 2001

Background : Matrix metalioproteinase(MMP)-2 and MMP-9 have been known to play an important role in cell migration and the tissue remodeling process by type IV collagen lysis, a major component of the basement membrane. Intra-alveolar fibrosis, secondary to an injury to the basement membrane of the alveolar epithelial lining, is a major process in the pathogenesis of idiopathic pulmonary fibrosis(IPF). Therefore, MMP-2 and MMP-9 was hypothesized to play an important role in IPF pathogenesis. As a result, their level may reflect the activity or prognosis. Method : Forty one progressive IPF patients(age $59.82{\pm}1.73$ years, M:F=23:18), 16 patients with stable IPF for more than one year without therapy(age : $63.6{\pm}2.8$ years, M:F=13:3), and 7 normal controls were enrolled in this study. The MMP-2 and MMP-9 levels in the BAL fluid and alveolar macrophage conditioned media(AM-CM) were measured by zymography and the TIMP-1 level was measured by ELISA. Results : 1) The MMP-2 level in BALF was highest in the progressive IPF group ($1.36{\pm}0.28$) followed by the stable group ($0.46{\pm}0.13$) and the controls ($0.08{\pm}0.09$), which was statistically significant. The MMP-9 level of the IPF ($0.31{\pm}0.058$) and the stable group ($0.22{\pm}0.078$) were higher than that of the control group ($0.002{\pm}0.004$). In the AM-CM, only MMP-9 was detected, which was significantly higher in IPF group ($0.80{\pm}0.1O$) than in the control group($0.23{\pm}0.081$). The TIMP-1 level was also higher in both the IPF ($36.34{\pm}8.62\;{\mu}g/ml$) and stable group ($20.83{\pm}8.53\;{\mu}g/ml$) compared to the control group ($2.80{\pm}1.05\;{\mu}g/ml$) (p<0.05). 3) There was a correlation between the MMP-2 level in the BALF with the total cell number(r=0.298) and neutrophils(r=0.357) (p<0.05), and the MMP-9 level with the number of neutrophils (r=0.407) and lymphocytes (r=0.574)(p<0.05). The TIMP-1 level correlated with the total number of cell (r=0.338, p<0.05) and neutrophils(r=0.449, p=0.059). Conclusion : Both MMP and TIMP appear to play an important role in IPF pathogenesis, and their level may reflect the disease activity.

• Sim-seong Yeon-gu
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• v.38 no.1
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• pp.1-44
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• 2023

Hexagram Bi (比 ䷇ 8) is one of the hexagrams comprised of one-unbroken line and five-broken lines. The hexagrams of one-unbroken and five-broken lines symbolize the relationship and dynamics between one yang-consciousness and the five-yin unconsciousness. The hexagram of one-unbroken line and five-broken lines has six different images depending on the position of the one unbroken line from the beginning line to the top line. In terms of psychology, this means that the position change of one yang line in relation to five yin lines may symbolize the function of consciousness which clarifies and determines the content of the psyche. In addition, the flow of psychic energy can be examined through the process of one unbroken line's movement. In other words, the psychic contents of the beginning line of hexagram Bok (復 ䷗ 24), which is the beginning of the hexagram of one-unbroken line and five-broken lines, proceed sequentially, and then arrive at the process of the last sixth, hexagram Bak (剝 ䷖ 23) through the fifth, the hexagram Bi (8). That is, it can be said that the content of the hexagram and the line determined according to the position of one unbroken line show a certain psychic flow. As a result, the first hexagram Bok (復 ䷗ 24), after recovering and starting newly, means the beginning of consciousness. After that the process of proceeding with the second, third, and fourth lines represents the flow of consciousness. And in the fifth place, the fifth line of hexagram Bi, it reaches its peak and is placed in the optimal state of consciousness because of its right and centered position at this hexagram Bi. Like nature, the psyche gradually enters the path of decline from the highest state, which leads to the last sixth, the top line of hexagram Bak. However, the top line of the hexagram Bak, where everything falls off, contains the content of starting again in its top line. It is the beginning line of hexagram Bok to inherit this. This means the circumambulation of the psyche that changes from a psychologically difficult state of depression to a stage of recovery. There is a stage that must be passed in this circulation process, and that is the hexagram Gon (坤 ䷁ 2). October(tenth month)'s hexagram Gon is placed between hexagram Bak, the ninth month of the lunar calendar, and hexagram Bok, the eleventh month of the lunar calendar. This represents that the flow of recovery must go through a maternal process of hexagram Gon. The retreat to the psychological uterus is inevitable in regenerating the psyche. This process flows from the hexagram Bak and through hexagram Gon to the hexagram Bok. At this situation the hexagram Gon acts the absolutely necessary role. In addition, the main body of the hexagrams of one-unbroken and five-broken lines, including the Bi hexagram, is also the Gon hexagram composed of six-broken lines. In other words, all six hexagrams of one-unbroken and five-broken lines have a certain relationship with the Gon hexagram, and it would be meaningful to look at the correlation between the unbroken lines of the hexagrams of one-unbroken and five-broken lines and the corresponding broken lines of the hexagram Gon. This can be said to be the dynamics of the maternal unconscious connected to the state of consciousness in six forms. Therefore, each hexagram of one-unbroken and five-broken lines symbolizes the expression of the integration the mother archetype with the consciousness. Revealing this well is the meaning of the hexagram of one-unbroken and five-broken lines. Its hexagram image consists of a combination of Gon (☷), which symbolizes the mother, and the thunder (☳) the eldest son, the water (☵) the middle son and the mountain (☶) the third son. As a result, the hexagram Bok (復 ䷗ 24), Sa (師 ䷆ 7), Gyeom (謙 ䷠ 15), Ye (豫 ䷏ 16), Bi (比 ䷇ 8) and Bak (剝 ䷖ 23) are sequentially created in the order of the unbroken line. This is symbolically the evolutionary process of consciousness. In this way, the hexagrams of one-unbroken and five-broken lines, which mean the conjunction of mother and son, represent the advancing relationship between the maternal unconscious and consciousness. In addition, the relationship with the mother according to the position of the son is related to the dynamics of mother archetype to the attitude of consciousness. The psychological meaning can be deduced from the flow of six lines of hexagrams of one-unbroken and five-broken lines. And the state in which the activation of the consciousness is at its peak is the fifth line of the hexagram Bi, and comparing it with the contents of the corresponding fifth line of hexagram Gon not only can find the state and meaning of the conjunction of consciousness and the maternal unconscious, but the entire flow can be compared to the individuation process.