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Relationships of Peripheral Inflammatory Marker With Suicide Attempt History (자살시도력과 말초혈액의 염증 지표 간의 연관성)

  • Su-Hyun Oh;Seung-Jun Kim;Sang-Ho Shin;Hong-Seok Oh;Jae-Chang Lee;Woo-Young Im;Na-Hyun Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.165-172
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    • 2023
  • Objectives : The purpose of this study is to determine whether there is a significant difference in the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio according to the history of suicide attempt in patients with psychiatric diseases. Methods : A medical record review was conducted on patients who had been hospitalized in Konyang University Hospital since 2021-03-01 to 2023-02-28 to collect demographic and clinical characteristics. T-test for continuous variables and Chi-square test for categorical variables were performed to determine demographic differences according to the history of suicide attempt, and the ANCOVA test was performed to compare the average value of peripheral inflammatory marker according to the history of suicide attempt with gender and age as covariates. One-way variance analysis was performed to determine whether the number of suicide attempt causes significant difference of the peripheral inflammatory marker. Results : The final analysis target of this study was 266 patients, 101 had history of suicide attempt, and 165 had no history of suicide attempt. The neutrophil-to-lymphocyte ratio (p<0.001) and platelet-to-lymphocyte ratio (p<0.001) were higher in patients with the history of suicide attempt than patients without the history of suicide attempt, but the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were not significantly increased depending on the serial increase of number of suicide attempts. Conclusions : This study suggests that peripheral inflammatory markers are meaningful and easily accessible indicators for predicting the risk of suicide attempt in psychiatric patients. We expect that prospective follow-up study will be conducted with more subjects and controlled potential confounding variables.

A Study on the Selection of the Joseon's Royal Placenta Chambers for Successive Registration in World Heritages Listings (조선 왕실 태실의 세계유산 등재 대상 선정에 대한 고찰)

  • LEE Jaewan
    • Korean Journal of Heritage: History & Science
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    • v.56 no.3
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    • pp.6-20
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    • 2023
  • The World Heritage Subcommittee of the Cultural Heritage Administration which examine The World Heritage Subcommittee of the Cultural Heritage Administration which The World Heri The World Heritage Subcommittee of the Cultural Heritage Administration which examined the Placenta Chamber of King Sejong's Princes applied for the world heritage priority list in 2020 recommended expanding it to the royal placenta chambers of Joseon distributed nationwide for successive registration instead of registering the Seongju placenta chamber only. On account of that, the issue of selecting items has become one of the important topics to be discussed in the registration of world heritages. Accordingly, this researcher investigated the subjects of successive registration based on such conditions as excellent universal value, heritage protection and management, authenticity, and completeness among the real estate cultural properties demanded by the UNESCO World Heritage Committee. First, 22 placenta chambers, the real estate cultural properties designated as cultural properties and protected and managed by the state and local governments, are subject to it. Second, it seems that placenta chambers that can be restored through research and historical investigation and become designated as cultural properties can additionally be added. Third, items such as the Seosamneung Royal Tombs built by Lee Wang-jik in the Japanese colonial era or Seongjong Placenta Chamber relocated as an example to realize the completeness of Joseon's Royal Placenta Chambers can be included as well. Meanwhile, many of the items designated as cultural properties are not in the original location, and they can be divided into those that were relocated for the intentions of the Japanese Empire and those that were not. Therefore, the researcher insists that it is necessary to select and add items with which we can understand the historicity in the relocation of placenta chambers during the Japanese colonial era and also to quickly designate those that have not been designated as cultural properties yet. Therefore, regardless of designation as cultural heritage, local governments must promote both restoration and designation and strive to include them in the list of successive registration of world heritages grounded on thorough historical investigation. Moreover, to add them to the list of successive registration of world heritages, the Cultural Heritage Administration and local governments should promote continuous research and genuine restoration of individual placenta chambers.

Analysis of the Influence of Role Models on College Students' Entrepreneurial Intentions: Exploring the Multiple Mediating Effects of Growth Mindset and Entrepreneurial Self-Efficacy (대학생 창업의지에 대한 롤모델의 영향 분석: 성장마인드셋과 창업자기효능감의 다중매개효과를 중심으로)

  • Jin Soo Maing;Sun Hyuk Kim
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.5
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    • pp.17-32
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    • 2023
  • The entrepreneurial activities of college students play a significant role in modern economic and social development, particularly as a solution to the changing economic landscape and youth unemployment issues. Introducing innovative ideas and technologies into the market through entrepreneurship can contribute to sustainable economic growth and social value. Additionally, the entrepreneurial intentions of college students are shaped by various factors, making it crucial to deeply understand and appropriately support these elements. To this end, this study systematically explores the importance and impact of role models through a multiple serial mediation analysis. Through a survey of 300 college students, the study analyzed how two psychological variables, growth mindset and entrepreneurial self-efficacy, mediate the influence of role models on entrepreneurial intentions. The presence and success stories of role models were found to enhance the growth mindset of college students, which in turn boosts their entrepreneurial self-efficacy and ultimately strengthens their entrepreneurial intentions. The analysis revealed that exposure to role models significantly influences the formation of a growth mindset among college students. This mindset fosters a positive attitude towards viewing challenges and failures in entrepreneurship as learning opportunities. Such a mindset further enhances entrepreneurial self-efficacy, thereby strengthening the intention to engage in entrepreneurial activities. This research offers insights by integrating various theories, such as mindset theory and social learning theory, to deeply understand the complex process of forming entrepreneurial intentions. Practically, this study provides important guidelines for the design and implementation of college entrepreneurship education. Utilizing role models can significantly enhance students' entrepreneurial intentions, and educational programs can strengthen students' growth mindset and entrepreneurial self-efficacy by sharing entrepreneurial experiences and knowledge through role models. In conclusion, this study provides a systematic and empirical analysis of the various factors and their complex interactions that impact the entrepreneurial intentions of college students. It confirms that psychological factors like growth mindset and entrepreneurial self-efficacy play a significant role in shaping entrepreneurial intentions, beyond mere information or technical education. This research emphasizes that these psychological factors should be comprehensively considered when developing and implementing policies and programs related to college entrepreneurship education.

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CT Evaluation of Long-Term Changes in Common Bile Duct Diameter after Cholecystectomy (담낭 절제술 후 총담관 직경의 장기 변화에 대한 CT 평가)

  • Sung Hee Ahn;Chansik An;Seung-seob Kim;Sumi Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.581-595
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    • 2024
  • Purpose The present study aimed to investigate the frequency and extent of compensatory common bile duct (CBD) dilatation after cholecystectomy, assess the time between cholecystectomy and CBD dilatation, and identify potentially useful CT findings suggestive of obstructive CBD dilatation. Materials and Methods This retrospective study included 121 patients without biliary obstruction who underwent multiple CT scans before and after cholecystectomy at a single center between 2009 and 2011. The maximum short-axis diameters of the CBD and intrahepatic duct (IHD) were measured on each CT scan. In addition, the clinical and CT findings of 11 patients who were initially excluded from the study because of CBD stones or periampullary tumors were examined to identify distinguishing features between obstructive and non-obstructive CBD dilatation after cholecystectomy. Results The mean (standard deviation) short-axis maximum CBD diameter of 121 patients was 5.6 (± 1.9) mm in the axial plane before cholecystectomy but increased to 7.9 (± 2.6) mm after cholecystectomy (p < 0.001). Of the 106 patients with a pre-cholecystectomy axial CBD diameter of < 8 mm, 39 (36.8%) showed CBD dilatation of ≥ 8 mm after cholecystectomy. Six of the 17 patients with long-term (> 2 years) serial follow-up CT scans (35.3%) eventually showed a significant (> 1.5-fold) increase in the axial CBD diameter, all within two years after cholecystectomy. Of the 121 patients without obstruction or related symptoms, only one patient (0.1%) showed IHD dilatation > 3 mm after cholecystectomy. In contrast, all 11 patients with CBD obstruction had abdominal pain and abnormal laboratory indices, and 81.8% (9/11) had significant dilatation of the IHD and CBD. Conclusion Compensatory non-obstructive CBD dilatation commonly occurs after cholecystectomy to a similar extent as obstructive dilatation. However, the presence of relevant symptoms, significant IHD dilatation, or further CBD dilatation 2-3 years after cholecystectomy should raise suspicion of CBD obstruction.

Characristics and Management Plans of Myeongwoldae and Myeongwol Village Groves Located in, Jeju (제주 팽림월대(彭林月臺)의 경관특성 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Chol, Yung-Hyun;Kahng, Byung-Seon;Kim, Young-Suk
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.68-81
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    • 2014
  • This study was conducted to identify the spacialty, to illuminate the existence and values of Myeongwoldae(明月臺) and Forest Myeongwol, and to suggest the sustainable usage, preservation and management plans with the purpose of ecological and cultural landscaping characteristic and value identification. The result of the study is as follows. Castle Myeongwol and Port Myeongwol shows the status of Hallim-eup Myeongwol District which is the administrative center of western Jeju as well as is the fortress. Building Wolgyejeongsa and School Woohakdang, the head temple of education and culture, located in Myeongwol District represents the spaciality of Myeonwol-ri which was the center of education. Stand Myeongwol is one of the most representative Confucian cultural landscapes in Jeju Island and the field of communion with nature where scholars enjoy poetries, nature, changgi(Korean chess), and go in the Joseon Dynasty period. It was found that the current relics of Myeongwoldae was recovered through the maintenance project conducted by Youth Group Myeongwol composed with Hongjong-si(洪鍾時) as the center during the Japanese colonial era in 1931. It seems that the stonework of Myeongwoldae composed of three levels in the order of square, octagon, and circle based on the heaven-man unity theory of Confucianism and the octagon in the middle is the messenger of Cheonwonjibang(天圓地方), in other words, between the square-shaped earth and the circle-shaped sky. It is assumed that both Grand Bridge Myeongwol and Bridge Myeongwol were constructed as arched bridges in early days. Bridge Myeongwol is the only arched bridge remaining in Jeju Island now, which has the modern cultural heritage value. In Forest Myeongwol, 97 taxa of plants were confirmed and in accordance with 'Taxonomic Group and Class Criteria of Floristic Specific Plants', eight taxa were found; Arachniodes aristata of FD IV and Ilex cornuta, Piper kadsura, Litsea japonica, Melia azedarach, Xylosma congestum, Richosanthes kirilowii var. japonica, Dichondra repens, Viburnum odoratissimum var. awabuki of FD III. Otherwise, 14 taxa of naturalized plants including Apium leptophylihum which is imported to Jeju Island only were confirmed. In Forest Myeongwol, 77 trees including 41 Celtis sinensis, 30 Aphananthe aspera, two Wylosma congestum, a Pinus densiflora, a Camellia japonica, a Melia azedarach, and an Ilex cornuta form a colony. Based on the researched data, the preservation and plans of Myeongwoldae and Forest Myeongwol is suggested as follows. Myeongwoldae, Bridge Myeongwol, and Forest Myeongwol should be managed as one integrated division. Bridge Myeongwol, an arched bridge which is hard to be found in Jeju Island is a high-standard stonework requiring long-term preservation plans. Otherwise, Grand Bridge Myeongwol that is exposed to accident risks because of deterioration and needs safety diagnosis requires measures according to the result of precise safety diagnosis. It is desirable to restore it to a two-sluice arched bridge as its initial shape and to preserve and use it as a representative local landmark with Stand Myeongwol. In addition, considering the topophsis based on the analysis result, the current name of Jeju Special Self-Governing Province Monument No. 19 'Myoengwol Hackberry Colony' should change to 'Myeongwol Hackberry-Muku Tree Colony'. In addition, the serial number system which is composed without distinction of hackberry and muku tree should be improved and the regular monitoring of big and old trees, specific plants, and naturalized species is required.

The Influence of Ventilation and Shade on the Mean Radiant Temperature of Summer Outdoor (통풍과 차양이 하절기 옥외공간의 평균복사온도에 미치는 영향)

  • Lee, Chun-Seok;Ryu, Nam-Hyung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.5
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    • pp.100-108
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    • 2012
  • The purpose of the study was to evaluate the influence of shading and ventilation on Mean Radiant Temperature(MRT) of the outdoor space at a summer outdoor. The Wind Speed(WS), Air Temperature(AT) and Globe Temperature(GT) were recorded every minute from $1^{st}$ of May to the $30^{th}$ of September 2011 at a height of 1.2m above in four experimental plots with different shading and ventilating conditions, with a measuring system consisting of a vane type anemometer(Barini Design's BDTH), Resistance Temperature Detector(RTD, Pt-100), standard black globe(${\O}$ 150mm) and data acquisition systems(National Instrument's Labview and Compfile Techs' Moacon). To implement four different ventilating and shading conditions, three hexahedral steel frames, and one natural plot were established in the open grass field. Two of the steel frames had a dimension of $3m(W){\times}3m(L){\times}1.5m(H)$ and every vertical side covered with transparent polyethylene film to prevent lateral ventilation(Ventilation Blocking Plot: VP), and an additional shading curtain was applied on the top side of a frame(Shading and Ventilation Blocking Plot: SVP). The third was $1.5m(W){\times}1.5m(L){\times}1.5m(H)$, only the top side of which was covered by the shading curtain without the lateral film(Shading Plot: SP). The last plot was natural condition without any kind of shading and wind blocking material(Natural Open Plot: NP). Based on the 13,262 records of 44 sunny days, the time serial difference of AT and GT for 24 hour were analyzed and compared, and statistical analysis was done based on the 7,172 records of daytime period from 7 A.M. to 8 P.M., while the relation between the MRT and solar radiation and wind speed was analyzed based on the records of the hottest period from 11 A.M. to 4 P.M.. The major findings were as follows: 1. The peak AT was $40.8^{\circ}C$ at VP and $35.6^{\circ}C$ at SP showing the difference about $5^{\circ}C$, but the difference of average AT was very small within${\pm}1^{\circ}C$. 2. The difference of the peak GT was $12^{\circ}C$ showing $52.5^{\circ}C$ at VP and $40.6^{\circ}C$ at SP, while the gap of average GT between the two plots was $6^{\circ}C$. Comparing all four plots including NP and SVP, it can be said that the shading decrease $6^{\circ}C$ GT while the wind blocking increase $3^{\circ}C$ GT. 3. According to the calculated MRT, the shading has a cooling effect in reducing a maximum of $13^{\circ}C$ and average $9^{\circ}C$ MRT, while the wind blocking has heating effect of increasing average $3^{\circ}C$ MRT. In other words, the MRT of the shaded area with natural ventilation could be cooler than the wind blocking the sunny site to about $16^{\circ}C$ MRT maximum. 4. The regression and correlation tests showed that the shading is more important than the ventilation in reducing the MRT, while both of them do an important role in improving the outdoor thermal comfort. In summary, the results of this study showed that the shade is the first and the ventilation is the second important factor in terms of improving outdoor thermal comfort in summer daylight hours. Therefore, it can be apparently said that the more shade by the forest, shading trees etc., the more effective in conditioning the microclimate of an outdoor space reducing the useless or even harmful heat energy for human activities. Furthermore, the delicately designed wind corridor or outdoor ventilation system can improve even the thermal environment of urban area.

Relationship of Compliance and Oxygen Transport in Experimental Acute Respiratory Failure during Positive End-Expiratory Pressure Ventilation (실험적 급성호흡부전에서 호기말양압에 의한 폐유순도와 산소운반의 변화 및 상관관계 - 호흡부전의 기전에 따른 차이 -)

  • Lee, Sang-Do;Yoon, Se-Jin;Lee, Bok-Hee;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.1
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    • pp.6-15
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    • 1993
  • Background: Positive end, expiratory pressure (PEEP) has become one of the standard therapies for adult respiratory distress syndrome (ARDS). Total static compliance has been proposed as a guide to determine the size of PEEP ('best PEEP') which is of unproven clinical benefit and remains controversial. Besides increasing functional residual capacity and thus improving oxygenation, PEEP stimulate prostacyclin secretion and was proposed for the treatment of acute pulmonary embolism. But little is known about the effect of PEEP on hemodynamic and gas exchange disturbances in acute pulmonary embolism. Methods: To study the validity of total static compliance as a predictor of 'best PEEP' in ARDS and acute pulmonary embolism, experimental ARDS was induced in mongrel dog with oleic acid and acute pulmonary embolism with autologous blood clot. Then hemodynamic and gas exchange parameters were measured with serial increment of PEEP. Results:In ARDS group, total static compliance and oxygen transport were maximal at 5 cm$H_2O$, and decreased thereafter (p<0.05). With increment of PEEP, arterial oxygen tension ($PaO_2$) and arterial carbon dioxide tension ($PaCO_2$) increased and cardiac output and physiological shunt decreased. In pulmonary embolism group, total static compliance, oxygen transport, physiological shunt and cardiac output decreased and $PaO_2$ and $PaCO_2$ increased with increment of PEEP (p<0.05). Comparing the change induced by increment of PEEP by 1 cm$H_2O$ in ARDS group with that in pulmonary embolism group, there was no significant difference between two groups except cardiac output which decreased more in pulmonary embolism group (p<0.05). In ARDS group, oxygen transport and total static compliance increased after PEEP application, and total static compliance was maximal at the PEEP level where oxygen transport was maximal. However in pulmonary embolism group, oxygen transport and total static compliance decreased after application of PEEP. There was significant correlation between change of total static compliance and change of oxygen transport in both groups. Conclusion: In both ARDS and acute pulmonary embolism, it can be concluded that total static compliance is useful as a predictor of 'best PEEP'.

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Studies on Lipids in Fresh-Water Fishes 8. Comparison of Lipid Components among Wild and Cultured Carp (Cyprinus carpio) and Israeli Carp (Cyprinus carpio nudus) (담수어의 지질에 관한 연구 8. 천연 및 양식 잉어와 이스라엘 잉어의 지질성분 비교)

  • CHOI Jin-Ho;RHIM Chae-Hwan;BAE Tae-Jin;YOON Tai-Heon;LEE Kang-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.5
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    • pp.447-454
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    • 1985
  • As a part of serial study for comparing lipid components in freshwater fishes, this work was undertaken to compare the lipid components among wild and cultured carp, Cyprinus carpio, and Israeli carp, Cyprinus carpio nudus. The lipid components of cultured carp were analyzed and compared with those of wild and Israeli carp. In the content of total lipid, the lipid content in cultured carp was slightly lower than that in wild one, but similar to that in Israeli carp. The lipid contents in viscera of wild and cultured carp were 2 times higher than those in edible portion, but the lipid content in viscera of Israeli carp showed a similar trend to that in edible portion. In the fatty acid composition of neutral lipid in edible portion, percentages of $C_{18:1},\;C_{18:2},\;C_{18:3},\;C_{22:5}\;and\;C_{22:6}$ in cultured carp wire higher than those in wild one, while percentages of $C_{16:0},\;C_{18:0},\;C_{16:1},\;C_{20:4}\;and\;C_{20:5}$ lower, and percentage of $C_{18:2}$ in Israeli carp was noticeably higher than that in wild and cultured carp. In the case of phospholipid in edible portion, percentages of $C_{18:0},\;C_{18:1},\;C_{18:2},\;C_{18:3}\;and\;_C{22:6}$ in cultured carp were higher than those in wild one, while percentages of $C_{16:0},\;C_{16:1},\;C_{20:4},\;C_{20:5}\;and\;C_{22:5}$ lower. The unsaturation (TUFA/TSFA) of neutral lipid in cultured carp was slightly higher than that in wild one, but slightly lower than that in Israeli carp. In the case of phospholipid, the unsaturation showed a similar trend to that of neutral lipid. The essential fatty acid content(TEFA) of neutral lipid in edible portion of cultured carp was higher than that of wild one, but that in viscera lower. In the case of phospholipid in edible portion, the essential fatty acid content in Israeli carp was slightly higher than that in wild and cultured carp, and that in wild one was higher than that in cultured one. The w3 highly unsaturated fatty acid contents(w3 HUFA) of neutral lipid almost showed a similar trend to the essential fatty acid contents in wild and cultured carp, and Israeli carp. In the case of phospholipid, the w3 HUFA in Israeli carp was considerably higher than those in cultured and wild carp. In the ratio (A/C) of fatty acid content(A) in cultured carp to that(C) in diet, the A/C ratios of $C_{20:5}\;w3(0.12),\;C_{22:5}\;w6(0.53),\;C_{22:5}\;w3(0.68)\;and\;C_{22:6}\;w3(0.26)$ were much lower and in the ratio (B/C) of fatty acid content (B) in Israeli carp, the B/C ratios of $C_{18:3}\;w3(0.61),\;C_{20:5}\;w3(0.11),\;C_{22:4}\;w6(0.16),\;C_{22:5}\;w6(0.07)\;and\;C_{22:6}\;w3(0.79)$ were also lower than the other fatty acid. Consequently, it is considered that the ratios of w3 HUFA is related to the biosynthesis of polyenoic acid and growth rates of cultured and Israeli carp.

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The Diagnostic Yield and Complications of Percutaneous Needle Aspiration Biopsy for the Intrathoracic Lesions (경피적 폐생검의 진단성적 및 합병증)

  • Jang, Seung Hun;Kim, Cheal Hyeon;Koh, Won Jung;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.916-924
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    • 1996
  • Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.

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Plasma Activity of Lysosomal Enzymes in Active Pulmonary Tuberculosis (활동성 폐결핵 환자에서 혈중 리소솜 효소의 활성도)

  • Koh, Youn-Suck;Choi, Jeong-Eun;Kim, Mi-Kyung;Lim, Chae-Man;Kim, Woo-Sung;Chi, Hyun-Sook;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.646-653
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    • 1995
  • Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

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