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Conservation Status, Construction Type and Stability Considerations for Fortress Wall in Hongjuupseong (Town Wall) of Hongseong, Korea (홍성 홍주읍성 성벽의 보존상태 및 축성유형과 안정성 고찰)

  • Park, Junhyoung;Lee, Chanhee
    • Korean Journal of Heritage: History & Science
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    • v.51 no.3
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    • pp.4-31
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    • 2018
  • It is difficult to ascertain exactly when the Hongjuupseong (Town Wall) was first constructed, due to it had undergone several times of repair and maintenance works since it was piled up newly in 1415, when the first year of the reign of King Munjong (the 5th King of the Joseon Dynasty). Parts of its walls were demolished during the Japanese occupation, leaving the wall as it is today. Hongseong region is also susceptible to historical earthquakes for geological reasons. There have been records of earthquakes, such as the ones in 1978 and 1979 having magnitudes of 5.0 and 4.0, respectively, which left part of the walls collapsed. Again, in 2010, heavy rainfall destroyed another part of the wall. The fortress walls of the Hongjuupseong comprise various rocks, types of facing, building methods, and filling materials, according to sections. Moreover, the remaining wall parts were reused in repair works, and characteristics of each period are reflected vertically in the wall. Therefore, based on the vertical distribution of the walls, the Hongjuupseong was divided into type I, type II, and type III, according to building types. The walls consist mainly of coarse-grained granites, but, clearly different types of rocks were used for varying types of walls. The bottom of the wall shows a mixed variety of rocks and natural and split stones, whereas the center is made up mostly of coarse-grained granites. For repairs, pink feldspar granites was used, but it was different from the rock variety utilized for Suguji and Joyangmun Gate. Deterioration types to the wall can be categorized into bulging, protrusion of stones, missing stones at the basement, separation of framework, fissure and fragmentation, basement instability, and structural deformation. Manually and light-wave measurements were used to check the amount and direction of behavior of the fortress walls. A manual measurement revealed the sections that were undergoing structural deformation. Compared with the result of the light-wave measurement, the two monitoring methods proved correlational. As a result, the two measuring methods can be used complementarily for the long-term conservation and management of the wall. Additionally, the measurement system must be maintained, managed, and improved for the stability of the Hongjuupseong. The measurement of Nammunji indicated continuing changes in behavior due to collapse and rainfall. It can be greatly presumed that accumulated changes over the long period reached the threshold due to concentrated rainfall and subsequent behavioral irregularities, leading to the walls' collapse. Based on the findings, suggestions of the six grades of management from 0 to 5 have been made, to manage the Hongjuupseong more effectively. The applied suggested grade system of 501.9 m (61.10%) was assessed to grade 1, 29.5 m (3.77%) to grade 2, 10.4 m (1.33%) to grade 3, 241.2 m (30.80%) and grade 4. The sections with grade 4 concentrated around the west of Honghwamun Gate and the east of the battlement, which must be monitored regularly in preparation for a potential emergency. The six-staged management grade system is cyclical, where after performing repair and maintenance works through a comprehensive stability review, the section returned to grade 0. It is necessary to monitor thoroughly and evaluate grades on a regular basis.

Prehospital Status of the Patients with Ischemic Chest Pain before Admitting in the Emergency Department (허혈성 흉통 환자의 응급의료센터 방문 전 상황)

  • Jin, Hye-Hwa;Lee, Sam-Beom;Do, Byung-Soo;Chun, Byung-Yeol
    • Journal of Yeungnam Medical Science
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    • v.24 no.1
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    • pp.41-54
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    • 2007
  • Background : The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). Materials and Methods : We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. Results : Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. Conclusion : Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.

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An Interpretation of the Folktale 'the Servant Who Ruined the Master's House' from the Perspective of Analytical Psychology: Centering on the Trickster Archetype (민담 '주인집을 망하게 한 하인'의 분석심리학적 이해: 트릭스터 원형을 중심으로)

  • Myoungsun Roh
    • Sim-seong Yeon-gu
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    • v.37 no.2
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    • pp.184-254
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    • 2022
  • Through this thesis, the psychological meaning of the Korean folktale 'the servant who ruined the master's house' was examined. The opposition between the master and the servant is a universal matter of the human psychology. It can be seen as a conflict between the hardened existing collective consciousness and the new consciousness to compensate for and renew it. From different angles, it has become the opposition between man's spiritual and instinctive aspects, between the conscious and the unconscious, or between the ego and the shadow. In the folktale, the master tries several times to get rid of the youngest servant, but the servant uses tricks and wits to steal food, a horse, the youngest sister, and all money from the master, and finally, take his life. It ends with the marriage of the youngest sister and the servant. Enantiodromia, in which the master dies, and the servant becomes the new master, can be seen that the old collective consciousness is destroyed, and the new consciousness that has risen from the collective unconscious takes the dominant position. In an individual's psychological situation, it can be seen that the existing attitude of the ego is dissolved and transformed into a new attitude. In the middle of the story, the servant marries the youngest sister by exploiting naive people to rewrite the back letter written by the master to kill him. This aspect can be understood negatively in the moral concept of collective consciousness, but it can also be seen as a process of integrating mental elements that have been ignored in the collective consciousness of the Joseon Dynasty, symbolized by a woman, a honey seller, and a hungry Buddhist monk. The new consciousness, represented by the servant, has the characteristics of a trickster that is not bound by the existing frame, so it can encompass the psychological elements that have been ignored in the collective consciousness. Such element may represent compensation or an alternative to the collective consciousness in the late Joseon Dynasty. The master puts the servant in a leather bag and hangs it on a tree to kill the servant. However, the servant deceives a blind man; he opened his eyes while hanged. Instead of the servant, the blind man dies, and the servant is freed. As the problem of the conflict between master and servant is finally entrusted to the whole spirit (Self) symbolized by a tree, the blind man gets removed. It can be understood as an intention of the Self to distinguish and purify the elements of recklessness, stupidity, and greed included in the trickster. Through these processes, the servant, which symbolizes a new change in collective consciousness or a new attitude of ego, solves the existing problems and takes the place of the master. While listening to the cunning servant's performance, the audience feels a sense of joy and liberation. At the same time, in the part where the blind man and the master's family die instead and the servant becomes the master, they experience feelings of fear and concern about the danger and uncontrollability of the servant. The tricksters appearing in foreign analogies are also thoroughly selfish and make innocent beings deceive or die in order to satisfy their desires and escape from danger. Efforts to punish or reform these tricksters are futile and they run away. Therefore, this folktale can also be seen as having a purpose and meaning to let us know that this archetypal shadow is very dangerous and that consciousness cannot control or assimilate it, but only awe and contemplate it. Trickster is an irrational manifestation of revivifying natural energy that rises from the unconscious as a compensation for hardened existing structure and order. The phenomenon may be destructive and immoral from the standpoint of the existing collective mind, but it should be seen as a function of the collective unconscious, a more fundamental psychic function that cannot be morally defined. The servant, a figure of the trickster archetype, is a being that brings transformation and has the duality and contradiction of destructiveness and creativity. The endings of this folktale's analogies are diverse, reflecting the diversified response of the audience's mind due to the ambivalence of the trickster, and also suggesting various responses toward the problem of the trickster from the unconscious. It also shows that the trickster is a problem of inconclusive and controversial contradictions that cannot be controlled with a conscious rational attitude, and that we can only seriously contemplate the trickster archetype within us.

Study on Safety Management Activity of Blood Test Room of Nuclear Medicine Department (핵의학과 혈액검사실의 안전 관리 활동에 대한 고찰)

  • Sim, Seong-Jae;Shin, Young-Kyun;Moon, Hyeong-Ho;Yoo, Seon-Hee;Jo, Shi-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.104-110
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    • 2011
  • Purpose: The object evaluation method about medical institutes of these days increases credibility of consumers about medical services by conducting a certification system about medical institutes. In addition, as nuclear medicine test rooms and diagnosis test medicine room adopt many kinds of international certification systems, the matters regarding safety management of test rooms are being regarded as important. Since the blood test rooms of nuclear medicine are exposed to many harmful factors such as infection from clinical specimen and radioactive isotope reagent, there is a need to pay lots of attention to the safety management of staff and patients. Therefore, this study discusses safety management activities of staff and patients, which are conducted in the blood test rooms of the nuclear medicine department in Asan Medical Center. Materials and Methods: In the blood test rooms of the nuclear medicine department in Asan Medical Center, the matters regarding comprehensive safety management by the person in charge of safety management are offered and all staff members of the test rooms apply them into work. Safety management education is regularly conducted according to established regulations, and infection is prevented through implementation of wearing personal protectors and hand sanitation during test work. In addition, technical safety guides and accident guides for interruption of electric power are provided against emergencies. Through infection management guides, infection prevention and preparation methods for infection are learned and radioactive isotope management, safety management about reagent use and safety guides about harmful chemical substances are being applied to work. Results: The blood test rooms of the nuclear medicine department apply safety management regulations to work. Under the situation where hand sanitation should be conducted, hands are washed to prevent infection between staff and patients, and for preventing infection from clinical specimen, personal protectors are worn. The reagent, which is classified as harmful substance, is separately stored to be easily recognized, radioactive wastes and general medical wastes are also safely managed. Through these lots of safety management activities, safety management awareness of staff members is enhanced, and patients are protected from many dangers. Conclusion: Staff members of the blood test rooms of the nuclear medicine department should be fully aware of safety management regulations and apply them to work. When better safety management suggestions are made, they need to be examined and applied for increasing quality of safety management for staff and patients.

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A Comparative Study of the Foreign Trade Strategies of Gaisong Merchants and Modern Companies in Korea. (현대기업과 개성상인의 해외진출전략의 비교분석)

  • Park, Sang-Gyu
    • Korean Business Review
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    • v.17
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    • pp.153-183
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    • 2004
  • The Gaisong Merchants can be regarded to playa pioneering role to activate the Korea's trade with foreign countries. In the early period of Yi-Dynasty, the Gaisong Merchants focused on personal trade, but in the middle period of Yi-Dynasty, they entered to the realm of governmental trade. Furthermore, their business activities widened to various forms of trades, for example, smuggling. Utilizing accumulated capital, Gaisong merchants expanded their trading activities to their neighboring countries such as Japan and China. In recent times, it is necessary for modem Korean companies to diversify risks through the establishment of corporations for production, marketing and R&D abroad or through joint venture, M&A and strategic alliance with foreign companies in order to reduce the risks originated from volatile economic and political situations. In this study, we utilize tools of comparative study to compare Gaisong Merchants' foreign trade strategies with those of modem companies such as AMOREPACIFIC, HANILCEMENT and SHINDORICO. The purpose of the paper is to test the hypothesis that modem Korean companies grew up by following the cases of Gaisong Merchants' business activities. We summarize our main findings as follows. First, both Gaisong Merchants and modem Korean companies have common functional core capability in the field of marketing, manufacturing technology, R&D, and human resources development. Second, both Gaisong Merchants and modem Korean companies have common organizational core capability. Third, both Gaisong Merchants and modem Korean companies have common infrastructures such as planning, finance, accounting and MIS. It constitutes the infrastructure of Korea's foreign trade sector. Fourth, both Gaisong Merchants and modem companies have common organizational culture in the field of management policy and philosophy. Actually, those factors are evaluated to be driving forces of Koera's success in foreign trade. In conclusion, the business activities of Gaisong Merchants who represented the peculiarity of Korean business spirit are partially inherited to current Korean business management. The value system and behavior pattern of modern Korean companies is succeeded from the spirit of Gaisong Merchants and it playa major role to specify the identity of Korean business administration.

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The Significance of Registration Convention and its Future Challenges in Space Law (등록협약의 우주법상 의의와 미래과제에 관한 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.2
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    • pp.375-402
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    • 2020
  • The adoption and entering into force of the Registration Convention was another achievement in expanding and strengthening the corpus iuris spatialis. It was the fourth treaty negotiated by the member states of the UNCOPUOS and it elaborates further Articles 5 and 8 of the Outer Space Treaty(OST). The Registration Convention also complements and strengthens the Article 11 of the OST, which stipulates an obligation of state parties to inform the UN Secretary-General of the nature, conduct, locations, and results of their space activities in order to promote international cooperation. The prevailing purposes of the Registration Convention is the clarification of "jurisdiction and control" as a comprehensive concept mentioned in Article 5 8 of the OST. In addition to its overriding objective, the Registration Convention also contributes to the promotion and the exploration and use of outer space for peaceful purposes. Establishing and maintaining a public register reduces the possibility of the existence of unidentified space objects and thereby lowers the risk such as, for example, putting the weapons of mass destruction secretly into orbit. And furthermore it could serve for a better space traffic management. The Registration Convention is a treaty established to implement Article 5 of OST for the rescue and return of astronaut in more detail. In this respect, if OST is a general law, the Registration Convention would be said to be in a special law. If two laws conflict the principle of lex specialis will be applied. Countries that have not joined the Registration Convention will have to follow the rules concerning the registration of paragraph 7 of the Declaration by the United Nations General Assembly resolution 1721 (X V I) in 1961. UN Resolution 1721 (XVI) is essentially non-binding, but appears to have evolved into the norm of customary international law requiring all States launching space objects into orbit or beyond to promptly provide information about their launchings for registration to the United Nations. However, the nature and scope of the information to be supplied is left to the discretion of the notifying State. The Registration Convention is a treaty created for compulsory registration of space objects by nations, but in reality it is a treaty that does not deviate from existing practice because it is based on voluntary registration. With the situation of dealing with new problems due to the commercialization and privatization of the space market, issues related to the definition of a 'space object', including matter of the registry state of new state that purchased space objects and space debris matter caused by the suspension of space objects launched by the registry state should be considered as matters when amendments, additional protocols or new Registration Convention are established. Also the question of registration of a flight vehicle in the commercial space market using a space vehicle traveling in a sub-orbital in a short time should be considered.

A Case Study - IT Outsourcing of the Korea Development Bank (산업은행: 금융 IT 아웃소싱 - 공동협력으로 안전한 문을 연다)

  • Kang, Ju-Young;Lee, Jae-Kyu
    • Information Systems Review
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    • v.7 no.2
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    • pp.229-255
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    • 2005
  • The Korea Development Bank promoted a total outsourcing for IT operation in 1999 for the first time in the banking industry. The Korea Development Bank became the center of public attention because the most banks were unwilling to take an outsourcing with external sources for the reason of financial operation accidents, securities, and threats of strikes. After the introduction of the total IT outsourcing, the Korea Development Bank has continuously diagnosed the problems of the IT outsourcing and adopted various proper complements for the enhancement of the IT outsourcing. As the result of the enhancement, the IT outsourcing of the Korea Development Bank marched into the joint liability operation period after going through the outsourcing operation period and the co-operation period. The joint liability operation which is the most leading outsourcing system which is adopted by the Korea Development Bank for the first time in the banking industry. Through the joint liability operation, the Korea Development Bank could accept the most up-to-date IT, concentrate internal manpower on the core capability, and secure flexibility of manpower. Also, the bank changed the relationship between the bank and the external sources from the one-sided relationship between a producers and a consumer to the joint liability relationship on which both sides are responsible for the operation, and could integrate the internal capacity with the professional know-how of the external IT outsourcing company. In this paper, we testified the soundness and validity for the worries of banks about the total IT outsourcing with external sources. And, we arranged the advantages and outcomes of the total IT outsourcing with external sources compared to the IT outsourcing with internal sources. Moreover, we expect that we can improve the closed financial IT outsourcing industry structure and raise the world competitive power of domestic IT outsourcing companies by correcting wrong ideas on the IT outsourcing with external sources.

A Neurobehavioral Performance Assessment in Lacunar Infarction Case-control Study (열공성 뇌경색 환자-대조군에서 신경행동검사의 수행 평가)

  • Kim, Ham-Gyum;Park, Sue-Kyung;Lee, Kun-Sei;Kim, Hyeoug-Su;Kim, Wha-Sun;Chang, Soung-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.3
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    • pp.255-262
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    • 2003
  • Objectives : We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. Methods : Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1:1 , Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test, Results : Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, add systolic blood pressure. From multivariate regression analysis, there was significant difference (p<0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. Conclusions : We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier defection for neurological abnormality in lacunar infarction.

Simulation of Soil Moisture in Gyeongan-cheon Watershed Using WEP Model (WEP 모형을 이용한 경안천 토양수분 모의)

  • Noh, Seong-Jin;Kim, Hyeon-Jun;Kim, Cheol-Gyeom;Jang, Cheol-Hee
    • Proceedings of the Korea Water Resources Association Conference
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    • 2006.05a
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    • pp.720-725
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    • 2006
  • 토양수분은 식물의 생장 및 가용수자원 산정 등에 있어서 중요한 요소로서 토양층 상부의 수 m내에 존재하는 수분의 양을 일컫는다. 토양수분과 토양수분의 공간적 시간적 특징들은 증발, 침투, 지하수 재충전, 토양침식, 식생 분포 등을 지배하는 중요한 요소이다. 강우 등으로 인한 지면과 지표하에서의 순간적인 포화공간의 형성 및 유출의 생성 등을 포함하는 과정과 증발산 등은 모두 비포화대(vadose zone) 혹은 토양층에서의 토양수분의 함량에 크게 의존하게 된다(이가영 등(2005)). 분포형 수문모형은 유역을 격자단위로 세분화하여 매개변수를 부여하고, 증발산, 침투, 지표면유출, 중간유출, 지하수유출, 하도 흐름 등 여러 가지 수문요소를 해석하는 종합적인 수문모형이다. 지표면에 내린 강우가 증발, 침투, 유출될 지는 토양수분의 함량에 크게 의존하게 되며, 따라서 토양수분에 대한 적절한 모의가 분포형 수문모형의 정확도를 좌우하는 핵심이라 할 수 있다. 본 연구에서는 분포형 수문모형인 WEP 모형을 경안천 유역(유역면적: $575km^2$, 유로연장: 49.3㎞)에 적용하여 토양수분의 시공간분포를 모의하였다. 지점별 토양수분 모의결과, 토양 매개변수의 최대, 최소값 내에서 적절히 모의됨을 확인하였으나, 관측값이 없어 실질적으로 타당한지 여부는 검증하지 못하였다. 토양수분비율, 연간 증발산량, 지표면 유출량 공간분포를 비교한 결과, 토양수분비율이 연간 증발산량 모의에 직접적인 영향을 주는 것을 확인할 수 있었다. 일부격자에서는 토양수분이 지나치게 높게 모의되었는데, 지하수위와 관련있는 것으로 보이며, 구축된 자료가 부족한 지하대수층에 대한 정보부족이 토양수분 계산에도 영향을 준 것으로 보인다. 본 연구는 WEP 모형의 토양수분 해석능력에 대한 시험적용에 그 의의가 있으며, 향후 토양 및 지표하 매개변수 정보가 충분히 갖추어지고, 토양수분 관측결과 있는 대상유역에 대한 적용이 요구된다.-Moment 방법에 의해 추정된 매개변수를 사용한 Power 분포를 적용하였으며 이들 분포의 적합도를 PPCC Test를 사용하여 평가해봄으로써 낙동강 유역에서의 저수시의 유출량 추정에 대한 Power 분포의 적용성을 판단해 보았다. 뿐만 아니라 이와 관련된 수문요소기술을 확보할 수 있을 것이다.역의 물순환 과정을 보다 명확히 규명하고자 노력하였다.으로 추정되었다.면으로의 월류량을 산정하고 유입된 지표유량에 대해서 배수시스템에서의 흐름해석을 수행하였다. 그리고, 침수해석을 위해서는 2차원 침수해석을 위한 DEM기반 침수해석모형을 개발하였고, 건물의 영향을 고려할 수 있도록 구성하였다. 본 연구결과 지표류 유출 해석의 물리적 특성을 잘 반영하며, 도시지역의 복잡한 배수시스템 해석모형과 지표범람 모형을 통합한 모형 개발로 인해 더욱 정교한 도시지역에서의 홍수 범람 해석을 실시할 수 있을 것으로 판단된다. 본 모형의 개발로 침수상황의 시간별 진행과정을 분석함으로써 도시홍수에 대한 침수위험 지점 파악 및 주민대피지도 구축 등에 활용될 수 있을 것으로 판단된다. 있을 것으로 판단되었다.4일간의 기상변화가 자발성 기흉 발생에 영향을 미친다고 추론할 수 있었다. 향후 본 연구에서 추론된 기상변화와 기흉 발생과의 인과관계를 확인하고 좀 더 구체화하기 위한 연구가 필요할 것이다.게 이루어질 수 있을 것으로 기대된다.는 초과수익률이 상승하지만, 이후로는 감소하므로, 반전거래전략을 활용하는 경우 주식투자기간은 24개월이하의 중단기가 적합함을 발견하였다. 이상의 행태적 측면과 투자성과측면의 실증결과를 통하여 한국주식시장에 있어서 시장수익률을 평균적으로 초과할 수 있는 거래전략은 존재하므로 이러한 전략을 개발 및 활용할 수 있으며, 특히, 한국주식시장에 적합한 거래전략은 반전거래전략이고, 이 전략의 유용성은 투자자가 설정한 투자기간보다 더욱 긴 분석기간의 주식가격정보에 의하여 최대한 발휘될 수 있음을 확인하였다.(M1), 무역적자의

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The Clinical Utility of Polymerase Chain Reaction in the Bronchoalveolar Lavage Fluid for the Detection of Mycobacteria (객담 도말 음성인 환자에서 기관지폐포 세척액 결핵균 중합 효소 연쇄반응 검사의 유용성)

  • Mo, Eun-Kyung;Kyung, Tae-Young;Kim, Dong-Gyu;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Kyung-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.519-528
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    • 1998
  • Background: Diagnosis of pulmonary tuberculosis is not easy when the sputum smear for Mycobacterium tuberculosis(M. Tb) is negative. We evaluated the clinical utility of polymerase chain reaction(PCR) for detecting M. Tb in bronchoalveolar lavage(BAL) samples. Methods: We recruited 84 patients whose sputum smear for M. Tb were negative or not available due to no production of sputum. We performed bronchoalveolar lavage for acid-fast stain, culture of mycobacteria, and PCR assay of BAL fluid. We analyzed the results of microbiologic examination. Results: The sensitivity of BAL fluid smear, culture, and PCR were 20%, 38%, and 40%, respectively. The specificity of BAL fluid PCR was 95%. The positive predictive value of PCR was 89%. The smear of BAL fluid was positive in 17%. The PCR of BAL fluid was the only diagnostic test in 17%. Therefore, the BAL fluid analysis including smear and PCR was diagnostic in 34 % within 24 hours. The BAL fluid analysis including smear, PCR, and culture was diagnostic in 55% within 2 month. Conclusion: The BAL fluid PCR was valuable method in the diagnosis of pulmonary tuberculosis in patients whose sputa were not available or reveal negative smear.

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