기관지천식의 발생과 악화에 있어서 Interleukin32의 역할

학위논문 (박사)-- 서울대학교 대학원 의과대학 의학과, 2017. 8. 조상헌.Background Innate immunity and infection are important in the development and exacerbation of asthma. Interleukin-32 (IL-32), a pro-inflammatory cytokine involved with innate immunity against various infectious stimuli, is involved in various chronic inflammatory diseases such as rheumatoid arthritis, Crohns disease, and chronic obstructive pulmonary disease (COPD). This study was conducted to evaluate the role of IL-32 in asthma. Methods The role of IL-32γ in the airway was investigated in human bronchial epithelial cells (BEAS2B) stimulated with common asthma aggravating factors such as NOD ligands, dsRNA, lipopolysaccharide (LPS), and allergen (Der p) from house dust mites. IL-32γ was measured in the plasma of patients with asthma (n = 103) and healthy controls (n = 51), and then determined in induced sputum supernatant of patients with asthma (n = 89). Relationships between IL-32γ, airway obstruction (FEV1), inflammation (neutrophil and eosinophil % of the airway) and exacerbation frequency were evaluated. Results In in vitro study, IL-32γ exhibited synergistic effects with NOD 1 ligand and dsRNA on the induction of IL-6 from BEAS2B cells, but not by LPS and Der p. Plasma IL-32γ was detected in 95% (98/103) of patients with asthma and the level of IL-32γ was higher in asthmatic patients than in healthy controls. In the analysis of induced sputum, IL-32γ was detected in the sputum of 25 of 89 (28.1%) patients with asthma, and the asthma exacerbation rate was significantly higher in this group (n = 25) than in the IL-32-negative group (n = 64) (p = 0.03). Conclusion This study suggests that IL-32γ in the airway could increase inflammatory response to infectious stimuli and there could be an important role of IL-32 in subtype of asthma characterized by frequent exacerbations.Introduction 1 Methods 4 1. In vitro study 4 2. IL-32 in patients with asthma 5 1) Study subjects .. 6 2) Sample preparation and measurement of cytokines . 9 3. Statistical analysis 10 Results 12 1. In vitro study 12 2. Plasma IL-32 in the patients with asthma . 13 3. IL-32 in the induced sputum of patients with asthma . 15 Discussion . 18 Reference 29 Tables 36 Figures 42 Korean abstract . 65Docto

Differences in lower airway inflammation according to the presence of atopy and nasal polyposis in patients with chronic rhinitis

학위논문(석사) --서울대학교 대학원 :의학과(면역학전공),2010.2.Maste

산업단지 하부 지반의 흡착 성토재로써 제올라이트 토양 혼합물의 특성평가

학위논문(석사)--서울대학교 대학원 :공과대학 건설환경공학부,2020. 2. 박준범.In the case of soil under the industrial zones, it is more vulnerable to heavy metal contamination than agricultural or residential areas due to high industrial activity. Unlike organic contamination, this heavy metal contamination does not naturally decompose by biodegradation over time and even become a source of groundwater pollution. Therefore, in this study, it is intended to reduce the spread of pollution and furthermore to prevent groundwater contamination by placing the adsorption fill layer under the industrial zone. In the case of soil under the industrial zones, sufficient bearing capacity should be provided to support the upper structure. Among the heavy metals, zinc and lead are mainly focus on this study which is prior contamination of South Korea. In this study, Zeolite, efficient sorbent for heavy metal removal, was mixed with weathered granite soil, which is commonly used as fill material in South Korea, to form an adsorptive fill layer. The geotechnical engineering characteristics of the mixture were analyzed through the standard compaction test, direct shear test, and permeability test. As a result of the standard test, all compounds except SZ75 showed values above the regulation value. As a result of the direct shear test before and after the adsorption test, all mixtures maintained an internal friction angle of 30̊. The results of the permeability test showed that hydraulic conductivity increased as the zeolite content increased. The batch test, column test, and even soil tank test were performed to test geoenvironmental engineering properties. The batch test results showed that adsorption capacity tends to increase with increasing zeolite content, and even SZ25 has a strong resistance to heavy metal desorption. The column test was performed to review the effects of flow. The result of the column adsorption test showed that the adsorption capacity of SZ25 and SZ50 showed similar value, which is believed to have affected by the hydraulic conductivity as well as adsorption ability. As with column desorption test results and batch test results, resistance to desorption increased as the zeolite content increased. The soil tank test was carried out to perform the test under more field-like conditions. The results showed that the trend that SZ25 showed about 3.5 times adsorption capability and had better resistance to desorption is similar to column result. In conclusion, SZ25 can be suggested as an optimum mixing ratio in an economical and engineering perspective. By placing the adsorption fill layer with the soil-zeolite mixture, it is expected that the area of soil contamination can be reduced and ground-water pollution can be prevented.산업단지 하부지반의 경우, 산업활동으로 인하여 다른 농업이나 주거 지역에 비해 중금속오염에 취약하다. 이러한 토양의 중금속오염은 유기화합물에 의한 오염과 달리 시간이 지나도 자연적으로 분해가 되지 않으며 심지어 지하수 오염의 원인이 되기도 한다. 따라서, 본 연구에서는 산업단지 하부지반의 성토층에 흡착층을 배치하여 오염의 확산을 줄이고 나아가 지하수 오염을 방지하고자 한다. 산업단지 하부지반의 경우, 상부의 구조물을 지지하기 위해 충분한 지지력을 확보해야 한다. 본 연구에서는 이러한 중금속 중 한국에서 높은 빈도와 농도로 발생하는 오염물질인 아연과 납에 집중하였다. 본 연구에서는 일반적으로 성토재로 이용되는 화강 풍화토를 기반으로 중금속제거에 효율적인 제올라이트를 혼합하여 흡착성 성토재를 형성하였다. 혼합물의 지반공학적 특성은 표준 다짐시험, 직접전단시험, 투수시험을 통하여 분석하였다. 표준 다짐시험 결과, SZ75를 제외한 모든 혼합물은 규정치 이상의 값을 나타냈다. 직접전단시험을 흡착 시험 전후로 수행한 결과, 모든 혼합물들은 내부마찰각 30˚를 유지하였다. 투수시험결과, 제올라이트 함량이 증가할수록 투수계수가 증가하는 경향을 보였다. 지반환경공학적 관점에서 배치시험, 컬럼시험, 나아가 토조시험을 수행하였다. 배치시험결과, 제올라이트 함량이 증가할수록 흡착능이 증가하는 경향을 보였으며, SZ25도 중금속 탈착에 강한 저항력이 있는 것으로 나타났다. 흐름에 의한 영향을 검토하기 위해 컬럼시험을 수행하였다. 컬럼 흡착시험결과, SZ25와 SZ50과 비슷한 결과가 나왔으며 이는 시험에 흡착능 뿐만 아니라 투수계수도 영향을 끼친 것으로 판단된다. 컬럼 탈착시험결과, 배치시험결과와 마찬가지로 제올라이트 함량이 증가할수록 탈착에 대한 저항성이 증가했다. 보다 현장과 비슷한 조건에서 시험을 수행하고자 토조시험을 수행하였다. 토조시험결과, 컬럼시험과 비슷하게 SZ25가 SZ0보다 약 3.5배의 흡착능을 발현하였으며 탈착에 대한 저항성도 더 뛰어난 것으로 나타났다. 결과적으로 제올라이트를 25퍼센트 섞은 SZ25가 경제적, 공학적으로 최적함수비에 가까우며, 이러한 혼합물로 흡착층을 배치함으로 토양오염의 범위를 줄이고 지하수오염을 방지할 수 있을 것으로 기대된다.Chapter 1. Introduction 1 1.1 Background 1 1.1.1 Industrial zones in South Korea 1 1.1.2 Heavy metal contamination under industrial zones (worldwide) 4 1.2 Research Concept 7 1.3 Objectives 9 Chapter 2. Literature Review 10 2.1 Previous research 10 2.1.1 Zeolite Efficiency of removing heavy metal by batch test 11 2.1.2 Zeolite Efficiency of removing heavy metal by column test 15 2.1.3 Zeolite amended material 17 2.1.4 Fill material using other material 19 2.2 Data analysis of adsorption isotherm equilibrium test 20 2.2.1 Langmuir adsorption isotherm model 20 2.2.2 Freundlich adsorption isotherm model 21 Chapter 3. Materials & Methods 22 3.1 Materials 22 3.1.1 Weathered soil and zeolite 22 3.1.1.1 Physical and chemical properties 22 3.1.1.2 X-ray Diffractometer (XRD) 25 3.1.1.3 Scanning Electron Microscope (SEM) 26 3.1.2 Mixing method 27 3.2 Methods 29 3.2.1 Geotechnical tests 30 3.2.1.1 Standard compaction test 30 3.2.1.2 Direct shear test 31 3.2.1.3 Permeability test 31 3.2.2 Geo-environmental tests 32 3.2.2.1 Batch tests 32 3.2.2.2 Column test 34 3.2.2.3 Soil tank test (pilot-scale test) 36 Chapter 4. Experimental results and discussion 38 4.1 Geotechnical tests 38 4.1.1 Standard compaction test 38 4.1.2 Direct shear test 39 4.1.3 Permeability test 41 4.2 Geo-environmental tests 42 4.2.1 Batch test 42 4.2.1.1 Adsorption batch test 42 4.2.1.2 Desorption batch test 46 4.2.2 Column test 49 4.2.2.1 Adsorption column test 49 4.2.2.2 Desorption column test 53 4.2.3 Soil tank test (pilot-scale test) 55 4.2.3.1 Adsorption soil tank test 55 4.2.3.2 Desorption soil tank test 57 Chapter 5. Conclusion and further study 59 5.1.1 Conclusion 59 5.1.2 Further study 61Maste

Comparison of perioperative outcomes in pancreatic head cancer patients following either a laparoscopic or open pancreaticoduodenectomy with a superior mesenteric artery first approach

Backgrounds/Aims: A superior mesenteric artery first approach (SFA) technique can improve the complete resection rate. It can be used to determine whether an operation can be performed by invading the superior mesenteric artery before performing a pancreatic transection in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to compare perioperative outcomes between laparoscopic and open SFA for PDAC. Methods: Between January 2017 and August 2019, consecutive patients who underwent laparoscopic and open pancreaticoduodenectomy (PD) for PDAC using SFA procedures were included and compared between laparoscopic and open procedures. Results: Fourteen and 83 patients underwent laparoscopic and open surgeries, respectively. In perioperative outcomes, there were no significant differences in the amount of intraoperative blood loss or transfusion rate between the two groups. In the laparoscopic group, the operation time was longer with less patients showing wound infection. R0 resection rate and the number of retrieved lymph nodes showed no significant difference. The average time to adjuvant chemotherapy was longer in the open group. There was no significant difference in the mean survival time or the recurrence free period. Conclusions: Patients who underwent laparoscopic PD using SFA showed perioperative outcomes comparable compared to those of patients who underwent open procedures performed by experienced surgeons

. Clinical Outcome of RAMPS for Left-Sided Pancreatic Ductal Adenocarcinoma: A Comparison of Anterior RAMPS Versus Posterior RAMPS for Patients without Periadrenal Infiltration

Radical antegrade modular pancreatosplenectomy (RAMPS) is considered an effective procedure for left-sided pancreatic ductal adenocarcinoma (PDAC). However, whether there are differences in perioperative outcomes, pathologies, or survival outcomes between anterior RAMPS (aRAMPS) and posterior RAMPS (pRAMPS) has not been reported previously. We retrospectively reviewed and compared the demographic, perioperative, histopathologic, and survival data of patients who underwent aRAMPS or pRAMPS for PDAC. We also compared these two groups among patients without periadrenal infiltration or adrenal invasion. A total of 112 aRAMPS patients and 224 pRAMPS patients were evaluated. Periadrenal infiltration, neoadjuvant treatment, and concurrent vessel resection were more prevalent in the pRAMPS group. After excluding patients with periadrenal infiltration, 106 aRAMPS patients were compared with 157 pRAMPS patients. There were no significant differences between the aRAMPS and pRAMPS groups in the pathologic tumor size, resection margin, proportion of tangential margin in the R1 resection, and number of harvested lymph nodes. The median overall survival and disease-free survival also did not differ significantly between the two groups. We cautiously suggest that pRAMPS will not necessarily provide more beneficial histopathologic outcomes and survival rates for left-sided PDAC cases without periadrenal infiltration. If periadrenal infiltration is not suspected, aRAMPS alone should be sufficiently effective

A comparison of minimally invasive vs open distal pancreatectomy for resectable pancreatic ductal adenocarcinoma: Propensity score matching analysis.

Background: Owing to concerns regarding adequate oncological outcomes and perioperative complications, minimally invasive distal pancreatectomy (MIDP) for pancreatic ductal adenocarcinoma (PDAC) has limited generalizability. The aim of this study was to assess the perioperative and oncologic outcomes of MIDP compared with open distal pancreatectomy (ODP) for resectable PDAC after propensity score matching (PSM). Methods: The patients who underwent MIDP and ODP for PDAC between January 2010 and December 2017 were retrospectively reviewed. Demographics, perioperative outcomes, pathological outcomes, and overall and disease-free survival data were collected to compare MIDP and ODP. After PSM, perioperative and oncologic outcomes were analyzed. Results: A total of 156 MIDP patients were compared with 156 ODP patients for resectable PDAC after PSM. Tumor size, TNM stage, differentiation, harvested lymph nodes, and positive lymph nodes were not different except for R1 resection and lymphovascular invasion between the MIDP and ODP groups. Operation times, overall complications, POPF, and adjuvant treatment were also not different between the two groups. The MIDP group had shorter hospital stays (10.0 vs 13.4 days, P < 0.001) and shorter interval times from surgery to adjuvant treatment (37.6 days vs 46.0 days, P = 0.002) than the ODP group. The MIDP group had better overall survival (34.9 vs 24.5 months, P = 0.012) and disease-free survival (16.2 vs 10.3 months, P = 0.001). Conclusion: Minimally invasive distal pancreatectomy has advantages with respect to postoperative hospital stay, interval between surgery, and adjuvant treatment. MIDP is associated with the possibility of improved survival rate for resectable PDAC