A Case of Nasopharyngeal Schwannoma Treated with Endoscopic Tumor Resection

Schwannoma is generally known as benign tumor originated from Schwann cells of peripheral nerve sheaths. This tumor is characterized by well-circumscribed, encapsulated, and slow growing. It is reported that it mainly appears in the head and neck area, but it is known that paranasal sinus and sinus are rarely seen within 4%. We describe an incidental schwannoma case arising from the nasopharyngeal level of a 41-year-old woman. The patient visited the out-patient clinic with a nasopharyngeal mass found incidentally on a health check. The tumor was then totally removed by endoscopic surgery without complications and diagnosed as a schwannoma. She had no sequelae or recurrence for 1year after surgery.ope

An Alternative Dendritic Cell-Induced Murine Model of Asthma Exhibiting a Robust Th2/Th17-Skewed Response

Purpose: Simple and reliable animal models of human diseases contribute to the understanding of disease pathogenesis as well as the development of therapeutic interventions. Although several murine models to mimic human asthma have been established, most of them require anesthesia, resulting in variability among test individuals, and do not mimic asthmatic responses accompanied by T-helper (Th) 17 and neutrophils. As dendritic cells (DCs) are known to play an important role in initiating and maintaining asthmatic inflammation, we developed an asthma model via adoptive transfer of allergen-loaded DCs. Methods: Ovalbumin (OVA)-loaded bone marrow-derived DCs (BMDCs) (OVA-BMDCs) were injected intravenously 3 times into non-anesthetized C57BL/6 mice after intraperitoneal OVA-sensitization. Results: OVA-BMDC-transferred mice developed severe asthmatic immune responses when compared with mice receiving conventional OVA challenge intranasally. Notably, remarkable increases in systemic immunoglobulin (Ig) E and IgG1 responses, Th2/Th17-associated cytokines (interleukin [IL]-5, IL-13 and IL-17), Th2/Th17-skewed T-cell responses, and cellular components, including eosinophils, neutrophils, and goblet cells, were observed in the lungs of OVA-BMDC-transferred mice. Moreover, the asthmatic immune responses and severity of inflammation were correlated with the number of OVA-BMDCs transferred, indicating that the disease severity and asthma type may be adjusted according to the experimental purpose by this method. Furthermore, this model exhibited less variation among the test individuals than the conventional model. In addition, this DCs-based asthma model was partially resistant to steroid treatment. Conclusions: A reliable murine model of asthma by intravenous (i.v.) transfer of OVA-BMDCs was successfully established without anesthesia. This model more accurately reflects heterogeneous human asthma, exhibiting a robust Th2/Th17-skewed response and eosinophilic/neutrophilic infiltration with good reproducibility and low variation among individuals. This model will be useful for understanding the pathogenesis of asthma and would serve as an alternative tool for immunological studies on the function of DCs, T-cell responses and new drugs.ope

Development of a Direct Numerical Simulation Method on the Nonlinear Dynamic Responses among Wave, Structure and Seabed

연안구조물을 설치할 때 지반의 안정성 해석에 있어서 가장 중요한 문제점으로 파랑의 존재를 들 수 있다. 해저지반은 파랑에 의한 반복하중을 받는 특성을 가지므로 지진과 같은 육상에서의 지반 거동과는 상당히 다른 특징을 갖는다. 지난 10여년 동안 파ㆍ구조물ㆍ해저지반의 상호간섭에 대한 연구에 발전을 보여 왔다. 그러나 파ㆍ구조물ㆍ해저지반의 상호간섭에 대해 이전의 연구자들은 해저불투과의 가정에 초점을 두고 있다. 파랑하중에 의한 지반내 간극수압은 연안구조물 부근에서의 세굴과 같은 지반의 안정성을 연구하는데 중요한 요소이다. 파ㆍ해저지반의 상호간섭에 대한 해석모형이 완전한 형태의 해를 주기 때문에 상호간섭문제의 기본적인 특성들은 수치모형에 비하여 쉽게 또는 효율적으로 분석될 수 있으나 이러한 해석적 접근은 단순한 해저지반인 경우로 제약되고 수심이 변하는 경우나 해저지반에 구조물이 놓여있을 경우 적용하기가 어렵다. 대부분의 연안구조물, 특히, 케이슨 형태의 방파제나 잠제는 기초지반과 같이 동적으로 거동한다. 최근 파ㆍ구조물ㆍ해저지반의 비선형 상호간섭을 해석하기 위하여 경계요소법(BEM)과 유한요소법(FEM), VOF법과 유한요소법(FEM)을 병용한 수치해석기법이 제안되었다. 하지만, 이러한 수치해석기법은 파동장과 지반부의 분리에 따른 가정 때문에 Hybrid기법을 적용하고 있다. 따라서 파랑하중하에서 파ㆍ구조물ㆍ해저지반의 동적응답을 적절히 모의하기 위한 수치모델의 개발이 필요하다. 본 연구에서는 파ㆍ구조물ㆍ해저지반의 비선형동적응답을 해석하기 위하여 직접수치해석기법(DNS)이 새롭게 제안되었다. 본 수치해석기법은 Darcy 와 Forchheimer 저항력이 추가된 Porous Body Model에 기초하고 있다. 해저접합면에서는 압력과 유량의 연속을 고려함으로써 유체부에서 다공질매질로의 변화가 가능하다. 이러한 방정식은 적절히 저항계수를 조절함으로써 비선형 층류흐름영역에서부터 완전난류흐름영역에까지 수치모의가 가능하게 된다. 새롭게 제안된 본 수치해석기법은 파ㆍ투과성잠제에 대해서 Kioka et al.(1994), 파ㆍ모래지반에 대해서는 Yamamoto et al.(1978), 파ㆍ투과성잠제ㆍ모래지반에 대해서는 Mizutani et al.(1997), 파ㆍ혼성방파제ㆍ모래지반에 대해서는 Mostafa et al.(1999)의 실험치와 각각 비교하여 좋은 일치성을 보였다. 또한, 새롭게 제안된 수치해석기법의 적용성을 검토하기 위하여 파ㆍ구조물(잠제, 혼성방파제)ㆍ해저지반의 결합에 의한 파동장 및 간극수압의 변화 등이 상세히 논의 되었다.For the geotechnical analysis in the construction and design of the coastal structures, one of the most important factors is an existence of wave. It is expected that the soil behaviours in the seabed subjected to cyclic wave loads are much different from that on the ground subjected to dynamic forces such as earthquake. In the past few decades, considerable effects have been devoted to analysis the phenomenon of waveㆍstructureㆍseabed interaction. However, most of the researches for waveㆍstructureㆍseabed interaction have been focused on the assumption of rigid seabed. The wave-induced pore pressure in the seabed are key factor in studying the stability of the seabed in the vicinity of coastal structure, like a toe scouring. Since analytical model for waveㆍseabed interaction gives a closed from solution, the fundamental characteristics can be analyzed easily and efficiently compared with numerical methods. But, analytical model is difficult to be applied to the cases with varying water depth or structure located on the seafloor, because this approach is limited to the simple geometrical case of the seabed. The most of the coastal structure behave dynamically with foundation soil and pore fluid in soil under wave loadings, particularly caisson type and submerged breakwater. Recently, Boundary Element Method(BEM)-Finite Element Method(FEM), Volume Of Fluid(VOF)-Finite Element Method(FEM) models for the nonlinear dynamic interaction among wave, structure and seabed is presented. But, BEM-FEM and VOF-FEM models are linked through applying hybrid numerical technique because of the assumptions that wave fields and seabed regime are uncouplied. Therefore, it is necessary to develope numerical model for simulating properly the dynamic responses among waveㆍstructureㆍseabed under wave loadings. In this paper, Direct Numerical Simulation(DNS) is newly proposed to study the nonlinear dynamic interaction among waveㆍstructureㆍseabed. This numerical model is based on the Porous Body Model in which the Darcy and Forchheimer friction are included. The transition from the fluid to the porous medium is achieved through a continuous of dynamic pressure and flow flux at the interfacial seabed surface. These equation can simulate the nonlinear laminar and transitional to full turbulent flow regimes through adjusting the resistance coefficient values. A newly proposed numerical model favorably well matchs with experimental results presented by Kioka et al.(1994) for waveㆍpermeable submerged breakwater, Yamamoto et al.(1978) for waveㆍcoarse sand, Mizutani et al.(1998) for waveㆍpermeable submerged breakwaterㆍcaorse sand and Mostafa et al.(1999) for waveㆍcomposite breakwaterㆍcaorse sand, respectively. Moreover, For the sake of discussing applicability of newly proposed numerical model, variations of the wave fields and pore pressure caused by coupling of waveㆍstructureㆍseabed, particularly submerged and composite breakwater, are discussed in detail.제1장 서 론 1 1.1 연구의 배경 1 1.2 기존의 연구 3 1.2.1 파ㆍ구조물의 상호간섭 3 1.2.2 파ㆍ해저지반의 상호간섭 5 1.2.3 파ㆍ구조물ㆍ해저지반 상호간섭 6 1.3 연구의 목적 7 1.4 연구의 구성 7 제2장 VOF-FDM 모델 9 2.1 수치해석 이론 9 2.1.1 기초방정식 9 2.1.2 격자설정과 셀내에서 변수위치의 결정 12 2.1.3 기초방정식의 이산화 13 2.1.4 SOLA SCHEME 15 2.2 SOLA-VOF법에 의한 자유수면의 추적 19 2.2.1 자유수면의 수치계산을 위한 추정모델 19 (1) 좌표계에 의한 방법 19 (2) 유체면 위치의 추적모델을 이용한 방법 19 (a) Marker입자에 의한 방법 19 (b) 높이함수를 이용하는 방법 20 (c) VOF법에 의한 방법 20 2.2.2 VOF함수의 이류방정식 21 2.2.3 VOF함수의 이류방정식에 대한 이산화 21 2.2.4 VOF함수에 의한 자유수면의 모델링 22 2.2.5 VOF함수에 의한 자유수면의 판정 및 Cell의 분류 23 2.2.6 VOF함수의 수치계산 25 2.3 경계조건 33 2.3.1 자유수면에서의 경계조건 33 (1) 유속경계조건 33 (2) 압력경계조건 34 2.3.2 개경계조건 35 2.3.3 그 외의 경계조건 37 2.4 조파조건 38 2.5 안정조건 41 2.6 수치계산의 흐름 42 제3장 수치해석기법의 검증 44 3.1 수치파동수로내에서 조파파형의 검증 44 3.1.1 시간파형 44 3.1.2 공간파형 48 3.2 해저지반내 층류저항의 영향 50 3.2.1 간극수의 흐름 50 3.2.2 지반내의 유속과 압력 52 3.2.3 지반내의 유속이 파동장에 미치는 영향 71 3.3 파ㆍ구조물의 상호간섭 73 3.4 파ㆍ해저지반의 상호간섭 75 3.5 파ㆍ구조물ㆍ해저지반의 상호간섭 77 제4장 파ㆍ잠제ㆍ지반의 상호간섭 83 4.1 수치파동수로와 잠제 83 4.2 잠제주변의 비선형파랑변형 특성 84 4.3 공간파고변화와 평균수위변화 91 4.4 잠제주변 및 지반내의 평균유속장 96 4.5 잠제주변 및 지반내의 최대간극수압분포 102 4.6 잠제저면에서 간극수압 107 제5장 파ㆍ혼성방파제ㆍ지반의 상호간섭 125 5.1 수치파동수로와 혼성방파제 125 5.2 혼성방파제주변의 비선형파랑변형 특성 126 5.3 공간파고변화와 평균수위변화 131 5.4 혼성방파제주변 및 지반내 평균유속장 136 5.5 혼성방파제주변 및 지반내 최대간극수압분포 143 5.6 케이슨 및 사석마운드의 저면에서 간극수압 150 5.6.1 사석마운드의 저면에서 간극수압 150 5.6.2 케이슨의 저면에서 간극수압 172 제6장 결 론 186 6.1 수치해석 186 6.2 해저지반내 층류저항의 영향 186 6.3 파ㆍ잠제ㆍ지반의 상호간섭 187 6.4 파ㆍ혼성방파제ㆍ지반의 상호간섭 188 참고문헌 19

점액류낭종으로 오인된 접형동에 발생한 콜레스테롤 육아종

Cholesterol granuloma is a histopathological diagnosis with features of cholesterol clefts, foreign body giant cells, and macrophages filled with hemosiderin. It is commonly found in the mastoid or petrous apex, but the involvement of paranasal sinuses is very rare. Radiologically, cholesterol granuloma show typical findings of hyperintense signals on both T1- and T2-weighted images on magnetic resonance imaging (MRI). We report two cases of cholesterol granuloma in the sphenoid sinus, which were first misinterpreted as mucoceles due to unusual MRI imagesope

Downregulation of Th17 cells in the small intestine by disruption of gut flora in the absence of retinoic acid.

Retinoic acid (RA), a well-known vitamin A metabolite, mediates inhibition of the IL-6-driven induction of proinflammatory Th17 cells and promotes anti-inflammatory regulatory T cell generation in the presence of TGF-beta, which is mainly regulated by dendritic cells. To directly address the role of RA in Th17/regulatory T cell generation in vivo, we generated vitamin A-deficient (VAD) mice by continuous feeding of a VAD diet beginning in gestation. We found that a VAD diet resulted in significant inhibition of Th17 cell differentiation in the small intestine lamina propria by as early as age 5 wk. Furthermore, this diet resulted in low mRNA expression levels of IL-17, IFN regulatory factor 4, IL-21, IL-22, and IL-23 without alteration of other genes, such as RORgammat, TGF-beta, IL-6, IL-25, and IL-27 in the small intestine ileum. In vitro results of enhanced Th17 induction by VAD dendritic cells did not mirror in vivo results, suggesting the existence of other regulation factors. Interestingly, the VAD diet elicited high levels of mucin MUC2 by goblet cell hyperplasia and subsequently reduced gut microbiome, including segmented filamentous bacteria. Much like wild-type mice, the VAD diet-fed MyD88-/-TRIF-/- mice had significantly fewer IL-17-secreting CD4+ T cells than the control diet-fed MyD88-/-TRIF-/- mice. The results strongly suggest that RA deficiency altered gut microbiome, which in turn inhibited Th17 differentiation in the small intestine lamina propriaope

A Case of Extrahepatic Metastasis of Hepatocellular Carcinoma in the Nasal Septum managed with Endoscopic Resection

Metastasis of hepatocellular carcinoma (HCC) in the nasal septum is an extremely rare condition. The proper management and the role of surgical intervention are still controversial and there is no evidence-based guideline for this specific condition. The authors of the present study report a case of HCC with sinonasal metastasis, managed by surgery to relieve nasal obstruction and frequent epistaxis. Complete removal of the tumor via endoscopic surgery was performed and the pathology was reported to be consistent with metastatic HCC. No additional treatment modality was considered for the septal lesion. During the 8-month postoperative period, the patient remained alive and satisfied with comfortable nasal breathing. The present case report stresses the importance of interdisciplinary collaboration. Proper consultation between surgeon and oncologist may lead to improved quality of life, even when the patient is in the terminal stage of HCC.ope

Geographic and demographic variations of inhalant allergen sensitization in Koreans and non-Koreans

BACKGROUND: To diagnose and treat respiratory allergic diseases, it is important to identify the specific allergens involved. Many differences exist between common inhalant allergens depending on the residential environment and demographic factors. This study aimed to compare common inhalant allergens between Koreans and non-Koreans according to their residential region, age, and sex. METHODS: This study evaluated 15,334 individuals who underwent serum tests for multiple allergen-specific immunoglobulin E at a tertiary academic medical center between January 2010 and December 2016. The individuals included 14,786 Koreans and 548 non-Koreans. The AdvanSure™ Allostation assay (LG Life Science, Korea) was used to test for 33 inhalant allergens. RESULTS: The house dust mite (HDM) was the most common allergen in both Koreans and non-Koreans, although the proportion of individuals with HDM sensitization was greater among Koreans. High sensitization rates for various pollen types were detected among Koreans in Gangwon region, whereas Japanese cedar pollen was unique among Koreans in Jeju region. Grass pollen and animal dander were relatively common among individuals from the Americas, whereas weed and grass pollen accounted for the 10 most common allergens for individuals from Central Asia. The total sensitization rate, sensitization to HDM, and sensitization to animal dander peaked among adolescents and young adults, then subsequently decreased with age. CONCLUSIONS: This large-scale study demonstrates that various regional and age-related differences exist in the allergen sensitization rates of Koreans and non-Koreans. These data could be useful for development of avoidance measures, immunotherapy for causative allergens, and policymaking regarding allergic diseases.ope

Nasal or Nasopharyngeal Tuberculosis Should be Considered in the Initial Diagnosis of Sino-Nasal Inflammatory Diseases

ope

Essays on Climate Change Computable General Equilibrium Models

학위논문 (박사)-- 서울대학교 환경대학원 : 환경계획학과, 2013. 8. 홍종호.This research reviews the problems of conventional computable general equilibrium (CGE) models which are widely used for climate change policy analysis. To solve the problems, it proposes multivariate distribution approach as an alternative way of representing the production activities in model structures and assesses the possibility of its practical employment. In the first part of this research, the basic characteristics of three well known global CGE models are reviewed and production function structures are pointed out as the main sources of the differences in carbon emission projections among models. Two experiments are introduced regarding the effects of changes in production function structures. In one experiment, the nested structure of constant elasticity substitution (CES) functions is substituting with alternative nesting structures. In another experiment, fixed input structures are partly applied for incorporating bottom-up approach with top-down mechanism of CGE models. The results show that these structural changes cause a considerable impact on the prediction results of greenhouse gas emissions and carbon prices. Also, the experiments are extended to the comparison of GDP losses among different model structures. Simulations for the case of Korea reveal that the estimations of GDP loss differs among model structures, raising some issues on applying them into practical policy making. In the second part, the performance of a global CGE model is analyzed in marginal abatement cost estimation when data disaggregation is applied. Extraordinary carbon prices are reported for the case of relatively large share of capital in the economies of a few developing countries. Empirical evidence indicates that the abnormal phenomenon is accounted for by the proportional relationship between capital intensity and carbon price. The analysis is extended to CES functions with a numerical analysis, concluding that the unusual phenomena may be connected to distribution parameters of CES functional forms which are most widely used in CGE models. In the last part, multivariate distribution approach is applied for an alternative description of energy related production activities. Applying theories on the microfoundations of aggregate production functions, it is shown that a set of bottom-up microscopic information can converge to specific aggregate production functions if assumptions are imposed on the statistical distribution of local production technologies. The actual characteristics of statistical distributions were reviewed for a real dataset of energy intensive manufacturing sector of Korea. To facilitate simulations and conveniently reproduce the relationships embedded in multivariate joint distribution maps, a statistical tool called copulas is introduced in advance. After the basic theory of copulas is briefly introduced, the performance of a copula model is investigated, revealing that a copula model is successful in describing heterogeneous microscopic information. After the introduction of copulas, a new type of CGE model is applied, in which an aggregation of local Leontief production functions takes over the role of conventional global production functions. A pilot model is composed to apply this scheme to a CGE model and it is shown that this new approach has some advantages: it eliminates the effect of the past time data and improves the precision of projection results.Table of Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i I. Overall introduction . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Motivations . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Overview and outline . . . . . . . . . . . . . . . . . . . . . 3 1.3 Contributions . . . . . . . . . . . . . . . . . . . . . . . . . 6 II. Structural differences between global climate change CGE models. . . . . 9 2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.2 Reviews on global CGE models . . . . . . . . . . . . . . . 14 2.2.1 Models . . . . . . . . . . . . . . . . . . . . . . . . 16 2.2.2 Static structure . . . . . . . . . . . . . . . . . . . . 18 2.2.3 Dynamic process . . . . . . . . . . . . . . . . . . . 25 2.3 Model structure analysis . . . . . . . . . . . . . . . . . . . 27 2.3.1 Change in energy-capital bundle structures . . . . . 29 2.3.2 Replacement with fixed input structures . . . . . . . 36 2.4 Policy implications . . . . . . . . . . . . . . . . . . . . . . 43 2.4.1 Carbon price . . . . . . . . . . . . . . . . . . . . . 43 2.4.2 Estimation of GDP change . . . . . . . . . . . . . . 46 2.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . 48 III. Carbon prices and parameter calibration in CES function structures. . . 51 3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 51 3.2 Problems in regional disaggregation . . . . . . . . . . . . . 54 3.2.1 Derivation of MACC using the EPPA model . . . . . 54 3.2.2 Regional deviations in carbon price . . . . . . . . . 61 3.3 Mathematical analysis . . . . . . . . . . . . . . . . . . . . 67 3.3.1 Ratio of capital intensity . . . . . . . . . . . . . . . 67 3.3.2 Extensions to the CES function . . . . . . . . . . . 74 3.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . 78 IV. The statistical distribution approach for a description of production activities . . 81 4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 81 4.2 Functional forms and data distribution . . . . . . . . . . . . 87 4.2.1 Microfoundations of production functions . . . . . . 87 4.2.2 Data analysis . . . . . . . . . . . . . . . . . . . . . 96 4.2.3 Dependence representation of the CES function . . . 103 4.3 The copula model . . . . . . . . . . . . . . . . . . . . . . . 106 4.3.1 Copula theory . . . . . . . . . . . . . . . . . . . . . 107 4.3.2 Construction of a copula model . . . . . . . . . . . 109 4.3.3 Performance of the copula model . . . . . . . . . . 113 4.3.4 The copula model with data disaggregation . . . . . 119 4.4 The statistical distribution approach . . . . . . . . . . . . . 128 4.4.1 Set of firms . . . . . . . . . . . . . . . . . . . . . . 128 4.4.2 Properties of cost functions . . . . . . . . . . . . . . 131 4.4.3 Elasticity of substitution . . . . . . . . . . . . . . . 137 4.5 Application of the distribution approach to CGE models . . 144 4.5.1 The pilot CGE model . . . . . . . . . . . . . . . . . 144 4.5.2 Projection results . . . . . . . . . . . . . . . . . . . 148 4.6 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 I. The structure of the pilot CGE model . . . . . . . . . . . . . 171 II. Source code . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185Docto

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