Prognostic Indicators for Acute Liver Failure Development and Mortality in Patients with Hepatitis A: Consecutive Case Analysis

PURPOSE: Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. MATERIALS AND METHODS: A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. RESULTS: The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD≥23.5 was significantly more predictive than a SIRS score≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. CONCLUSION: MELD and SIRS scores≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores≥3 were valuable in predicting mortality of patients with a MELD≥23.5.ope

Combined Intrathoracic and Intraperitoneal Splenosis after Splenic Injury: Case Report and Review of the Literature

Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.ope

Sarcoidosis Presenting with Massive Pleural Effusion and Elevated Serum and Pleural Fluid Carbohydrate Antigen-125 Levels

A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.ope

Genome-based identification of Pvr4 conferring resistance against potyvirus in Capsicum annuum

학위논문 (박사)-- 서울대학교 대학원 : 식물생산과학부, 2015. 8. 최도일.Pvr4 is a resistance gene showing broad-spectrum resistance against multiple potyviruses, including Pepper mottle virus (PepMoV), Pepper severe mosaic virus (PepSMV), and Potato virus Y (PVY). Capsicum annuum landrace CM334 is known to have Pvr4, but it has not been cloned and the mechanism of resistance is unknown. To identify the avirulence factor in potyviruses corresponding to Pvr4, a total of eleven viral cistrons of PepMoV were expressed into potyvirus-resistant (Pvr4) and -susceptible (pvr4) pepper plants. Hypersensitive response (HR) was observed only when a RNA-dependent RNA polymerase (NIb) of PepMoV was expressed in Pvr4-haboring pepper leaves in a genotype-specific manner. In addition, the over-expression of NIb proteins of other potyviruses including PepSMV, PVY also induced HR in Pvr4-harboring pepper plants. These results indicate that NIbs of PepMoV, PepSMV, and PVY may play important roles as avirulence factors for Pvr4 in pepper plants. To identify Pvr4 resistance gene against potyvirus in pepper, genome-based cloning with two populations including BC1F3 and F2 populations was performed. High-density molecular markers including 32 co-dominant markers were developed in the TG420 marker region using tomato and pepper genome. Three SNP markers showed a co-segregation with Pvr4 in two populations and Pvr4 is located within 350 kb region containing sixteen annotated genes. Among them, eight genes were coiled-coil (CC) nucleotide-binding site leucine-rich repeat (NB-LRR) and they were clustered in this region. Transient over-expression of the eight NB-LRR type genes and NIb of PepMoV in susceptible pepper (C. annuum Jupiter) and Nicotiana benthamiana leaves revealed that only one gene (CA10g21170) induced HR at 2 dpi. The relative amounts of PepMoV RNA transcripts and protein were significantly suppressed in the leaves that transiently over-expressed of CA10g21170 after 3 dpi. Furthermore, CA10g21170 showed resistance against other potyviruses including PepSMV and PVY. Consequently, these results prove that CA10g21170 is indeed Pvr4 leading to recognize NIb and suppress PepMoV, PepSMV and PVY replication. Pvr4 consisted of seven exons and encodes a CC-NB-LRR type protein with 1746 amino acids. Genomic region of Pvr4 including exon and intron is 13,870 bp. In planta assays using the TRV-based gene silencing revealed that silencing of HSP90, SGT1 and RAR1 in N. benthamiana suppressed HR induced by Pvr4 and NIb of PepMoV. To confirm the heterologous in planta expression of Pvr4 in other plant, Pvr4-harboring transgenic potato were generated. Inoculation of virus validated that the replication of PVY-O was significantly suppressed in the transgenic upper leaves. Taken together, the cloned potyvirus resistance gene, Pvr4 could provide information for the application of broad-spectrum potyvirus resistance in crop breeding, as well as for understanding potyvirus resistance mechanisms in plants.ABSTRACT…………………………………………………………………i CONTENTS………………………………………………………………iv LIST OF TABLES………………………………………………………viii LIST OF FIGURES…………………………………………………………ix LIST OF ABBREVIATIONS……………………………………………xii GENERAL INTRODUCTION……………................................................1 CHAPTER 1. Identification of RNA-dependent RNA polymerase (NIb) as the avirulence factor of potyvirus in Pvr4-bearing pepper plants ABSTRACT……………………………………………….………………13 INTRODUCTION…………………………………………………………14 MATERIALS AND METHODS……….………………………………….18 Plant materials……………………………………………...….………18 Application of Pvr4-linked CAPS marker for identification of pepper genotype………………………………………………….………19 Cloning of potyvirus cistrons for in planta expression………………19 In planta expression assay in pepper plants……….……………..…24 Immunodetection of PepMoV-encoded proteins………………..……25 RESULTS…………………………………………………………...……26 Genotypes and PepMoV accumulation in pepper plants ………….…26 Identification of NIb as the avirulence factor of PepMoV in Pvr4-bearing pepper plants……………………………………………………...29 NIb proteins of other potyviruses as avirulence factors in Pvr4-mediated resistance …………………………………………………………38 DISCUSSION……………………………………………………………42 REFERENCES……………………………………………..……………46 CHAPTER 2. Genome-based cloning of Pvr4 conferring multiple potyvirus resistance from Capsicum annuum CM334 ABSTRACT………………………………………………………………52 INTRODUCTION…………………………………………………………54 MATERIALS AND METHODS…………………………………………58 Plant materials ………………………………………………………58 Phenotypic evaluation against potyviruses……………………………58 Development of Cleaved Amplified Polymorphic Sequences (CAPS) markers…………………………………………………………59 BAC library screening and sequence analysis…………………………61 Cloning of Pvr4 candidates by ligation-independent cloning (LIC)…61 Transient over-expression of Pvr4 candidates and NIbs of potyviruses..63 Phenotypic evaluation of Pvr4 in N. benthamiana………………….....64 Construction of the TRV-Pvr4 vectors and VIGS in pepper…………65 Construction of the signaling components for VIGS assays in N. benthamiana……………………………………………………66 Analysis of transcript levels by reverse transcription polymerase chain reaction (RT-PCR)………………………………………………66 Transformation of potato plants and selection of transgenic potato plants……………………………………………………………67 Phenotypic evaluation of Pvr4 in transgenic potato plants……………68 RESULTS…………………………………………………………………69 Genetic analysis of Pvr4 resistance to PepMoV ……………................69 Comparative mapping of the Pvr4 locus in tomato and pepper………73 Development of Pvr4-linked markers…………………………………75 Candidate gene annotation in the Pvr4 locus…………………………78 Identification of Pvr4 function by transient co-expression assay……80 Specific interaction of Pvr4 and PepMoV-NIb………………………80 Sequence analysis of the Pvr4 and pvr4 genes…………………………85 Resistance of Pvr4 against potyviruses in N. benthamiana……………87 The nature of the Pvr7 gene present in C. chinense PI159236……….92 Virus-induced gene silencing (VIGS) of Pvr4…………………………97 Signaling pathway of Pvr4-mediated HR…………...…………………99 Resistance of transgenic potato harboring Pvr4……………………102 DISCUSSION……………………………………………………………105 Genome-based mapping of the Pvr4 gene……………………………105 Identification of the Pvr4 gene function by transient co-expression assay……………………………………………………………….....107 Sequence analysis of the Pvr4 and pvr4 genes………………………108 Resistance of the Pvr4 gene against potyviruses in N. benthamiana….109 Signaling pathway of Pvr4-mediated HR…………………………….110 The nature of the Pvr7 gene present in C. chinense PI159236………111 Resistance of transgenic potato harboring Pvr4………………………112 REFERENCES…………………………………………………………113 ABSTRACT IN KOREAN………………………………………………122Docto

녹색성장을 위한 지표선정 체계 제안

학위논문 (석사)-- 서울대학교 대학원 : 보건학과(보건학전공), 2011.2. 김호.Maste

The Effect of Environmental Factors on the Association between Airborne Particulate Matter and Mortality in East Asia

학위논문 (박사)-- 서울대학교 대학원 : 보건학과, 2017. 2. 김호.Background: Worldwide, air pollution is responsible for large numbers of deaths, and substantial epidemiological research has provided evidence for the association between air pollution and mortality. There has been growing demand from policymakers for a better understanding of the relationship between air pollution and adverse health effects, including mortality. Methods: First, we examined seasonal patterns in the short-term association of airborne particulate matter (PM) smaller than 10 μm (PM10) with daily mortality in 29 cities in three East Asian countries. Stratified time-series models were used to determine whether seasons alter the effect of PM10 on mortality. Furthermore, this effect was first quantified for each season and at each location using a time-series model, after which city-specific estimates were pooled using a hierarchical Bayesian model. Second, we investigated the effects of temperature on the relationship between PM10 and mortality due to non-accidental, cardiovascular, and respiratory death in seven cities in South Korea. We applied stratified time-series models to the datasets in order to examine whether the effects of PM10 on mortality were modified by temperature. The effect of PM10 on daily mortality was estimated for different temperature ranges at each location using a time-series model, then the estimates were pooled through a random-effects meta-analysis using the maximum likelihood method. Lastly, we estimated the durational effect on mortality of consecutive days with a daily mean PM10 concentration of ≥ 75 µg/m3. A standard time-series Poisson model was fitted in each location with duration as the main variable of interest while controlling for daily mean PM10 concentration, meteorological variables, seasonal trend, and day of the week. Moreover, the duration-mortality relationships were estimated and then a meta-analysis of the country-specific estimates was performed using the maximum likelihood method. In addition, the additional percent increase in deaths were calculated considering the consecutive days of elevated PM10 levels for each country. Findings: For seasonal analysis, a 10 µg/m3 increase in PM10 was significantly associated with increases in non-accidental mortality of 0.44% (95% confidence interval [CI]: 0.03%, 0.8%) in spring and 0.42% (95% CI: 0.02%, 0.82%) in the fall for Japan. In South Korea, a 10 µg/m3 increase in PM10 was significantly associated with increases in non-accidental mortality of 0.51% (95% CI: 0.01%, 1.01%) in summer and 0.45% (95% CI: 0.03%, 0.87%) in the fall, in cardiovascular disease mortality of 0.96% (95% CI: 0.29%, 1.63%) in the fall, and in respiratory disease mortality of 1.57% (95% CI: 0.40%, 2.75%) in the fall. In China, a 10 µg/m3 increase in PM10 was associated with increases in non-accidental mortality of 0.33% (95% CI: 0.01%, 0.66%) in summer and 0.41% (95% CI: 0.09%, 0.73%) in winter, in cardiovascular disease mortality of 0.41% (95% CI: 0.08%, 0.74%) in spring and 0.33% (95% CI: 0.02%, 0.64%) in winter, and in respiratory diseases mortality of 0.78% (95% CI: 0.27%, 1.30%) in winter. For the modifying effect of temperature, a total of 828,787 non-accidental deaths were registered from 2000-2009 from 7 cities in South Korea. The highest overall risk between PM10 and non-accidental or cardiovascular mortality was observed on extremely hot days (daily mean temperature: > 99th percentile) in individuals aged 99th percentile) in men and a very high temperature range (95-99th percentile) in women. For the durational effect, the mortality risk is significantly higher overall when the elevated PM10 concentration lasts multiple days in all three countries. Estimated non-accidental mortality was increased by 0.68% (95% CI: 0.35, 1.01) for Japan, 0.48% (95% CI: 0.30, 0.66) for South Korea, and 0.24% (95% CI: 0.14, 0.33) for China for an additional consecutive day of PM10 ≥ 75 µg/m3. For the annual maximum duration of high PM10 (≥ 75 µg/m3) in Japan (2.40 days), South Korea (6.96 days), and China (42.26 days) corresponded to increases in non-accidental death of 1.64% (95% CI: 1.31, 1.98), 3.37% (95% CI: 3.19, 3.56) and 10.43% (95% CI: 10.33, 10.54), respectively. Interpretation: Our analyses suggest that the acute effect of particulate air pollution varies seasonally and geographically, temperature affects the relationship between the PM10 levels and cause-specific mortality, and there are additional mortality effects when high PM10 levels last for several days while accounting for the effect of each days PM10 concentration. These findings have important implications for the planning of public health interventions to minimize the health burden of air pollution.Chapter 1. Introduction 1 Chapter 2. Seasonal analysis of the short-term effects of air pollution on daily mortality in Northeast Asia 5 2.1 Introduction 5 2.2 Materials and methods 7 2.2.1 Data collection 7 2.2.2 Statistical analysis 10 2.3 Results 14 2.3.1 Summary statistics 14 2.3.2 Lag effects 20 2.3.3 Overall effects 20 2.3.4 Effect by season 20 2.4 Discussion 25 2.5 Conclusion 30 Chapter 3. Temperature modifies the association between particulate air pollution and mortality: a multi-city study in South Korea 31 3.1 Introduction 31 3.2 Materials and methods 34 3.2.1 Scope of the study and data collection 34 3.2.2 Statistical analysis 36 3.3 Results 43 3.4 Discussion 53 3.5 Conclusion 58 Chapter 4. Associating mortality with prolonged high PM10 events in Northeast Asia 59 4.1 Introduction 59 4.2 Methods 62 4.2.1 Study design 62 4.2.2 Mortality data 62 4.2.3 Environmental data 63 4.2.4 Statistical analysis 63 4.3 Results 69 4.4 Discussion 76 4.5 Conclusion 79 Chapter 5. General Discussion 80 5.1 Summary of the topics 80 5.2 Public health insights 81 References 83 Abstract in Korea 116Docto

한국 성인 만성폐쇄성폐질환 환자에서의 체질량지수 및 제지방지수

Dept. of Medicine/석사Background: Body mass index (BMI) and fat free mass index (FFMI) are known to decrease in patients with chronic obstructive pulmonary disease (COPD). In these patients, a low BMI and FFMI are associated with worsening lung function and poor prognosis. Limited data is available on the relationship between BMI, FFMI and COPD in Asian countries, where mean BMI is lower than in Western countries.Methods: We used the data in Korean National Health and Nutrition Survey (KNHANES) from the years 2008 to 2010. A total of 822 subjects with documented airway obstruction and the same number of control subjects matched for age, sex and smoking status were selected. Spirometry and dual energy X-ray absorptiometry (DXA) were used for analysis. Result: Subjects with COPD had a lower mean BMI and FFMI compared with the control group (23.6 vs. 23.9 kg/m2 for BMI and 17.2 vs. 17.5 kg/m2 for FFMI, p = 0.015 and p = 0.013, respectively). The BMI and FFMI values decreased significantly in subjects with severe airway obstruction (p < 0.001), while those subjects with mild to moderate airway obstruction had values equivalent to those of the control group. The proportion of subjects who were underweight (BMI < 18.5 kg/m2) or who had a low FFMI (FFMI < 5 percentile) was significantly higher in the severe airway obstruction group (p < 0.001). The decrease in FFMI was more prominent in the lower extremities, followed by the upper extremities and the trunk. Subjects who were underweight had significantly lower FEV1 and FEV1/FVC values when compared with others subjects (p < 0.001). Conclusion: BMI and FFMI are decreased in adults with severe airway obstruction. The decrease in FFMI deficit was more prominent in the lower extremities. We suggest that the assessment of BMI and body composition is necessary in patients with severe airway obstruction, and active rehabilitation has to be considered to preserve fat free mass in those patients.ope

다공성 양극산화알루미늄 막을 이용한 Ru 나노튜브배열의 형성과 이 나노튜브를 통과하는 DNA의 전기역학적 거동에 대한 연구

Thesis(masters) --서울대학교 대학원 :재료공학부, 2009.2.Maste

Natural Burial as a Political Ideological Phenomenon: Beyond the System

일본에서는 에도 시대 후기부터 메이지 시대 무렵에 선조 대대로의 묘 형식이 확립되었다. 그러나 1990년대 이후 현저한 변화가 나타나기 시작했다. 혈연, 지연과 상관 없이 같은 묘석이나 초목 아래 유골을 매장하는 합장묘, 개인이나 핵가족 단위로 초목 아래 유골을 매장하는 수목장, 바다나 산 등에 산골(散骨)하는 장법 등이 나타난 것이다. 일본 장례문화의 변화에 있어서 중요한 요소인 선조관의 양상에 대해, 선행 연구는 전후 가족제도의 변화에 발맞추는 형태로 선조관도 변화하고 있다고 보았다. 그러나 일본 근대의 선조관 및 선조 대대로의 묘의 성립에 있어서 메이지 정부의 개입이 큰 영향을 미쳤다는 연구 결과들을 고려한다면, 메이지 정부의 통치 이념을 반영하며 형성된 선조관과 그에 대한 행위자들의 작용/반작용의 실천의 축적이, 1990년 이후의 장례문화의 변화의 한 축을 담당하고 있을 가능성을 제기할 수 있다. 이 글은 자연장을 중심으로 정치 이데올로기적인 측면에서 현대의 장례 문화가 어떻게 형성되고 있는가를 고찰한다.In Japan, the form of family tomb was established between the late Edo period and the Meiji era. However, striking changes began to appear since the 1990s. In other words, different types of tombs, such as collective graves that buries remains under the same gravestone or vegetation regardless of blood relationship or regional ties, jumokusō that buries individual or nuclear familys remains under a tree, or sankotsu (散骨) that scatters cremated remains at sea or on mountains, had appeared. The view of ancestors is an important factor in analyzing changes of Japans funeral culture, and previous researches concluded that the view of ancestors had transformed in accordance with the development of postwar family system. However, considering the results of studies that the Meiji government's intervention greatly influenced on the formation of modern Japanese view of ancestors and family tombs, it is a possibility that the view of ancestors, which was formulated in terms of the reflection of the Meiji governments political ideology, and the accumulation of practices of actors actions and reactions had played critical roles in bringing changes of funeral culture since the 1990s. In this article, I analyze how the contemporary funeral culture has formed in a political ideological aspect by focusing on the case of natural burial.이 논문은 2008년 정부(교육과학기술부)의 재원으로 한국연구재단의 지원을 받아 연구되었음(NRF-2008-362-B00006)

성폭력 피해경험자의 형사사법절차상 2차 피해 메커니즘

학위논문(석사) --서울대학교 대학원 :협동과정(여성학전공), 2009.2.Maste