Endolichenic Fungal Community Analysis by Pure Culture Isolation and Metabarcoding: A Case Study of Parmotrema tinctorum

Lichen is a symbiotic mutualism of mycobiont and photobiont that harbors diverse organisms including endolichenic fungi (ELF). Despite the taxonomic and ecological significance of ELF, no comparative investigation of an ELF community involving isolation of a pure culture and high-throughput sequencing has been conducted. Thus, we analyzed the ELF community in Parmotrema tinctorum by culture and metabarcoding. Alpha diversity of the ELF community was notably greater in metabarcoding than in culture-based analysis. Taxonomic proportions of the ELF community estimated by metabarcoding and by culture analyses showed remarkable differences: Sordariomycetes was the most dominant fungal class in culture-based analysis, while Dothideomycetes was the most abundant in metabarcoding analysis. Thirty-seven operational taxonomic units (OTUs) were commonly observed by cultureand metabarcoding-based analyses but relative abundances differed: most of common OTUs were underrepresented in metabarcoding. The ELF community differed in lichen segments and thalli in metabarcoding analysis. Dissimilarity of ELF community intra lichen thallus increased with thallus segment distance; inter-thallus ELF community dissimilarity was significantly greater than intra-thallus ELF community dissimilarity. Finally, we tested how many fungal sequence reads would be needed to ELF diversity with relationship assays between numbers of lichen segments and saturation patterns of OTU richness and sample coverage. At least 6000 sequence reads per lichen thallus were sufficient for prediction of overall ELF community diversity and 50,000 reads per thallus were enough to observe rare taxa of ELF.

Determination of Diversity, Distribution and Host Specificity of Korean Laccaria Using Four Approaches

The genus Laccaria (Hydnangiaceae, Agaricales) plays an important role in forest ecosystems as an ectomycorrhizal fungus, contributing to nutrient cycles through symbiosis with many types of trees. Though understanding Laccaria diversity and distribution patterns, as well as its association with host plants, is fundamental to constructing a balanced plant diversity and conducting effective forest management, previous studies have not been effective in accurately investigating, as they relied heavily on specimen collection alone. To investigate the true diversity and distribution pattern of Laccaria species and determine their host types, we used four different approaches: specimen-based analysis, open database search (ODS), NGS analysis, and species-specific PCR (SSP). As a result, 14 Laccaria species have been confirmed in Korea. Results regarding the species distribution pattern were different between specimen-based analysis and SSP. However, when both were integrated, the exact distribution pattern of each Laccaria species was determined. In addition, the SSP revealed that many Laccaria species have a wide range of host types. This study shows that using these four different approaches is useful in determining the diversity, distribution, and host of ECM fungi. Furthermore, results obtained for Laccaria will serve as a baseline to help understand the role of ECM fungi in forest management in response to climate change.

Changes in Health Care Utilization during the COVID-19 Pandemic / 보건행정학회지

Background@#After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. @*Methods@#We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020.Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. @*Results@#In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. @*Conclusion@#Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

Guild Patterns of Basidiomycetes Community Associated With Quercus mongolica in Mt. Jeombong, Republic of Korea

Depending on the mode of nutrition exploitation, major fungal guilds are distinguished as ectomycorrhizal and saprotrophic fungi. It is generally known that diverse environmental factors influence fungal communities; however, it is unclear how fungal communities respond differently to environment factors depend on fungal guilds. In this study, we investigated basidiomycetes communities associated with Quercus mongolica using 454 pyrosequencing. We attempted to detect guild pattern (ectomycorrhizal or saprotrophic fungal communities) by comparing the influence of geography and source (root and surrounding soil). A total of 515 mOTUs were detected from root (321) and soil (394) of Q. mongolica at three sites of Mt. Jeombong in Inje County. We found that patterns of diversity and community structure were different depending on the guilds. In terms of alpha diversity, only ectomycorrhizal fungi showed significant differences between sources. In terms of community structure, however, geography significantly influenced the ectomycorrhizal community, while source appeared to have a greater influence on the saprotrophic community. Therefore, a guild-based view will help to elucidates novel features of the relationship between environmental factors and fungal communities.

Four New Species of Amanita in Inje County, Korea

Amanita (Agaricales, Basidiomycota) is one of the most well-known genera composed of poisonous mushrooms. This genus of almost 500 species is distributed worldwide. Approximately 240 macrofungi were collected through an ongoing survey of indigenous fungi of Mt. Jeombong in Inje County, Korea in 2014. Among these specimens, 25 were identified as members of Amanita using macroscopic features. Specimens were identified to the species level by microscopic features and molecular sequence analyses of the internal transcribed spacer and large subunit of nuclear ribosomal RNA. We molecularly identified 13 Amanita species, with seven species matching previously recorded species, four species (A. caesareoides, A. griseoturcosa, A. imazekii, and A. sepiacea) new to Korea, and two unknown species.

Re-evaluation of the Genus Antrodia (Polyporales, Basidiomycota) in Korea

The wood decay fungi Antrodia P. Karst. play important ecological roles and have significant industrial and economic impacts as both wood degraders and sources of pharmaceutical and biotechnological products. Although each Antrodia species has distinct morphological characteristics, the misidentification rate is especially high due to their simple morphological characters. A combination of morphological and internal transcribed spacer region sequence analyses revealed that 27 of 89 specimens previously identified by morphology alone were correct, whereas 35 of these specimens were misidentified as other Antrodia species. We report here that seven Antrodia species exist in Korea (A. albida, A. heteromorpha, A. malicola, A. serialis, A. sinuosa, A. sitchensis, and A. xantha) and based on these specimens, we provide taxonomic descriptions of these species, except for A. serialis, which was only confirmed by isolate.

A Checklist of the Basidiomycetous Macrofungi and a Record of Five New Species from Mt. Oseo in Korea

Basidiomycetous macrofungi play important roles in maintaining forest ecosystems via carbon cycling and the mobilization of nitrogen and phosphorus. To understand the impact of human activity on macrofungi, an ongoing project at the Korea National Arboretum is focused on surveying the macrofungi in unexploited areas. Mt. Oseo was targeted in this survey because the number of visitors to this destination has been steadily increasing, and management and conservation plans for this destination are urgently required. Through 5 field surveys of Mt. Oseo from April to October 2012, 116 specimens of basidiomycetous macrofungi were collected and classified. The specimens were identified to the species level by analyzing their morphological characteristics and their DNA sequence data. A total of 80 species belonging to 57 genera and 25 families were identified. To the best of our knowledge, this is the first study to identify five of these species-Artomyces microsporus, Hymenopellis raphanipes, Pholiota abietis, Phylloporus brunneiceps, and Sirobasidium magnum-in Korea.

Delimitation of Russula Subgenus Amoenula in Korea Using Three Molecular Markers

Distinguishing individual Russula species has been difficult due to extensive phenotypic plasticity and obscure morphological and anatomical discontinuities. Due to highly similar macroscopic features, such as the presence of a red-cap, species identification within the Russula subgenus Amoenula is particularly difficult. Three species of the subgenus Amoneula have been reported in Korea. We used a combination of morphology and three molecular markers, the internal transcribed spacer (ITS), 28S nuclear ribosomal large subunit (LSU), and RNA polymerase II gene (RPB2), for identification and study of the genetic diversity of Russula subgenus Amoenula in Korea. We identified only two species in Korea (R. mariae and R. violeipes); these two species were indistinguishable according to morphology and LSU, but were found to be reciprocally monophyletic species using ITS and RPB2. The markers, ITS, LSU, and RPB2, have been tested in the past for use as DNA barcoding markers, and findings of our study suggest that ITS and RPB2 had the best performance for the Russula subgenus Amoneula.

Severe bronchospasm in a premature infant during induction of anesthesia caused ventilation failure / 대한마취과학회지

No abstract available.

The Effects of Laser Refractive Surgery for Correcting Residual Refractive Error after Implantation of ReSTOR(R) Multifocal IOL

PURPOSE: To evaluate the clinical effects of excimer laser refractive surgery on eyes with residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses. METHODS: We retrospectively reviewed the medical records of 10 eyes of 6 patients who had undergone cataract surgery with implantation of multifocal intraocular lenses. Photorefractive keratectomy (PRK) (5 eyes) and laser-assisted in situ keratomileusis (LASIK) (5 eyes) was performed on 10 eyes with residual refractive error. RESULTS: After cataract surgery and before laser surgery, the mean spherical equivalent (SE) was -0.34 +/- 0.89 D and the mean astigmatism was 2.08 +/- 0.55 D. Six months after laser surgery, the mean SE was -0.33 +/- 0.30 D (p = 0.354) and the mean astigmatism was 0.23 +/- 0.28 D. The changes in astigmatism between paired preoperative and postoperative values were statistically significant (p < 0.0001). At 6 months after surgery, uncorrected distance visual acuity significantly improved to 0.11 +/- 0.10 (log MAR) (p < 0.0001) There were no significant changes in the best corrected distance visual acuity and uncorrected near visual acuity (p = 0.073, p = 0.100). CONCLUSIONS: On the basis of predictability and stability, excimer laser surgery appears to be a clinically useful procedure to correct residual refractive error after implantation of ReSTOR(R) multifocal intraocular lenses.

Establishment of a Radiation-Induced Fibrosis Model in BALB/c Mice / 대한방사선종양학회지

PURPOSE: Although radiation-induced fibrosis is one of the common sequelae occurring after irradiation of skin and soft tissues, the treatment methods are not well standardized. This study aimed to establish the skin fibrosis mouse model by fractionated radiation for the further mechanism studies or testing the efficacy of therapeutic candidates. MATERIALS AND METHODS: The right hind limbs of BALB/c mice received two fractions of 20 Gy using a therapeutic linear accelerator. Early skin damages were scored and tissue fibrosis was assessed by the measurement of a leg extension. Morphological changes were assessed by H&E staining and by Masson's Trichrome staining. TGF-beta1 expression from soft tissues was also detected by immunohistochemistry and PCR. RESULTS: Two fractions of 20 Gy irradiation were demonstrated as being enough to induce early skin damage effects such as erythema, mild skin dryness, dry and wet desquamation within several weeks of radiation. After 13 weeks of irradiation, the average radiation-induced leg contraction was 11.1+/-6.2 mm. Morphologic changes in irradiated skin biopsies exhibited disorganized collagen and extracellular matrix fibers, as well as the accumulation of myofibroblasts compared to the non-irradiated skin. Moreover, TGF-beta1 expression in tissue was increased by radiation. CONCLUSION: These results show that two fractions of 20 Gy irradiation can induce skin fibrosis in BALB/c mice accompanied by other common characteristics of skin damages. This animal model can be a useful tool for studying skin fibrosis induced by radiation.

Development and Effects' Analysis of Nutrition Education Program for Diabetes Mellitus at Community Health Center: Focused on Individual Daily Energy Requirements and Food Exchange Units / 대한지역사회영양학회지

The purpose of this study was to investigate effects of the developed nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at a community health center. Developed the nutrition education program, four weeks' nutrition education including provided twice individual meal as diet therapy (2 hour/lesson/week, 4 week), was provided to 20 diabetic elderly (12 male, 8 female, 50-75 yrs): 1st lesson "Introduction: management of diabetes mellitus", 2nd lesson "6 Food groups and sources of 6 food groups", 3rd lesson "Individual daily energy requirements and food exchange units", and 4th lesson "Food choice for diabetes mellitus". For effects' analysis of the developed program, we assessed the changes in anthropometric characteristics; biochemical characteristics and nutrient intakes using 24 hr recall method. Effects of the developed nutrition education program were as follows: weight was significantly decreased, blood urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c) were significantly decreased, and distribution of subjects in BUN and HbA1c was significantly changed. In protein : fat : carbohydrate (PFC) ratio, it was significantly changed from 15.98 : 16.30 : 66.69 to 17.51 : 18.94 : 64.10. In evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), protein, fiber, fat, vitamin E, niacin, folic acid, calcium and zinc were shown significantly positive changes in distribution of subjects according to intake level. The index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased. In conclusion, the developed 4 weeks' nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at community health center may improve the symptom of diabetes mellitus.

Clinical Analysis of Contralateral Bulla of Lung on HRCT in the Patients Having Video-Assisted Thoracoscopic Surgery for Unilateral Primary Spontaneous Pneumothorax / 대한흉부외과학회지

BACKGROUND: It is controversial whether the presence of bullae on the contralateral lung on HRCT plays a role in occurrence of contralateral primary spontaneous pneumothorax. We analyzed the significance of bullae on the contralateral lung and the risk factors associated with contralateral occurrence of primary spontaneous pneumothorax. MATERIAL AND METHOD: Three hundred ninety four patients who were undergone Video.Assisted Thoracoscopic Surgery for primary spontaneous pneumothorax between January 2004 and December 2009 were reviewed. The clinical features, HRCT and treatment of these patients were analyzed retrospectively. RESULT: Twenty eight of 394 patients had contralateral occurrence (7.10%). The average time was 13.06+/-9.79 months. A presence of contralateral bullae of lung on HRCT may not seem to be significant for occurrence of contralateral primary spontaneous pneumothorax (p=0.059). But bullae numbers were much more in contralateral pneumothorax patients (p=0.011). Younger than 20, being underweight (Body Mass Index<18.5 kg/m2) are independent risk factors for contralateral occurrence (odds ratio, 5.075 (1.679~5.339), 2.366 (1.048~5.339) respectively). CONCLUSION: The presence of bullae on the contralateral lung on HRCT was not significantly influenced the occurrence of contralateral primary spontaneous pneumothorax. However, age, body mass index, and the number of bullae were significant factors for the contralateral pneumothorax. We suggest that those high risk patients may require special attentions and general supportive care to prevent occurrence of contralateral primary spontaneous pneumothorax during the follow-up.

Development of a Semi-automatic Computer System to Register MRI Lesions Onto a Brain Template for Quantitative Analyses in Clinical Trials Having MRI Findings as Surrogate Endpoints: A Preliminary Report

BACKGROUND: Clinical trials that utilize imaging findings as surrogate endpoints are considered to be cost-effective. However, unlike numeric data, magnetic resonance imaging (MRI) findings are not quantifiable. Thus, we have begun to develop a software package that is able to convert qualitative MRI findings into quantifiable data. METHODS: Computer software (DUIH_Image) was created with which every patient's MRI data can be registered on a standard brain template. Interuser and intrauser reliabilities for the registration were measured, and then a proof-of-principle experiment was conducted to determine whether the system could identify factors that were associated with a greater National Institutes of Health Stroke Scale (NIHSS) score at admission. We studied 40 consecutive patients [65.1+/-14.2 years old (mean+/-SD); 22 males and 18 females] with first-ever acute lacunar infarction of the corona radiata, who were divided into two groups according to their NIHSS score (i.e., low: 0-2; high: > or =3). The following parameters were compared between these two groups: (1) data retrieved from clinical profiles, including demographic and risk factor variables; and (2) accumulated diffusion MRI lesions mapped on a standard template. RESULTS: Modest levels of interuser and intrauser reliability were observed (p<0.05, R(2)=0.63-0.84, Pearson correlations). Regarding the clinical profiles, no significant difference was found for the numeric data sets or infarct size between the two groups. However, on the accumulated lesion map image, the lesion area that overlapped the most was located more posterolaterally in the high NIHSS score group than in the low NIHSS score group. CONCLUSIONS: In this pilot study we have demonstrated the potential usefulness of the DUIH_Image software. We plan to update this software to enable its utilization in actual clinical trials.

Metastasis of Non-Small Cell Lung Cancer to Ipsilateral Breast: A Case Report / 한국유방암학회지

Breast tissue is an unusual site for metastatic disease, particularly for non-small cell lung cancer (NSCLC). Aside from contralateral breast cancer, the most common tumors metastasizing to the breast are malignant melanoma and hematopoietic malignances. We recently experienced a case of a 49-year-old female patient with solitary metastasis of NSCLC to ipsilateral breast tissue. She was diagnosed as NSCLC of left lung and underwent left upper lobectomy in 2001. She was then treated with etoposide/cisplatin chemotherapy and radiation therapy. After 35 months, she was referred to our breast clinic because of a nodular opacity in the left breast revealed by screening breast ultrasound, which proved to be of pulmonary origin. She was treated by wide excision and with docetaxel/cisplatin chemotherapy. However, 37 months after breast surgery, a metastatic lesion developed in the same breast and she received modified radical mastectomy. We report this case with a review of the literature.

Periosteal Ewing's Sarcoma of the Rib / 대한흉부외과학회지

A 43-yr-old patient visited our department with intermittent chest pain he had suffered with for the past 2 months. Chest CT showed an egg shaped mass in the left chest wall. Local resection was performed for distinguishing the mass from a neurogenic tumor. The diagnosis was periosteal Ewing sarcoma of the rib. Since there was no evidence of metastasis based on the PET-CT, a 2nd operation was done with wide resection and thoracoplasty. The patient was then treated with combined chemotherapy. There has been no local recurrence for the last 1 year. The patient's age and tumor origin were distinct from the usual characteristics of Ewing's sarcoma. Periosteal Ewing's sarcoma of the rib has rarely been reported. We report here on a case of periosteal Ewing's sarcoma of the rib along with a review of the relevant medical literature.

The Policy Direction for Health Promotion in Korea

It has been over 10 years since the health promotion policy is carried out by government and the level of health of Korean people has been dramatically improved. However, persistent increase in chronic diseases and the rapid aging require comprehensive health promotion policies for the establishment of cost effective health care system. Furthermore, the current global economic difficulties necessitate the implementation of appropriate health care system for underprivileged groups of people. In 2009, in an effort to effectively remedy these situations, the Ministry of Health, Welfare and Family Affairs implemented a new health promotion policy with focus on five strategic areas; reinforcement of health care support for the underprivileged groups; strengthening health promotion management including smoking and obesity prevention; preparation for the next generation's health by supporting pregnancy and childbirth; establishing the preventive system for chronic diseases such as cardiovascular disease and asthma; governmental support for suicide and alcohol abuse prevention and improvement of mental health care service. From the socioeconomic perspective, the current health promotion policy in Korea contributes to raising national income level by producing job opportunities, through the revitalization of new service sector. It is expected that the introduction of Health Care Service will contribute more to this trend.

The Policy Direction for Health Promotion in Korea

It has been over 10 years since the health promotion policy is carried out by government and the level of health of Korean people has been dramatically improved. However, persistent increase in chronic diseases and the rapid aging require comprehensive health promotion policies for the establishment of cost effective health care system. Furthermore, the current global economic difficulties necessitate the implementation of appropriate health care system for underprivileged groups of people. In 2009, in an effort to effectively remedy these situations, the Ministry of Health, Welfare and Family Affairs implemented a new health promotion policy with focus on five strategic areas; reinforcement of health care support for the underprivileged groups; strengthening health promotion management including smoking and obesity prevention; preparation for the next generation's health by supporting pregnancy and childbirth; establishing the preventive system for chronic diseases such as cardiovascular disease and asthma; governmental support for suicide and alcohol abuse prevention and improvement of mental health care service. From the socioeconomic perspective, the current health promotion policy in Korea contributes to raising national income level by producing job opportunities, through the revitalization of new service sector. It is expected that the introduction of Health Care Service will contribute more to this trend.

Paragonimiasis with Simultaneous Multifocal Lesions / 대한흉부외과학회지

A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.

Clinical Review of Totally Implantable Venous Catheter / 대한흉부외과학회지

BACKGROUND: The introduction of central venous catheters in 1979 has aided the administration of chemotherapy to oncologic patients. We analyzed the clinical reviews and complications of totally implantable venous catheters in an effort to achieve optimal management. MATERIAL AND METHOD: We retrospectively studied 100 cases with totally implantable venous catheter at our hospital and we report the results. RESULT: 100 totally implantable venous catheters were placed in the right subclavian vein in 74 cases (74%), the left subclavian vein in 21 cases, the right jugular vein in 3 cases, the left jugular vein in 1 case and the right femoral vein in 1 case. The immediate complications were 5 cases in malposition of the catheter and 5 cases of arterial puncture. The late complications were 1 case of subclavian vein thrombosis, which was treated with anticoagulation, and 2 cases of pinch-off syndrome. There were no other early or late complications. CONCLUSION: The low rate of complications in this study confirms the safety and convenience of using totally implantable venous catheter in patients undergoing prolonged chemotherapy. Yet because Infection, thrombosis, and catheter fracture are the most common long term complications of totally implantable venous catheters, early diagnosis and management of these problems can prevent severe complications.