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Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood $Henoch-Sch\"{o}nlein$ Purpura Nephritis (소아 $Henoch-Sch\"{o}nlein$ 자반병 신염의 임상양상 및 병리소견과 임상경과)

  • Huh Yun-Jung;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.30-37
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. Methods : The clinical features, initial laboratory and pathologic findings, and clinical out-come were evaluated in 60 children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. Results : The ratio of male to female patients was 1.2:1. The interval between the onset of $Henoch-Sch\"{o}nlein$ purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome In 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. Conclusion : Renal manifestation and pathologic findings correlated with the clinical out-come. It is necessary to evaluate the correlation between pathologic findings and treatment.

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The Comparison of DVH between Multiple arc FSRT and Conformal FSRT (Multiple arc FSRT와 Conformal FSRT의 DVH 비교)

  • Kim Ki-Hwan;Kim Jun-Sang;Jang JiYoung;Kim Jae-Sung;Kim Seong-Ho;Song Chang-Joon;Park Min-Kyu;Cho Moon-June
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.261-267
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    • 1999
  • Purpose : In FSRT (Fractionated stereotactic radiotherapy) planning, we studied the usefulness between multiple arc FSRT and conformal FSRT by comparing tumor shape and DVH (dose volume histogram). Materials and Methods In Chungnam Univ. hospital, we had treated the sixteen patients with FSRT from Aug. 1997 to Dec. 1998. In choosing multiple arc FSRT or conformal FSRT, we had considered If (irregular factor) after calculating tumor volume and surface area. We had considered multiple arc FSRT if tumor shape was similar to sphere or the value of If was less than 1.25, conformal FSRT if tumor shape was very irregular or If was more than 1.3. For evaluation of treatment planning, we had considered the appropriate DVH for tumor volume and for critical organs. Results : The errors between reference point and the coordinates point on AP, Lat radiography were less than 1 mm before treatment. We had planned $3\~$5 arcs for multiple arc FSRT, $5\~6$ports for conformal FSRT. The mean dose distribution of tumor volume of cumulative DVH between multiple arc FSRT and conformal FSRT was 90.6, 85%, respectively. The dose of critical organs irradiated was less than $5\%$ maximum dose of cumulative DVH. Conclusion : We had obtained the similar value between multiple arc FSRT and conformal FSRT, so that we had appropriate treatment planning of FSRT for multiple arc FSRT and conformal FSRT according to tumor shape and size.

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Analysis of Water Balance in Closed Transplants Production System (폐쇄형 묘생산 시스템의 수분 수지 분석)

  • Kim, J.K.;Kim, Y.H.;Choi, Y.H.;Lee, M.G.
    • Journal of Bio-Environment Control
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    • v.12 no.3
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    • pp.152-159
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    • 2003
  • This study was conducted to analyze the water consumption in closed transplants production system (CTPS) for the production of quality transplants and to investigate the effect of relative humidity on the water balance in CTPS. Potato (Solanum tuberosum L. cv. Dejima) plug seedlings were grown for 15 days at air temperature of 20$^{\circ}C$, relative humidity of 70%, photoperiod of 16/8 h, and photosynthetic photon flux (PPF) of 200 ${\mu}mol{\cdot}m^{-2}{\cdot}s^{-l}$ following rooting for 5 days in CTPS. Amount of humidified, dehumidified, irrigated and evapotranspirated water were 67.9 kg${\cdot}m^{-2},\;196.9{\cdot}m^{-2},\;44.3\;kg{\cdot}m^{-2},\;33.5\;kg{\cdot}m^{-2}$, respectively. Water content of media and plants were 1.2 kg${\cdot}m^{-2},\;6.9\;kg{\cdot}m^{-2}$, respectively. Three relative humidity levels of 60, 70, and 80% were provided to analyze the effect of humidity on the water balance in CTPS. Amount of humidified, dehumidified, irrigated, evapotranspiratad water and water contents of media and plants increased with increasing relative humidity. Since the water consumption required to produce plug seedlings in CTPS dec1eased with decreasing relative humidity, the available water utilization efficiency of CTPS increased with decreasing relative humidity. CTPS showed high available water utilization efficiency of 0.92 - 0.97 if dehumidified water in CTPS was recycled. The development of CTPS with recycling system of dehumidified water will not only reduce the water consuming for the production of transplants but contribute to the establishment of plant production economizing in water consumption.

Acute Renal Failure after On-pump Coronary Artery Bypass Surgery (체외순환하 시행한 관상동맥우회술 후 발생한 급성신부전증)

  • Jin, Ung;Jo, Min-Seop;Park, Chan-Beom;Sa, Young-Jo;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.416-422
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    • 2004
  • Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.

Variations of the Wind-generated Wave Characteristics around the Kyung-gi Bay, Korea (경기만 근해에서 풍파의 특성 변화)

  • Kang, Ki-Ryong;Hyun, Yu-Kyung;Lee, Sang-Ryong
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.4
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    • pp.251-261
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    • 2007
  • The wind-wave interaction around the Kyung-gi Bay, Korea, was studied using the observed data from ocean buoy at DeuckJeuck-Do from Jan. to Dec., 2005, and from waverider data at KeuckYeulBee-Do on Mar. 19-26 and May 23-28, 2005. Wind-driven surface waves and wave-driven wind speed decrease were estimated from the ocean buoy data, and the characteristics of wave spectrum response were also investigated from the waverider data for the wave developing and calm stages of sea surface, including the time series of spectrum pattern change, frequency trend of the maximum energy level and spectrum slope for the equilibrium state range. The wind speed difference between before and after considering the wave effect was about $2ms^{-1}$ (wind stress ${\sim}0.1Nm^{-2}$) for the wind speed range $5-10ms^{-1}$ and about $3ms^{-1}$ (wind stress ${\sim}0.4Nm^{-2}$) for the wind speed range $10-15ms^{-1}$. Correlation coefficient between wind and wave height was increased from 0.71 to 0.75 after the wave effect considered on the observed wind speed. When surface waves were generated by wind, the initial waves were short waves about 4-5 sec in period and become in gradual longer period waves about 9-10 sec. For the developed wave, the frequency of maximum energy was showed a constant value taking 6-7 hours to reach at the state. The spectrum slope for the equilibrium state range varied with an amplitude in the initial stage of wave developing, however it finally became a constant value 4.11. Linear correlation between the frictional velocity and wave spectrum for each frequency showed a trend of higher correlation coefficient at the frequency of the maximum energy level. In average, the correlation coefficients were 0.80 and 0.82 for the frequencies 0.30 Hz and 0.35 Hz, respectively.

A Case Study on Application of the Menu Engineering Technique in Government Offices Contract Foodservice (관공서급식소의 메뉴엔지니어링기법을 적용한 메뉴분석 사례연구)

  • Rho, Sung-Yoon
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.78-96
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    • 2009
  • The purpose of this study was to analyze and evaluate the menu served in government offices foodservice by using Kasavana & Smith's Menu-Engineering. Sales and food costs were collected from the daily sales reports for a year from Jan 2 to Dec 31 in 2007. Calculation for menu analysis and customer's data were done by computer using the MS 2003 Excel spreadsheet program and SPSS 12.0 package program. Menu mix% (MM%) and unit contribution margin were used as variables by Kasavana & Smith. Four possible classifications by Menu-Engineering technique were turned out as 'STAR', 'PLOWHORSE', 'PUZZLE', 'DOG'. The main menus served during a year were 128 dishes and about 141 peoples visited this restaurant daily. The mean age of the men was $44.1\;{\pm}\;6.3$, women were $32.7\;{\pm}\;6.4$ and showed that was statistically higher than that of women (p < .0001). The rates of STAR menus were 'Western style (75.0%)', 'guk/tang-ryu (48.1%)', 'jjigae/ jeongol-ryu (23.1%)', 'bap-ryu (17.2%)' in sequence. There were no STAR menus in gui/jorim/jjim-ryu. PLOWHORSE menus were 'gui-ryu (75.0%)', 'guk/tang-ryu (29.6%)', 'bap-ryu (27.6%)' in sequence. There were no PUZZLE or DOG menus in 'jjigae/jeongol-ryu'. PUZZLE menus were 'jorim/jjim-ryu and Myeonryu (each 33.3%)', 'bap-ryu (31.0%)' in sequence. PUZZLE menus were a lots of 'Chinese food (75.0%)' and 'myeonryu (55.6%)'. This study provides the basic data based on regularly menu analysis method applied the scientific menu analysis techniques in government offices food services, I'd like to suggest that the menu management must be done based on the necessity and result of menu analysis according to the seasonal and middle, long-term plans.

Surgery Alone or Postoperative Adjuvant Radiotherapy in Rectal Cancer - With Respect to Survival, Pelvic Control, Prognostic Factor - (직장암에서 수술단독 또는 수술후 방사선치료 -생존율, 골반종양제어율, 예후인자를 중심으로-)

  • Nam, Taek-Keun;Ahn, Sung-Ja;Nah, Byung-Sik
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.327-334
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    • 2001
  • Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

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Clinical Study of Corrosive Injury of the Esophagus (식도부식증의 임상적 고찰)

  • 박철원;송기준;이형석;안경성;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.5.3-6
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    • 1981
  • There are too many kinds of esophageal corrosive agents, such as sodium hydrochloride, acetic acid, hydrochloric acid, etc. Esophageal burn due to above chemical agents are decreasing recently, but still many patients visited to the hospital because of swallowing corrosive agents for the purpose of suicide or accidentally. Among the treatment of corrosive injury of the esophagus, prevention of esophageal stricture is the key point. Recently various methods are using as the treatment of corrosive esophagitis and prevention of esophageal stricture. 51 cases of corrosive injury of the esophagus who had been admitted and treated at the Dept. of Otolaryngology, Han Yang University Hospital during past 9 years (from May 1972 to Dec. 1980) were evaluated and report the result about age distribution, sex incidence, monthly distribution, cause of swallowing, swallowing agents, arriving time at hospital after swallowing, changes on oral and pharyngeal mucosa, laboratory findings, emergency treatment and treatment during admission, treatment follow up results and complications with review of liter ature. Following results were obtained; 1. Female patients 27 cases (52.9%) were more than male patients 24 cases (47.1%) and its ratio was 1.13 : 1. 2. Age distribution showed predilection for age of 21-30 with 20 cases(39.2%), and 11-20 with 11 cases (21.6%), 31-40 with 7 cases(13.7%), over 50 with 7 cases (13.7%) were following. 3. Monthly distribution showed predilection for March with 8 cases(15.7%), and April, July with 7 cases (13.7%), September with 6 cases(l1.8%), October 5 cases(9.8%) were following. 4. For the purpose of suicide was the most cause of swallowing with 40 cases(78.4%), and accidentally swallowing 11 cases(21.6%). 5. Acetic acid was the most swallowing agent with 24 cases (47.0%), and hydrochloric acid 11 cases (21.5%), lye 8 cases(15.7%), iodine 2 cases(3.9%) were following. 6. Arriving time at the hospital after swallowing showed predilection for within 12 hours with 42 cases (82.4%), and from 12 hours to 24 hours with 4 cases(7.8%) was next. 7. Moderate change with injection and swelling was the prevalent change on oral and pharyngeal mucosa with 20 cases(39.2%) and severe cases with ulceration 18 cases (35.3%), mild cases with injection 10 cases (19.6%) were following. 8. Leukocytosis was seen on 40 cases (78.4%), and increased Hct. was seen 31 cases (60.8%). On urine analysis, 14 cases(27.5%) showed over 1.030 S.G., and proteinuria was seen on 25 cases(49.0%), glycosuria was seen on 5 cases(9.8%) and hematuria was seen on 6 cases(11.8). 9. Gastric lavage was done on 30 cases (58.8%) as emergency treatment and on 3 cases(5.9%) tracheostomy was done for the airway keeping. 10. As methods of treatment during admission, L-tube insertion was done on 50 cases (98.0%), antibiotics was given to 49 cases (96.1%), steroid and antacid were given to 46 cases(90.2%). 11. 36 cases(70.6%) were in favorable condition after proper treatment, but 2 cases (3.9%) were expired during admission, 4 cases (7.8%) showed esophageal stricture in-spite of treatment, and 1 case(2.0%) showed pyloric stenosis. 12. Complications were observed in 8 cases (17.7%). Renal failure (4 cases), aspiration pneumonia (2 cases), upper G-I bleeding (1 cases), and diabetic coma (1 cases) were seen in order of frequency.

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The Results of Combined External Radiotherapy and Chemotherapy in the Management of Esophageal Cancer (식도암의 방사선-항암화학 병용치료결과)

  • Lee Hyun Joo;Suh Hyun Suk;Kim Jun Hee;Kim Chul Soo;Kim Sung Rok;Kim Re Hwe
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.17-23
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    • 1996
  • Purpose : To evaluate the role of combination therapy of external radio-therapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. Materials and Methods : A retrospective review of evaluable 55 esophageal cancer patients referred to the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul, 1983 and Dec. 1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group (ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fifty patients had squamous cell carcinomas. Radiation doses of 2520-6480c0y were delivered over a period of 4-7weeks, using 4MV LINAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1, 2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. Resuts : Median follow up Period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months (20 days-73 months) in B group. The 1, 2 YSRs were $26.7\%$, $8.9\%$ in A group, $12.7\%$, $4.3\%$ in B group (p>0.05), respectively. The 1, 2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose (5000cGymore or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were $43.8\%$. $25.0\%$, respectively. Complete response rate of $25.0\%$ in A and $8.3\%$ in B were achieved. The local failure and distant metastsis were $52.4\%$. $23.8\%$ in A group, $64.3\%$, $14.3\%$ in 8 group, respectively. The combination therapy revealed more frequent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to moderate. Conclusion : The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.

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Comparative Study on the Regimens with Pyrazinamide or Ofloxacin in the retreatment of pulmonary tuberculosis (폐결핵 재치료에서 Pyrazinamide 복합처방과 Ofloxacin 복합처방의 효과에 관한 비교 연구)

  • Choi, In Hwan;Park, Seung Kyu;Kim, Kyeong Ho;Kim, Jin Ho;Kim, Cheon Tae;Song, Sun Dae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.871-881
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    • 1996
  • Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

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