• Title/Summary/Keyword: Abnormal change

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Development and Application of a Methodologyfor Climate Change Vulnerability Assessment-Sea Level Rise Impact ona Coastal City (기후변화 취약성 평가 방법론의 개발 및 적용 해수면 상승을 중심으로)

  • Yoo, Ga-Young;Park, Sung-Woo;Chung, Dong-Ki;Kang, Ho-Jeong;Hwang, Jin-Hwan
    • Journal of Environmental Policy
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    • v.9 no.2
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    • pp.185-205
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    • 2010
  • Climate change vulnerability assessment based on local conditions is a prerequisite for establishment of climate change adaptation policies. While some studies have developed a methodology for vulnerability assessment at the national level using statistical data, few attempts, whether domestic or overseas, have been made to develop methods for local vulnerability assessments that are easily applicable to a single city. Accordingly, the objective of this study was to develop a conceptual framework for climate change vulnerability, and then develop a general methodology for assessment at the regional level applied to a single coastal city, Mokpo, in Jeolla province, Korea. We followed the conceptual framework of climate change vulnerability proposed by the IPCC (1996) which consists of "climate exposure," "systemic sensitivity," and "systemic adaptive capacity." "Climate exposure" was designated as sea level rises of 1, 2, 3, 4, and 5 meter(s), allowing for a simple scenario for sea level rises. Should more complex forecasts of sea level rises be required later, the methodology developed herein can be easily scaled and transferred to other projects. Mokpo was chosen as a seaside city on the southwest coast of Korea, where all cities have experienced rising sea levels. Mokpo has experienced the largest sea level increases of all, and is a region where abnormal high tide events have become a significant threat; especially subsequent to the construction of an estuary dam and breakwaters. Sensitivity to sea level rises was measured by the percentage of flooded area for each administrative region within Mokpo evaluated via simulations using GIS techniques. Population density, particularly that of senior citizens, was also factored in. Adaptive capacity was considered from both the "hardware" and "software" aspects. "Hardware" adaptive capacity was incorporated by considering the presence (or lack thereof) of breakwaters and seawalls, as well as their height. "Software" adaptive capacity was measured using a survey method. The survey questionnaire included economic status, awareness of climate change impact and adaptation, governance, and policy, and was distributed to 75 governmental officials working for Mokpo. Vulnerability to sea level rises was assessed by subtracting adaptive capacity from the sensitivity index. Application of the methodology to Mokpo indicated vulnerability was high for seven out of 20 administrative districts. The results of our methodology provides significant policy implications for the development of climate change adaptation policy as follows: 1) regions with high priority for climate change adaptation measures can be selected through a correlation diagram between vulnerabilities and records of previous flood damage, and 2) after review of existing short, mid, and long-term plans or projects in high priority areas, appropriate adaptation measures can be taken as per this study. Future studies should focus on expanding analysis of climate change exposure from sea level rises to other adverse climate related events, including heat waves, torrential rain, and drought etc.

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The embryological studies on the interspecific hybrid of ginseng plant (Panax ginseng x P. Quiuquefolium) with special references to the seed abortion (인삼의 종간잡종 Panax ginseng x P Quinquefoilium의 발생학적 연구 특히 결실불능의 원인에 관하여)

  • Jong-Kyu Hwang
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.5 no.1
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    • pp.69-86
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    • 1969
  • On the growing of the interspecific hybrid ginseng plant, the phenomena of hybrid vigoures are observed in the root, stem, and leaf, but it can not produce seeds favorably since the ovary is abortive in most cases in interspecific hybrid plants. The present investigation was undertaken in an attempt to elucidate the embryological dses of the seed failure in the interspecific hybrid of ginseng (Panax Ginseng ${\times}$ P. Quinque folium). And the results obtained may be summarized as follows. 1). The vegetative growth of the interspecific hybrid ginseng plant is normal or rather vigorous, but the generative growth is extremely obstructed. 2). Even though the generative growth is interrupted the normal development of ovary tissue of flower can be shown until the stage prior to meiosis. 3). The division of the male gameto-genetic cell and the female gameto-genetic cell are exceedingly irregular and some of them are constricted prior to meiosis. 4). At meiosis in the microspore mother cell of the interspecific hybrid, abnormal division is observed in that the univalent chromosome and chromosome bridge occure. And in most cases, metaphasic configuration is principally presented as 23 II+2I, though rarely 22II+4I is also found. 5). Through the process of microspore and pollen formation of F1, the various developmental phases occur even in an anther loclus. 6). Macro, micro and empty pollen grains occur and the functional pollen is very rare. 7). After the megaspore mother cell stage, the rate of ovule development is, on the whole, delayed but the ovary wall enlargement is nearly normal. 8). Degenerating phenomena of ovules occur from the megaspore mother cell stage to 8-nucleate embryo sac stage, and their beginning time of constricting shape is variously different. 9). The megaspore arrangement in the parent is principally of the linear type, though rarely the intermediate type is also observed, whereas various types, viz, linear, intermediate, Tshape, and I shape can be observed in hybrid. 10). After meiosis, three or five megaspore are some times counted. 11). Charazal end megaspore is generally functional in the parents, whereas, in F1, very rarely one of the center megaspores (the second of the third megaspore) grows as an embryo sac mother cell. 12). In accordance with the extent of irregularity or abnormality in meiosis, division of embryo sac nuclei and embryo sac formation cause more nucellus tissue to remain within th, embryo sac. 13). Even if one reached the stage of embryo sac formation, the embryo sac nuclei are always precarious and they can not be disposed to theil proper, respective position. 14). Within the embryo sac, which is lacking the endospermcell, the 4-celled proembryo, linear arrangement, is observed. 15). Through the above respects, the cause of sterile or seed failure of interspecific hybrid would be presumably as follows, By interspecific crossing gene reassortments takes place and the gene system influences the metabolism by the interference of certain enzyme as media. In the F1 plant, the quantity and quality of chemicals produced by the enzyme system and reaction system are entirely different from the case of the parents. Generally, in order to grow, form, and develop naw parts it is necessary to change the materials and energy with reasonable balance, whereas in the F1 plant the metabolic process becomes abnormal or irregular because of the breakdown of the balancing. Thus the changing of the gene-reaction system causes the alteration of the environmental condition of the gameto-genetic cells in the anther and ovule; the produced chemicals cause changes of oxidatio-reduction potential, PH value, protein denaturation and the polarity, etc. Then, the abnormal tissue growing in the ovule and emdryo sac, inhibition of normal development and storage of some chemicals, especially inhibitor, finally lead to sterility or seed failure. Inconclusion, we may presume that the first cause of sterile or seed abortion in interspecific hybrids is the gene reassortment, and the second is the irregularity of the metabolic system, storage of chemicals, especially inhibitor, the growth of abnormal tissue and the change of the polarity etc, and they finally lead to sexual defect, sterility and seed failure.

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The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Relationship on the Refractive Status of the High School 3rd Grade Students with Subnormal Visual Acuity in Gwangju Metropolitan City (광주지역 고등학교 3학년생의 비정시안의 굴절상태에 대한 고찰)

  • Yoon, Young;Ryu, Geun-Chang
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.3
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    • pp.105-110
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    • 2007
  • To investigate the ametropia and refractive error of 222 ametropic eyes of the 111 high school students in Gwangju Metropolitan City, the visual acuity test was performed by the object and subject method. 85% of the eye types were positive for myopia, 14% for emmetropia, and 1% for hyperopia, respectively. 38% of the abnormal refraction eyes were positive for simple myopia, 4% for myopia simple astigmatism, 56% for myopia compound astigmatism, and 0% for simple hyperopia, 0% for hyperopia simple astigmatism, 2% for hyperopia compound astigmatism, 0% for mixed astigmatism, respectively. 92% of the axes fo astigmatism were for astigmatism with-the-rule, 6% for astigmatism against-the rule, 2% for astigmatism oblique, respectively. As for the astigmatic power, 0.50 < cylinder < 1.00D was 68%, 1.00 < cylinder < 2.00D was 25%, and anything over the 2.00 cylinder D was 7%. As for the equivalent spheric power of myopic abnormal refraction eyes, -0.50 < spheric equivalent < -2.00D was 26%, -2.00D < spheric equivalent < -6.00D was 55% and anything over the -6.00D was 19%. The rate of wearing glasses was 74%. It increases compared to 20 years ago. 91% of the eye test place was the optical shop, 9% the eye doctor hospital. 80% of the students need to change their optical lenses because spherical equivalent power was over 0.50D.

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Clinical study on safety of Scolopendrid aquacupuncture (오공약침의 안전성에 대한 임상적 연구)

  • So, Ki-suk;Choi, Hoi-kang;Park, So-young;Koh, Kang-hun;Kim, Sung-nam;Lee, Ok-ja;Yun, Min-young;Mun, Hyung-chul;Kim, Sung-chul;Lee, Jung-hun;Na, Won-kyung
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.136-148
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    • 2004
  • Objective: Recently scolopendrid aquacupuncture has been a good effect on pain control but it has not been known about clinical safety. So, In order to prove the clinical safety of scolopendrid aquacupuncture, We have observed the physical reac-tion and clinical pathology test after scolopendrid aquacupuncture treatment. Methods: We analyzed physical reaction and clinical pathology test before and after Scolopendrid aquacupuncture treatment of 30 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results & Conclusions: The results were summarized as follows. 1) The distribution of sex was 14 males and 16 females, and the average of patients age was 46.2 years. 2) The distribution of symptom was lumbago, lumbago with radiating pain, nuchal pain and knee joint pain. 3) In the 30 patients treated with Scolopendrid aquacupuncture, hematologic test did not show remarkable change. 4) In the 30 patients treated with Scolopendrid aquacupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 1.0%(from 3.3% to 2.3%) compared with previous study. 5) In the 30 patients treated with Scolopendrid aquacupuncture, Renal function test(BUN, Cr) and abnormal rate(from 2.5% to 2.0%) showed a slight decrease on the contrary. 6) In the 30 patients treated with Scolopendrid aquacupuncture. Electrolyte were normal range before & after treatment. 7) In the results of the Urine analysis of 30 patients, Leukocyte, Protein. Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aquacupuncture treatment, and the rest almost made no difference. 8) In the Physical reactions, all of the patients complained of pain of body partially, only one patient showed reddish and itch, but symptoms like those were entirely disappeared within 24 hours and whole body pain, swelling, headache, dizziness, fatigue and nausea was not observed.

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The Clinical Usefulness of Electroencephalography : Comparison of Findings Electroencephalography with Findings of Brain Computed Tomography and Magnetic Resonance Imaging (뇌파의 임상적 유용성 : 뇌파소견과 뇌전산화 단층촬영 검사 및 뇌자기공명 영상검사 소견을 비교하여)

  • Kang, Dong-Woo;Lee, Young-Ho;Choi, Young-Hee;Chung, Young-Cho
    • Sleep Medicine and Psychophysiology
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    • v.3 no.2
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    • pp.1-17
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    • 1996
  • To demonstrate the clinical usefulness of electroencephalography (EEG) and factors increasing the usefulness of EEG, the authors evaluated each relationship between EEG related factors and clinical variables, and neuroimaging studies (CT and MRI)-related factors, and factors which are related with routine neurological examination for 207 patients who had been evaluated with both of EEG and neuroimaging study(CT or/and MRI). The results were as follows: 1) Abnormality of EEG findings had significant relationships with chief complaints, diagnosis, medication use, seizure attack, pathological reflex, and level of consciousness. However there were no significant correlations between abnormality of EEG findings and neuroimaging studies (CT and MRI)- related factors. 2) Laterality of EEG findings had significant relationships with abnormality, laterality, and focality of CT findings, and also with abnormality of MRI findings. But there were no significant correlations between laterality of EEG findings and clinical variables, and neurological examination-related factors. 3) Anterior-posterior distribution of EEG findings was significantly related with medication use. 4) Focality of EEG findings had significant relationships with sex, sensory dysfunction sign, and cerebellar dysfunction sign. But there were no significant correlations between focality of EEG findings and neuroimaging studies(CT and MRI) related factors. 5) Abnormal EEG pattern had significant correlations with various factors, such as age, chief complaints, duration from onset of symptom to taking MRI, seizure attack, abnormality and nature of lesion in CT findings, cortical atrophy in MRI findings, motor dysfunction sign, sensory dysfunction sign, and pathological reflex. 6) With abnormality on sleep activation, age, age of onset, seizure attack, ventricular enlargement in CT findings, and abnormality of MRI findings were significantly correlated. 7) With abnormality on hyperventilation activation, duration of illness and laterality of MRI findings were significantly correlated. Above results may suggest that abnormality of EEG findings is more closely related with functional change of the brain than structural changes of the brain and laterality of EEG findings is vice versa. And also that medication use has an influence on anterior versus posterior distribution of EEG findings and focality of EEG findings is not related with structural changes of the brain. Activation with sleep may be effective to show age differences and provocation of seizure activity and hyperventilation may be effective to detect the abnormal EEG findings by cerebrovascular insufficiency.

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Association between Dietary Behavior and Esophageal Squamous Cell Carcinoma in Yanting

  • Zhao, Lin;Liu, Chun-Ling;Song, Qing-Kun;Deng, Ying-Mei;Qu, Chen-Xu;Li, Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8657-8660
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    • 2014
  • Background: Yanting is one of high risk areas for esophageal cancer and the screening program was therefore initiated there. This study was aimed to investigate the dietary behaviors on the risk of esophageal squamous cell carcinoma (ESCC), among the individuals with normal and abnormal esophagus mucosa. Materials and Methods: A frequency matched case-controls study was proposed to estimate the different distribution of dietary behavior between individuals of control, esophagitis and cancer groups. Cancer cases were selected from hospitals. Esophagitis cases and controls were selected from screening population for ESCC. Health workers collected data for 1 year prior to interview, in terms of length of finishing a meal, temperature of eaten food and interval between water boiling and drinking. Chi-square, Kruskal-Wallis tests and unconditional logistic regression model were used to estimate differences and associations between groups. Results: Compared with controls, length of finishing a meal ${\geq}15mins$ was related to a reduced OR for cancer (OR=0.46, 95%CI, 0.22-0.97) and even compared with cases of esophagitis, the OR of cancer was reduced to 0.30 (95%CI, 0.13-0.72). The OR for often eating food at a high temperature was 2.48 (95%CI 1.06, 5.82) for ESCC as compared with controls. Interval between water boiling and drinking of ${\geq}10mins$ was associated with lower risk of cancer: the OR was 0.18 compared with controls and 0.49 with esophagitis cases (p<0.05). Conclusions: Length of eating food ${\geq}15mins$ and interval between water boiling and drinking ${\geq}10mins$ are potentially related to reduced risk of esophageal SCC, compared with individuals with normal and abnormal esophageal mucosa. Recommendations to Yanting residents to change their dietary behaviors should be made in order to reduce cancer risk.

Botulinum Toxin A Treatment for Cervical Dystonia Resulting in Endoscopic Thyroidectomy: A Case Report (내시경 갑상샘 절제술 후 발생한 경부 근긴장이상증의 보툴리늄 A 독소를 이용한 치료: 증례보고)

  • Oh, Hwa-Young;Choi, Hwan-Jun;Nam, Doo-Hyun;Kim, Jun-Hyuk;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.207-211
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    • 2011
  • Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

Bone Marrow Immunoscintigraphy for the Detection of Skeletal Metastasis in Malignant Tumors: A Comparison with $^{99m}Tc$-MDP Bone Scan (악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : $^{99m}Tc$-MDP 뼈스캔과의 비교)

  • Lee, Kyung-Han;Choi, Chang-Woon;Bang, Yung-Jue;Chung, Jun-Key;Chung, Hong-Keun;Lee, Myoung-Chul;Kim, Byoung-Kook;Kim, Noe-Kyeong;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.89-97
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    • 1994
  • Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, $^{99m}Tc$ labeled anti-granulocyte monoclonal antibody (anti-NCA-95 MAb) has been introduced as a new bone marrow imaging agent. To evaluate the usefulness of $^{99m}Tc$ anti-NCA MAb bone marrow scans for detecting skeletal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan findings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the remaining 50% did not. Most of these non matched lesions were suggested to be nonspecific lesions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, bit metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus $^{99m}Tc$ anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

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Antiepileptic Therapy for Latent Epilepsy (잠복성 간질에 대한 항간제 투여의 뇌파상 효과)

  • Park, Choong-Sub;Byun, Yung-Joo;Ha, Jung-Sang
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.71-75
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    • 1985
  • The clinical state with EEG pattern similar to interval discharge of epileptics is named as latent epilepsy, which does not necessarily mean that the patient will develop epilepsy later. However, since there is possibility of developing epilepsy on later date, antiepileptic mainly dilantin was tried to control the abnormal EEG. Since January to October 1985, total 580 headache sases with more than moderately abnormal EEG Visited the Neurology clinic. Among them 162 cases with interval seizure pattern (ISP) of epilepsy were selected for the study. The main ISP was 1. diffuse theta and/or delta bursts and 2. spikes. Since the study is only analysis of clinical treatment of 162 cases Without previous planning based on financial aid, about 30% of the patients did not return after the 1st EEG examination, in 42% failed to follow the EEG after the treatment and only remaining 28% of the cases were studied. Among 29 patients who were treated with Dilantin 100mg tid po, 16 improved and 13 not. Of the 13, 4 showed partial Improvement and partial progression. Case 1. In 4 weeks of antiepileptic the ray (AR), spikes disappeared but in 2 months developed bursts. Case 2. In 17days of AR, spikes and bursts disappeared but in 3 months bursts reccured. Case 3. In 1 week of AR, bursts disappeared but spikes developed. Case 4. In 3 months of AR, no change of spikes and bursts and she discontinued the AR. In 6 months she developed grandmal seizure. Eighteen cases, treated with other drugs except antiepileptics, all showed improvement. The other drugs were vincaprol, polygammalon, aronamin, ATP and hydergine. The improved cases had spikes more often than theta bursts. In view of the small number of the cases due to dropping most patients out of present study, it is considered meaningless to perform statistical analysis. Further well planned study With more patients is to be expected.

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