• Title/Summary/Keyword: Body fluid

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Effect of PLA2 Inhibitor Rutin on Endotoxin-Induced Acute Lung Injury (내독소로 유도된 급성폐손상에서 PLA2의 억제제인 Rutin의 효과)

  • Kim, Seong-Eun;Lee, Young-Man;Park, Won-Hark
    • Applied Microscopy
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    • v.34 no.1
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    • pp.31-42
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    • 2004
  • Acute respiratory distress syndrome (ARDS) is a kind of acute lung injury characterized by inflammatory disruption of alveolar-capillary barrier and notorious for its high mortality. Neutrophils cause cell damage through the production of free radicals, inflammatory mediators, and proteases in ARDS. $PLA_2$ might serve a primary regulatory role in the activation of neutrophils. This present study was performed to elucidate the effect of rutin known as $PLA_2$ inhibitor on ARDS induced by endotoxin. Endotoxin had increased lung myeloperoxidase (MPO) activity, BAL (bronchoalveolar lavage) protein content, numbers of neutrophils in BALF (bronchoalveolar lavage fluid) compared with those of control rat (p<0.001). In addition, histological evidence of lung injury was correlated with neutrophil influx into alveolar space and cerrous perhydroxide granules were found in lining of endothelial cell, alveolar type I, II cells. In contrast, pretreated group of rutin had significantly decreased all of the parameters (p<0.001). These data suggest that inhibition of $PLA_2$ is one step approach that block the process of ARDS. Accordingly, we conclude that rutin can be used as the prophylactic agent for ARDS on the bases of these experimental results.

Motion Analysis of Light Buoys Combined with 7 Nautical Mile Self-Contained Lantern (7마일 등명기를 결합한 경량화 등부표의 운동 해석)

  • Son, Bo-Hun;Ko, Seok-Won;Yang, Jae-Hyoung;Jeong, Se-Min
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.24 no.5
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    • pp.628-636
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    • 2018
  • Because large buoys are mainly made of steel, they are heavy and vulnerable to corrosion by sea water. This makes buoy installation and maintenance difficult. Moreover, vessel collision accidents with buoys and damage to vessels due to the material of buoys (e.g., steel) are reported every year. Recently, light buoys adopting eco-friendly and lightweight materials have come into the spotlight in order to solve the previously-mentioned problems. In Korea, a new lightweight buoy with a 7-Nautical Mile lantern adopting expanded polypropylene (EPP) and aluminum to create a buoyant body and tower structure, respectively, was developed in 2017. When these light buoys are operated in the ocean, the visibility and angle of light from the lantern installed on the light buoys changes, which may cause them to function improperly. Therefore, research on the performance of light buoys is needed since the weight distribution and motion characteristics of these new buoys differ from conventional models. In this study, stability estimation and motion analyses for newly-developed buoys under various environmental conditions considering a mooring line were carried out using ANSYS AQWA. Numerical simulations for the estimation of wind and current loads were performed using commercial CFD software, Siemens STAR-CCM+, to increase the accuracy of motion analysis. By comparing the estimated maximum significant motions of the light buoys, it was found that waves and currents were more influential in the motion of the buoys. And, the estimated motions of the buoys became larger as the sea state became worser, which might be the reason that the peak frequencies of the wave spectra got closer to those of the buoys.

A Bibliographic Study on the Types of Differential Diagnosis of Amnesia (건망(健忘)의 변증분형(辨證分型)에 대(對)한 연구(硏究))

  • Choi, Yong-Jun;Seong, Gang-Gyoung;Mun, Byoung-Sun
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.374-406
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    • 1996
  • This study has been carried out to investigate the types of differential diagnosis of amnesia. The results are as follows; 1. Amnesia has various types of differential diagnosis(辨證分型) ; deficiency of both the heart and spleen(心脾兩虛型), deficiency of the heart(心虛型), deficiency of the kidney(腎虛型), breakdown of the coordination between the heart and the kidney(心腎不交型), mental confusion due to phlegm(痰迷心竅型), accumulation of stagnant blood(蓄血型), internal injury by seven emotion (七情所傷型). 2. The type of deficiency of both the heart and spleen(心脾兩虛型) occurs when the heart and spleen is injured by overthinking(思慮過度), The symptoms are heart palpitation(心悸), continuous palpitation(??), insomnia(少寐), hypochondric discomfort(心煩), dream disturbed sleep(多夢), being easy to be scared(易驚), dizziness(眩暈), these are caused by blood deficiency of the heart(心血不足), poor appetite(飮食不振), loss of appetite(納?), short breath(氣短), sense of turgid abdormen(腹部膨滿感), loose stool(泥狀便), these are caused by deficiency of the spleen(脾虛), lassitude and weakness (身倦乏力), lassitude of the extremities (四肢無力), dim complexion (面色少華), pale lips(舌質淡), thready and feeble(脈細弱無力), these are caused by deficiency of both qi and the blood(氣血虛損). The remedy is nourishing the heart-blood(養心血) and regulating the spleen(理脾土). I can prescribe the recipes such as Guibitang(歸脾湯), Gagambosimtang(加減補心湯), Seongbitang(醒脾湯), Insin-guisadan(引神歸舍丹), Insamyangyoungtang(人蔘養榮湯), Sojungjihwan(小定志丸), Yungjigo(寧志膏), Palmijungjihwan(八味定志丸), etc., 3. The type of deficiency of the heart(心虛型) occurs when the heart-blood is injured by the mental tiredness(神勞) and so blood cannot nourish the heart. The symptoms are amnesia(健忘), short breath(氣短), heart palpitation(心悸), perspire spontaneously(自汗), facial pallidness(顔面蒼白), pale lips (舌質淡白), feeble pulse and lassitude(脈虛無力), intermittent pulse(結代脈). The remedy is nourishing the hart and blood and allaying restlessness(補心益血安神). I can prescribe the recipes such as Chenwangbosimdan(天王補心丹), Jeongji-hwan(定志丸), Gaesimhwan(開心丸), Youngjigo(寧志膏), Chilseonghwan(七聖丸), Baegseogyoungtang(白石英湯), Oseohwan(烏犀丸), Yangsinhwan(養神丸), Guisindan(歸神丹), Bogsinsan(茯神散), Jinsamyohyangsan(辰砂妙香散), Cheongeumboksinsan(千金茯神散), Samjotang(蔘棗湯), jangwonhwan(壯元丸), Sa gunjatang(四君子湯) minus rhizoma atractylodis macrocephalae(白朮) plus rhizoma acori graminei(石菖蒲), radix polygalae(遠志), cinnabaris(朱砂), etc. 4. The type of deficiency of the kidney(腎虛型) occurs when the kidney-qi and kidney-essence is deficient(腎氣腎精不足) and so it cannot nourish the brain. The symptoms arc amnesia(健忘), ache at the waist and lassitude in the lower extremities(腰산腿軟), dizziness and tinnitus(頭暈耳嗚), emmission and premature ejaculation(遺精早泄), burning sensation of the five centres(五心煩熱), flushed tongue(舌紅), rapid and small palse(脈細數). The remedy is nourishing the kidney and strengthen the essence(補腎益精). I can prescribe the recipes such as Gagamgobonhwan(加減固本丸), Jeongjihwan(定志丸), Gongseongchlmjungdan(孔聖枕中丹), Yugmigihwanghwan(六味地黃丸) plus ra-dix polygalae(遠志), fructus schizandrae(五味子), Yugmigihwanghwan(六味地黃丸) plus radix polygalae(遠志), fructus schizandrae(五味子), rhizoma acori graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), Palmihwan(八味丸) plus fructus schizandrae(五味子), semen zizyphi spinosae(酸棗仁). etc., 5. The type of breakdown of the coordination between the heart and the kidney (心腎不交型) occurs when the heart-fire(心火) and kidney-fluid(腎水) are imbalanced. The symptoms are amnesia(健忘), hypochondric discomfort(心煩), insomnia(失眠), dizziness and tinnitus(頭最耳嗚), feverish sensation m the palms and soles(手足心熱), emmision(遺精), ache at the waist and lassitude in the lower extremities(腰?腿軟), flushed tongue(舌紅), rapid pulse(脈數). The remedy is coordinating each other(交通心腎). I can prescribe the recipes such as Gangsimdan(降心丹), Jujaghwan(朱雀丸), Singyotang(神交湯), Simsinyang- gyotang(心腎兩交湯), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), rhizoma acari graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), etc., 6. The type of mental confusion due to phlegm(痰迷心竅型) occurs when the depressed vital energy(氣鬱) create phlegm retention(痰飮) and phlegm stagnancy(痰濁) put the heart and sprit(心神) out of order. The symptoms arc amnesia(健忘), dizziness(頭暈), chest distress(胸悶), nausea(惡心), dull(神思欠敏), dull and slow facial expression(表情遲鈍), tongue with yellow and greasy fur(舌苔黃?), sliperry pulse(脈滑). The remedy is removing heat from the heart to restore consciousness and dispersing phlegm(淸心化痰開竅) I can prescribe the recipes such as Gamibogryeongtang(加味茯?湯), Goa-rujisiltang(瓜蔞枳實湯), Jusaansinhwan(朱砂安神丸), Dodamtang(導痰湯) plus radix saussurea(木香), Yijintang(二陳湯) plus succus phyllostachyos(竹瀝), rhizoma zingiberis(生薑) Ondamtang(溫膽湯) plus rhizoma acori graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc., 7. The type of accumulation of stagnant blood(蓄血型) occurs when the blood is accumulated in the lower part of body. The symptoms are amnesia(健忘), chest distress(胸悶), icteric skin(身黃), rinsing the mouth but don't wanting eat(漱水不欲燕), madness(發狂), black stool(屎黑), pain in the lower abdomen(小腹硬痛). The remedy is dispersing phlegm and absorb clots (化痰化瘀), I can prescribe the recipes such as Jeodangtang(抵當湯), Daejeodanghwan(代抵當丸), Hyeolbuchugeotang (血府逐瘀湯) plus rhizoma acori graminei (石菖蒲), rhizoma curcumae aromaticae(鬱金), Jusaansinhwan(朱砂安神丸) plus rhizoma curcumae aromaticae(鬱金), radix polygalae(遠志), semen persicae(桃仁), cortex moutan radicis(收丹皮), etc., 8. The type of internal injury by seven emotion(七情所傷型) occurs when the anger injures the will stored in the kidney(腎志). The symptoms are amnesia(健忘), heart palpitation(心悸). hot temper(易怒), being easy to be scared(善驚), panic(易恐). The remedy is relieving the depressed liver and regulating the circulation of qi(疏肝解鬱). I can prescribe the recipes such as Tongultang(通鬱湯), Sihosogantang(柴胡疏肝湯) plus rhizoma acari graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc.

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A Study of the Defense Mechanism against Herbivores of 8 Species of the Genus Acer (단풍나무류 8종의 초식에 대한 방어전략 탐색)

  • Kim, Gab-Tae;Lyu, Dong-Pyo;Kim, Hoi-Jin
    • Korean Journal of Environment and Ecology
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    • v.23 no.5
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    • pp.411-417
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    • 2009
  • This research is intended to discover physiological and biochemical defense mechanisms against herbivores of 8 species of the genus Acerby examining the morphological characteristics of the leaf, the structure and number of leaf domatia, herbivores insects and mites feeding on leaves, which were collected from the trees growing in Mt. Chiak, Mt. Cheongtae, Mt. Jungwang, Mt. Bangtae, Mt. Taebaek and Wonju City. This research was conducted from May through July, 2009, and the results are as follows. The domatia of A. pseudosieboldianum, A. pictum subsp. mono and A. mandshuricum belongs to tuft type; that of A. palmatum, A. triflorum and A. tschonoskii pocket+tuft type; and that of A. tegmentosum pocket type. The number of domatia per leaf turned out to be the highest in the case of A. tegmentosum(20.2), and the lowest in the case of A. ginnala (4.2). Leaf surface trichomes of A. palmatum, A. pseudosiebotdianum, A. ginnala and A. mandshuricum are covered with villi; those of A. pictum subsp. mono and A. triflorum with soft, pilose type of hair, and those of A. tschonoskii with stiff, strigose hair. The trichome density of lower leaf surface is found to be higher than that of the upper leaf surface. Only in the case of A. palmatum, A. pseudosieboldianum, A. tegmentosum and A. tschonoskii, a small amount of nectar is found to be secreted from the distal vein parts of the leaf margin. The number of mites on each leaf are found to be significantly different among tree species, and average mites number per leaf was the highest in the case of A. tschonoskii (9.2/leaf), and A. mandshuricum, A. pseudosieboldianum, and A. triflorum follow it in decreasing order. Minute insects attacking the leaf of Acer spp. include Periphyllus californiensis, P. viridis, Psylla spp, and gall mites, and the number of these insects are found in Periphyllus californiensis, Psylla spp, P. viridis, and Cicadellidae sp. in decreasing order. The natural enemies of these herbivores insects are predatory mites, such as Chilocorus rubidus, Coccinella septempunctata and the nymph, Aphidius ervi, Poecilocoris lewisi and its larva, and Poecilocoris lewisi. Lasius japonicus and Formica japonica are symbiotic with aphids, and supports herbivores. Finally, our research confirmed that predatory mites attack Periphyllus californiensis and suck the body fluid of their victim. This proves that mites form a symbiotic relationship with plants through the mediation of leaf domatia. This also indicates that a protective mutualism may be more conspicuous in temperate broad-leaved trees.

Effects of Modified Ultrafiltration in Pediatric Open Heart Surgery (소아 개심술에 있어서 변형초여과법의 효과)

  • 전태국;박표원
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.591-597
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    • 1997
  • Cardiopulmonary bypass in children is associated with capillary leak which results in an increase in total body water after open heart surgery The purpose of these studies was to assess the cardiopulmonary effects of modified ultrafiltration after pediatric open heart surgery Study h: Twenty-six consecutive children aged 0.1 ~ 10 years(median 7 months) underwent cardiac operation inc rporating modified ultrafiltration. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at the flow rate of 100~ 15011min for 3 ~ 14 min. After modified ultrafiltration, elevation of hematocrit(28.3% $\pm$ 3.6% vs. 33.8olo $\pm$ 4.Ooloi p < 0.001), increased systolic 1)loots Pressure(66.7 $\pm$ 11.2mmHg vs. 76.2$\pm$ 11.BmmHg, p < 0.02), and decreased central venous pressure(7.8 $\pm$ 3.7mmHg vs. 6.9$\pm$ 2.gmmHg, p<0.001) were observed. Study B: Twenty-six children who underwent cardiac operation with the diagnosis of VSD under 2 years were assigned to control(n= 14) or modified ultrafiltration(n= 12). Peak inspiratory pressure checked immediately after operation was significantly lower in modified ultrafiltration group than in control group(20.0$\pm$ 2.4 cmH20 vs.22.4$\pm$ 2.3cmH20, p < 0.03). Modified ultrafiltration after cardiopillmonary bypass in children improves early homodynamics and pulmonary mechanics, and represents an excellent option for perioperative managemen of accumulation of fluid in the tissues. We will continually employ the modified ultrafiltration technique in pediatric cardiac operations.

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Effect of Modified Ultrafiltration on the Postoperative State after Pediatric Open Heart Surgery. (소아 개심술에 있어서 변형 초여과법(Modified Ultrafiltration)이 술후 상태에 미치는 영향)

  • 방종경;천종록;김규태
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.456-465
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    • 1998
  • Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.

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Splenocyte-mediated immune enhancing activity of Sargassum horneri extracts (괭생이 모자반 추출물의 비장세포 면역활성 증강 효과)

  • Kim, Dong-Sub;Sung, Nak-Yun;Han, In-Jun;Lee, Byung-Soo;Park, Sang-Yun;Nho, Eun Young;Eom, Ji;Kim, Geon;Kim, Kyung-Ah
    • Journal of Nutrition and Health
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    • v.52 no.6
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    • pp.515-528
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    • 2019
  • Purpose: This study examined the immunological activity and optimized the mixture conditions of Sargassum horneri (S. horneri) extracts in vitro and in vivo models. Methods: S. horneri was extracted using three different methods: hot water extraction (HWE), 50% ethanol extraction (EE), and supercritical fluid extraction (SFE). Splenocyte proliferation and cytokine production (Interleukin-2 and Interferon-γ) were measured using a WST-1 assay and enzyme-linked immunosorbent assay, respectively. The levels of nitric oxide and T cell activation production were measured using a Griess assay and flow cytometry, respectively. The natural killer (NK) cell activity was determined using an EZ-LDH kit. Results: Among the three different types of extracts, HWE showed the highest levels of splenocyte proliferation and cytokine production in vitro. In the animal model, three different types of extracts were administrated for 14 days (once/day) at 50 and 100 mg/kg body weight. HWE and SFE showed a high level of splenocyte proliferation and cytokine production in the with and without mitogen-treated groups, whereas EE administration did not induce the splenocyte activation. When RAW264.7 macrophage cells were treated with different mixtures (HWE with 5, 10, 15, 20% of SFE) to determine the optimal mixture ratio of HWE and SFE, the levels of nitric oxide and cytokine production increased strongly in the HWE with 5% and 10% of SFE containing group. In the animal model, HWE with 5% and 10% of SFE mixture administration increased the levels of splenocyte proliferation, cytokine production, and activated CD4+ cell population significantly, with the highest level observed in the HWE with 5% of SFE group. Moreover, the NK cell activity was increased significantly in the HWE with 5% of SFE mixture-treated group compared to the control group. Conclusion: The optimal mixture condition of S. horneri with immune-enhancing activity is the HWE with 5% of SFE mixture. These results confirmed that the extracts of S. horneri and its mixtures are potential candidate materials for immune enhancement.

W-Sn-Bi-Mo Mineralization of Shizhuyuan deposit, Hunan Province, China (중국 호남성 시죽원 광상의 W-Sn-Bi-Mo광화작용)

  • 윤경무;김상중;이현구;이찬희
    • Economic and Environmental Geology
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    • v.35 no.3
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    • pp.179-189
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    • 2002
  • The Geology of the Shizhuyuan W-Sn-Bi-Mo deposits, situated 16 Ian southeast of Chengzhou City, Hunan Province, China, consist of Proterozoic metasedimentary rocks, Devonian carbonate rocks, Jurassic granitic rocks, Cretaceous granite porphyry and ultramafic dykes. The Shizhuyuan polymetallic deposits were associated with medium- to coarse-grained biotite granite of stage I. According to occurrences of ore body, ore minerals and assemblages, they might be classified into three stages such as skarn, greisen and hydrothernlal stages. The skarn is mainly calcic skarn, which develops around the Qianlishan granite, and consists of garnet, pyroxene, vesuvianite, wollastonite, amphibolite, fluorite, epidote, calcite, scheelite, wolframite, bismuthinite, molybdenite, cassiterite, native bismuth, unidetified Bi- Te-S system mineral, magnetite, and hematite. The greisen was related to residual fluid of medium- to coarse-grained biotite granite, and is classified into planar and vein types. It is composed of quartz, feldspar, muscovite, chlorite, tourmaline, topaz, apatite, beryl, scheelite, wolframite, bismuthinite, molybdenite, cassiterite, native bismuth, unknown uranium mineral, unknown REE mineral, pyrite, magnetite, and chalcopyrite with minor hematite. The hydrothermal stage was related to Cretaceous porphyry, and consist of quartz, pyrite and chalcopyrite. Scheelite shows a zonal texture, and higher MoO) content as 9.17% in central part. Wolframite is WO); 71.20 to 77.37 wt.%, FeO; 9.37 to 18.40 wt.%, MnO; 8.17 to 15.31 wt.% and CaO; 0.01 to 4.82 wt.%. FeO contents of cassiterite are 0.49 to 4.75 wt.%, and show higher contents (4.]7 to 4.75 wt.%) in skarn stage (Stage I). Te and Se contents of native bismuth range from 0.00 to 1.06 wt.% and from 0.00 to 0.57 wt.%, respectively. Unidentified Bi-Te-S system mineral is Bi; 78.62 to 80.75 wt.%, Te; 12.26 to 14.76 wt.%, Cu; 0.00 to 0.42 wt.%, S; 5.68 to 6.84 wt.%, Se; 0.44 to 0.78 wt.%.

Optimal Lactic Acid Fermentation Conditions and Quality Properties for Rubus coreanus Miquel (Bokbunja) and Chlorella Mixtures (복분자와 클로렐라 혼합물의 젖산발효 최적조건 및 품질 특성)

  • Kim, Jae-Young;Lee, Sang-Uk;Kim, Na-Hyung;Moon, Kwang-Hyun;Baek, Seung-Hwa
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.3
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    • pp.386-395
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    • 2016
  • To develop a functional fermentation food from Rubus coreanus Miquel (Bokbunja) and chlorella mixtures, optimal lactic acid fermentation conditions were established, and quality properties based on physicochemical evaluation such as chemical compositions, free sugars, organic acids, and antibacterial activities were investigated. Regarding optimal fermentation strain selection, formation of lactic acid was best in Lactobacillus plantarum among the experimental strains (10 kinds), and the optimal fermentation temperature was $37^{\circ}C$. In addition, overall acceptability in the sensory evaluation was highest in the 5% chlorella mixture sample. Therefore, quality properties of the prepared sample under the established optimal fermentation conditions were investigated. Moisture, total sugar (dry basis), crude fiber (dry basis), and pH of fermented Rubus coreanus Miquel juice (RCM) with 5% chlorella mixture (RCM-C5) were reduced by 4.90%, 14.15%, and 0.32%, respectively, as compared with non-fermented RCM. Meanwhile, crude protein, crude fat, and crude ash (dry basis) of RCM-C5 were elevated by 13.75%, 0.18%, and 0.73%, respectively, as compared with RCM. The yellowness (b value) of color values was greater in RCM-C5 compared to RCM. The free sugar and organic acid contents of RCM-C5 were elevated by 0.97% and 616.30 mg%, respectively, as compared with RCM. In addition, the gram positive bacterium Staphylococcus aureus was elevated by 5.83% while gram negative bacteria Escherichia coli and Salmonella Typhimurium were elevated by 2.94% and 4.67%, respectively, as compared with RCM. In conclusion, the quality properties of RCM and chlorella lactic acid fermentation mixtures were improved compared with the general RCM product. Consequently, it is possible to apply fermented RCM as a functional fermentation food.

National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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