• Title/Summary/Keyword: Conundrum

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The large-conductance calcium-activated potassium channel holds the key to the conundrum of familial hypokalemic periodic paralysis

  • Kim, June-Bum;Kim, Sung-Jo;Kang, Sun-Yang;Yi, Jin Woong;Kim, Seung-Min
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.445-450
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    • 2014
  • Purpose: Familial hypokalemic periodic paralysis (HOKPP) is an autosomal dominant channelopathy characterized by episodic attacks of muscle weakness and hypokalemia. Mutations in the calcium channel gene, CACNA1S, or the sodium channel gene, SCN4A, have been found to be responsible for HOKPP; however, the mechanism that causes hypokalemia remains to be determined. The aim of this study was to improve the understanding of this mechanism by investigating the expression of calcium-activated potassium ($K_{Ca}$) channel genes in HOKPP patients. Methods: We measured the intracellular calcium concentration with fura-2-acetoxymethyl ester in skeletal muscle cells of HOKPP patients and healthy individuals. We examined the mRNA and protein expression of KCa channel genes (KCNMA1, KCNN1, KCNN2, KCNN3, and KCNN4) in both cell types. Results: Patient cells exhibited higher cytosolic calcium levels than normal cells. Quantitative reverse transcription polymerase chain reaction analysis showed that the mRNA levels of the $K_{Ca}$ channel genes did not significantly differ between patient and normal cells. However, western blot analysis showed that protein levels of the KCNMA1 gene, which encodes $K_{Ca}$1.1 channels (also called big potassium channels), were significantly lower in the membrane fraction and higher in the cytosolic fraction of patient cells than normal cells. When patient cells were exposed to 50 mM potassium buffer, which was used to induce depolarization, the altered subcellular distribution of BK channels remained unchanged. Conclusion: These findings suggest a novel mechanism for the development of hypokalemia and paralysis in HOKPP and demonstrate a connection between disease-associated mutations in calcium/sodium channels and pathogenic changes in nonmutant potassium channels.

Extracorporeal Shock Wave Therapy with Meridian and Acupoint Theory for Knee Osteoarthritis: Systematic Review (경혈경락이론에 근거한 체외충격파 치료가 무릎 관절염에 미치는 영향: 체계적 문헌 고찰)

  • Kim, Byung-Jun;Lee, Sang-Hyun;Kim, Hyun-Tae;Park, Hye-Jin;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.2
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    • pp.41-48
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    • 2021
  • Objectives To determine the evidence of effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for knee osteoarthritis. Methods By March 3, 2021, five foreign electronic databases and six Korean medical electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupoint OR acupuncture point)'. This key words was set up to increase the sensitivity of the search. After the search, knee osteoarthritis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of three studies showed positive results for the using ESWT with meridian and acupoint theory for knee osteoarthritis compared with the control group on efficancy rate, visual analog scale and lysholm knee score. but there remains a conundrum regarding the safety of ESWT in the treatment of knee osteoarthritis. Conclusions Most of studies showed ESWT with meridian and acupoint theory were statistically effective to knee osteoarthritis. However there are limitations that the number of selected studies was small, risk of bias was unclear. So use of ESWT with meridian and acupoint theory for knee arthritis has limited evidence compared to usual care.

A Study on the Adoption of Discovery in Copyright Litigation (저작권 소송 절차에서 디스커버리 도입에 관한 소고)

  • Kim, Si Yeol
    • Journal of Software Assessment and Valuation
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    • v.16 no.2
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    • pp.25-35
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    • 2020
  • In the Korean litigation system, structural maldistribution of evidence still remains a conundrum. Numerous solutions have been discussed so far and, today, few people deny the need for adopting a system similar to the discovery procedure in the United States. In the intellectual property (IP) domain, a wide range of legislative attempts have been made to improve the litigation system, especially for patent litigation. However, the adoption of discovery in copyright litigation is seldom discussed, despite the fact that copyright infringement lawsuits increasingly involve highly technical issues, especially in case of copyrightable computer programs. The lack of discussion on discovery adoption forms a stark contrast with the active attempts to adapt and adopt discovery procedure for patent litigation. In copyright infringement lawsuits, especially for copyrighted computer programs, securing evidence takes on crucial importance. However, in reality, there are numerous obstacles. Some lawsuits proceed even without properly securing the infringed work. To address this issue, the current litigation system needs to be improved by adopting a procedure similar to discovery. This paper reviews what solutions are being utilized today, and how we should approach the issue.

Determinants Influencing Housing-Option Decision of Gen Y: The Case of Vietnam

  • Ha Thu LUONG;Dung Manh TRAN;Dan Linh Ngoc NGUYEN;Van Bao NGUYEN;Anh Thuc LE;Hieu Van PHAM
    • Journal of Distribution Science
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    • v.21 no.7
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    • pp.51-63
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    • 2023
  • Housing is not only a basic requirement, but also a method to maintain stability and improve living. In the period of rapid social development which has a significant impact on the aging population, the housing issue is an impediment to Gen Y in Asia. Therefore, solving the housing conundrum is the most effective solution to other social problems. Purpose: This research is conducted to investigate factors influencing housing-option decisions of Gen Y and proposes recommendations to them as well as Governments and the real estate investors. Research design, data, and methodology: The Theory of Planned Behavior was employed with the expanded variables (Financial status, Location, Public services and Government incentives) based on literature review. Results: With 445 valid responses, almost all proposed hypotheses are accepted, which supports the positive interrelationship among variables. In the stage of data processing, we have determined the influence of each factor to the dependent variable "Actual Behavior", thereby helping real estate investors understand their desires, as well as improve the ability to meet customer needs. Conclusion: This is the basis to determine the influence of these factors, thereby providing recommendations to customers and what is more, giving real estate enterprises an insight of customers' demand in order to improve product quality and optimize the benefits of each party.

Exploring Efficient Solutions for the 0/1 Knapsack Problem

  • Dalal M. Althawadi;Sara Aldossary;Aryam Alnemari;Malak Alghamdi;Fatema Alqahtani;Atta-ur Rahman;Aghiad Bakry;Sghaier Chabani
    • International Journal of Computer Science & Network Security
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    • v.24 no.2
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    • pp.15-24
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    • 2024
  • One of the most significant issues in combinatorial optimization is the classical NP-complete conundrum known as the 0/1 Knapsack Problem. This study delves deeply into the investigation of practical solutions, emphasizing two classic algorithmic paradigms, brute force, and dynamic programming, along with the metaheuristic and nature-inspired family algorithm known as the Genetic Algorithm (GA). The research begins with a thorough analysis of the dynamic programming technique, utilizing its ability to handle overlapping subproblems and an ideal substructure. We evaluate the benefits of dynamic programming in the context of the 0/1 Knapsack Problem by carefully dissecting its nuances in contrast to GA. Simultaneously, the study examines the brute force algorithm, a simple yet comprehensive method compared to Branch & Bound. This strategy entails investigating every potential combination, offering a starting point for comparison with more advanced techniques. The paper explores the computational complexity of the brute force approach, highlighting its limitations and usefulness in resolving the 0/1 Knapsack Problem in contrast to the set above of algorithms.

Workload Measurement of Home Health Care Nurses상 Services using Relative Value Units (가정간호행위 업무량의 상대적 가치 측정에 관한 연구)

  • 이태화;박정숙;김인숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1543-1555
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    • 2000
  • Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.

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The Pyeongchang 2018 Olympic Winter Games and North Korea's Denuclearization (2018 평창동계올림픽과 북한의 비핵화)

  • Lee, Hong Jong
    • Korea and Global Affairs
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    • v.2 no.1
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    • pp.93-112
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    • 2018
  • The Pyeongchang 2018 Olympic Winter Games is a good example of functionalism in integration theories. President Moon Jae-in is extremely lucky to play host to the Winter Olympics. Moon should be particularly happy to have declared the 23rd Winter Games open, because a handful of North Korean athletes marched into the Pyeongchang Stadium as members of a joint team from "Corea," the result of his strenuous efforts to have the North participate in the world festival of sports on snow and ice. But the president of this divided nation hardly draws envy from other world leaders, as he is faced with the daunting task of accommodating the selfish positions of surrounding powers concerning North Korean nuclear and missile threats. North Korea, a trivial competitor in winter sports, scored big outside the games' sporting arenas by inviting President Moon to summit talks in Pyongyang. As a precondition for a 2018 summit, Pyongyang will first ask for the cessation of the annual joint Korea-US military exercises. President Moon invested a lot in the Olympic delegates from the North. Korea's leader will now have to start a truly difficult game which will require the best of best strategies as well as a great deal of wisdom and tenacity not only to deal with the weapons of mass destruction-toting North Koreans, but also with allies. On the other hand, Moon needs to make the effort to reset domestic politics with tolerance and compromise, so he can better concentrate on the conundrum of North Korean nuclear and missile threats.

Improvisation and Fantasy: Beauvais Grotesque Tapestry (즉흥과 환상: 보베 제작소의 《그로테스크》 태피스트리)

  • Chung, Eunjin
    • Art History and Visual Culture
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    • no.21
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    • pp.126-147
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    • 2018
  • This paper is to find the theme and meaning of the Beauvais Grotesque tapestry considered a conundrum. The three works are chosen from Beauvais Grotesque consisting of six tapestries, which are The Offering to Pan, The Musician and Dancers, The Camel in the J. Paul Getty Museum. I analyzed these works by dividing them into grotesque ornaments, chinoiserie motifs, and scenography. The Offering to Pan shows the influence of Raphael's Grotesque tapestry, but Beauvais work followed the design of Jean Berain's Grotesque with arabesque. In The Musician and Dancers, chinese ceramics, textiles, and Chinese people in edge were noted. Especially, the Chinese with yellow skin in the border reveals the European gaze on China at that time. In the 18th century, Chinoiserie was prevalent through stage designs rather than books. The Camel, playing Brighella, makes it clear that this tapestry is a stage of Comedia dell'arte. The characteristic of Comedia is a mixture of genres such as music and dance, with no scripting 'improvisation.' Features of Comedia are 'improvisation' without a script and a mixture of genres such as music and dance. Thus, the Grotesque tapestry transfers the stage of the Comedia into threads woven. In addition, the horizontal stage decoration with the disappearance of the perspective vanishing point is related to the era of regent of Philippe d'Orl?ans (1674-1723). Above all, the grotesque, Chinoiserie, and scenography are all fantasies separated from reality. Therefore, the Beauvais Grotesque tapestry represents of 'improvisation' and 'fantasy' in which there is no narrative theme or meaning, as if the script of Comedia did not exist.

Efficacy of intraosseous saline injection for pain management during surgical removal of impacted mandibular third molars: a randomized double-blinded clinical trial

  • Jawahar Babu. S;Naveen Kumar Jayakumar;Pearlcid Siroraj
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.3
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    • pp.163-171
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    • 2023
  • Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group) Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

Peirce and the Problem of Symbols (퍼스와 상징의 문제)

  • Noh, Yang-jin
    • Journal of Korean Philosophical Society
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    • v.152
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    • pp.59-79
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    • 2019
  • The main purpose of this paper is to critically examine the intractable problems of Peirce's notion of 'symbol' as a higher and perfect mode of sign, and present a more appropriate account of the higher status of symbol from an experientialist perspective. Peirce distinguished between icon, index, and symbol, and suggested symbol to be a higher mode of sign, in that it additionally requires "interpretation." Within Peirce's picture, the matter of interpretation is to be explained in terms of "interpretant," while icon or index are not. However, Peirce's conception of "interpretant" itself remains fraught with intractable opacities, thereby leaving the nature of symbol in a misty conundrum. Drawing largely on the experientialist account of the nature and structure of symbolic experience, I try to explicate the complexity of symbol in terms of "the symbolic mapping." According to experientialism, our experience consists of two levels, i.e., physical and symbolic. Physical experience can be extended to symbolic level largely by means of "symbolic mapping," and yet is strongly constrained by physical experience. Symbolic mapping is the way in which we map part of certain physical experience onto some other area, thereby understanding the other area in terms of the mapped part of the physical experience. According to this account, all the signs, icon, index, and symbol a la Peirce, are constructed by way of symbolic mapping. While icon and index are constructed by mapping physical level experience onto some signifier(i.e. Peirce's "representamen"), symbol is constructed by mapping abstract level experience onto some signifier. Considering the experientialist account that abstract level of experience is constructed by way of symbolic mapping of physical level of experience, the symbolic mapping of abstract level of experience onto some other area is a secondary one. Thus, symbol, being constructed by way of secondary or more times mapping, becomes a higher level sign. This analysis is based on the idea that explaining the nature of sign is a matter of explaining that symbolic experience, leaving behind Peirce's realist conception of sign as a matter of an event or state of affairs out there. In conclusion, I suggest that this analysis will open up new possibilities for a more appropriate account of the nature of signs, beyond Peirce's complicated riddles.