• Title/Summary/Keyword: Death pattern

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Neuroglial Reaction in the Substantia Nigra and Striatum of 6-Hydroxydopamine Induced Parkinson's Disease Rat Model (흰쥐 흑질내 수산화도파민 주입으로 유도된 파킨슨병 모델에서 흑질과 선조체의 신경교세포 반응)

  • Yang, Kyung Won;Sung, Jae Hoon;Kim, Moon Chan;Lee, Moon Yong;Lee, Sang Won;Choi, Seung Jin;Park, Choon Keun;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.688-698
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    • 2001
  • Objectives : Parkinson's disease is a well-known neurodegenerative disease characterized by dopaminergic cell death in the substantia nigra. The reactive gliosis by activated astrocytes and microglias is no more regarded as a simple sequel of neuronal cell death. Microglial activation takes place in a stereotypic pattern with graded morphologic and functional(resting, activated and phagocytic) changes. In Parkinson's disease animal model, the degree of microglial activation along the nigro-striatal dopaminergic tract has not been studied intensively. The purpose of this study was to elucidate the characteristics of microglial reaction and to grade its degree of activation at substantia nigra and corpus striatum using 6-hydroxydopamine induced rat model of Parkinson's disease. Methods : Using Sprague-Dawley rat, parkinsonian model was made by 6-hydroxydopamine(OHDA) induced destruction of medial and lateral substantia nigra(SN). The rat was sacrificed 3-, 5-, 7-, 14- and 21-day-after operation. For control group, we injected saline with same manner and sacrificed 3-day after operation. With immunohistochemistry, we examined dopaminergic neuronal cells and microglial expression using tyrosine hydroxylase (TH) and OX-42 antibodies, respectively. Also we performed in situ hybridization for osteopontin, a possible marker of subset in activated microglia. Results : 1) In lesioned side of substantia nigra and corpus striatum, the TH immunoreactivity was markedly decreased in whole experimental groups. 2) Using optical densitometry, microglia induced immunoreactivity of OX-42 was counted at SN and corpus striatum. At SN, it was increased significantly on the lesioned side in control and all time-dependent experimental groups. At striatum, it was increased significantly in post lesion 3-day group only(p <0.05). Compared to control group, immunoreactivity of OX-42 on lesioned side was increased in groups, except post lesion 21-day group, at SN. Only post lesion 3-day group showed significance at striatum(p <0.05). Compared to SN region, immunoreactivity of OX-42 was much weaker in striatum. 3) Microscopically, the microglias showed typically different activation pattern. At SN, numerous phagocytic microglias were found at pars compacta and reticularis of lesion side. At striatum, no phagocytic form was found and the intensity of staining was much weaker. 4) At SN, the immunoreactivity of osteopontin showed definite laterality and it was markedly increased at pars compacta of lesion side with relatively short duration time. At striatum, however, it was not detected by in situ hybridization technique. Conclusion : The nigral 6-OHDA induced rat model of Parkinson's disease revealed several characteristic patterns of microglial reaction. At SN, microglias was activated shortly after direct neuronal damage and maintained for about three weeks. In contrast, despite of sufficient dopaminergic insufficiency at striatum, activation of microglias was trivial, and distinguished 3 day later. Antegrade slow neuronal degeneration is major pathophysiology in striatal dopaminergic deficiency. So, the acuteness of neuronal damage and consequential degree of neuronal degeneration may be important factor for microglial activation in neurodegenerative diseases such as Parkinson's disease. Additionally, osteopontin may be a possible marker for several subsets of activated microglia, possibly the phagocytic form.

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Research on the Legal Composition and Institutional Systems of The Dao Constitution: Focusing on The Constitution of the Republic of Korea (『도헌』의 법률적 구성과 제도적 장치 연구 - 대한민국헌법을 중심으로 -)

  • Kim, Young-jin
    • Journal of the Daesoon Academy of Sciences
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    • v.40
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    • pp.77-114
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    • 2022
  • The purpose of this study is to analyze the ideological background, legal composition, and separation of powers contained within the institutional devices of The Dao Constitution based on the basic principles of the legal system, which would be embodied in The Constitution of the Republic of Korea. The ideological background of The Dao Constitution is that of the religion, Daesoon Jinrihoe. In Daesoon Jinrihoe, it is held that the Supreme God, Sangje, determined that Mutual Contention, the ruling pattern of the Former World, ran contrary to His divine will and this endangered the world as nature and humans had also fallen into Mutual Contention. As an act of divine intervention, Sangje established Mutual Beneficence so that nature and humanity could follow Mutual Beneficence as a paradigm shift culminating in a Great Opening of the universe. Sangje, the agent behind the paradigm shift, revealed His divine will that humans transform into mutually beneficent humans. Therefore, The Dao Constitution was written to be a set of fundamental norms based on the 'rights and obligations of the members of Daesoon Jinrihoe' to accept and implement the will of Sangje as it applies to each member's mission. The legal composition of The Dao Constitution consists of the body and supplementary provisions. The text consists of general rules, moral rights and obligations, origins, and institutional devices. Institutional devices include the Central Council, the Institute of Propagation and Edition, the Institute of Religious Services, Works, Financial Management, and the Institute of Audit and Inspection. The legal composition of The Dao Constitution is similar to that of the Constitution. The difference is that while the Constitution applies a 'principle of maximum rights and minimum obligations,' The Dao Constitution stipulates more obligations than rights in order to complete the mission of the members. The principle of separation of powers is applied to the institutional devices in The Dao Constitution. In The Dao Constitution, the organizational form of the central headquarters has been divided into a 'before and after' scheme surrounding the death of Dojeon. The organizational form of the central headquarters prior to Dojeon's death was similar to a Constitutional Monarchy. After the death of Dojeon, the central headquarters' organizational form became similar to a parliamentary cabinet system. The separation of powers at central headquarters is divided among a legislative power (the Central Council), an executive power (the Institute of Religious Services), and a judicial power (the Institute of Audit and Inspection). The separation of powers within the functions of the central government first occurs between the Central Council and its employees, then between the Central Council and the Institute of Auditing and Inspection, and also between the Legislative Government and the Institute of Religious Services. Furthermore, the principle of a vertical separation of powers exists between the central headquarters and the local organization.

A Clinical Analysis of Femur Neck Fracture in Elderly Patients (노년층에서 대퇴경부 골절의 치료)

  • Ihin, Joo-Choul;Ahn, Myun-Whan;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.11-22
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    • 1985
  • Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).

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Clinical Analysis of Arterial Occlusive Disease in the Lower Extremity (하지 혈행장애의 임상적 고찰)

  • 서정욱;조은희
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.889-896
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    • 1996
  • Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial by- pass operation has been advocated by some authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A Univer- sity Hospital between March 1990 and August 1995 was analyzed. The patients were 92 males and 9 females ranging fro 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular trauma in 3 cases and pseudoaneurysm in 3 cases. - The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were posterior tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases. The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which Included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with inverted Y-gr ft In 3 cases, femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliad bypass in 1 case Over all postoperative patency rates were 83.6 oyo at 1 year, 75.5% at 3 years and limb salvage rate was 86.8 oyo . Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the order of multiple organ failure, acute renal failure, and sepsis.

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The Demands on Parish Nursing Services by Pastors in Busan (부산지역 목회자의 교구간호사업 요구조사)

  • Sohn, Sue-Kyung;Kang, Kyung-Ja;Lee, Jj-Hyun;Lee, Young-Eun;Park, Choon-Hwa
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.182-196
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    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

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Improvement of Fontan Circulatory Failure after Conversion to Total Cavopulmonary Connection (완전 대정맥-폐동맥 연결수술로 전환 후의 폰탄순환장애 개선)

  • Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.559-565
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    • 2003
  • By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.

Effects of Sowing Method and Summer Management on Stubbli Carbohydrate Reserves and Microclimate of Orchargrass Meadow (파종방법 및 여름철 관리가 Orchargrass채초지의 그루터기 저장탄수화물 함량 및 미기상에 미치는 영향)

  • 권찬호;김동암
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.12 no.2
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    • pp.77-84
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    • 1992
  • This experiment was designed to gain information on factors affecting stubble death of orchardgrass (Dactylis glomerata L.) during the first rainy season. According to the experimental plan, the effects of sowing methods, drainages and cutting dates on the stubble carbohydrate content of orchardgrass, available soil moisture content of experimental plots, temperatures at the ground level and in the soil, and relative light intensity and humidity at the base of orchardgrass canopy were measured during the rainy season. The carbohydrate content of orchardgrass was sharply decreased to 2.9 % at 3rd day after cutting in the plots cut before rainy season and a gradural recovery was noted following the sharp reduction, but in the plots cut after rainy season, orchardgrass showed 5.5% of carbohydrate content before cutting and 3.0% at the 3rd day after cutting. The same pattern in both carbohydrate reduction and recovery was found between two cutting treatments. The available soil moisture content in the plots cut before rainy season was slightly higher than that in the plots cut after rainy season. But after the rainy season, the available soil moisture content in the plots cut after rainy season was higher than that in the plots cut before rainy season. Soil temperature at lOcm depths in the plots cut before rainy season was higher than that in the plots cut after rainy season. Daily maximum air temperature at the ground level in the plots cut before rainy season was higher than that in the plots cut after rainy season and changeable. Relative humidity at the ground level was below 70% in the plots cut before rainy season, but 75 to 90 % was observed in the plots cut after rainy season. Relative light intensity at the ground level in the plots cut before rainy season was much higher, recorded 50 to 90 %, than that in the plots cut after rainy season showing less than 10%. The results of this study suggest that the stubble death of orchardgrass during the rainy season is due to plant diseases influenced by a decrease of light penetration and increase of relative humidity at the base of the grass canopy.

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

A Study of CVA patients에 Experience of the Illness (뇌졸중 환자의 질병경험에 관한 연구)

  • 남선영
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.479-489
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    • 1998
  • This work was done for 9 patients having experience of a herb medical treatment after being diagnosed as CVA during a year from January, 1996 to December, 1996 by using an ethnographic research method. The summarized results of this research are following. Ⅰ. THE EXPERIENCE OF THE ILLNESS First, the falling-ill phase is the time that they have the first stroke of paralysis and the decision pattern of medical institution' comes out. The emotional experience in the period is something like 'flustration', 'anxiety', 'despair', and 'expectation'. Second, the active-treatment phase is the time that the patients as well as their family or care giver not only show the positive attitude and actively participate in the illness treatment but also show a lot of interest in medical institutions and activities of health recovery. There is a primary factor of the continuation of treatment as an experience of treatment and being crushed and sensitivity as an experience of the illness. Third, the rehabilitation phase is the time that the patients or their family become tired and insensitive to the treatment and recuperation, and then reduce the treatment activity. There is a primary influence factor of the discontinuance of treatment as an experience of treatment and physical experience and emotional experience as an experience of the illness. The physical experience is divided into 'personal-hygiene care', and 'the sphere of activity' The emotional experiences are 'blaming someone', 'contempt' and 'despair' as a negative experience and 'hope' as a positive experience. Ⅱ. COPING STRATEGY There are a physical coping, an emotional and mental coping, a social coping, and a spiritual coping as a coping strategy used for the patients to overcome their illness and adjust themselves to their altered life. First, the physical coping comes out as 8 categories, 'using an auxiliary tool', 'doing exercise', 'protecting', 'improving their diet', 'taking care of something', 'using subsidiary medicines', 'trying a folk remedy', and 'having interest in their health'. Second, for the emotional and mental coping, there are 'accepting' and 'trying' as a positive coping and a failure of control as a negative coping. Third, the social coping is appeared as 'being supported'. Fourth, the spiritual coping is recognized as' recourse to God' and 'preparation of death'. After all, the elderly CVA patients in an agricultural area choose the act of treatment based on the traditional belief and the relationship with a caretaker. A personal health can be maintained by taking care of themselves and controling their mind, and the overcome of the illness is decided on the basis of traditional concepts and cultural principles in which the patients as well as the family, neigbors and take carers should work out together and cooperate with each other in order to achieve that.

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The Grotesque Fashion in modern Fashion (현대 패션에 나타난 그로테스크)

  • 최정화;유영선
    • Journal of the Korean Society of Costume
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    • v.40
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    • pp.151-170
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    • 1998
  • The purpose of this study is to examine the value of grotesque fashion and to predict the future fashion trend. The grotesque originates the formative art. It emerges towards of a century or transitional period in most case. In particular, it was used as the expressive method of an individual's inside and a satire on society through the work of artists in the Middle Age, the renaissance, the sym-bolism, the dadaism, the surrealism, the pop art, the technology art, and the post-modernism, etc. The grotesque in fashion is represented in the work of avant-garde fashion designers who lead the high fashion. The grotesque fashion which was combined with an image of non-formality, non-rationality, an absurdity and reality. It has been begun shape of female dress in the renaissance. Afterwards, it was represented in extremely exaggerated and distorted pop art, hippies' fashion in the 1960's. In the 1970's, it was reflected in genderless rock star and destructive punk fashion. It was also represented in the androgynous fashion which was combined with both sexes, the goth/gothic fashion which was expressed with a realistic and fanciful shape and the tattoo of skin-head in the 1980's. In the 1990's, the grungy look which was dirty and the cyber punk fashion. In general, it was also expressed by the avant-garde fashion designers. To sum up, a grotesque fashion which is expressed by experimental designers is classified into four shapes. 1, Union of some extraneous is expressed as different kinds of fashion theme, such as abnormality of texture, uses of surrealistic elements and chaos of sex. Although it appears that the abnormal union of grotesque has only discord and collision, it also shows a feeling of freedom for the tension. 2. Introduction of real and fanciful image is expressed as a cyborg, realistic description of disgusting animal skin and aggressive shape. Especially, it is worth while to notice Tierre Mugler and Alexander Macqueen's work which expressed the shape of mingling human of Middle Age. 3. distortion or exaggeration is expressed as an unformed shape, the exaggeration of a clothing size, the abnormal exaggeration of human body and the ignorance of clothing form. 4. Introduction of a disgusting image is expressed as an extremity of reality, motifs of death, clothing material of disgusting hair and the ostentation of sex. Motto which leads modern fashion is something new and shocking. The grotesque fashion is an expression of eagerness for something new. It often show something ironic in the form of humor which is embedded in an abnormal and shocking pattern. The grotesque fashion is represented as an extreme beauty. It will stand as an important element of the future fashion and as a particular style with the change and fluidity.

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