• Title/Summary/Keyword: Disease control

Search Result 7,410, Processing Time 0.044 seconds

Type 2 Diabetes Mellitus in Children (소아연령에서의 2형 당뇨병의 임상적 고찰)

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.5
    • /
    • pp.646-653
    • /
    • 2002
  • Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

Cholesterol Lowering Effect of Ethanol Extracts of Salted and Fermented Small Shrimp in Rats Administered a High Fat Diet (발효 새우젓의 에탄올 추출물이 고지방 식이를 급여한 흰쥐의 콜레스테롤 저하 효과)

  • Kim, Yong-Hyun;Han, Kook-Il;Jeon, Mi-Ae;Kwon, Hyun-Jung;Park, Min-Kyung;Han, Man-Deuk
    • Microbiology and Biotechnology Letters
    • /
    • v.39 no.3
    • /
    • pp.281-286
    • /
    • 2011
  • This study was performed to investigate the effects of salted and fermented shrimp ethanol extract (SFS) on serum lipid metabolism and hepatocytes in rats. Male Sprague-Dawley rats were administered 60% fat feed to induce hypercholesterolemia and were divided into five groups. Experimental groups were classified according to administered diet: normal diet group (NC), high cholesterol diet group (HC), high cholesterol and low dose shrimp extract (20 mg/kg) group (HC-SFSL), high cholesterol and high dose shrimp extract (200 mg/kg) group (HC-SFSH), and high cholesterol and lovastatin (20 mg/kg) group (HC-Lov). The experimental diets were fed ad libitum for 14 days. Compared with the control group, the serum cholesterol and triglycerides were 40.4 and 64.7% lower in the group fed HC-SFSH respectively. Low density lipoprotein (LDL)-cholesterol concentration in serum decreased in the HC-SFSH group compared with the HC group. In a histological assay, hepatocytes in the HC group showed that the vacuolated cells by fat appear clear due to the large amount of intracytoplasmic fat, whereas the liver hepatocytes in the group fed SFS effectively decreased fatty liver and intracytoplasmic fats. These results suggest that the extract of salted and fermented shrimp has an antiatherosclerotic effect and may lessen the effects of cardiovascular disease by reducing the cholesterol level in serum.

A Study on BMI, Diet Perception and Dietary Behavior of Female University Students (여대생의 체질량지수, 다이어트 인식과 다이어트 행동에 관한 연구)

  • Lee, JinHee
    • Journal of the Korean Applied Science and Technology
    • /
    • v.37 no.3
    • /
    • pp.463-472
    • /
    • 2020
  • The purpose of this study is to identify the BMI, diet perception and diet behavior of female university students. A descriptive survey design was used 165 students from October 29 to November 9, 2018. Data were analyzed using mean, t-test, ANOVA, cross analysis with SPSS 21.0. Total diet perception was 3.44 points, highest sub category was 'practice' with 4.00 points, followed by 'information and education' with 3.58 points, 'necessity' with 3.32 points and lowest category was 'self-recognition' with 2.84. 65 students(43.0%) were 'less than three times' in 'Number of diets' and diet methods was 65(43.0%) for 'food control' and 62(41.1%) for 'exercise'. During in a week, 98 students(84.9%) exercised within three hours, followed by 33(21.9%) who did not exercised at all. 22 students(14.6%) said they experienced damage from dieting, while the types included gastrointestinal disease, menstrual irregularity and hair loss. The total score of diet perception according to BMI was lower in the underweight group than in the normal and overweight groups(p<.001). In diet 'practice' category, low weight group scored lower than normal weight and overweight groups(p<.05). In 'information and education' category, overweight group scored the highest, followed by normal and underweight groups(p<.001). In diet 'necessity' and 'self-recognition' categories, low weight group scored lower than normal weight and overweight groups(p<.001). Diet behavior by diet perception was different in number and method of diet(p<.001). Based on the results, it is thought that attention and education are needed to form a proper diet perception and maintain healthy living for female university students.

Production and Inhibition of Cellulolytic and Pectolytic Enzymes by Cylindrocarpon destructans(Zins.) Scholten Causing Root Rot of Ginseng (인삼뿌리썩음병균, Cylindrocarpon destructans에 의한 섬유소분해효소 및 펙틴질분해효소의 분필 및 억제)

  • Lee Jin Woo;Chung Hoo Sup
    • Korean journal of applied entomology
    • /
    • v.13 no.1 s.18
    • /
    • pp.1-10
    • /
    • 1974
  • The activities of pectolytic and cellulolytic enzymes produced from slices of ginseng root infected with Cylindrocarpon destructains(Zins.) Scholtern were proportional to each concentration and reaction time. Activities of cellulase(Cx), endo-polygalacturonase(endo-PG), endo-polymethylg-alacturonase(endo-PMG), exo-polygalacturonase(exe-PG), and exe-polymethylgalacturonase(exo-PMG) were maximum on the 4th day after inoculation. No endo-PG and endo-PMG were detected at the first and second days, while exo-PG exo-PMG were active. On the 6th day, all pectic enzymes were completely lost, whereas Cx remained at a high concentration. pH optima of Cx, endo-PG, endo-PMG, exo-PG, and exo-PMG were 6.0, 5.5, 8.0, 7.0 to 7.5, and 8.5, respectively. Temperature optima of Cx, endo-PG, endo-PMG exo-PG, and exo-PMG were $66^{\circ}C\;53^{\circ}C\;41^{\circ}C\;37^{\circ}C\;and\;40^{\circ}C$, respectively. Cx was only inhibited by $0.05M\; Hg^{++}$ among 16 ions tested. Inhibitory effects of ions on pectolytic enzymes varied, however$M Fe^{+++}\;and\;0.05M\;Al^{+++}$ were the best in general. Among 8 fungicides, none of them inhibited all the enzymes studied at $0.1\%$, active ingredients. Exo-PG were highly inhibited by all of the fungicides, of which difolatan was the most inhibitory to all the pectic enzymes. $Ca^{++}\; at\; 0.02M\; and\;Fe^{+++}\;at\;0.02M$ completely inhibited all the pectolytic enzymes, and Cx was inhibited $30\%$ and $70\%$ at the same concentration, respectively Formalin almost inhibited exo-PG and exe-PMG at $0.8\%$ but not the other enzymes especially Cx. Difolatan at $0.8\%$ inhibited all the enzymes concerned above $80\%$. The cellulolytic and pectolytic enzymes of C. destructans must be closely associated with the ginseng root rot and should be inhibited to control the disease effectively.

  • PDF

Seroepidemiology of helminthic diseases in Yanbian of the People's Republic of China (중국 연변지역 주요 기생충질환에 대한 혈청역학적 조사)

  • Joo, Kyoung-Hwan;Quan, Fu Shi;Kwon, Hye-Soo;Cho, Sung-Weon;Li, Shun Yu
    • Journal of agricultural medicine and community health
    • /
    • v.23 no.2
    • /
    • pp.275-285
    • /
    • 1998
  • Antibody responses(IgG) to Paragonimus westermani. Clonorchis sinensis, Cysticercus cellulosae, Sparganum Anisakis simplex, Toxocara canis and Trichinella spiralis were studied. The ELISA technique was performed to determine the prevalence of above helminthic diseases. 975 cases obtained from Yanbian of China during October, 1995 to July, 1997 were examined with a positive antibody titer of 5.74% in clonorchiasis, 4.92% in paragonimiasis, 1.54% in cysticercosis. 8.51% in sparganosis, 1.85% in anisakiosis, 12.51% in toxocariasis, and 7.08% in trichinosis respectively. And 23.87% in showed positive antibody titer at least one of the seven helminths. The differences of the age and sex in the positive sera were analysed by the Chi-squared test and the level of significance accepted was p<0.05. The significant differences in positive antibody production were P.W.(p<0.01). C.S.(p<0.01), A.S.(p<0.05). T.C.(p<0.001), and T.S.(p<0.01) respectively in age groups. sparganosis(p<0.05) in sex groups. Other parasites showed that there were no significant differences among age groups and sex groups(males and females). Higher positive antibody rate of C.S. and P.W. occured in the 50-59 years old and those of T.C. and T.S. happened in the 20-29 years old. Patients of internal disease showed more positive antibody titer, that is to say, there was significant difference between positive rate of internal diseases and that of control (p<0.01. p<0.05) in 6 helminths except cysticercosis. The result showed that some cross reactions existed among nematodes, and the developed techniques(EITB) should be done for a correct diagnosis. Also the prevalence of some important helminths may be evaluated from the result and it would be a basic data for controlling parasitic diseases in Yanbian.

  • PDF

Comparative Study on Social Support and Perceived Health between Obese Women and Normal Weight Women (비만여성과 정상체중 여성의 사회적지지 및 건강지각의 비교)

  • Kim, Jeong-Ah;Wang, Myoung-Ja
    • Research in Community and Public Health Nursing
    • /
    • v.15 no.4
    • /
    • pp.587-599
    • /
    • 2004
  • Purpose: The purpose of this study is to compare abdomen-fat rate, life style and social-support between normal weight women and obese women. Method: 304 women objectives from their 30 to 59 years of age were selected living in Je-chon city, Chung-Buck province and their height and weight were measured from April 1st to June 30th, 2003. Data were classified into low-weight group ($18.5kg/m^2$), normal-weight group ($18.5{\sim}22.9kg/m^2$), over weight group ($23{\sim}24.9kg/m^2$), and obese group ($25kg/m^2$) following the Korean Conference of Obesity, 2001. in which 119 people in the normal weight group and 91 people in the obese group, i.e. total 210 people were analyzed in sequence. Using SPSS Win 10.1 Program, frequency and percentile, and by ANOVA, $X^2-test$ and t-test were treated. Results: The average age of obese women was 46.68 distributing 40.7% of forties and 39.6% of fifties while normal-weight women were average 41.73-year old distributing 53.8% of forties and 34.5% of thirties, which revealed aged in obese women. The body fat rate of obese women averaged $37.52{\pm}4.17%$, in which 98.9% of obese women and 21.0% of normal weight women with a more than 30% of body-fat rate resulted in a higher body-fat rate in obese women. The waists of obese women averaged $88.37{\pm}8.22cm$, in which more than 85cm showed in obese women of 68.2% and normal weight women of 7.6% indicating a higher waist-fat rate in obese women. The abdomen-fat rate of more than 0.85 of waist vs hip-fat showed 74.7% in obese women and 58.4% in normal weight women, indicating a higher abdomen-fat rate in obese women. Obese women and normal weight women showed significant differences in education level, number of children, religion, menstrual status, and mother's weight. Especially, obese women ate hotter or saltier food than normal weight women preferring meat. However, no significant differences appeared in marital status, social economic status. occupation. eating habits. smoking. drinking and physical exercise. Social support levels showed a lower rate in obese women than in normal weight women, indicating a statistically significant difference (p<.05). Observing areas of social support, obese women showed lower rates in attachment/intimacy, social integrity, opportunity of foster and confidence in value except help and instruction, which indicated a statistically significant difference (p<.05). Social support for obese women showed significant differences in age, education level, social hierarchy, religion and menstrual status. Obese women were more negative than normal weight women in health recognition, indicating a statistically significant difference (p<.01). Normal weight women showed higher health recognition when provided high social support and significantly low (p<.01) health recognition when provided low social support. However, there was no significant difference in health recognition in obese women whether high or low social support was given. The health recognition of obese women showed significant differences in age, education level, social hierarchy, number of children, menstrual status, physical exercise, eating habits, eating taste and preference of food. Conclusion: Obese women showed elder than normal-weight women, higher body-fat rate and abdomen-fat rate, lower social support, and a tendency to more negative health recognition. Therefore, providing weight-control programs for the treatment of obesity and prevention of recurrence for obese women to prevent progressing to adult disease and promote a healthy life, we suggest that better eating habits and the encouragement of regular physical exercise should be included, as well as total approachment on change of health recognition and social support would be needed.

  • PDF

The Effects of Prostaglandin and Dibutyryl cAMP on Osteoblastic Cell Activity and Osteoclast Generation (Prostaglandin과 Dibutyryl cAMP가 조골세포의 활성과 파골세포 형성에 미치는 영향)

  • Mok, Sung-Kyu;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
    • /
    • v.26 no.2
    • /
    • pp.448-468
    • /
    • 1996
  • To maintain its functional integrity, bone is continuously remodelled by a process involving resorption by osteoeclasts and formation by osteoblasts, In order to respond to changes in the physical environment or to trauma with the relevant action, this process is strictly regulated by locally synthesized or systemic fators, Prostaglandin $E_2(PGE_2$) is perhaps one of the best studied factors, having been known to affect bone cell function for several decades.$PGE_2$ has both anabolic and catabolic activities. Excess of $PGE_2$ has been implicated in a number of pathological states associated with bone loss in a number of chronic inflammatory conditions such as periodontal disease and rheumatoid arthritis. $PGE_2$ and other arachidonic acid metabolites have been shown to be potent stimulators of osteoclastic bone resorption in organ culture. The anabolic effects of $PGE_2$ were first noticed when an increase in periosteal woven bone formation was seen after the infusion of $PGE_2$ into infants in order to prevent closure of the ductus arteriosus. The cellular basis for the catabolic actions of $PGE_2$ has been well characterized. $PGE_2$increases osteoclast recruitment in bone marrow cell cultures. Also $PGE_2$ has a direct action on osteoclast serving to inhibit activity and can also indirectly activate osteoclast via other cells in the vicinity, presumably osteoblast. The cellular mechanisms for the anabolic actions of $PGE_2$ are not nearly so well understood. The purpose of this paper was to study the effects of $PGE_2$ and dibutyl(DB)cAMP on osteoblastic clone MC3T3El cells and on the generation of osteoclasts from their precursor cells. The effect of $PGE_2$ and DBcAMP on the induction of alkaline phoaphatase(AlP) was investigated in osteoblastic clone MC3T3El cells cultured in medium containing 0.4% fetal bovine serum. $PGE_2$ and DBcAMP stimulated ALP activity and MTT assay in the cells in a dose-dependent manner at concentrations of lO-SOOng/ml. Cycloheximide, protein synthesis inhibitor, inhibited the stimulative effect of $PGE_2$ and DBcAMP on ALP activity in the cells. $PGE_2$also increased the intracellular cAMP content in a dose-dependent fashion with a maximal effect at 500ng/ml. The effect of $PGE_2$ on the generation of osteoclasts was investigated in a coculture system of mouse bone marrow cells with primary osteoblastic cells cultured in media containing 10% fetal bovine serum.After cultures, staining for tartrate-resistant acid phosphatase(TRAP)-marker enzyme of osteoclast was performed. The TRAP(+) multinucleated cells(MNCs), which have 3 or more nuclei, were counted. More TRAP(+) MNCs were formed in coculture system than in control group. $PGE_2(10^{-5}10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in culture. $PGE_2(10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in coculture of osteoblastic clone MC3T3E1 cells This results suggest that $PGE_2$ stimulates the differentiation of osteoblasts and generation of osteoclast, and are involved in bone formation, as well as in bone resorption.

  • PDF

Effects of Green Tea Extract on Acute Ethanol-induced Hepatotoxicity in Rats (녹차추출물이 에탄올 투여에 의한 초기 간 손상에 미치는 영향)

  • Jin, Dong-Chun;Jeong, Seung-Wook;Park, Pyoung-Sim
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.39 no.3
    • /
    • pp.343-349
    • /
    • 2010
  • The liver is the major target of ethanol toxicity and oxidative stress plays a role in development of alcoholic liver disease. This study was performed to investigate the effects of green tea extracts (GTE) on acute ethanol-induced hepatotoxicity in rats. Experimental animals were divided into 4 groups, control, GTE, ethanol, and GTE+ethanol treatment, with 5 rats in each group. Ethanol (6 g/kg body weight (BW)) and GTE (200 mg/kg BW) were treated by gavage. At 1 hour, 3 hours and 20 days (6 g/kg BW every 2 days for total 10 doses) after ethanol and/or GTE treatments, animals were killed; hepatic tumor necrosis factor-alpha (TNF-$\alpha$) and glutathione level, serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), hepatic antioxidant enzymes (SOD, CAT, GPx) activities and hepatic thiobarbituric acid reactive substances (TBARS) were measured. At 1 hour and 3 hours, hepatic TNF-$\alpha$ levels were increased significantly in ethanol group and ethanol+GTE group but that levels was significantly lower in ethanol+GTE group compared with ethanol group. Hepatic glutathione level was decreased by ethanol treatment but GTE prevented the ethanol-induced glutathione decrement. The levels of liver marker enzymes (AST, ALT), liver antioxidant enzymes (SOD, CAT, GPx) and lipid peroxidation marker (TBARS) were not changed in rats of 1 and 3 hours after ethanol treatment. After 20 days, GTE decreased the changes of liver marker enzymes (AST, ALT) activities and TBARS level by ethanol. This study shows that GTE beneficially modulates TNF-$\alpha$ and glutathione levels in liver of ethanol administered rats. The GTE supplementation could be beneficial to liver by decreasing early changes of biomarkers of liver damage caused by ethanol.

Detection of Pyrazinamide-Resistant Mycobacterium tuberculosis is by PCR-SSCP of pncA Gene (pncA 유전자 PCR-SSCP법을 이용한 결핵균 Pyrazinamide 내성의 진단)

  • Shim, Tae-Sun;Kim, Young-Whan;Chin, Jae-Yong;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.45 no.6
    • /
    • pp.1178-1187
    • /
    • 1998
  • Background : Recently the incidence of tuberculosis is increasing in many countries and control of the disease is further threatened by the emergence of multi-drug resistant tuberculosis. So rapid detection of drug resistance is very important. Pyrazinamide (PZA) is a first-line chemotherapeutic agent for tuberculosis. Now in Korea, we perform PZase activity test instead of actual pyrazinamide susceptibility test for the detection of PZA resistant M. tuberculosis. Recently the pncA gene, encoding the PZase of M. tuberculosis, was completely sequenced. And it was reported that the mutation of pncA gene would be associated with PZA resistance of M. tuberculosis. Therefore we performed this study to evaluate the possibility for the rapid detection of PZA resistant M. tuberculosis using PCR-SSCP of pncA gene. Method : 44 cultured clinical isolates of M. tuberculosis, BCG Tokyo strain. BCG French strain, and one M. bovis isolate were studied. We used H37Rv as the reference strain, The PZase activity test was done at the reference laboratory of Korean Tuberculosis Institute. DNA was extracted by bead-beater method and 561 bp fragment including pncA gene was amplified by PCR. The PCR product were digested by BstB I enzyme. SSCP was done using MDE gel. Of the 44 strains of M. tuberculosis, 22 strains were PZase-positive and other 22 strains were PZase negative. Results : Of the 22 PZase positive strains, 18 strains(82%) showed the same mobility compared with that of H37Rv and 4(18%) showed different mobility. Of the 22 PZase-negative strains, 19(86%) strains showed the same mobility pattern compared with that of H37Rv and 3(14%) showed different mobility. Naturally PZA-resistant BeG-French strain, BCG-Tokyo strain, and one M. bovis isolate showed the same band pattern each other, but their mobility were different from that of H37Rv. The results of PZase activity test and PCR-SSCP of pncA of M. tuberculosis were statistically significantly correlated each other (p<0.01). Conclusion : The PCR-SSCP after BstB I restriction of pncA gene of M. tuberculosis may be a useful method for the rapid detection of PZA-resistant M. tuberculosis.

  • PDF

The Levels of Interferon-gamma, Interleukin-2 Receptor, Interleukin-6 and Interleukin-10 in the Patients with Malignant Pleural Effusion, Tuberculosis Effusion, Parapneumonic Effusion, and Lung Emphysema? (악성 흉수, 결핵성 흉수 및 부폐렴 삼출액과 농흉에서 Interferon-gamma, Interleukin-2 Receptor, Interleukin-6, Interleukin-10 농도의 비교)

  • Kim, Myung-Hoon;Kim, Seung-Joon;Park, Yong-Keun;Kim, Seok-Chan;Lee, Sook-Young;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.5
    • /
    • pp.568-575
    • /
    • 2000
  • Background : Cytokines are chemical mediators that control and modulate many inflammatory processes. They work in different fashions in a variety of diseases. Discriminating between malignant effusion, tuberculous effusion, and parapneumonic effusion are crucial from the clinical view-point in Korea. In the current study, interferon-gamma (IFN-${\gamma}$), soluble interleukin-2 receptor (IL-2R), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured for this purpose. Methods : Pleural fluids from patients with malignant disease, tuberculosis, parapneumonic effusion and lung empysema were collected and gauged using commercial ELISA kits. Results : 34 patients were enrolled in this study. Among these 15 cases were malignant effusions, 12 were tuberculosis pleurisy and 7 were parapneumonic effusion and lung empyema. The levels of cytokines measured in this study were as follows, in order of frequency, malignant effusion, tuberculous effusion, parapneumonic effusion and lung empyema. The levels of INF-${\gamma}$ were higher in tuberculous effusion than in malignant or parapneumonic effusion ($295.5{\pm}585.5$ vs. $16.7{\pm}50$ vs. $10.0{\pm}0$ pg/ml, p>0.05). The levels of IL-2R were higher in tuberculous effusion than in malignant or parapneumoruc effusion ($7423.5{\pm}3752.8$ vs. $3247.4{\pm}1713.3$ vs. $3790.2{\pm}3201.1$ pg/ml, p<0.05). No significant differences were found in the levels of IL-6 between the groups ($600{\pm}12.8$ pg/ml in malignant effusion, $556.4{\pm}161.7$ pg/ml in tuberculous effusion, $514.4{\pm}224.8$ pg/ml in parapneumoruc effusion). IL-10 levels were higher in parapneumoruc effusion than in malignant or tuberculous effusions ($98.4{\pm}141.7$ vs. $28.2{\pm}55.5$ vs. $11.3{\pm}11.7$ pg/ml, p<0.05). Conclusion : These results suggest that the measurement of IL-2R levels in pleural fluids may be a useful means of differentiating between tuberculous effusion and pleural effusions of other origins, and that the measurement of IL-10 levels in pleural fluids may be useful to differentiate between parapneumonic effusion and pleural effusions of other origins.

  • PDF