• Journal of Hospice and Palliative Care
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• v.14 no.1
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• pp.28-33
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• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.576-587
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• 2009

Background: The up-regulation of the nitric oxide (NO)-cGMP pathway might be involved in the change of vascular reactivity in rats 3 days after they suffer acute myocardial infarction. However, the underlying mechanism for this has not been clarified. Material and Method: Acute myocardial infarction (AMI) was induced by occluding the left anterior descending coronary artery (LAD) for 30 min (Group AMI), whereas the sham-operated control rats were treated similarly without LAD occlusion (Group SHAM), The concentration-response relationships for phenylephrine (PE), KCl, acetylcholine (Ach) and sodium nitroprusside (SNP) were determined in the endothelium intact E(+) and endothelium denuded E(-) thoracic aortic rings from the rats 3 days after AMI or a SHAM operation. The concentration-response relationships of PE in the E(+) rings from the AMI rats were compared with those relationships in the rings pretreated with nitric oxide synthase (NOS) inhibitor $N{\omega}$-nitro-L-arginine methyl ester (L-NAME) or the cyclooxygenase inhibitor indomethacin. The plasma nitrite/nitrate concentrations were checked via a Griess reaction. The cyclic GMP content in the thoracic aortic rings was measured by radioimmunoassay and the endothelial nitric oxide synthase (eNOS) mRNA expression was assessed by real time PCR. Result: The mean infarct size (%) in the rats with AMI was $21.3{\pm}0.62%$. The heart rate and the systolic and diastolic blood pressure were not significantly changed in the AMI rats. The sensitivity of the contractile response to PE and KCl was significantly decreased in both the E(+) and E(-) aortic rings of the AMI group (p<0.05). L-NAME completely reversed these contractile responses whereas indomethacin did not (p<0.05). Moreover, the sensitivity of the relaxation response to Ach was also significantly decreased in the AMI group (p<0.05). The plasma nitrite and nitrate content (p<0.05), the basal cGMP content (p<0.05) and the eNOS mRNA expression (p=0.056) in the AMI rats were increased as compared with the SHAM group. Conclusion: Our findings indicate that the increased eNOS activity and the up-regulation of the NO-cGMP pathway can be attributed to the decreased contractile or relaxation response in the rat thoracic aorta 3 days after AMI.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.167-172
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• 2010

Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. Results : Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P =0.022) and fraction of inspired oxygen (P <0.001) were significantly higher in the dead group and values of base excess (P =0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, $CO_2$, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P =0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P =0.022). Conclusion : Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.

• Journal of Korean Medical classics
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• v.7
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• pp.198-231
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• 1994

Up to now, after I had examined the relation between the origin of Fung(風) and Gi(氣) and the mean of Fung in medical science, I obtained the conclusion being as follows. The first, Fung(風) means a flux of Gi(氣) and Gi shows the process by virtue of the form of Fung, namely, Fung means motion of Gi. In other words, it is flow of power. Accordingly, the process of all power can give a name Fung. The second, Samul(事物) ceaselessly interchange with the external world to sustain the existence and life of themselves. And they make a adequate confrontation against the pressure of the outside. This the motive power of life action(生命活動) is Gi and shows its the process on the strength of Fung. The third, Samul(事物) incessantly releases power which it has to the outside. Power released to the outside forms the territory of the established power in the environment of them and keep up their substance(實體) in the space time(時空). It can be name Fung because the field(場) of this power incessantly flows. The fourth, man operates life on the ground of the creation of his own vigor(生氣) for himself as the life body(生命體) of the independence and self-support. The occurence of this vigor and the adjustment process(調節作用) is supervised by Gan(肝). That is to say, Gan plays a role to regulate and manage the process of Fung or the action of vigor with Fung-Zang(風臟). The fifth, because the Gi-Gi adjustment process(氣機調節作用) of Gan is the same as the process of Fung, Fung that operates the cause of a disease is attributed to the disharmony of the process of the human body Gi-Gi. Therefore, the generating pathological change is attributed to the extraordinary of the function by the incongruity of Gi-Gi(氣機) or the disorder of the direct motion of Gi-Hyul(氣血). Because the incongruity of this Gi-Gi of the human body gives rise to the abnormal of Zung-Gi(正氣) in the human body properly cannot cope with the invasion of 'Oi-Sa(外邪). Furthermore, Fung serves as the mediation body of the invasion of other Sa-Gi(邪氣) because of its dynamics, By virtue of this reason, Fung is named the head of all disease. And because the incongruity of the Gi-Gi has each other form according to Zang-Bu(臟腑), Kyung-Lak(經絡), and a region, the symptoms of a disease appear differently in line with them as well. The sixth, Fung-byung(風病) is approximately separated Zung-Fung(中風) and Fung-byung(猍義의 風病). Zung-fung and Fung-byung is to be attributed to the major invasion of each Jung-gi and Fung-sa(正氣와 風邪). But these two kinds stir up the problem to the direct motion of Gi-hyul(氣血) and the harmony of Gi-Gi in the human body. When one cures it, therefore, Zung-fung has to rectify Gi-Gi and the circulation of Gi-hyul on the basis of the supplement of Jung-gi(正氣) and Fung-byung must make the harmony of Gi-Gi with the Gu-fung(驅風). -Go-gi(調氣), Sun-Gi(順氣). Hang-Gi(行氣) - All existing living things as well as man maintain life on the ground of the pertinent harmony between the soul(精神) and the body(肉體). As soon as the harmony falls down, simultaneously life disappears as well. And Fung which means the outside process between Gi(氣) and Gi(氣) makes the action of their life cooperative and unified, Accordingy, the understanding of Fung, first, has to start wi th the whole thought that not only all Samul(事物) but also the soul and the body are one.

• The Korean Journal of Pharmacology
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• v.27 no.1
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• pp.33-43
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• 1991

To study the age dependent change of Na, K-ATPase in the erythrocyte of hypertensive rat, 1-kidey 1-clip hypertensive rat was made by the removal of right kidney and partial ligation of left renal artery. After 4 weeks, aged erythrocyte fraction was separated by density gradient centrifugation, and Na, K-ATPase activity and $^3H-ouabain$ binding with ghost cell membrane and ouabain sensitive Rb-uptake with whole cell were measured. 1) In the hypertensive rats, blood pressure was significantly increased to 165.5/119.0 mmHg (systolic/diastolic). Mean corpuscular volume and membrane protein(mg) per $10^9RBC$ were decreased and hemoglobin content was increased in the aged erythrocyte. 2) Na, K-ATPase activity in the solution containing 110 mM NaCl and 10 mM KCI, was decreased in hypertensive rat, and decreased in aged erythrocyte of both group. 3) Ouabain sensitive Rb-uptake by low RbCl concentration(4 mM) was slightly decreased in aged erythrocyte compared to that in young erythrocyte of each group, but slightly increased in young erythrocyte in hypertensive rat compared to that in normotensive rat. 4) Ouabain sensitive Rb-uptake by high RbCl concentration(16 mM) was decreased about 30% to 50 % in aged erythrocyte in both group. And in hypertensive rat, especially in young erythrocyte it was significantly decreased compared to that in normotensive rats. 5) $^3H-ouabain$ binding at 0.13 or $1{\times}10^-6M$ ouabain concentration was slightly decreased in aged erythrocyte of normotensive rat, and significantly decreased in aged erythrocyte of hypertensive rats. 6) $^3H-ouabain$ binding at 6 or $64{\times}10^-6M$ ouabain concentration is slightly decreased in aged erythrocyte of both group, but significantly decreased in young and aged erythrocyte of hypertensive rats compared to that of normotensive rats. The present results suggest that (1) in the young erythrocyte of hypertensive rat, the alterations of Na-pump activity that slightly increased in weak stimulation and inhibited in strong stimulation, may be related to increased molecular activity and the decrease in the number of low affinity site without change in high affinity site, (2) in the aged erythrocyte of normotensive rat, inhibited Na-pump may be related to the change in molecular activity of pump. (3) And in the aged erythrocyte of hypertensive rat, it may be related to the decrease in the number of high and low affinity site as well as the change in molecular activity

• Korean Journal of Remote Sensing
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• v.27 no.4
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• pp.481-494
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• 2011

Investigation of the $CO_2$ exchange between biosphere and atmosphere at regional, continental, and global scales can be directed to combining remote sensing with carbon cycle process to estimate vegetation productivity. NASA Earth Observing System (EOS) currently produces a regular global estimate of gross primary productivity (GPP) and annual net primary productivity (NPP) of the entire terrestrial earth surface at 1 km spatial resolution. While the MODIS GPP algorithm uses meteorological data provided by the NASA Data Assimilation Office (DAO), the sub-pixel heterogeneity or complex terrain are generally reflected due to coarse spatial resolutions of the DAO data (a resolution of $1{\circ}\;{\times}\;1.25{\circ}$). In this study, we estimated inputs retrieved from MODIS products of the AQUA and TERRA satellites with 5 km spatial resolution for the purpose of finer GPP and/or NPP determinations. The derivatives included temperature, VPD, and solar radiation. Seven AmeriFlux data located in the Corn Belt region were obtained to use for evaluation of the input data from MODIS. MODIS-derived air temperature values showed a good agreement with ground-based observations. The mean error (ME) and coefficient of correlation (R) ranged from $-0.9^{\circ}C$ to $+5.2^{\circ}C$ and from 0.83 to 0.98, respectively. VPD somewhat coarsely agreed with tower observations (ME = -183.8 Pa ~ +382.1 Pa; R = 0.51 ~ 0.92). While MODIS-derived shortwave radiation showed a good correlation with observations, it was slightly overestimated (ME = -0.4 MJ $day^{-1}$ ~ +7.9 MJ $day^{-1}$; R = 0.67 ~ 0.97). Our results indicate that the use of inputs derived MODIS atmosphere and land products can provide a useful tool for estimating crop GPP.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.43-49
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• 2004

Background: Acute thoracic aortic dissections involving the aortic arch differ in diagnosis, surgical procedures, and operative results compared to those that do not involve the aortic arch. In general cerebral perfusion under deep hypothermic circulatory arrest (HCA) is performed during the repair of the aortic arch dissection. Here, we report our surgical results of the aortic arch dissection repair using retrograde cerebral perfusion (RCP) and its safety. Material and Method: Between January 1996 and June 2002, 22 consecutive patients with aortic arch dissection underwent aortic arch repair. In 20 of them RCP was performed under HCA. RCP was done through superior vena cava in 19 patients and by systemic retrograde venous perfusion in 1, in whom it was difficult to reach the SVC. When the patient's rectal temperature reached 16 to 18$^{\circ}C$, systemic circulation was arrested, and the amount of RCP amount was 481.1 $\pm$292.9 $m\ell$/min with perfusion pressure of 20∼30 mmHg. Result: There were two in-hospital deaths (4.5%) and one late death (9.1%). Mean circulatory arrest time (RCP time) was 54.0$\pm$ 13.4 minutes (range, 7 to 145 minutes). RCP time has no correlation with the appearance of consciousness, recovery of orientation, or ventilator weaning time (p=0.35, 0.86, and 0.92, respectively). Ventilator weaning was faster in patients with earlier recovery of consciousness and orientation (r=0.850, r=926; p=0.000, respectively). RCP of more than 70 minutes did not affect the appearance of consciousness, recovery of orientation, ventilator weaning time, exercise time, or hospital stay (p=0.42, 0.57, 0.60, 0.83, and 0.51, respectively). Conclusion: Retrograde cerebral perfusion time under hypothermic circulatory arrest during repair of aortic arch dissection may not affect recovery of orientation, ventilator weaning time, neurologic complications, and postoperative recovery.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.23-29
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• 2003

Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

• Journal of the Korean Society of Hazard Mitigation
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• v.9 no.6
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• pp.31-39
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• 2009

This study has found that there is a reverse phase with interdecadal variation in temporal variations of tropical cyclone (TC) genesis frequency (TCGF) between Northwest sector and Southeast sector, based on climatological mean tropical cyclone genesis location over the western North Pacific. The TCGF in the Northwest sector has been increased since the mid 1980s (1986-2005), while TCGF in the Southeast sector was higher until the early 1970s (1951-1970). The analysis of a difference between 1986-2005 and 1951-1970 showed results as follows: i) Through the analysis of vertical wind shear (VWS) and sea surface temperature (SST), less VWS and higher SST in the former (latter) period was located in the Northwest (Southeast) sector. ii) In the analysis of TC passage frequency (TCPF), TCs occurred in the Northwest sector frequently passed from east sea of the Philippines, through East China Sea, to Korea and Japan in the latter period, while TCs in the former period frequently has a lot of influences on South China Sea (SCS). In the case of TCs occurred in the Southeast sector, TCs in the west (east), based on $150^{\circ}E$ had a high passage frequency in the latter (former) period. In particular, TCs during the latter period frequently moved toward from the east sea of the Philippines to SCS and southern China. iii) This difference of TCPF between the two periods was characterized by 500 hPa anomalous pressure pattern. Particularly, anomalous cyclonic circulation strengthened over the East Asian continent caused anomalous southerlies along the East Asian coast line from the east sea of the Philippines to be predominate. These anomalous winds served as steering flows that TC can easily move toward same regions.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.42 no.5
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• pp.579-596
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• 1997

A simulation study was carried out to delineate potential effects of the lake-induced climate change on crop productivity around Lake Imha which was formed after a multi-purpose dam construction in Andong, Korea. Twenty seven cropping zones were identified within the 30 km by 25 km study area. Five automated weather stations were installed within the study area and operated for five years after the lake formation. A geostatistical method was used to calculate the monthly climatological normals of daily maximum and minimum temperature, solar radiation and precipitation for each cropping zone before and after the dam construction. Daily weather data sets for 30 years were generated for each cropping zone from the monthly normals data representing "No lake" and "After lake" climatic scenarios, respectively. They were fed into crop models (ORYZA1 for rice, SOYGRO for soybean, CERES-maize for corn) to simulate the yield potential of each cropping zone. Calculated daily maximum temperature was higher after the dam construction for the period of October through March and lower for the remaining months except June and July. Decrease in daily minimum temperature was predicted for the period of April through August. Monthly total radiation was predicted to decrease after the lake formation in all the months except February, June, and September and the largest drop was found in winter. But there was no consistent pattern in precipitation change. According to the model calculation, the number of cropping zones which showed a decreased yield potential was 2 for soybean and 6 for corn out of 27 zones with a 10 to 17% yield drop. Little change in yield potential was found at most cropping zones in the case of paddy rice, but interannual variation was predicted to increase after the lake formation. the lake formation.