• Korean Circulation Journal
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• v.52 no.4
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• pp.251-264
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• 2022

Heart failure with preserved ejection fraction (HFpEF) accounts for approximately half of all heart failure (HF) cases. The prevalence of HFpEF is increasing due to an aging population with hypertension, diabetes mellitus, and obesity. HFpEF remains a challenging clinical entity due to a lack of effective treatment options. Traditional HF medications have not been shown to reduce mortality of patients with HFpEF, and an implantable cardioverter-defibrillator is not indicated due to normal ejection fraction. Sudden death is the most common mode of death in patients with HFpEF; however, the underlying mechanisms of sudden death are not fully elucidated. Although ventricular arrhythmias are responsible for the majority of sudden deaths in general, their contribution to sudden deaths in HFpEF patients is likely less significant. The mechanisms of ventricular arrhythmias in HFpEF are 1) reduced conduction velocity due to ventricular hypertrophy, 2) delayed repolarization due to potassium current down-regulation, 3) calcium leakage due to altered excitation-contraction coupling, and 4) increased ventricular fibrosis caused by systemic inflammation. Hypertension and subsequent ventricular hypertrophy reduce the conduction velocity in HFpEF hearts via heterogeneous distribution of connexin 43. Delayed repolarization caused by potassium current down-regulation in HFpEF hearts provides a window for early afterdepolarization to trigger ventricular arrhythmias. Altered excitation-contraction coupling in HFpEF can cause calcium to leak and trigger delayed afterdepolarization. Increased systemic inflammation and subsequent ventricular fibrosis provide substrates for re-entry. Further research is warranted to investigate the detailed mechanisms of ventricular arrhythmias in HFpEF.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.64-87
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• 2002

The purpose of this study is aimed to grasp the factors, which may influence the harmonized organizational efficiency of the objects of hospital structure as well as its structural constituents of each departments of administration, nursing, and para-medical personnels, in order to provide basic data enable to contribute in the development of hospital. The survey data involved in the study was derived from 385 personnels working in 5 medium and small sized hospitals in Seoul area. The main finding of the study can be summarized as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of male, over 30 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in administration departments are higher, its organizational efficiency is higher in comparison with those of nursing and para-medical departments. 2. The organizational efficiency in accordance with satisfaction and the motive contributional factors is higher as much as the high satisfactory level in every departments in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance between administration and para-medical departments. In as much as the job circulation is intact, job standard level is higher and the more job responsibility the higher organizational efficiency, while the more workload and the more work feud resulted lower organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as higher educational level of over university graduates, management of organization and the job level are satisfied, the psychological motive contributional level is higher, while the lesser job difficulty, the smooth job performance, the higher level of professional expertise, the higher structural formalization level, the smooth intercommunication, have affected as major influence factors of the structural characteristics of organizational efficiency. 6. As the management of hospital organization, the job level and personal relation are satisfied or psychological motive is provided, especially when there are no difficult jobs or smooth job circulation and no job feud are prevailing, it was apparent that the organizational efficiency is improving accordingly. The nursing departments has high educational standard and is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. The para-medical departments is also satisfied the management and job level of hospital organization and it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of the medium and small sized hospitals, the management and job level as well as personal relation are preferably satisfied, whereas the level of job circulation, job responsibility, the expertise and formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on several hospitals in Seoul area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially, as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the medium and small sized hospitals.

• Journal of Environmental Health Sciences
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• v.46 no.1
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• pp.103-109
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• 2020

Objectives: Using as a sleep evaluation tool the Pittsburgh Sleep Quality Index (PSQI), this paper studied the effects of earthing on the amount and quality of sleep by examining a patient population of people who used and did not use earthing mats and a group of general healthy people. Methods: From September to November 2019, 30 patients who voluntarily used an earthing mat, 40 patients who did not use an earthing mat, and 40 healthy people who did not use an earthing mat were selected. A questionnaire applying the PSQI (Pittsburgh Sleep Quality Index) after being translated into Korean was distributed starting November 29, 2019 to 110 subjects. Out of them, 101 subjects who completed the questionnaire were examined. All statistics used SPSS 25.0. Results: The first overall score showed that all three groups had problems sleeping, with five points or more, but the general population had better sleep quality than the patient group. It also showed that the using matgroup had better quality of sleep than the ones that did not use the earthing mat In addition, the analysis of the third group through the variance analysis showed significance at >0.05 for the general population and the patient group. Based on this, a multi-comparison analysis of the third group showed significantly less than 0.05 in patients who do not use an earthing mat compared to the public. First of all, there are no statistically significant differences between the three groups in subjective sleep quality, sleep latency, and sleep time, but an analysis of multiple comparison analysis with the general population group showed that the quality of sleep was worse compared to those that used the mat. In addition, sleep efficiency, sleep disorder, sleeping pills, and daytime dysfunction were found to be less than >0.05 in the three groups. Conclusions: These results suggest that if you ground your body to Earth during sleep, the secretion of cortisol will decrease night levels, sync more with the natural 24-hour circulation rhythm profile, and that when you sleep, sleep is better and pain and stress are associated with the study. While the preceding study cannot confirm that contact with the ground affects the quality of sleep, it suggests that it is relevant as shown in this paper.

• Korean Circulation Journal
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• v.52 no.8
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• pp.606-620
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• 2022

Background and Objectives: Protein-losing enteropathy (PLE) is a devastating complication after the Fontan operation. This study aimed to investigate the clinical characteristics, treatment response, and outcomes of Fontan-associated PLE. Methods: We reviewed the medical records of 38 patients with Fontan-associated PLE from 1992 to 2018 in 2 institutions in Korea. Results: PLE occurred in 4.6% of the total 832 patients after the Fontan operation. After a mean period of 7.7 years after Fontan operation, PLE was diagnosed at a mean age of 11.6 years. The mean follow-up period was 8.9 years. The survival rates were 81.6% at 5 years and 76.5% at 10 years. In the multivariate analysis, New York Heart Association Functional classification III or IV (p=0.002), low aortic oxygen saturation (<90%) (p=0.003), and ventricular dysfunction (p=0.032) at the time of PLE diagnosis were found as predictors of mortality. PLE was resolved in 10 of the 38 patients after treatment. Among medical managements, an initial heparin response was associated with survival (p=0.043). Heparin treatment resulted in resolution in 4 patients. We found no evidence on pulmonary vasodilator therapy alone. PLE was also resolved after surgical Fontan fenestration (2/6), aortopulmonary collateral ligation (1/1), and transplantation (1/1). Conclusions: The survival rate of patients with Fontan-associated PLE has improved with the advancement of conservative care. Although there is no definitive method, some treatments led to the resolution of PLE in one-fourth of the patients. Further investigations are needed to develop the best prevention and therapeutic strategies for PLE.

• Journal of Genetic Medicine
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• v.7 no.2
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• pp.138-144
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• 2010

Purpose: Endothelial progenitor cells (EPCs), which mediates neovascularization of uterine endometrium may be involved in the neovascularization in the utero-placental circulation. Low numbers of endothelial progenitor colony-forming unit (CFU) in culture are predictive biomarker of vascular disease. The aim of the present study was to evaluate whether the number of CFU in preeclampsia differed from that in normal pregnancy. Materials and Methods: Women with singleton normal (n=26) or preeclamptic (n=20) pregnancies were studied during the third trimester. The number of EPCs was quantified by CFU methodology. Plasma levels of angiogenic factors, vascular endothelial growth factor (VEGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) were determined by enzyme-linked immunoassay. Results: CFU numbers were significantly decreased in the preeclamptic patients compared with the controls (median, 3; range 1-12 vs. 31; 3-81 CFU/well, P<0.001). A majority of the cells comprising individual colonies were positive for endothelial characteristics (Ulex europaeus lectin staining and acetylated low-density lipoprotein uptake). Plasma levels of the sFlt-1 were highly elevated (P<0.001) in patient with preeclampsia compared to controls, whereas PlGF were highly reduced (P=0.004), but these factors did not associate with CFU numbers. Conclusion: Our results suggest that reduced numbers of CFU obtained from maternal peripheral blood may contribute to the development of preeclampsia.

• Journal of the Korean Institute of Landscape Architecture
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• v.51 no.2
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• pp.12-27
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• 2023

In this study, among the construction-type parks in Gangdong-gu, targeting parks with high environmental and ecological value located on the urban green axis, a plan was prepared for the ecological renewal of urban parks, and a design that applied to them was proposed. The renewal target site was selected by analyzing the general condition of Gangdong-gu and urban parks, the land use and green area ratio, park green area, and the green axis of Gangdong-gu. Gangdong-gu has 54 parks, including 2 neighborhood parks and 52 children's parks. In the first stage of the current status review, 17 parks were extracted through locational value analysis, such as location and adjacency to the natural axis and green axis. In the second stage, eight parks were selected among the first-stage extraction parks based on the ratio of green spaces and open spaces within each park service area. In the third stage, two of the second stage extraction parks were selected based on whether the legal standard of the park area was met, and in the fourth stage, one of the third stage extraction parks was selected through an aging survey of the park. As for the urban ecological status of the renewal target site, the status of land use in the aspect of entropy reduction, the status of soil cover in the aspect of water circulation, and the status of planting structure in the aspect of biodiversity were investigated. As for the status of the three renewal sites, the green area was insufficient at 18.3-45.3%, and the facility area was 54.7%-81.7%, which was judged to have low urban temperature reduction effects. The impervious pavement area accounted for 34.5% to 48.9% of the park area, accounting for most of the facility area, and it was judged that the water circulation function was insufficient. The planting structure consisted of a single layer and a double layer structure, and although the tree layer was good, the lower vegetation was poor, and there was no planting site of edible plants or large hardwood trees, so the biodiversity was low. After the ecological renewal design of Seonrin Children's Park, Dangmal Children's Park, and Saemmul Children's Park, which were selected as the renewal targets in this study, the ecological area ratio of each park increased by 1.4 to 3 times than before the renewal. If the urban parks located on the urban green axis are examined from the perspective of the urban ecosystem and renewed ecologically, it is judged that the expected effect will be high in reducing entropy, improving water circulation, and laying the foundation for biodiversity in terms of the urban ecosystem.

• (The) Research of the performance art and culture
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• no.19
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• pp.379-418
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• 2009

This study is a link in a chain which grope for the description of puppet performance history. This study imply my intention which is not a description of puppet performance 'history' but a description of 'puppet performance' history. Object materials of this study is materials connected with puppet performance from ancient times to Chosun dynasty. Object materials of this study include not only records but also remains and pictures. Discussion start with regulation of puppet performance materials and establishment of a classification criterion. As a result of that discussion, the age of puppet performance is as follows: 'the age of diverse use of puppet', 'the age of ritual puppet performance of worship', 'the age of play puppet performance of handling', 'the age of ritual puppet performance of display', 'the age of ritual puppet performance of expulsion', 'the age of ritual puppet performance of handling', 'the age of play puppet performance of display', 'the age of play puppet performance of handling and voice-acting'. According to the internal division of age, the description of puppet performance history which is spread chronologically is attempted. As a result of the description, I confirm that puppet performance reveal a one's unfolding process. And a distinct aspect from the general cultu! re history is found. The development process which is a changeover that is 'from ritual puppet performance to play puppet performance' is amended by a circulation of ritual puppet performance and play puppet performance'. And the development process which is a changeover 'from static puppet to dynamic puppet' is amended by a circulation of static puppet and dynamic puppet'. Like this the thing which is laid in the inside which is not a one sided changeover but is a circulation is said that from one age of puppet performance to other age of puppet performance is not a close of former puppet performance tradition. Unfolding from one age to other age, on the other hand former puppet performance reveal aspect which is a continuance and change with a one's vitality. And a relation of mutual influence is exist between the ritual puppet performance and the play puppet performance on a large scale, among the puppet performance types on a small scale. this also don't overlook in cas! e of a groping of puppet performance history.

• Journal of Digital Convergence
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• v.14 no.10
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• pp.563-570
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• 2016

This study investigated applicable values and developments of 5 different kinds of oriental medicine materials as functional supplements or medicinal uses, known to improve blood circulation by means of analyzing nutritional compositions and antioxidant activities. Among general nutritional compositions, protein, iron and copper contents in Polygini Multiflori Radix (20.28%, $132.22{\mu}g$/100 g, $26.54{\mu}g$/100 g), Angelica Gigantis Radix (16.54%, $98.20{\mu}g$/100 g, $32.15{\mu}g$/100 g) and Paeoniae Radix(18.67%, $62.10{\mu}g$/100 g, $20.32{\mu}g$/100 g) were significantly higher than other materials. Angelica Gigantis Radix had the highest of total polyphenols and flavonoid contents, Polygini Multiflori Radix (middle), Paeoniae Radix (the lowest). Antioxidant activities by using DPPH radicals removal showed the highest in Polygini Multiflori Radix, Angelica Gigantis Radix (middle), Paeoniae Radix (the lowest). This study tried to use integrated approaches, including Western and Oriental medicine to improve blood circulation and to set up base to develop products originated from natural compositions.

• Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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• 2001.06a
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• pp.3104-3104
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• 2001

The research described here was undertaken with the aim of monitoring, optimizing and ultimately controlling the production of heterofermentative microbes used as starters in the salami industry. The use of starter cultures in the fermented meats industry is a well-established technique used to shorten and standardize the ripening process, and to improve and control the organoleptic quality of the final product. Starter cultures are obtained by the submerged cultivation of suitable microorganisms in stirred, and sometimes aerated, fermenters where monitoring of key physiological parameters such as the concentration of biomass, substrates and metabolites suffers from the general lack of real-time measurement techniques applicable to aseptic processes. In this respect, the results of the present work are relevant to all submerged fermentation processes. Previous work on the application of on-line NIR spectroscopy to the lactic acid fermentation (Dosi et al. - Monreal NIR1995) had successfully used a system based on a measuring cell included in a circulation loop external to the fermenter. The fluid handling and sterility problems inherent in an external circulation system prompted us to explore the use of an in-line system where the NIR probe is immersed in the culture and is thus exposed to the hydrodynamic conditions of the stirred and aerated fluid. Aeration was expected to be a potential source of problems in view of the possible interference of air bubbles with the measurement device. The experimental set-up was based on an in-situ sterilizable NIR probe connected to the instrument by means of an optical fiber bundle. Preliminary work was carried out to identify and control potential interferences with the measurement, in particular the varying hydrodynamic conditions prevailing at the probe tip. We were successful in defining the operating conditions of the fermenter and the geometrical parameters of the probe (flow path, positioning, etc.) were the NIR readings were reliable and reproducible. The system thus defined was then used to construct and validate calibration curves for tile concentration of biomass, carbon source and major metabolites of two different microorganisms used as salami starters. Real-time measurement of such parameters coupled with the direct interfacing of the NIR instrument with the PC-based measurement and control system of the fermenter enabled the development of automated strategies for the interactive optimization of the starter production process.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.178-184
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• 2017

This study was performed on 16 patients diagnosed with tsutsugamushi disease and cerebral infarction from January 2007 to December 2015. An acute cerebral infarction was diagnosed by brain MRI and MRA. Tsutsugamushi disease was diagnosed using a polymerase chain reaction. To distinguish the difference between the generalized cerebral infarction and infarction with tsutsugamushi disease, the blood pressure and body temperature were measured uponadmission. In general, the blood pressure increases during an acute cerebral infarction. Interestingly, in this study, 12 patients showed a systolic blood pressure less than 130 mmHg uponadmission. The location of the cerebral infarction and whether single or multiple cerebral infarction were examined. Thirteen patients had a cerebral infarction in anterior circulation and 3 patients developed in posterior circulation. To evaluate the coagulation disorders, prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, fibrin degradation product (FDP). D-dimer, which is generally known to increase in an acute cerebral infarction, showed a significant increase in the 13 patients. Fibrin degradation products (FDP) showed a significant increase in 15 patients. The pathophysiological mechanism of tsutsugamushi disease is known as vasculitis, which may result in an endothelial cell injury and proliferation of the endothelial wall, which may lead to a cerebral infarction accompanied by coagulopathy. Without endothelial cell damage and proliferation, a vasospasm caused by vasculitis may cause vasoconstriction and cerebral infarction.