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Relation between Changes of DITI and Clinical Results according to the Level and Extent of Sympathicotomy in Essential Hyperhidrosis (본태성다한증에서 흉부교감신경의 차단 범위와 부위에 따른 임상결과와 체열변화 사이의 관계)

  • 최순호;임영혁;이삼윤;최종범
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.64-71
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    • 2004
  • Background: Video-assisted sympathicotomy is a safe and effective method for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side-effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the relationship between temperature change measured by DITI (digital infrared thermographic imaging) and clinical results according to the level and extent of sympathicotomy in essential hyperhidrosis. we tried to obtain a more precisely and objectively, the distribution and degree of compensatory sweating by DITI and also for ascertaining the clinical usefulness. Material and Method: From January 2000 to June 2002, the thoracoscopic sympathicotomy was performed in 28 patients suffering from essential hyperhidrosis in Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into four groups, Group I: patients having undergone T2 sympathicotomy, Group II: patients having undergone T3 sympathicotomy, Group III: patients having undergone T3,4 sympathicotomy, and Group IV: patients having undergone T2,3,4 sympathicotomy. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory and plantar sweating, and temperature changes of entire body measured by DITI Result: There was no difference in age and follow-up period among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However, the rate of long-term satisfaction were 85.8%, 85.8%, 42.9%, and 28.6% in group I, II, III, and IV (p<0.05). More than embarrassing compensatory sweating was present in 14.2%, 14.2%, 57.1%, 71.4% in group I, II, III, and IV (p<0.05) In regard to plantar sweating, decrease in sweating was expressed in each of four groups, but was not significant between groups. An apparent increase of temperature measured by DITI indicated sufficient denervation and predicted long-lasting relief of essential hyperhidrosis and also decrease in temperature of trunk and lower extremity by DITI had correlated well with postoperative satisfaction, and also postoperative compensatory sweating. Conclusion: We suggested that the incidence and degree of compensatory sweating was closely related to the site and the extent of thoracic sympathicotomy. Resection of the lower interganglionic neural fiber of the second thoracic sympathetic ganglion on the third rib is the most practical and minimally invasive treatment than other surgical methods. We were also to anticipated the distribution and degree of compensatory sweating by DITI precisely and objectively and for ascertaining the clinical usefulness.

Clinical Features of Enuresis in Children with Diabetes Mellitus (소아 당뇨병 환아에서 야뇨증의 임상적 특징)

  • Kim, Myoung-Uk;Kim, Sae-Yoon;Choi, Jung-Youn;Cho, Min-Hyun;Ko, Cheol-Woo;Kim, Heung-Sik;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.210-217
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    • 2010
  • Purpose : Diabetes mellitus (DM) is known as one of the common causes of secondary enuresis in children. However, enuresis in diabetic children is overlooked only as a symptom of polyuria due to hyperglycemia. We evaluated the prevalence of nocturnal enuresis in children with diabetes mellitus in this paper. Methods : Among children with diabetes in three hospitals in Daegu area, 117 agreed to 'Tele research by means of a questionnaire'. Results : Diabetic patients were divided into two groups: Nocturnal enuresis and nonnocturnal enuresis group. thirty-two of 117 (27.0%) patients were in enuresis group, with more daytime urination than non-nocturnal enuresis group ($4.2{\pm}1.6/3.6{\pm}1.2$ times, P=0.016). HbA1c at diagnosis was $12.0{\pm}2.3%/12.0{\pm}2.5%$, and at follow-up $9.3{\pm}2.3%/8.3{\pm}2.3%$ (P =0.042). Insulin was administered at $1.1{\pm}0.5/1.1{\pm}0.4$ units/kg/day. Ten children of enuresis (31.2%) group were monosymptomatic (MNE) and 22 (68.8%) children were non-monosymptomatic enuresis (non-MNE). Fourteen (43.8%) of enuresis group had persistent symptoms, with 5 MNE and 9 non-MNE each. HbA1c at diagnosis was $11.1{\pm}2.5$, $12.4{\pm}2.1$, higher in non-MNE (P=0.144). Average arousal during sleep was step $3.3{\pm}1.2$, $2.5{\pm}1.0$, higher in improved enuresis group (P=0.059). Conclusion : Nocturnal enuresis among DM patients is underestimated. However, considering psychological and social effects of enuresis in children, extensive and long-term studies are needed in the future to clarify relationship between prevalence and DM control.

Role of Citrate Synthase in Acetate Utilization and Protection from Stress-Induced Apoptosis

  • Lee, Yong-Joo;Kang, Hong-Yong;Maeng, Pil Jae
    • Proceedings of the Microbiological Society of Korea Conference
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    • 2008.05a
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    • pp.39-41
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    • 2008
  • The yeast Saccharomyces cerevisiae has been shown to contain three isoforms of citrate synthase (CS). The mitochondrial CS, Cit1, catalyzes the first reaction of the TCA cycle, i.e., condensation of acetyl-CoA and oxaloacetate to form citrate [1]. The peroxisomal CS, Cit2, participates in the glyoxylate cycle [2]. The third CS is a minor mitochondrial isofunctional enzyme, Cit3, and related to glycerol metabolism. However, the level of its intracellular activity is low and insufficient for metabolic needs of cells [3]. It has been reported that ${\Delta}cit1$ strain is not able to grow with acetate as a sole carbon source on either rich or minimal medium and that it shows a lag in attaining parental growth rates on nonfermentable carbon sources [2, 4, 5]. Cells of ${\Delta}cit2$, on the other hand, have similar growth phenotype as wild-type on various carbon sources. Thus, the biochemical basis of carbon metabolism in the yeast cells with deletion of CIT1 or CIT2 gene has not been clearly addressed yet. In the present study, we focused our efforts on understanding the function of Cit2 in utilizing $C_2$ carbon sources and then found that ${\Delta}cit1$ cells can grow on minimal medium containing $C_2$ carbon sources, such as acetate. We also analyzed that the characteristics of mutant strains defective in each of the genes encoding the enzymes involved in TCA and glyoxylate cycles and membrane carriers for metabolite transport. Our results suggest that citrate produced by peroxisomal CS can be utilized via glyoxylate cycle, and moreover that the glyoxylate cycle by itself functions as a fully competent metabolic pathway for acetate utilization in S. cerevisiae. We also studied the relationship between Cit1 and apoptosis in S. cerevisiae [6]. In multicellular organisms, apoptosis is a highly regulated process of cell death that allows a cell to self-degrade in order for the body to eliminate potentially threatening or undesired cells, and thus is a crucial event for common defense mechanisms and in development [7]. The process of cellular suicide is also present in unicellular organisms such as yeast Saccharomyces cerevisiae [8]. When unicellular organisms are exposed to harsh conditions, apoptosis may serve as a defense mechanism for the preservation of cell populations through the sacrifice of some members of a population to promote the survival of others [9]. Apoptosis in S. cerevisiae shows some typical features of mammalian apoptosis such as flipping of phosphatidylserine, membrane blebbing, chromatin condensation and margination, and DNA cleavage [10]. Yeast cells with ${\Delta}cit1$ deletion showed a temperature-sensitive growth phenotype, and displayed a rapid loss in viability associated with typical apoptotic hallmarks, i.e., ROS accumulation, nuclear fragmentation, DNA breakage, and phosphatidylserine translocation, when exposed to heat stress. Upon long-term cultivation, ${\Delta}cit1$ cells showed increased potentials for both aging-induced apoptosis and adaptive regrowth. Activation of the metacaspase Yca1 was detected during heat- or aging-induced apoptosis in ${\Delta}cit1$ cells, and accordingly, deletion of YCA1 suppressed the apoptotic phenotype caused by ${\Delta}cit1$ mutation. Cells with ${\Delta}cit1$ deletion showed higher tendency toward glutathione (GSH) depletion and subsequent ROS accumulation than the wild-type, which was rescued by exogenous GSH, glutamate, or glutathione disulfide (GSSG). Beside Cit1, other enzymes of TCA cycle and glutamate dehydrogenases (GDHs) were found to be involved in stress-induced apoptosis. Deletion of the genes encoding the TCA cycle enzymes and one of the three GDHs, Gdh3, caused increased sensitivity to heat stress. These results lead us to conclude that GSH deficiency in ${\Delta}cit1$ cells is caused by an insufficient supply of glutamate necessary for biosynthesis of GSH rather than the depletion of reducing power required for reduction of GSSG to GSH.

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A Study on the Village Improvement Plan by Typological Analysis of Greenbelt-lifted Villages (개발제한구역 해제취락 유형분석을 통한 취락정비방안 연구)

  • Yoon, Jeong-Joong;Choi, Sang-Hee
    • Land and Housing Review
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    • v.4 no.1
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    • pp.77-87
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    • 2013
  • About 1,800 villages have released from Greenbelt since Greenbelt-reform-policy for readjustment of the area was promoted after 1997. Even though the government intended to attract planned development & improvement of these lifted villages through District Unit Plan and designating the lifted area as low-rise and low-density zoning considering the characteristics of the Greenbelt region, there are still many problems to be solved: a lack of funds, insufficient capability for self-improvement and unexecuted SOCs in long-term etc. It seems that these problems are caused by focusing on the lifting areas itself instead of researching deeply the condition and characteristics of the villages and searching proper direction/plans of improvement before lifting Greenbelt In addition, the existing plan of village improvement and management was not considering physical and spacial characteristics of the areas, social and economic situation of residents and relationship between the villages and surrounding cities, though these conditions are different among each villages, and the related regulations are applied uniformly across all the villages and those have been causing many civil appeals and environmental problems. In these respects, this study aims to consider the problems of the lifted villages using the existing researches on them and to make typology by characteristics-data of the villages and to establish improvement strategies of each types. In this study, the villages were classified into 5 types as a result of cluster analysis on 424 villages among all 1,800 through variables of locational potentiality : location, accessibility, size and form of village, condition of regulations etc. According to function of the villages, they were divided into 4 types: urban-type, rural-type, industrial-type and neighborhood-centered-type. This study also drew 4 improvement-strategy-types by combination of locational potentiality and village-function : type of improving life-environment, type of improving production-infra, type of inducing-planned-improvement and type of constructing center-of living-circle. Finally, this study suggested the directions of the each 4 types to desirable improvement and management which could be used to make and complement plans for village improvement.

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

  • Park, Jee Min;Yoo, Eun Gyong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.646-653
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    • 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.

Flood Risk Estimation Using Regional Regression Analysis (지역회귀분석을 이용한 홍수피해위험도 산정)

  • Jang, Ock-Jae;Kim, Young-Oh
    • Journal of the Korean Society of Hazard Mitigation
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    • v.9 no.4
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    • pp.71-80
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    • 2009
  • Although desire for living without hazardous damages grows these days, threats from natural disasters which we are currently exposed to are quiet different from what we have experienced. To cope with this changing situation, it is necessary to assess the characteristics of the natural disasters. Therefore, the main purpose of this research is to suggest a methodology to estimate the potential property loss and assess the flood risk using a regional regression analysis. Since the flood damage mainly consists of loss of lives and property damages, it is reasonable to express the results of a flood risk assessment with the loss of lives and the property damages that are vulnerable to flood. The regional regression analysis has been commonly used to find relationships between regional characteristics of a watershed and parameters of rainfall-runoff models or probability distribution models. In our research, however, this model is applied to estimate the potential flood damage as follows; 1) a nonlinear model between the flood damage and the hourly rainfall is found in gauged regions which have sufficient damage and rainfall data, and 2) a regression model is developed from the relationship between the coefficients of the nonlinear models and socio-economic indicators in the gauged regions. This method enables us to quantitatively analyze the impact of the regional indicators on the flood damage and to estimate the damage through the application of the regional regression model to ungauged regions which do not have sufficient data. Moreover the flood risk map is developed by Flood Vulnerability Index (FVI) which is equal to the ratio of the estimated flood damage to the total regional property. Comparing the results of this research with Potential Flood Damage (PFD) reported in the Long-term Korea National Water Resources Plan, the exports' mistaken opinions could affect the weighting procedure of PFD, but the proposed approach based on the regional regression would overcome the drawback of PFD. It was found that FVI is highly correlated with the past damage, while PFD does not reflect the regional vulnerabilities.

The Multi-door Courthouse: Origin, Extension, and Case Studies (멀티도어코트하우스제도: 기원, 확장과 사례분석)

  • Chung, Yongkyun
    • Journal of Arbitration Studies
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    • v.28 no.2
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    • pp.3-43
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    • 2018
  • The emergence of a multi-door courthouse is related with a couple of reasons as follows: First, a multi-door courthouse was originally initiated by the United States government that increasingly became impatient with the pace and cost of protracted litigation clogging the courts. Second, dockets of courts are overcrowded with legal suits, making it difficult for judges to handle those legal suits in time and causing delays in responding to citizens' complaints. Third, litigation is not suitable for the disputant that has an ongoing relationship with the other party. In this case, even if winning is achieved in the short run, it may not be all that was hoped for in the long run. Fourth, international organizations such as the World Bank, UNDP, and Asia Development Bank urge to provide an increased access to women, residents, and the poor in local communities. The generic model of a multi-door courthouse consists of three stages: The first stage includes a center offering intake services, along with an array of dispute resolution services under one roof. At the second stage, the screening unit at the center would diagnose citizen disputes, then refer the disputants to the appropriate door for handling the case. At the third stage, the multi-door courthouse provides diverse kinds of dispute resolution programs such as mediation, arbitration, mediation-arbitration (med-arb), litigation, and early neutral evaluation. This study suggests the extended model of multi-door courthouse comprised of five layers: intake process, diagnosis and door-selection process, neutral-selection process, implementation process of dispute resolution, and process of training and education. One of the major characteristics of extended multi-door courthouse model is the detailed specification of individual department corresponding to each process within a multi-door courthouse. The intake department takes care of the intake process. The screening department plays the role of screening disputes, diagnosing the nature of disputes, and determining a suitable door to handle disputes. The human resources department manages experts through the construction and management of the data base of mediators, arbitrators, and judges. The administration bureau manages the implementation of each process of dispute resolution. The education and training department builds long-term planning to procure neutrals and experts dealing with various kinds of disputes within a multi-door courthouse. For this purpose, it is necessary to establish networks among courts, law schools, and associations of scholars in order to facilitate the supply of manpower in ADR neutrals, as well as judges in the long run. This study also provides six case studies of multi-door courthouses across continents in order to grasp the worldwide picture and wide spread phenomena of multi-door courthouse. For this purpose, the United States and Latin American countries including Argentina and Brazil, Middle Eastern countries, and Southeast Asian countries (such as Malaysia and Myanmar), Australia, and Nigeria were chosen. It was found that three kinds of patterns are discernible during the evolution of a multi-door courthouse model. First, the federal courts of the United States, land and environment court in Australia, and Lagos multi-door courthouse in Nigeria may maintain the prototype of a multi-door courthouse model. Second, the judicial systems in Latin American countries tend to show heterogenous patterns in terms of the adaptation of a multi-door courthouse model to their own environments. Some court systems of Latin American countries including those of Argentina and Brazil resemble the generic model of a multi-door courthouse, while other countries show their distinctive pattern of judicial system and ADR systems. Third, it was found that legal pluralism is prevalent in Middle Eastern countries and Southeast Asian countries. For example, Middle Eastern countries such as Saudi Arabia have developed various kinds of dispute resolution methods, such as sulh (mediation), tahkim (arbitration), and med-arb for many centuries, since they have been situated at the state of tribe or clan instead of nation. Accordingly, they have no unified code within the territory. In case of Southeast Asian countries such as Myanmar and Malaysia, they have preserved a strong tradition of customary laws such as Dhammthat in Burma, and Shriah and the Islamic law in Malaysia for a long time. On the other hand, they incorporated a common law system into a secular judicial system in Myanmar and Malaysia during the colonial period. Finally, this article proposes a couple of factors to strengthen or weaken a multi-door courthouse model. The first factor to strengthen a multi-door courthouse model is the maintenance of flexibility and core value of alternative dispute resolution. We also find that fund raising is important to build and maintain the multi-door courthouse model, reflecting the fact that there has been a competition surrounding the allocation of funds within the judicial system.

An Empirical Analysis of Fixed Asset Investment Smoothing Effects of Working Capital (운전자본의 고정자산투자 스무딩효과의 실증적 분석)

  • Shin, Min-Shik;Kim, Soo-Eun;Kim, Gong-Young
    • The Korean Journal of Financial Management
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    • v.25 no.4
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    • pp.25-51
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    • 2008
  • In this paper, we analyse empirically the fixed asset investment smoothing of working capital of firms listed on Korea Securities Market. The main results of this study can be summarized as follows. Firms will seek to lower long-term cost by smoothing fixed asset investment and maintaining stationary investment with working capital. Working capital is not only an important use of fund, but also a source of liquidity that should be used to smooth fixed asset investment relative to cash flow shocks if firms face financial constraints. Working capital investment is more sensitive than fixed asset investment to cash flow fluctuations. If firms face financial constraints, working capital investment will compete with fixed asset investment for the limited pool of available cash flows. So, fixed asset investment will have negative relationship with working capital investment. However, criticism that the positive correlation between cash flows and fixed asset investment could arise simply because cash flows is proxy variable for investment demand. Finally, controlling for the fixed asset investment smoothing effects of working capital results in a much larger estimate of the long run impact of financial constraints. Financial constraints is measured by dividend payout ratio and market access level. Fazzari et al. (1988), Fazzari and Petersen (1993), and Faulkender et al. (2008) emphasize that low dividend firms or market unaccessible firms are more likely to face financial constraints, and rarely make use of new equity issuing. The results from empirical analysis show that financial constraints can be better explained using 'adjustment cost' concept. Specifically, the results show that financial constraints exist and that in order to measure financial constraint effects more succinctly, fixed asset investment smoothing effects with working capital should be considered.

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Annual Variations of Litterfall Production in a Broadleaved Deciduous Forest at the Mt. Keumsan LTER Site (금산 장기생태연구 조사지 낙엽활엽수림 낙엽낙지량의 연변동)

  • Kim, Choonsig;Lim, Jong Hwan;Lee, Im Kyun;Park, Byung Bae;Chun, Jung Hwa
    • Journal of Korean Society of Forest Science
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    • v.102 no.2
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    • pp.210-215
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    • 2013
  • Litterfall production represents a major contribution of carbon and nutrient cycling in forest ecosystems. This study was carried out to determine the litterfall production in a broadleaved deciduous forest at the Mt. Keumsan Long Term Ecological Research (LTER) site, Southern Korea. Littefall was collected monthly or bimonthly from the site for 7 years from 2004 to2010. Leaf and reproductive (catkins) litters showed a seasonal variation, but litters of needle, branch, and barks were not changed across the seasons. Annual leaf litter of Quercus serrata and Carpinus laxiflora were significantly different (p<0.05) but that of C. cordata, Chamaecyparis obtusa, and Pinus thunbergii was not significantly changed for 7 years (p>0.05). Annual average litterfall production was 5,223 kg/ha, but annual variations were very large with minimum of 4,110 kg/ha/yr in 2004 and maximum of 6,002 kg/ha/yr in 2007. Total litterfall comprised of 2,323 kg/ha/yr in Q. serrata, 442 kg/ha/yr in C. laxiflora, 157 kg/ha/yr in C. cordata, 131 kg/ha/yr in Acer pseudosieboldianum, 390 kg/ha/yr in other deciduous tree species, 74 kg/ha/yr in P. thunbergii, 37 kg/ha/yr in C. obtusa, 672 kg/ha/yr in branches, 515 kg/ha/yr in miscellaneous, 448 kg/ha/yr in reproductive parts, and 54 kg/ha/yr in barks. respectively. The results indicate that litterfall production of the Mt. Keumsan LTER site was yearly fructurated with the positive linear relationship between leaf or total litterfall and annual mean temperature if no disturbance such as a typoon, and was lower than that of other Korean LTER sites.

Relation Among Parameters Determining the Severity of Bronchial Asthma (기관지천식 환자의 증상의 중증도를 나타내는 지표들간의 연관성)

  • Lee, Sook-Young;Kim, Seung-June;Kim, Seuk-Chan;Kwon, Soon-Suk;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.585-593
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    • 2000
  • Background : International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendation of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. Methods : This study examined the relationship between the symptom score and measurements of $FEV_1$ and PEF when expressed as a percentage of predicted values in asthmatics (n=107). Results : The correlation of $FEV_1$ % with PEFR% was highly significant (r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of $FEV_1$ % and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of $FEV_1$ % and symptom score. 39% of the patients classified as having moderate asthma on the basis of $FEV_1$ % recording would be considered to have severe asthma if symptom score alone were used. Low baseline $FEV_1$ and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. Conclusion : The relationships between the symptom score, PEFR and $FEV_1$ were generally poor. When assessing asthma severity, age, duration, $PC_{20}$, and baseline $FEV_1$ should be considered.

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