Post-stroke atrial fibrillation has been frequently reported especially in the patients with right insular infarct as an evidence of cerebrogenic mechanism affecting on cardiac rhythm. However, conversion to normal sinus rhythm after stroke in patients who had atrial fibrillation has not been reported. A 88-year-old men who had untreated atrial fibrillation was admitted to hospital due to left middle cerebral artery territory infarction. During admission, second ischemic attack occurred in right middle cerebral artery territory. At that time, his atrial fibrillation converted spontaneously to normal sinus rhythm. Restored sinus rhythm sustained until he died due to sepsis. This case is evidence supporting a theory that brain is associated with control of cardiac rhythm. If no risk factor is revealed by intensive investigation in patients with acute cerebral infarctions that cardioembolism is strongly suspected as a cause, physicians should concern transformation of atrial fibrillation to normal sinus rhythm after stroke.
Giresini, Linda;Sassu, Mauro;Butenweg, Christoph;Alecci, Valerio;De Stefano, Mario
Earthquakes and Structures
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v.12
no.4
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pp.409-423
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2017
This paper proposes a quick and simplified method to describe masonry vaults in global seismic analyses of buildings. An equivalent macro-element constituted by a set of six trusses, two for each transverse, longitudinal and diagonal direction, is introduced. The equivalent trusses, whose stiffness is calculated by fully modeled vaults of different geometry, mechanical properties and boundary conditions, simulate the vault in both global analysis and local analysis, such as kinematic or rocking approaches. A parametric study was carried out to investigate the influence of geometrical characteristics and mechanical features on the equivalent stiffness values. The method was numerically validated by performing modal and transient analysis on a three naves-church in the elastic range. Vibration modes and displacement time-histories were compared showing satisfying agreement between the complete and the simplified models. This procedure is particularly useful in engineering practice because it allows to assess, in a simplified way, the effectiveness of strengthening interventions for reducing horizontal relative displacements between vault supports.
Purpose - This paper investigates the theories and practices of Most-Favored-Nation (MFN) clauses. The MFN clause became a controversial issue during the past two decades, especially in the context of investment arbitration. This paper aims to clarify a reasonable way to apply MFN clauses. It in particular focuses on the territoriality requirements and the scope of investment activity which are common features included in most of investment treaties. Design/methodology - This paper analyses two investment arbitration cases, Ansung Housing and Beijing Urban Construction. Through the case study, this paper reveals limitations of the currently dominant views on the operation of MFN clauses. It then tries to reconstruct the system of MFN application within the relevant arbitration principles. Findings - Tribunals of recent investment arbitration as represented in the two cases above employed strict literal interpretation of the treaty provisions, especially of the phrase "in its territory". This paper finds a more functional interpretation is appropriate and consistent with theories of public international law and developments of global economy. Originality/value - Existing studies either stuck to literal interpretation or suggested more flexible interpretation of the phrase "in its territory" without full explanation. This paper tries to fill the gap in the existing discussion by analyzing legal foundations and theoretical structure for an effective interpretation of MFN clauses.
The education will boil from daily life and as doing desirably, Nammyung emphasized. This fact all people importantly from education, to think. But recognizes this problem the center of life and study of oneself and the case which indicates writes. Nammyung led and recognized the importance of daily life from education. The life of the human being becomes more distant from daily life and when being absorbed in being external makes a valuable territory lose from life. When with the same interest of education becomes more distant from daily life of life, the education makes the meaning lose. When meaning the education is embodied from if human life, must have an educational interest in daily life. And works from the daily life which is repeated, meeting, association, dialogue and relationship, introspection etc. must become the interest territory of education, the education must devise is value from daily life the possibility of experiencing in order to be. Because the work which is ordinary, meeting from ordinary, with human relation and association dialogs, reflective etc. to compose a life. When the education excepts a daily life consequently, will not be able to give the value which is important in life. When saying conclusively, the education must escape from the fact that considers seriously a knowledge acquisition and a compensation. And the education must do to make a value the people experience rather from daily life. The resultant education will be able to accomplish the essential function of the education which loses, daily life will be valuable and there is a possibility which to make feel will do. With being like that, education could be reconciled with the people.
The NDVI(normalized difference vegetation index) dataset is unique or main tool to assess the global, multi seasonal, multi annual, and multi spectral changes over the World. These features are useful for environmental studies in particular, for the vegetation coverage monitoring of the country as Mongolia, where are large pastureland and pastoral animal husbandry, which dependent on natural conditions. Pasture vegetation cover is changing accordingly with both of global climate change and anthropogenic effect or human impacts. Using past 20 years (1982-2001) NDVI derived from NOAA satellite, its dynamical trend has been decreased in all natural zones differently. Also applied the method named "Two Years Differences" which could calculate the number of years with increased or decreased NDVI values at the same place. From May to September have occurred the 9 years maximum decreases of NDVI over Mongolia, but it obtained differently in spatial and temporal scale. In 24.4 ? 32.7% of all territory occurred one year decrease of NDVI and in 18% occurred more than 3 years frequent decrease of NDVI. According to the linear trend of NDVI and in 18% occurred more than 3 years frequent decrease of NDVI dynamics over 69% of whole territory of Mongolia NDVI values had been decreased due to both natural and human induced impacts to the pasture condition. In this paper also included some results of the integrated analyses of NOAA/NDVI and ground truth data over Monglia separately by natural zones.
Proceedings of the Korea Water Resources Association Conference
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2020.06a
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pp.78-78
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2020
The Se San and Srepok river basins (2S) are the two major tributaries of the Mekong River, both of which originate in the territory of Viet Nam and flow to Cambodia to meet at Stung treng with the Sekong river (originating in Lao PDR) to form the 3S river basin before joining the Mekong mainstream. In the territory of Viet Nam, the 2S river basins are located in the Central Highlands including 5 provinces, arranged by geographical location from north to south namely Kon Tum, Gia Lai, Dak Lak, Dak Nong and Lam Dong. This is a region with a very important strategic position in terms of economy, politics and defense for the whole country with many potential advantages for economic development. However, the limited and vulnerable basin water resources are under the pressure of socio-economic development in line with increasing water demands for various sectors. In order to overcome the water management challenges, a long-term water resources planning has conducted to support the 2S River Basin Committee (RBC) in effective planning and operation as part of the WB Mekong-Integrated Water Resources Management (IWRM) Project. This paper introduces the outline and progress of the river basin planning using analytical DSS toolkits to analyze, evaluate and formulate the planning options.
Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.
Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Lee, Chang-Young
Nuclear Medicine and Molecular Imaging
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v.43
no.4
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pp.280-286
/
2009
Purpose: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. Materials and Methods: Eight patients (3 men and 5 women, 64.8$\pm$10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. Results: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1$\pm$2.2 ml/min/100 g and -2.1$\pm$2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3$\pm$2.9 ml/min/100 g, p =0.025 and 0.1$\pm$1.3%, p =0.036). Conclusion: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPEG would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.
This paper examines Jang Hyeongwang's cultural awareness and the way of practice by focusing on his spirit of humanities in relation to the understanding of territory and bibliographic materials. In fact, this starts from conflicting evaluations on Jang Hyeongwang's way of learning in the field of Korean history. Jang Hyeongwang emphasizes realization of humanity, which is considered as basic framework of culture. He claims the indivisibility of Dao(道) and culture(mun文) by arguing that almighty principle of Dao manifests itself through phenomena of culture. In other words, Dao is the root of culture and, at the same time, culture is the necessary element of making Dao valuable. Furthermore, he insists that realization of human culture is the gist of manifesting the pattern of nature. In this vein, the roles of human beings are so important in creating humanistic civilization. He considers all kinds of human affairs as the contents of humanistic culture, which are contained in six classics. Especially, He says that the moral is reality of human culture and that literature is a literal expression of humanistic spirit. Thus, he criticizes that there are literatures without moral practices. He pays a special attention to his indigenous culture. He links the cultural understanding of geography, which is the foundation of realizing humanistic spirit, to awareness of Korean territory and grasps the territory in the light of topography of geographic power. Thus, he defines it as "Central Field" which bears comparison with China (middle kingdom). With the positive understanding of his country, he insisted that Korean indigenous culture and custom are as much advanced as China and was so proud of the moral characters and norms that Korean people had formed so far. Moreover, Jang truly exhibited affection to Korean literature, which had formed through Korean history. Kim Hyu, one of his students, activates Jang's will to preservation of Korean culture. Over twenty years, Kim completed Collected Record of Korean Literatures(haedong munhon ch'ongnok 海東文獻總錄). Actually, he started the preparatory works for compiling them. We should keep in mind that this compilation was completed following Japanese Invasion of Korea in 1592. It means that he has cultural awareness of preserving Korean literal heritages. Hence, it can be evaluated as the results of the enhancement of national studies. We have seen that He truly highlights realization of humanistic spirit by insisting the practices of moral values. In fact, his mind is linked to genuine affection to Korean territory, culture and literatures. Such affection can be paraphrased as moral awareness of humanity and its practices. In conclusion, his humanistic spirit should be understood as strong belief on universality of human morality. His cultural awareness of homeland and the will to practices should be considered as cultural pride of Korean intellectual traditions rather than following Chinese culture blindly.
The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age $55{\pm}7$ yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the % stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the "myocardial ischemic score" (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD ($\geq50%$ coronary stenosis by angiography) by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel deseases. Overall sensitivity was 97%. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70% for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCX lesions (kappa : 0.32). There were siginificant correlations between the MIS and SDE in LAD (rs=0.56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0.0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.
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