• Title, Summary, Keyword: L′Hospital rule

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EVALUATIONS OF THE IMPROPER INTEGRALS ${\int}_0^{\infty}$[sin$^{2m}({\alpha}x)]/(x^{2n})dx$ AND ${\int}_0^{\infty}$[sin$^{2m+1}({\alpha}x)]/(x^{2n+1})dx$

  • Qi, Feng;Luo, Qiu-Ming;Guo, Bai-Ni
    • The Pure and Applied Mathematics
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    • v.11 no.3
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    • pp.189-196
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    • 2004
  • In this article, using the L'Hospital rule, mathematical induction, the trigonometric power formulae and integration by parts, some integral formulae for the improper integrals ${\int}_0^{\infty}$[sin$^{2m}({\alpha}x)]/(x^{2n})dx$ AND ${\int}_0^{\infty}$[sin$^{2m+1}({\alpha}x)]/(x^{2n+1})dx$ are established, where m $\geq$ n are all positive integers and $\alpha$$\neq$ 0.

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A Study on the Correlation of Heart Rate Variability and Coldness of Hands (수부 냉증 정도와 Heart Rate Variability(HRV)의 상관성 연구)

  • Nam, Eun-Young;Yoo, Su-Jeoung;Kim, Hyung-Jun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.4
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    • pp.46-56
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    • 2015
  • Objectives : Cold hypersensitivity has been regarded to be associated with Autonomic Nervous System (ANS). This study aims to investigate the indicator of cold hypersensitivity of hands and evaluate the correlation between indicator of coldness of hands and Heart Rate Variability (HRV). Methods : We studied 55 patients with cold hypersensitivity of hands who visited in SeMyung University Hospital from 17 August 2015 to 21 August 2015. Thermometer and VAS scale were used for the diagnosis of cold hypersensitivity. After careful examination to rule out other disease which may affect thermometer and HRV data, patients were taken thermometer, those with thermal difference between upper arm (L4) and palm(P8), also asked to answer a VAS scale of cold hypersensitivity of hands, VAS more than 4 were enrolled for evaluation. Results : There was significant correlation between L4-P8 temperature difference and VAS score of cold hypersensitivity. In HRV data, normalized high frequency (HF normal) was significantly correlated with L4-P8 temperature difference, which was objective indicator of cold hypersensitivity of hands. Conclusions : L4-P8 temperature difference using thermometer is objective indicator of cold hypersensitivity, based on VAS scale. Cold hypersensitivity is highly related with ANS, regulating body heat and temperature. HRV is considered to be widely used in cold hypersensitivity in hands for evaluation of ANS.

Usefulness of the procalcitonin test in young febrile infants between 1 and 3 months of age

  • Lee, In Sul;Park, Young Jin;Jin, Mi Hyeon;Park, Ji Young;Lee, Hae Jeong;Kim, Sung Hoon;Lee, Ju Suk;Kim, Cheol Hong;Kim, Young Don;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.61 no.9
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    • pp.285-290
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    • 2018
  • Purpose: To study the usefulness of the procalcitonin (PCT) test in young febrile infants between 1 and 3 months of age. Methods: We evaluated the medical records of 336 febrile infants between 1 and 3 months of age who visited the Emergency Department or outpatient department of Samsung Changwon Hospital from May 2015 to February 2017, and analyzed the clinical characteristics between infants in the serious bacterial infection (SBI) group and non-SBI group. Results: Among the 336 infants, 38 (11.3%) had definitive SBI (bacteremia, n=3; meningitis, n=1; urinary tract infection, n=34). The mean PCT ($6.4{\pm}11.9ng/mL$) and C-reactive protein (CRP) level ($3.8{\pm}2.6mg/dL$), and the absolute neutrophil count (ANC) ($6,984{\pm}4,675$) for patients in the SBI group were significantly higher than those for patients in the non-SBI group (PCT, $0.3{\pm}1.2ng/mL$; CRP, $1.3{\pm}1.6mg/dL$; ANC, $4,888{\pm}3,661$). PCT had lower sensitivity (43.6%), but higher specificity (92.6%) and accuracy (86.9%) than CRP (92.3%, 25.3%, and 33.0%) for identifying SBI. The area under the receiver operating characteristic curves (AUCs) for definitive SBI were PCT 77.0%, CRP 80.8%, WBC 56.8%, ANC 67.8%, and PLT 48.1%. The AUCs for definitive SBI were PCT+CRP 85.4%, PCT+WBC 77.2%, PCT+ANC 81.3%, CRP+WBC 80.1%, and CRP+ANC 81.6%. Conclusion: Our results suggest that the PCT test or a combination of PCT and CRP tests is a more accurate and specific biomarker to detect and rule out SBIs.

Bioequivalence of Boryung Torsemide Tablet to Torem Tablet (Torasemide 10 mg) by High Performance Liquid Chromatography/UV Detector

  • Cho, Hea-Young;Kang, Hyun-Ah;Park, Chan-Ho;Kim, Se-Mi;Kim, Dong-Ho;Park, Sun-Ae;Kim, Kyung-Ran;Hur, Hyeon;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.35 no.5
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    • pp.323-328
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    • 2005
  • The purpose of the present study was to evaluate the bioequivalence of two torasemide tablets, Torem tablet (Roche Korea Co., Ltd., Korea, reference drug) and Boryung Torsemide tablet (Boryung Pharmaceutical Co., Ltd., Korea, test drug), according to the guidelines of Korea Food and Drug Administration (KFDA). After adding an internal standard (furosemide) to human serum, serum samples were extracted using 5 mL of ethyl acetate. Compounds were analyzed by reverse-phase HPLC method with UV detection. This method showed linear response over the concentration range of 0.05 ug/mL with correlation coefficient of 0.999. The lower limit of quantitation using 0.5 mL of serum was 0.05 ug/mL which was sensitive enough for pharmacokinetic studies. Twenty-eight healthy male Korean volunteers received each medicine at the torasemide dose of 20 mg in a $2{\times}2$ crossover study. There was a one-week washout period between the doses. Serum concentrations of torasemide were monitored by an HPLC-UV for over a period of 12 hr after the administration. $AUC_{t}$(the area under the serum concentration-time curve from time zero to 12 hr) was calculated by the linear trapezoidal rule method. $C_{max}$ (maximum serum drug concentration) and $T_{max}$ (time to reach $C_{max}$) were compiled from the serum concentration-time data. Analysis of variance was carried out using logarithmically transformed $AUC_{t}$ and $C_{max}$. No significant sequence effect was found for all of the bioavailability parameters indicating that the crossover design was properly performed. The 90% confidence intervals of the $AUC_{t}$ ratio and the $C_{max}$ ratio for Boryung Torsemide/Torem were log 0.97-10g 1.03 and log 0.93log 1.12, respectively. These values were within the acceptable bioequivalence intervals of log 0.80-log 1.25. Thus, the criteria of the KFDA guidelines for the bioequivalence was satisfied, indicating Boryung Torsemide tablet and Torem tablet are bioequivalent.

Effectiveness of Electroconvulsive Therapy Augmentation on Clozapine-Resistant Schizophrenia

  • Kim, Hye Sung;Kim, Se Hyun;Lee, Nam Young;Youn, Tak;Lee, Jeoung Hyuk;Chung, Seunghyun;Kim, Yong Sik;Chung, In Won
    • Psychiatry investigation
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    • v.14 no.1
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    • pp.58-62
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    • 2017
  • Objective This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. Methods Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. Results The average number of ECT sessions was $13.4({\pm}4.6)$. Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by $17.9({\pm}12.8)$ points (p=0.0384) on average, which represented a reduction of $25.5%({\pm}14.3)$. 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. Conclusion This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.

A Case of Severe Hypercalcemia Causing Acute Kidney Injury: An Unusual Presentation of Acute Lymphoblastic Leukemia

  • Hyun, Hye Sun;Park, Peong Gang;Kim, Jae Choon;Hong, Kyun Taek;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.21-25
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    • 2017
  • Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

Toxicokinetics of paraquat in Korean patients with acute poisoning

  • Kim, Hak-Jae;Kim, Hyung-Ki;Lee, Hwayoung;Bae, Jun-Seok;Kown, Jun-Tack;Gil, Hyo-Wook;Hong, Sae-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.1
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    • pp.35-39
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    • 2016
  • To conduct a kinetic study of paraquat (PQ), we investigated 9 patients with acute PQ intoxication. All of them ingested more than 20 ml of undiluted PQ herbicide to commit suicide and arrived at our hospital early, not later than 7 h after PQ ingestion. The urine dithionite test for PQ in all of the nine patients was strongly positive at emergency room. Blood samples were obtained every 30 min for the first 2~3 h and then every 1 or 2 h, as long as the clinical progression was stable among the patients for 30 h after PQ ingestion. The area under the plasma concentration-time curve ($AUC_{inf}$), which was extrapolated to infinity, was calculated using the trapezoidal rule. Toxicokinetic parameters, such as the terminal elimination half-life, apparent oral clearance, and apparent volume of distribution ($V_d/F$) were calculated. The maximum PQ concentration ($C_{max}$) and the time to reach maximum PQ concentration ($T_{max}$) were also obtained. Plasma PQ concentrations in nine patients were well described by a bi-exponential curve with a mean terminal elimination half-life of $13.1{\pm}6.8h$. $C_{max}$ and $AUC_{inf}$ were $20.8{\pm}25.7mg/l$ and $172.5{\pm}160.3h{\cdot}mg/l$, respectively. Apparent volume of distribution and apparent oral clearance were $50.9{\pm}61.3l/kg$ and $173.4{\pm}111.2l/h$, respectively. There were a significant correlation (r=0.84; p<0.05) between the PQ amount ingested and $C_{max}$. $AUC_{inf}$ also showed a significant correlation (r=0.83; p<0.05) with the PQ amount ingested. These correlations provide evidence that PQ has dose-linear toxicokinetic characteristics.

Effect of Butyrate on Adenovirus-Mediated Herpes Simplex Virus Thymidine Kinase Gene Therapy (Butyrate가 Adenoviral Vector로 이입한 Herpes Simplex Virus Thymidine Kinase 유전자치료에 미치는 영향)

  • Park, Jae-Yong;Kim, Jeong-Ran;Chang, Hee-Jin;Kim, Chang-Ho;Park, Jae-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.587-595
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    • 1998
  • Background: Recombinant adenovirus hold promise as vectors to carry therapeutic genes for several reasons: 1) they can infect both dividing and non-dividing cells; 2) they have the ability to directly transduce tissues in vivo; 3) they can easily be produced in high titer; and 4) they have an established record of safety as vaccination material. However, one of the major limitation in the use of adenoviruses is that transgene expression is quite short because adenovirusees insert their DNA genome episomally rather than by chromosomal integration, and an immune response against the virus destroys cells expressing the therapeutic gene. Since sodium butyrate has been reported to induce adenovirus-mediated gene expression, we hypothesized that treatment of tumor cells, transduced with herpes simples virus thymidine kinase(HSVtk) gene using adenoviral vector, with butyrate could augment the effect of gene therapy. Methods: We transduced HSVtk gene, driven by the cytomegalovirus promoter, into REN cell line(human mesothelioma cell line). Before proceeding with the comparison of HSVtk/ganciclovir mediated bystander killing, we evaluated the effect of butyrate on the growth of tumor cells in order to rule out a potential antitumor effect of butyrate alone, and also on expression of HSVtk gene by Western blot analysis. Then we determined the effects of butyrate on bystander-mediated cell killing in vitro. Results: There was no inhibition of growth of cells exposed to butyrate for 24 hours at a concentration of 1.5mM/L. Toxic effects were seen when the concentration of butyrate was greater than 2.0mM/L. Gene expression was more stable and bystander effect was augmented by butyrate treatment of a concentration of 1.5mM/L. Conclusion: These results provide evidence that butyrate can augment the efficiency of cell killing with HSVtk/GCV system by inducing transgene expression and may thus by a promising new approach to improve responses in gene therapy using adenoviral vectors.

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Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis (과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증)

  • Chung, Jae-Kyung;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.40-44
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    • 2011
  • Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

Analysis of Orthotropic Body Under Partial-Uniform Shear Load (부분(部分) 등분포(等分布) 전단하중(剪斷荷重)을 받는 이방성(異方性) 구조체(構造體)의 해석(解析))

  • Chang, Suk Yoon
    • Journal of The Korean Society of Civil Engineers
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    • v.4 no.1
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    • pp.1-10
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    • 1984
  • This dissertation presents an exact solution for the shearing and normal stresses of an orthotropic plane body loaded by a pairtial-uniform shear load. The solution satisfies the equilibrium and compatibility equations concurrently. An Airy stress function is introduced to solve the problem related to an orthotropic half-infinite plane under a partial-uniform shear load. All the equations for orthotropy must be degenerated into the expressions for isotropy when orthotropic constants are replaced by isotropic ones. The author has evaluated all the equations of orthotropy and succeeded in obtaining exactly identical expressions to the equations of isotropy which were derived independently by means of L'hospital's rule. The analytical results of, isotropy ate compared with the simple results of other investigator. Since a concentrated shear load is a particular case of partial-uniform shear load, all the equations of partial-uniform shear load case are degenerated into the expressions for concentrated load case of isotropy and orthotropy. The formal solution is expressed in terms of closed form. The numerical results for orthotropy are evaluated for two kinds and two different orientations of the grain of wood. The type of wood considered are three-layered plywood and laminated delta wood. The distribution of normal and shearing stresses are shown in figures. It is noted that the distribution of stresses of orthctropic materials dependson the type of materials and orientations of the grain.

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