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A comparative review of epinephrine and phenylephrine as vasoconstrictors in dental anesthesia: exploring the factors behind epinephrine's prevalence in the US

  • Navkiran Deol;Gerardo Alvarez;Omar Elrabi;Gavin Chen;Nalton Ferraro
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.293-302
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    • 2023
  • This review paper delves into the comparative study of epinephrine and phenylephrine as vasoconstrictors in dental anesthesia, exploring their histories, pharmacological properties, and clinical applications. The study involved a comprehensive literature search, focusing on articles that directly compared the two agents in terms of efficacy, safety, and prevalence in dental anesthesia. Epinephrine, with its broad receptor profile, has been a predominant choice, slightly outperforming in the context of prolonging dental anesthesia and providing superior hemostasis, which is crucial for various dental procedures. However, the stimulation of beta-adrenergic receptors caused by epinephrine poses risks, especially to patients with cardiovascular conditions. Phenylephrine, a selective alpha-1 adrenergic agonist, emerges as a safer alternative for such patients, avoiding the cardiovascular risks associated with epinephrine. Moreover, its vasoconstrictive effect may not be as deleterious as that of epinephrine, due to its selective action. This review reveals that despite the potential benefits of phenylephrine, epinephrine continues to dominate in clinical settings, due to its historical familiarity, availability, and cost-effectiveness. The lack of commercially available pre-made phenylephrine dental carpules in most countries, except Brazil, and a knowledge gap within dental academia regarding phenylephrine, contribute to its limited use. This review concludes that while both agents are effective, the choice between them should be based on individual patient conditions, availability, and the practitioner's knowledge and familiarity with the agents. The underuse of other vasoconstrictors like levonordefrin and the unavailability of phenylephrine in pre-mixed dental cartridges in many countries highlights the need for further exploration and research in this field. Furthermore, we also delve into the role of levonordefrin and examine the rationale behind the exclusion of phenylephrine from commercially available pre-mixed local anesthetic carpules, suggesting a need for a responsive approach from pharmaceutical manufacturers to the distinct needs of the dental community.

SARS-CoV-2 Delta (B.1.617.2) Variant: A Unique T478K Mutation in Receptor Binding Motif (RBM) of Spike Gene

  • Hyunjhung Jhun;Ho-Young Park;Yasmin Hisham;Chang-Seon Song;Soohyun Kim
    • IMMUNE NETWORK
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    • v.21 no.5
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    • pp.32.1-32.14
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    • 2021
  • Over two hundred twenty-eight million cases of coronavirus disease 2019 (COVID-19) in the world have been reported until the 21st of September 2021 after the first rise in December 2019. The virus caused the disease called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Over 4 million deaths blame COVID-19 during the last one year and 8 months in the world. Currently, four SARS-CoV-2 variants of concern are mainly focused by pandemic studies with limited experiments to translate the infectivity and pathogenicity of each variant. The SARS-CoV-2 α, β, γ, and δ variant of concern was originated from United Kingdom, South Africa, Brazil/Japan, and India, respectively. The classification of SARS-CoV-2 variant is based on the mutation in spike (S) gene on the envelop of SARS-CoV-2. This review describes four SARS-CoV-2 α, β, γ, and δ variants of concern including SARS-CoV-2 ε, ζ, η, ι, κ, and B.1.617.3 variants of interest and alert. Recently, SARS-CoV-2 δ variant prevails over different countries that have 3 unique mutation sites: E156del/R158G in the N-terminal domain and T478K in a crucial receptor binding domain. A particular mutation in the functional domain of the S gene is probably associated with the infectivity and pathogenesis of the SARS-CoV-2 variant.

A Study on Trade Structure between MERCOSUR and Korea (남미공동시장(MERCOSUR)과 한국의 교역구조에 관한 연구)

  • Chong-Suk Park
    • Asia-Pacific Journal of Business
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    • v.14 no.4
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    • pp.371-385
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    • 2023
  • Purpose - The purpose of this study is to analyze Korea's trade relations centered on the MERCOSUR, a major economic integration in Latin America, and identify its problems and suggest measures that can be taken by the government and corporations to reinforce economic cooperation. Design/methodology/approach - To improve the level of contribution of the study, an empirical analysis is necessary. However, due to limited data access, the study will approach the topic of trade relations between Korea and the MERCOSUR with various statistics and literature. Findings - First, there is an urgent need for changes in import-export goods between Korea and the MERCOSUR, as trade is focused on specific items. Second, although foreign direct investment from Korea to the MERCOSUR is centered in manufacturing and mining industries, there should be different investment strategies by countries and industries. Third, it is necessary to reinforce commercial cooperation. Korea currently has Free Trade Agreements with Chile, Peru, and Columbia, but not with MERCOSUR. Therefore, Korea must take active measures to sign an TA with MERCOSUR, which has been put on hold. Research implications or Originality - Latin America has the most thriving market when it comes to Free Trade Agreements worldwide. MERCOSUR is a South American Trade Bloc established by the Treaty of Asunción in 1991 and Protocol of Ouro Preto in 1994. Its full members are Brazil, Argentina, Uruguay and Paraguay. However, there is still a lack of research on the MERCOSUR, and corporations that aim to enter the Latin American market face difficulties due to lack of information. By investigating MERCOSUR and its prospects and analyzing the trade relations with Korea, this study will provide strategic measures for corporations that wish to enter the Latin American market.

A study of Development of Transmission Systems for Terrestrial Single Channel Fixed 4K UHD & Mobile HD Convergence Broadcasting by Employing FEF (Future Extension Frame) Multiplexing Technique (FEF (Future Extension Frame) 다중화 기법을 이용한 지상파 단일 채널 고정 4K UHD & 이동 HD 융합방송 전송시스템 개발에 관한 연구)

  • Oh, JongGyu;Won, YongJu;Lee, JinSeop;Kim, JoonTae
    • Journal of Broadcast Engineering
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    • v.20 no.2
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    • pp.310-339
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    • 2015
  • In this paper, the possibility of a terrestrial fixed 4K UHD (Ultra High Definition) and mobile HD (High Definition) convergence broadcasting service through a single channel employing the FEF (Future Extension Frame) multiplexing technique in DVB (Digital Video Broadcasting)-T2 (Second Generation Terrestrial) systems is examined. The performance of such a service is also investigated. FEF multiplexing technology can be used to adjust the FFT (fast Fourier transform) and CP (cyclic prefix) size for each layer, whereas M-PLP (Multiple-Physical Layer Pipe) multiplexing technology in DVB-T2 systems cannot. The convergence broadcasting service scenario, which can provide fixed 4K UHD and mobile HD broadcasting through a single terrestrial channel, is described, and transmission requirements of the SHVC (Scalable High Efficiency Video Coding) technique are predicted. A convergence broadcasting transmission system structure is described by employing FEF and transmission technologies in DVB-T2 systems. Optimized transmission parameters are drawn to transmit 4K UHD and HD convergence broadcasting by employing a convergence broadcasting transmission structure, and the reception performance of the optimized transmission parameters under AWGN (additive white Gaussian noise), static Brazil-D, and time-varying TU (Typical Urban)-6 channels is examined using computer simulations to find the TOV (threshold of visibility). From the results, for the 6 and 8 MHz bandwidths, reliable reception of both fixed 4K UHD and mobile HD layer data can be achieved under a static fixed and very fast fading multipath channel.

Microbe Hunting: A Curious Case of Cryptococcus

  • Bartlett, Karen H.;Kidd, Sarah;Duncan, Colleen;Chow, Yat;Bach, Paxton;Mak, Sunny;MacDougall, Laura;Fyfe, Murray
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2005.06a
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    • pp.45-72
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    • 2005
  • C. neoformans-associated cryptococcosis is primarily a disease of immunocompromised persons, has a world-wide distribution, and is often spread by pigeons in the urban environment. In contrast, C. gattii causes infection in normal hosts, has only been described in tropical and semi-tropical areas of the world, and has a unique niche in river gum Eucalyptus trees. Cryptococcosis is acquired through inhalation of the yeast propagules from the environment. C. gattii has been identified as the cause of an emerging infectious disease centered on Vancouver Island, British Columbia, Canada. No cases of C. gattii-disease were diagnosed prior to 1999; the current incidence rate is 36 cases per million population. A search was initiated in 2001 to find the ecological niche of this basidiomycetous yeast. C. gaftii was found in the environment in treed areas of Vancouver Island. The highest percentage of colonized-tree clusters were found around central Vancouver Island, with decreasing rates of colonization to the north and south. Climate, soil and vegetation cover of this area, called the Coastal Douglas fir biogeoclimatic zone, is unique to British Columbia and Canada. The concentration of airborne C. gattii was highest in the dry summer months, and lowest during late fall, winter, and early spring, months which have heavy rainfall. The study of the emerging colonization of this organism and subsequent cases of environmentally acquired disease will be informative in planning public health management of new routes of exposure to exotic agents in areas impacted by changing climate and land use patterns. Cryptococcosis is an infection associated with an encapsulated, basidiomycetous yeast Cryptococcus neoformans. The route of entry for this organism is through the lungs, with possible systemic spread via the circulatory system to the brain and meninges. There are four cryptococcal serogroups associated with disease in humans and animals, distinguished by capsular polysaccharide antigens. Cryptococcus neoformans: variety grubii (serotype A), variety neoformans (serotype D), and variety gattii (serotypes B and C) (Franzot et at. 1999). C. neoformans variety gattii has recently been elevated to species status, C. gattii. C. neoformans val. grubii and var. neoformans have a world-wide distribution, and are particularly associated with soil and weathered bird droppings. In contrast, C. gattii (CG) is not associated with bird excrement, is primarily found in tropical and subtropical climates, and has a restricted environmental niche associated with specific tree species. (Ellis & Pfiffer 1990) Ellis and Pfeiffer theorize that, as a basidiomycete, CG requires an association with a tree in order to become pathogenic to mammals. In Australia, CG has been found to be associated with five species of Eucalypts, Eucalyptus camaldulensis, E. tereticornis, E. blakelyi, E. gomphocephala, and E. rudis. Eucalypts, although originally native to Australia, now have a world-wide distribution. CG has been found associated with imported eucalypts in India, California, Brazil, and Egypt. In addition, in Brazil and Columbia, where eucalypts have been naturalized, native trees have been shown to harbour CG (Callejas et al. 1998; Montenegro et al. 2000). In British Columbia, Canada, since the beginning of 1999, there have been 120 confirmed cases of cryptococcal mycoses associated with CG in humans, including 4 fatalities (data from British Columbia Centre for Disease Control), and over 200 cases in animal pets in BC (data from Central Laboratory for Veterinarians). What is remarkable about the BC outbreak of C. gattii-cryptococcosis is that all of the cases have been residents of, or visitors to, a narrow area along the eastern coast of Vancouver Island, BC, from the tip of the island in the south (Victoria) to Courtenay on the north-central island as illustrated in Figure 1. Of the first 38 human cases, 58% were male with a mean age of 59.7 years (range 20 - 82): 36 cases (95%) were Caucasian. Ten cases (26%) presented with meningitis, the remainder presented with respiratory symptoms. Cultures recovered from cases of cryptococcosis associated with the outbreak were typed as serogroup B, which is specific to CG (Bartlett et al. 2003). This was the first reported outbreak of CVG in Canada, or indeed, the world. Where infection with CG is endemic, for example, Australia, the incidence of cryptococcosis ranges from 1.8 - 4.7 per million between the southern and northern states (Sorrell 2001). However, the overall incidence of cryptococcosis in immunocompenent individuals has been estimated at 0.2 per million population per year (Kwon-Chung et al. 1984). The population of Vancouver Island is approximately 720,000,consequently, even if the organism were endemic, one would expect a maximum of 0.15 cases of cryptococcal disease annually.

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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.

Cytotoxic Effect and Protein Expression by Korean Regional Propolis on HeLa Ovarian Cancer Cell Line (HeLa 암세포주에 대한 국산 프로폴리스의 독성 효과 및 단백질 발현 변화)

  • Kim, Sung-Kuk;Woo, Soon Ok;Han, Sang Mi;Kim, Se Gun;Bang, Kyung Won;Kim, Hyo Young;Choi, Hong Min;Moon, Hyo Jung
    • Journal of Apiculture
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    • v.34 no.3
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    • pp.245-254
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    • 2019
  • We investigated the anti-tumor effects and molecular mechanism of Brazil, China and Korean regional propolis on HeLa ovarian cancer cell line. Each propolis extracts was prepared by ethanol extraction method. Cytotoxicity of propolis extracts was determinated by EZ-cytox cell viability assay. To necessity of anti-tumor effect and molecular mechanism of propolis, we must be adjusting propolis concentration. Due to 100 ㎍/mL of propolis extract were reduced cell viability to less than 50%, we adjusted all of propolis concentration to 100 ㎍/mL. By Western blotting analysis, we confirmed that anti-tumor mechanism of Brazil, China and Korea regional propolis has significantly difference. All of propolis was activated apoptosis related molecules such as PARP, caspase-3. However, cell proliferation signaling molecules including Akt1, ERK and Bcl-2 were reduced the protein expression level. Especially, the expression of tumor suppressor protein p53 was significantly increased in propolis-treated group such as Gyeonggi, Chungbuk, Chungnam, Jeonbuk, Gyeongnam and China. The phosphorylation of Bax which as apoptosis indicator was appeared in propolis-treated group such as Gyeonggi, Gangwon, Chungnam, Gyeongbuk, China. In this results showed that the regional propolis has completely different mechanism in anti-tumor. Thus, propolis extracts may be useful source of functional materials on anti-cancer and it will be able to choose the suitable propolis for cancer therapy by analyzing individual characteristics.

A Study on the Trend of Stone Industry and Residue (석재 산업 및 부산물 동향 조사)

  • Chea, Kwang-Seok;Lee, Young Geun;Koo, Namin;Youn, Hojoong;Lim, Jong-Hwan
    • Korean Journal of Mineralogy and Petrology
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    • v.35 no.1
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    • pp.1-12
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    • 2022
  • Stone has been used for various purposes, such as for building stones, megaliths, ornamental stones, hunting and grinding throughout history. The global stone production amounted to around 153 million tons in 2018 excluding quarry waste, up 0.8% on year. Of them, stone residues accounted for 71%. The worldwide stone trading decreased 1.5 million tons to 56.5 million tons in 2018. The average price of stone was 34.1 USD per square meter, down 2.5% from the previous year. It's down 7% when only considering trading between the world's top twelve exporters. But in the three leading countries, Italy, Greece and Brazil, the price saw a sharp increase. In 2018, stone imports and exports totaled 815 million square meters, raising over 20 billion USD of revenue. Imports were largely led by six countries: China, Italy, Turkey, India, Brazil, Spain and Portugal, from largest to smallest.) In terms of stone use per 1,000 population, it was 117 square meters in 2001, and it increased to 264 square meters in 2017 and 266 square meters in 2018. The volume more than doubled during the period, but it has been declining slightly in recent years. China, India, Saudi Arabia and Belgium were the only countries that the stone use per 1,000 population exceeded 1,000 square meters. The increase rate was steepest in China, India and the United States, from largest to smallest. The global stone production is likely to grow to 69.85 million tons by 2025, despite the global economic downturn.

Dyeing Properties of Yerba Mate Tea on the Fabrics (마테차를 이용한 직물의 염색성)

  • Yoo, Hye-Ja;Jeon, Sung-Taek
    • Journal of the Korean Society of Clothing and Textiles
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    • v.36 no.4
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    • pp.412-421
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    • 2012
  • The yerba mate that grows in the subtropical forests of South America is an evergreen tree within the Aquifoliaceae family. The yerba mate (Ilex paraguariensis) tea is habitually used as a drink in Argentina, Paraguay, Uruguay, and Southern Brazil. A wild mate tree needs about 25 years to fully grow to 15 a height of meters; however, they only grow to a height of 3-5 meters when cultivated. The leaves are 7-11 cm long and 3-5cm wide with a serrated margin. Yerba mate tea-based beverages are made from the leaves and stems of the mate tree. It is known that they contain a rich content of antioxidants and polyphenol, vitamins, amino acids, minerals and colorants. Dyeing properties of a mate plant in the silk, wool, linen and cotton fabrics were investigated. Constituents of colorant of mate tea are chlorophyll and carotinoid; in addition, it has more minerals such as (Fe, Ca, Mn, Mg, Na, K, Zn, and Cu) than green tea. Mate tea colorants showed good affinity to silk and wool fabrics. It was found that the optimum condition for dyeing was 30 minutes for dyeing time, 7 for pH of dyebath, and at a dyeing temperature of $80^{\circ}C$. The maximum absorbance wavelength (${\lambda}_{max}$) of silk and wool fabrics dyed with mate tea were at 420-440nm; however, that of linen and cotton fabrics were at 400nm. K/S values of fabrics dyed under optimum conditions were 1.979 for silk fabrics, 1.541 for wool fabrics, 0.551 for linens and 0.465 for cotton fabrics. Munsell hue values of dyed fabrics measured 3.1Y-6.4GY for silk, 1.4Y-8.3Y for wool, 5.5Y-3.7GY for linen, and 5.3Y-1.3GY for cotton. All dyed fabrics showed hues in-between greenish yellow and greenyellow. Colorfastness to rubbing, perspiration and dry-cleaning of dyed fabrics with mate tea were very good; however, the grades of colorfastness to washing of dyed linen and cotton fabrics were poor, and colorfastness to light were poor.

A Study on the Regional Policy for Promoting the Creation of Technology Based Innovation Firms (기술혁신형 중소기업의 창업환경 조성방안)

  • Lee, J.H.;Bae, B.Y.
    • Korean Business Review
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    • v.21 no.1
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    • pp.91-117
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    • 2008
  • Since the late 20th century, due to the globalization of markets and the rapid developments of information and communication technologies, the world has entered into the age of fierce competition. With their abundant low-cost labor, former communist countries such as China, Russia and East Europe and former low-developed countries such as India and Brazil have received foreign investments from major industrial companies. Thus, there are no other alternatives remained for Korea and OECD countries other than moving the industrial economies to the knowledge based innovation systems. In the knowledge based innovation systems, economic developments and employments of regions and nations depend solely on companies situated in their territories. In this article, after reviewing the current state of technological based innovation small firms in korea, we provide a theoretical framework to promote the level of technology based innovation and entrepreneurship. The theoretical framework for analysis and policy suggestions is based on the Schumpeter's value system model that consist of supply factors, demand factors, and supporting institutions. In order to create more innovative small businesses, we insist on the followings. First, more R&D and innovation activities related with promising new technologies should be performed. Second, more R&D funds for technological innovation small companies should be provided from governments. Third, more M&A transactions and technology transactions should be marketed freely and competitively. Fourth, more business incubating services and venture capital services should be provided. Fifth, entrepreneurship and innovation culture should be popular and institutionized among people.

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