• Title/Summary/Keyword: Pain

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Evaluation of usefulness for Stereotactic Partial Breast Irradiation(S-PBI) by using Surface Fiducial Marker (표면위치표지자를 적용한 정위적 부분유방방사선치료의 유용성 평가)

  • Kim, JongYeol;Jung, DongMin;Kim, SeYoung;Yoo, HyunJong;Choi, JungHoan;Park, HyoKuk;Baek, JongGeol;Lee, SangKyu;Cho, JeongHee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.99-108
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    • 2021
  • Purpose: The goal of this study is to evaluate usefulness of noninvasive method instead of previous inserting Fiducial Marker Method when performing Stereotactic Partial Breast Irradiation in CyberKnife. Material and methods: For consistency of Imaging Center, we evaluated both oblique images at angle 45 and 315 acquired from 2D Simulator and CyberKnife quantitatively through dice similarity coefficient. Also, location reproducibility of Surface Fiducial Marker was analyzed from 2D Simulator, treatment plans and CyberKinfe images by using 8 Fiducial Markers made of gold attached to ATOM Phantom based on our institution's protocols. Results: The results of the estimated consistency were 0.87 and 0.9 at the oblique angle 45 and 315, respectively. For location consistency of Surface Fiducial Markers, values of horizontal vertical direction of left breast were Superior/Inferior 0.3 mm, Left/Right -0.3 mm, Anterior/Posterior 0.4 mm, and the values of rotational direction were Roll 0.3 °, Pitch 0.2 °, Yaw 0.4 °. The values of horizontal vertical direction of right breast were Superior/Inferior -0.1 mm, Left/Right -0.1 mm, Anterior/Posterior -0.1 mm, and the values of rotational direction were Roll 0.2°, Pitch 0.1°, Yaw 0.1°. Conclusions: We expect that the protocols used by Surface Fiducial Markers when performing Stereotactic Partial Breast Irradiation in CyberKnife will provide protection from pain and cut expenses for treatment and reduce treatment errors and make treatment more accurate by suggesting treatment protocols based on high consistency of Imaging Center and reproducibility of Fiducial Markers.

Outcome of Conservative Treatment of the Zone I, II 5th Metatarsal Base Fracture under Early Weight-Bearing (제5 중족골 제1, 2 구역 골절의 조기 체중부하의 비수술적 치료 결과)

  • Gwak, Heui-Chul;Park, Dae-Hyun;Kim, Jung-Han;Lee, Chang-Rack;Kwon, Yong-Uk;Kim, Dong-Seok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.150-156
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    • 2021
  • Purpose: To determine how the location, displacement, intra-articular involvement, comminution of a 5th metatarsal base fracture affect results of early weight-bearing treatment. Materials and Methods: From January 2013 to July 2017, 34 cases of 34 patients diagnosed with a fracture of the zone I and II 5th metatarsal base were enrolled. The mean follow-up period was 13 months (6-15 months). One patient was excluded as a refracture during the follow-up period, and 33 patients underwent conservative treatment. Anteroposterior, lateral, and simple oblique radiography and computed tomography of the foot were performed to evaluate the location and displacement of the fracture, the degree of joint involvement, and comminution. In all 33 patients, a short leg cast or boot brace was selected immediately after the injury, tolerable weight bearing was allowed. If the pain disappeared, full weight bearing was performed after wearing a plain shoe or postoperative shoe. As a clinical result, the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the final follow-up. During outpatient follow-up, a simple radiograph of the foot was taken to confirm the time of radiological bone union and return to work. Results: Nine males and 24 females, with an average age of 48.7 years, were enrolled in the study. Twenty-four patients had zone I fractures, and nine patients had zone II fractures. Twenty-two out of 33 patients had a fracture displacement of 2 mm or more. Nine and five patients had joint involvement and comminution, respectively. There was a statistically significant return to work from zone I to zone II. The AOFAS score was excellent at the final follow-up and there was no significant difference. When classifying and comparing the degree of fracture displacement, joint involvement, and comminution, there were no significant differences in the radiological union time and return to work. In all cases, satisfactory results were obtained at the final follow-up. Conclusion: Satisfactory clinical results can be obtained by allowing early weight-bearing regardless of the fracture location, displacement, joint involvement, or comminution in zone I and II 5th metatarsal base fractures.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

The Diaspora Narrative and Aesthetics in Handol's Tarae (한돌 타래의 디아스포라 서사와 미학)

  • Shin, Sa-Bin
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.189-219
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    • 2020
  • This study is an analysis of Handol Heung-Gun Lee's Tarae, which is a coinage combining the Korean words for "playing an instrument" and "song", in terms of narrative and aesthetics. The components for analysis are the phenomena and nature of binary oppositions between nature and human beings, between alienation and interest, between division and unification, and between diaspora and people of the national community. Tarae in the period from the late 1970s to the early 1990s described the experience of pain and loss from non-resistance and disobedience in protest against social problems that emerged during the era of miliary dictatorship, such as industrialization, urbanization, reckless development, Westernization, university-oriented education, the gap between rich and poor, human alienation, and the conflicts arising from the division of the nation. After Handol overcame the lack of creative motivation with self-reflection and effort, Tarae took the form of a diaspora epic meta-narratives integrating the "sound of nature and his true nature" and "the awareness of diaspora and the spirit of the Korean people". The epics of the homeland, the national soil and the people, which began with "Teo", became more intense in terms of a sense of diaspora as they shifted their focus from an origin to a path with "Hanmoejulghi" as the turning point. Handol seeks inspiration in the source of narrative rather than in music. His Tarae focuses on "adding rhythm for lyrics". For this reason, the semiotic features of Tarae have a limitation in that its extrinsic phonology is simple even if its intrinsic meaning (i.e., emotion of sadness) is profound and subtle. In order to elicit sympathy from the audience and impress them, it is necessary to strike a balance between the implicit (semantic) part and the explicit (phonological) part. To share the emotion of sadness with more people, it is necessary to strengthen phonological elements. Sympathy for sadness and deep impression on the audience are more often induced by the mood of similar sentiments than by the stories of the same experience. The aesthetics of sadness in Tarae began with the narratives of past experience which were expressed in the contexts of loss, loneliness, and poverty that Handol had experienced since childhood. However, the aesthetics of sadness, deepened over the period of a long hiatus in Handol's career as a composer, formed the narratives of ultimate salvation, embodying even the diaspora experience of others (e.g., displaced people, overseas adoptees, ethnic Koreans in Russia, victims of Japanese military sexual slavery, etc.). This gave Tarae the potential to go beyond the limits of the ethnic group of Korea. Tarae, as a "dispersed sound", can benefit from the appeal of deep sadness at the point of contact with other forms of world music. It may form a global diaspora discourse because Tarae is oriented towards interculturalism rather than anti-multiculturalism. The future challenge and goal of Handol's Tarae would be to continue to find areas of sympathy and broaden the horizon of awareness as diaspora music.

How did 'Partisan' become 'The red': The impossibility of pain-representation in the 1970s-1980s - Focusing on Lee Byung-Ju's 『Jirisan』 ('빨치산'은 어떻게 '빨갱이'가 되었나: 1970-80년대 고통의 재현불가능성 -이병주의 『지리산』을 중심으로)

  • Park, Suk-Ja
    • Journal of Popular Narrative
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    • v.27 no.2
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    • pp.143-177
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    • 2021
  • In the history of Korean literature, evaluations on 『Jirisan』 (Lee Byeong-ju) are bisected. Some evaluate it as a novel of authentic records which reproduces the history before and after the emancipation objectively while others say it takes advantage of anti-communistic ideology. This study analyzes that difference is resulted not from the distinction of perspectives but from cracks in the text. This is associated with the process of 『Jirisan』's publication. 『Jirisan』 was published serially in 『Sedae』 from 1972, and then, part of the manuscript was published in 1978 and the whole edition published in a series came to be republished in 1981. After that, in 1981 and 1985, part of the follow-up story was printed on the magazine, and then, with the memoirs of those two years as materials, the sixth and seventh volumes were again published through 'revision'. In other words, the publication of 『Jirisan』 is divided into that of the edition published in a series and that of the edition published in 1985 including the contents of revision. The theme of the work, 『Jirisan』 differs according to the point of its completion you may think of. This researcher pays attention to the difference of perspectives between the contents up to the fifth volume and those of the sixth and seventh volumes. Particularly, his evaluation on 'partisans' seems to have changed. In the edition published in a series, he extended 'partisans' into the independence movement in the Japanese colonial era under the Revitalizing Reforms system and adopted the representation of 'partisans' three-dimensionally whereas in the sixth and seventh volumes, he reproduced 'partisans' as beings that were the 'doctrinaire' and 'vicious' 'Reds' and had to be punished. In brief, with 『Jirisan』, he represented 'partisans' in the background of history before and after the emancipation and segmented the discourse, representation and ideology of the Cold War system, but in the process of revision, he stitched up 'partisans' as beings that were evil and losers. Consequently, with 『Jirisan』, he revealed the process of division and contention that proceeded around anti-communism/capitalism within the abyss of the 1970's to 80's and reproduced 'partisans' as beings that were either 'hostile (the Reds)' or 'unknown (losers)

The Family and Individual in the Transmedia Storytelling of Young Adult Narratives (청소년서사의 트랜스미디어 스토리텔링에 나타나는 가족과 개인)

  • Chung, Hye-Kyung
    • Journal of Popular Narrative
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    • v.27 no.2
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    • pp.215-262
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    • 2021
  • This thesis focuses on Wandeuki and Elegant Lies - novels written by Kim Ryeo-reong and adapted into the film by Director Lee Han; this thesis analyzes the process of storytelling being transformed as the media is converted. Also, this thesis discusses cultural-political implications of transmedia storytelling where different narrative responses coexist concerning post-IMF family disorganization and "individualization." First of all, this thesis critically reviews existing discourses on the concept of transmedia storytelling and refers to 'transfictionality' the narratological concept of Marie-Laure Ryan in order to look into media conversion storytelling that starts from original novels. The novels Wandeuki and Elegant Lies show two aspects of "individualization" that adopts existential conditions of family disorganization. Wandeuki deviates from patriarchal family romance through self-discovery and exhibits loose family bond, which is something similar to companionship of close individuals. Elegant Lies shows individualization of pain by portraying a teenager who found herself completely isolated, while showing that it is impossible for the people left behind to mourn. On the other hand, director Lee Han's films and show stories in which family members, who are confronting family dissolution, rediscover and restore their families against family dissolution. The film promotes the expansion of family community through multicultural identity, and the film completes condolence of the people left behind by having the remaining families survive as survivors of suicide. The storyworld of the novels puts emphasis on 'self-discovery' of individual adolescents, while the storyworld of the movies puts emphasis on 'rediscovery of family'. Through transformation of storytelling - especially the redesigning of narrative structures called "modification" - transmedia storytelling shows that the relationship between media-converted texts is far from "faithful representation," but rather, shows conflicting themes and perspectives. With a reference point of 'the emergence of character' transmedia storytelling, which is predicated on the original work but aims to free itself from the original work by transforming storytelling through media conversion, opens up polyphonic storyworld by creating heterogeneous voices. In the post IMF-era, where uncertainty mounts over family dissolution and individualization, polyphonic storyworld created by transmedia storytelling provides an opportunity to experience disparate desires over individual freedom/risk and complacency toward community. We can call this the cultural-political implication of transmedia storytelling based on transferring, transcednding, and transforming.

Effectiveness of Drain Insertion and Irrigation in the Treatment of Septic Arthritis of the Knee under Local Anesthesia (국소 마취하 배액관 삽입 및 세척을 통한 화농성 슬관절염의 치료의 효용성)

  • Yi, Jin Woong;Oh, Byung Hak;Heo, Youn Moo;Jang, Min Gu;Min, Young Ki;Seo, Kyung Deok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.310-316
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    • 2021
  • Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm3 (32,400-203,904/mm3), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union? (쇄골 간부 복합 골절에서 재건 금속판 및 환 강선을 이용한 수술적 치료: 환 강선이 골 유합을 방해하는가?)

  • Kim, Kyung-Tae;Shin, Chung-Shik;Park, Young-Chul;Kim, Dong-hyun;Kim, Min-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.245-252
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    • 2021
  • Purpose: This study examined the radiological and clinical outcomes of internal fixation using a reconstruction plate and 21G circumferential wire in comminuted midshaft clavicular fractures. Materials and Methods: A retrospective cohort study was performed on 51 patients between 2005 and 2019. Thirty-two patients underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and 19 patients underwent surgery without a wire. The patients were assessed with the radiographic parameters, the University of California at Los Angeles (UCLA) score, and the visual analogue scale (VAS) pain score. Based on this, patients who operated without a circumferential wire were set as the control group, and the differences in bone union between the two groups were compared. Results: Thirty-two patients were followed-up for an average of 65 weeks, and 19 patients in the control group were followed-up for an average of 56 weeks. The radiological evaluation confirmed the anatomical reduction and bone union in all 32 patients. No case of nonunion was present. The UCLA score was 32.38 on average and 33.11 in the control group (p=0.395). The VAS score was 1.00 on average and 0.84 in the control group (p=0.668). A significant difference in the bony union time was observed between the group who underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and the control group (p=0.015). On the other hand, there was no statistical significance when other variables were controlled (p=0.107). Conclusion: For displaced midshaft clavicular fractures, internal fixation using a reconstruction plate and 21G circumferential wire maintained accurate anatomical reduction. The satisfactory clinical and radiological results mean that internal fixation using a reconstruction plate and 21G circumferential wire may be a good option for surgical treatment.

Utilizing the Idle Railway Sites: A Proposal for the Location of Solar Power Plants Using Cluster Analysis (철도 유휴부지 활용방안: 군집분석을 활용한 태양광발전 입지 제안)

  • Eunkyung Kang;Seonuk Yang;Jiyoon Kwon;Sung-Byung Yang
    • Journal of Intelligence and Information Systems
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    • v.29 no.1
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    • pp.79-105
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    • 2023
  • Due to unprecedented extreme weather events such as global warming and climate change, many parts of the world suffer from severe pain, and economic losses are also snowballing. In order to address these problems, 'The Paris Agreement' was signed in 2016, and an intergovernmental consultative body was formed to keep the average temperature rise of the Earth below 1.5℃. Korea also declared 'Carbon Neutrality in 2050' to prevent climate catastrophe. In particular, it was found that the increase in temperature caused by greenhouse gas emissions hurts the environment and society as a whole, as well as the export-dependent economy of Korea. In addition, as the diversification of transportation types is accelerating, the change in means of choice is also increasing. As the development paradigm in the low-growth era changes to urban regeneration, interest in idle railway sites is rising due to reduced demand for routes, improvement of alignment, and relocation of urban railways. Meanwhile, it is possible to partially achieve the solar power generation goal of 'Renewable Energy 3020' by utilizing already developed but idle railway sites and take advantage of being free from environmental damage and resident acceptance issues surrounding the location; but the actual use and plan for these solar power facilities are still lacking. Therefore, in this study, using the big data provided by the Korea National Railway and the Renewable Energy Cloud Platform, we develop an algorithm to discover and analyze suitable idle sites where solar power generation facilities can be installed and identify potentially applicable areas considering conditions desired by users. By searching and deriving these idle but relevant sites, it is intended to devise a plan to save enormous costs for facilities or expansion in the early stages of development. This study uses various cluster analyses to develop an optimal algorithm that can derive solar power plant locations on idle railway sites and, as a result, suggests 202 'actively recommended areas.' These results would help decision-makers make rational decisions from the viewpoint of simultaneously considering the economy and the environment.

A Survey of Patient Satisfaction with the use of Aloe Vera Mist for Skin Care during Radiation Therapy for Breast Cancer (유방암 방사선치료 중 피부 관리를 위한 알로에 베라 미스트 사용에 대한 환자 만족도 조사)

  • Han-A Yun;Hyo-Young Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.2
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    • pp.231-242
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    • 2023
  • This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.