• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.100-104
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• 2019

Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.34 no.8
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• pp.31-41
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• 2018

This research examines pioneering works of two representative Western modern architects which played a significant role in constructing modernity in the early 20th century: Frank Lloyd Wright's Florida Southern College and Ludwig Mies van der Rohe's Illinois Institute of Technology. These two campuses were constructed and developed at the similar period by two named architects, and these were considered the collections of iconic modern buildings in the States. However, design approaches and principles of these buildings were totally opposite ways: Frank Lloyd Wright's Florida Southern College was in the roof of organic architecture drawn from a great Chinese sage, Laotze, which have more five hundred years history. On the other hand, Ludwig Mies van der Rohe's Illinois Institute of Technology was well embodied the International Style which originated from European tradition in the early 20th century, and Mies was one of the leaders of the International Style. These different approaches could be understood in the discussion of the meaning of the Greek concept of paradoxa which was mentioned by a German philosopher Martin Heidegger. Comparing the paradoxical gestures of these two campuses can reveal the truth of each campus master plans and expand the discourse of modern architectures.

• English & American cultural studies
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• v.13 no.1
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• pp.1-28
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• 2013

Edward Abbey is regarded as one of the most influential ecological or nature writers. He celebrates the American Southwestern desert, argues for wilderness preservation, and advocates politically-oriented environmental activism to defend wilderness. He, however, does not classify himself as a nature writer, but rather places himself in the tradition of a kind of autography. His books show his fascination with the delicate harmony of the desert, and at the same time his personal journey over the desert. That is, eco-centered, he keeps his journey into the heart of the desert. He finds the desert harsh, brutal, fatal, and most of all, indifferent. The desert reveals simplicity and mystery, silence and revelation, and emptiness and fulfillment. This mythical and paradoxical essence of the desert draws him into the place and inspires redemptive humility and beauty, which, in turn, peel off his old ego or self. During his journey, Abbey tries to immerge himself with the desert yet remains intact and individual. The desert serves for him as the bedrock which sustains him and offers an opportunity to gain a new whole perspective. Like a pocket hunter in the desert whom he characterizes himself, he sticks to the desert to dig out ground for his existence and survival. Pulling the energy and force of the desert into his soul, Abbey is free, or compelled to contemplate what is beyond the human. His experience in and of the desert leads to a discovery of self and initiates selfhood.

• Journal of English Language & Literature
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• v.59 no.4
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• pp.527-544
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• 2013

William Shakespeare's dirge, "The Phoenix and the Turtle," is still a crux in the Shakespearean canon and interpretation. The poem is still believed a dark allegory dealing with some arcane and obscure courtly matters and politics. However, we cannot recover its allegorical significance. This interpretive situation enforces us to read the poem as a self-conscious artwork in terms of its paradoxical language and meta-poetic metaphors. Paradox, as a subspecies of metaphor, challenges categorical and judgmental absolutes, and produces a sense of wonder in reconciling the logically contradictory opposites. In this poem the urn containing the ashes of the phoenix and the turtle is the icon of the mysterious unity of art, born of the wonderful marriage of male and female. Shakespeare's poem demonstrates in itself the magical power of poetic language in transforming an elegy into an epithalamion. The union of the phoenix and the turtle defies the singularity of their respective entity, and at the same time it retains their distinctive particularity of the two-ness. This neo-Platonic mystery of the "married chastity" is a paradox which confounds reason and verifies the poetic truth of imaginative intellect. The marriage of Christian perichoresis is crystallized in the artwork of the urn, which is admired at by posterity, though the marriage was issueless, due to its passing virtue. "The Phoenix and the Turtle" depicts the metaphor-making process and its effect, the poem.

• English & American cultural studies
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• v.10 no.2
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• pp.49-72
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• 2010

As the first of Philip Roth's recent series of novels that delve into American Cold War history deeply entwined with the post-war Jewish American experience, American Pastoral traces the tragic fall of a third-generation Jewish American named Seymour "Swede" Levov, whose dream of complete assimilation to the post-ethnic American paradise is irrecoverably disrupted when his young daughter blows up the local post office to protest against the Vietnam War. This essay proposes to examine Swede Levov's interrupted pursuit of the American dream by locating it within specific Cold War contexts and national imaginaries propagated particularly during the years from John F. Kennedy to Lyndon B. Johnson. In so doing, I will argue that Roth presents a paradoxical vision of Jewish American identity that could be acquired by performing perpetual self-effacement and submergence into the non-place of anonymity and doubleness, a mythic location of the post-ethnic Cold War American family. Levov's life becomes true part of the mythic narrative of American history when he realizes that his life, just like the nation's history, is a series of temporalities radically discontinued without any manageable detour ot divine bypass to cross over. Rather than indicating Roth's retraction from the postmodern understanding of subjectivity, the novel's historical realism, I will argue, serves to illuminate the postmodern conditions of American Cold War history and ethnic identity.

• The Journal of Information Systems
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• v.30 no.2
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• pp.165-188
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• 2021

Purpose This study was conducted to identify the multidimensional role of institutional mechanisms in the linear relationship of satisfaction, trust and repurchase intention, which are used as an important concept in the research of e-commerce. To this end, a research model was proposed by combining concepts which are the concept of perceived effectiveness of institutional mechanisms for overall e-commerce environment(e.g., PEEIM) and the concep of perceived effectiveness of institutional structures(e.g., PEIS) of a specific marketplace based on the social cognitive theory. Design/methodology/approach This study was conducted by dividing the data into two groups to identify institutional mechanisms and trust-building relationships according to the institutional contexts inherent in e-commerce. The institutional contexts were set up for the top two online companies and the bottom two online companies according to the results of the open market brand assessment from 2018 to 2019 in South Korea. Findings The result of this study found that PEIS had a direct impact on trust in both high and low groups respectively whereas PEEIM presented different paradoxical results in high and low groups. In the relationship between the satisfaction and the trust in the vendor of the high group, PEEIM showed negative moderating effects but in the relationship between the trust and the repurchase intention of the low group PEEIM showed positive moderating effects.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.183-187
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• 2022

Flail chest is a critical medical condition in which multiple segmentally fractured adjacent ribs cause paradoxical movement of the thoracic cage in patients with severe blunt trauma injury. Surgical stabilization is considered essential in patients who require mechanical ventilation. However, there is no consensus on which surgical procedure to choose among the various available techniques or when to perform surgery. We report the case of a patient with traumatic anterior flail chest due to bilateral multiple fractures of the ribs requiring surgical stabilization in whom weaning from mechanical ventilation had failed. The Nuss procedure using double bars with the bridge technique was performed for chest wall stabilization. The patient was weaned from mechanical ventilation on postoperative day 44 and she underwent bar removal on postoperative day 71. After extensive rehabilitation for multiple trauma, she was discharged successfully. The patient currently shows no recurrence of chest wall depression in outpatient follow-up.

• Molecules and Cells
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• v.45 no.9
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• pp.610-619
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• 2022

Cellular senescence plays a paradoxical role in tumorigenesis through the expression of diverse senescence-associated (SA) secretory phenotypes (SASPs). The heterogeneity of SA gene expression in cancer cells not only promotes cancer stemness but also protects these cells from chemotherapy. Despite the potential correlation between cancer and SA biomarkers, many transcriptional changes across distinct cell populations remain largely unknown. During the past decade, single-cell RNA sequencing (scRNA-seq) technologies have emerged as powerful experimental and analytical tools to dissect such diverse senescence-derived transcriptional changes. Here, we review the recent sequencing efforts that successfully characterized scRNA-seq data obtained from diverse cancer cells and elucidated the role of senescent cells in tumor malignancy. We further highlight the functional implications of SA genes expressed specifically in cancer and stromal cell populations in the tumor microenvironment. Translational research leveraging scRNA-seq profiling of SA genes will facilitate the identification of novel expression patterns underlying cancer susceptibility, providing new therapeutic opportunities in the era of precision medicine.

• Journal of Hospice and Palliative Care
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• v.26 no.1
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• pp.18-21
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• 2023

The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient's condition.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.2
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• pp.93-111
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• 2023

The authors investigated the artistic characteristics of autistic savant artists, hypotheses on the proximate and ultimate causes of their emergence, recent psychological and other studies about them, and psychological and neuroaesthetic studies about non-savant autistic individuals. The artistic features of autistic savant artists were significantly similar to those of outsider artists. Furthermore, the authors investigated the explanatory power of the paradoxical functional facilitation theory, the superior visual perception hypothesis, the "Hmmmmm" hypothesis, and the Neanderthal theory of autism regarding the emergence of autistic savant artists. In addition, we investigated whether an increase in savant characteristics was related to a decrease in the ability for social communication. The authors suggested that in studies on the aesthetic experience of non-savant autistic individuals, their aesthetic experience ability is never lower than that of neurotypical individuals and that some non-savant autistic individuals may potentially have artistic talent. Finally, the authors reviewed the effectiveness of the "autism savant spectrum syndromic disorder" proposed by some researchers. More scientific and systematic studies on autistic savant artists from a multidisciplinary perspective are warranted.