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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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Preservation of Fish Community by the Construction of the Tamjin Dam (탐진댐 건설에 따른 어류군집 보전방안)

  • Choi, Chung-Gil;Joh, Seong-Ju;Kim, Jong-Hae;Kim, Dong-Sup
    • Korean Journal of Ecology and Environment
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    • v.35 no.3 s.99
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    • pp.237-246
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    • 2002
  • Tamjin Dam is built in the upper reaches of the Tamjin River which flows through the Janghung-gun and Gangjin-gun of the Jeollanamdo, Korea. In order to map out a preservation strategy of the fish community from dam construction, We studied the distribution of fish distribution and changes of the habitat environment. we found 49 fish species inhabiting in the downstream and upstream of the Tamjin Dam. Among them, migratory fish were two species sweet smelt, Plecoglossus altivelis and freshwater eel, Anguilla japonica. The Coreoperca kawamebari which designated as a species to be protected by The Ministry of Environment of Korea was also observed. After the dam construction, reservoir would be filled with water and running water system will change to standing water system. Then the habitat and spawning space for mountain torrent fish will be reduced and the migration of migratory fish to upstream will be blocked. Through our study, we proposed several ways to protect fish community. In order to preserve the reduced habitat and spawning area of mountain torrent fish, a fishway has been diagnosed to be built in the shallow reservoir in the entrance of the upriver. The establishment of artificial spawning ground on the riverside has been recommended. In addition, We propose a creation of a shelter for fresh water eel, Anguilla japonica in areas where the depth of the water is about l0m by laying rocks. Since it is difficult for a spawning ground to be formed naturally in the reservoir due to the year-round changes in water level, We suggested a floating spawning facility using an artificial fixture. In the downstream of the dam, a waterway-style habitat and spawning ground in the river and increasing the diversity and abundance of fish fauna in the Tamjin River. A low-cost and highly efficient operational fishway has been recommended so that migratory fish such as Plecoglossus altivelis (sweetfish) can migrate from the lower reaches to the upper reaches of the river.

Physical properties of novel composite using Portland cement for retro-filling material (치근단 역충전용 포틀랜드 시멘트 신복합재료의 물리적 성질 고찰)

  • Lee, Sang-Jin;Cho, Ok-In;Yum, Ji-Wan;Park, Jeong-Kil;Hur, Bock;Kim, Hyeon-Cheol
    • Restorative Dentistry and Endodontics
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    • v.35 no.6
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    • pp.445-452
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    • 2010
  • Objectives: The aim of this study was to compare apical sealing ability and physical properties of MTA, MTA - AH-plus mixture (AMTA) and experimental Portland cement - Epoxy resin mixture (EPPC) for a development of a novel retro-filling material. Materials and Methods: Forty-nine extracted roots were instrumented and filled with gutta-percha. Apical root was resected at 3 mm and the retro-filling cavity was prepared for 3 mm depth. Roots were randomly divided into 3 groups of 15 roots each. The retro-filling was done using MTA, AMTA, and EPPC as the groups divided. Four roots were used as control groups. After setting in humid condition for 24 hours, the roots were immersed in 1% methylene blue dye solution for 72 hours to test the apical leakage. After immersion, the roots were vertically sectioned and photos were taken to evaluate microleakage. Setting times were measured with Vicat apparatus and digital radiographs were taken to evaluate aluminum equivalent thickness using aluminum step wedge. The results of microleakage and setting time were compared between groups using one-way ANOVA and Scheffe's post-hoc comparison at the significance level of 95%. Results: AMTA and EPPC showed less microleakage than MTA group (p < 0.05). AMTA showed the highest radio-opacity than other groups and the novel EPPC showed 5 mm aluminum thickness radio-opacity. EPPC showed the shortest initial and final setting times than other groups while the MTA showed the longest (p < 0.05). Conclusions: Under the condition of this study, the novel composite using Portland cement-Epoxy resin mixture may useful for retro-filling with the properties of favorable leakage resistance, radio-opacity and short setting time.

Effect of a frontal impermeable layer on the excess slurry pressure during the shield tunnelling in the saturated sand (포화 사질토에서 전방 차수층이 쉴드터널 초과 이수압에 미치는영향)

  • Lee, Yong-Jun;Lee, Sang-Duk
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.13 no.4
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    • pp.347-370
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    • 2011
  • Slurry type shield would be very effective for the tunnelling in a sandy ground, when the slurry pressure would be properly adjusted. Low slurry pressure could cause a tunnel face failure or a ground settlement in front of the tunnel face. Thus, the stability of tunnel face could be maintained by applying an excess slurry pressure that is larger than the active earth pressure. However, the slurry pressure should increase properly because an excessively high slurry pressure could cause the slurry flow out or the passive failure of the frontal ground. It is possible to apply the high slurry pressure without passive failure if a horizontal impermeable layer is located in the ground in front of the tunnel face, but its location, size, and effects are not clearly known yet. In this research, two-dimensional model tests were carried out in order to find out the effect of a horizontal impermeable layer for the slurry shield tunnelling in a saturated sandy ground. In tests slurry pressure was increased until the slurry flowed out of the ground surface or the ground fails. Location and dimension of the impermeable layer were varied. As results, the maximum and the excess slurry pressure in sandy ground were linearly proportional to the cover depth. Larger slurry pressure could be applied to increase the stability of the tunnel face when the impermeable layer was located in the ground above the crown in front of the tunnel face. The most effective length of the impermeable grouting layer was 1.0 ~ 1.5D, and the location was 1.0D above the crown level. The safety factor could be suggested as the ratio of the maximum slurry pressure to the active earth pressure at the tunnel face. It could also be suggested that the slurry pressure in the magnitude of 3.5 ~4.0 times larger than the active earth pressure at the initial tunnel face could be applied if the impermeable layer was constructed at the optimal location.

An Empirical Comparative Study of the Seaport Clustering Measurement Using Bootstrapped DEA and Game Cross-efficiency Models (부트스트랩 DEA모형과 게임교차효율성모형을 이용한 항만클러스터링 측정에 대한 실증적 비교연구)

  • Park, Ro-Kyung
    • Journal of Korea Port Economic Association
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    • v.32 no.1
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    • pp.29-58
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    • 2016
  • The purpose of this paper is to show the clustering trend and the comparison of empirical results and is to choose the clustering ports for 3 Korean ports(Busan, Incheon and Gwangyang Ports) by using the bootstrapped DEA(Data Envelopment Analysis) and game Cross-efficiency models for 38 Asian ports during the period 2003-2013 with 4 input variables(birth length, depth, total area, and number of cranes) and 1 output variable(container TEU). The main empirical results of this paper are as follows. First, bootstrapped DEA efficiency of SW and LT is 0.7660, 0.7341 respectively. Clustering results of the bootstrapped DEA analysis show that 3 Korean ports [ Busan (6.46%), Incheon (3.92%), and Gwangyang (2.78%)] can increase the efficiency in the SW model, but the LT model shows clustering values of -1.86%, -0.124%, and 2.11% for Busan, Gwangyang, and Incheon respectively. Second, the game cross-efficiency model suggests that Korean ports should be clustered with Hong Kong, Shanghi, Guangzhou, Ningbo, Port Klang, Singapore, Kaosiung, Keelong, and Bangkok ports. This clustering enhances the efficiency of Gwangyang by 0.131%, and decreases that of Busan by-1.08%, and that of Incheon by -0.009%. Third, the efficiency ranking comparison between the two models using the Wilcoxon Signed-rank Test was matched with the average level of SW (72.83 %) and LT (68.91%). The policy implication of this paper is that Korean port policy planners should introduce the bootstrapped DEA, and game cross-efficiency models when clustering is needed among Asian ports for enhancing the efficiency of inputs and outputs. Also, the results of SWOT(Strength, Weakness, Opportunity, and Threat) analysis among the clustering ports should be considered.

Fractionation and Pollution Index of Heavy Metals in the Sangdong Tungsten Mine Tailings (광미에 존재하는 중금속의 분획화와 오염도 평가)

  • Yang, Jae-E.;Kim, Hee-Joung;Jun, Sang-Ho
    • Korean Journal of Soil Science and Fertilizer
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    • v.34 no.1
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    • pp.33-41
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    • 2001
  • Enormous volumes of mining wastes from the abandoned and closed mines are disposed without a proper treatment in the upper Okdong River basin at Southeastern part of Kangwon Province. Erosion of these wastes contaminates soil, surface water, and sediments with heavy metals. Objectives of this research were to fractionate heavy metals in the mine tailing stored in the Sangdong Tungsten tailing dams and to assess the potential pollution index of each metal fraction. Tailing samples were collected from tailing dams at different depth and analyzed for physical and chemical properties. pH of tailings ranged from 7.3 to 7.9. Contents of total N and organic matter were in the ranges of 3.2~5.5%, and 1.3~9.1%, respectively. Heavy metals in the tailings were higher in the newly constructed tailing dam than those in the old dam. Total concentrations of metals in the tailings were in the orders of Zn > Cu > Pb > Ni > Cd, exceeded the corrective action level of the Soil Environment Conservation Law and higher than the natural abundance levels reported from uncontaminated soils. Relative distribution of heavy metal fractions was residual > organic > reducible > carbonate > adsorbed, reversing the degree of metal bioavailability. Mobile fractions of metals were relatively small compared to the total concentrations. Distribution of metals in the tailing dam profiles was metal specific. Concentrations of Cu at the surface of tailing dams were higher than those at the bottom. Pollution index (PI) values of each fraction of metals were ranged from 4.27 to 8.51 based on total concentrations. PI values of mobile fractions were lower than those of immobile fractions. Results on metal fractions and PI values of the tailing samples indicate that tailing samples were contaminated with heavy metals and had potential to cause a detrimental effects on soil and water environment in the lower part of the stream. A prompt countermeasure to prevent surface of tailings in the dams from water and wind erosions is urgently needed.

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Analysis of the Weight of SWOT Factors of Korean Venture Companies Based on the Industry 4.0 (4차 산업혁명 기반 한국 벤처기업의 SWOT요인에 대한 중요도 분석)

  • Lee, Dongik;Lee, Sangsuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.4
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    • pp.115-133
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    • 2021
  • This study examines the concept and related technologies of the 4th industrial revolution that has been mixed so far and examines the socio-economic changes and influences resulting from it, and the cases of responding to the 4th industrial revolution in major countries. Based on this, by deriving SWOT factors and calculating the importance of each factor for Korean venture companies to prepare for the forth industrial revolution, it was intended to help the government and policymakers in suggesting directions for establishing related policies. Furthermore, the purpose of this study was to suggest a direction for securing global competitiveness to Korean venture entrepreneurs and to help with basic and systematic analysis for further academic in-depth research. For this study, a total of 21 items derived through extensive literature research and data research to understand what are the necessary competency factors for internal and external environmental changes in order for Korean venture companies to have global competitiveness in the era of the 4th Industrial Revolution. After reviewing SWOT factors by three expert groups and confirming them through Delphi survey, the importance of each item was analyzed by using AHP, a systematic decision-making technique. As a result of the analysis, it was shown that Strength(48%), Opportunity(25%), Threat(16%), Weakness(11%) were considered important in order. In terms of sub-items, 'quick and flexible commercialization capability', 'platform/big data/non-face-to-face service activation', and 'ICT infrastructure and it's utilization' were shown to be of the comparatively high importance. On the other hand, in the lower three items, 'macro-economic stability and social infrastructure', 'difficulty in entering overseas markets due to global protectionism', and 'absolutely inferior in foreign investment' were found to have low priority. As a result of the correlation verification by item to see differences in opinions by industry, academia, and policy expert groups, there was no significant difference of opinion, as industry and academic experts showed a high correlation and industry experts and policy experts showed a moderate correlation. The correlation between the academic and policy experts was not statistically significant (p<0.01), so it was analyzed that there was a difference of opinion on importance. This was due to the fact that policy experts highly valued 'quick and flexible commercialization', which are strengths, and 'excellent educational system and high-quality manpower' and 'creation of new markets' which are opportunity items, while academic experts placed great importance on 'support part of government policy', which are strengths. The implication of this study is that in order for Korean venture companies to secure competitiveness in the field of the 4th industrial revolution, it is necessary to have a policy that preferentially supports the relevant items of strengths and opportunity factors. The difference in the details of strength factors and opportunity factors, which shows a high level of variability, suggests that it is necessary to actively review it and reflect it in the policy.

A Study on the Asia Container Ports Clustering Using Hierarchical Clustering(Single, Complete, Average, Centroid Linkages) Methods with Empirical Verification of Clustering Using the Silhouette Method and the Second Stage(Type II) Cross-Efficiency Matrix Clustering Model (계층적 군집분석(최단, 최장, 평균, 중앙연결)방법에 의한 아시아 컨테이너 항만의 클러스터링 측정 및 실루엣방법과 2단계(Type II) 교차효율성 메트릭스 군집모형을 이용한 실증적 검증에 관한 연구)

  • Park, Ro-Kyung
    • Journal of Korea Port Economic Association
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    • v.37 no.1
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    • pp.31-70
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    • 2021
  • The purpose of this paper is to measure the clustering change and analyze empirical results, and choose the clustering ports for Busan, Incheon, and Gwangyang ports by using Hierarchical clustering(single, complete, average, and centroid), Silhouette, and 2SCE[the Second Stage(Type II) cross-efficiency] matrix clustering models on Asian container ports over the period 2009-2018. The models have chosen number of cranes, depth, birth length, and total area as inputs and container TEU as output. The main empirical results are as follows. First, ranking order according to the efficiency increasing ratio during the 10 years analysis shows Silhouette(0.4052 up), Hierarchical clustering(0.3097 up), and 2SCE(0.1057 up). Second, according to empirical verification of the Silhouette and 2SCE models, 3 Korean ports should be clustered with ports like Busan Port[ Dubai, Hong Kong, and Tanjung Priok], and Incheon Port and Gwangyang Port are required to cluster with most ports. Third, in terms of the ASEAN, it would be good to cluster like Busan (Singapore), Incheon Port (Tanjung Priok, Tanjung Perak, Manila, Tanjung Pelpas, Leam Chanbang, and Bangkok), and Gwangyang Port(Tanjung Priok, Tanjung Perak, Port Kang, Tanjung Pelpas, Leam Chanbang, and Bangkok). Third, Wilcoxon's signed-ranks test of models shows that all P values are significant at an average level of 0.852. It means that the average efficiency figures and ranking orders of the models are matched each other. The policy implication is that port policy makers and port operation managers should select benchmarking ports by introducing the models used in this study into the clustering of ports, compare and analyze the port development and operation plans of their ports, and introduce and implement the parts which required benchmarking quickly.

Effects of Supplementation of Multienzymes in Diets Containing Different Energy Levels on Growth Performance, Nutrient Digestibility, Blood Metabolites, Microbiota and Intestinal Morphology of Broilers (에너지 수준이 다른 사료에 복합효소제의 첨가가 육계의 사양성적, 영양소 소화율, 혈액성상, 장내미생물 균총 및 소장 융모에 미치는 영향)

  • Shim, Young Ho;Kim, Jin Soo;Hosseindoust, Abdolreza;Ingale, Santosh Laxman;Choi, Yo Han;Kim, Min Ju;Ohh, Seung Min;Ham, Hyung Bin;Chae, Byung Jo
    • ANNALS OF ANIMAL RESOURCE SCIENCES
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    • v.28 no.3
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    • pp.97-107
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    • 2017
  • The present study was conducted to investigate the effects on growth performance, nutrient digestibility, and gut health of broiler chickens when a dietary supplementation of multienzymes was added to diets, containing different energy levels. A total of 480 broiler chickens of similar body weight (Ross 308, 1-day-old) were randomly subjected to four treatments. The dietary treatments included a corn-soybean meal-based diet supplemented with: multienzyme (amylase+protease+ mannanase+xylanase+phytase), 0.05% enzyme, and different energy levels (3010 and 3060 kcal/kg). The experimental diets were fed to the chicks in a mash form for 35 days in two phases (1-21 d, phase I; and 22-35 d, phase II). During the overall period, chicks fed with diets supplemented with multienzymes had a better weight gain (p<0.05) and feed conversion ratio (FCR) than those fed with diets without enzymes. There was no difference in the growth rate and FCR among the chicks fed with diets supplemented with enzymes, even though the dietary energy levels were different. The apparent fecal and ileal digestibility of dry matter, gross, crude protein, calcium, and phosphorus were significantly enhanced (p<0.05). The population of cecal and ileal Lactobacillus spp. was significantly increased (p<0.05), and Clostridium spp. and coliforms were significantly decreased (p<0.05) in diets supplemented with enzymes. Villus height and villus height to crypt depth ratio in the small intestine was also significantly enhanced (p<0.05) in diets supplemented with enzymes. In conclusion, multienzyme supplementation had positive effects on the weight gain of broilers, FCR, digestibility of nutrients, and on the growth of intestinal microbiota.

An Analysis on the Survey of the Cultural Heritage Committee (문화재위원회 설문조사 분석)

  • Kim, Hong-real
    • Korean Journal of Heritage: History & Science
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    • v.37
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    • pp.405-444
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    • 2004
  • The Cultural Heritage Committee is an advisory committee established under the Cultural Heritage Administration with the aim of carrying out examination and deliberation on preservation, management and use of cultural heritage. The Cultural Heritage Administration is the highest administrative organization in terms of Korean cultural heritage. It was founded to produce and execute policies on cultural heritage, an important task that requires a high level of specialized knowledge, skills and academic expertise. It involves in-depth investigation and consultation of experts in the field of cultural heritage. An organization consisting of distinguished experts, the Cultural Heritage Committee plays an important role in policymaking on cultural heritage of Korea. The Korean government established the Bureau of Cultural Heritage in October 1961, and enacted provisions (as a presidential decree) on the organization on March 27, 1962, according to the Cultural Heritage Act established on January 10 of the same year. The Cultural Heritage Committee was opened as a deliberation committee according to the law, on which currently 90 members serve in 8 subcommittees. The term of office of a committees member is two years. The deliberation of the committee, which covers the entire range of cultural heritage, including their designation and cancellation, is normally concluded by the deliberation and decision of each subcommittee. This study aims to analyze of the survey of the Cultural Heritage Committee as the highest organ for the deliberation of policies on the matters of cultural heritage. The subject of the analysis in this study is a questionnaire survey that was conducted between Oct. 20 and Nov. 29, 2003, of 116 former and current members of the committee.