• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.1-8
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• 2015

Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.

• Tuberculosis and Respiratory Diseases
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• 제67권4호
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• pp.318-324
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• 2009

Background: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. Methods: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. Results: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5${\pm}$3.98 months with a follow-up period of 28.2${\pm}$26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. Conclusion: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.

• Journal of Acupuncture Research
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• 제26권2호
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• pp.125-145
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• 2009

Objectives : To analyze the inclusion criteria of participants, control group interventions, and the results of prior studies of acupuncture for OA. Also to identify aspects of the procedure that are associated with positive outcomes in order to establish ideal acupuncture treatment model. And to assess the methodological quality of the trials with modified Jadad score and FEAS in order to evaluate the quality of prior studies and find out whether or not acupuncture has a positive effect in treating OA. Methods : Articles up to the date of November 2008 were searched via computerized databases of PubMed, Journal of Korean Oriental Medicine, The Journal of Korean Acupuncture & Moxibustion Society and Journal of Oriental Rehabilitation Medicine. Bibliographies of reviewed papers were also searched and reviewed. Only randomized controlled trials (RCTs) and systematic reviews concerning the effects of acupuncture or electroacupuncture (EA) on symptoms of osteoarthritis of the human knee, published in English and Korean were included. The acupuncture treatment methods of the reviewed trials were assessed based on STRICTA. And the methodological quality of the trials was assessed by modified Jadad score and FEAS. Results : Twenty one trials of acupuncture for OA were analyzed. Based on the results of this review the following factors might contribute to optimal results from acupuncture treatment. 1) Usage of $ST_{35}$, $GB_{34$, $EX_{32}$, $ST_{36}$ and $SP_9$ acupuncture points. 2) More than four acupuncture points should be used. 3) More than 15 minutes of needle retention time. 4) Needle length-40mm and diameter-0.30mm 5) Usage of EA 6) more than 10 times treatment 7) Treatment frequency of more than once a week, 8) Treatment duration longer than 6 to 8 weeks. Conclusions : High quality clinical trials of Acupuncture for OA is still in lack. Future investigators must concentrate their attentions on the quality of acupuncture treatment itself used in the trials as well as the methodological quality of trials.

• Journal of Oral Medicine and Pain
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• 제24권4호
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• pp.397-410
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• 1999

In order to obtain the basic data concerning the optimal parameters in using Nd:YAG laser as a therapeutic modality to dentinal hypersensitivity, the author prepared 3 sections of sound dentin and 10 sections of sclerotic dentin with thickness of $0.5mm{\pm}0.1mm$ from human extracted teeth of anteriors and premolars, and applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, pulse duration $120{\mu}sec$, fiber diameter $320{\mu}m$) to surfaces of sound and sclerotic dentin sections for 1 second with contact/unidirectional moving mode of the fiber under speed of 3mm~4mm/sec and parameters of 0.5W/10Hz, 1.0W/10Hz, 1.5W/10Hz, 2.0W/10Hz: $62J/cm^2$, $124J/cm^2$, $187J/cm^2$, $249J/cm^2$. The author comparatively evaluated the characteristics of ultrastructural changes on surfaces of sound and sclerotic dentin sections irradiated by the pulsed Nd:YAG laser using the scanning electron microscopy. A fairly ill-defined bordered surface of partially closed and melted dentinal tubules can be seen on the scanning electron microscopic feature of the sound dentin surface irradiated by the pulsed Nd:YAG laser with energy density of $62J/cm^2$. The physical modification of sound dentin surface extensively occurred depended on the increase of energy density from $62J/cm^2$ to $124J/cm^2$, $187J/cm^2$, $249J/cm^2$. While, a fairly well-defined bordered surface of partially closed and melted dentinal tubules with thickened peritubular dentin can be seen on the scanning electron microscopic feature of the sclerotic dentin surface irradiated by the pulsed Nd:YAG laser with energy density of $62J/cm^2$. The physical modification of sclerotic dentin surface of a fairly rough, shallow depression with many cracks, thickened peritubular dentin and structureless dentinal tubules extensively occurred depended on the increase of energy density from $62J/cm^2$ to $124J/cm^2$, $187J/cm^2$, $249J/cm^2$ compared to those of sound dentin surface irradiated by the pulsed Nd:YAG laser under the same parameters. Therefore, it is recommended that the pulsed Nd:YAG laser as a therapeutic modality to dentinal hypersensitivity should be applied with the less energy density than $62J/cm^2$ on the sound dentin surface, and its energy density on the partially sclerotic dentin surface should be lower than that on the sound dentin surface to preserve tooth from unnecessary excessive structural destruction.

• Journal of Embryo Transfer
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• 제15권3호
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• pp.247-253
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• 2000

This study was undertaken to optimize enucleation and reconstitution methods for the production of cloned mice by somatic cell nuclear transfer Outbred ICR mouse oocytes at the metapahse- II stage were retrieved from female mice superovulated by PMSG and hCG. In Experiment 1, oocytes were enucleated in medium supplemented with cytochalasin B (CCB) of 3 levels (0, 7.5 or 15 $\mu\textrm{g}$/mL), and higher rate of encleation was obtained at 7.5 and 15 $\mu\textrm{g}$/mL than at $\mu\textrm{g}$/mL. In Experiment 2, oocytes enucleated in 7.5 $\mu\textrm{g}$/mL CCB-containing medium were reconstituted with different types of somatic cell by following methods; 1) cumulus cells by direct cell injection, 2) cumulus cells by electric fusion (1.25 kV/cm, 2 pulses for each 70 $mutextrm{s}$) or 3) STO cells by the electrofusion. Electrofusion of STO cells with enucleated oocytes yielded the greatest (P<0.05) rate of reconstitution without lysis (76%) than any other combinations. Although significant decrease in the rate of somatic cell introduction was found, the electrofusion of cumulus cells yielded better rate of reconstitution than direct injection (0 vs. 18%). In Experiment 3, the duration of electric stimulation for the fusion was changed to either 50 $mutextrm{s}$ or 90 $mutextrm{s}$, but no significant improvement of reconstitution efficacy was obtained. In conclusion, this study showed that ICR mouse oocytes could be used for the production of reconstituted oocytes and a fusion method of 1.25 KV/cm with 2 pulses using 570 cell was the optimal.

• Journal of the Korea Academia-Industrial cooperation Society
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• 제19권8호
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• pp.312-321
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• 2018

The Korean DR market proposes suppression of peak demand under reliability crisis caused a natural disaster or unexpected power plant accidents as well as saving power plant construction costs and expanding amount of reserve as utility's perspective. End-user is notified a DR event signal DR execution before one hour, and executes DR based on requested amount of load reduction. This paper proposes a DR energy management algorithm that can be scheduled the optimal operations of chiller system and ESS in the next day considering the TOU tariff and DR scheme. In this DR algorithm is divided into two scheduling's; day-ahead operation scheduling with temperature forecasting error and operation rescheduling on DR operation. In day-ahead operation scheduling, the operations of DR resources are scheduled based on the finite number of ambient temperature scenarios, which have been generated based on the historical ambient temperature data. As well as, the uncertainties in DR event including requested amount of load reduction and specified DR duration are also considered as scenarios. Also, operation rescheduling on DR operation day is proposed to ensure thermal comfort and the benefit of a COB owner. The proposed method minimizes the expected energy cost by a mixed integer linear programming (MILP).

• Journal of the Korea Academia-Industrial cooperation Society
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• 제19권2호
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• pp.497-507
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• 2018

Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

• Journal of Oral Medicine and Pain
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• 제25권4호
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• pp.415-425
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• 2000

In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

• Journal of the Korean Geotechnical Society
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• 제18권2호
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• pp.161-170
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• 2002

This paper describes a systematic way of simultaneously identifying the ambient pore pressure and the rigidity index $(=G/s_u)$ of soil by applying an optimization technique to the early part of piezocone dissipation test result. An analytical solution developed by Randolph & Wroth(1979) was implemented in normalized from to express the build-up and dissipation of excess pore pressures around a piezocone as a function of the rigidity index. An ambient pore pressure and optimal rigidity index were determined by minimizing the differences between theoretical and measured excess pore pressure curves using optimization technique. The effectiveness of the proposed back-analysis method was examined against the well-documented performance of piezocone dissipation tests(Tanaka & Sakagami, 1989), from the viewpoints of proper determination of selected target parameters and saving of test duration. It is shown that the proposed back-analysis method can evaluate properly the ambient pore pressure and the rigidity index by using only the early phase of the dissipation test data. Also, it is shown that the proposed back-analysis method permits the horizontal coefficient of consolidation to be identified rationally. Consideration for strain level of back-analyzed rigidity index shows that it corresponds to at least intermediate to large strain level.

• Korean Journal of Construction Engineering and Management
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• 제6권5호
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• pp.89-101
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• 2005

The early phase of construction projects, communication among the related participants has great influence on the further transaction of the projects. However, important decision making are made by the experience of the field managers in practice without the method for systematic analysis. For example, in building construction project, selection process for construction method has been executed by decision making of some architects dependent on their experience. As a result, there have been frequent construction method alterations during the construction process and delay of duration, addition of cost, etc have followed accordingly. The main reasons of such a mal-functional transaction are due to the absent of the reasonal procedure of decision making reflecting the characteristics of construction project. Therefore, there is a need for an supporting tool and production design for the selection of rational construction method. The objective of this study is to propose production design process and decision making model in relation to various influent factors at the early phase of construction projects. To achieve these objectives, this study 1)analyzes the prior theory about production design, 2)we have studied about selection process for optimal construction method through constraint analysis in structural works, 3)performs a case study to embody the problems of the production design, and 4)proposes a cooperative committee model for supporting production design by analyzing the results of case study and interviewing experts. It is anticipated that the effective tool of proposed model would be able to improve communication among the related participants and systematically accumulate data that might be used in similar construction projects.