• Clinical Pain
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• v.18 no.1
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• pp.1-7
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• 2019

Objective: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS). Method: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day. Results: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes. Conclusion: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.

• Journal of Korean Foot and Ankle Society
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• v.27 no.4
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• pp.131-136
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• 2023

Purpose: This study compared the clinical and radiology results of arthrodesis between the anterior and transfibular approaches with a lateral malleolar-saving procedure in ankle arthritis. Materials and Methods: This study was a retrospective study of 31 cases who underwent ankle arthrodesis with the anterior approach (14 cases) and trans-fibular approach (17 cases). The remnant lateral malleolus was fixed during the trans-fibular procedure. The patients included 17 females and 14 males with a mean age of 57.2 (range 41~73) years; the mean follow-up was 30.4 (range 15~68) months. The clinical and radiology outcomes, including the American Orthopedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and union time, were recorded. The complications and subjective satisfaction degrees were also recorded and compared between the two groups. Results: Clinically, the preoperative mean AOFAS score and VAS in the anterior approach group were 39.3 and 7.4, respectively, which changed to 61.9 and 3.1 postoperatively. In the trans-fibular approach group, the mean AOFAS score and VAS increased from 36.6 to 64.2 and 7.1 to 2.4, respectively. On the other hand, no significant differences in the clinical results were observed between the two groups. The time to achieve union was 9.2 and 11.6 weeks in the anterior and transfibular approach groups, respectively. Three patients (21%) complained of tenderness and discomfort around the fibular tip in the anterior approach group, and seven patients (41%) showed a gap between the talus and remnant lateral malleolus in the trans-fibular approach group. Conclusion: There was no difference in the clinical and radiological results between the anterior and transfibular approaches with a lateral malleolar saving procedure in ankle arthrodesis. Careful selection of the approach method according to the patient's preoperative condition is needed to prevent remnant discomfort or nonunion around the lateral malleolus.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.1
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• pp.90-104
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• 2011

This study identified the scenic characteristics in Gugok and symbolism reflected in titles of the scenery of the season in Gugok from a perspective of Sundoism concentrated on Galeun Gugok in Goisan which is influenced most greatly by Sundoism hermit ideas in Korea, along with Seonyudong-Gugok. In addition, it suggested a measure for arrangement and narrative Storyboard of Galeun Gugok structure corresponding with promotion and propagation of Gugok cultural scenes and educational goals. According to analysis and interpretation of the various Gugoks forming Galeun Gugok in terms of their titles, names engraved in surrounding elements and the coherent symbolic meanings of its scenery and place through comparison with secenery of near Seonyudong-Gugok, the result shows that Galeun Gugok comprises wishes for eternal life in the forms of Taoist hermit-related scenery of the season within the range of stream and old stories based on environmental affordance. In figurative way, it ultimately presents the Wonyung(圓融) idea which seeks a harmonious combination of God and humankind. In particular, consciousness of longevity without problems is deeply inherent in the background of eternalness of plants, divinity of animals and natural homeostasis. Also, 9 Gok Seongukam set up at visual terminal reflect noticeably that a game Go is the amusement of the immortals, which describe 9 ranks of GO figuratively. Galeun Gugok is formed in a unity structure, which is hermit-oriented Sundoism and motif, such as longevity and immortality, divinity and enjoyment of Sundoism hermit rather than used as a method to achieve taste for the arts or ethics. Given the fact, it presents eternal longevity and atmosphere of seclusion in very strong way. Development of spatial Storyboard structure based on this is interpreted as 'Entering the world of hermits(Introduction)'-'Looking the world(Development)'-'Living with hermits(Turn)'-'Becoming hermit(Conclusion).' Finally, the scenery image of Galeun Gugok presented in surface structure is based on beauty of the immortal land scenery as well as beauty of pre-achieved space in Gugokdongcheon and arranged the vertical narrative structure as divine space of 9 ranks of GO. Taking those into account, scenery story board of Galeun Gugok was suggested in accordance with a theme of 6 cuts; Gnagsun(降仙)-Sungyeong(仙境)- Sunyak(仙藥)-Sunhak(仙鶴)-Sunyu(仙遊)-Eunsun(隱仙). It is obvious that hermit which live an eternal life as a representative of Sundoism, should be the main motif of scenery planning in a filed of modem landscaping. Therefore, the most valuable component in designing Korean landscape must be the homeostasis of surrounding landscape which supports the characteristics of invariability and divinity of nature.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.411-417
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• 2019

Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.123-135
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• 2012

Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.481-488
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• 2005

Purpose: Functional imaging of dopamine transporter (DAT) defines integrity of the dopaminergic system, and DAT is the target site of drugs of abuse such as cocaine and methamphetamine. Functional imaging the DAT may be a sensitive and selective indicator of neurotoxic change by the drug. The aim of the present study is to evaluate the clinical implications of qualitative/quantitative analyses of dopamine transporter imaging in methamphetamine abusers. Materials and Methods: Six detoxified methamphetamine abusers (abuser group) and 4 volunteers (control group) were enrolled in this study. Brain MRI was performed in all of abuser group. Abuser group underwent psychiatric and depression assessment using brief psychiatric rating scale (BPRS) and Hamilton depression rating scale (HAMD), respectively. All of the subjects underwent I-123 IPT SPECT (IPT SPECT). IPT SPECT image was analysed with visual qualitative method and quantitative method using basal ganglia dopamine transporter (DAT) specific/non-specific binding ratio (SBR). Comparison of DAT SBR between abuser and control groups was performed. We also performed correlation tests between psychiatric and depression assessment results and DAT SBR in abuser group. Results: All of abuser group showed normal MRI finding, but had residual psychiatric and depressive symptoms, and psychiatric and depressive symptom scores were exactly correlated (r=1.0, p=0.005) each other. Five of them showed abnormal finding on qualitative visual I-123 IPT SPECT Abuser group had lower basal ganglia DAT SBR than that of control ($2.38{\pm}0.20\;vs\;3.04{\pm}0.27$, p=0.000). Psychiatric and depressive symptoms were negatively well correlated with basal ganglia DAT SBR (r=-0.908, p=0.012, r=-0.924, p=0.009). Conclusion: These results suggest that dopamine transporter imaging using I-123 IPT SPECT may be used to evaluate dopaminergic system of the basal ganglia and the clinical status in methamphetamine abusers.

• Cartoon and Animation Studies
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• s.50
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• pp.101-130
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• 2018

Since the advent of the Smart Devices, the smartphone has become a popular tool to view Webtoon. This phenomenon has caused the convergence of cutting-edge technologies and Webtoons in diverse forms, creating unique versions of Webtoons including, but not limited to Smart-toon, Effect-toon, Cut-toon, Dubbing-toon, Moving-toon, AR-toon, VR-toon, and Interaction-toon. By comparison to these rich diversities of Webtoons in the online industry, there is a lack of academic research on this topic. There are some papers which talk about the different types of multimedia technology conversion and its case presentation or the effectiveness and problems of visual effect, but the effects of these convergence technologies on comic readers' concentration and reading effectiveness have never been investigated so far. Therefore, this paper will discuss the unique method of immersive storytelling that is often used in comics and analyze each aspects of immersive method in technology-converged Webtoons along with its problems. Furthermore, this paper will analyze different aspects of "immersion" and interaction elements that can be found in the popular Interaction-toon, (Encountered). Through this, this paper discusses the positive influence of the interaction elements on comic readers' immersion level and its limitation. To classify the technology-converged Webtoons in terms of the immersion level, the Effect-toon sometimes interferes viewer's flow by using excessive use of multimedia effect, creating information overload. The Smart-toon which applied motions to each frame under horizontal mode of smartphones was a good try, but it hindered the readers' activeness and made it hard for the readers to be fully absorbed in the story. The VR-toon, which utilizes virtual reality gadgets to allow viewers to explore the world of Webtoon was also a nice try to overcome the limitation of vertical screens. However, it often caused dispersion of user's attention and reduced the users' immersion level. The Moving-toon which only emphasized the reading convenience also invaded readers' activeness and disturb users' concentration. On the other hand, the cartoonist Il-Kwon Ha applied high technologies such as face recognition technology, augmented reality techniques, 360-degree panorama technology, and haptic technology to his cartoon (Encountered). This allowed the readers to form a sense of closeness towards the cartoon characters which let the readers to identify themselves with the characters and interact with them. By this way, the readers can be fully immersed in the story. However, technology abuse, impractical production and hackneyed storylining often showed later in the story remains as its limitations.