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이희승 대한의사협회 2014 대한의사협회지 Vol.57 No.1
Perioperative opioid-induced hyperalgesia (OIH) can be defined as the “increased perception of pain after opioid-based anesthesia and surgery” since hyperalgesia is defined as “increased pain from a stimulus that normally provokes pain.” OIH has been identified mainly after remifentanil-based anesthesia in surgical patients given the high dose and rapid withdrawal used. The mechanisms of OIH have been postulated mainly by the cellular-level adaptation in internalization of the receptors and downregulation of intracellular coupling, upregulation of spinal dynorphins, and activation of N-methyl-D-aspartate receptors have been postulated as well. The clinical aspects of OIH with various causes, especially remifentanil, have been investigated. Pros and cons related to remifentanil-induced hyperalgesia have been suggested. The dose and duration of remifentanil used in surgery and anesthesia can be the appropriate factors for OIH, including the way of setting for the control groups of those studies, and the methods for evaluating the pain. Opioids remain one of the most powerful pain killers for acute pain management. Opioids are sometimes necessary for perioperative analgesia, but OIH can be an unavoidable risk. Ongoing interest in OIH and the development of anesthesia optimized for its prevention will increase the quality of perioperative life.
이희승,왕백설 한국관광산업학회 2012 Tourism Research Vol.37 No.-
Dark tourism (also known as black or grief tourism) is tourism involving travel to sites associated with death and tragedy. Dark tourism is also a subject area that has seen substantially growth over the past decades. For many years dark tourism has been part of our fascination, dating back to the pilgrims. However, in a academic point’s of view, there is not enough papers regarding dark tourism phenomenon. This study therefore examines insight into the tourists who visit the sites associated with death, disaster, war or conflict. Specifically in this paper, 186 tourists who participate in a tour of Gwang-ju 5·18 national cometary conduct questionnaire survey. Using this survey method, this study traces the dark tourism participants’ motivations related to their socio-demographical profiles and travel patterns. In addition to discussing specific aspects of dark tourism phenomenon, theoretical implications related to the greater realm of dark tourism motivations are analysed and discussed.