• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.60-65
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• 2014

Purpose: To diagnose soft tissue tumor, such as lipoma and Schwannoma, magnetic resonance imaging (MRI) is sufficient in most cases. However, various characteristics are found in MRI images of Schwannoma, thus other type of tumors are often misdiagnosed as Schwannoma with MRI images. In this study, we evaluate the diagnostic value of specific MRI findings of Schwannoma. Materials and Methods: From January 2002 to May 2013, 104 patients who are suspected as Schwannoma rith MRI images are included in data, and the final diagnosis is confirmed with biopsy. Patients are divided into group 1 and group 2 who are confirmed as Schwannoma and other disease with biopsy, respectively. Results: 92 patients were diagnosed as Schwannoma (group 1) and 12 patients were diagnosed as other disease (group 2). We investigate the diagnostic value of specific MRI findings of Schwannoma. 41 patients of group 1 (45%) and 0 patients of group 2 (0%) showed target sign, 47 patients of group 1 (51%) and 2 patients of group 2 (17%) showed fascicular sign, 44 patients of group 1 (48%) and 5 patients of group 2 (42%) showed fat split sign, 28 patients of group 1 (30%) and 1 patients of group 2(9%) showed nerve entering and exiting sign, and 8 patients of group 1 (9%) and 6 patients of group 2 (50%) showed none of four specific findings on their MRI images. 52 patients of group 1 (57%) and 5 patients of group 2 (42%) have tumors on the pathway of nerve. Target sign could be considered as the best diagnostic value of the sign we investigate (p<0.05). Conclusion: Although specific MRI findings have powerful diagnostic value, patients are often misdiagnosed as Schwannoma with MRI findings. Therefore, if patients who are suspected as Schwannoma based on MRI findings have no target sign on their MRI images, we should consider the possibility of other disease.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.113-119
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• 2004

Purpose: To determine the utility of sonographically guided percutaneous core needle biopsy to diagnose musculoskeletal soft tissue masses. Methods: A prospective study was performed in 55 patients referred for image-guided needle biopsy of primary or recurrent soft tissue masses and bone lesion or suspected solitary metastasis with extraosseous masses. Tissue samples were obtained with a 14-gauge or 18-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 49 biopsies confirmed by successful clinical treatment (11 cases) or surgical resection (38 cases). Results: An accurate diagnosis was obtained in 47 (97%) of 49 biopsies; sensitivity was 95%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 6 cases. Considering all 55 biopsies, high-quality specimens were obtained in 87%. There were no serious complications. Conclusions: Sonographically guided core needle biopsy is accurate and safe, in soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.122-129
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• 2009

Purpose: To evaluate treatment outcomes of malignant melanoma and to analyze the factors that contributes to outcomes. Materials and Methods: We reviewed the 51 cases of malignant melanoma from March, 1997 to March, 2004 and were followed up more than 5 years. Average age was 49.4. We compared 5-year survival rate for each age, gender, site of occurrence, depth of tumor, metastasis of regional lymph node and immuno-chemo therapy. Results: 5-year survival rate was 88.5% for the age group below 65, 88.0% for the age group 65 and above, 62.5% for male and 100% for female. 5-year survival rate for the site of occurrence showed 100% in upper extremities, and 80.0% in lower extremities and 100% in other sites. 5-year survival rate was 100% for the stage below Clark stage III and 79.3% for the stage above IV. In surgical resection, 5-year survival rate was 66.7% for lymph node metastasis group and 94.9% for non-lymph node metastasis group. Conclusion: The prognostic factors of malignant melanoma were gender, tumor site, depth of tumor (Clark's stage) and metastasis of regional lymph node. But, there was no relation between the age and the survival rate in our study.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.104-110
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• 2009

Purpose: Compared to soft tissue sarcoma, the relative risk of extraskeletal osteosarcoma is still not clear. The purpose of this study is to identify the difference in survival and local recurrence rate between two soft tissue sarcomas. Materials and Methods: Twelve patients with pathologically confirmed extraskeletal osteosarcoma were analysed. For retrospective matched case-control study, we selected 72 patients who were confirmed as high grade soft tissue sarcoma and had similar tumor location, tumor size and age to extraskeletal osteosarcoma. Results: Median age was 50 years old. Five cases were located in upper extremity, four in the buttocks, three in the lower extremity. Overall survival rate of extraskeletal osteosarcoma group and high grade soft tissue sarcoma group at 5 years were 52% and 55%. There is no significant difference (p=0.8). Local recurrence rate and metastasis rate were 58%, 67% in extraskeletal osteosarcoma group and 36%, 51% in soft tissue sarcoma group, which were not stastistically significant(p=0.2, p=0.4). Conclusion: Extraskeletal osteosarcoma have similar local recurrence, metastasis and survival rate compare to high grade soft tissue sarcoma. The number of patients of this study were too small to identify outcome of extraskeletal osteosarcoma. Further multi-institutional study should be attempted.

• Proceedings of the Korea Information Processing Society Conference
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• 2000.10a
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• pp.67-70
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• 2000

최근 네트워크 서비스 및 분산 컴퓨팅 환경의 급격한 발전과 더불어 인터넷 기반 지리정보 시스템과 이 기종 시스템간에 상호 운용성을 지원하는 분산 지리정보시스템의 기술이 혁신적으로 발전하게 되었다. 현재 이러한 상호 운용성과 더불어 기 구축된 시스템의 재 사용성을 극대화하기 위하여 개방형 컴포넌트 소프트웨어 기술이 발표[1]되었으며, 최근 발표되는 지리정보시스템들도 이러한 개방화와 컴포넌트화 기술을 채택하여 개발되고 있다. 이러한 개방형 컴포넌트 소프트웨어 기술은 컴퓨터 소프트웨어 산업 전반에 커다란 파급 효과를 끼치고 있다. 지리정보시스템 분야에서는 OpenGIS Consortium(OGC)을 주축으로 하여 개방형 컴포넌트 지리정보시스템을 위한 표준 구현 사양을 발표하고 있으며, 이러한 표준 사양을 수용한 제품들이 개발되고 있는 실정이다. 본 논문에서는 분산 환경에서 다양한 관계형 데이터베이스시스템을 이용하여 OGC가 제시한 OLE/COM 기반의 데이터 제공자 컴포넌트의 설계 및 구현에 중점을 두고 있다. 본 시스템의 데이터 제공자 컴포넌트는 순수한 관계형 데이터베이스시스템 기반 위에서 구성되므로, 우선 OGC에서 요구하는 GIS 관련 핵심 기능들을 제공하기 위해서 우선 관계형 데이터베이스와 ODBC를 이용하여 공간엔진을 구성하고 있다. 본 공간 엔진은 OGC 사양을 충족하기 위해서 이용되는 최소한의 기능-공간데이터 관리 기능, 공간 연산 처리, 공간 색인 기능 그리고 클라이언트와 통신하기 위한 기능-들을 포함하고 있다. 그러므로 본 논문에서는 이러한 공간 엔진의 기반 위에서 OGC OLE DB 제공자 컴포넌트의 설계 및 구현 방법에 대해서 자세히 살펴보고 실제 SQL Server 7.0 환경에서 구축된 공간 엔진 및 OLE DB 제공자 컴포넌트의 구현 예에 대하여 살펴볼 것이다. 혈액내방사선 조사량이 안전용량 범위(200rad)에 속하며 48시간 후 체내잔류량은 서양인과 큰 차이가 없었다.비출현의 소견을 보이는 악성종양 환자의 골 신티그람 53개중 44개 (83.0%)에서 척추 및 늑골에 미만성, 또는 다발성 침습이 관찰되었다. 또 골전이 부위를 두개골, 척추, 견대부, 늑골, 골반, 사지의 근위부 장골의 6개 부위로 나누어 분석할 경우 49개(92.5%)에서 3부위 이상에 전이가 발견되었고, 35개(66.0%)에서 4부위 이상에 전이가 발견되었으며, 5부위 이상, 6개 부위에 모두 전이가 발견된 것은 각각 20개 (37 7%), 11개(20.8%)이었다. 이상의 성적으로 보아 악성종양 환자의 골 신피그라피에서 신장 영상의 비출현은 종양의 광범위한 골전이를 간접적으로 시사하는 소견으로 생각된다. 여러 악성종양중 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높음은 주목할 만한 것이라 하겠다.출한 결과 인,규소 증가와 자가영양성 미소플랑크톤(ANP)증가에 미치는 요인이 해안과 외해에서 동일하게 가장 큰 설명력을 보였다. N:P 비도 해안에서 36.4, 외해에서 32.6을 보이고 있어 인이 상당히 부족한 것으로 나타났다. 따라서 조사해역은 인이 식물플랑크톤 성장에 중요한 제한요인으로 작용하고 있다고 판단된다.의 회전. 전위력의 강도, 적용시점, 그리고 키, 체중등의 신체적 요인 등이 있으나 능숙한 기계사용과 정확한 슬관절 위치에서 검사할 때 전방 십자 인대 파열에 대한 진단에 유용한 기구이다.태라고 하였다. 본 연구에서는 이러한 근거를 바탕으로 개방형 문제의 유형을 다양한 답이 존재하는 문제, 다양한 해결 전략이 가능한 문제, 답이 없는 문제, 문제 만들기, 일반화가 가능한 문제 등으로 보고, 수학적 창의성 중

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.195-200
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• 2007

Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.131-138
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• 2003

Purpose: We analyzed our malignant peripheral nerve sheath tumor (MPNST) cases to find out their oncologic results following by each treatment modalities. Materials and Methods: Thirty four patients with MPNST were registered in Korea Cancer Center Hospital from Feb. 1986 to Nov. 1996. Seventeen cases were male and 17, female. Average age was 41 years (range 18 to 74). Location of the tumor was as follows; 17 in lower extremity, 11 upper extremity, 4 trunk, and 2 retroperitoneum. Following the AJC classification, stage IA were 2 cases, stage IIA 2, stage IIB 6, stage III 16 and stage IV 8. Twenty six patients took operations and adjuvant chemotherapy and/or radiation therapy, 3 operation only and 3 adjuvant chemotherapy or radiation therapy. Average follow up period was 33.5 months (5.6 to 146.1). Kaplan-Meiyer method was done for survival curve, and log rank test for comparison analysis. Results: Fourteen cases were continuous disease free, 2 no evidence of disease, 2 alive with disease and 14 dead of disease states at final follow up. Actual 5-year and 10-year survival rates were 53.5%, 35.7%. Local recurrence rate after operation was 24.1%. 5-year survival rates of stage I/II/III were 100/85.7/55.9% and 2-year survival rate of stage IV was 14.3% (p=0.04). In 21 cases operated with stage II-III, wide margin (15cases) had 76.0% 5-year survival rate, and marginal or intralesional marigin (6cases) had 40.0%. The actual 5-year survival rate of the group which were done 4 or more cycles chemotherapy (8cases) was 71.4% and the actual 3-year survival rate less than 4cycles chemotherapy (6cases) was 83.3% (p=0.96). In 19 cases operated with stage II-III and which had no radiotherapy, marginal or intralesional margin (5cases) had 3 cases of local recurrences (60.0%), though wide margin (14cases) had 4 cases recurrences (28.6%). There was no local recurrence in 8cases which had pre-or post-operative radiotherapy. Conclusions: Surgical margin is an important factor in local recurrence. Resection margin has a tendency to influence the survival despite insufficient statistical significance. Conventional chemotherapy has no defnite statistical sigficance in the effect on local control and survival. Preoperative and postoperative radiotherapy has some positive effect on local control.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.8-13
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• 2010

Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.60-66
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• 2007

Purpose: The purpose of this study was to evaluate the functional outcomes of periacetabular malignant bone tumors treated by internal pelvectomy without reconstruction. Materials and methods: Between January 1996 and December 2005, eight patients with primary malignant or metastatic periacetabular bone tumors were treated by internal pelvectomy without reconstruction. There were 6 men and 2 women. Mean age was 42 years old. There were 3 osteosarcomas, 3 chondrosarcomas and 2 metastatic carcinomas. The type of pelvic resections were 6 type I+II+III, 1 type I+II and 1 type II+II resection. The functional outcomes were evaluated with ISOLS revised criteria. The follow up period ranged from 6 to 84 months. Results: At last follow up, 5 patients showed CDF, 2 patients, AWD and the remained 1, DOD. The mean functional score for pain, functional activity, emotional acceptance, use of external support, walking ability and gait were 4.9, 2.9, 2.9, 1.5, 2.3 and 2.5 respectively. The total functional score ranged from 37% to 70%(average: 56%). There were three temporary nerve palsies. Conclusion: The internal pelvectomy without reconstruction for selective difficult periacetabular malignant tumors could be a viable option with fewer complications and fair functional outcomes.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.81-87
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• 2007

Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.