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The Clinical Outcome of Dedifferentiated Chondrosarcoma (역분화 연골육종의 임상 결과)

  • Kong, Chang-Bae;Lee, Seung Yong;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.164-171
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    • 2019
  • Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

Prognostic Factors after Arthroscopic Treatment of Infectious Knee Arthritis (감염성 슬관절염의 관절경적 치료 이후 예후 인자에 대한 분석)

  • Kang, Sang-Woo;Choi, Eui-Sung;Kim, Dong-Soo;Jung, Ho-Seung;Hong, Seok-Hyun;Go, Ban-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

Clinical Results of Anterolateral Thigh Perforator Flap for Soft Tissue Reconstruction of the Foot and Ankle (족부 및 족관절부 연부조직 재건을 위한 전외측 대퇴 천공지 피판술의 임상결과)

  • Han, Soo-Hong;Hong, In Tae;Lee, Yohan;Jo, Yong-Gil;Kwon, Young Woo
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.40-48
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    • 2017
  • Purpose: Soft tissue reconstruction of a defect around the foot and ankle is a particularly challenging procedure due to the anatomical and functional characteristics of this area. Hence, only a limited number of treatment options are available. Moreover, if patients wish to avoid additional scars on the ipsilateral lower leg for cosmetic reasons, even fewer options are available for treatment. The authors used an anterolateral thigh perforator flap for soft tissue defects in this area, when other surgical options were inadequate. The aim of this study was to report the clinical results and the efficacy of this procedure. Materials and Methods: Sixteen cases of soft tissue defects around the foot and ankle were included. Participants included 12 male and 4 female subjects, and the mean age was 34 years. The most common cause of defect was acute trauma, and the average follow-up period was 33 months. Flap survival time, surgical complications, and ambulation status at the final follow-up stage were evaluated. Results: All 16 flaps successfully survived, except for one case with partial flap necrosis that was thought to be due to weight bearing earlier than scheduled. All patients were able to walk independently without any aid at the final follow-up stage. No patients showed other significant surgical complications. Conclusion: The anterolateral thigh perforator flap is a good alternative for soft tissue defects of the foot and ankle, when other options are not applicable. This study also demonstrated that surgery using an anterolateral thigh perforator flap is safe and highly reliable.

Reader-Response Criticism about the Functional relation of Romance, Women and Patriarchy -Based on Janice A. Radway's Reading the Romance: Women, Patriarchy and Popular Literature (로맨스, 여성, 가부장제의 함수관계에 대한 독자반응비평 -제니스 A. 래드웨이의 『로맨스 읽기: 여성, 가부장제와 대중문학』을 중심으로)

  • Lee, Jung-Oak
    • Journal of Popular Narrative
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    • v.25 no.3
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    • pp.349-383
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    • 2019
  • This paper examined the meaning and task of romance research with a focus on Reading the Romance(1984) by Janice A. Radway. This book, which analyzes romance texts by examining the situation and meaning of reading romance by women readers integrating between cultural studies and literary studies, is one of the most popular studies on the romance genre. Radway scrutinized the practical significance of reading romance in a community of women readers. Through a study involving questionnaires and in-depth interviews, she found that for women, romance reading is a 'compensatory fiction' that brings happiness and emotional redemption through a sense of liberation achieved by escaping from patriarchal daily life. The romance that women prefer is composed of 4 stages and 13 divisions: 'Encounter → Attest → Recovery → Happy End'. It also maintains a formula that begins with an immature female character's identity crisis and ends with a blissful union that recognizes the intrinsic value of the main character, who has turned into a man who is considerate of the women. Therefore, romance plays the role of pursuit of the 'female utopian fantasy' and at the same time a reconciliation of women to patriarchy. Feminist critics of the day criticized this argument. However, reading romance is a 'feminine reading', and romance is literature about the functional relationship between women's lives and patriarchy. Yet the interpretation could differ depending on the different viewpoints and definitions of the women's utopian fantasy. In recent years, the conditions of female reader's lives, awareness and imagination have been changing rapidly. As a result, the female utopian fantasy has also changed significantly. Nevertheless, women's lives in the real patriarchal system are still contradictory, and their adventurous imagination is spreading in alternative spaces such as the subculture. In this regard, the question is about the definition of romance and the meanings of romance research are still important task.

A Study on Park Gye-hyeong -Focusing on the Change of Romantic writing (박계형론 -낭만적 글쓰기의 변주를 중심으로)

  • Jin, Sun-Young
    • Journal of Popular Narrative
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    • v.25 no.2
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    • pp.247-275
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    • 2019
  • We hope that more diverse interests will arise in the novels by Park Gye-hyeong By looking at writers and works in time, we identified the key element of Park Gye-hyeong's novels as 'romantic'. Romantic nature of this time is lyrical, sentimental, spiritual, unrealistic and idealistic. Based on a romantic understanding of the world, the core sanction of the novel is love, focusing on feelings of sadness, and on the aspects of joy, separation, and pain that arise from loving relationships rather than the aspects of joy. Based on the feelings of grief, the novels end with failure, death and betrayal, thus embodying tragic romanticism. Before her marriage, Park Gye-hyeong's novels were love stories that revealed her longing for beautiful love based on sensibility. The idyllic world and longing for nature reveal a romantic world-view. Ultimately, it is a fictional worldview that the author seeks to despair and long for, and to find the sincerity and morality of love in an environment that does not. Park Gye-hyeong, who became a housewife, expressed that she wanted to write a piece that can give readers a sense of nostalgia by embodying "romance at a high level," not "sentimental." In subsequent works, physical relationships are treated as failures of love and spiritual relationships as the fruit of love, revealing the lofty spirituality, idealistic longing and religious nature of love. Park Gye-hyeong confessed her shame about her previous work when she published a new one after more than two decades of writing. And after more than two decades of reflection, her new novel had a new theme of "recovering destroyed humanity." However, the search for "humanity" in the two novels released after the write-off tends to be somewhat hasty at the end of the novel. The question of human nature, sin and forgiveness, is the next best thing to save as a way of life, rather than as a result of the intense inner agony and behavior of the characters within the narrative, and this also shows a sudden shift in religiousness at the end of the novel. Therefore, the romantic meaning of the superficial is superficial.

Melodrama, the Paradox of Modern Imagination Coordinating Moral Norms and Emotions -Based on the Developmental Approach (멜로드라마, 도덕규범과 감정을 조율하는 근대적 상상력의 역설 -발생론적 접근을 중심으로)

  • Lee, Jung-Oak
    • Journal of Popular Narrative
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    • v.25 no.1
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    • pp.9-54
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    • 2019
  • Since the birth of melodrama in the early Enlightenment era, it has flowed through various cultures and media. In order to grasp the principle of differentiation of melodrama and the direction of its change, a developmental approach to the formation process of melodrama is necessary. In this regard, this paper examines the formation process of modern melodrama and its aesthetic features around the time of the French Revolution. The modern melodrama was formed in the period between the end of the 18th century and the start of the 19th century. It was born at the intersectional point of the contradictions of the modern imagination and the political paradox of the French Revolution, which demanded an autonomous citizenship but did not recognize a woman as a citizen. The aesthetic of women's sacrifice and tears reproduced in the modern melodrama is a political aspiration to restore a corrupt society by glamorizing a woman as a moral icon. This was an icon to save a society under divide and crisis and a coordination of emotions to conceal sexist violence in the politics of the exclusion of women. The aesthetic of women's sacrifice and tears reproduced in modern melodrama has consistently been considered under negative evaluation such as a play of moral hypocrisy and vulgar drama. However, the academic interest in melodrama in the 1970s has been amplified due to the "Sirk-melo" which is a transition to the new aesthetic of women's sacrifice and tears, encompassing not only women, but also races and classes. In modern society, entering the era of uncertainty, where various social problems, national disasters, and global disasters have become commonplace, 'the aesthetic of women's sacrifice and tears' are shifting from gender differences to various victim narratives. Reviewing new theoretical trends and changes of recent melodrama as well as analyzing specific works are left as follow-up tasks.Since the birth of the melodrama in the early Enlightenment era, it has flowed through various cultures and media. In order to grasp the principle of differentiation of melodrama and the direction of its change, a developmental approach to the formation process of melodrama is basically necessary. In this regard, this paper examines the formation process of modern melodrama and its aesthetic features around the time of the French Revolution.

Evaluation of ABO Antibody Titration Using Tube and Column Agglutination Techniques (ABO 동종 응집소 역가 측정을 위한 시험관 및 미세원주응집법의 평가)

  • Cho, Chi-Hyun;Kim, Ha-Nui;Yun, Seung-Gyu;Choi, Gye-Ryung;Choi, Jae-Yeoul;Kim, Jang-Su;Lim, Chae-Seung;Kim, Young-Kee;Lee, Kap-No
    • Laboratory Medicine Online
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    • v.1 no.1
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    • pp.57-63
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    • 2011
  • Background: ABO antibody titration is useful for the evaluation of ABO-incompatible bone marrow or solid organ transplantations, yet the results quite vary between different test methods used. We compared the results of microcolumn agglutination and tube methods. Methods: Anti-A and anti-B isoagglutionin titers were determined in 63 healthy individuals (23 O, 20 A, and 20 B blood groups) using 4 different methods: immediate spin tube (tube), microcolumn agglutination without anti-human globulin (AHG) (CAT), tube with AHG (tube-AHG) and microcolumn agglutination with AHG (CAT-AHG). Results: The median (range) titers of anti-A and anti-B in group O individuals by tube, CAT, tube-AHG, and CAT-AHG methods were 64 (8-512), 64 (8-512), 128 (8-2,048), and 128 (16-2,048); 64 (16-128), 128 (16-256), 128 (16-512), and 256 (16-512), respectively. The median (range) titers of anti-A in group B and anti-B in group A individuals by the four methods were 64 (16-128), 128 (8-128), 128 (8-256), and 256 (8-256); 64 (8-128), 64 (8-128), 32 (8-128), and 64 (8-256), respectively. The isoagglutinin titer measured by CAT-AHGmethod was the highest. The titers measured by CAT and CAT-AHG methods were 0-1 titer higher than those by tube and tube-AHG methods, respectively. Whatever method was used, the isoagglutinin titers were higher in women than in men. Conclusions: CAT-AHG was the most sensitive method among the four methods tested. Since AHG titer values are critical for the clinical management and CAT has less manual procedures than tube method, CAT-AHG method could be used for the standardization of ABO antibody titration in different institutions.

The Effects of Play Activities in Forest on the Emotional Vocabulary Change of Children (숲놀이 활동이 유아의 감정어휘 변화에 미치는 영향)

  • Jandg, Hyun Hee;Kim, Mi Jin;Yun, Suk Yonng;Choi, Byung Jin
    • Journal of the Korean Society of Floral Art and Design
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    • no.41
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    • pp.3-12
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    • 2019
  • The purpose of this study was to investigate the effect of forest play activities on children's emotional vocabulary change. Forest play activities were conducted for 498 children aged 4 to 5 years old who visited the environmental training in G city for forest play activity for 1 hour. As a result, positive vocabulary was significantly improved from 0.95±0.78 before forest play to 1.15±1.21 after forest play(p=.003) and negative vocabulary was significantly decreased from 1.27±1.58 to 0.41±1.10(p=.000). In the case of male children, positive vocabulary was increased significantly from 0.96±0.82 to 1.36±1.24(p=.000), in the case of negative vocabulary, it decreased significantly from 1.42±1.74 to 0.55±1.30(p=.000). In the case of female children, negative vocabulary was significantly decreased from 1.12±1.37 to 0.26±0.26(p=.000), but the positive vocabulary increase was not significant(p=.851). As a result of age, for a 4-year-old children, positive vocabulary did not show significant difference between before and after forest play(p=.471), and negative vocabulary was significantly increased from 1.04 ± 1.42 before forest play to 0.41±1.16 after forest play(p=.000). For a 5-year-old children, positive vocabulary was increased significantly from 0.96±0.85 to 1.23±1.21(p=.001) and negative vocabulary was decreased significantly from 1.41±1.65 to 0.41±1.06(p=.000). As a result of this study, it was found that play activities using various natural objects in the forest were directly related to nature, resulting in positive vocabulary increase and negative vocabulary decrease.

Effects of Career Education and Psychological Counseling Satisfaction on Career Self-Efficacy of High School Students (고등학생의 '진로와 직업' 교육과 '진로심리검사' 교육의 만족도가 진로결정 자기효능감에 미치는 영향)

  • Paik, Ju Kyung;Kim, Eung Yong;Chun, Jun Hyep
    • Journal of Naturopathy
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    • v.8 no.1
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    • pp.29-39
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    • 2019
  • Purposes: The purpose of this study was to investigate the satisfaction of each activity in the high school students (568 students) after school career education (Career and vocation, Curriculum-related career education, Special lecture related to career, Entrance exam session, Career psychology test, Internet lecture), and then to analyze the career decision-making self-efficacy of the items Goal selection, Job information, Problem solving and Future plan by high, middle, and low group. Methods: Questionnaires administered to subjects after career education counseling education. Results: Career decision - making self - efficacy was significantly higher in the high group than in the middle and low groups in the goal selection, job information, problem-solving and future planning by the educational satisfaction on career and vocation, curriculum-related lectures, entrance examination session (p<.001). The level of satisfaction of special career lectures was in the order of low group> high group> middle group in career decision self - efficacy, and the values of high and low groups were significantly higher than those of the middle group. The effect of satisfaction on career decision self - efficiency in Career psychological examination education was in the order of top> middle> low groups in goal choice and job information, and the high group values were significantly higher than the middle and low groups. In the problem solving and future planning, there was a difference between high, middle, and low group values, but there was no significant difference. The effect of the satisfaction of the internet course on the career decision self - efficacy was not significant, but there was a difference between the high, middle, and low groups. Satisfaction with the internet course was low and did not affect the decision - making self - efficacy significantly. Conclusion: The higher the satisfaction of career education, the higher self - determination efficacy of goal selection, job information, problem solving and future plan. This study suggests the direction of career education.

A Study on the Awareness & Preferences about the Nursing Homes (노인요양시설에 대한 고령자 인식 및 시설 내부 색채선호 경향에 관한 연구)

  • Jeong, Mu Lin;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.29
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    • pp.319-331
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    • 2017
  • South Korea has entered the age of aging society since the elderly population over 65 reached 13.1% in 2015. This increase rate is the fastest in the OECD members. as a part of the precaution, the Korean government has enforced the long term care insurance from July 2008 and the increase of related nursing homes until 2015 was 220.2% which is rapid and quantitative. It was natural that quantitative expansion leads to qualitative improvement. With regard to service environment conditions, color environment draws attention as one of the most effective measures. color environment supports nursing home's spatial functions and the aged class is subject to the research as the potential customers. This study aims to understand color environment, conduct surveys for color preference and attitude toward color environment, and suggest directions for color environment plan. The ultimate goal is to improve the quality of Korean nursing home environment. It studied definition, state, color environment and space functions of nursing homes as well as the preceding researches. With 100 people over 60s in Busan and Gyeongnam area (52 male and 48 female), the survey examined attitudes for color environment and color preference by space functions in nursing home. The research method is as follows. First, as a result of the consciousness survey on color environment in elderly nursing home, it considers service (37%), medical service (20%), and location (19%) heavily in order. color environment plan is not recognized significantly. However, the need of indoor color plan in the elderly nursing homes has "agree (32%) and "strongly agree (25%), which suggests that color introduction is required to the nursing homes. Second, the indoor coloration for the elderly nursing homes has various color preferences. The color preference order for bedroom was R, P, and G but this order changes in nursing space (program room) to G, R, and Y. The communal space such as lobby prefers R, G and Y in order. R color was preferred in general.