• Title/Summary/Keyword: 우연성

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A Folktale education that promotes communication between generations considering difference in cultural background (문화적 맥락의 차이에 따른 설화 향유의 한 양상과 세대 간 소통을 위한 설화 교육 시론)

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.

A Survey of the Status of Nutrition in Rural Korea (농촌(農村) 영양실태(營養實態)에 관(關)한 조사(調査))

  • Lee, Geum-Yeong;Suh, Myung-Sook
    • Journal of Nutrition and Health
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    • v.6 no.1
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    • pp.71-76
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    • 1973
  • 1. This survey is somewhat different from that conducted by Yonsei University, although being in many respects, very similar. We found the average per capita caloric intake to be 7 or 8% of what it should be. Of that caloric intake, 84.5% in the model village here and 82.2% in the compared village Bupyong, by and large depends on cereal grains. Since such grains tend to distend the stomach, the farmers, it seems,should substitute fat for a part of their diet so as to dimish digestive pain and still receive the necessary calories. 2. Protein is the most important nutrient for the development of physical strength and improvement of health, but the average daily intake is only 68.3% of the necessary amount. It is desirable that the ratio of vegetable protein to that of animal be one to three for maintaining one's health. Most of the villager's protein, however, comes from plants: the intake of animal protein, at a level of only 13.6 g, is far below such a one to three ratio. 3. In the model village, 497.6 mg, of inorganic calcium is the daily intake level. In the compared village it is 505.5 mg, making a difference of only 8mg. This, however, is 35% less than the recommended intake. More than 50% of this calcium comes from cereals and other plants. Moreover, plant calcium which has much oxakuc acud us not as nutritional as animal calcium, so their calcium diet is less than it would appear. We must, therefore, make efforts to receive as good nutritional calcium as possible. 4. Among the vitamin group, the daily average intake of vitamin A and vitamin $B_{2}$ are respectively 40% and 32% less than the desired intake, while vitamin $B_{1}$ happens to be taken in sufficient quantities and more niacin is taken than which is even necessary. The intake of vitamin C is much more than the necessary quantity. However, this figure was calculated from uncooked food; if the loss from cooking were to be considered, the real intake might well be a little less. Also, as this survey was carried out in May, some of these results were influenced by the fact that lettuce and spinach are seasonally popular. In conclusion, except for a few nutrients which are in abundance, the normal food intake in a day is, on the whole, less than the average recommended. Furthermore despite the fact that both of these places are model villages in the development of nutrition, it seems that they have not gotten out of such conventional eating habiys as the almost dependancy on cereal grains. Cow's milk, sheep's milk, eggs and so on produced by each farmhouse are not used for their own families but are taken to the market for the purpose of making money. Accordingly, I think from now we must seek to improve, guide and enlighten the farmers as to how to correct their eating habits and implement changes in their lives so that our firm purpose may be achieved.

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A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Leukocyte count and hypertension in the health screening data of some rural and urban residents (일부 농촌과 도시의 건강선별조사 자료로 본 백혈구수와 고혈압과의 관계)

  • Lee, Choong-Won;Yoon, Nung-Ki;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.3 s.35
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    • pp.363-372
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    • 1991
  • We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit $cells/mm^3$, Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140mmHg and/or diastolic blood pressure more than 90mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives ($6965.93{\pm}1997.01\;vs\;6490.61{\pm}1941.32,\;P=0.00$) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% Confidence interval, Ci 0.62-1.59), 3/5 quintile 1.41 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI. 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for it indicated a significant trend ($X^2_{trend}=5.53,\;df=1,\;P<0.05$). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic. regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error resulting from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.

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Discussion on the Necessity of the Study on the Principle of 'How to Mark an Era in Almanac Method of Tiāntǐlì(天體曆)' Formed until Han dynasty (한대(漢代) 이전에 형성된 천체력(天體曆) 기년(紀年) 원리 고찰의 필요성에 대한 소론(小論))

  • Seo, Jeong-Hwa
    • (The)Study of the Eastern Classic
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    • no.72
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    • pp.365-400
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    • 2018
  • The signs of $G{\bar{a}}nzh{\bar{i}}$(干支: the sexagesimal calendar system) almanac, which marked each year, month, day and time with 60 ordinal number marks made by combining 10 $Ti{\bar{a}}ng{\bar{a}}ns$(天干: the decimal notation to mark date) and 12 $D{\grave{i}}zh{\bar{i}}s$(地支 : the duodecimal notation to mark date), were used not only as the sign of the factors affecting the occurrence of a disease and treatment in the area of traditional oriental medicine, but also as the indicator of prejudging fortunes in different areas of future prediction techniques.(for instance, astrology, the theory of divination based on topography, four pillars of destiny and etc.) While theories of many future predictive technologies with this $G{\bar{a}}nzh{\bar{i}}$(干支) almanac signs as the standard had been established in many ways by Han dynasty, it is difficult to find almanac discussion later on the fundamental theory of 'how it works like that'. As for the method to mark the era of $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆: a calendar made with the sidereal period of Jupiter and the Sun), which determines the name of a year depending on where $Su{\grave{i}}x{\bar{i}}ng$(歲星: Jupiter) is among the '12 positions of zodiac', there are three main ways of $$Su{\grave{i}}x{\bar{i}}ng-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(歲星紀年法: the way to mark an era by the location of Jupiter on the celestial sphere), $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$ (太歲紀年法: the way to mark an era by the location facing the location of Jupiter on the celestial sphere) and $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法: the way to mark an era with Ganzhi marks). Regarding $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法), which is actually the same way to mark an era as $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(太歲紀年法) with the only difference in the name, there are more than three ways, and one of them has continued to be used in China, Korea and so on since Han dynasty. The name of year of $G{\bar{a}}nzh{\bar{i}}$(干支) this year, 2018, has become $W{\grave{u}}-X{\bar{u}}$(戊戌) just by 'accident'. Therefore, in this discussion, the need to realize this situation was emphasized in different areas of traditional techniques of future prediction in which distinct theories have been established with the $G{\bar{a}}nzh{\bar{i}}$(干支) mark of year, month, day and time. Because of the 1 sidereal period of Jupiter, which is a little bit shorter than 12 years, once about one thousand years, 'the location of Jupiter on the zodiac' and 'the name of a year of 12 $D{\grave{i}}zh{\bar{i}}s$(地支) marks' accord with each other just for about 85 years, and it has been verified that recent dozens of years are the very period. In addition, appropriate methods of observing the the twenty-eight lunar mansions were elucidated. As $G{\bar{a}}nzh{\bar{i}}$(干支) almanac is related to the theoretical foundation of traditional medical practice as well as various techniques of future prediction, in-depth study on the fundamental theory of ancient $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆) cannot be neglected for the succession and development of traditional oriental study and culture, too.

Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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