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Limb Salvage Using a Combined Distal Femur and Proximal Tibia Replacement in the Sequelae of an Infected Reconstruction on Either Side of the Knee Joint (슬관절 주위 재건물 감염 후유증 시 슬관절 상하부 종양인공관절을 이용한 사지 구제술)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Park, Hwanseong;Nam, Heeseung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.37-44
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    • 2019
  • Purpose: Tumor infiltration around the knee joint or skip metastasis, repeated infection sequelae after tumor prosthesis implantation, regional recurrence, and mechanical failure of the megaprosthesis might require combined distal femur and proximal tibia replacement (CFTR). Among the aforementioned situations, there are few reports on the indication, complications, and implant survival of CFTR in temporarily arthrodesed patients who had a massive bony defect on either side of the knee joint to control infection. Materials and Methods: Thirty-four CFTR patients were reviewed retrospectively and 13 temporary arthrodesed cases switched to CFTR were extracted. All 13 cases had undergone a massive bony resection on either side of the knee joint and temporary arthrodesis state to control the repeated infection. This paper describes the diagnosis, tumor location, number of operations until CFTR, duration from the index operation to CFTR, survival of CFTR, complications, and Musculoskeletal Tumor Society (MSTS) score. Results: According to Kaplan-Meier plot, the 5- and 10-year survival of CFTR was 69.0%±12.8%, 46.0%±20.7%, respectively. Six (46.2%) of the 13 cases had major complications. Three cases underwent removal of the prosthesis and were converted to arthrodesis due to infection. Two cases underwent partial change of the implant due to loosening and periprosthetic fracture. The remaining case with a deep infection was resolved after extensive debridement. At the final follow-up, the average MSTS score of 10 cases with CFTR was 24.6 (21-27). In contrast, the MSTS score of 3 arthrodesis cases with failed CFTR was 12.3 (12-13). The average range of motion of the 10 CFTR cases was 67° (0°-100°). The mean extension lag of 10 cases was 48° (20°-80°). Conclusion: Although the complication rates is substantial, conversion of an arthrodesed knee to a mobile joint using CFTR in a patient who had a massive bony defect on either side of the knee joint to control infection should be considered. The patient's functional outcome was different from the arthrodesed one. For successful conversion to a mobile joint, thorough the eradication of scar tissue and creating sufficient space for the tumor prosthesis to flex the knee joint up to 60° to 70° without soft tissue tension.

Entertainment History Perspective - Around the Grand Duchess to Appear in Movies 'Elizabeth' - (엔터테인먼트 관점에서 바라본 영화로 본 역사 - 영화 '엘리자베스'에 나와 있는 여성 통치자에 대한 관점을 중심으로 -)

  • Choi, Sun-Ah
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.6
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    • pp.247-256
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    • 2019
  • The importance of the convergence education is getting more and more emphasized. But the university convergence education has not yet met today's needs. So this study is focused on showing effective practice methods and finding development directions of the university convergence criticism education. One of a significant trend of the contemporary academic education of liberal arts is the tendency of the convergent and integrative studies. What is essential in the convergent and integrative studies creativity. The zeitgeist of knowledge-based society is change and innovation. In response to its request, college education is being asked to do convergence education, And general education as the basis of convergence education is strengthened.

Characteristics of Benthic Environment and Polychaete Communities of Gamak Bay, Korea (가막만의 저서환경과 다모류군집 특성)

  • Yoon, Sang-Pil;Jung, Rae-Hong;Kim, Youn-Jung;Kim, Seong-Soo;Lee, Jae-Seong;Park, Jong-Soo;Lee, Won-Chan;Choi, Woo-Jung
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.4
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    • pp.287-304
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    • 2007
  • This study was carried out to investigate spatio-temporal variations of benthic environment and macrobenthic polychaete communities in Gamak Bay where excessive organic matters from untreated sewage effluents and fish and shellfish farming activities have been accumulated in certain regions. Such environmental variables as sediment composition, organic content, acid volatile sulfide and dissolved oxygen content etc. were measured and polychaete specimens were taken in September 1999 and February 2000. In September 1999, organic contents were up to three times higher in the northwestern part of the bay and the area closed to Gukdong harbor than in the rest of the bay. In particular, benthic environment of the northwestern part of the bay was extremely deteriorated by the occurrence of hypoxia and highly concentrated sulfide. Of 28 stations investigated in summer, 5 stations located in the northwestern part were azoic. In the rest of the stations, a total of 119 polychaete species were sampled with a mean density of 900 $ind./m^2$. While species richness was higher in the entrance and central part of the bay where water exchanges with open sea were relatively active, density was higher in the moderately enriched stations neighbouring Gukdong harbor and fish farms where such potential indicators of organic pollution as Aphelochaeta monilaris, Lumbrineris longifolia were largely dominant. In February 2000, a total of 81 polychaete species appeared with a mean density of 2,802 $ind./m^2$ from 12 stations sampled in winter. Azoic areas were recolonized by Capitella capitata, Pseudopolydora paucibranchiata and Dipolydora socialis which showed maximum density in the innermost station. On the other hand, the rest of the stations were dominated by Euchone alicaudata and Praxillella affinis. The configuration of the stations sampled in summer and winter on the multidimensional scaling plots reflected the position of each stations within the bay in which there were great differences in organic content, sulfide concentration and oxygen content rather than in sediment composition. Therefore, heterogeneities in polychaete community structure in Gamak Bay were primarily influenced by the degree of the disturbance depending on the position within the bay.

A Study on Space Creation and Management Plan according to Characteristics by Type in Each Small-Scale Biotope in Seoul - Base on the Amphibian Habitats - (서울시 소규모 생물서식공간 유형별 특성에 따른 조성 및 관리방안 연구 - 양서류 서식지를 중심으로 -)

  • Park, Ha-Ju;Han, Bong-Ho;Kim, Jong-Yup
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.2
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    • pp.110-126
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    • 2024
  • This study conducted a classification of small-scale biological habitats created in Seoul to analyze and synthesize location characteristics, habitat structure, biological habitat functions, and threat factors of representative sites, as well as derive creation and management problems according to the ecological characteristics. The aim was to suggest improvement measures and management items. Data collected through a field survey was used to categorize 39 locations, and 8 representative sites were selected by dividing them into location, water system, and size as classification criteria for typification. Due to the characteristics of each type, the site was created in an area where amphibian movement was disadvantageous due to low or disconnected connectivity with the hinterland forest, and the water supply was unstable in securing a constant flow and maintaining a constant water depth. The habitat structure has a small area, an artificial habitat structure that is unfavorable for amphibians, having the possibility of sediment inflow, and damage to the revetment area. The biological habitat function is a lack of wetland plants and the distribution of naturalized grasses, and threats include the establishment of hiking trails and decks in the surrounding area. Artificial disturbances occur adjacent to facilities. When creating habitats according to the characteristics of each type, it was necessary to review the possibility of an artificial water supply and introduce a water system with a continuous flow in order to connect the hinterland forest for amphibian movement and locate it in a place where water supply is possible. The habitat structure should be as large as possible, or several small-scale habitats should be connected to create a natural waterfront structure. In addition, additional wetland plants should be introduced to provide shelter for amphibians, and facilities such as walking paths should be installed in areas other than migration routes to prevent artificial disturbances. After construction, the management plan is to maintain various water depths for amphibians to inhabit and spawn, stabilize slopes due to sediment inflow, repair damage to revetments, and remove organic matter deposits to secure natural grasses and open water. Artificial management should be minimized. This study proposed improvement measures to improve the function of biological habitats through the analysis of problems with previously applied techniques, and based on this, in the future, small-scale biological habitat spaces suitable for the urban environment can be created for local governments that want to create small-scale biological habitat spaces, including Seoul City. It is significant in that it can provide management plans.

An Analysis of Wooden Wells from the Three Kingdoms Period in the Yeongsan River Basin (영산강유역 삼국시대 목조우물에 대한 검토)

  • CHOI Misook
    • Korean Journal of Heritage: History & Science
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    • v.57 no.3
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    • pp.6-22
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    • 2024
  • This paper examines the characteristics of wooden wells from the Three Kingdoms period that were discovered in the Yeongsan River basin, in addition to their functions based on the distribution of the remains and excavated artifacts found near the wells. A total of 11 wooden wells have been found at six archeological sites along the middle and upper reaches of the Yeongsan River basin. These wooden wells were built in a wider variety of forms than wells made of other materials due to the ease of processing resulting from the physical properties of wood. However, due to the limited geological conditions in which these wells can be installed and their rapid decay, the discovery of such wells is rare. They tend to be located in the clay and mud layers of old river channels or near river channels where it was relatively easy to obtain water from the riverbed. The wooden wells are mostly square or rectangular in shape and were assembled transversely, and some include support beams in their construction. The backfill was reinforced with either stone, a mixture of stone and clay, or a mixture of clay and pottery shards. The material mainly used was pine wood boards, with wood from chestnut trees being used as a sub-material. Various artifacts, such as pottery and wooden containers, animal bones, and seeds, have been excavated in small quantities. The excavated pottery items consist mostly of flat cups with a cover, mounted cups, pottery stands, wide-mouthed jars with a hole, and round pottery. Based on the environment and remains of the sites, the wells are thought to have been used for domestic and production purposes. The assumed primary function was to obtain domestic water, as most of the wells were located within residential spaces where the area's inhabitants lived. The wells were also used to obtain water for agricultural purposes, as well as for productive purposes such as for operating kilns and smelters. Lastly, the wooden wells were also found to be strongly associated with rites, as evidenced by the artifacts found inside them.

Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery (변형 근치적 유방절제술 시행 환자의 방사선 치료 시 3D-bolus와 step-bolus의 비교 평가)

  • Jang, Wonseok;Park, Kwangwoo;Shin, Dongbong;Kim, Jongdae;Kim, Seijoon;Ha, Jinsook;Jeon, Mijin;Cho, Yoonjin;Jung, Inho
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.7-16
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    • 2016
  • Purpose : This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. Materials and Methods : The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. Results : The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0.3%. However, to mention the average prescribed dose for the part of lung and heart, that of 3D-bolus was decreased by 11% for lung and by 8% for heart, compared to that of step-bolus. Conclusion : It was confirmed through this research that the dose uniformity could be improved better through the device of 3D-bolus than through the device of step-bolus, as the device of 3D-bolus, produced in consideration of the contact condition of skin surface of chest wall, could be attached to patients' skin more nicely and the thickness of chest wall can be guaranteed more accurately by the device of 3D-bolus. It is considered that 3D-bolus device can be highly appreciated clinically because 3D-bolus reduces the dose on the adjacent organs and make the normal tissues protected, while that gives no reduction of dose on chest wall.

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Validity and Pertinence of Administrative Capital City Proposal (행정수도 건설안의 타당성과 시의성)

  • 김형국
    • Journal of the Korean Geographical Society
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    • v.38 no.2
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    • pp.312-323
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    • 2003
  • This writer absolutely agrees with the government that regional disequilibrium is severe enough to consider moving the administrative capital. Pursuing this course solely to establish a balanced development, however, is not a convincing enough reason. The capital city is directly related to not only the social and economic situation but, much more importantly, to the domestic political situation as well. In the mid-1970s, the proposal by the Third Republic to move the capital city temporarily was based completely on security reasons. At e time, the then opposition leader Kim, Dae-jung said that establishing a safe distance from the demilitarized zone(DMZ) reflected a typically military decision. His view was that retaining the capital city close to the DMZ would show more consideration for the will of the people to defend their own country. In fact, independent Pakistan moved its capital city from Karachi to Islamabad, situated dose to Kashmir the subject of hot territorial dispute with India. It is regrettable that no consideration has been given to the urgent political situation in the Korean peninsula, which is presently enveloped in a dense nuclear fog. As a person requires health to pursue his/her dream, a country must have security to implement a balanced territorial development. According to current urban theories, the fate of a country depends on its major cities. A negligently guarded capital city runs the risk of becoming hostage and bringing ruin to the whole country. In this vein, North Koreas undoubted main target of attack in the armed communist reunification of Korea is Seoul. For the preservation of our state, therefore, it is only right that Seoul must be shielded to prevent becoming hostage to North Korea. The location of the US Armed Forces to the north of the capital city is based on the judgment that defense of Seoul is of absolute importance. At the same time, regardless of their different standpoints, South and North Korea agree that division of the Korean people into two separate countries is abnormal. Reunification, which so far has defied all predictions, may be realized earlier than anyone expects. The day of reunification seems to be the best day for the relocation of the capital city. Building a proper capital city would take at least twenty years, and a capital city cannot be dragged from one place to another. On the day of a free and democratic reunification, a national agreement will be reached naturally to find a nationally symbolic city as in Brazil or Australia. Even if security does not pose a problem, the governments way of thinking would not greatly contribute to the balanced development of the country. The Chungcheon region, which is earmarked as the new location of the capital city, has been the greatest beneficiary of its proximity to the capital region. Not being a disadvantaged region, locating the capital city there would not help alleviate regional disparity. If it is absolutely necessary to find a candidate region at present, considering security, balanced regional development and post-reunification scenario of the future, Cheolwon area located in the middle of the Korean peninsula may be a plausible choice. Even if the transfer of capital is delayed in consideration of the present political conflict between the South and the North Koreas, there is a definite shortcut to realizing a balanced regional development. It can be found not in the geographical dispersal of the central government, but in the decentralization of power to the provinces. If the government has surplus money to build a new symbolic capital city, it is only right that it should improve, for instance, the quality of drinking water which now everyone eschews, and to help the regional subway authority whose chronic deficit state resoled in a recent disastrous accident. And it is proper to time the transfer of capital city to coincide with that of the reunification of Korea whenever Providence intends.

Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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The Characteristic of Laws on the Kind of Urban Green Spaces and the Legal Requirements for the Green Spaces of Urban Habitat in China (중국의 도시녹지 종류와 도시거주구 녹지의 설치 기준에 관한 법제도의 현황과 특성)

  • Shin, Ick-Soon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.3
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    • pp.1-11
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    • 2013
  • This study investigated Chinese Laws on the kind of urban green spaces and the legal requirements for the green spaces of urban habitat and analyzed the specificities of them intending to provide basic data to suggest bringing in or not the relevant Chinese Laws to Korea. This study can be summarized as follows: First, the concept of Chinese urban green spaces(g.s.) classified by 5 kinds(park g.s., production g.s., protection g.s., attachment g.s., the others g.s.) placed the park and green spaces in the same category unlike the Korean urban green spaces that only distinguishes between park and green spaces. The Chinese Urban Park is classified by 4 kinds(composite park, community park, special park, linear park) at the 'Standard for urban green spaces classification' which is below in rank of the legal system. Second, in case of calculation for green spaces ratio of urban green spaces in China, the green rooftop landscaping area should not be included as a green spaces area except the rooftop of a basement or semi basement building to which residents have easy access. The green spaces requirements and compulsory secure ratio by 3 habitat kinds(habitat, small habit, minimum habitat) of when to act as a residential plan is regulated. Third, the green spaces system is obligated to establish at habitat green spaces plan and is specified to conserve and improve existing trees and green spaces. The green spaces ratio on reconstruction for old habitat is relaxed to be lower than for new habitat and a gradient of green spaces is peculiarly clarified. The details and requirements for establishment and the minimum area intending for each classes of the central green spaces(habitat park, children park, minimum habitat's green spaces) are regulated. Especially at a garden style of minimum habitat's green spaces, intervals between the south and north houses and a compulsory security for green spaces area classifying into two groups(closing type green spaces and open type green spaces) by a middle-rise or high-rise building are clarified. System of calculation for green spaces area is presented at a special regulation. Fourth, a general index(area/person) of public green spaces within habitat to achieve by 3 habitat kinds is determined, in this case, the index on reconstruction for a deterioration zone can be relaxed to be lower to the extent of a specified quantity. A location and scale, minimum width and minimum area per place of public green spaces are regulated. A space plot principle including adjacent to a road, greening area ratio against total area, security of open space and the shadow line boundary of sunshine are also regulated to intend for public green spaces. Fifth, the minimum horizontal distance between the underground cables and the surrounding greening trees are regulated as the considerable items for green spaces when setting up the underground cables. The principle to establish green spaces within public service facilities is regulated according to the kind of service contents. It shall be examined in order to import or not the special regulations that only exist in Chinese Laws but not in Korean Laws. The result of this study will contribute to gain the domestic landscape architect's' sympathy of the research related to Chinese urban green spaces laws requiring immediate attention and will be a good chance to advance into the internationalization of Korean Landscape Architectural Laws.

A Study on the Construction and Landscape Characteristics of Munam Pavilion in Changnyeong(聞巖亭) (창녕 문암정(聞巖亭)의 조영 및 경관특성에 관한 연구)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Ahn, Gye-Bog
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.2
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    • pp.27-41
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    • 2014
  • This study aims to investigate the history, cultural values prototype through literature analysis, characteristics of construction, location, space structure and landscape characteristics by Arc-GIS on the Munam pavilion(聞巖亭) in Changnyeong. The results were as follows. First, Shin-cho((辛礎, 1549~1618) is the builder of the Munam pavilion and builder's view of nature is to go back to nature. The period of formation of Munam pavilion is between 1608-1618 as referred from document of retire from politics and build a pavilion. Secondly, Munam pavilion is surrounded by mountains and located at the top of steep slope. Pavilion was known as scenic site of the area. But damaged in a past landscape is caused by near the bridge, agricultural facilities, town, the Kye-sung stream of masonry and beams. Thirdly, Munam pavilion is divided into the main space, which is located on the pavilion, space in located on the pavilion east and west and the orient space, which is located on the Youngjeonggak. Of these, original form of Munam pavilion is a simple structure composed of pavilion and Munam rock, thus at the time of the composition seems to be a direct entry is possible, unlike the current entrance. Fourth, Spatial composition of Munam pavilion is divided into vegetation such as Lagerstroemia indica trees in Sa-ri in Changnyeong, ornament such as letters carved on the rocks and pavilion containing structure. The vegetation around the building is classified as precincts and outside of the premises. Planting of precincts was limited. Outside of area consists of front on the pavilion, which is covered with Lagerstroemia Indica forest and Pinus densiflora forest at the back of the pavilion. Ofthese,LargeLagerstroemiaIndicaforestcorrespondstothenaturalheritageasHistoricalrecordsofrarespeciesresourcesthatareassociated withbuilder. Letterscarvedontherocksrepresenttheboundaryof space, which is close to the location of the Munam pavilion and those associated with the builder as ornaments. Letters carved on the rocks front on the pavilion are rare cases that are made sequentially with a constant direction and rules as act of record for families to honor the achievements. Fifth, 'The eight famous spots of Munam' is divided into landscape elements that have nothing to do with bearing 4 places and landscape elements that have to do with bearing 4 places. Unrelated bearings of landscape elements are Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Okcheon valley, Gwanryongsa temple and Daeheungsa temple. Bearing that related element of absolute orientation, which is corresponding to the elements are Daeheungsa temple, Hwawangsan mountain, Kye-sung stream and Yeongchwisan mountain. Relative bearing is Gwanryongsa temple, Yeongchwisan mountain and Kye-sung stream Gongjigi hill. At Lagerstroemia indica trees in Sa-ri in Changnyeong, Pinus densiflora forest at the back of the pavilion, Kye-sung stream and Okcheon valley, elements are exsting. Currently, it is difficult to confirm the rest of the landscape elements. Because, it is a generic element that reliable estimate of the target and locations are impossible for element. Munam pavilion is made for turn to nature by Shin-cho(辛礎). That was remained a record such as Munamzip(聞巖集) and Munamchungueirok(聞巖忠義錄) that is relating to construction of pavilion. Munam pavilion located in a unique form, archival culture through the letters carved on the rocks and Large Lagerstroemia indica forest and through eight famous spots, cultural landscape elements can be assumed that those elements are remained.