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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.

An Archaeology of Cinema as a Real/Imaginary Narrative Medium (상상적/실제적 서사 미디어로서 영화에 대한 미디어고고학)

  • Jeong, Chan-Cheol
    • Journal of Popular Narrative
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    • v.25 no.4
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    • pp.361-395
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    • 2019
  • This paper take a media archaeological approach to cinema transformed into a narrative medium during its transitional period, 1903-1915. To accomplish this, I will explore the question of as which narrative medium cinema was imagined and also how it was institutionalized as a narrative medium with authorship. I will explain that the imaginary and real ideas and changes on cinema resonated with each other on the foundation of its technological aspects such as indexicality, 23 frames/sec. and montage. It was during the transitional period that cinema was transformed from a medium representing spectacle to a medium of narration. The establishment of the American film copyright law in 1912 was an institutional, real outcome from the contemporary understanding of cinema as a narrative medium. At the same time, various ideas emerged that led to imagining of cinema as a complete narrative medium, incomparable to any other. From a media archaeological perspective, the imaginary ideas of media resonate with their actual course of development. These imaginary ideas are not just imaginary, but rather reflect the contemporary desire for the medium. This paper looks into the transitional period based on this media archaeological point of view. To this end, this paper will briefly introduce the notion of media archaeology as a media theory and then discuss Eric Kluitenberg's concept of 'an archaeology of imaginary media' and its methodologies. Second, it will explore literary and cinematic imagining of cinema as a powerful medium of storytelling, while discussing the ways in which cinema's technological characteristics played a decisive role in these imaginings. Also to show the techno-deterministic role of cinema in the real world, this paper will explore how its technological characteristics were considered as an important element in the processes through which America's first motion picture copyright was institutionalized in 1912 after two historical copyright cases: one is Edison v. Lubin in 1903 and Kalem v. Harper Brothers in 1909. Ultimately, this paper will lead us to an understanding of the history of cinema as a medium and its developments in more multi-layed way, as communication between the real and imaginary, and give us perspectives toward what cinema is.

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.

<New material> A Historical Study on the Memorandum Record of 『Gyeongja(庚子)·Daetongryeok(大統曆)』 (<신자료> 『경자년(庚子年) 대통력(大統曆)』에 관한 고증 연구 - 비망 기록을 중심으로 -)

  • RO Seungsuk
    • Korean Journal of Heritage: History & Science
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    • v.56 no.2
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    • pp.12-26
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    • 2023
  • Recently, 『Gyeongja(庚子)/Daetongryeok(大統曆)』(1600), a memorandum record of Yu Seong-ryong during the reign of King Seonjo(宣祖) of the Joseon Dynasty, was returned to Korea from Japan, and about 4,000 letters in cursive characters have been interpreted by Ro Seung-suk. The contents for 203 days written in the margin of 『Gyeongja(庚子)/Daetongryeok(大統曆)』 are mostly new, and are meaningful in understanding Yu's life and social association circumstances. There are daily routines of each day, contemporary figures, diseases and oriental medicine prescriptions. In particular, the combat record of Admiral Yi Sun-shin in 83 letters on the cover is very important to understand the situation in those days. It seems that the reason for writing the combat situations a year and a few months after Admiral Yi died in war was to honor his distinguished military service for a long time by King Seonjo's order according to the public opinion of the royal court. The record can be classified into two categories. First, Admiral Yi sighed when he heard about Yu's dismissal from the office in Gogeumdo, and was always alert with clear water on the boat after the Battle of Waekyo Castle. Second, he was killed by bullets shot by the enemy while directly encouraging battle, not listening to his men who tried to dissuade him from leading the naval battle at Noryang. This only contained contents of devoting his life desperately, which is an important proof of the theory of his death in war. It also contains nine methods for making liquor and another method that wasn't known to the public, and seems to include popular alcohol brewing methods or newly devised ones. In addition, there is a detail that Heo Jun, the author of 『Donguibogam』, introduced medicine to Yu, along with being unable to attend ancestral rites and relieving the poor written in red. There are also stories about Kang Hang(姜沆) returning to Korea after being captured by Japan and Lee Deok-hong(李德弘)'s son, who introduced Gugapseondo(龜甲船圖, the first picture of the Turtle Ship in Korea) to King Seonjo. In the light of the above, 『Gyeongja(庚子)/Daetongryeok(大統曆)』is an important historical record to empirically research not only figures related to Yu but also the circumstances of those days since it contains new facts that are not in the existing literature. In particular, the big accomplishment of this study is to correct the mistakenly known theory of Admiral Yi's suicide and to find out the new fact that Heo Jun provided medical information. In this respect, this book is expected to serve as a testament to the future study of the history and characters related to Yu in the mid-Joseon period.

Tumorigenesis after Injection of Lung Cancer Cell Line (SW-900 G IV) into the Pleural Cavity of Nude Mice (누드마우스의 흉강에 폐암세포주의 주입에 의한 종양형성과 HER2/neu와 TGF-${\beta}_1$의 발현)

  • Park, Eok-Sung;Kim, Song-Myung;Kim, Jong-In
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.588-595
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    • 2010
  • Background: Base on types of tumor, the types of expressed tumor is diverse and the difference in its expression rate is even more various. Due to such reasons an animal model is absolutely needed for a clinical research of lung cancer. The author attempted oncogenesis by cultivating a cell line of non-small cell carcinoma and then injecting it inside thoracic cavities of nude mice. The author conducted quantitative analyses of HER2/neu tumor gene - an epidermal growth factor receptor (EGFR) related to lung cancer, and TGF-${\beta}_1$, which acts as a resistance to cell growth inhibition and malignant degeneration. In order to investigate achievability of the oncogenesis, histological changes and the expression of cancer gene in case of orthotopic lung cancer is necessary. Material and Method: Among 20 immunity-free male BALB/c, five nude mice were selected as the control group and rest as the experimental group. Their weights ranged from 20 to 25 gm (Orient, Japan). After injection of lung cancer line (SW900 G IV) into the pleural cavity of nude mice, They were raised at aseptic room for 8 weeks. HER2/neu was quantitatively analyzed by separating serum from gathered blood via chemiluminiscent immunoassay (CLIA), and immunosandwitch method was applied to quantitatively analyze TGF-${\beta}_1$. SPSS statistical program (SPSS Version 10.0, USA) was implemented for statistical analysis. Student T test was done, and cases in which p-value is less than 0.05 were considered significant. Result: Even after lung cancer was formed in the normal control group or after intentionally injected lung cancer cell line, no amplification of HER2/neu gene showed reaction. However, the exact quantity of TGF-${\beta}_1$ was $28,490{\pm}8,549pg/mL$, and the quantity in the group injected with lung cancer cell was $42,362{\pm}14,449pg/mL$, meaning 1.48 times highly Significant (p<0.483). It proved that HER2/neu gene TGF-${\beta}_1$ had no meaningful interconnection. Conclusion: TGF-${\beta}_1$ gene expressed approximately 1.48 times amplification in comparison to the control group. The amplification of TGF-${\beta}_1$ meant somatic recuperation inhibition mechanism due to carcinogenesis in nude mice was definitely working. It may be implemented as a quantitative analysis that allows early detection of lung cancer in human body.

A Case of Complete Remission after Concurrent Chemoradiotherapy for Esophageal Squamous cell Carcinoma with Solitary Bone Metastasis (고립성 골 전이를 동반한 식도편평세포암에서 동시 항암화학방사선 요법 후 완전관해를 보인 1례)

  • Woo Jin Lee;Hoon Jai Chun;Ye Ji Kim;Sun Young Kim;Min Ho Seo;Hyuk Soon Choi;Eun Sun Kim;Bora Keum;Yoon Tae Jeen;Hong Sik Lee;Soon Ho Um;Chang Duck Kim;Ho Sang Ryu
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.53-57
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    • 2013
  • There is no established treatment for esophageal carcinoma with metastasis. For the metastatic esophageal squamous cell carcinoma, chemotherapy or best supportive care according to patient's performance status are accepted as an available treatment. We report a case of complete remission after concurrent chemoradiotherapy for esophageal squamous cell carcinoma with metastatic lesion in 5th thoracic vertebrae. A 57-year-old man with ongoing dysphagia and weight loss was admitted to our hospital. On the endoscopic and radiologic imaging evaluation,the patient was diagnosed as a squamous cell carcinoma of esophagus with solitary metastatic lesion in 5th thoracic vertebrae. The patient was treated with combination chemotherapy (5-fluorouracil (5-FU) and cisplatin) and concurrent radiotherapy for two months to relieve dysphagia. Because metastatic lesion in thoracic vertebrae was located near the primary esophageal tumor, the metastatic lesion could be included within the radiation field. After concurrent chemoradiotherapy, consecutive 4 cycles of chemotherapy had been carried out. Primary esophageal tumor with metastatic lymph nodes and metastatic lesion in 5th thoracic vertebrae disappeared on follow up computed tomography (CT) and positron emission tomography-CT (PET-CT). Follow up endoscopic biopsy revealed no remnant malignant cells at previous primary cancer lesion.

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Analytical Psychology in Psychiatric Clinics (진료현장에서의 분석심리학 : 정신건강의학과 진료실에서 접하는 문제들의 분석심리학적 접근 경험)

  • Sang-Hag Park
    • Sim-seong Yeon-gu
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    • v.35 no.2
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    • pp.85-112
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    • 2020
  • How does analytical psychology help understand patients at general psychiatric clinics? It's necessary to think about how knowledge of analytical psychology can help young psychiatrists who are in training. Patients who come to us bring symptoms(problems). Symptoms can be compared to tickets to a movie theater. Symptoms accompanied by complaints of pain are not only pathological phenomena to be eliminated, but an important pathway to access the patients' inner problems. In terms of seeing the whole, the point of view in analytical psychology is to see the unconscious as well as the consciousness, even the elements the patients do not speak or know of. When determining indications and contra-indications during the initial process of treating a patient, it is more important to acknowledge the therapist's capabilities and limitations than the patient's condition or limitations The approach to complaints of the same symptoms may differ depending on whether the patient is in the first half or the second half of one's life. Analytical psychology is empirical psychology that experiences and it adheres to a phenomenological position that recognizes the phenomenon as true in itself, not logically right or wrong. The analytical psychological view of understanding mental phenomena asks the causal perspective of why the symptoms occurred. At the same time, the therapist, along with the patient, must seek answers to the question of why now and for what purpose. A therapist is a person who experiences the patient's personal development process together. In analytical psychotherapy, the therapist's attitude is more emphasized than the treatment method or technique; it is regarded as of the utmost importance. In this regard, analytical psychology is a practical and useful therapeutic tool, and is a field of study that can be widely used in actual psychiatric clinics. In addition to understanding the patient, it is also the most important discipline for the therapists, especially for the education and growth of those who want to become a treatment tool themselves.

Single Center Experience of the Balloon-Stent Technique for the Treatment of Unruptured Distal Internal Carotid Artery Aneurysms: Sharing a Simple and Reliable Tip to Use Scepter-Atlas Combination (원위내경동맥에 위치한 비파열성 동맥류의 치료에 있어 풍선-스텐트 테크닉에 대한 단일기관의 경험: Scepter-Atlas 조합을 사용하기 위한 간단하지만 확실한 방법)

  • Yu-jung Park;Jieun Roh;Seung Kug Baik;Jeong A Yeom;Chul-Hoo Kang;Hee Seok Jeong;Sang Won Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1258-1273
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    • 2021
  • Purpose The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

A Study of Psychometric Function Curve for Korean Standard Monosyllabic Word Lists for Preschoolers (KS-MWL-P) (한국표준 학령전기용 단음절어표 (Korean Standard Monosyllabic Word Lists for Preschoolers, KS-MWL-P)의 심리음향기능곡선 연구)

  • Shin, Hyun-Wook;Kim, Jin-Sook
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.534-541
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    • 2009
  • Word recognition test (WRT) for the children can be useful for diagnosing the degree of communication disability, prescribing hearing instruments, planning aural rehabilitation and speech therapy, and determination of site of lesions. The Korean standard monosyllabic word lists for preschoolers (KS-MWL-P) were developed considering the criteria given by the literatures. However, the authors of KS-MWL-P suggested more children should be included to verify homogeneity of the lists using psychometric function curve since only 8 children participated in the developing process. The purpose of this study was to explore the homogeneity of KS-MWL-P for supplementing the limitations of the lists employing psychometric analysis. To 23 preschoolers who have normal-hearing, 100 monosyllabic KS-MWL-P words were examined with the pictures. Psychometric function curve with linear slopes of 20% and 80%'s correct rates through accounting recognition scores of each monosyllabic word at variable intensities from -10 to 40 dBHL was obtained and analyzed. As a result, s-shaped psychometric function curve was presented with increasing correct rate depending on intensity and showed no statistical significant differences among each word and list. The congruous graph shapes among lists also indicated good homogeneity and the list 1,2,3,4's average slopes were 4.48, 3.86, 4.65, 4.50. It was verified that the homogeneity was suitable because the analysis of variance showed no statistical significance among lists (p>0.05). However, KS-MWL-P's order of slope according to the order of the number of items, $1{\sim}10$, $1{\sim}20$, $1{\sim}25$ showed no difference with the p-value of 0.93, 0.59, 0.91, 0.70 for the lists 1,2,3, and 4, respectively. Although KS-MWL-P was assumed that the lower-numbered items were easy for testing younger ages, this study's results could not agree with the author's conclusion. Considering this matter, rearranging of the number of items should be performed according to the analysis of slope suggested by this study for testing younger children with easier items. Other than this, in conclusion, KS-MWL-P was proved to be useful for clinical and rehabilitative evaluating and training tools for preschoolers.

A Psychological Interpretation of Fairly Tale Mokdoryung, Son of Tree (한국민담 '목(木)도령'의 분석심리학적 해석)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.25 no.2
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    • pp.224-264
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    • 2010
  • A brief story of the tale follows : Mokdoryung was a son of an arbor tree and a fairly. When the boy was 7-8 years old, mother-fairy returned to the sky. By using father-tree, Mokdoryung survived from the flood where he saved ants, mosquitos, and a boy with the same age. They arrived on top of the highest mountain, met an old woman with two daughters, worked as servants. With help of insects, Mokdoryung passed the trials, married to a wise daughter and 2 couples became the ancestor of the mankind. Interpretation of the tale starts with amplification of tree which symbolizes Self and Libido. As the son of the tree-spirit and a fairly from the sky, Mokdoryung is a kind of 'divine child' which represents a psychic possibility to understand archetypal nature of unconscious. Adversities of early childhood due to mother's absence regarded as necessary condition for 'divine child' to attain highest good. Flood can be compensation of absence of feminine as well as to bring a new life. The notion of father·tree becomes a kind of life-boat has to do with union of opposite(vertical phallic tree and horizontal feminine boat). Ants and mosquitoes represent upper and lower level of unconsciousness, they mediate divine power. Therefore respecting insects means respecting unconscious, and reward of insects means salvation come from unconscious. The boy saved from the flood presents emergence of psychic energy in its latent unconscious condition to create mental dynamism. The old woman is Great Mother or anima, the controller or guider of unconscious. Working as servants can be an active service for the divine marriage. Trials of separating millet from sand, and finding right direction relate to separatio, means one needs to be separated from unconscious before conunctio, union of opposite. Two sets of couple becoming ancestor of man-kind has to do with number 4 (quaternity) as well as regeneration. Although the tale includes both positive couple (Mokdoryung, wise daugther in east room). and negative couple(shadow side of Mokdoryung, step daughter in west room)as ancestors of mankind, "Good" seems to be more valued than "evil".