• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.69-76
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• 2003

Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.18-23
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• 2003

Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.79-86
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• 2011

Purpose: Modular tumor prosthesis is the most popular recontructive modality after resection of malignat tumor in extremity. Complications and survival of tumor prosthesis reconstruction are well-known. however, reports on the long-term outcome of tumor prosthesis in osteosarcoma patientss are scarece. Materials and Methods: In 158 cases as diagnosed as osteosarcoma from feburary 1989 to December 2006 in a single cancer center. We retrospectively reviewd 48 osteosarcoma patients who under went tumor prosthetic reconstruction. Mean follow up preiod was 75.6 months (range; 60 to 179 months). There were 28 males, 20 females and mean age was 22.4 years (range; 11-71). Pathologic subtypes were conventional central osteosarcoma in 46 cases and periosteal in 2 cases. The location of the tumor was proximal tibia (26 cases), distal femor (20 cases), femor diaphysis (1 case), and tibia diaphysis (1 case). In 41 cases built-up-type tumor prosthesis have been used and 7 cases expansion-type tumor prosthesis have been used. We used Musculoskeletal tumor society (MSTS) grading system to asses post operation function, and we analyzed survival rate of patient and tumor prosthesis and complication. Results: The overall survival rate was 77.7% and disease free survival rate was 68.9%. The survival rate of tumor prosthesis was 73%, in last follow up tumor prosthesis has been removed in 12 cases. All of them, 17 complications occurred, which included infection in 16 cases, Periprosthetic Fracture and Loosening of tumor prosthesis in 4 cases, articular instability in 4 cases. MSTS functional score was 74.1% in post operation. Conclusion: In long term follow up result, Primary tumor prosthesis -a reconstruction method after a wide extensional resecion of a bone tumor- can be a effective treatment method in asepect of survival rate, functional assesment and complication.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.56-63
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• 2013

Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.

• The Journal of the Korea Contents Association
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• v.18 no.5
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• pp.191-214
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• 2018

This research empirically analyzed the selection factors and the locational selection factors of the medical service facilities according to the gradual increase of the importance of the selection factors and the locational selection factors regarding the establishments of the small- and medium-sized hospitals according to the rapid changes of the socio-economic conditions. By analyzing the priority order according to the levels of the importance of each evaluation item factor through a research related to the selection factors and the locational selection factors of the small- and medium-sized hospitals and by drawing what the important factors that have the influences on the competitiveness of the pre-existent small- and medium-sized hospitals are through the classification of the real estate locational factors and the non-locational factors, the purpose lies in utilizing them as the basic data and materials for the opening strategies of the small- and medium-sized hospitals considering the special, locational characteristics according to the important factors of the selection factors of the small- and medium-sized hospitals, regarding the medical suppliers that have been preparing, for opening the new, small- and medium-sized hospitals. Based on the results of the preceding researches and the researches on the case examples, 28 evaluation factors were arrived at in terms of the level of the medical treatment, the medical services, the accessibilities of the hospitals, the conveniences of the hospitals, and the physical environment. And, regarding the 28 detailed evaluation factors that had been collected, through the interviews with the related experts, the 5 factors of the medical level, the medical service, the expertise of the hospital, the convenience of the hospital, and the physical environment were selected as the upper class evaluation factors. And, according to each upper class, a total of 28 low-part evaluation factors were selected. Regarding the optimal evaluation factors that were selected, the optimal locational factors were selected by carrying out an AHP questionnaire survey investigation with 200 medical experts as the subjects. Regarding the AHP analysis results, similarly with the case examples of the precedent researches, the levels of the importance appeared in the order of the medical level, the medical services, the accessibility of the hospital, the physical environment, and the convenience. And the factors that were related to the facilities of a hospital appeared low. The results of this research can be applied in providing the basis for the decision-makings regarding the selections of the locations of the small- and medium-sized hospitals in the future.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.28-35
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• 2001

Purpose : Authors investigated the efficiency of preoperative MRI in suspicious glomus tumor and the clinical outcomes after marginal excision. Materials and Methods : In 10 cases of glomus tumors in the fingers, authors retrospectively analyzed the clinical data, including previous trauma, treatment history, preoperative symptoms, physical examination, plain radiography, MRI (9 cases), pathological findings and postoperative complications. Results : The patients had pain in 10 cases, tenderness in 9 cases, cold sensitivity in 3 cases and edema in one case. MRI showed low signal (3 cases) or iso-signal (5) intensity on T1 weighted image, high signal intensity (8) on T2 weighted image, and all the lesions were enhanced in gadolinium enhancement images. The exact locations of glomus tumors were median in 6 cases, lateral in 5, lateral fold in 2 and pulp in 3 in transverse section and nail bed in 5 cases and nail matrix in 5 in sagittal section. Marginal excision was performed by lateral approach in one case and transungual in 9 cases. Histologically, all 10 cases were composed of solid sheets of round cells interrupted by thin-walled blood vessels. Most of clinical symptoms were disappeared in all cases after operation. Nail deformity was found in one case, which was originated from nail matrix, however, there was no recurrence. Summary : Clinical symptom was the most impotant factor in diagnosis of glomus tumor in the fingers. However, preoperative MRIs were helpful in patients, who had obscure pain or prolonged clinical symptoms with suspicious glomus tumors. Preoperative MRI might be one of the most useful tools for establishing the exact diagnosis and detecting the location of glomus tumors, in spite of the relatively high expenses.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.25-31
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• 2005

Purpose: This study was designed to know the usefulness of the MRI to distinguish lipoma and well differentiated liposarcoma (WDL). Materials and methods: 47 lipomatous tumors with MRI were reviewed among the 107 lipomatous tumors operated in our department. MRI examinations and their corresponding pathology reports were compared to determine sensitivity, specificity, diagnostic ability, positive predictable value and negative predictable value. Statistical analysis was performed to know the relationship between malignancy of the tumor (WDL) with the age and gender of the patients, and location, depth, size and the enhancement of tumors in MRI. Results: Among 28 lipoma in MRI examinations, 26 were proved as lipoma in pathology, and only 6 were WDL from 19 suspicious lesions in MRI, and others were proved as lipoma variants mostly. The varieties of lipoma variants were fibrolipoma, angiolipoma, spindle cell lipoma, lipoblastoma and angiomyolipoma. The sensitivity, specificity, diagnostic ability, positive predictable value and negative predictable value of MRI were 100%, 68 %, 72%, 31% and 100% in WDL, and 90%, 89%, 89%, 93% and 84% in lipoma. Among the variants to distinguish WDL and lipoma, the size of tumor and enhancement in MRI were significant statistically (p<0.05). Conclusion: MRI was highly sensitive in detection of WDL and highly specific in detection of simple lipoma. The size of tumor and enhancement in MRI were significant variants to distinguish WDL and lipoma. When MRI finding is non-specific, it is more likely to represent one of lipoma variants.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.1
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• pp.9-13
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• 2013

Purpose: We evaluated oncologic outcomes of chondrosarcomas and analyzed the disease-free survival rate of chondrosarcomas according to the various factors. Materials and Methods: We performed a retrospective study for the disease-free survival rate of 48 chondrosarcomas, 44 of which underwent surgical treatment and followed up more than 18 months since 1993, and in the remaining 4 cases, the patients died before 18 months after surgery. The vsariables were location, tumor volume, histologic grade, stage, age at presentation and treatment performed. The mean follow up period was 43.8 months (1-196 months). Results: The overall disease-free survival rate was 77.1% at mean 43.8 month follow up. The 5 year- and 10 year disease-free survival rates were 64% and 58% respectively. The histologic grade, stage, age at presentation revealed statistical significance on disease-free survival. All 9 patients treated with extended curettage for grade 1 central chondrosarcomas revealed disease-free survival with excellent functional outcome. Conclusion: The disease-free survival rate of chondrosarcomas mainly depended on histologic grade, stage and age at presentation. Local recurrence and distant metastasis also revealed statistically significant differences of disease-free survival rate. Comparing to wide resection, extended curettage for low-grade central chondrosarcomas in extremities were efficient methods with similar survival rate and less functional losses and complications.

• Journal of the Korean Society for Marine Environment & Energy
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• v.9 no.4
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• pp.193-202
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• 2006

The Consultative Meeting of the Convention on the Prevention of Marine Pollution by Dumping of Wastes and other matter, 1972 (London Convention 1972) has requested to International Maritime Organization (IMO) Marine Environmental Protection Committee to collaborate and help clarify a boundary issue between International Convention for the Prevention of Pollution from Shops, 1973 as modified by the Protocol of 1978 (MARPOL) and the London Convention concerning 'dumping' versus 'discharges' during normal operations of ships in 2004, and subsequently established a Joint London Convention/MEPC Correspondence Group. The Contracting Parties to London Convention expressed their environmental concerns on the broad interpretation of the "cargo-associated wastes" by the States, which could be discharged by ships under MARPOL. Regulatory regimes for the cargo residues appear to vary among states. Some countries require fur ships to discharge their cargo wastes into the port reception facility and IMO also recommends doing so. This paper examines the related current national and international legal texts for the regulation of disposal of wastes from ships in order to analyze the current global concern on the marine pollution associated with waste discharge during operations of ships. In particular, we attempt to evaluate the likely marine environmental consequences arising from the disposal of cargo residue using an hypothetical case for the coal cargo residue among bulk cargos in this paper, since location, magnitude and frequency of the discharge of coal cargo residues into the sea adjacent to Korean Peninsula are not readily available. The cargo residues may be discharged to the sea according to MARPOL 73/78; however, its marine environmental consequences can be significant depending upon the characteristics and amounts of wastes to be discharged. Also the public tolerance of the environmental consequences would be widely different among nations. Multilateral environmental agreements, in general, more strictly apply their rules if there are other options to disposal at sea, i.e. port reception facility in this case. Therefore, port reception facilities for the wastes generated by ships are recommended to be further constructed in major national ports in order to reduce the risk of environmental damages during the operations of ships.

• Journal of the Korean Society of Marine Environment & Safety
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• v.21 no.6
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• pp.662-671
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• 2015

As the type of Hazardous and Noxious Substances(HNS) becomes various and the transport volume of HNS increases, HNS spill incidents occur frequently on land and the sea. In view of various damages to human lives and properties by HNS spills, it is necessary to educate and train professional personnel in preparation for and response to potential HNS spills. This study shows the current state of response systems and education courses against HNS spill incidents on land and the sea to compare those with each other between land and sea in Korea. Incident command system on land are basically similar to that at sea, but leading authority which is responsible for combating HNS spills at sea is changeable depending on the location of HNS spill, as it were, Korea Coast Guard(KCG) is responsible for urgent response to HNS spill at sea, while municipalities are responsible for the response to HNS drifted ashore. Education courses for HNS responders on land are established at National Fire Service Academy(NFSA), National Institute of Chemical Safety(NICS), etc., and are diverse. Education and training courses for HNS responder at sea are established at Korea Coast Guard Academy(KCGA) and Marine Environment Research & Training Institute(MERTI), and are comparatively simple. Education courses for dangerous cargo handlers who work in port where land is linked to the sea are established at Korea Maritime Dangerous Goods Inspection & Research Institute(KOMDI), Korea Port Training Institute(KPTI) and Korea Institute of Maritime and Fisheries Technology(KIMFT). Through the comparison of education courses for HNS responders between land and sea, some recommendations such as extension of education targets, division of an existing integrated HNS course into two courses composed of operational level and manager level with respective refresh course, on-line cyber course and joint inter-educational institute course in cooperation with other relevant institutes are proposed for the improvement in education courses of KCG and KOEM(Korea Marine Environment Management Corporation) to educate and train professionals for combating HNS spills at sea in Korea.