• Title/Summary/Keyword: Korean song

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Giant Schwannoma May Mimic Soft Tissue Sarcoma (악성 연부 종양으로 오인하기 쉬운 신경 및 연부조직의 거대 신경초종)

  • Kim, Yongsung;Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kim, Kyunghoon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.511-519
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    • 2020
  • Purpose: Schwannoma is a benign tumor that occurs mainly in the peripheral nerve. If the tumor is large or is in areas other than the nerves, it is likely to be mistaken for malignant soft tissue tumors. The authors reviewed 50 cases of giant schwannomas and assessed the distribution of the primary locations, clinical symptoms, radiological and pathological diagnosis, and diagnostic accuracy. Materials and Methods: Of the 214 pathologically confirmed schwannomas, 50 cases with a maximum diameter of 5 cm or more were extracted. The entire cohort was classified into three subgroups (major peripheral nerve, intramuscular, bone) according to the primary location, and the anatomical locations were specified. Results: When the entire cohort was classified according to the primary location, 14 tumors occurred in the major peripheral nerve, 31 cases in the muscle, and 5 cases in the bone. The mean size of the tumor in the entire cohort was 7.0 cm, and the intramuscular subgroup had the largest size with 8.0 cm. The radiological diagnosis revealed 33 out of 50 cases to be benign schwannoma (66.0%), 15 cases as low-grade malignancy (30.0%), and the remaining two cases (4.0%) as a suspicious tuberculosis abscess and tenosynovial giant cell tumor, respectively. On the clinical symptoms, Tinel sign was the most common in the peripheral nerve group with 78.6% (11/14), while 93.5% of the intramuscular group had palpation of the mass with a mean duration of 66.6 months. In the bone group, one out of five cases was reported as a low-grade malignancy. Two cases of postoperative complications were encountered; one was bleeding after tumor excision, which required hemostasis, and the other was peroneal nerve palsy after surgery. Conclusion: When assessing the large-sized soft tissue tumors in the muscles, the possibility of a benign schwannoma should be considered if 1) there is a long period of mass palpation and 2) non-specific findings in MRI. Preoperative pathology confirmation with a biopsy can help reduce the risk of overtreatment.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Availability of Positron Emission Tomography-Computed Tomography for the Diagnosis of the Soft Tissue Tumor through Ultrasound-Guided Biopsy (초음파 유도하 침 생검을 이용한 연부조직 종양의 진단에 있어 양전자방출 컴퓨터 단층촬영술의 유용성)

  • Jun, Se Bin;Kim, Jeung Il;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.398-403
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    • 2021
  • Purpose: A biopsy is needed to diagnose soft tissue tumors. However, it is extremely difficult to pinpoint the site of a tumor due to the heterogeneity of sarcomas. Thus, even when an open biopsy is conducted, it is difficult to diagnose a soft tissue tumor. In such cases, an ultrasound (US)-guided biopsy is used to improve the diagnostic accuracy. This study evaluated the accuracy of US-guided biopsy for a diagnosis of soft tissue tumors found initially in a magnetic resonance (MR) perfusion and assessed the availability of positron emission tomography-computed tomography (PET-CT) for a diagnosis of soft tissue tumors. Materials and Methods: From January 2014 to December 2018, the US-guided biopsy was performed on 152 patients with a suspected soft tissue tumor found in an MR perfusion and 86 cases were definitively diagnosed with a soft tissue tumor. The accuracy of the US-guided biopsy was assessed retrospectively. Among the 86 cases, only MR perfusion was used before the biopsy in 50 cases, while both MR perfusion and PET-CT was conducted on 36 cases. The accuracy was analyzed to determine if the PET-CT could improve the precision of a biopsy. Results: From 86 cases, 34 out of 50 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 32 out of 36 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis and the US-guided biopsy. These results show significant differences in the accuracy of US-guided biopsy. In the case of soft tissue sarcomas, 6 out of 12 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 17 out of 18 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis. Moreover US-guided biopsy also showed significant differences in the accuracy of US-guided biopsy. Conclusion: In diagnosing soft tissue tumors, a US-guided biopsy is a well-known tool for its high accuracy. However, the heterogeneity of sarcoma makes it difficult to locate the exact site for a biopsy using only MR perfusion. Thus, the use of PET-CT will meaningfully improve the accuracy of a diagnosis by precisely targeting the site for the US-guided biopsy.

Clinical Results of Lateral-Posterior Internal Fixation for the Treatment of Scapular Body Fractures (견갑골 체부 골절에서 외측 후방 금속판 고정술의 치료 결과)

  • Lee, Yoon-Min;Yeo, Joo-Dong;Song, Seok-Whan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.46-53
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    • 2020
  • Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

A Study on the Cooperation between Medical Care and Law - Focusing on the discussion of the role of clinical practice guideline in Japan - (의료와 사법(司法)의 협력 -일본에서의 진료가이드라인의 역할에 대한 논의를 중심으로-)

  • Song, young-min
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.39-65
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    • 2022
  • There are two aspects of clinical practice guidelines that act as non-legal control before medical practice and as legal control standards after medical practice. The essential purpose of clinical practice guidelines is the former, but the latter action cannot be excluded. The clinical practice guidelines are a means of linking law and medical care. The negative perception of clinical practice guidelines that medical professionals' autonomy can be violated by the enactment of clinical practice guidelines is an excessive negative evaluation of clinical practice guidelines. Rather, judicial judgment based on clinical practice guidelines plays a role in respecting the autonomy of medical professionals. In other words, the clinical practice guidelines suppress legal regulations on medical care as much as possible and are based on doctors' professional ethics and self-discipline, and patient awareness and cooperation. In order to establish an ideal relationship of cooperation between doctors and patients, 'medical ethics' must be incorporated as a legal means. Clinical practice guidelines are the most appropriate means for incorporating such medical ethics into legal procedures. The lawyer solves the case with a legal syllogism that establishes a norm and applies facts to it to conclude. For the resolution of medical disputes, Clinical practice guidelines are used to establish norms that doctors should perform for specific diseases, and conclusions are drawn by applying the established norms to specific medical practices. When it is not easy to apply the established norms to specific medical practices, medical judgments by experts, such as emotions, expert testimony, and explanations by expert members, are used. As such, the Law respects the autonomy of medical care even in the establishment of norms and the application of norms. In particular, Clinical practice guidelines prepared independently by the medical community are referred to in establishing norms, which are the prerequisites for legal syllogism. This shows that doctors participate in the formation of precedents and contribute to the formation of norms. The use of clinical practice guidelines in trials is respect and consideration for the autonomy of medical care. Although there may be an aspect in which the autonomy of individual doctors is limited by clinical practice guidelines, it should be considered that the autonomy of doctors as a group is respected. In this way, the clinical practice guidelines play a role in protecting the autonomy of the "medical" group from the logic of the "law."

A Comparison between Simulation Results of DSSAT CROPGRO-SOYBEAN at US Cornbelt using Different Gridded Weather Forecast Data (격자기상예보자료 종류에 따른 미국 콘벨트 지역 DSSAT CROPGRO-SOYBEAN 모형 구동 결과 비교)

  • Yoo, Byoung Hyun;Kim, Kwang Soo;Hur, Jina;Song, Chan-Yeong;Ahn, Joong-Bae
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.24 no.3
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    • pp.164-178
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    • 2022
  • Uncertainties in weather forecasts would affect the reliability of yield prediction using crop models. The objective of this study was to compare uncertainty in crop yield prediction caused by the use of the weather forecast data. Daily weather data were produced at 10 km spatial resolution using W eather Research and Forecasting (W RF) model. The nearest neighbor method was used to downscale these data at the resolution of 5 km (W RF5K). Parameter-elevation Regressions on Independent Slopes Model (PRISM) was also applied to the WRF data to produce the weather data at the same resolution. W RF5K and PRISM data were used as inputs to the CROPGRO-SOYBEAN model to predict crop yield. The uncertainties of the gridded data were analyzed using cumulative growing degree days (CGDD) and cumulative solar radiation (CSRAD) during the soybean growing seasons for the crop of interest. The degree of agreement (DOA) statistics including structural similarity index were determined for the crop model outputs. Our results indicated that the DOA statistics for CGDD were correlated with that for the maturity dates predicted using WRF5K and PRISM data. Yield forecasts had small values of the DOA statistics when large spatial disagreement occured between maturity dates predicted using WRF5K and PRISM. These results suggest that the spatial uncertainties in temperature data would affect the reliability of the phenology and, as a result, yield predictions at a greater degree than those in solar radiation data. This merits further studies to assess the uncertainties of crop yield forecasts using a wide range of crop calendars.

The Diaspora Narrative and Aesthetics in Handol's Tarae (한돌 타래의 디아스포라 서사와 미학)

  • Shin, Sa-Bin
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.189-219
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    • 2020
  • This study is an analysis of Handol Heung-Gun Lee's Tarae, which is a coinage combining the Korean words for "playing an instrument" and "song", in terms of narrative and aesthetics. The components for analysis are the phenomena and nature of binary oppositions between nature and human beings, between alienation and interest, between division and unification, and between diaspora and people of the national community. Tarae in the period from the late 1970s to the early 1990s described the experience of pain and loss from non-resistance and disobedience in protest against social problems that emerged during the era of miliary dictatorship, such as industrialization, urbanization, reckless development, Westernization, university-oriented education, the gap between rich and poor, human alienation, and the conflicts arising from the division of the nation. After Handol overcame the lack of creative motivation with self-reflection and effort, Tarae took the form of a diaspora epic meta-narratives integrating the "sound of nature and his true nature" and "the awareness of diaspora and the spirit of the Korean people". The epics of the homeland, the national soil and the people, which began with "Teo", became more intense in terms of a sense of diaspora as they shifted their focus from an origin to a path with "Hanmoejulghi" as the turning point. Handol seeks inspiration in the source of narrative rather than in music. His Tarae focuses on "adding rhythm for lyrics". For this reason, the semiotic features of Tarae have a limitation in that its extrinsic phonology is simple even if its intrinsic meaning (i.e., emotion of sadness) is profound and subtle. In order to elicit sympathy from the audience and impress them, it is necessary to strike a balance between the implicit (semantic) part and the explicit (phonological) part. To share the emotion of sadness with more people, it is necessary to strengthen phonological elements. Sympathy for sadness and deep impression on the audience are more often induced by the mood of similar sentiments than by the stories of the same experience. The aesthetics of sadness in Tarae began with the narratives of past experience which were expressed in the contexts of loss, loneliness, and poverty that Handol had experienced since childhood. However, the aesthetics of sadness, deepened over the period of a long hiatus in Handol's career as a composer, formed the narratives of ultimate salvation, embodying even the diaspora experience of others (e.g., displaced people, overseas adoptees, ethnic Koreans in Russia, victims of Japanese military sexual slavery, etc.). This gave Tarae the potential to go beyond the limits of the ethnic group of Korea. Tarae, as a "dispersed sound", can benefit from the appeal of deep sadness at the point of contact with other forms of world music. It may form a global diaspora discourse because Tarae is oriented towards interculturalism rather than anti-multiculturalism. The future challenge and goal of Handol's Tarae would be to continue to find areas of sympathy and broaden the horizon of awareness as diaspora music.

Effects of Conflict Management Strategy Within Supply Chain on Partnership and Performance (공급망 내 갈등관리전략이 파트너십과 성과에 미치는 영향)

  • Ham, Yoon-Hee;Song, Sang-Hwa
    • Korean small business review
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    • v.42 no.1
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    • pp.79-105
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    • 2020
  • While individual enterprises with different objectives each other within supply chains require a variety of resources to achieve their own seeking goals and performances, it is necessary to form interdependent relationships among the enterprises to secure the resources what they need, as the individual enterprises are supposed to have limitations on such as time, space and cost to secure all the resources. In this process, conflict possibilities rise and opportunistic behaviors increase due to those environmental factors such as unbalanced information among enterprises, limited rationality, pursuit of interests, and risk aversion. Those existing studies on conflicts in the field of supply chains have limitations in that they failed to present specific conflict management strategies based on the conflict types from the perspective of the conflict resolution mechanism as the studies have made only focused on investigating the causes of conflicts and the impact of conflicts on performance. In this study, therefore, it used the TKI model of Kilmann and Thomas(1977) to subdivide the conflict management strategies in the process of transactions within supply chains by enterprises, and looked into the impact on partnership and performance according to each strategy. As the results, it showed that those types of conflict management strategies such as concession type and cooperation type had a positive(+) impact on the relationship commitment as a factor of partnership, and it was identified that the relationship commitment had a positive(+) impact on performance. In other words, it can be considered that the enterprises making use of the concession type & the cooperation type conflict management strategies under the situation of conflict would be able to have a very positive impact on their performances if they can make good relationship commitment such as investments in and efforts for the sustainable relationship along with the conflict management, while recognizing the importance of relationship. The most important meaning of this study lies on in terms of that it would be contributable to strengthening the partnership between enterprises and minimizing the risk of supply chains caused by conflicts through these results from the study.

Effects of Dietary Supplementation of Ginseng By-Products on Growth Performance, Organ Weight and Blood Biochemical Characteristics in Broiler (육계 사료 내 인삼 부산물 첨가 급여가 생산성, 장기 무게 및 혈액 생화학 특성에 미치는 영향)

  • Lee, Jun-Ho;Park, Hye-Sung;Song, Ju-Yong;Kim, Bong-Ki;Park, Hee-Bok;Kim, Ji-Hyuk
    • Korean Journal of Poultry Science
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    • v.48 no.4
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    • pp.267-275
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    • 2021
  • The aim of this study was to analyze the effect of dietary supplementation with ginseng berry, stems, and leaves on the growth performance, organ development, and blood biochemical characteristics of broilers. One hundred twenty one-day-old male broiler chicks (Ross 308) were randomly allocated to five groups: control (CON), ginseng berry 0.5% (GB1), ginseng berry 1.0% (GB2), ginseng stems and leaves 0.5% (GLS1), and ginseng stems and leaves 1.0% (GLS2). During the grower period (1-21 d), the body weight gain of all ginseng by-product fed groups was significantly higher (p<0.05) than that of the control group. During the finisher period (22-35 d), the feed intake in GLS2 was significantly higher (p<0.05) than that in the other groups, but there was no significant difference in weight gain or feed conversion ratio. No significant differences were detected among treatments when the growth performance was analyzed throughout the entire period (1-35 d). There was no significant difference in the serum biochemical profile, except for blood glucose. Glucose levels were significantly lower (p<0.05) in GLS groups, and tended to be lower in GB groups when compared to the control. Major organ weights showed no significant differences among treatment groups when compared to each other. In conclusion, dietary supplementation of ginseng by-products may improve the early growth of broiler chickens and reduce blood glucose levels.