• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.164-171
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• 2019

Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.141-149
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• 2019

Purpose: To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. Materials and Methods: A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative followup were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups. Results: In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05). Conclusion: When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.30-36
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• 2019

Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.133-140
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• 2019

Purpose: This study examined the radiological and clinical outcomes of tibiotalocacalcaneal arthrodesis using retrograde intramedullary nailing in a severe hindfoot deformity and ankle/subtalar arthritis. Materials and Methods: A total of 22 patients (22 cases) with a severe hindfoot deformity and arthritis underwent tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. The average age was 57.4 years (22-82 years) and the mean follow-up was 29.6 months (12-74 months). The radiological outcomes included an assessment of the preoperative and postoperative coronal ankle alignment, hindfoot alignment, sagittal alignment, and postoperative union time. The clinical outcomes were evaluated using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and postoperative complications. The results were analyzed statistically by dividing the patients into two groups based on a 10° angle of deformity. Results: Regarding the preoperative coronal ankle alignment, 14 patients had a mean varus deformity of 17.8°±14.5° and six had a mean valgus deformity of 8.1°±6.6°. Postoperatively, a satisfactory postoperative coronal ankle alignment of less than 5° was obtained in all patients. Regarding the preoperative hindfoot alignment, 12 patients showed a mean varus deformity of 15.2°±10.5° and six had a mean valgus deformity of 8.1°±4.2°. In total, 94.4% (17 patients) had satisfactory postoperative hindfoot alignment of less than 5°. Radiological union was achieved in 90.9% at an average of 19.2 weeks (12-32 weeks) and there were 2 cases of nonunion. The clinical outcomes showed improvement in the mean VAS and AOFAS scores (p<0.001, p<0.001, respectively). Even a preoperative severe deformity more than 10° showed a significant deformity correction of coronal ankle alignment and hindfoot alignment, postoperatively (p<0.001, p<0.001, respectively). No significant differences were found between the patients with a preoperative coronal ankle deformity more than 10° and those less than 10° regarding the mean postoperative coronal ankle alignment (p=0.162). Conclusion: Tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is an acceptable technique for achieving satisfactory deformity correction, high union rate with minimal complications, and improvement of the clinical outcomes. In addition, tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing is considered an effective treatment option, particularly in severe ankle and hindfoot deformities.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.157-163
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• 2019

Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.33-39
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• 2017

Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

• Korea Trade Review
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• v.42 no.5
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• pp.71-91
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• 2017

This purpose of this study is to examine how emotional intelligence has a moderating effect on the relationship between emotional labor and job burnout. To test the hypotheses, moderation analysis, mediation analysis and moderated mediation analysis were performed. Of the 1,500 self-report questionnaires distributed to franchise employees, 1,412 usable responses and utilized in the final analyses. The resoults show that emotional labor significantly affected job burnout, and job burnout completely mediated the effect of emotional labor on turnover intention. And emotional intelligence moderated the relationship between emotional labor and job burnout, suggesting that the emotional dissonance-job burnout relationship was stronger in the low emotional intelligence group than in the high emotional intelligence group. The results of this study provide some implications for Korean companies entering the Chinese franchise field. First, the mediating effects of "emotional labor → job burnout → turnover intention" and the effect of emotional labor on job burnout were mitigated by self-efficacy in Chinese franchise workers. And the self-efficacy of the employees was an important factor. The implication of this study is that self-efficacy, which is a controlling variable affecting emotional labor, job burnout, and turnover intention, is important, so Korean companies that enter the Chinese franchise employ employees with high self-efficacy and to develop and implement an employee education program that can enhance self-efficacy.

• SUVANNABHUMI
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• v.3 no.1
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• pp.47-66
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• 2011

Malay society is rooted on the Islamic concept. That Islam influenced every corner of that Malay society which had ever been an edge of the civilizations of the Indus and Ganges. Once the letters of that Hindu religion namely Sanscrit was adopted to this Malay society for the purpose of getting the Malay language, that is, Bahasa Melayu down to the practical literation but in vain. The Sanscrit was too complicated for Malay society to imitate and put it into practice in everyday life because it was totally different type of letters which has many of the similar allographs for a sound. In the end Malay society gave it up and just used the Malay language without using any letters for herself. After a few centuries Islam entered this Malay society with taking Arabic letters. It was not merely influencing Malay cultures, but to the religious life according to wide spread of that Islam. Finally Arabic letters was to the very means that Malay language was written by. It means that Arabic letters had been used for Arabic language in former times, but it became a similar form of letters for a new language which was named as Malay language. This Arabic letters for Arabic language has no problems whereas Arabic letters for Malay language has some of it. Naturally speaking, arabic letters was not designed for any other language but just for Arabic language itself. On account of this, there occurred a few problems in writing Malay consonants, just like p, ng, g, c, ny and v. These 6 letters could never be written down in Arabic letters. Those 6 ones were never known before in trying to pronounce by Arab people. Therefore, Malay society had only to modify a few new forms of letters for these 6 letters which had frequently been found in their own Malay sounds. As a result, pa was derived from fa, nga was derived from ain, ga was derived from kaf, ca was derived from jim, nya was derived from tha or ba, and va was derived from wau itself. Where must these 6 newly modified letters be put on this Arabic keyboard? This is the very core of this working paper. As a matter of course, these 6 letters were put on the place where 6 Arabic signs which were scarecely written in Malay language. Those 6 are found when they are used only in the 'shift-key-using-letters.' These newly designed 6 letters were put instead of the original places of fatha, kasra, damma, sukun, tanween and so on. The main differences between the 2 set of 6 letters are this: 6 in Arabic orginal keyboard are only signs for Arabic letters, on the other hand 6 Malay's are real letters. In others words, 6 newly modified Malay letters were substituted for unused 6 Arabic signs in Malay keyboard. This type of newly designed Malay Jawi Script keyboard is still used in Malaysia, Brunei and some other Malay countries. But this sort of keyboard also needs to go forward to find out another way of keyboard system which is in accordance with the alphabetically ordered keyboard system. It means that alif is going to be typed for A key, and zai shall be typed when Z key is pressed. This keyboard system is called 'Malay Jawi-English Rumi matching keyboard system', even though this system should probably be inconvenient for Malay Jawi experts who are good at Arabic 'alif-ba-ta'order.

• Journal of agriculture & life science
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• v.50 no.5
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• pp.173-182
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• 2016

This study was aimed to identify the phenotypic relationships between calving interval and lactation curve parameters in Korean Holstein cow. The data of 36,505 lactation records was obtained from the Dairy Herd Improvement program run by Dairy Cattle Improvemnet Center of National Agricultural Federation of Korea. All lactation records were collectied from the multiparous cows calving between 2011 to 2013. The estimated lactation curves were drawn using Wood model based on actual milk yield records, and NLIN Procedure of SAS program (ver. 9.2). General linear multivariate models for calving interval, 305-d milk yield, lactation parameters(A, b, c), persistency, peak day, and peak yield included fixed effects of calving year-season (spring, summer, fall and winter) and parity(2, 3 and 4). For calving interval, 305-d milk yield, lactation parameters(A, b, c), persistency, peak day and peak yield, all two fixed effect(calving year-season, parity) were significant(p<0.05). The estimated lactation functions using Wood model for 2, 3, and 4 parity were yt=24.66t0.175e-0.00302t, yt=24.69t0.192e-0.00334t, and yt=24.22t0.200e-0.00341t, respectively. Phenotypic correlation (partial residual correlation) between calving interval and 305-d milk yield, A, b, c, persistency, peak day, and peak yield were 0.093, -0.014, 0.028, -0.046, 0.099, 0.085, and 0.052, respectively. To conclude, if calving interval increase then ascent to peak, persistency, peak day and peak yield are increase, and descent after peak is decrease. So, total 305-d milk yield is increase.

• Journal of agriculture & life science
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• v.50 no.4
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• pp.147-155
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• 2016

This study presented a measure for turning by-products, released from land farming sites, into resources. The measure involved adding food by-products such as rice bran and nonfat soybean to the sludge, released from the eel farming sites, inoculating the lactic acid bacteria, Aspergillus oryzae, and Bacillus subtilis by step, fermenting them, and measuring the changed ingredients of the fermented fodder. The water content of the fermented fodder by the step of preparation was the first-step fermented product (14.6%) using the lactic acid bacteria, and the second and third-stage fermented product (33.0% and 34.0% respectively) using Aspergillus oryzae and Bacillus subtilis. The pH level was found to be 5.38 in the first-step fermented product due to the secretion of lactic acid caused by the lactic acid bacteria, and the pH level of the second and third-stage fermented products was 5.66 and 7.26, respectively, showing that the pH level increased. The phytic acid content was 0.126g/100g in the first-step fermented product, 0.004g/100g in the second-stage fermented product, and 0.093g/100g in the third-stage fermented product. The measurement of nitrogen content revealed that the amino nitrogen content was high with 1226.37mg% in the second-stage fermented product, and a little lower with 710.18mg% in the third-stage fermented product. The ammonium nitrogen content increased from 0.988mg/kg in the first-stage fermented product to 1.502mg/kg in the third-stage fermented product. Total nitrogen content increased to 2.78% in the first-stage fermented product, 4.08% in the second-stage fermented product, and 4.85% in the third-stage fermented product. As fermentation continued with the three microbes, the phytic acid decreased, and the protein decomposition rate increased. Also, due to the 3 step fermentation, the low-molecule nitrogen ingredient content increased, suggesting that the fodder was developed to offer high digestion and absorption.