• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

• Journal of Environmental Impact Assessment
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• v.31 no.4
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• pp.226-240
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• 2022

Local governments over a certain size in Republic of Korea may conduct Environmental Impact Assessment (EIA) considering regional characteristics if it is necessary, in accordance with Article 42 of the 「Environmental Impact Assessment Act」. However, it was investigated that the number of local government EIA operation in many local governments was less than initial expectations. In order to improve it, the status of ordinances and consultation guidelines which are different for each local government need to be compared, and the institutional issues forthe relevant local governments must be found considering regional characteristics. Furthermore, detailed regulation and guidance on the local government EIA procedure should be included in the consultation guidelines and related information need to be provided. In this study, focusing on the case of Incheon Metropolitan City, the status of local government EIA ordinances in metropolitan cities and provinces with a similar condition was investigated, and the types and scope of target projects were compared and analyzed. In addition, consultation guidelines forIncheon Metropolitan City were written, and improvements on the procedure flow and overall schedule designation derived from the process were presented. In the case of Incheon Metropolitan City, there were no detailed information officially announced regarding the regulations of the local government EIA ordinance and follow-up management, so the administrative system of the local government needed to be reinforced in this field. Meanwhile, considering the status of local environment and geography, some target project types were deemed necessary to be added: port construction projects, water resource development projects, railroad construction projects, and military facilities installation projects. The results of this study will provide useful information to local governments which want to improve their operation effectiveness by reorganizing the local government EIA system and preparing specific guidelines.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.133-143
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• 2021

Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.

• 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 Popular Narrative
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• v.25 no.1
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• pp.9-54
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• 2019

Since the birth of melodrama in the early Enlightenment era, it has flowed through various cultures and media. In order to grasp the principle of differentiation of melodrama and the direction of its change, a developmental approach to the formation process of melodrama is necessary. In this regard, this paper examines the formation process of modern melodrama and its aesthetic features around the time of the French Revolution. The modern melodrama was formed in the period between the end of the 18th century and the start of the 19th century. It was born at the intersectional point of the contradictions of the modern imagination and the political paradox of the French Revolution, which demanded an autonomous citizenship but did not recognize a woman as a citizen. The aesthetic of women's sacrifice and tears reproduced in the modern melodrama is a political aspiration to restore a corrupt society by glamorizing a woman as a moral icon. This was an icon to save a society under divide and crisis and a coordination of emotions to conceal sexist violence in the politics of the exclusion of women. The aesthetic of women's sacrifice and tears reproduced in modern melodrama has consistently been considered under negative evaluation such as a play of moral hypocrisy and vulgar drama. However, the academic interest in melodrama in the 1970s has been amplified due to the "Sirk-melo" which is a transition to the new aesthetic of women's sacrifice and tears, encompassing not only women, but also races and classes. In modern society, entering the era of uncertainty, where various social problems, national disasters, and global disasters have become commonplace, 'the aesthetic of women's sacrifice and tears' are shifting from gender differences to various victim narratives. Reviewing new theoretical trends and changes of recent melodrama as well as analyzing specific works are left as follow-up tasks.Since the birth of the melodrama in the early Enlightenment era, it has flowed through various cultures and media. In order to grasp the principle of differentiation of melodrama and the direction of its change, a developmental approach to the formation process of melodrama is basically necessary. In this regard, this paper examines the formation process of modern melodrama and its aesthetic features around the time of the French Revolution.

• The Journal of the Society of Stroke on Korean Medicine
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• v.12 no.1
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• pp.16-23
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• 2011

Object : The purpose of this study is to observe the changes of symptoms and signs diagnosised by differentiation of the pattern identification in stroke patients. Methods : Seventy subjects were recruited from patients with stroke within ten days of onset. We chose twenty-nine subjects diagnosised as same differentiation of the pattern identification, and who had at least on follow up session. We had investigated change of symptoms and signs diagnosised by differentiation of the pattern identification. Results : There were five symptoms and signs (thick fur, dry fur, difficult defecation, heat vexation and aversion to heat, normal pulse) and ten (heavy-headedness, frequency of defecation, hard defecation, feel heavy, slippery pulsem, dry mouth, bitter taste in the mouth, feel lazy, look lazy) symptoms and signs that were statistically significant improved in fire-heat patterns and dampness-phlegm pattern, respectively. Conclusions : This study provides evidence that collaborative treatment is effective in improving some symptoms and signs in acute ischemic stroke patients diagnosised by fire-heat pattern and dampness-phlegm pattern. Further studies with larger scale, longer observation period would be required.

• Korean Journal of Agricultural and Forest Meteorology
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• v.25 no.4
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• pp.346-358
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• 2023

Due to the acceleration of climate change or global warming, it is important to predict rice productivity in the future and investigate physiological changes in rice plants. The research aimed to explore how rice adapts to climate change by examining the response of nitrogen absorption and nitrogen use efficiency in rice under elevated levels of carbon dioxide and temperature, utilizing the SPAR system for analysis. The temperature increased by +4.7 ℃ in comparison to the period from 2001 to 2010, while the carbon dioxide concentration was held steady at 800 ppm, aligning with South Korea's late 21st-century RCP8.5 scenario. Nitrogen was applied as fertilizer at rates of 0, 9, and 18 kg 10a^-1, respectively. Under conditions of climate change, there was an 81% increase in the number of panicles compared to the present situation. However, grain weight decreased by 38% as a result of reduction in the grain filling rate. BNUE, indicative of the nitrogen use efficiency in plant biomass, exhibited a high value under climate change conditions. However, both NUEg and ANUE, associated with grain production, experienced a notable and significant decrease. In comparison to the current conditions, nitrogen uptake in leaves and stems increased by 100% and 151%, respectively. However, there was a 25% decrease in nitrogen uptake in the panicle. Likewise, the nitrogen content and NDFF (Nitrogen Derived from Fertilizer) in the sink organs, namely leaves and roots, were elevated in comparison to current levels. Therefore, it is imperative to ensure resources by mitigating the decrease in ripening rates under climate change conditions. Moreover, there seems to be a requirement for follow-up research to enhance the flow of photosynthetic products under climate change conditions.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.41 no.4
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• pp.49-56
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• 2023

This study analyzes the entirety of Okhojeongdo's content found in the Punggojip, written by Kim Jo-Sun, who created Okhojeong. Through an examination of the literature confirming Okhojeong within the Punggojip, the study compares the existing research with the Okhojeongdo's content. Additionally, it clarifies the relationships between the disciple, the garden, and related historical facts. The results are as follows. First, Kim Jo-Sun, who created Okhojeong, had a strong literary inclination, which made it relatively easy to estimate the original form of the garden, as he expressed detailed content related to the design and management of the garden. Second, the historical dating of the creation of Okhojeong was previously estimated to be around 1815 based on the inscriptions on the Eulhaebyeok. However, it is more appropriate to revise this to 1804, as revealed by Lee Sung-min, who discovered records in Dongseonggyoyeojip, indicating that Kim Jo-Sun purchased the Jang's house. Third, Kim Jo-Sun's literary hobby, as depicted in Punggojip, closely followed Chinese classics. However, the part about creating the garden is supported by factual and garden archaeological records, giving it inherent value. Regarding the expansion of the garden site, it is estimated that the southern boundary of Okhojeong was extended by about half a unit(kan; 間) through a transfer from Kim saeng Saho. Various additions, stone statues, peculiar rocks, ornamental trees, and accompanying elements are found throughout the garden. Particularly noteworthy are the techniques and aesthetics of creating a stone pagoda, and there are mentions of transplanting young pine trees with professional insights. The love for harmony and elegance in the garden is woven throughout the poetry. Additionally, the process of selecting the location for Okhojeong, the understanding of the terrain and topography, the assessment of existing vegetation, the process of cutting down trees and selecting the soil, the construction of houses with tiles and thatched roofs all contribute to demonstrating the comprehensive stages of creating Okhojeong, providing insight into the location and construction process of the Sanbanru pavilion, showcasing the archaeological value of the garden. A follow-up study is needed to excavate more information about the original form of Okhojeong garden through the interpretation of the collections of the literary works of the influential figures introduced in Punggojip in the future.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.147-156
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• 2020

Purpose The objective of this study was to evaluate the diagnostic value and threshold levels of cytokeratin fragment 21-1 (CYFRA 21-1) in fine-needle aspiration (FNA) washouts for detection of lymph node (LN) recurrence in postoperative breast cancer patients. Materials and Methods FNA cytological assessments and CYFRA 21-1 measurement in FNA washouts were performed for 64 axillary LNs suspicious for recurrence in 64 post-operative breast cancer patients. Final diagnosis was made on the basis of FNA cytology and follow-up data over at least 2 years. The concentration of CYFRA 21-1 was compared between recurrent LNs and benign LNs. Diagnostic performance and cut-off value were evaluated using a receiver operating characteristic curve. Results Regardless of the non-diagnostic results, the median concentration of CYFRA 21-1 in recurrent LNs was significantly higher than that in benign LNs (p < 0.001). The optimal diagnostic cut-off value was 1.6 ng/mL. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CYFRA 21-1 for LN recurrence were 90.9%, 100%, 100%, 98.1%, and 98.4%, respectively. Conclusion Measurement of CYFRA 21-1 concentration from ultrasound-guided FNA biopsy aspirates showed excellent diagnostic performance with a cut-off value of 1.6 ng/mL. These results indicate that measurement of CYFRA 21-1 concentration in FNA washouts is useful for the diagnosis of axillary LN recurrence in post-operative breast cancer patients.

• 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.