• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.244-252
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• 2020

Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

• Journal of Venture Innovation
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• v.3 no.2
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• pp.95-109
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• 2020

The source of value-added creation in modern times has been transformed from material to man's value-added generating power, and ownership of the means of production has been converted from a particular landlord, capitalist to a person with value-added capacity, and a system of capital participation is needed beyond the profit-sharing system or performance incentive system in which workers of an enterprise participate in simple profits if they significantly increase the added value of the company. It is also necessary to introduce our private stock system as a means of addressing the problem of capital bias and for the stable development of capitalism. The purpose of Employee Stock Ownership Plans is to improve the economic and social status of workers and promote labor-management cooperation by allowing workers to acquire and hold shares of the stock company in which the employee ownership association is established through the employee ownership association, but the reality is that our stock ownership system has failed to achieve its purpose due to insufficient protection against the employee. In terms of welfare, the acquisition of our company shares should include active government support for the welfare of workers' ownership on a social welfare level rather than on the logic of the capital market, and in terms of investment, it would not be appropriate to apply the regulation for investor protection to see workers' acquisition of our company shares as 'investment' in the view of workers' willingness to own shares on the stock market. Therefore, as a way to support and deregulate employee's stock acquisition, 1. Expanding direct support, such as tax support, 2. As employee's stock ownership association is being discussed as a division's nature, it is less effective in terms of various management, not investment, and 3. Those who own stocks with 1% of the company's shares and 300 million won in face value will be classified as major shareholders. As a way to reduce the risk of management of our company owners and cooperative funds, As a measure to reduce the risk of management of our company owners and cooperative funds, only our employee shareholders' association shall manage the fund in a long-term deposit, and even though our employee's stock is managed by the association or company after the end of the deposit period, the management of each employee shall be allowed and In terms of improving the utilization of our company's stock and fund, 1. Employee's stockholders are prohibited from lending during the deposit period, but it is necessary to improve profitability by allowing them to borrow under strict restrictions, 2. It is necessary to make the use of the employee's welfare funds available for the preservation of losses, and to stipulate the redemption obligations of unlisted companies in order to improve the redemption system of our company.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.49-56
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• 1997

Purpose : To evaluate the pathologic effects of preoperative radiotherapy o the resectable distal rectal cancer, we analyzed the results of postoperative pathologic findings for the patients with preoperative radiotherapy ant surgery Materials and Methods: From July 1995 to April 1996, we treated sixteen patients of resectable rectal cancer with preoperative radiation therapy and curative surgery At diagnosis, Thomas Jefferson (TJ) system was used for the clinical stage of the Patients. We treated the patients with conventional radiation therapy of 4500~5000cGy before surgery. The surgery was carried out 4 weeks after completion of radiation therapy. Modified Astler Coller (MAC) system was used for the postoperative pathologic stage. We analyzed the pathologic stages and findings according to preoperative clinical stage and compared with those of the control group in similar clinical stages. Result : All patients were treated with sphincter preservation surgery after Preoperative radiation therapy. Pathoiogic complete response (CR) was shown in 1 case $(6.3\%)$. We compared the results between preoperative radiation therapy group (Preop.RT group) and surgery only group (control group). In TJ stage II, among nine patients of Preop.RT group, 8 patients $(88.9\%)$ were in MAC stage 8 except 1 CR patient, but among 17 patients of control group. 11 patients$(64.7\%)$ were in MAC stage B and 6 Patients $(35.3\%)$ in MAC stage C. In TJ stage III, among 7 patients of Preop.RT group, 4 patients $(57.1\%)$ were in MAC stage B and 3 patients$(42.9\%)$ in MAC stage C. Among 14 Patients of control group, 4 patients $(28.6\%)$ were in MAC stage B and 10 Patients $(71.4\%)$ in MAC stage C. Above results showed that postoperative Pathologic stage was decreased in Preop.RT group with statistical significance (P=0.049). The postoperative Pathologic findings (blood vessel invasion. Iymphatic vessel invasion, perineural invasion) were decreased in the Preop.RT group compared with those of control group. But statistical significance was found only in Iymphatic vessel invasion (p=0.019). Conclusion : The Postoperative pathologic stages and adverse Prognostic pathologic findings were decreased in preoperative radiation therapy group. The Iymphatic vessel invasion and MAC stage C findings were abruptly decreased in Preoperative radiation therapy group. The preoperative radiation therapy was found to be effective in resectable rectal cancer. The patients group in our study was very small and long term follow up was not done. Therefore, further study about this issues is needed.