Factors for Survival and Complications of Malignant Bone Tumor Patients with a Total Femoral Replacement (대퇴골 전치환술 받은 악성 골종양 환자의 생존인자와 합병증)
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- 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.
This study analyzed research trends related to Christian school education in Korea. In order to analyze academic societies and conferences related to Christian school education, the topics of conferences and research results and theses related to Christian school education in Korea were collected to analyze the frequency and trend of Christian school education-related topics. In addition, papers searched as "Christian schools" among the academic journal's published papers were classified and organized. In order to understand research trends related to Christian school education, the year and frequency of academic journals related to Christian school education were analyzed, and the contents of the published papers were divided into research schools, research subjects, and research contents.As a result of analyzing research trends of Christian school education, it was found that there were very few academic exchanges or academic activities related to Christian school education, and most supported lectures and meetings related to the reconstruction of curriculum and class management directly supporting school sites. Therefore, this study proposed that academic societies and conferences should be revitalized in Christian school education-related institutions. In addition, this study found that annual academic conferences of Christian education-related academic societies were rarely held under the theme of Christian school education, and suggested to revitalize research related to Christian school education in the academic societies of Christian education in order that God's kingdom may be restored and expanded in the area of education by recovering school education through active research on Christian school education. Third, as a result of analyzing the papers published in domestic journals, it was confirmed that research on Christian school education was mainly conducted around universities, and the topics were limited to history, curriculum, religious education, identity, and missionary work. In this regard, this study proposed to expand the research topics related to Christian school education. Finally, as a result of analyzing the published academic journals that studied on Christian school education, it was found that the non-Christian camp is also conducting research with interest in Christian schools, and thus, communication with the non-Christian camp was proposed to revitalize research on Christian school education.
This study interpreted the logical validity of the landscape restoration and maintenance patterns of Changgyeonggung Palace, where modern landscapes coexist. The results of the study are as follows; First, the changes in the landscape restoration and maintenance attitude concerning the Changgyeonggung management organization were identified. With the establishment of the Office of the Imperial Garden, an imperial property was nationalized. The Cultural Heritage Managing Department was opened in 1961, and Changgyeonggung Palace were preserved as designated as historical sites in 1963. An environmental purification was implemented by the Changgyeonggung Office as a follow-up measure for restoration in 1983. As the Cultural Heritage Administration promoted in 1999 and the Royal Palaces and Tombs Center was established in 2019, the palace has been managed professionally as a palace landscape to provide a viewing environment. Second, In the 'Purification Period of Changgyeongwon(1954~1977)', environmental purification was carried out to restore amusement facilities, install facilities for cherry blossom viewing, and develop the place into a national zoo. In the 'Reconstruction Period of Changgyeonggung(1983~1986)', restoring function as an urban park, reserving green areas, the outside space was recreated in the traditional feel, and the forest area was generally maintained. In the 'Supplementation Period of Traditional Landscape Architecture Space(1987~2009)', a uniform green landscape was created with pine trees and various vegetation landscapes centered on the flower beds. In the 'Improvement and Maintenance Period of Viewing Environment(2010~2022), a master plan was reestablished on the premise of utilization, but maintenance has been carried out in a small scale centering on unit space. Third, regarding the validity of the landscape restoration and maintenance, It was found in terms of 'originality' that the recovery of the palace system has not been expanded for over 40 years in existing areas. The 'characteristics of the times', which shows whether multi-layered history was taken into account, Changgyeongwon was excluded from the discussion in the process of setting the base year twice. In terms of 'integrity,' the area of the Grand Greenhouse where the historic states coexists needs a maintenance policy that binds the greenhouse, carpet flower bed, and Chundangji Pond. The 'utility' identified as the utilization of spaces suggests the establishment of a sense of place in the Grand Greenhouse area, which is concentrated with programs different from other areas.
This study analyzed policy implementation factors focusing on how Donuimun, a demolished cultural heritage, was digitally restored and the policy implementation process of Donuimun Gate restoration. Through this, the characteristics of the implementation process of the digital Donuimun Gate restoration policy promoted by public-private multilateral collaboration were examined and implications were sought for how institutions with different interests solved problems and collaborated in the implementation process. The research method was focused on policy implementation factors including policy executive factors, policy content factors, policy resource factors, and policy environment factors, and the process was analyzed for each detailed component. Along with literature analysis, in-depth interviews were conducted with participants in policy implementation. As a result of the study, first, it was found in the policy executive factor that the quick decision-making leadership of the policy manager and the flexible attitude of the person in charge of the government agency had a positive effect on preventing conflicts between different interest groups. Second, in terms of policy content, establishing a common goal that everyone can accept and moving forward consistently gave trust and created synergy. Third, in the policy implementation resource factor, the importance of the budget was emphasized. Finally, as an environmental factor for policy implementation, the opening of 5G mobile communication for the first time along with the emergence of the Fourth Industrial Revolution at the time of policy implementation acted as a timely factor. The digital Donuimun Gate was the first case of restoring a lost cultural heritage with AR and VR, and received attention and support from the mass media and the public. This also shows that digital restoration can be a model case that can be a solution without conflicts with local residents where cultural heritages are located or conflicts between stakeholders in the preservation and restoration of real objects.
Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70