• 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 the Korean Society of Radiology
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• v.83 no.2
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• pp.254-264
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• 2022

The Korean Society of Radiology and Medical Guidelines Committee amended the existing 2016 guidelines to publish the "Korean Clinical Practice Guidelines for Adverse Reactions to Iodide Contrast for Injection and Gadolinium Contrast for MRI: The Revised Clinical Consensus and Recommendations (2022 Third Edition)." Expert members recommended and approved by the Korean Society of Radiology, the Korean Academy of Asthma, Allergy and Clinical Immunology, and the Korean Nephrology Society participated together. According to the expert consensus or systematic literature review, the description of the autoinjector and connection line for the infection control while using contrast medium, the acute adverse reaction, and renal toxicity to iodized contrast medium were modified and added. We would like to introduce the revised contents.

• Korean Circulation Journal
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• v.52 no.6
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• pp.460-474
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• 2022

Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05-1.24) but not in those by the 2017 ACC/AHA definition. Elevated on-treatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18-1.70) and stroke (aHR, 1.19; 95% CI, 1.08-1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10; 95% CI, 1.04-1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion: Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

• Journal of The Korean Association For Science Education
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• v.44 no.4
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• pp.325-341
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• 2024

This study examined how specific aspects of epistemic cognition are developed in elementary students during modeling activities, using the Apt-AIR framework. The study focused on a class unit titled 'Shall We Find Out What the Landscape of a Riverside Looks Like?' which is part of the land chapter in the third-grade Korean elementary science curriculum. Ambitious Science Teaching (AST) was applied as a teaching strategy to enhance students' model construction. Seven science classes were conducted in line with the core practices of AST, with 29 elementary school students participating in the study. The classes were organized into four stages: initial model composition, inquiry activity, group model composition-sharing, and final model construction. The class activities at each stage were analyzed using both the AIR model, i.e., epistemic aim and value (A), epistemic ideals (I), and reliable epistemic processes (R), and the multi-faceted framework for epistemic thinking from the Apt-AIR framework. The results of the study revealed that in science classes emphasizing modeling activities based on the core practices of AST, the elementary students progressively developed more sophisticated explanatory models that included causal relationships explaining the topographic differences between the upstream and downstream sections of a river. This result was due to their engagement in constructing initial models to describe phenomena, supplementing the initial models using data collected in the model experiment, and participating in discussions to share and evaluate group models. Additionally, from the perspective of the Apt-AIR framework, the aspects of epistemic cognition demonstrated by the elementary students in their modeling activities were appropriate for engaging with cognitive processes related to epistemic aims and values, epistemic ideals, and reliable processes. The other four aspects of the Apt-AIR framework, however, were not performed as effectively. In particular, the application of reliable epistemic processes for knowledge construction required more improvement.