• Title/Summary/Keyword: Indication subject

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The Medial Sural Artery Perforator Flap: A Historical Trek from Ignominious to "Workhorse"

  • Hallock, Geoffrey G.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.240-252
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    • 2022
  • Rather than just another "review," this is intended to be an "overview" of the entire subject of the medial sural artery perforator (MSAP) flap as has been presented in the reconstructive literature from its inception in 2001 until the present, with any exceptions not purposefully overlooked. Unfortunately, the pertinent anatomy of the MSAP flap is always anomalous like most other perforator flaps, and perhaps even more variable. No schematic exists to facilitate the identification of a dominant musculocutaneous perforator about which to design the flap, so some adjunctive technology may be highly valuable for this task. However, if a relatively thin free flap is desirable for a small or moderate sized defect that requires a long pedicle with larger caliber vessels, the MSAP flap deserves consideration. Indeed, for many, this has replaced the radial forearm flap such as for partial tongue reconstruction. Most consider the donor site deformity, even if only a conspicuous scar on the calf, to be a contraindication. Yet certainly if used as a local flap for the knee, popliteal fossa, or proximal leg, or as a free flap for the ipsilateral lower extremity where a significant recipient site deformity already exists, can anyone really object that this is not a legitimate indication? As with any perforator flap, advantages and disadvantages exist, which must be carefully perused before a decision to use the MSAP flap is made. Perhaps not a "workhorse" flap for general use throughout the body, the MSAP flap in general may often be a valuable alternative.

The Effect of the Contingent Liabilities Caused by Project Financing of the Domestic Construction Firms

  • Kang, Namhee;Kim, Hyunjung;Choi, Jaehyun
    • International conference on construction engineering and project management
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    • 2015.10a
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    • pp.683-684
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    • 2015
  • Project Financing (PF) is the long-term financing of infrastructure and industrial projects based upon the projected cash flows of the project rather than the balance sheets of its sponsors. However, the financial institution, the subject of financing in the case of PF in Korea, the lack of validation system of business, rather than to assess the feasibility of the project, requested a credit reinforcement to the construction company, the fact is Construction Company on loans of the employer is the guarantor or debt argument commitments accordingly. As a result, PF contingent liabilities, which are indirect debt, are triggered in the construction company, not included in the financial statements, along with the disclosure standards established according to 2009 PF contingent liabilities, and major can be a management item. In this study, PF contingent liabilities is of Pearson of the index and the PF debt ratio showing the main financial ratios and risk by classifying the credit rating and contractors Ranking of construction companies in order to analyze the impact on the financial condition of the company was performed correlation analyzes, through the Pearson correlation coefficient analysis indicated quantitative or negative relationship to derive the explicit indication.

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An Analysis of the Association between Subject Matter Knowledge and Pedagogical Content Knowledge for Science Teachers: The Case of Earth Science Teachers' Lesson on Atmospheric Pressure (과학 교사의 교과내용학지식과 교과교육학지식의 연관성 분석: 지구과학 교사의 대기압 수업 사례)

  • Lee, Ki-Young
    • Journal of The Korean Association For Science Education
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    • v.33 no.6
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    • pp.1219-1236
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    • 2013
  • The purpose of this study was to investigate the association between subject matter knowledge (SMK) and pedagogical content knowledge (PCK) for science teachers. To this end, a total of 26 secondary Earth science teachers participated in this study and a concept diagnostic questionnaire and a lesson planning task of atmospheric pressure were devised to give an indication of participating teachers' SMK and PCK, respectively. The results of this study are summarized as follows: First, participating teachers showed a variety of SMK levels about atmospheric pressure. Second, teachers at high level of SMK focused on 'supplementary' and 'fundamental' curriculum contents for in-depth conceptual understanding, but teachers at low level of SMK, on the contrary, stressed 'applicative' curriculum contents. Third, teachers at high level of SMK grasped students' misconceptions and difficulties in learning atmospheric pressure far more concretely than teachers at low level of SMK. Lastly, teachers at high level of SMK showed a tendency to use learner-centered instructional strategy by utilizing students' prior knowledge, but teachers at low level of SMK were inclined toward teacher-directed concept explanation. Based on this study, some implications for effective science teacher preparation programs were also discussed.

Analysis of Trends in Informatics·Computer Teacher Appointment Examination Subjects (정보·컴퓨터교사 임용시험과목 출제경향 분석)

  • Yang, HyeJi;Lee, WonGyu;Kim, JaMee
    • The Journal of Korean Association of Computer Education
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    • v.21 no.2
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    • pp.11-19
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    • 2018
  • The informatics computer teacher appointment examination is the only national test to measure the competence of educators in teaching students relevant informatics content. The purpose of this study is to provide suggestions and directions for improvement of the informatics computer teacher appointment exam. To this end, we collected appointment exam questions from 2002, when the informatics computer teacher appointment exam first started, to 2017. Based on evaluation areas and evaluation content factors of the indication subject of informatics computer, we built the analysis framework and criteria used in this study. The analysis took into account the revision of basic required courses and changes in the types of exam questions. We analyzed the percentage of points allotted to the subject matter compared to the total number of points, and also the trends of exam questions by school year. The results of the analysis are as follows: first, improvements should be made to avoid concentration in certain areas of the basic required courses of the informatics computer subject. Second, the discrepancy between the exam and the curriculum of basic required courses must be addressed to properly teach and evaluate preliminary teachers. It is significant that this study serves as a stepping stone in supplying highly competent teachers to the field through improving the informatics computer teacher appointment examination.

Reliability of Colposcopy in Turkey: Correlation with Pap Smear and 1-year Follow Up

  • Mesci-Haftaci, Simender;Ankarali, Handan;Caglar, Mete;Yavuzcan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7317-7320
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    • 2014
  • Background: A cytologic reading of a Papanicolaou (pap) smear followed, if the result is positive, by a colposcopic search for abnormal cells is the most common screening method for cervical cancer used worldwide. We aimed to present the correlation of smear and colposcopic findings with 6- to 12-month follow-up results and related factors in women who underwent colposcopy in Turkey. Materials and Methods: The study population consisted of women who attended the gynecology department and were referred for colposcopic evaluation in 2011-2012. A total of 232 women between ages 17 and 68 years were included. Colposcopy indications were ASCUS and higher lesions at cervical smear, macroscopic suspicious lesions, post-coital bleeding history with suspicious smear, and repeated cervical inflammation. All patients were recalled for 6- to 12-month follow-ups. Results: The most common colposcopy indication was ASCUS, and the most common biopsy result was inflammation. Nearly half of the patients returned for the control 6-month follow-up, and almost 20% of patients for a 1-year follow up. Conclusions: Colposcopic biopsy is an effective method in indicated patients but is not sufficient in itself if awareness of the subject is not raised in the population. One of the most important aims of cancer screening programs should be enabling patients in developing countries to take responsibility. Patients must be encouraged to apply to the hospital for better disease control.

Evaluation of Giarydia lumblia Detection Method in Stool Specimens Fixed with SAF Solution (SAF 고정변에서 람블편모충(Giardia lamblia)시스트 검출을 위한 검사방법의 평가)

  • Kim, Yeong-Chang;Kim, Jae-Jin;Lee, Geun-Tae
    • Parasites, Hosts and Diseases
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    • v.23 no.2
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    • pp.285-292
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    • 1985
  • The present study has been designed as a basic study on laboratory diagnosis of giardiasis and to demonstrate a more effective method for the detection of Giardia lamblia cyst with the inherent advantages of minimizing both the number of stool examinations required and the interval of stool collections for estimating the real state of prevalence in the shortest time possible. There were 3 subject groups of 75 children each currently residing in an orphanage in Gunsan city, Jeonbuk province from which stool specimens were collected every day, every other day, and every 3 days. The procedure is as follows: 1) resuspend the InKed sample after fixation with SAF solution 2) centrifuge the sediment for 1 min. at 2, 000 rpm after straining through gauze into a tube 3) divide the sediment into 3 parts and use them for direct fecal smear, formalin-ether concentration (MGL) and zinc sulfate ($ZnSO_4$) floatation techniques. The results are summarized as follows: 1. Overall infection rate after 10 trials showed a 60% positive indication. The positive rate among children under 4 years old was significantly higher than the rate in children over 4 years old. No significant difference in rate by sex was observed. 2. The results of eBaminations by direct fecal smear and MGL techniques appeared more accurate than that obtained by $ZnSO_4$ ftoatation method as indicated by a higher positive rate. Of all three methods concerned, combinations of two demonstrated a higher positive rate than that shown by any one alone. 3. In three consecutive examinations under varying conditions such as different days, the cyst detection rate by MGL technique indicated 83%. In 5 examinations under the same varying conditions, the indicated rate was 94%. 4. The interval of stool collection proved to be insignificant for the cyst detection rate. In conclusion, both MGL method and modified fecal direct smear can provide a good cyst detection rate of G. lamblia provided that more than 3 consecutive examinations of stool under varying conditions are carried out.

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Analyzing Place Location Knowledge Items of the Korean Geography Subject in the College Scholastic Ability Test: Focusing on Human (Economic) Geography (대학수학능력시험 한국지리 과목의 위치정보 문항 출제 경향 연구: 인문(경제)지리 문항을 중심으로)

  • Lee, Soyoung
    • Journal of the Economic Geographical Society of Korea
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    • v.24 no.1
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    • pp.29-51
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    • 2021
  • The present research explores the tendency of the items that require Place Location Knowledge (PLK) of the Korean Geography subject in the College Scholastic Ability Test. The major findings are as follows. First, the geographical regions of the items are spatially skewed, especially in the Yeongnam regions, which are tested more frequently compared to the others. Second, the fact-based items more concern with regionality such as geographic indication system and regional festivals. Third, the concept-based items can be divided into physical geography and human geography and there were four items related to economic geography. Fourth, students tend to find it challenging in the items asking PLK. The difficulty varies according to the type of items. The students find concept-based items which require high-order thinking more challenging. There is also differences identified between contents. For example, the section of physical geography, especially climatology-related, were considered the most challenging followed by those of economic geography. Finally, the differences in the rate of correct answer are associated with the scale of the regions covered in the items and students experienced more difficulty in the items asking more precise scale.

The Requirement and Effect of the Document of Carriage in Respect of the International Carriage of Cargo by Air (국제항공화물운송에 관한 운송증서의 요건 및 효력)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.67-92
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    • 2008
  • The purpose of this paper is to research the requirements and effect of the document of carriage in respect of the carriage of cargo by air under the Montreal Convention of 1999, IATA Conditions of Carriage for Cargo, and the judicial precedents of Korea and foreign countries. Under the Article 4 of Montreal Convention, in respect of the carriage of cargo, an air waybill shall be delivered. If any other means which preserves a record of the carriage are used, the carrier shall, if so requested by the consignor, deliver to the consignor a cargo receipt. Under the Article 7 of Montreal convention, the air waybill shall be made out by the consignor. If, at the request of the consignor, the carrier makes it out, the carrier shall be deemed to have done so on behalf of the consignor. The air waybill shall be made out in three original parts. The first part shall be marked "for the carrier", and shall be signed by the consignor. The second part shall be marked "for the consignee", and shall be signed by the consignor and by the carrier. The third part shall be signed by the carrier who shall hand it to the consignor after the goods have been accepted. Under the Article 5 of Montreal Convention, the air waybill or the cargo receipt shall include (a) an indication of the places of departure and destination, (b) an indication of at least one agreed stopping place, (c) an indication of the weight of the consignment. Under the Article 10 of Montreal Convention, the consignor shall indemnify the carrier against all damages suffered by the carrier or any other person to whom the carrier is liable, by reason of the irregularity, incorrectness or incompleteness of the particulars and statement furnished by the consignor or on its behalf. Under the Article 9 of Montreal Convention, non-compliance with the Article 4 to 8 of Montreal Convention shall not affect the existence of the validity of the contract, which shall be subject to the rules of Montreal Convention including those relating to limitation of liability. The air waybill is not a document of title or negotiable instrument. Under the Article 11 of Montreal Convention, the air waybill or cargo receipt is prima facie evidence of the conclusion of the contract, of the acceptance of the cargo and of the conditions of carriage. Under the Article 12 of Montreal Convention, if the carrier carries out the instructions of the consignor for the disposition of the cargo without requiring the production of the part of the air waybill or the cargo receipt, the carrier will be liable, for any damage which may be accused thereby to any person who is lawfully in possession of that part of the air waybill or the cargo receipt. According to the precedent of Korea Supreme Court sentenced on 22 July 2004, the freight forwarder as carrier was not liable for the illegal delivery of cargo to the notify party (actual importer) on the air waybill by the operator of the bonded warehouse because the freighter did not designate the boned warehouse and did not hold the position of employer to the operator of the bonded warehouse. In conclusion, as the Korea Customs Authorities will drive the e-Freight project for the carriage of cargo by air, the carrier and freight forwarder should pay attention to the requirements and legal effect of the electronic documentation of the carriage of cargo by air.

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A Study on the Regional Self-sufficiency for In-patient Care Services (입원의료의 진료권별 자체충족도에 관한 연구)

  • Han, Dal-Sun;Kwon, Soon-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.285-295
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    • 1990
  • The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

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Antibiotics Use in Infected Patients with Terminal Stage of Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - (말기 암 환자에서 감염에 대한 항생제 사용 - 대한가정의학회 완화의학연구회 세미나에 기초한 -)

  • Jeong, Hwee-Soo;Kim, Dae-Young;Song, Kyoung-Po;Korean Family Medicine Palliative Medicine Research Group, Korean Family Medicine Palliative Medicine Research Group;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.43-47
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    • 2007
  • Decision-making of antibiotics use in infected patients with terminal stage of cancer was difficult for physicians, because of responsibility of solving a medical problem and burden on patients distressed by worthless life expansion. Korean Family Medicine Palliative Medicine Research Group discussed this subject using a case of a 65 year-old male having terminal stage of sigmoid colon cancer with extended cutaneous infection who was treated local antibiotics, improved but expired at the 12th hospital day. We reviewed related literatures and proposed a guide for antibiotics use in inferred patients with terminal stage of cancer. Antibiotics should be used for symptom control as major indication, especially when patients suffered from urinary symptoms. Appropriate antibiotics should be chosen based or sensitivity test. the most important considering factor should be patient and family members' wish about antibiotics use.

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