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The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2021 The Korean Society of Radiology.)

Background: Vancomycin-dependent enterococci (VDE) are clinically equivalent to vancomycin-resistant enterococci (VRE), but more difficult to detect. This study was purposed to characterize VDE microbiologically and epidemiologically., Methods: The patients from whom VDE were detected from April 2007 to March 2008 were investigated. For available isolates, minimal inhibitory concentrations (MICs) of and the levels of dependence on vancomycin and teicoplanin were measured by E test (AB Biodisk, Sweden), and a test for reversion of VDE to non-dependent VRE (NDVRE) and pulsed field gel electrophoresis (PFGE) were performed. Patients' demographic and clinical findings were reviewed via electronic medical records., Results: VDE were recovered from 6 (2.2%) of 272 patients carrying VRE during this study period. All patients were already colonized or infected by VRE and treated with vancomycin for 13 to 107 days. VDE were isolated from pleural fluid (one), urine (four), and stool (one). All isolates carried vanA with vancomycin MICs of >256 microg/mL, but two of them had intermediate susceptibilities to teicoplanin. Because 4 VDE isolates were reverted to NDVRE with single passage, vancomycin dependence was measurable for only two isolates as equal and above 0.064 and 0.5 microg/mL respectively, and was reverted after 5 and 7 passages, respectively. Six VDE isolates showed no related clones in PFGE analysis, and 3 of 4 available pairs of initial VRE isolates and subsequent VDE isolates were identical clones., Conclusions: VDE were not rare and seemed to emerge independently from VRE with a prolonged use of vancomycin. Vancomycin-dependence was reverted within several passages.

Purpose: This study was conducted to develop an instrument measuring awareness of osteoporosis., Methods: The process included construction of a conceptual framework, generation of 86 preliminary items, verification of content validity, selection of secondary items, verification of construct validity and extraction of final items. The 86 items were reviewed for content validity by two groups of experts and were tested to evaluate inter item correlation coefficient by two groups of adult women. From June to August 2007, data were collected from 383 adult women who lived in Seoul and provinces in Korea. Data were analyzed by performing item analysis, Varimax factor analysis and Cronbach's alpha., Results: There were 31 items in the final instrument categorized into 5 factors. The factors were labeled as "preventive behaviors (10 items)", "risk factors (5 items)", "characteristics of osteoporosis (6 items)", "improving bone health (5 items)", and "bone physiology (5 items)". Cumulative percent of variance was 60.92% and eigen values ranged from 1.20 to 12.44. Cronbach's alpha was .948 and ranged from .804 to .917., Conclusion: Validity and reliability of the scale are confirmed in this study showing its utility for measuring awareness of osteoporosis for women. Utilization of the scale will also contribute to designing an appropriate prevention program for osteoporosis.