• Archives of Plastic Surgery
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• 제49권5호
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• pp.652-655
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• 2022

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.139-145
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• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• 한국간호교육학회지
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• 제7권1호
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• pp.126-142
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• 2001

Although a call for the implementation of PBL in nursing education is getting increased, it has not been actively implemented as it could be. The main reason for this situation seems to be the lack of well designed learning packages. Well designed PBL packages can be the core factor for the successful implementation of PBL. However, this seems to be the hardest task for teachers wanting to implement PBL. Therefore, the purpose of this study is to develop a systematic framework of PBL package development process and provide the examples of its application. This framework of the process of PBL package development includes thirteen steps. First of all, the team needs to decide a topic to be explored in the package and then clusters concepts related to the topic. Second, the team selects a real situation and writes it as a story. Third, knowledge, skills, and attitudes that practitioners need to know to deal with the situation will be explored. Fourth, learning objectives will be written. The next, the team will check if the situation includes multidisciplinary concepts and content. Sixth, the story will be divided into several parts. Seventh, part 1 will be written. Eighth, clinical documents related to part 1 need to be prepared. Ninth, the team will write a suggested approach for students. Then, they need to prepare a tutor's guide for part 1. Eleventh, the team will prepare a list of reading materials and plan for lectures and clinical laboratory sessions. Twelfth, they will write part 2 ~ part N following the steps from the seventh to the eleventh. The last step is evaluating the package and amending it as needed. These thirteen steps are very detailed and easy to follow for beginners. It is expected that this framework will contribute to accelerate the implementation of PBL in nursing education.

• 한국콘텐츠학회논문지
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• 제21권6호
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• pp.639-652
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• 2021

최근 급변하는 사회 환경에 따라 유연한 사고력 및 문제해결능력 등을 갖춘 창의·융합형 실무 인재 양성이 중요해지고 있다. 따라서 대학은 학생들이 다학제적으로 협력하고 융합하여 학교에서 배운 내용을 토대로 실무현장의 프로젝트를 수행 할 수 있는 교육경험을 제공하는 것이 필요하다. 이에 본 연구는 산학협력기반 다학제적 융합 캡스톤디자인 교육과정을 통해 통합적 문제해결능력을 갖춘 창의적 인재양성을 목표로 설계·계발·운영하였다. 이를 위해 참여 기업 및 융합 교수팀을 구성하고 함께 교육과정을 개발하고 D대학 화장품공학부 재학생을 대상으로 15주간 운영하였다. 교육이 끝난 후 학습만족도와 인지된 학업성취도를 조사한 결과 5점 만점에 각각 3.77점, 3.86점으로 보통 이상으로 나타났다. 그리고 참여 경험에 대한 심층인터뷰 결과 긍정적 경험과 관련된 5개 주제와 부정적 경험과 관련된 3가지 주제가 도출되었다. 본 연구는 향후 산학협력기반 다학제적 융합 캡스톤디자인 교육과정 운영 시 기초자료를 제공할 수 있을 것이다.

• Journal of Nutrition and Health
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• 제44권5호
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• pp.384-393
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• 2011

The objective of this study was to determine the nutritional support in patients treated in medical intensive care units (MICUs) by evaluating the extent of current nutritional support using the patient care plan and considering the association between nutritional status and the amount of nutrition supplied. From April to December 2010, 114 patients (age ${\qeq}$ 18 years) admitted to the MICU and who underwent nutritional support for > 5 days were included. Descriptive statistics showed that the 114 patients received nutritional support within 1.2 ${\pm}$ 0.7 days and for 16.2 ${\pm}$ 11.7 days in the MICUs. The total delivered/required caloric ratio was 81.08 ${\pm}$ 27.31%, and the protein ratio was 80.32 ${\pm}$ 28.93%. Patients who received > 80% of required calories and protein showed improved nutritional status (p < 0.05). The results showed that adequate nutritional support is crucial to critically ill patients. We suggest early nutritional screening using simple tools such as periodic monitoring and management to recalculate nutritional status and nutritional requirements and nutritional support using a multidisciplinary method. Systematic nutritional support teams are needed to provide adequate nutritional support for patients in the MICU.

• Journal of information and communication convergence engineering
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• 제6권3호
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• pp.323-326
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• 2008

Data Envelopment Analysis (DEA) is a theoretically sound framework for performance analysis that offers many advantages over traditional methods such as performance ratios and regression analysis. Largely the result of multidisciplinary research during the last three decades in economics, engineering and management, DEA is best described as an effective new way of visualizing and analyzing performance data. Besides, overseas information technology companies have aggressively tried to enter the domestic market. In the age of globalization and high competition, it is imperative that the system integration (SI) companies need to introduce the performance evaluation models of SI projects, including Capability Maturity Model and Software Process Improvement and Capability Determination, to gain a competitive advantage. Therefore, it makes our research regarding evaluation of SI projects very opportune. The purpose of the study is not only to evaluate efficiency of each project by DEA but also to gain insight into various factors such as project complexity, team members' man-months structure, and process index(project management index) that link to the projects performance.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1200-1206
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• 2009

Child sexual abuse is not a rarely encountered problem. Child sexual abuse is a pediatric disease entity with lifelong impact. Child sexual abuse, different from sexual assault, is not always accompanied by violent force and usually repeated over a period of time. Child sexual abuse should be approached by multidisciplinary team experts. Every pediatrician should know the child protection network in his district and be competent in the child sexual abuse medical evaluation and treatment as a primary doctor. In order to accomplish that goal, the Korean Pediatric Society should change the pediatric residency training curriculum and foster child sexual abuse experts. Pediatricians have responsibilities to do their active role in response to children at risk.

• 대한안전경영과학회지
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• 제15권4호
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• pp.209-216
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• 2013

By means of the model competition, this research analyzed the factor of patient management, the factor of policy support, and the factor of medical treatment system. Concretely, the factor of policy support forms a positive effects on the factor of medical treatment system. Practically, well-established healthcare policy provide and facilitate the effective medical treatment system. of the hospital. And, in the effective medical treatment system, hospitals try to develop the patient management of the chronic disease. From the empirical research, this paper concluded that the factor of medical treatment system. mediated by the factor of policy support. Also, the factor of medical treatment system promotes the development of patient management in the chronic disease.

• Journal of Mechanical Science and Technology
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• 제17권10호
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• pp.1543-1551
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• 2003

The present study investigates turbulent flows subject to strong wall injection in a channel through a Direct Numerical Simulation technique. These flows are pertinent to internal flows inside the hybrid rocket motors. A simplified model problem where a regression process at the wall is idealized by the wall blowing has been studied to gain a better understanding of how the near-wall turbulent structures are modified. As the strength of wall blowing increases, the turbulence intensities and Reynolds shear stress increase rapidly and this is thought to result from the shear instability induced by the injected flows at the wall. Also, turbulent viscosity grows rapidly as the flow moves downstream. Thus, the effect of wall-blowing modifies the state of turbulence significantly and more sophisticated turbulence modeling would be required to predict this type of flows accurately.

• 정신신체의학
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• 제3권1호
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• pp.91-97
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• 1995

Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.