• Title/Summary/Keyword: Multidisciplinary treatment

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The Influence of Acrylic Resin Solution Concentration on Properties of Recycled Fine Aggregate (아크릴 수지 농도 차이가 순환잔골재의 물성에 미치는 영향)

  • Kkot-Nim Park;Ji-Hyun Kim;Chul-Woo Chung;Young-Chan Kim
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.12 no.2
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    • pp.188-195
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    • 2024
  • Recently, the use of recycled aggregates from construction waste has been introduced as a solution for environmental problems and aggregate shortage. In spite of the various methods to promote recycling of recycled aggregate, the use of recycled aggregate as the structural aggregate has been limited because the quality of recycled aggregate(especially recycled fine aggregate) has been considered lower than that of natural aggregate. In this work, recycled fine aggregate was immersed for an hour in acrylic resin solutions of various concentrations to improve its quality, the appropriate immersion concentration was selected by measuring the absorption capacity and skeletal density of the recycled fine aggregate, and mortar specimens were prepared to evaluate the mechanical performance in order to propose a applicable treatment process to promote the use of recycled fine aggregate. According to the experimental results, as the acrylic resin concentration increased, the absorption capacity and skeletal density of the recycled fine aggregate decreased. The absorption capacity was lowest at acrylic resin concentrations around 6 to 8 %. However, among mortar specimens made of recycled fine aggregate immersed in acrylic resin solution, the compressive strength was the highest at 4 % acrylic resin concentration, suggesting that the use of higher concentration acrylic resin solution can actually lower the compressive strength of mortar.

Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline (2020년 개정 진료 치침에 따른 과민성폐렴의 진단)

  • Soojung Park;Yu-Whan Oh;Eun-Young Kang;Hwan Seok Yong;Cherry Kim;Ki Yeol Lee;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.817-825
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    • 2021
  • Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

Clinical Application and Limitations of Myeloma Response Assessment and Diagnosis System (MY-RADS) (골수종 반응평가와 진단체계의 임상적용 및 제한점)

  • Dong Kyun Kim;Sung-Soo Park; Joon-Yong Jung
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.51-74
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    • 2023
  • Multiple myeloma, which is a proliferative disease of plasma cells that originate from a single clone, is the second most common hematologic malignancy following non-Hodgkin lymphoma. In the past, its diagnosis was made based on clinical findings (so-called "CRAB") and a skeletal survey using radiographs. However, since the implementation of the International Myeloma Working Group's revised guideline regarding the radiologic diagnosis of multiple myeloma, whole-body (WB) MRI has emerged to play a central role in the early diagnosis of multiple myeloma. Diffusion-weighted imaging and fat quantification using Dixon methods enable treatment response assessment by MRI. In keeping with the trend, a multi-institutional and multidisciplinary consensus for standardized image acquisition and reporting known as the Myeloma Response Assessment and Diagnostic System (MY-RADS) has recently been proposed. This review aims to describe the clinical application of WB-MRI based on MY-RADS in multiple myeloma, discuss its limitations, and suggest future directions for improvement.

Results of Curative Treatment for Cancer of the Tonsil (편도암의 근치적 치료 결과)

  • Park, Won;Ahn, Yong-Chan;Lim, Do-Hoon;Baek, Chung-Whan;Son, Young-Ik;Park, Keun-Chil;Kim, Kyoung-Ju;Lee, Jeung-Eun;Kang, Min-Kyu;Park, Young-Je;Nam, Hee-Rim;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.261-268
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    • 2003
  • Purpose: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. Materials and Methods: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S$\pm$RT group), and radiation therapy in 10 (RT$\pm$CT group). The median follow-up period was 41 months. Results: AJCC stages were I/II in four, III in two, and IV in 21 patients. The 5-year disease-free survival rate was 73.3$\%$ in all patients, 70.6$\%$ in the S$\pm$RT group, and 77.8$\%$ in the RT$\pm$CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S$\pm$CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4$\%$). Two patients among the RT$\pm$CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0$\%$). The 5-year overall survival rate was 77.0$\%$ in all patients, 80.9$\%$ in the S$\pm$RT group, and 70.0$\%$ in the RT$\pm$CT group. Conclusion: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S$\pm$RT and RT$\pm$CT. RT$\pm$CT is judged to be an alternative option that can avoid the functional disability after surgical resection.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH PERVASIVE DEVELOPMENTAL DISORDER (입원한 전반적발달장애 소아청소년의 임상특성)

  • Pyo, Kyung-Sik;Bahn, Geon-Ho;Hong, Kang-E;Park, Tae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.237-246
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    • 1998
  • Objectives and Methods:This study investigated clinical characteristics, treatment modality, outcome of 57 children and adolescent inpatients(male 53, female 4) who were diagnosed as pervasive developmental disorder(PDD) by DSM-Ⅳ criteria recent five years. Results:1) The mean age at admission was $96{\pm}28.2$ months, and the mean age at which they first visited treatment facility was $52{\pm}26.6$ months. The mean hospitalization period was $43.7{\pm}31.3$ days. 2) Diagnosis:Twenty-seven(47.4%) of subjects met DSM-Ⅳ criteria for PDD NOS. Fifteen (26.3%) met for autistic disorder, nine(15.8%) met for Asperger's syndrome, and two(3.5%) met for childhood disintegrative disorder. 3) Comorbid diagnosis:The most common comorbid dignosis was attention deficit hyperactivity disorder(23.8%). 4) IQ test:IQ test for twenty-eight subjects was possible. The Average of the subjects was $70{\pm}27.5$. Fifteen(53.6%) of the subjects were approximate or under 70. 5) Neurology Abnormality:EEG findings of eleven(21.2%) subjects were abnormal, brain CT or MRI findings of eight subjects(21.6%) were abnormal. 6) Family Hx:Depressive disorder were found in Eight mothers(14%). Familial loading was found in twenty families(35.1%), and familial loading of PDD was found in three(5.3%). Conclusion:The most important thing for the management of PDD is early detection and early treatment. To do so, multidisciplinary team approach should be emphasized.

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Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

Analysis of media trends related to spent nuclear fuel treatment technology using text mining techniques (텍스트마이닝 기법을 활용한 사용후핵연료 건식처리기술 관련 언론 동향 분석)

  • Jeong, Ji-Song;Kim, Ho-Dong
    • Journal of Intelligence and Information Systems
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    • v.27 no.2
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    • pp.33-54
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    • 2021
  • With the fourth industrial revolution and the arrival of the New Normal era due to Corona, the importance of Non-contact technologies such as artificial intelligence and big data research has been increasing. Convergent research is being conducted in earnest to keep up with these research trends, but not many studies have been conducted in the area of nuclear research using artificial intelligence and big data-related technologies such as natural language processing and text mining analysis. This study was conducted to confirm the applicability of data science analysis techniques to the field of nuclear research. Furthermore, the study of identifying trends in nuclear spent fuel recognition is critical in terms of being able to determine directions to nuclear industry policies and respond in advance to changes in industrial policies. For those reasons, this study conducted a media trend analysis of pyroprocessing, a spent nuclear fuel treatment technology. We objectively analyze changes in media perception of spent nuclear fuel dry treatment techniques by applying text mining analysis techniques. Text data specializing in Naver's web news articles, including the keywords "Pyroprocessing" and "Sodium Cooled Reactor," were collected through Python code to identify changes in perception over time. The analysis period was set from 2007 to 2020, when the first article was published, and detailed and multi-layered analysis of text data was carried out through analysis methods such as word cloud writing based on frequency analysis, TF-IDF and degree centrality calculation. Analysis of the frequency of the keyword showed that there was a change in media perception of spent nuclear fuel dry treatment technology in the mid-2010s, which was influenced by the Gyeongju earthquake in 2016 and the implementation of the new government's energy conversion policy in 2017. Therefore, trend analysis was conducted based on the corresponding time period, and word frequency analysis, TF-IDF, degree centrality values, and semantic network graphs were derived. Studies show that before the 2010s, media perception of spent nuclear fuel dry treatment technology was diplomatic and positive. However, over time, the frequency of keywords such as "safety", "reexamination", "disposal", and "disassembly" has increased, indicating that the sustainability of spent nuclear fuel dry treatment technology is being seriously considered. It was confirmed that social awareness also changed as spent nuclear fuel dry treatment technology, which was recognized as a political and diplomatic technology, became ambiguous due to changes in domestic policy. This means that domestic policy changes such as nuclear power policy have a greater impact on media perceptions than issues of "spent nuclear fuel processing technology" itself. This seems to be because nuclear policy is a socially more discussed and public-friendly topic than spent nuclear fuel. Therefore, in order to improve social awareness of spent nuclear fuel processing technology, it would be necessary to provide sufficient information about this, and linking it to nuclear policy issues would also be a good idea. In addition, the study highlighted the importance of social science research in nuclear power. It is necessary to apply the social sciences sector widely to the nuclear engineering sector, and considering national policy changes, we could confirm that the nuclear industry would be sustainable. However, this study has limitations that it has applied big data analysis methods only to detailed research areas such as "Pyroprocessing," a spent nuclear fuel dry processing technology. Furthermore, there was no clear basis for the cause of the change in social perception, and only news articles were analyzed to determine social perception. Considering future comments, it is expected that more reliable results will be produced and efficiently used in the field of nuclear policy research if a media trend analysis study on nuclear power is conducted. Recently, the development of uncontact-related technologies such as artificial intelligence and big data research is accelerating in the wake of the recent arrival of the New Normal era caused by corona. Convergence research is being conducted in earnest in various research fields to follow these research trends, but not many studies have been conducted in the nuclear field with artificial intelligence and big data-related technologies such as natural language processing and text mining analysis. The academic significance of this study is that it was possible to confirm the applicability of data science analysis technology in the field of nuclear research. Furthermore, due to the impact of current government energy policies such as nuclear power plant reductions, re-evaluation of spent fuel treatment technology research is undertaken, and key keyword analysis in the field can contribute to future research orientation. It is important to consider the views of others outside, not just the safety technology and engineering integrity of nuclear power, and further reconsider whether it is appropriate to discuss nuclear engineering technology internally. In addition, if multidisciplinary research on nuclear power is carried out, reasonable alternatives can be prepared to maintain the nuclear industry.

Development of a Clinical Pathway for Gastrectomy and Effect of Its Implementation in One Tertiary Hospital (위절제술 환자의 표준진료지침 개발 및 적용 효과)

  • Kim, Eun-Hee;Kim, Chul-Gyu;Lee, Sun-Gyo;Kim, Soon-Duck;Lee, Hae-Ok;Kwon, Jeong-Soon;Lee, Kyeong-Mi;Lee, Min-Mi;Sim, Soon-Mi;Lyu, Yong-Man;Sin, Jong-Sik;Kang, Eun-Hee;Lee, Sang-Il;Kim, Byung-Sik;Oh, Sung-Tae;Yook, Jeong-Hwan;Park, Su-Kil
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.176-189
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    • 2003
  • Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers (비소세포성 폐암의 방사선치료 성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.72-81
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    • 1994
  • Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns, follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

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