• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.347-358
• /
• 2021

Acute trauma is a common cause of mortality in individuals aged < 40 years. As organ preservation has become important in treating trauma patients, the treatment is shifting from surgical management to non-operative management. A multidisciplinary team approach, including interventional radiology (IR), is essential for the optimal management of trauma patients, as IR plays an important role in injury evaluation and management. IR also contributes significantly to achieving the best clinical outcomes in critically ill trauma patients. This pictorial essay aims to present and summarize various interventional treatments in trauma patients requiring critical care.

• Archives of Plastic Surgery
• /
• v.51 no.1
• /
• pp.130-134
• /
• 2024

Refractory chylous ascites can cause significant nutritional and immunologic morbidity, but no clear treatment has been established. This article introduces a case of a 22-year-old female patient with an underlying lymphatic anomaly who presented with refractory chylous ascites after laparoscopic adnexectomy for ovarian teratoma which aggravated after thoracic duct embolization. Ascites (>3,000 mL/d) had to be drained via a percutaneous catheter to relieve abdominal distention and consequent dyspnea, leading to significant cachexia and weight loss. Two sessions of hybrid lymphovenous anastomosis (LVA) surgery with intraoperative mesenteric lymphangiography guidance were performed to decompress the lymphatics. The first LVA was done between inferior mesenteric vein and left para-aortic enlarged lymphatics in a side-to-side manner. The daily drainage of chylous ascites significantly decreased to 130 mL/day immediately following surgery but increased 6 days later. An additional LVA was performed between right ovarian vein and enlarged lymphatics in aortocaval area in side-to-side and end-to-side manner. The chylous ascites resolved subsequently without any complications, and the patient was discharged after 2 weeks. The patient regained weight without ascites recurrence after 22 months of follow-up. This case shares a successful experience of treating refractory chylous ascites with lymphatic anomaly through LVA, reversing the patient's life-threatening weight loss. LVA was applied with a multidisciplinary approach using intraoperative mesenteric lipiodol, and results showed the possibility of expanding its use to challenging problems in the intraperitoneal cavity.

• Tuberculosis and Respiratory Diseases
• /
• v.87 no.2
• /
• pp.123-133
• /
• 2024

Interstitial lung diseases (ILDs) are a diverse collection of lung disorders sharing similar features, such as inflammation and fibrosis. The diagnosis and management of ILD require a multidisciplinary approach using clinical, radiological, and pathological evaluation. Progressive pulmonary fibrosis (PPF) is a distinct form of progressive and fibrotic disease, occurring in ILD cases other than in idiopathic pulmonary fibrosis (IPF). It is defined based on clinical symptoms, lung function, and chest imaging, regardless of the underlying condition. The progression to PPF must be monitored through a combination of pulmonary function tests (forced vital capacity [FVC] and diffusing capacity of the lung for carbon monoxide), an assessment of symptoms, and computed tomography scans, with regular follow-up. Although the precise mechanisms of PPF remain unclear, there is evidence of shared pathogenetic mechanisms with IPF, contributing to similar disease behavior and worse prognosis compared to non-PPF ILD. Pharmacological treatment of PPF includes immunomodulatory agents to reduce inflammation and the use of antifibrotics to target progressive fibrosis. Nintedanib, a known antifibrotic agent, was found to be effective in slowing IPF progression and reducing the annual rate of decline in FVC among patients with PPF compared to placebos. Nonpharmacological treatment, including pulmonary rehabilitation, supplemental oxygen therapy, and vaccination, also play important roles in the management of PPF, leading to comprehensive care for patients with ILD. Although there is currently no cure for PPF, there are treatments that can help slow the progression of the disease and improve quality of life.

• Journal of Gastric Cancer
• /
• v.23 no.1
• /
• pp.3-106
• /
• 2023

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.1
• /
• pp.5-25
• /
• 2020

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion: The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.1
• /
• pp.561-571
• /
• 2016

Purpose: This study reviewed the innovative educational strategies that have been implemented successfully in US baccalaureate nursing education programs to facilitate appropriate attitudes about caring for older adults. Methods: The data were collected through a search of PubMed and CINAHL using the key words, gerontological or geriatric, attitudes about aging or older people, baccalaureate or undergraduate nursing education or curriculum. Results: The successful strategies are categorized as follows: 1) a multidisciplinary approach integrating aging issues and gerontological contents into diverse nursing courses, 2) active participation of community-dwelling healthy older individuals as an educational mentor, 3) use of audiovisual materials to investigate the misconceptions and attitudes about aging, and 4) discussion through critical thinking and self-reflection toward aging. Implications: For the interdisciplinary approach within nursing courses, it is essential to derive the key contents for gerontological nursing applicable to integration into diverse nursing courses. In addition, it is necessary to provide administrative support for implementing innovative strategies and constructing consistent partnerships with the community for active participation of the elderly as a mentor. Lastly, recognizing the significance of educational strategies for enhancing desirable attitudes toward gerontological nursing and supporting the development of educational capability of a faculty are key issues.

• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1207-1215
• /
• 2009

Purpose:To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. Methods:We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. Results:Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was $54.3{\pm}49.2$ months, and the current mean age of the children was $8.3{\pm}6.4$ years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. Conclusion:A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.

• Archives of design research
• /
• v.20 no.3 s.71
• /
• pp.299-314
• /
• 2007

For the past 20 years, the growth and development of university-design-educational institutes contributed to the industrial development of our country. Due to the technological fluctuation and changes in the industrial structure in the latter half of the 20th century, the enterprise is demanding professionally-oriented design manpower. The principle which appears from instances of the advanced nations is to accommodate the demands in social changes and apply them to educational design programs. In order to respond promptly to the industrial demand especially, the advanced nations adopted "multidisciplinary design education programs" to lead innovation in the area of design globally. The objective of the research consequently is to suggest an educational system and a program through which the designer can be educated to obtain complex knowledge and the technique demanded by the industry and enterprise. Nowadays in order to adapt to a new business environment, designers specially should have both the knowledge and techniques in engineering and business administration. We suggest that the IPDI, a multidisciplinary design educational system and program is made up of the coordinated operation of major classes, on-the-job training connection, educational system for research base creation, renovation design development program for the application and the synthesis of alternative proposals about the training facility joint ownership by connecting with the education of design, business administration and engineering.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.1
• /
• pp.119-125
• /
• 2009

Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.

• Journal of Digital Convergence
• /
• v.13 no.6
• /
• pp.297-305
• /
• 2015

Forest area was applied as health promotion place for resident. Korea Forest Service set the term of "forest healing" based on the application of forest area as health promotion, which multidisciplinary approach in forest policy, and construct the "healing forest" for the healing space. Handicapped was excluded from the forest healing service as healing forest was located in the point away from urban area. The standard of healing forest size was difficult to set as urban forest area was fragmented. This study conducted on adequate standard of healing forest size in urban region. This study surveyed the laws related to the outdoor recreation place, and the walking range of the handicapped (elders, disabilities). The results were deduced with interrelationship between two factors(forest policy, human walking range). Healing forest size was not departmentalized for urban area compared with the standard of similar outdoor space (tourism complex, urban parks). Healing forest size was changed from 50ha to 25ha in national forest, from 30ha to 15ha in private forest considered with walking range of handicapped. This study contributes the evidence as the standard of healing forest size for health promotion in urban resident.