• Archives of Plastic Surgery
• /
• v.49 no.5
• /
• pp.652-655
• /
• 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.

• Korean Journal of Radiology
• /
• v.23 no.7
• /
• pp.732-741
• /
• 2022

Objective: To determine the impact of dedicated subspecialized radiologists in multidisciplinary team (MDT) discussions on the management of lower gastrointestinal (GI) tract malignancies. Materials and Methods: We retrospectively analyzed the data of 244 patients (mean age ± standard deviation, 61.7 ± 11.9 years) referred to MDT discussions 249 times (i.e., 249 cases, as five patients were discussed twice for different issues) for lower GI tract malignancy including colorectal cancer, small bowel cancer, GI stromal tumor, and GI neuroendocrine tumor between April 2018 and June 2021 in a prospective database. Before the MDT discussions, dedicated GI radiologists reviewed all imaging studies again besides routine clinical reading. The referring clinician's initial diagnosis, initial treatment plan, change in radiologic interpretation compared with the initial radiology report, and the MDT's consensus recommendations for treatment were collected and compared. Factors associated with changes in treatment plans and the implementation of MDT decisions were analyzed. Results: Of the 249 cases, radiologic interpretation was changed in 73 cases (29.3%) after a review by dedicated GI radiologists, with 78.1% (57/73) resulting in changes in the treatment plan. The treatment plan was changed in 92 cases (36.9%), and the rate of change in the treatment plan was significantly higher in cases with changes in radiologic interpretation than in those without (78.1% [57/73] vs. 19.9% [35/176], p < 0.001). Follow-up records of patients showed that 91.2% (227/249) of MDT recommendations for treatment were implemented. Multiple logistic regression analysis revealed that the nonsurgical approach (vs. surgical approach) decided through MDT discussion was a significant factor for patients being managed differently than the MDT recommendations (odds ratio, 4.48; p = 0.017). Conclusion: MDT discussion involving additional review of radiology examinations by dedicated GI radiologists resulted in a change in the treatment plan in 36.9% of cases. Changes in treatment plans were significantly associated with changes in radiologic interpretation.

• Journal of Ecology and Environment
• /
• v.47 no.4
• /
• pp.228-240
• /
• 2023

Growing complexity in ecosystem structure and functions, under impacts of climate and land-use changes, requires interdisciplinary understandings of processes and the whole-system, and accurate estimates of the changing functions. In the last three decades, observation networks for biodiversity, ecosystems, and ecosystem functions under climate change, have been developed by interested scientists, research institutions and universities. In this paper we will review (1) the development and on-going activities of those observation networks, (2) some outcomes from forest carbon cycle studies at our super-site "Takayama site" in Japan, and (3) a few ideas how we connect in-situ and satellite observations as well as fill observation gaps in the Asia-Oceania region. There have been many intensive research and networking efforts to promote investigations for ecosystem change and functions (e.g., Long-Term Ecological Research Network), measurements of greenhouse gas, heat, and water fluxes (flux network), and biodiversity from genetic to ecosystem level (Biodiversity Observation Network). Combining those in-situ field research data with modeling analysis and satellite remote sensing allows the research communities to up-scale spatially from local to global, and temporally from the past to future. These observation networks oftern use different methodologies and target different scientific disciplines. However growing needs for comprehensive observations to understand the response of biodiversity and ecosystem functions to climate and societal changes at local, national, regional, and global scales are providing opportunities and expectations to network these networks. Among the challenges to produce and share integrated knowledge on climate, ecosystem functions and biodiversity, filling scale-gaps in space and time among the phenomena is crucial. To showcase such efforts, interdisciplinary research at 'Takayama super-site' was reviewed by focusing on studies on forest carbon cycle and phenology. A key approach to respond to multidisciplinary questions is to integrate in-situ field research, ecosystem modeling, and satellite remote sensing by developing cross-scale methodologies at long-term observation field sites called "super-sites". The research approach at 'Takayama site' in Japan showcases this response to the needs of multidisciplinary questions and further development of terrestrial ecosystem research to address environmental change issues from local to national, regional and global scales.

• Journal of the Korea Society of Computer and Information
• /
• v.17 no.11
• /
• pp.197-206
• /
• 2012

The objectives of this study are to investigate core learning ability necessary for the 21st century and to develop core human resources required for social and national development in the future. The '21st Century Learning Ability Project' is to approach the existing knowledge and learning multidisciplinary and interactively based on the learning ability of each learner and individually and socially valuable themes. Even in Korea, a variety of intersubject integrative educational curriculum was attempted to cultivate learning ability. However, there are not enough teachers who can teach the differences between the content and characteristics for each subject by fully understanding them. Thus, it is difficult to apply them easily to the field of education. Thus, this study develops the multidisciplinary customized educational curriculum in order to develop the learning ability necessary for the 21st century, analyzes the reality of the educational curriculum integrating the academic knowledge in order to support this effectively. As a result, this study offers the interdisciplinary customized integrated model applicable to elementary and middle schools.

• The Journal of the Korea Contents Association
• /
• v.10 no.1
• /
• pp.286-294
• /
• 2010

Complex Regional Pain Syndrome(CRPS) is a chronic neruopathic pain syndrome, most frequently encountered after trauma, nerve injury, fracture, cerebral vascular accident(CVA), spinal injury, and surgery to a limb, and affected by diverse factors such as disease process, intervention method, and other biopsychosocial components. Occupational therapy as a multidisciplinary treatment approach may be potentially useful when simultaneously targeting such biological, psychological, and social components. Biological treatment can focus on increasing functional use of extremity for promoting independence. Psychological intervention can include relaxation/biofeedback training and cognitive-behavioral treatments, and social approach can focus on recreational therapy and vocational rehabilitation. Occupational therapy will encourage functional restoration, pain management, and regaining of psychological components with collaboration between different disciplines.

• Korean Journal of Audiology
• /
• v.25 no.1
• /
• pp.49-54
• /
• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Audiology & Otology
• /
• v.25 no.1
• /
• pp.49-54
• /
• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Preventive Medicine and Public Health
• /
• v.57 no.2
• /
• pp.157-166
• /
• 2024

Objectives: Children with disabilities may exhibit a multitude of symptoms, and treatment requires a multidisciplinary approach for a satisfactory outcome. Lack of awareness among physicians, lack of referral, and lack of inter-sectoral coordination have hindered paediatric practice in Tamil Nadu, a state in India with a striking childhood disability rate that warrants a timely interdisciplinary approach. However, the perspectives of paediatricians on paediatric physiotherapy are unknown. The aim of the study was to investigate the perspectives of practicing paediatric physicians in Chennai on the role of physiotherapy in paediatrics. Methods: For an in-depth exploration, qualitative semi-structured interviews were conducted in person with 10 paediatricians. Audio from the sessions was recorded and transcribed, and data saturation was achieved through iterative analysis. Results: A grounded theory analysis of the results yielded 5 domains under which the perspectives and expectations of the physicians were described, along with the barriers experienced by patients' parents as explained by their paediatrician. The responses highlighted deficits in awareness, structural support, accessibility and direct communication between physicians and physiotherapists. Conclusions: Paediatric physicians have different opinions, and some ignorance persists concerning paediatric physiotherapy. This study warrants a proper structure of the paediatric rehabilitation unit and regular interdisciplinary meetings and focus group discussions to increase access for parents and improve patient outcomes.

• Journal of Engineering Education Research
• /
• v.9 no.2
• /
• pp.52-70
• /
• 2006

Systems Engineering(SE), as a special discipline evolved from multidisciplinary and interdisciplinary design knowledges and practical lessons learned from development practices, is required to develop today's ever-growing large complex systems. As computer speed and analytic sophistication accelerate their applications, modern society's needs have become increasingly varied and complex. Rapid advances in Systems Engineering and its education programs among the developed countries demonstrate their needs as an alternative to what is lacking from traditional disciplinary engineering to meet new challenges of our changing social environments. Systems Engineering is an interdisciplinary approach that includes both management and technical processes. Its processes, methods, and tools are used to evolve, define, and verify an integrated, life-cycle balanced set of system solution that satisfy customer needs and requirements. The process methodology offers a top-down comprehensive, iterative and recursive problem solving process which includes the stating the problems, investigating the alternatives, architecting and modeling the system, integrating and operating the system, assessing and re-evaluating the system performances. The purpose of this paper is to research the cases of SE educational programs for both domestic and other developed countries and to propose recommendations for the domestic SE educational programs in the future.

• Journal of the Korean Chemical Society
• /
• v.64 no.2
• /
• pp.79-83
• /
• 2020

A novel pharmacophore with epinastine (1) and NSAID moieties (2-5) was designed by molecular hybridization approach. The hybrid compounds 6-9 were synthesized by EDCI/HOBt or HATU-mediated coupling of 1 with salicylic acid (2), mefenamic acid (3), indomethacin (4) and naproxen (5), respectively, and were assessed for their inhibitory effect against NO production in LPS-induced RAW-264.7 macrophages in vitro. The Hybrids were found to exhibit significant NO production inhibitory effects with half-maximal inhibitory concentration (IC₅₀) values ranging in between 15.96 ± 1.32 and 36.68 ± 2.53 μM and were non-cytotoxic to macrophages. Comparing the inhibition concentration (IC₅₀), cytotoxicity concentration (CC₅₀) and in vitro efficacy index (iEI), 6 (IC₅₀ = 17.97 ± 1.92 μM; iEI = 11.13) and 9 (IC₅₀ = 15.96 ± 1.32 μM; iEI = 12.53) were better suited than other hybrids as well as their parent compound. Our findings signify that hybrids 6 and 9 may serve as platforms for continued investigations for the development of more efficient anti-inflammatory agents.