• Title/Summary/Keyword: Multidisciplinary approach

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Hyperpolarized Carbon-13 Magnetic Resonance Imaging: Technical Considerations and Clinical Applications

  • Ying-Chieh Lai;Ching-Yi Hsieh;Yu-Hsiang Juan;Kuan-Ying Lu;Hsien-Ju Lee;Shu-Hang Ng;Yung-Liang Wan;Gigin Lin
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.459-472
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    • 2024
  • Hyperpolarized (HP) carbon-13 (13C) MRI represents an innovative approach for noninvasive, real-time assessment of dynamic metabolic flux, with potential integration into routine clinical MRI. The use of [1-13C]pyruvate as a probe and its conversion to [1-13C]lactate constitute an extensively explored metabolic pathway. This review comprehensively outlines the establishment of HP 13C-MRI, covering multidisciplinary team collaboration, hardware prerequisites, probe preparation, hyperpolarization techniques, imaging acquisition, and data analysis. This article discusses the clinical applications of HP 13C-MRI across various anatomical domains, including the brain, heart, skeletal muscle, breast, liver, kidney, pancreas, and prostate. Each section highlights the specific applications and findings pertinent to these regions, emphasizing the potential versatility of HP 13C-MRI in diverse clinical contexts. This review serves as a comprehensive update, bridging technical aspects with clinical applications and offering insights into the ongoing advancements in HP 13C-MRI.

Navigating the landscape of clinical genetic testing: insights and challenges in rare disease diagnostics

  • Soo Yeon Kim
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.8-15
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    • 2024
  • With the rapid evolution of diagnostic tools, particularly next-generation sequencing, the identification of genetic diseases, predominantly those with pediatric-onset, has significantly advanced. However, this progress presents challenges that span from selecting appropriate tests to the final interpretation of results. This review examines various genetic testing methodologies, each with specific indications and characteristics, emphasizing the importance of selecting the appropriate genetic test in clinical practice, taking into account factors like detection range, cost, turnaround time, and specificity of the clinical diagnosis. Interpretation of variants has become more challenging, often requiring further validation and significant resource allocation. Laboratories primarily classify variants based on the American College of Medical Genetics and Genomics and the Association for Clinical Genomic Science guidelines, however, this process has limitations. This review underscores the critical role of clinicians in matching patient phenotypes with reported genes/variants and considering additional factors such as variable expressivity, disease pleiotropy, and incomplete penetrance. These considerations should be aligned with specific gene-disease characteristics and segregation results based on an extended pedigree. In conclusion, this review aims to enhance understanding of the complexities of clinical genetic testing, advocating for a multidisciplinary approach to ensure accurate diagnosis and effective management of rare genetic diseases.

Venous Free Flap with Interposition Bypass Graft for Arteriovenous Fistula Preservation: A Case Report

  • Cyril Awaida;Marion Aribert;Natalie Weger;Kendall Keck;Andrei Odobescu
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.568-572
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    • 2023
  • Cutaneous squamous cell carcinoma (CSCC) overlying an arteriovenous fistula (AVF) is rare and presents unique challenges. This case report describes a method of fistula preservation after CSCC excision using a flow-through venous free flap. The saphenous vein of the venous flap was used as flow-through segment for AVF preservation. The flap was inserted along the dorsal aspect of the forearm wound and microvascular anastomosis of the arterial inflow was completed using a vein just proximal to the radiocephalic fistula anastomosis. Venous outflow was established by creating an end-to-end vascular anastomosis between the cephalic vein and the greater saphenous vein. A separate subcutaneous vein was used to provide a low-pressure outflow for the flap to avoid congestion. This case demonstrates an option for AVF preservation that has not been previously described. It also highlights the importance of a multidisciplinary approach for the safe treatment of CSCCs overlying AVFs.

Systematic Review of Research Progress on Borderline Resectable Pancreatic Cancer: A Bibliometric and Visualized Analysis (경계성 절제가능형 췌장 연구 동향에 대한 체계적인 문헌 고찰: 계량서지학적 분석 및 시각화된 분석)

  • Jae Keun Park;Ji Woong Hwang
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.23-30
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    • 2024
  • Borderline resectable pancreatic cancer, an intermediate stage between a completely resectable state and an unresectable state, requires a multidisciplinary treatment approach. This study aimed to elucidate the main characteristics and recent research trends regarding borderline resectable pancreatic cancer to gain further insights into them. Data from published papers about borderline resectable pancreatic cancer were collected from Web of Science (2014-2023) for the analysis. This study included 355 papers; data on major countries, publishing organizations, and keywords were collected and analyzed. Furthermore, R studio and VOSviewer were used for the qualitative and quantitative analyses of keywords. Publication of papers on borderline resectable pancreatic cancer was observed to be increasing annually by 12.8%, with the United States and Japan being the main publishing countries. In 2014, keywords related to surgery and chemotherapy were dominant; however, a shift toward more integrative approaches, such as neoadjuvant therapy, was observed over time. This study demonstrates rapidly evolving trends and paradigm changes in the research and management of borderline resectable pancreatic cancer. Thus, the results of this study are expected to contribute to establishing future research strategies and improving patient treatment outcomes.

Lived Experiences of Parents of Children with Celiac Disease: A Descriptive Qualitative Study

  • Nesibe S. Kutahyalioglu;Gamze Kas Alay
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.146-157
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    • 2024
  • Purpose: Celiac disease (CD) is one of the most prevalent food-related illnesses in children, with a global prevalence of approximately 1.4%. CD can create an emotional burden, particularly on mothers, who are mainly responsible for managing challenges related to adherence to a gluten-free diet, high food costs, and food problems in schools and social areas. There is a gap in the literature, and parental experiences of raising children with CD should be explicitly examined. This qualitative study sought to provide insights into the experiences of parents raising a child with CD in the Turkish context. Methods: This study used a descriptive qualitative research methodology and conducted individual semi-structured video-based dyadic interviews with 19 parents. Results: Participants experienced both challenges and motivators through management of their children's CD. Analyses of the interview transcripts through the data uncovered three main themes focusing primarily on parental concerns: (1) parental challenges in child's disease management, (2) supportive care needs, and (3) parental expectations. Conclusion: A multidisciplinary team should approach the child and family immediately after diagnosis, and facilities should support parents with continuing education and psychological, financial, and social assistance.

Spectrum of Pulmonary Fibrosis from Interstitial Lung Abnormality to Usual Interstitial Pneumonia: Importance of Identification and Quantification of Traction Bronchiectasis in Patient Management

  • Takuya Hino;Kyung Soo Lee;Joungho Han;Akinori Hata;Kousei Ishigami;Hiroto Hatabu
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.811-828
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    • 2021
  • Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.

Research Trends and Future Direction for Sustainable Agricultural and Forest Management (지속가능한 영농·영림을 위한 국내외 연구동향 및 향방)

  • Kim, Hakyoung;Choi, Sung-Won;Kim, Joon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.17 no.3
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    • pp.236-247
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    • 2015
  • Domestic agricultural and forest management suffers disturbances arising from rapid economic, social and environmental changes including climate change. Sustainable management has emerged as a key to overcoming these challenges. From the domestic and international viewpoint, we have identified mainly three (i.e. indicator, accounting, and ecological) approaches to sustainable management of agricultural and forest ecosystems. Compared to persistent investment in indicator and accounting approaches, we find the paucity of the domestic efforts in ecological approach. The latter approach can be facilitated based on the long-term meteorological and flux data including the ecosystem-level energy, matter and information flows, which have been monitored and managed by Korea Meteorological Administration, Rural Development Administration and Korea Forest Service. In order to keep up with vigorous international efforts toward sustainable ecosystem management, more interdisciplinary, multidisciplinary and transdisciplinary collaborations among diverse domestic sectors and institutes are essential.

Treatment Protocol for Cleft Lip and/or Palate Children in Kyushu University Hospital

  • Suzuki, Akira
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.2
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    • pp.69-82
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    • 2012
  • Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

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A systems thinking approach to explore the structure of urban walking and health promotion in Seoul (서울시민의 보행과 건강증진에 관한 시스템 사고 기반의 구조 탐색)

  • Kim, Dong Ha;Chung, Chang-Kwon;Lee, Jihyun;Kim, Kwang Kee;JeKarl, Jung;Yoo, Seunghyun
    • Korean Journal of Health Education and Promotion
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    • v.35 no.5
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    • pp.1-16
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    • 2018
  • Objectives: This study aimed to examine systems behavior of urban walking by analyzing a dynamic structure in Seoul, South Korea. Methods: As a systems thinking approach to urban walking and health promotion, we developed a Casual Loop Diagram based on literature review and expert consultation. The reviewed literature included: 1) qualitative studies that explores the experiences of urban walkers in Seoul; 2) a systematic review study on the built environmental factors related to walking; 3) policy research reports related to urban walking in Seoul. Results: The feedback structure for urban walking was related to the three urban environments (safety & walking environment, socioeconomic environment, and public transportation environment), and was characterized by a trade-off consisting of eight reinforcing loops and four balancing loops. Conclusions: The policies for a walkable city require multi-sectoral cooperation in order to change the causal loop structure related to the decline of walking. Therefore, it is necessary to establish legal and institutional conditions so that multi-sectoral and multidisciplinary approaches are possible.

A Study on the Model of Equipment Layout Verification for Offshore Plant Maintenance Equipment Engineering (해양플랜트 유지보수장치 엔지니어링을 위한 장비 배치 검증수행모델에 관한 연구)

  • Han, Seong Jong;Park, Peom
    • Plant Journal
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    • v.13 no.4
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    • pp.41-47
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    • 2017
  • This paper is a study on validation model that can verify the arrangement of equipment constituting offshore plant using system engineering approach in offshore plant tender stage. In order to design offshore plant topside maintenance equipment, topside layout verification should be preceded. However, there are many errors in the bidding stage due to the FEED results that are not perfect, the verification can not be performed sufficiently due to the limitation of the bidding period and others reasons. Therefore, we propose a validation model that can effectively verify the equipment layout within a limited condition by simplifying the main process in the system engineering process, which is a multidisciplinary approach, and confirmed through the Functional Deployment Model. Also, we verified the validation model for topside equipment deployment through case studies.

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