• Title/Summary/Keyword: Multidisciplinary approach

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Roundtable Discussion at the UICC World Cancer Congress: Looking Toward the Realization of Universal Health Coverage for Cancer in Asia

  • Akaza, Hideyuki;Kawahara, Norie;Nozaki, Shinjiro;Sonoda, Shigeto;Fukuda, Takashi;Cazap, Eduardo;Trimble, Edward L.;Roh, Jae Kyung;Hao, Xishan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.1-8
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    • 2015
  • The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized a Roundtable Discussion as part of the official program of the UICC World Cancer Congress 2014 in Melbourne, Australia. The theme for the Roundtable Discussion was "Looking Toward the Realization of Universal Health Care 'UHC' for Cancer in Asia" and it was held on December 5, 2014. The meeting was held based on the recognition that although each country may take a different path towards the realization of UHC, one point that is common to all is that cancer is projected to be the most difficult disease to address under the goals of UHC and that there is, therefore, an urgent and pressing need to come to a common understanding and awareness with regard to UHC concepts that are a priority component of a post-MDG development agenda. The presenters and participants addressed the issue of UHC for cancer in Asia from their various perspectives in academia and international organizations. Discussions covered the challenges to UHC in Asia, collaborative approaches by international organizations, the need for uniform and relevant data, ways to create an Asia Cancer Barometer that could be applied to all countries in Asia. The session concluded with the recognition that research on UHC in Asia should continue to be used as a tool for cancer cooperation in Asia and that the achievement of UHC would require research and input not only from the medical community, but from a broad sector of society in a multidisciplinary approach. Discussions on this issue will continue towards the Asia-Pacific Cancer Conference in Indonesia in August 2015.

Case Studies Via Level Classes Of The Convergence Program For Verifying The Center Of Gravity (무게중심 확인 융합 프로그램의 수준별 수업 적용 사례연구)

  • Kim, Su Geum;Ryu, Shi Kyu;Kim, Sun Bae
    • Journal of the Korean School Mathematics Society
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    • v.17 no.4
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    • pp.771-804
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    • 2014
  • The concept of the center of gravity is presently being introduced in elementary school curriculums and is broadly applied to Mathematics, Physics, and the Engineering field in University education which are mostly theoretical classes much separated from actual life in the practical educational field. In 2013, ${\bigcirc}{\bigcirc}$ University of Science and Gifted Education, had developed the multidisciplinary approach program of verifying the center of gravity for gifted students, but this program was reconstructed and applied to ordinary students and the effectiveness was analyzed to lay the foundation and generalize this convergence education. Including experiments for verifying the center of gravity in an object with a hollow interior and the existence of a center of gravity outside an object, I proposed realizing the calculations by considering the weight of the lever, the Principle of the lever being a core factor when finding the center of gravity. We altered the existing 8 step program to a 4 step program for the told 65 students from elementary, Junior and High School students, letting them freely select the class lecture by themselves. The analysis attained from surveys, debates and interviews showed that by precise error analysis, students achieved a higher success experience, showing us the importance of the development of a new convergence program.

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An Epidemiologic Study of Low Back Pain of Women Working at a General Hospital (종합병원 근무 여성의 요통에 대한 요인 분석)

  • Park, Dong-Gu;Ahn, Myun-Whan;Ahn, Jong-Chul;Kim, Sae-Dong;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.186-196
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    • 2007
  • Background : The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. Materials and Methods : An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. Results : The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. Conclusion : Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

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Successful Treatment of Severe Bumble foot in a Northern Goshawk (Accipiter gentilis) (북방 참매에서 발생한 Bumble foot의 성공적인 치료 증례)

  • Chung, Tae-ho;Oh, Seungkuk;Kim, Jung-Hyun;Kim, Hyun-Ju;Park, Chul
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.268-271
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    • 2015
  • About 2-year old northern goshawk (Accipiter gentilis) which is designated as natural monument (#323-1) in Republic of Korea was rescued by a local farmer and presented with a 2-weeks history of pain, swelling, stiffness and limping. On physical examination, plantar pododermatitis and digit IV weakness were observed. Radiographic findings also showed bone lyses with soft tissue swelling in the foot. A definite diagnosis was made as stage III bumble foot after multidisciplinary approach of the patient. Bacterial culture was performed, and concurrently antibiotic susceptibility testing is determined using wound site exudates specimen. Bacterial isolates were identified as Staphylococcus aureus, known normal skin flora. Treatment was initiated with surgical incision and necrotized tissues removal. Lavage-drainage and ball bandage were applied with topical mupirocin ointment application. Doughnut shaped pad was attached on bottom of the ball bandage to reduce weight bearing. After three weeks of intensive care, the wound site completely healed but digit IV weakness remained permanently. The goshawk returned to nature after eight weeks after treatment.

Factors Associated with a Prolonged Length of Hospital Stay in Patients with Diabetic Foot: A Single-Center Retrospective Study

  • Choi, Sang Kyu;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Jee Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.539-544
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    • 2017
  • Background We conducted this study to identify factors that may prolong the length of the hospital stay (LHS) in patients with diabetic foot (DF) in a single-institution setting. Methods In this single-center retrospective study, we evaluated a total of 164 patients with DF, and conducted an intergroup comparison of their baseline demographic and clinical characteristics, including sex, age, duration of diabetes, smoking status, body mass index, underlying comorbidities (e.g., hypertension or diabetic nephropathy), wound characteristics, type of surgery, the total medical cost, white blood cell (WBC) count, C-reactive protein (CRP) levels, erythrocyte sedimentation rate, and albumin, protein, glycated hemoglobin, and 7-day mean blood glucose (BG) levels. Results Pearson correlation analysis showed that an LHS of >5 weeks had a significant positive correlation with the severity of the wound (r=0.647), WBC count (r=0.571), CRP levels (r=0.390), DN (r=0.020), and 7-day mean BG levels (r=0.120) (P<0.05). In multiple regression analysis, an LHS of >5 weeks had a significant positive correlation with the severity of the wound (odds ratio [OR]=3.297; 95% confidence interval [CI], 1.324-10.483; P=0.020), WBC count (OR=1.423; 95% CI, 0.046.0-356; P=0.000), CRP levels (OR=1.079; 95% CI, 1.015-1.147; P=0.014), albumin levels (OR=0.263; 95% CI, 0.113.3-673; P=0.007), and 7-day mean BG levels (OR=1.018; 95% CI, 1.001-1.035; P=0.020). Conclusions Surgeons should consider the factors associated with a prolonged LHS in the early management of patients with DF. Moreover, this should also be accompanied by a multidisciplinary approach to reducing the LHS.

Three-year Analysis of Patients and Treatment Experiences in the Regional Trauma Center of Gachon University Gil Hospital between 2011 and 2013 (가천대학교 길병원 권역외상센터 3개년 내원 환자 및 치료 경험 분석(2011~2013))

  • Yoon, Yong-Cheol;Lee, Jung-Nam;Chung, Min;Jeon, Yang Bin;Park, Jae Jeong;Yu, Byung Chul;Lee, Gil Jae;Cho, Hyun Jin;Ma, Dae Sung;Lee, Min A;Choi, Jung Ju;Son, Seong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.170-177
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    • 2014
  • Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

Study on Economic Value and Variance on Water Supply in Industrial Complexes (산업단지 내 공업용수 공급의 경제적 가치 및 한계생산가치 변동성에 관한 연구)

  • Kim, Gilho;Kim, Deokhwan;Kim, Kyungtak;Kim, Hung Soo
    • Journal of Wetlands Research
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    • v.20 no.2
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    • pp.190-200
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    • 2018
  • This study estimated the marginal production value based on the production function approach to confirm the economic value of industrial water supply projects. For this, we analyzed 4 data sets classified by 11 industry types according to Cobb-Douglas Function, Translog Function, and Translog function with sector dummy variables. As a result, the average industrial marginal product value of the entire industry was 3,217~5,357 won/ton, 2,994~4,569 won/ton and 3,620~5,342 won/ton, respectively. The results by industry type were the largest in furniture and other manufacturing industries and showed the lowest marginal production value in the textile and leather industries. Overall, the results from the Cobb-Douglas function were highly evaluated. And the volatility according to data sets was also analyzed in the Cobb-Douglas function. There have been few studies on the economic value of industrial water compared to domestic water. It is considered that multidisciplinary consensus will be needed through active research in the future.

A Shared Electronic Medical Record for Lung Cancer Clinic (폐암 클리닉을 위한 공유 전자의무기록)

  • Kim, Kyu-Sik;Park, Eun-Sun;Kim, Seung-Seok;Kim, Hyung-Woo;Kim, Young-Chul;Bom, Hee-Seung;Ahn, Sung-Ja;Na, Kook-Joo;Kim, Yun-Hyeon;Kim, Yu-Il;Lim, Sung-Chul;Moon, Jai-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.480-486
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    • 2005
  • Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.

MULTIDISCIPLINARY APPROACH OF A PATIENT WITH MENTAL RETARDATION UNDER GENERAL ANESTHESIA : A CASE REPORT (정신지체 환자의 협력 진료에 의한 전신마취 하 치과치료 증례)

  • Jang, Yoon-Hyoung;Pae, Ah-Ran;Choi, Sung-Chul;Park, Jae-Hong;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.5 no.1
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    • pp.23-26
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    • 2009
  • Mental retardation is defined by the American Psychiatric Association as" subnormal general intellectual functioning which originates during the developmental period and is associated with impairment of either learning and social adjustment or maturation, or both." A patient with mild to moderate mental retardation can be managed adequately using restraints and medications. However, in case of severe or profound mental disability, dental treatment cannot be accomplished even with the use of behavior modification, physical restraints and sedation techniques. When treatment in the dental office has much difficulty, hospitalization for dental treatment under general anesthesia can and should be considered. This case presents the treatment of a patient with mental retardation who was referred to our department for comprehensive dental care. Dental examination revealed widespread dental caries and a severe anterior open bite with crowding problems. Under general anesthesia, generalized caries treatment was performed by our department, and the anterior dental esthetics was achieved in collaboration with the department of prosthodontic dentistry.

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Three cases of primary mediastinal Nonseminomatous germ cell tumors (원발성 종격동 비정상피종성 생식세포종 3예)

  • Lee, Soon Il;Yong, Suk Joong;Song, Kwang Seon;Shin, Kye Chul;Yang, Kyung Moo;Cho, Mee Yon;Lim, Hyung Rae;Yoo, Kwang Ha;Cho, Hwa Sang;Yoo, Jong Kil;Song, Jong Oh
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.1008-1018
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    • 1996
  • Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

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