• 제목/요약/키워드: Multidisciplinary approach

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Intestinal Hypoganglionosis Leading to Intestinal Failure and the Compassionate Use of OmegavenTM

  • Khalaf, Racha;Karjoo, Sara;Danielson, Paul;Wilsey, Michael;Shakeel, Fauzia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권1호
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    • pp.55-60
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    • 2017
  • Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to $Omegaven^{TM}$, a fat emulsion comprised of omega-3 fatty acids. $Omegaven^{TM}$ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with $Omegaven^{TM}$ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of $Omegaven^{TM}$. No current guidelines for the diagnosis and management of hypoganglionosis are available. We recommend a multidisciplinary approach and the use of novel therapies such as fat emulsions composed of omega-3 fatty acids for improved patient outcomes. Appropriate compassionate use protocols should be obtained from the Food and Drug Administration prior to initiation of $Omegaven^{TM}$.

Pedicled Anterolateral Thigh Flaps for Reconstruction of Recurrent Trochanteric Pressure Ulcer

  • Bahk, Sujin;Rhee, Seung Chul;Cho, Sang Hun;Eo, Su Rak
    • Archives of Reconstructive Microsurgery
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    • 제24권1호
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    • pp.32-36
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    • 2015
  • The reconstruction of recurrent pressure sores is challenging due to a limited set of treatment options and a high risk of flap loss. Successful treatment requires scrupulous surgical planning and a multidisciplinary approach. Although the tensor fascia lata flap is regarded as the standard treatment of choice-it provides sufficient tissue bulk for a deep trochanteric sore defect-plastic surgeons must always consider the potential of recurrence and accordingly save the second-best tissues. With the various applications of anterolateral thigh (ALT) flaps in the reconstructive field, we report two cases wherein an alternative technique was applied, whereby pedicled ALT fasciocutaneous island flaps were used to cover recurrent trochanteric pressure sores. The postoperative course was uneventful without any complications. The flap provided a sound aesthetic result without causing a dog-ear formation or damaging the lower-leg contour. This flap was used as an alternative to myocutaneous flaps, as it can cover a large trochanteric defect, recurrence is minimized, and the local musculature and lower-leg contour are preserved.

악교정 수술을 동반한 임플란트 보철물을 이용한 완전구강회복 증례 (Full-mouth rehabilitation by immediate implantation combined with orthognathic surgery: a clinical report)

  • 안혜림;허지예;김철훈;황희성;김복주
    • 대한치과보철학회지
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    • 제54권1호
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    • pp.57-64
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    • 2016
  • 악교정 수술과 임플란트 보철을 통한 전악재건술의 임상적 치료는 보철과 의사에게 도전적인 과제이다. 본 증례는 골격적 부조화를 가진 다발성 우식증 환자의 진단과 치료에 있어서 치의학의 여러 분야의 협진을 보여주었다. 그 결과로 악교정 수술을 동반한 발치 후 즉시 임플란트 식립 및 조기 하중을 가하는 임플란트 보철물에 의한 전악 재건이 예견가능하고 효과적인 치료 방법이었기에 이를 보고하고자 한다.

학교 실내공기질 및 건강 영향 (School Indoor Air Quality and Health Effects)

  • 양원호
    • 한국환경보건학회지
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    • 제35권3호
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    • pp.143-152
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    • 2009
  • Indoor air quality at classrooms is of special concern since students are susceptible and indoor air problems can be so subtle that it does not always produce easily recognizable health effects. The main objectives of the study were to investigate the time-activity pattern of school students, to determine the sources of poor indoor air quality in schools, and to demonstrate how indoor air quality in schools causes adverse health effects such as headache, upper airway irritation, fatigue, and lethargy. Recent articles ranging from 1987-2009 related to school indoor air quality were systematically reviewed. Building-associated health effects can increase student absences from school and degrade the performance of children while in school. The reduced ventilation rate was associated with a decreased ability to concentrate along with increased adverse health symptoms. There was an association between residential proximity to busy roads and a variety of adverse respiratory health outcomes in children. Consequently, the current findings suggest the need for control strategy for school indoor air pollutants with multidisciplinary approach methods because Korea has no other natural resources except manpower especially.

주거학 교육의 특성화 증대방안으로서 시설경영 교과과정 도입의 탐색적 연구 (An Exploratory Study of a Facilities Management Program as a Way of Specialization of Housing Studies)

  • 이경희;조유현;김영주;이소영
    • 가족자원경영과 정책
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    • 제11권3호
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    • pp.107-121
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    • 2007
  • Many housing studies and education programs in Korea have focused on design, planning, and construction. Houses and nearby environments are a large portion of the total assets each household possesses. However, effective and efficient housing management of housing assets has been relatively neglected. Facility management can be defined as the practice of coordinating the physical environment with the people and process (work of the organization). The purpose of this study is to figure out the construct of courses of Housing majors in the College of Human Ecology in Korea and investigate facilities management programs and courses provided in the U.S. to explore the possibility of merging facility management perspectives and educational programs into housing studies. Many courses provided in facility management programs have human ecology perspectives in terms of a multidisciplinary approach, life cycle commitment, and various stakeholders building physical, social, and ecological milieu. By merging and supplementing the existing curricula of housing and consumer studies, facility nanagement programs and courses could be a possible alternative to specialized housing education programs.

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Phytomonitoring of the Genotoxicity of Environmental Pollutants: An Application to Armenian Nuclear Power Plant

  • Kim, Jin Kyu;Aroutiounian, Rouben M.;Nebish, Anna A.;Kim, Jin-Hong
    • 방사선산업학회지
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    • 제9권4호
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    • pp.181-185
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    • 2015
  • Today the biosafety evaluation, a common problem of vital importance, is based on internationally proved test-systems, standards and techniques. The paradigm of biosafety includes multidisciplinary approach, a combination of physical, chemical and biological tests to monitor the environmental level of pollutants and needs to be improved by modern approaches. The genetic risk of environmental pollutions has long been studied by many researchers. In this study, used was the known sensitive plant test-system, clones of plant Tradescantia (spiderwort) able to detect gene mutations (frequency of mutational events and formation of micronuclei) in combination with chemical and, in some instances, with radiological measurements. In addition, male gametophyte generation of fruit trees was applied as bioindicators of genotoxicity. The obtained results did not show any significant increase along with wind direction. As for the male gametophyte assay, the fertility of the investigated fruit-trees near to NPP did not significantly differ from that of the control point. The influence of the NPP on the male generative system of the investigated taxa of fruit trees for the investigated year was not revealed. The system described needs to be expanded by species of interest (human) as there is a difficulty to transfer the revealed dose correlations to humans. The development of this idea includes various levels: population (epidemiological studies), individual, cellular, molecular (DNA), etc.

권역외상 및 응급센터에서 성형외과의 참여방안 (Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers)

  • 임남규;강동희
    • 대한의사협회지
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    • 제61권12호
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

뇌성마비 아동의 엉덩관절에 관한 연구 (A Study for Hip Joint in Children with Cerebral Palsy)

  • 오태영
    • 신경치료
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    • 제22권3호
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    • pp.43-48
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    • 2018
  • Purpose The purpose of this study is to identify the prevalence, risk factors, characteristics, and interventions of hip joint problems in children with cerebral palsy, and to be able to serve as leverage for early detection, prevention, and function recovery. Method The electronic journal site was searched by the search terms "cerebral palsy", "hip joint", "hip joint dislocation", we analyzed and descript the cited articles from domestic and foreign papers in Pubmed 9, Science Direct 7, and K RISS analysis and analysis. Results Children with cerebral palsy showed the different prevalence according to their disability type, severity, and functional level, and we knew that abnormal neuromuscular control, stiffness, and biomechanical changes could be risk factors. Migration Index, Acetabolum Index, Neck shaft angle using by radiography and passive ROM test, special tests were available for the diagnosis and evaluation of the hip joint. Combination of physical therapy and orthopedic surgery was very important intervention, and complementary alternative therapy, orthosis, and postural assistant are effective. Conclusion We suggested that early detection and prevention is the most important periodic examination and that a multidisciplinary approach is a major factor in intervention.

암 생존자 직장복귀 중재 프로그램 연구 고찰 (A Literature Review of Return-to-Work Interventions for Cancer Survivors)

  • 배가령;조주희;전서희
    • 한국직업건강간호학회지
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    • 제28권2호
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    • pp.83-93
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    • 2019
  • Purpose: Cancer patients are at a higher risk of being unemployed or facing difficulty in returning to work (RTW) than individuals without health concerns. The aim of this study is to identify and describe interventions developed specifically to assist cancer patients to RTW after treatment. Methods: A comprehensive search was conducted from September to October 2018 in different international databases: PubMed, Medline, and Embase. Studies using qualitative, quantitative, or mixed designs were included if they satisfied the following criteria: (a) described an intervention to assist cancer patients to RTW during or after treatment; (b) conducted on patients aged 18 and over and diagnosed with cancer; (c) written in English; (d) published in peer-reviewed journals. Results: Fourteen studies met the inclusion criteria. Counseling with physical activity intervention, behavioral training to reduce fatigue, and multi-disciplinary rehabilitation programs were found to be effective. Conclusion: Interventions adopting a multidisciplinary approach were effective for RTW in cancer patients. This literature review emphasizes the need for more tailored interventions based on survivors' needs and characteristics in the RTW field.

Twenty-one-year follow-up of variable onset MELAS syndrome with heteroplasmic nt3243A>G mtDNA mutation: A case report

  • Song, Wung Joo;Lee, Yoon Jin;Kang, Joon Won;Chang, Mea Young;Song, Kyu Sang;Kang, Dae Young;Kim, Sook Za
    • Journal of Genetic Medicine
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    • 제16권1호
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    • pp.31-38
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    • 2019
  • Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a maternally inherited mitochondrial disorder of which m.3243A>G is the most commonly associated mutation, resulting in an inability to meet the energy requirements of various organs. MELAS poses a diagnostic challenge owing to its multiple organ involvement and great clinical variability due to its heteroplasmic nature. We report three cases from a family who were initially misdiagnosed with myasthenia gravis or undiagnosed. Although there is no optimal consensus treatment approach for patients with MELAS because of the disease's heterogeneity, our 21-year-long therapy regimen of ${\text\tiny{L}}-arginine$, ${\text\tiny{L}}-carnitine$, and coenzyme Q10 supplementation combined with dietary management appeared to provide noticeable protection from the symptoms and complications. Prompt early diagnosis is important, as optimal multidisciplinary management and early intervention may improve outcomes.