• Journal of Yeungnam Medical Science
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• 제38권3호
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• pp.194-201
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• 2021

Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient's adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

• 한국BIM학회 논문집
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• 제10권4호
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• pp.11-21
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• 2020

With increasing interest and research on smart cities, there is also an increasing number of studies on urban facilities that can be built within smart cities. According to these studies, smart cities' urban facilities are likely to become high value-added industries. However, the concept of smart city is not clear because it involves various fields. Therefore, in this study, the definition of Next-Generation(N.G) Smart City Facilities with Digital Twin and Digital Chain is carried out through a multidisciplinary approach. Based on this, Next-Generation Smart City Facilities will be divided into High Value-Added Products and Big Data Platforms. Subsequently, the definition of the Digital Chain containing the data flow of the entire process built through the construction of the Digital Twin proceeds. The definitions derived are applied to the Next-Generation Noise Barrier Tunnel to ensure that data is exchanged at the Digital Twin stage, and to review the proposed configuration of the Digital Chain and Data Flow in this study. The platform definition and Digital Chain of Next-Generation Smart City Facilities proposed in this study suggest that it can affect not only the aspects of data management that are currently in the spotlight, but also the manufacturing industry as a whole.

• 대한두경부종양학회지
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• 제37권2호
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• pp.11-17
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• 2021

Head and neck cancer is the 6^th most frequently diagnosed solid tumor in the world. Alcohol consumption, smoking, and HPV infection are associated with the incidence of head and neck squamous cell carcinoma (HNSCC). Although a multidisciplinary approach is a key strategy for the treatment of locally advanced HNSCC, systemic therapy is the mainstream of recurrent or metastatic HNSCC treatment. Stage IV HNSCC has a relatively poor prognosis with median overall survival of around one year. There have been many clinical trials to investigate the efficacy of target agents in the treatment of HNSCC. In the HPV-negative HNSCC, TP53 and CDKN2A are the most commonly mutated genes. In the HPV-positive HNSCC, the PI3K pathway is frequently altered. EGFR, PI3K, cell cycle pathway, MET, HRAS, and IL6/JAK/STAT pathway are explored targets in HNSCC. In this study, we review the target pathways and agents under research. We also introduce here umbrella trials of recurrent or metastatic HNSCC conducted by the Korea Cancer Study Group. The combination of target agents with immune checkpoint inhibitors or cytotoxic chemotherapies would be a future step in the precision medicine of HNSCC treatment.

• 대한치과교정학회지
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• 제52권6호
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• pp.451-460
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• 2022

Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.77-82
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• 2022

Sarcomatoid squamous cell carcinoma (SSCC), a biphasic malignant tumor consisting of atypical squamous epithelial and mesenchymal elements mixed with epithelioid and spindle cells, is a variant of squamous cell carcinoma. Cutaneous SSCC is very rare and aggressive and has a poor prognosis. Here, we report a case of cutaneous SSCC with satellites and in-transit metastases. A 79-year-old woman presented with a protruding mass on the left temporal area sized 1.2×1.0 cm. The punch biopsy report indicated keratoacanthoma or well-differentiated squamous cell carcinoma. The size of the tumor increased to 2.7×2.0 cm after 8 days. An excisional biopsy was performed with a 2 mm safety margin. The tumor was identified as SSCC with a clear resection margin. Reoperation was performed thrice with an increased safety margin of 10 mm; however, the cancer recurred along with satellites and in-transit metastases. Chemoradiotherapy was administered; however, the size of the tumor increased along with satellites and in-transit metastases. The patient expired 162 days after the initial excision. Complete excision and immediate multidisciplinary approach should be combined during the early stages due to the aggressiveness and poor prognosis of cutaneous SSCC with satellites and in-transit metastasis.

• Journal of Hospice and Palliative Care
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• 제25권3호
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• pp.99-109
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• 2022

Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (𝛽=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (𝛽=0.22, P=0.007), and cancer pain management knowledge (𝛽=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

• Journal of Oral Medicine and Pain
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• 제48권1호
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• pp.3-10
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• 2023

This review aimed to update our knowledge of the classification, pathophysiology, prognosis, and treatment of trigeminal neuralgia (TN), with the intention of establishing better treatment protocols. The latest version of the International Classification of Headache Disorders uses an etiology-based approach to characterize TN patients, potentially contributing to the development of targeted treatment measures. Noticeable changes in the recent European Academy of Neurology guidelines for the management of TN include the use of magnetic resonance imaging for exclusion of secondary TN and differentiation of idiopathic and classical TN. Additionally, the use of botulinum toxin type A as an addon therapy for mid-term treatment of TN has also been included. Though there has been limited recent progress in the treatment of TN, previous studies emphasize the importance of customized, multidisciplinary management protocols that include drug therapy optimization; provision of continuous education and support; and timely referral of medically refractory patients for surgery in order to achieve favorable prognosis. Furthermore, slow but growing evidence on gene mutations will help elucidate the pathophysiology of TN and contribute to the development of targeted drugs that are effective and safe.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.281-285
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• 2023

Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.

• 산업경영시스템학회지
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• 제46권4호
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• pp.53-62
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• 2023

Effects-Based Operations (EBO) refers to a process for achieving strategic goals by focusing on effects rather than attrition-based destruction. For a successful implementation of EBO, identifying key nodes in an adversary network is crucial in the process of EBO. In this study, we suggest a network-based approach that combines network centrality and optimization to select the most influential nodes. First, we analyze the adversary's network structure to identify the node influence using degree and betweenness centrality. Degree centrality refers to the extent of direct links of a node to other nodes, and betweenness centrality refers to the extent to which a node lies between the paths connecting other nodes of a network together. Based on the centrality results, we then suggest an optimization model in which we minimize the sum of the main effects of the adversary by identifying the most influential nodes under the dynamic nature of the adversary network structure. Our results show that key node identification based on our optimization model outperforms simple centrality-based node identification in terms of decreasing the entire network value. We expect that these results can provide insight not only to military field for selecting key targets, but also to other multidisciplinary areas in identifying key nodes when they are interacting to each other in a network.

• Steel and Composite Structures
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• 제50권4호
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• pp.403-418
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• 2024

In this paper, vibration and energy absorption characteristics of a nanostructure which is composed of two embedded porous annular/circular nanoplates coupled by a viscoelastic substrate are investigated. The modified couple stress theory (MCST) and the Gurtin-Murdoch theory are applied to take into account the size and the surface effects, respectively. Furthermore, the structural damping effect is probed by the Kelvin-Voigt model and the mathematical model of the problem is developed by a new hyperbolic higher order shear deformation theory. The differential quadrature method (DQM) is employed to obtain the out-of-phase and in-phase frequencies of the structure in order to predict the dynamic response of it. The acquired results reveal that the vibration and energy absorption of the system depends on some factors such as porosity, surface stress effects, material length scale parameter, damping and spring constants of the viscoelastic foundation as well as geometrical parameters of annular/circular nanoplates. A bird's-eye view of the findings in the research paper offers a comprehensive understanding of the vibrational behavior and energy absorption capabilities of annular/circular porous nanoplates. The multidisciplinary approach and the inclusion of porosity make this study valuable for the development of innovative materials and applications in the field of nanoscience and engineering.