• 제목/요약/키워드: Multidisciplinary approach

검색결과 309건 처리시간 0.021초

Skull Metastasis of Gastric Gastrointestinal Stromal Tumor Successfully Managed by Surgery

  • Park, Inkeun;Chung, Dong Hae;Yoo, Chan Jong;Shin, Dong Bok
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.94-97
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    • 2017
  • Gastrointestinal stromal tumors (GISTs) are rare, but are the most common mesenchymal neoplasm of the gastrointestinal tract. The most common sites of metastasis are liver and peritoneum, while bone metastasis is rare. We report on a patient with skull metastasis after seven years of treatment with imatinib for metastatic GIST. She underwent metastasectomy consisting of craniectomy with excision of the mass, and cranioplasty and continued treatment with imatinib and sunitinib, without evidence of cranial recurrence. She died of pneumonia sepsis one year after metastasectomy. Skull metastasis of GIST is a very rare presentation, and an aggressive multidisciplinary approach should be considered whenever possible.

협동 최적화 방법을 이용한 강상자형교의 생애주기비용 최적설계 (Optimum Life-Cycle Cost Design of Steel Box Girder Bridges Using Collaborative Optimization)

  • 조효남;민대홍;권우성
    • 한국전산구조공학회:학술대회논문집
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    • 한국전산구조공학회 2001년도 가을 학술발표회 논문집
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    • pp.201-210
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    • 2001
  • In this study, large-scale distributed design approach for a life cycle cost (LCC) optimization of steel box girder bridges was implemented. A collaborative optimization approach is one of the multidisciplinary design optimization approaches and it has been proven to be best suited for distributed design environment. The problem of optimum LCC design of steel box girder bridges is formulated as that of minimization of the expected total LCC that consists of initial cost maintenance cost expected retrofit costs for strength, deflection and crack. To discuss the possibility of the application for the collaborative optimization of steel box girder bridges, the results of this algorithm are compared with those of single level algorithm. From the numerical investigations, the collaborative optimization approach proposed in this study may be expected to be new concepts and design methodologies associated with the LCC approach.

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RNA 타이 클럽의 유전암호 해독 연구: 다학제 협동연구와 공동의 연구의제에 관한 고찰 (Deciphering the Genetic Code in the RNA Tie Club: Observations on Multidisciplinary Research and a Common Research Agenda)

  • 김봉국
    • 과학기술학연구
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    • 제17권1호
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    • pp.71-115
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    • 2017
  • 1953년에 이론물리학자 조지 가모프는 "DNA의 염기 서열에 의해 단백질의 아미노산 서열이 암호화된다"는 가설로 단백질 합성 현상을 설명했고, "다이아몬드 코드"라는 핵산-단백질 정보전달 모형을 제안했다. 왓슨, 크릭, 브레너, 스텐트 같은 당대의 생물학자들은 이런 대담한 제안에 관심을 보이며 가모프와 토론했고, 이에 가모프는 이들 간의 의견교환을 활성화하기 위해 RNA 타이 클럽이라는 비공식 연구자 모임을 결성했다. 이후 생물학자들뿐만 아니라 물리학자, 수학자, 컴퓨터엔지니어들이 RNA 타이 클럽에 동참했고, 이들의 다학제적 유전암호 해독 연구는 1950년대 후반까지 활발히 이루어졌다. 본고는 RNA 타이 클럽의 형성, 성장, 와해의 과정을 살피면서 다음과 같은 논제를 다루려 한다. 첫째, 정통 생물학과 거리가 먼 '문자열 간 번역원리를 찾는 가모프의 수학적 접근'은 어떻게 생물학자들의 공동의 연구의제로 채택될 수 있었을까? 둘째, RNA 타이 클럽의 연구의제는 어떻게 다양한 학제의 연구주제들로 풍부하게 확장될 수 있었을까? 셋째, RNA 타이 클럽의 쇠락과 와해를 가져온 요인은 무엇이었을까? 이런 분석을 통해, 본고는 타이 클럽 연구자들의 근본 가정인 "아미노산 서열에 배열 패턴이 존재한다"는 가정이 다양한 학제적 접근방식을 매개하는 연결고리 역할을 했고, 또 이를 통해 당대 생물학의 실험 데이터를 활용할 수 있게 되면서 이들의 번역코드 연구는 유의미한 생물학 연구방법으로 자리 잡을 수 있게 되었음 주장할 것이다. 아울러 위의 논의의 연장선상에서 타이 클럽의 와해 요인을 해명함으로써, 다양한 학제의 연구자들을 성공적으로 매개할 생산적 연구의제가 갖춰야 할 요건은 무엇인지 고찰해 볼 것이다.

뇌졸중 환자를 위한 팀접근 재활프로그램의 효과 (The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors)

  • 조복희
    • 재활간호학회지
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    • 제6권2호
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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만성동통에 대한 정신시체의학적 접근 -생물학적 접근- (The Biological Approach of Chronic Pain)

  • 오병훈
    • 정신신체의학
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    • 제3권1호
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    • pp.91-97
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    • 1995
  • Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

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농업 ${\cdot}$ 농촌 지역사회개발에 대한 관점 (Perspectives on Agricultural Concerns and Rural Community Development : A Qualitative Approach for Distribution Dimention)

  • 신윤호
    • 농촌지도와개발
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    • 제4권1호
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    • pp.91-96
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    • 1997
  • 미래사회의 농업-농촌은 다양성과 복합성을 지닌 도시화된 형태로의 변화를 예견해 볼 수 있다. 이는 인력개발, 기술개발, 시설개발, 문화개발 및 환경개발 및 환경개발 등 그 영역과 요구 또한 구체화되고 다양화되는 추세에 비추어 볼 수 있다. 이 연구는 연구자의 관점(qualitative approach)에서 농업-농촌사회 개발 전문가들의 개발 진행과 그 영역들은 무엇이며 어느 영역들에 개발비중을 두었는 지를 알아 보는 데 있었다. 11명의 농업 및 농촌 지역 개발 전문가들의 개발관점은 그 중요성과 영역의 다양성에서 공통점과 차이점이 있었다. 즉, 인력개발과 경제개발 영역에서 공통점으로 보였으며, 환경영역 및 문화영역에서 다소의 차이가 있었다. 이제 농업-농촌개발은 "instead of"의 개발접근이 지양되면서 "as well as"의 다각적 접근(multidisciplinary approach)이어야 한다. 또한, 개발의 개념은 성장(growth)이 아닌 유지(keeping)와 진행(process)의 차원에서 이해되어야 한다.

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간호대학생들의 시스템 사고 기반 천식환자 간호과정 분석 (Analysis of Asthma Patient Nursing Process Based on the Systems Thinking of Nursing Students)

  • 김현영;오현수;윤은경
    • 한국시스템다이내믹스연구
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    • 제14권2호
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    • pp.55-69
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    • 2013
  • The purpose of this study is to analyze nursing students' proficiency with ST(Systems Thinking) approach concerning asthma patient nursing process. For this study, 20 nursing students created causality cognitive maps which were consisted of the contents of 'asthma nursing care'. The word association and causality cognitive map were used to estimate ability of the ST. As a result, the students failed to understand the nursing process with the ST approach, or alternatively they applied low level ST approach and had a lower understanding of it. The findings of this study suggest that the development of a ST-based nursing educational program in order for nursing students to improve their ST ability as well as knowledge integration for multidisciplinary practice.

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The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study

  • Cho, Won-Tae;Cho, Jae-Woo;Kim, Jinil;Kim, Jin-Kak;Oh, Jong-Keon;Kim, Hak Jun;Kim, Namryeol;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.139-145
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    • 2016
  • Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

미숙아의 퇴원 후 관리 (Post discharge care of prematurity)

  • 윤혜선
    • Clinical and Experimental Pediatrics
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    • 제50권1호
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    • pp.14-19
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    • 2007
  • Advances in neonatal care have been responsible for the improved survival of prematurity but have not resulted in decreased morbidity. Once the high-risk infants is discharged from the hospital, his or her many special care needs do not cease. A well-coordinated multidisciplinary approach is essential in the follow-up care of these infants. Special attention must be given to their growth and nutrition, immunization, vision and hearing, and sequelae of illnesses experienced during the neonatal period. The role of pediatrician in helping these infants attain their full physical, neurodevelopmental, emotional, and psychosocial potential by providing optimal care is invaluable.