• 제목/요약/키워드: multidisciplinary data

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A Standardized Pathology Report for Gastric Cancer: 2nd Edition

  • Young Soo Park;Myeong-Cherl Kook;Baek-hui Kim;Hye Seung Lee;Dong-Wook Kang;Mi-Jin Gu;Ok Ran Shin;Younghee Choi;Wonae Lee;Hyunki Kim;In Hye Song;Kyoung-Mee Kim;Hee Sung Kim;Guhyun Kang;Do Youn Park;So-Young Jin;Joon Mee Kim;Yoon Jung Choi;Hee Kyung Chang;Soomin Ahn;Mee Soo Chang;Song-Hee Han;Yoonjin Kwak;An Na Seo;Sung Hak Lee;Mee-Yon Cho;The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists
    • Journal of Gastric Cancer
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    • 제23권1호
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    • pp.107-145
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    • 2023
  • The first edition of 'A Standardized Pathology Report for Gastric Cancer' was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements. The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

당뇨병 표준진료지침 적용 효과에 관한 연구 (Effect of Critical Pathway on Diabetes Mellitus)

  • 신미옥;서신원;송복례;김경희;윤건호;유양숙;김희승
    • 한국의료질향상학회지
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    • 제7권1호
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    • pp.60-70
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    • 2000
  • Background : The aim of this study was to examine the effectiveness of the critical pathway to diabetic patients who were admitted in the hospital. Methods : For establishment of critical pathway for diabetic patients, we organized the multidisciplinary care team. During 5 months, 31 diabetic inpatients were applied the critical pathway and the results were compared with 11 diabetic inpatients who were treated with conventional way. We assessed the patients satisfaction, knowledge on the disease, compliance of medical regimen, length of stay(LOS) and hospital cost. We used the computer program SAS for statistical analysis. Data were summarized with mean, and analyzed using t-test repeated measures ANOVA and Wilcoxon rank sum test. Results : Length of stay(LOS) was remarkably shortened in critical pathway group compared with the conventional treatment group($7.6{\pm}1.23$ vs $12.0{\pm}4.73$, p<0.000). Although LOS was significantly shortened in critical pathway group, patients satisfaction was much higher than conventional treatment group. There were no significant difference of knowledge on the disease, compliance of medical regimen and blood glucose level between two groups at discharge. Hospital cost of each patients also significantly decreased in critical pathway group(890,000 won vs 1,280,000 won, p<0.05). Conclusion : These results showed that establishment of critical pathway for diabetic inpatients with team approach is the one of the way to improve the quality of diabetic patients management and to enhance the efficiency of hospital management.

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Design Structure Matrix를 활용한 플랜트 설계의 최적 협업 체계에 관한 연구 (A Study on an Optimal Plant Design Collaboration System Using a Design Structure Matrix)

  • 윤종이;김정환;강상혁;서종원
    • 대한토목학회논문집
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    • 제33권1호
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    • pp.337-346
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    • 2013
  • 플랜트 설계는 매우 다양한 공학 분야가 참여하는 고도로 복잡한 시스템이다. 이 방대한 시스템에 관여된 각 서브시스템은 각기 다른 서브시스템과 수시로 정보를 주고 받으며 작업을 반복하게 되는 복잡한 관계를 형성한다. 이런 복잡한 프로세스에서 체계적인 설계관리는 성공적인 플랜트 설계를 위한 필수적인 요건이다. 이에 본 연구에서는 Design Structure Matrix를 이용하여 플랜트의 최적 설계 협업 체계를 도출하였다. 이를 위해 전문가 설문 및 워크샵을 수행하여 플랜트 설계의 주요 업무, 설계 서브시스템, 설계요소, 관련설계요소, 그리고 그들간의 관계를 파악하였다. 효율적인 분석을 위해 Visual Basic Application과 Matlab을 이용하여 자동화된 분석 프로그램을 개발하였다. 제안된 방법과 프로그램을 소각로 설계 시스템에 적용한 결과 유효한 주요 반복작업 그룹들을 도출할 수 있었다. 도출된 결과물은 설계 협업 전략 수립에 유용하게 활용될 수 있을 것으로 사료된다.

간접간호중재의 수행 및 위임에 관한 분석 (Identification and delegation of indirect care interventions)

  • 염영희;김소인;차보경
    • 간호행정학회지
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    • 제5권2호
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    • pp.197-207
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    • 1999
  • The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

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퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰 (A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home)

  • 이현주;김유경;오의금
    • 임상간호연구
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    • 제23권3호
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

Distribution, side involvement, phenotype and associated anomalies of Korean patients with craniofacial clefts from single university hospital-based data obtained during 1998-2018

  • Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Lim, Seung-Weon;Yang, Il-Hyung;Ha, Jeong Hyun;Kim, Sukwha;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제50권6호
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    • pp.383-390
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    • 2020
  • Objective: To investigate the distribution, side involvement, phenotype, and associated anomalies of Korean patients with craniofacial clefts (CFC). Methods: The samples consisted of 38 CFC patients, who were treated at Seoul National University Dental Hospital during 1998-2018. The Tessier cleft type, sex, side involvement, phenotype, and associated anomalies were investigated using non-parametric statistical analysis. Results: The three most common types were #7 cleft, followed by #0 cleft and #14 cleft. There was no difference between the frequency of male and female. Patients with #0 cleft exhibited nasal deformity, bony defect, and missing teeth in the premaxilla, midline cleft lip, and eye problems. A patient with #3 cleft (unilateral type) exhibited bilateral cleft lip and alveolus. All patients with #4 cleft were the bilateral type, including a combination of #3 and #4 clefts, and had multiple missing teeth. A patient with #5 cleft (unilateral type) had a posterior openbite. In patients with #7 cleft, the unilateral type was more prevalent than the bilateral type (87.0% vs. 13.0%, p < 0.001). Sixteen patients showed hemifacial microsomia (HFM), Goldenhar syndrome, and unilateral cleft lip and palate (UCLP). There was a significant match in the side involvement of #7 cleft and HFM (87.5%, p < 0.01). Patients with #14 cleft had plagiocephaly, UCLP, or hyperterorbitism. A patient with #30 cleft exhibited tongue tie and missing tooth. Conclusions: Due to the diverse associated craniofacial anomalies in patients with CFC, a multidisciplinary approach involving a well-experienced cooperative team is mandatory for these patients.

Clinical Implication of Surgically treated Abdominoperineal Soild Tumor in the Newborn : A Single-Center Experience

  • Cho, Yong-Hoon;Kim, Soo-Hong;Kim, Hae-Young;Han, Young-Mi;Lee, Na-Rae;Bae, Mi-Hye;Park, Kyung-Hee;Byun, Shin-Yun
    • Neonatal Medicine
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    • 제25권1호
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    • pp.23-28
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    • 2018
  • Purpose: Abdominoperineal solid tumors presenting in neonates often require surgical intervention during the neonatal period. Although we report our single-center experience, this study would be meaningful to understand the clinical implications of these neoplasms. Methods: We retrospectively reviewed and analyzed the clinical data and characteristics of 22 patients (${\leq}28$ days old) diagnosed with histopathologically confirmed abdominoperineal solid neoplasms (benign or malignant) after surgical resection. Results: The mean gestational age and postnatal age at the time of operation were $38.3{\pm}1.8weeks$ and $13.5{\pm}8.3days$, respectively. Most patients (18/22, 81.8%) were diagnosed during antenatal care visits; however, 4 (18.2%) were identified after birth. The mean tumor size was $6.4{\times}5.3cm$ (3.5-17.0 cm), and tumors occurred most frequently within the sacrococcygeal region (8/22, 36.4%). Histopathologically, 14 patients (63.6%) demonstrated benign tumors and 8 (36.4%) demonstrated malignant tumors. Germ cell tumors and hepatoblastomas were the most commonly observed tumors. Fortunately, all patients showed a localized pattern of tumor involvement without distant metastasis. No recurrence or mortality was observed during the follow-up period (mean $66.4{\pm}44.2months$). Conclusion: Abdominoperineal solid tumors occurring in neonates show variable clinical patterns during the antenatal and postnatal monitoring/screening periods. We conclude that aggressive and multidisciplinary approaches could achieve good clinical results in these patients.

애니메이션의 Movement 동인(動因)에 대한 이론적 고찰 (A theoretical Study on the Motive of Movement in Animation)

  • 이상원
    • 조형예술학연구
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    • 제3권
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    • pp.62-86
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    • 2001
  • This study is based on theoretical background about movements of visual communication highlighted in digital age. Such movements are variously expressed in animation with the advancement of media, and their expression has great effect on visual art. Artists' concern and endeavor about movement expression techniques have been continued by impressionism, expressionism, futurism, cubism closely related with the birth of movie from late 19th century to early 20th century. At that time, stationary 2D space in plane screen couldn't express movement or time directly. Later, artists and designers have attempted to approach illusions in pictures or 4 dimension and movements by 2D or 3D computer graphics. The visual image in present digital age is to see, to hear, to feel by timing, so it is necessary for the most efficient way of message communication. And then, it is the time to start new, scientific, and creative study about production techniques of animation and expression of movements, since domestic animation productions are rapidly changed from cell to digital. The aim of this study is to clarify the motive of movement by theoretical inquiry of animation. Various aspects of animation as synthetic art have been examined by mathematical, scientific, and philosophical viewpoint. The results will be useful to the expression of motions for maximization of emotional effect in animation production or basic data of virtual simulation about certain situation. Therefore, such study should be managed as multidisciplinary research in the rapidly changing visual culture paradigm. namely, animation includes much more imaginative & creative power than simple function or techniques, so it has to be recognized as special synthetic art(visual art) constructing an area, the formative art with philosophical viewpoint and scientific principles.

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요통환자의 신체상과 생활적응에 관한 연구 (A Study on Adjustment of Daily Living and Body Image of Patients with Low Back Pain)

  • 구희서
    • 보건교육건강증진학회지
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    • 제6권1호
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    • pp.91-105
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    • 1989
  • The purpose of this study is to identify the body images of patints with low back pain and their status on adjustment of daily living. The data were collected from 11 general hospitals during Feburary 2, 1987 through May 30,1987. One hundred and ninety five subjects having physical therapy treatment because of low back pain were analyzed. For measurement of body image, 11 pairs of adjectives were used on semantic differential scale, and for measurement of adjustment of daily living, 10 items were used on a likert type scale. Results of the study are summerised as follows. 1. The average patient age were 34yeats and 62% of the patients were men. High school grade completed were 43.1% and Cause of Low Back Pain were respctively;Unknown etiology 31.8%, lifting heavy objects 27.7%, Traffic accident and injury 17.9%. Types of treatment were;medication plus physical therapy 54.9%, physical therapy only 22.6%. Average treatment duration were 24.5 months. 2. There were significant difference in the body image between before low back pain and after low back pain. The body image before low back pain were 59.89(Mean) but after low back pain were 37,24(Mean) and two groups were statistically significant (t=21.3, p<0.00l). 3. there were no significant difference in the body image between the male and female.(t=1.49, p>0.05) 4. The correlation between body image and adjustment of daily living. in both sexes showed positive correlation coefficient; male(r=0.4648, p<0.00l) female(r=0.4516, p<0.00l) respectively. It means that patients with positive body image can adjust well in daily living. 5. The relation between the body image and general variables revealed sigificant difference with occupation and age.(F=2.12 p<0.05, F=3.48 p<0.05). That is different occupation and different age groups can show different body image. In conculsion with the above results, It is my strong belief that multidisciplinary approach including the concept of body image and patient education about postural care, activities of daily living, lifting mechanics should be applied in treating and dealing with those patients.

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A Comparison of the Effectiveness of Before and After the Regional Trauma Center's Establishment

  • Song, Bo Hyung;Hyun, Sung Youl;Kim, Jin Joo;Cho, Jin Seong;Ma, Dae Sung;Kim, Ha Kyung;Lee, Geun
    • Journal of Trauma and Injury
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    • 제29권3호
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    • pp.68-75
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    • 2016
  • Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.