• 제목/요약/키워드: Early Intervention

검색결과 938건 처리시간 0.025초

Watch Out for the Early Killers: Imaging Diagnosis of Thoracic Trauma

  • Yon-Cheong Wong;Li-Jen Wang;Rathachai Kaewlai;Cheng-Hsien Wu
    • Korean Journal of Radiology
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    • 제24권8호
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    • pp.752-760
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    • 2023
  • Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

급성 활동성 심내막염의 수술적 치료 (Surgical Treatment of Acute Active Endocarditis)

  • 김성호
    • Journal of Chest Surgery
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    • 제27권9호
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    • pp.759-763
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    • 1994
  • Between November 1990 and December 1993, 9 patients underwent surgical intervention for acute active endocarditis at Gyeongsang National University Hospital. All the patients were operated on within the first six weeks after onset of symptoms for various reasons. Surgical indications for early surgery were heart failure, systemic septic emboli, new murmur and growing vegetation. Most common infecting organism was Staphylococcus[55 %], and the others were Streptococcus, anaerobes, Candida and unknown in 1 case. The infection was in the mitral valve in 5 patients, the aortic valve in 2, the aortic and mitral in 1, and the aortic and pulmonary in 1. There was one operative death[11 %] and no late death. Preoperative Functional Class were II in 4 patients, III in 5 and after surgery all the patients improved to Class I. We conclude that early surgical intervention in acute active endocarditis is effective in most instances.

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Hemorrhagic Diathesis as the Presenting Symptom of Neonatal Cholestasis

  • Faverey, Liesbeth Claire;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권3호
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    • pp.191-195
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    • 2014
  • A 4-week-old infant presented with a coagulation disorder resulting from a vitamin K deficiency. The vitamin K deficiency was caused by neonatal cholestasis due to biliary atresia. Jaundice, hepatomegaly and pale stools are the predominant presenting symptoms of biliary atresia, none of which were recognized in our patient before admission. However, the patient presented with bleeding caused by vitamin K deficiency. She was fully breastfed and had received adequate doses of vitamin K at birth and from the age of 1 week. In case of a hemorrhagic diathesis due to neonatal cholestasis, timely identification of treatable underlying disorders, in particular biliary atresia, is important because an early surgical intervention results in a better prognosis. Meticulous history taking and a thorough physical exam can be decisive for an early diagnosis and subsequent intervention.

심내막염 환자의 수술적 치료 (Early Surgical Intervention of Active Infective Endocarditis)

  • 박국양
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.121-130
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    • 1988
  • During one year period from Sep. 1986 to Sep. 1987, we have experienced 6 cases of infective endocarditis requiring surgical interventions. All 6 patients had class IV or V cardiac disability at the time of surgery. The indication for surgery was rapidly progressive congestive heart failure in all cases. Four patients underwent aortic valve replacement including one double valve replacement. Two other patients required other surgical procedures, removal of large left atrial vegetation mass in one patient and excision of destroyed pulmonary valve and aortic vegetation in the other patient. Two patients died; one of mitral annulus rupture after release of aortic clamp and the other of mediastinal bleeding 3 months after replacement of aortic valve. Three out of 4 survivors are in NYHA Class I and the remaining patient is in Class II. We emphasize that early operative intervention is life-saving in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy.

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The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • 제62권3호
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

Psychological Intervention for Post-traumatic Stress Disorder among Witnesses of a Fatal Industrial Accident in a Workers' Health Center

  • Kang, Dong-Mug;Kim, Se-Yeong;Kim, Yoon-Ji;Kim, Jung-Ann
    • Safety and Health at Work
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    • 제8권4호
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    • pp.410-412
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    • 2017
  • Post-traumatic stress disorder (PTSD) is a serious problem not only among workers who experience industrial accidents but also among workers who witness such accidents. Early intervention is needed to prevent prolonged psychological problems. There has been no study conducted regarding the psychological problems of and interventions for bystander workers in Korea. This study introduces the experience of intervention on psychological problems at the Busan Workers' Health Center workers who witnessed their colleagues' death. An investigation and an intervention were conducted according to the Korean Occupational Safety and Health Agency (KOSHA) Guide. In total, 21 individuals including indirect observers showed statistical differences on scores of the Impact Event Scale Revised and the Patient Health Questionnaire 9 after the intervention. Future interventions and research involving a larger sample size over a longer period are needed. The KOSHA Guide could be a useful tool for urgent psychological intervention in the event of major workplace disasters.

Barriers to Early Palliative Care

  • Yoon, Seok-Joon
    • Journal of Hospice and Palliative Care
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    • 제23권4호
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    • pp.252-255
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    • 2020
  • This article aims to discuss the barriers hindering cancer patients from receiving early palliative care, which has been demonstrated to be more effective in improving quality of life and controlling symptoms. Specifically, there are barriers in four aspects of delivering early palliative care. First, the difficulty of starting discussions about early palliative care and the lack of adequate appointment time can impede communication between oncologists and patients and their family members. Second, determining the timing of referral and deciding upon and applying a standard for referral can be barriers in the process of referral from oncology to palliative care. Third, palliative care patients and their family members can face difficulties regarding in what format and by whom the services will be delivered. Fourth, biases, misinformation, and inaccurate beliefs can be barriers in the process of patients and their family members accepting care. In order to facilitate early palliative care, research and policy regarding these barriers are necessary, along with efforts made by medical staff.

임부(姙婦)의 Flack test에 관(關)하여 (Flack Test in Pregnant Women)

  • 김원재;남태현;김규수;채의업
    • The Korean Journal of Physiology
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    • 제10권1호
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    • pp.49-54
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    • 1976
  • The change of heart rates during Flack Test was observed in the pregnant women, $24{\sim}48$weeks, of gestational age, to analyze mechanical and neural regulatory factors in responses to the positive lung inflation. The results obtained were summarized as followings: 1) Endurance tine of Flack Test was 37.6 sec, in the nonpregnant women, and 25.1 sec. in the pregnant women. 2) When Flack Test was employed, heart rate was decreased in early stage of Flack Test in the pregnant women, while heart rate was increased in the nonpregnant women. 3) In the pregnant women bradycardia due to abdominal mechanical intervention in early stage of Flack Test was prominent, while tachycardia was found in the nonpregnant women. 4) During Flack Test, tachycardia due to sympathetic central reflex activation was observed immediately after bradycardia in early stage of Flack Test. 5) It may be noted that Flack Test employed in the present study is a useful model to evaluate and analyze the neural and mechanical abdominal intervention factor in response to the positive inflation of lung in pregnant women.

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ASD 아동의 초기 사회기술 향상을 위한 인지-운동 통합 기반 악기연주 중재 (Cognitive-Motor Interaction-Based Instrument Playing for Improving Early Social Skills of Children With Autism Spectrum Disorder)

  • 유현경
    • 인간행동과 음악연구
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    • 제20권1호
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    • pp.75-97
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    • 2023
  • 본 연구에서는 학령전기 자폐스펙트럼장애(ASD) 아동을 대상으로 인지-운동 통합 기반 악기연주 중재를 제공하여 초기 사회기술이 향상하는지를 알아보고자 하였다. 대상자는 평균 만5.6세의 ASD 아동 총 9명로, 개별로 30분씩 주 2회, 총 12회의 세션에 참여하였다. 중재는 자기 감각 증진 및 자기조절(1단계), 상호작용에 대한 의도 형성(2단계), 상호적 활동에 대한 수용(3단계), 상호적 맥락에서의 움직임 조정(4단계), 공동행동 수행(5단계)의 5단계로 구성되었다. 중재 전후 초기 사회-의사소통 평가 척도(ESCS) 내 과제를 참고해 공동주의 행동 및 상호작용 행동을 측정하였고, 참여 아동의 보호자가 사회적 반응성 척도(SRS-2)를 평정하도록 하였다. 또한, 타인(연구자)에 맞추어 움직임(드럼 연주)의 타이밍을 조절하는지 측정하는 사회적 동기화 과제를 실시하였다. 연구 결과, 참여 ASD 아동은 초기 사회기술에 있어 유의한 향상을 보였고, 사회적 동기화 과제에서도 동기화 반응 속도를 제외한 동기화 정확도 및 지속시간에 있어 유의한 향상이 나타났다. SRS-2 척도에서는 유의한 차이가 나타나지 않았는데 이는 장기간 개입이 필요함을 시사한다. ASD 아동의 초기 사회기술 발달에 있어 인지-운동 통합이 중요한 역할을 하는 점을 고려할 때, 본 연구 결과는 인지-운동 통합 기반 악기 연주가 사회적 정보를 인지적으로 처리하고 이를 바탕으로 사회적 맥락에서 움직임을 조정하는 과정의 측면에서 ASD 아동의 사회기술 발달 증진을 위한 효과적인 방안이 될 수 있음을 시사한다.

가족(성인자녀)에 의한 노인부양의 종류와 정도에 영향을 미치는 이전(원) 가족관계 양상 분석 및 개입전략의 제시 (Dynamics of Family of Origin That Affect the Level of Support for the Elderly Parent Provided by the Family of Adult Children : Analysis and Intervention)

  • 엄명용
    • 한국사회복지학
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    • 제47권
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    • pp.206-242
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    • 2001
  • A survey research was conducted for a sample of 306 adult children who have an elderly parent or both parents alive. The purpose of the research was to test a structural equation model which specified the effects of early family relationships on comtemporary relationships and assistance patterns between adult children and their parents. The data were analyzed using EQS for Windows 5.7, utilizing maximum likelihood method. The results showed that early family relationships affected filial concern first, which in turn affected the level of assistance provided by adult children for elderly parents. No direct effect has been found between early family relationships and the level of assistance by adult children for elderly parents. Filial concern was played as an intervening variable. Early family relationships gave no direct effects to adult children's intention to assist their parents. Here again, filial concern was played as an intervening factor. Adult children's intention to assist their parents had not been led directly to provision of actual support to parents by their adult children. Thus, it was identified that intention to support is one thing, and the actual support is another. Controlling for the effects of filial concern, overall, early family relationship patterns gave no differential effects to the different aspects of support provided to parents by their adult children. On the basis of these results, this paper provided both discussions and suggestions for some strategies of intervention in the present family relationships in order for the inter-generational exchange of supports to happen in the future.

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