• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.183-191
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• 2011

Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened Widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

• Korean Journal of Radiology
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• v.24 no.8
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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.

• Journal of Hospice and Palliative Care
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• v.23 no.4
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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.

• The Korean Society of Law and Medicine
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• v.25 no.1
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• pp.3-58
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• 2024

It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.

• Childhood Kidney Diseases
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• v.26 no.1
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• pp.31-39
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• 2022

Alport syndrome (AS) is a progressive hereditary nephritis that is often accompanied by sensorineural hearing loss and ocular abnormalities. It is inherited in three modes of X-linked AS (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, while ARAS and ADAS are caused by those in COL4A3 or COL4A4. There is currently no curative treatment for AS; however, angiotensin-converting enzyme inhibitors (ACEi) can improve the outcome of AS. In the past decade, multiple studies have shown that early intervention with ACEi upon isolated microscopic hematuria or microalbuminuria could delay disease progression, and early diagnosis is crucial for early treatment. Therefore, a new classification of AS based on molecular diagnoses has been proposed, including the paradigm shift of re-classifying female "carriers" to "patients" and "thin basement membrane nephropathy" to "ADAS." In addition, with the detection of COL4A mutations in some patients with biopsy-confirmed IgA nephropathy, focal segmental glomerulosclerosis, and chronic kidney disease of unknown origin, it is suggested that the phenotype of AS should be expanded. In this review, we highlight the landmark studies and guidelines published over the past decade and introduce strategies for early diagnosis and treatment to improve the outcomes of AS.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.25-35
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• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• Korean Circulation Journal
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• v.48 no.11
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• pp.964-973
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• 2018

The burden of valvular heart disease (VHD) is increasing with age, and the elderly patients with moderate or severe VHD are notably common. When to operate in asymptomatic patients with VHD remains controversial. The controversy is whether early surgical intervention should be preferred, or a watchful waiting approach should be followed. The beneficial effects of early surgery should be balanced against operative mortality and long-term results. Indications of early surgery in each of the VHD will be discussed in this review on the basis of the latest American and European guidelines.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.493-501
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• 2021

The Asian Society of Cardiovascular Imaging (ASCI) was established in 2006 to improve the healthcare, education, training, quality control, and research in cardiovascular imaging in Asia. The ASCI is presently active, with more than 1400 members from 53 countries. Herein, the evolution and current development of the ASCI are described, including the early history, organization, annual congresses, collaboration with international sister societies, official journal, and the ASCI School. The ASCI has successfully led the development of cardiovascular imaging in Asia and will continue to grow.

• Child Health Nursing Research
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• v.6 no.3
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• pp.397-410
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• 2000

This is a nonequivalent control group pretest- posttest design in quasi experimental basis to assess how the thermal head and feet support influences on early stage weight gain in premature neonates. The clients were selected among the premature infants with the weight under 2000gms and with the gestational period under 37 weeks, admitted over 15 days in K university hospital, Seoul. The control group of 29 were selected from January 1998 to August 1998, who were without head and feet thermal support, and the experimental group of 30 were selected from September 1998 to May 1999, who were with the two thermal interventions. The results of the study follow, 1.The experimental group with thermal interventions showed more weight gain than the control group without thermal interven- tions, which was statistically significant between the two groups. 2.The physiological weight loss after birth showed less in the experimental group than in the control group. 3.The recovery of the birth weight after the physiologic weight loss showed no statistical difference between the experimental group and the control group. Consequently, the thermal head and feet supportive nursing intervention could be applied as a nursing intervention program to help the premature neonates' development. With the results above we should like to suggest the following: 1) A continuous application in the practice of our thermal supportive intervention for the premature neonates, a development of the content through evaluation, and a comparision of the results through a long time study. 2) A neccessity of deveopment of various study and cross comparision. 3) A neccessity of multi-angular study on the premature infants' characteristics influencing the thermal therapy and the study of the individual differences of the clients.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.107-119
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• 2018

PURPOSE: This research was intended to investigate the influence to function recovery at the early stage after surgery, by conducting Multipath Electrical Simulation and isometric exercise treatment as early stage medical treatment method for Total knee arthroplasty patients. METHODS: The subject of 30 patients having Unilateral Total knee arthroplasty over age 65, Multipath Electrical Simulation and isometric exercise (experiment group I), Conventional Electrical Simulation and isometric exercise (experiment group II) and isometric exercise (control group). The intervention was performed in 5 times per a week and 60 minutes per a day during 4 weeks. We performed research by conducting Neuromuscular Electrical Stimulation and isometric exercise together and measured pain, range of motion, muscle strength and gait ability before and after intervention. RESULTS: The result showed therapeutic improvement in experiment group I, experiment group II and control group, but Multipath Electrical Simulation and isometric exercise showed significant improvement in function recovery of early stage compared to Conventional Electrical Simulation and isometric exercise, only isometric exercise. CONCLUSION: Based on research result, in order for early state function recovery of Total knee arthroplasty patients, when conducting neuromuscular electrical stimulation and isometric exercise together, especially when applying Multipath Electrical Stimulation, we could know that it showed more significant improvement to function recovery after surgery. Also, we suggest that Multipath Electrical Simulation may become a useful tool as a method for intervention and performing in various diseases for weakening of Quadriceps muscle.