• Title/Summary/Keyword: Specialized Hospital

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Impact of Initial Helical Abdominal Computed Tomography on the Diagnosis of Hollow Viscus Injury and Blunt Abdominal Traumare (복부 둔상 및 유강장기 손상에 있어서 초기 나선형 복부전산화 단층촬영의 진단적 가치)

  • Cho, Young-Duck;Hong, Yun-Sik;Lee, Sung-Woo;Choi, Sung-Hyuk;Yoon, Young-Hoon;Lim, Sung-Ik;Jang, Ik-Jin;Baek, Seung-Won
    • Journal of Trauma and Injury
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    • v.21 no.1
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    • pp.28-35
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    • 2008
  • Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

A Study on the Changes in Forest Laws and System of Forest Specialists (산림법제도의 변천과 산림전문가 양성의 체계에 관한 연구)

  • Youn, Jong-Myoun;Kim, Dong-Pil;Kim, Yeong-Ha
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.6
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    • pp.1-15
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    • 2021
  • This study considered Forest Specialists, who are nurtured by the legal system through the analysis of laws and regulations under the jurisdiction of the Korea Forest Service. In particular, the transition process of forest-related laws and laws to train forest specialists were identified. In addition, changes and characteristics regarding the cultivation of professional forestry talents according to forestry policy were investigated. As a result, it was found that Forest Specialist on policy dealt with forestry success for forestry promotion, and forestry engineers dealt with technical skills for forestry industry development. In addition, according to the revision of the laws for the sustainable use of timber, wood-structural engineers, timber grade evaluators, and timber education specialists are trained separately. Forest Specialists concerned with forest welfare policies were found to train forest experts and complete specialized training courses to provide various services for forest cultural and recreation facilities, healing forests, and forest leisure sports facilities. There is an instructor for forest leisure sports. Forest welfare experts are divided into forest education experts and forest healing instructors; forest education specialists are further divided into forest interpreters, forest guides for children, and forest trekking guides. Forest Specialists on forest protection policy were found to train arboretum and garden experts for the efficient management and exhibition of arboretums. Gardens and tree doctors and tree treatment technicians for arboretums wer also trained. A tree doctor and a tree treatment technician were found to have the necessary qualifications to run a tree hospital business, diagnosing and treating tree damage. Therefore, it is thought that the Korea Forest Service is nurturing Forest Specialists with technical capabilities for forestry promotion, forest industry development, and tree treatment; and the Forest Specialists can provide education and welfare services at culture, recreation, treatment, and conservation sites in forests.

Current Status and Actual Conditions of the Use of Occupational Therapy Evaluation Tools in Relation to the Type of Therapy Institution (국내 아동작업치료 기관별 평가도구 사용 현황 및 실태에 관한 연구)

  • Gil, Young-Suk;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.47-58
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    • 2023
  • Objective : This study aimed to investigate the current status and actual use of assessment tools by institutions in the field of occupational therapy with children in Korea. Methods : The study was conducted with 67 occupational therapists working with children in Korea. To investigate the use of evaluation tools by area, knowledge of the evaluation tools, and desire to participate in further education, the questionnaires used in studies by Lee, Hong, and Park (2018) and Kim (2015) were modified and supplemented according to the child evaluation tools currently in usein institutions in Korea. For data collection, we distributed Google questionnaires to child occupational therapists for 3 weeks using convenience sampling. Excel was used to analyze the use of the evaluation tools according to institution. Technical statistics and frequency analyses were used to verify the general characteristics, evaluation-related information, status of evaluation tool use, knowledge levels relating to evaluation tools, and desire to participate in education. A t-test was used for the evaluation tool status. Results : Welfare centers used the most evaluation tools, with an average of 11.1, followed by university hospitals, rehabilitation hospitals, clinics, and daycare centers. There were differences in the choice of tools used, hospital with the Jebsen-Taylor hand function test and the Wee-FIM (Functional Independence Measure) being the most frequently applied. Centers, daycare centers, and welfare center the Sensory Profile test and clinical observation were also used often. Regarding the level of knowledge of evaluation tools and the desire to participate further in education, 30 (44.8%) of the respondents had not completed their education, and 42 (62.7%) rated their knowledge level as generally low. When asked about the importance of using a manual to guide them in their use of evaluation tools, 66 (98.6%) answered positively, and 66 (98.6%) answered that they needed specialized training in the use of evaluation tools. Conclusion : This study makes it possible to understand the use and status of evaluation tools as used by different institutions in Korea in the field of child occupational therapy It is anticipated that it will provide the basis for introducing existing evaluation tools and preparing new evaluation tools to be used in this field in Korea.