쉐도잉 연습: Arteriovenous Malformation (AVM) Treatment | Brigham and Women's Hospital - YouTube로 영어 말하기 배우기

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What happens when a person comes in with a brain AVM?
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What happens when a person comes in with a brain AVM?
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We talk about the natural history.
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That means if we do nothing about this brain AVM,
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what's going to happen next?
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Are they going to have a hemorrhage the next day?
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Or is it going to be five years or never?
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Well, unfortunately, we don't always know.
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We don't have a crystal ball.
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So we try to make predictions that will help this person,
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this patient and their family,
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make the best decisions for their health.
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So what goes into that decision?
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The size of the AVM,
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the location of the AVM,
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the hemorrhagic status, and a host of other risk factors that we go through in our clinic visit.
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Then we decide, well, AVMs that have never ruptured have about a 2.4% risk of hemorrhage every year.
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So if you add that up, it gets significant.
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Sounds small, but for a 20-year-old,
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over the next 60 years of his or her life,
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2.5% each year can add up very, very quickly.
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And for each hemorrhage, there could be a 30% or higher percent chance of morbidity or major mortality.
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So what are the ways that an AVM can be treated?
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Well, first, it can be observed.
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That is one observational treatment,
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understanding the risk benefits and alternatives that go into that.
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But I think another way that we specialize here at the Brigham and Women's Hospital is surgery.
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What are the advantages of surgery?
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Surgery means we can go in,
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delicately dissect out the vessels that need to be preserved for normal function of the brain
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and remove the vessels that are abnormal,
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the ones that would potentially lead to a hemorrhage or death.
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And we do that under a microscope,
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and we take our time.
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I always turn off the clock when we do this part of the operation,
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because it really just doesn't matter.
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It means that we get this thing out in one piece,
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and that patient will do well, because that's a cure.
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And they can walk out of the hospital and never have to worry about this again.
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So when it works, it's fantastic.
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And depending on the grade of the lesion,
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one through five, the risks change.
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So the smaller the size, the less risk.
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The bigger the size, the higher the risk.
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Another way that we treat brain AVMs at Brigham and Women's Hospital is through radiosurgery,
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radiation, directly shrinking down the AVM,
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perhaps in those AVMs that aren't amenable to surgery.
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Now, the good part about brain AVM radiation is that there's very little upfront risk.
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The not so good part is it takes years for the radiation to work and may not always work.
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And so we have to judge the balance and risk of all of these management decisions.
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Another way that brain AVMs can be treated is endovascular,
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something we also do, that I personally do and my partners do.
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We put a catheter inside of the blood vessels of the brain,
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go inside, find the AVM,
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fill it with embolic material to try to close it down.
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And usually that's used as an adjunct or a helpful hand for surgery.
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So the multidisciplinary approach is nothing new to neurosurgery or to medicine in general,
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but for brain AVMs it's quite useful because the different modalities of treatment are done by different specialists.
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I myself do both endovascular and surgery,
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but we have colleagues that are gonna help us with the radiation effects.
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We get together on Thursdays in a conference and discuss each patient,
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their goals, the lesion, and how we may be able to help as a team.
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And then we bring that information back to the patient and say,
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well, these were the opinions,
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but what is best for you?
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And in this circumstance, in our hospital,
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in this patient, it's all very individual.
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You know, you can't just open a book and say,
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what's the right answer for a brain AVM?
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It's just much too complex.
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It has to do with the person's goals
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and what they're going to do in their life and what age they are and what is their risk tolerance.
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So each one of these conversations has to be individualized.
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We keep track of all our patients.
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I know all of them from the very beginning.
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I want to know my results so that we know we're doing a good job.
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So we benchmark ourselves against anyone.
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And if you come to me,
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I'll show you what the last 100 were like.
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And I think that's really important.
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My goal for any patient that I encounter is
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that I deliver the best and absolute best possible care that I can for that patient.
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That means it's got to be individualized to understand that patient.
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Where are they coming from?
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Whose family are they? their mother,
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father, son, daughter, what matters to this person?
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Because in our profession, it's not just the disease we wanna treat,
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we wanna help the person.
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We want them to get back to life, be functional.
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Whatever it is their goals are become my goals.

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이 수업에 대하여

이번 수업에서는 뇌동정맥 기형(AVM)에 대한 치료 방법을 소개하는 유튜브 영상을 통해 중요한 의료 용어 및 표현을 학습합니다. 이 과정에서 뇌동정맥 기형과 관련된 다양한 위험 요소와 치료 옵션에 대한 이해를 높일 수 있습니다. 주요 치료 방법인 관찰, 수술, 방사선 요법, 그리고 혈관 내 치료에 대해 배워보며 실제 상황에서 사용되는 영어 어휘와 구문을 익힐 것입니다. 이러한 학습은 유튜브 영어 공부를 통한 효과적인 shadow speak 연습 자료로 활용할 수 있습니다.

주요 어휘 및 구문

  • brain AVM (뇌동정맥 기형)
  • hemorrhage (출혈)
  • surgery (수술)
  • risk factors (위험 요소)
  • radiosurgery (방사선 수술)
  • observe (관찰하다)
  • morbidity (질병 상태)
  • endovascular (혈관 내)

연습 팁

이번 영상의 음성을 따라 하는 shadowing 연습을 통해 발음과 억양을 개선할 수 있습니다. 영상이 말하는 속도는 적당히 빠르기 때문에, 처음에는 천천히 반복해 보면서 발음을 정확하게 익히는 것이 좋습니다. 특히 전문 용어가 많으므로, 각 용어마다 몇 번씩 소리 내어 연습해 보세요. 또한, shadowspeaks를 이용하여 영상의 자연스러운 대화 톤을 따라 한다면 실제 의사소통 능력 향상에 많은 도움이 될 것입니다. 마지막으로, 문장이나 구문을 적어보며 다양한 문맥 속에서 이 단어들이 어떻게 사용되는지를 확인하는 것도 좋습니다. 이번 수업을 통해 배운 내용은 shadowing site에서 연습할 수 있는 훌륭한 기초 자료가 될 것입니다.

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