• Title/Summary/Keyword: 치료권고안

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Palliative Sedation for Terminal Cancer Patient (말기 암 환자에서 완화적 진정 증례 토론)

  • Kim, Do-Yeun
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.106-110
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    • 2008
  • Palliative sedation has been used in patients who undergo intractable suffering at the end of life. Its implementation, however, may be complicated due to resistance of clinicians and barrier of bioethical issues. Here, we present 50-year-old man with stomach cancer and multiple bone metastasis who was treated with palliative chemotherapy and radiotherapy. He suffered from refractory pain on the whole body even after standard analgesics and multidisplinary effort to relieve. Upon shared decision for sedation, he was given midazolam until discharge. Literature reviews reveal cases similar to the present case.

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The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Clinical Manifestation, Epidemiology, Course, Causes, and Comorbidity (전반적 발달장애의 한국형 치료 권고안 : 임상양상, 역학, 경과, 원인, 동반질환)

  • Yoo, Han-Ik;Cho, In-Hee;Yoo, Hee-Jeong;Koo, Young-Jin;Chung, Un-Sun;Ahn, Joung-Sook;Ahn, Dong-Hyun;Son, Jung-Woo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.88-96
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    • 2007
  • Pervasive developmental disorders are characterized by lifelong impairments in fundamental social and/or communication skills and by the presence of seemingly purposeless and repetitive behaviors, interests, or activities. A number of possible biological etiologies, including genetic, structural and functional brain abnormalities, have been identified in patients with pervasive developmental disorders. In addition, clinicians should take the possibility of comorbid psychiatric conditions into consideration when making the differential diagnosis of pervasive developmental disorders.

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment - (주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 -)

  • Shin, Yun Mi;Kim, Eui-Jung;Kim, Yunsin;Bhang, Soo Young;Lee, Eunha;Lee, Cheol-Soon;Chang, Hyoung Yoon;Hong, Minha;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.84-95
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that begins in early childhood and can persist throughout adulthood. ADHD causes difficulties in various area of life, such as academic achievement, peer relationships, family functioning, employment and marriage. Although ADHD is known to respond well to medication, such treatment is more effective when combined with psychosocial (non-pharmacologic) therapy in terms of alleviating the core symptoms and improving appropriate functions. Psychosocial treatment interventions are divided into psychoeducation, behavioral parent training, school intervention, cognitive behavior therapy, social skill training, parent-child interaction therapy, play therapy, other treatments (coaching, complementary and alternative medicine), neurofeedback and Cogmed. Adult ADHD cognitive behavioral therapy is described separately. These practice parameters summarize the evidence for psychosocial treatment. Based on this evidence, specific recommendations are provided for psychosocial interventions.

The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Pharmacological Treatment (전반적 발달장애의 한국형 치료 권고안 : 약물치료)

  • Cho, In-Hee;Yoo, Han-Ik K.;Son, Jung-Woo;Yoo, Hee-Jeong;Koo, Young-Jin;Chung, Un-Sun;Ahn, Dong-Hyun;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.109-116
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    • 2007
  • The objective of this review is to establish practice parameters for pharmacological treatment of children and adolescents with pervasive developmental disorders. We performed a detailed review of the literature, including a wide range of controlled clinical trials, open trials, case reports, and side-effect profiles of related drugs. Few medications have a treatment indication for pervasive developmental disorders, and few studies with well-controlled methodology are available for evaluating treatment results. Pharmacological treatments focus on associated target symptoms because symptom reduction may improve educational and social ability and enhance quality of life. Well-controlled trials have been conducted for some SSRI(selective serotonin reuptake inhibitor) antidepressants, risperidone, and methylphenidate, and showed reduction of some target symptoms. Since the medications are not specific to autism and do not treat core symptoms of the disorder, their potential side effects should be carefully considered. Family education is necessary to give proper information on target symptoms, limitation of drug treatments, and risks.

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The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Non-Pharmacological Treatment (전반적 발달장애의 한국형 치료 권고안 : 비약물적 치료)

  • Koo, Young-Jin;Cho, In-Hee;Yoo, Hee-Jeong;Yoo, Han-Ik K.;Son, Jung-Woo;Chung, Un-Sun;Ahn, Dong-Hyun;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.117-122
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    • 2007
  • Practice parameters for non-pharmacological treatment of children and adolescents with pervasive developmental disorders are based on the scientific literature for evidence-based practices. Appropriate educational and behavioral interventions are important in improving the long-term outcome in pervasive developmental disorders. Early and sustained intervention appears to be particularly important. The goal for interventions is to gain pragmatic skills for verbal communication, playing with peers, daily living routines, self-management, and social adaptation. Appropriate involvement and collaboration with parents and family are essential for well-functioning intervention programs. The life-long nature of autism implies that the clinician should maintain an active role in long-term treatment planning and family support. Vocational training and training for more independent living are important for adolescents with autism. Professionals should be knowledgeable about local and national resources and opportunities for family support as well as support of the individual.

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Evaluation of Photoneutron Dose in Radiotherapy Room Using MCNPX (MCNPX를 이용한 방사선 치료실의 광중성자 선량 평가)

  • Park, Eun-Tae
    • The Journal of the Korea Contents Association
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    • v.15 no.6
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    • pp.283-289
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    • 2015
  • Recently, high energy photon radiotherapy is a growing trend for increasing therapy results. Commonly, if you use high energy photons above 6~8 MeV nominal accelerator voltage, It lead the photo-nuclear reaction and the generation of photo-neutron are accompanied and these problematic factors are issued in the view of radiation protection. Therefore, in this study analyzed for dose distribution of photo-neutron in radiotherapy room based on MCNPX. As a result, absorbed dose is increased sharply from 10 MV to 12 MV. It was founded that the rapid increasement of photoneutron fluence was related to the absorbed dose at above 10 MV. Also, in case of the recommendation of ICRP 103, the outcome of an exchanged equivalent dose which based on calculated an absorbed dose, showed lower equivalent dose than ICRP 60 by reflecting the contribution of secondary photon for absorbed dose of human body in the low energy band.

3D 치료시 Couch rotation에 의한 Isocenter 변화에 대한 고찰

  • 박용철;주상규;송기원;정천영
    • The Journal of Korean Society for Radiation Therapy
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    • v.12 no.1
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    • pp.144-146
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    • 2000
  • 삼차원 입체조형치료는 정상조직의 장해를 최소화하고 종양부위에 집중적으로 조사할 수 있는 장점을 가지고 있어 임상 적용범위가 넓어지고 있다. 일반적으로 정상조직의 장해를 줄이기 위해 다양한 방사선 조사방향이 사용되며 특히 비 동일면상에서의 조사가 많이 이루어진다. 따라서 couch 회전이 동반되며 couch는 선형가속기의 다른 기계적 오차보다 많은 오차를 유발할 수 있는 잠재적인 위험을 안고 있다. 저자는 이러한 오차의 정도를 파악하고 이를 개선할 수 있는 방법에 대해 알아보고자 했다. couch 회전에 따른 Isocenter의 변화를 평가하기 위해 3대(Primus, Simens, USA/CL600c & 2100c, Varian, USA)의 선형가속기를 이용하였으며 이중 1대의 장비에는 couch 회전시 오차를 줄이기 위해 고안된 couch 고정장치를 장착하였다. 환자가 테이블에 부하를 주지 않은 상태에서 회전을 실시하여 Isocenter의 변화를 측정하고 환자가 테이블에 누워있는 상황을 재현하기 위해 human phantom을 위치시킨 후 동일한 회전검사를 실시하여 각각의 오차를 비교 분석하였다. 각 실험은 10회씩 반복 측정하여 평균치를 얻었으며 오차의 분석은 AAPM 권고안인 오차중심의 반경으로 표현했다. 3대의 선형가속기를 이용하여 얻은 결과 테이블에 부하를 주지 않은 상태의 회전오차는 평균 2mm, 3.2mm, 2mm로 측정되었으며 휴먼 phantom을 올려놓고 부하를 준 상태에서의 오차는 평균 2.1mm, 4mm, 2.1 mm이였다. 또한 고정장치를 이용한 상태에서의 평균오차는 1.9mm로 나타났다. 삼차원 입체조형치료 시 couch 회전에 따른 Isocenter 오차는 장비의 종류 및 작업자의 사용방법에 따라 다르게 나타났으며 테이블의 부하가 클수록 많은 오차를 보였다. 또한 couch 고정장치를 부착한 장비에서의 결과치 만이 AAPM에서 권고하는 오차의 한계에(${\le}2mm$) 들어감을 알 수 있었다. 따라서 정기적인 QA가 필수적이며 Couch Locking System과 같이 오차를 줄일 수 있는 보조장치의 부착이 많은 도움을 줄 것으로 생각된다. 아울러 이러한 오차를 보정할 수 있는 방법이 강구되어야 할 것으로 사료된다.

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Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules (양성갑상선결절에 대한 효과적이고 안전한 고주파절제의 적용)

  • Jin Yong Sung
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.985-998
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    • 2023
  • Radiofrequency ablation (RFA) has been a representative, non-surgical treatment for benign thyroid nodules that cause cosmetic problems or compression symptoms. The procedure of RFA should be performed effectively and safely. This review discusses the patient selection, pre-procedure evaluation and planning, principles, devices, techniques, and complications with reference to the guidelines and research on thyroid RFA. In particular, this review will devote to introduce RFA techniques and to provide practical help in the implementation of this procedure.

The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Diagnosis and Assessment (전반적 발달장애의 한국형 치료 권고안 : 진단 및 평가)

  • Yoo, Hee-Jeong;Cho, In-Hee;Koo, Young-Jin;Yoo, Han-Ik;Son, Jung-Woo;Chung, Un-Sun;Ahn, Joung-Sook;Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.2
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    • pp.97-108
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    • 2007
  • Multiple areas of development are affected in pervasive developmental disorders(PDD), and assessments of various aspects of behavior and development are essential for diagnosis. The object of this review is to provide the practical guidelines for the assessment of core features of PDD, including abnormalities in communication, social interaction, and repetitive and stereotyped behavior. It covers the issues of differential diagnosis within and outside the PDD category, standardized diagnostic tools, assessment of intellectual and language functions, and the early diagnosis of PDD in infancy. This guideline also stresses the process of medical and neurological evaluation for proper diagnosis of PDD.

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