• Title/Summary/Keyword: 치료 권고안

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

  • Kim, Bung-Nyun;Yoo, Han-Ik;Kang, Hwa-Yeon;Kim, Ji-Hoon;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Hee-Jeong;Cheon, Keun-Ah;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.26-30
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    • 2007
  • This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder (ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy (individual psychotherapy) and non-traditional therapy (art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment fur children and adolescents with ADHD.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

The Activity Check of Brachytherapy Isotope (근접치료동위원소의 Activity Check)

  • Kim, Gun-Oh;Lee, Byung-Koo;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.21-27
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    • 2004
  • An isotope Ir-192, which is used in brachytherapy depends on import in whole quantities. There are a few ways for its activity. measurement using Welltype chamber or the way to rely on authentic decay table of manufacturer. In-air dosimetry using Farmer Chamber, etc. In this paper, let me introduce the way using Farmer chamber which is easier and simple. With the Farmer chamber and source calibration jig, take a measurement the activity of an isotope Ir-192 and compare the value with the value from decay table of manufacturer and check the activity of source. The result of measurement, compared the value from decay table, by ${\pm}2.1\%$. (which belongs to recommendable value for AAPM ${\pm}5\%$ as difference of error range) It is possible to use on clinical medicine. With the increase in use of brachytherapy, the increase of import is essential. And an accurate activity check of source is compulsory. For the activity check of source, it was possible to use Farmer chamber and source calibration jig without additional purchase of Well type chamber.

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Korean Clinical Imaging Guidelines for Justification of Diagnostic Imaging Study for COVID-19 (한국형 COVID-19 흉부영상 진단 시행 가이드라인)

  • Kwang Nam Jin;Kyung-Hyun Do;Bo Da Nam;Sung Ho Hwang;Miyoung Choi;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.265-283
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    • 2022
  • To develop Korean coronavirus disease (COVID-19) chest imaging justification guidelines, eight key questions were selected and the following recommendations were made with the evidence-based clinical imaging guideline adaptation methodology. It is appropriate not to use chest imaging tests (chest radiograph or CT) for the diagnosis of COVID-19 in asymptomatic patients. If reverse transcription-polymerase chain reaction testing is not available or if results are delayed or are initially negative in the presence of symptoms suggestive of COVID-19, chest imaging tests may be considered. In addition to clinical evaluations and laboratory tests, chest imaging may be contemplated to determine hospital admission for asymptomatic or mildly symptomatic un-hospitalized patients with confirmed COVID-19. In hospitalized patients with confirmed COVID-19, chest imaging may be advised to determine or modify treatment alternatives. CT angiography may be considered if hemoptysis or pulmonary embolism is clinically suspected in a patient with confirmed COVID-19. For COVID-19 patients with improved symptoms, chest imaging is not recommended to make decisions regarding hospital discharge. For patients with functional impairment after recovery from COVID-19, chest imaging may be considered to distinguish a potentially treatable disease.

Case Report of Radiotherapy to a Breast Cancer Patient with a Pacemaker (인공심장박동기가 이식된 유방암환자의 방사선 치료에 대한 사례 보고)

  • Chae, Seung-Hoon;Park, Jang-Pil;Lee, Yang-Hoon;Yoo, Suk-Hyun;Seong, Won-Mo;Kim, Kyu-Bo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.197-203
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    • 2012
  • Purpose: In this study, we considerate our radiation therapy process for the breast cancer patient implanted a pacemaker applying the machine movement surgery, shielding, beam selection. Materials and Methods: We perform radiation therapy to a 54 years old, breast cancer patient implanted a pacemaker. The patient underwent a surgery to move the position of a pacemaker to right side breast after consultation with cardiology department. Prescribed dose was 5,040 cGy and daily dose 180 cGy for 28 fractions. The 10 MV photon energy, field size 0/$9.5{\times}20$ cm, half beam and opposing portal irradiation are used. To find out appropriate thickness of shielding board, we carried out an experiment using a solid water phantom ($30{\times}30{\times}7$ cm), a Farmer-type chamber (TN30013, PTW, Germany) and a shielding board (Pb $28{\times}27{\times}0.1$ cm). We calculated expected absorbed dose to te pacemaker with absorb ratio and shielding ratio. In the PTP system (Eclipse, Varian, USA), we figured out how much radiation would be absorbed to the machine with and without shielding. First day of the radiation therapy, we measured head scatter to the pacemaker with MOSFET Dose Verification System (TN-RD-70-W, Medical Canada Ltd., Canada). Results: In the phantom measurement, we found out appropriate thickness was 2 mm of shielding board. In the RTP, when using 2 mm shielding the pacemaker will be absorbed 11.5~38.2 cGy and DVH is 77.3 cGy. In the first day of the therapy, 4.3 cGy was measured so 120.4 cGy was calculated during total therapy. The patient was free from any side effects, and the machine also normally functioned. Conclusion: As the report of association which have public confidence became superannuated, there is lack of data about new machine. We believe that radiation therapy to thiese kind of patients could be done successfully with co-operation, patient-suitable planning, accurate QA, frequent in-vivo dosimetry and monitoring.

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Guideline for Imaging Dose on Image-Guided Radiation Therapy (영상유도방사선치료에 있어 영상선량 가이드라인)

  • Cho, Byung Chul;Huh, Hyun Do;Kim, Jin Sung;Choi, Jin Ho;Kim, Seong Hoon;Cho, Kwang Hwan;Cho, Sam Ju;Min, Chul Kee;Shin, Dong Oh;Lee, Sang Hoon;Park, Dong Wook;Kim, Kum Bae;Choi, Sang Hyoun;Kim, Hye Young;Ahn, Woo-Sang;Kim, Tae Hyeong;Han, Su Cheol
    • Progress in Medical Physics
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    • v.24 no.1
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    • pp.1-24
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    • 2013
  • As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

The Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder(I) - Introduction, Clinical Features and Course - (주의력결핍 과잉행동장애 한국형 치료 권고안(I) -서론, 임상 양상 및 경과-)

  • Ahn, Dong-Hyun;Kang, Hwa-Yeon;Kim, Bung-Nyun;Kim, Ji-Hoon;Shin, Dong-Won;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Cheon, Keun-Ah;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.3-9
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    • 2007
  • Based on the broad and in-depth literature review, the dedicated members of the committee for the development of Korean attention-deficit hyperactivity disorder (ADHD) practice parameter develop the Korean practice parameter for ADHD. Members of the Korean Academy of child and Adolescent Psychiatry (KACAP) had reviewed the drafts through off-line and on-line access to the drafts. Feedbacks from the members of KACAP were carefully integrated into the current practice parameter. This article presents the state of the art knowledge regarding the assessment and the management of ADHD. Recommendations in the end of the practice parameter may help clinician to make decisions in clinical practice, but are not likely to override the clinician's decision in natural settings. Future directions to complement the limitation of the current practice parameter is suggested.

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A Systematic Review of Randomized Controlled Trials on Acupuncture for Shoulder Pain Based on Jadad Scale and revised STRICTA recommendations (견비통에 대한 침치료 임상연구의 체계적 문헌 고찰 - Jadad Scale 및 개정된 STRICTA 권고안을 중심으로 -)

  • Park, Tae-Hyun;Oh, Chang-Keun;Park, Yu-Lee;Yang, Seung-Bum;Kim, Jae-Hyo
    • Korean Journal of Acupuncture
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    • v.29 no.1
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    • pp.93-108
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    • 2012
  • Objectives : This study aims to review randomized controlled trials on acupuncture for shoulder pain according to Jadad Scale and revised STRICTA. Methods : Seven electronic databases including PUBMED, SCOPUS, RISS were searched for randomized controlled trials (RCT) of acupuncture for shoulder pain. Results : 16 RCTs were included: 14 were published in English and 2 were published in Korean. According to Jadad scale, 15 RCTs had high quality. However, most of the studies could not meet the double blindness criteria. All RCTs meet 12.9 items on average in STRICTA. Conclusions : This systematic review shows four conclusions as follows. Traditional Chinese Medicine is often used in style of acupuncture. Spots of LI15, TE14, GB21 and LI11, stainless steel needle($0.3mm{\times}40mm$), 20 retention time, manual stimulation, $Deqi$, and 2 times a week treatment (total 12) are often used. Double-blinded clinical trials needs to be conducted. It is controversial to use minimal acupunctures on controlled groups of RCTs on acupuncture for shoulder pain. Description about practitioner's background needs clarifying.

Current Applications and Future Perspectives of Brain Tumor Imaging (뇌종양 영상의 현재와 미래)

  • Ji Eun Park;Ho Sung Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.467-487
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    • 2020
  • Anatomical imaging is the basis of the diagnosis and treatment response assessment of brain tumors. Among the existing imaging techniques currently available in clinical practice, diffusion-weighted imaging and perfusion imaging provide additional information. Recently, with the increasing importance of evaluation of the genomic variation and heterogeneity of tumors, clinical application of imaging techniques using radiomics and deep learning is expected. In this review, we will describe recommendations for magnetic resonance imaging protocols focusing on anatomical images that are still important in the clinical application of brain tumor imaging, and the basic principles of diffusion-weighted imaging and perfusion imaging among the advanced imaging techniques, as well as their pathophysiological background and clinical application. Finally, we will review the future perspectives of radiomics and deep learning applications in brain tumor imaging, which have been studied to a great extent due to the development of computer technology.

Dosimetric Effect on Selectable Optimization Parameters of Volumatric Modulated Arc Therapy (선택적 최적화 변수(Selectable Optimization Parameters)에 따른 부피적조절회전방사선치료(VMAT)의 선량학적 영향)

  • Jung, Jae-Yong;Shin, Yong-Joo;Sohn, Seung-Chang;Kim, Yeon-Rae;Min, Jung-Wan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.15-25
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    • 2012
  • The aim of this study is to evaluate plan quality and dose accuracy for Volumetric Modulated Arc Therapy (VMAT) on the TG-119 and is to investigate the effects on variation of the selectable optimization parameters of VMAT. VMAT treatment planning was implemented on a Varian iX linear accelerator with ARIA record and verify system (Varian Mecical System Palo Alto, CA) and Oncentra MasterPlan treatment planning system (Nucletron BV, Veenendaal, Netherlands). Plan quality and dosimetric accuracy were evaluated by effect of varying a number of arc, gantry spacing and delivery time for the test geometries provided in TG-119. Plan quality for the target and OAR was evaluated by the mean value and the standard deviation of the Dose Volume Histograms (DVHs). The ionization chamber and $Delta^{4PT}$ bi-planar diode array were used for the dose evaluation. For treatment planning evaluation, all structure sets closed to the goals in the case of single arc, except for the C-shape (hard), and all structure sets achieved the goals in the case of dual arc, except for C-shape (hard). For the variation of a number of arc, the simple structure such as a prostate did not have the difference between single arc and dual arc, whereas the complex structure such as a head and neck showed a superior result in the case of dual arc. The dose distribution with gantry spacing of $4^{\circ}$ was shown better plan quality than the gantry spacing of $6^{\circ}$, but was similar results compared with gantry spacing of $2^{\circ}$. For the verification of dose accuracy with single arc and dual arc, the mean value of a relative error between measured and calculated value were within 3% and 4% for point dose and confidence limit values, respectively. For the verification on dose accuracy with the gantry intervals of $2^{\circ}$, $4^{\circ}$ and $6^{\circ}$, the mean values of relative error were within 3% and 5% for point dose and confidence limit values, respectively. In the verification of dose distribution with $Delta^{4PT}$ bi-planar diode array, gamma passing rate was $98.72{\pm}1.52%$ and $98.3{\pm}1.5%$ for single arc and dual arc, respectively. The confidence limit values were within 4%. The smaller the gantry spacing, the more accuracy results were shown. In this study, we performed the VMAT QA based on TG-119 procedure, and demonstrated that all structure sets were satisfied with acceptance criteria. And also, the results for the selective optimization variables informed the importance of selection for the suitable variables according to the clinical cases.