• 제목/요약/키워드: 치료 권고안

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

  • 김도연
    • Journal of Hospice and Palliative Care
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    • 제11권2호
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    • pp.106-110
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    • 2008
  • 완화적 진정은 임종이 임박한 불응성 증상을 가진 환자들에게 고려될 수 있는 치료이지만 부적절한 진정으로 인한 윤리적인 문제가 쟁점이 된다. 본 증례는 수차례항암화학요법과 완화적 방사선 치료에도 불구하고 진행되는 다발성 뼈 전이를 동반한 전이성 위암을 가진 50세 남자에게 완화적 진정을 시행했던 예를 권고안에 비추어 후향적 검토하였다. 환자는 표준적인 통증경감치료에 불응성으로 판단되었고 환자의 의사결정능력 부족으로 환자보호자에게 완화적 진정에 대한 치료 목적 및 예견되는 부작용을 설명한 후 midazolam으로 완화적 진정을 시작하였다. 본 증례에 통하여 완화적 진정의 적응, 완화적 진정의 시작 전 의사 결정, 완화적 진정 시작, 완화적 진정 시작 후의 돌봄에 대한 토의를 하였고 국내실정을 반영한 권고안 마련을 제의하는 바이다.

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

  • 유한익;조인희;유희정;구영진;정운선;안정숙;안동현;손정우
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권2호
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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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주의력결핍 과잉행동장애 한국형 치료 권고안(IV) - 비약물적 치료 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (IV) - Non-Pharmacologic Treatment -)

  • 신윤미;김의정;김윤신;방수영;이은하;이철순;장형윤;홍민하;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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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.

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

  • 조인희;유한익;손정우;유희정;구영진;정운선;안동현;안정숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권2호
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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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전반적 발달장애의 한국형 치료 권고안 : 비약물적 치료 (The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Non-Pharmacological Treatment)

  • 구영진;조인희;유희정;유한익;손정우;정운선;안동현;안정숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권2호
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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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MCNPX를 이용한 방사선 치료실의 광중성자 선량 평가 (Evaluation of Photoneutron Dose in Radiotherapy Room Using MCNPX)

  • 박은태
    • 한국콘텐츠학회논문지
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    • 제15권6호
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    • pp.283-289
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    • 2015
  • 현재 방사선치료는 치료효과를 높이기 위해 고에너지 광자선의 사용이 증가하고 있는 추세이다. 일반적으로 6~8 MeV 이상의 고에너지 광자선을 사용하는 경우에는, 광핵반응에 의한 광중성자가 발생됨으로써 방사선 방호의 측면에서 많은 문제를 야기 시킬 수 있다. 이에 본 연구는 MCNPX를 이용하여 방사선 치료실의 광중성자 선량분포를 분석하였다. 그 결과 10 MV와 12 MV 구간에서 급격한 흡수선량의 증가를 보였다. 이를 통해 10 MV를 시작으로 광중성자 플루언스의 급격한 증가가 흡수선량으로 연계됨을 알 수 있었다. 또한 산출된 흡수선량을 바탕으로 등가선량을 환산한 결과는 ICRP 103 권고안의 경우, 낮은 에너지 범위에서 인체의 흡수선량에 대한 2차 광자의 기여를 반영함으로써 ICRP 60 권고안에 비해 낮은 등가선량을 나타냈다.

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

  • 성진용
    • 대한영상의학회지
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    • 제84권5호
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    • pp.985-998
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    • 2023
  • 고주파절제는 외모상의 문제나 경부 압박 증상을 유발하는 양성갑상선결절에 대한 대표적인 비수술적 치료법으로 시술은 효과적이면서도 안전하게 시행되어야 한다. 이 종설은 갑상선고주파절제에 대한 권고안들과 연구 논문들을 참조하여 대상 환자 선정, 시술 전 평가 및 치료 계획, 치료 원리 및 치료 기구, 시술법, 합병증 등에 대한 정보를 제공하려는 목적으로 작성되었다. 특히 시술법에 많은 부분을 할애해 시술 시행에 실질적인 도움을 주고자 한다.

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

  • 유희정;조인희;구영진;유한익;손정우;정운선;안정숙;안동현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권2호
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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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전반적 발달장애의 한국형 치료 권고안 : 개발과정과 의의 (The Korean Practice Parameter for the Treatment of Pervasive Developmental Disorders : Development and Implications)

  • 안정숙;구영진;손정우;유한익;유희정;정운선;조인희;안동현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제18권2호
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    • pp.85-87
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    • 2007
  • The new research data and rapid development of psychotropic drugs over the past few years have warranted the development of clinical practice guidelines for managing pervasive developmental disorder(PDD). These guidelines are urgently needed due to the recent changes in social circumstances and clinical situations in Korea. Despite the many limitations and problems surrounding the development of these guidelines, the Korean Academy of Child and Adolescent Psychiatry(KACAP) has decided to develop the Korean Practice Parameters for the Treatment of PDD. The goal, basic principles, organization, and implications of this development project are introduced in this special paper. We expect these practice parameters to be a useful reference not only for child psychiatrists and other healthcare professionals in clinical practice, but also for the autistic patients themselves and their caregivers. The practice parameters shall be revised and improved in the near future.

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