• 우울조울병
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• 제16권3호
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• pp.123-128
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed to provide more proper guidelines for clinicians. In this study, we evaluated treatment strategies of elderly patients with bipolar disorders of KMAP-BP 2018. Methods : Sixty-one psychiatrists of the review committee with vast clinical experiences in treating bipolar disorders, completed the survey. An expert consensus was obtained, on pharmacological treatment strategies for elderly patients with bipolar disorder. The executive committee analyzed results, and discussed the results to produce the final algorithm. Results : In elderly patients with bipolar disorder, first-line treatment option for acute manic episode is monotherapy, with atypical antipsychotics or mood stabilizer, and a combination of mood stabilizer and atypical antipsychotics. First-line treatment option for acute depressive episode, was a combination of mood stabilizer and atypical antipsychotics, monotherapy with atypical antipsychotic or mood stabilizer, and atypical antipsychotics with lamotrigine. Conclusion : In KMAP-BP 2018, the recommendation for treatment option in elderly patients with bipolar disorder, was newly introduced. We expect this algorithm may provide valuable information, and facilitate treatment of elderly patients with bipolar disorder.

• 중환자간호학회지
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• 제7권1호
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• pp.1-10
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• 2014

Purpose: The purpose of this study was developing a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Methods: The algorithm was developed through a methodological design. First, a pilot study was performed to determine the incidence of pneumonia. The second step was development of a preliminary algorithm through a literature review and collection of nurse opinions. The third step was to establish content validity using a panel of 12 experts. The fourth step was revision of the algorithm. Next, 20 intensive care unit nurses applied the revised algorithm for six months to their actual treatment, and the practical feasibility was verified after that. Results: In the patients for whom this algorithm was applied, no cases of pneumonia occurred. The algorithm that was developed by the present author was suitable for clinical application. Conclusion: The effect and practical feasibility of the algorithm was tested with a few patients in this study. The effect of this algorithm should be examined by applying it to more patients on an ongoing basis.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.450-453
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• 2002

In radiotherapy treatment planning, it is critical to deliver the radiation dose to tumor and protect surrounding normal tissue. Recent developments in functional imaging and radiotherapy treatment technology have been raising chances to control tumor saving normal tissues. A brain phantom which could be used for image registration technique of CT-MR and CT-SPECT images using surface matching was developed. The brain phantom was specially designed to obtain imaging dataset of CT, MR, and SPECT. The phantom had an external frame with 4 N-shaped pipes filled with acryl rods, Pb rods for CT, MR, and SPECT imaging, respectively. 8 acrylic pipes were inserted into the empty space of the brain phantom to be imaged for geometric evaluation of the matching. For an optimization algorithm of image registration, we used Downhill simplex algorithm suggested as a fast surface matching algorithm. Accuracy of image fusion was assessed by the comparison between the center points of the section of N-shaped bars in the external frame and the inserted pipes of the phantom and minimized cost functions of the optimization algorithm. Technique with partially transparent, mixed images using color on gray was used for visual assessment of the image registration process. The errors of image registration of CT-MR and CT-SPECT were within 2mm and 4mm, respectively. Since these errors were considered within a reasonable margin from the phantom study, the phantom is expected to be used for conventional image registration between multimodal image datasets..

• Journal of Trauma and Injury
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• 제25권4호
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• pp.261-266
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• 2012

Purpose: Traumatic pancreatic injury is not common in abdominal trauma injury. However, the morbidity and the mortality rates of patients with pancreatic injury, which are related with difficulties of initial assessment, establishment of diagnosis, and treatment are relatively high. The aim of this study is to review our institution's experience and suggest a diagnosis and therapeutic algorithm for use in cases involving traumatic pancreatic injury. Methods: Eighteen(18) patients with blunt pancreatic injury from January, 2004 to October 2012 were included in this study. We analyzed treatment and diagnosis method, other organ injury, treatment interval, hospital stay and complications retrospectively. Results: Nine patients were treated with conservative medication and another nine patients were treated surgically. Complications occurred in nine patients, and one patient died due to intraventricular hemorrhage and subdural hemorrhage with multiple organ failure. Delayed surgery was performed in three cases. The early and delayed surgery groups showed difference in hospital stay and intensive care unit stay. Delayed surgery was associated with a longer hospital stay (p=0.007) than immediate surgery. Conclusion: In blunt pancreatic trauma, proper early diagnosis and prompt treatment are recommended necessity. Based on this review of our experience, we also suggest the adoption of our institution's algorithm for cases involving traumatic pancreatic injury.

• 한국의사학회지
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• 제35권1호
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• pp.13-36
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• 2022

For the past several decades, East Asian medicine has been examined in order to uncover its effectiveness in areas where biomedicine is found wanting. Although scientific approaches have been increasingly used to verify the utility of treatment techniques, countless traditional medical techniques found in ancient texts remain to be tested. Currently, about 20,000 or so ancient medical texts are recognized within the East Asian medical tradition. Although some famous texts have been translated and studied, many still exist only as original manuscripts. We are interested in the medical techniques that are listed in those manuscripts. Even before we can ascertain whether such ancient forms of medical treatment can be applied today it is important to understand the full picture of what kind of treatment technology exists. This study aims to develop a database program that automatically converts the original textual description of an East Asian medical technique into a more standardized version. First, our team analyzed the ways that medical skills were described and then designed a database algorithm that recognized the meaningful keywords of the descriptive text for a medical treatment and put it in the right cell in a structured table.

• 대한방사선치료학회지
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• 제26권1호
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• pp.11-19
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• 2014

목 적 : 최적화 알고리즘에 적용되는 최적화 인자들의 영향을 고려하여, 가장 적합한 인자 값을 도출함으로써 이상적인 치료계획을 쉽게 설계할 수 있도록 하고자 한다. 대상 및 방법 : 본 연구의 세기조절방사선치료에서 선량계산 알고리즘은 PBC(Pencil Beam Convolution)이고, 최적화 알고리즘은 DVO(Dose Volume Optimizer 10.0.28)이다. 두경부 환자의 세기조절방사선치료에서 치료계획용적의 처방선량은 동시에 2.2 Gy와 2.0 Gy가 될 수 있도록 하였다. 치료계획은 6 MV, 7개의 조사야로 역선량계산방법으로 수립하였다. 최적화 알고리즘 인자는 용적선량-조건강도(Priority, Constrain), 선량부 드럼강도(Smooth)로 선정하고, 각 인자들의 변화량에 따른 치료계획의 영향을 분석하였다. 용적선량-조건강도는 기준 조건강도를 정하고, 비율은 같지만 절대 값은 다른 최적화 과정을 실시하였다. 또한 조건강도의 절대 값에 변화에 따른 치료용적과 주변 정상장기들을 평가하였다. 선량부드럼강도는 기준 조건의 단순 변화와 용적선량-조건강도와 관련시킨 변화를 치료계획에 반영시켰다. 치료계획은 처방선량지수(Conformal Index, CI), 처방선량포함지수(Paddick's Conformal Index, PCI), 선량균질지수(Homogeneity Index, HI)와 각 장기의 평균선량으로 평가하였다. 결 과 : 용적선량-조건강도의 비율을 동일하게 하고 절대 값을 변화 시켰을 때 CI값은 다르지만, PCI는 $1.299{\pm}0.006$, HI는 $1.095{\pm}0.004$, D5%/D95%는 $1.090{\pm}1.011$으로 처방선량에 대한 영향은 유사하였다. 이하선의 평균선량은 용적선량-조건강도의 절대 값이 40, 60, 70, 90으로 증가될 때, 67.4, 50.3, 51.2, 47.1 Gy로 감소하였다. 각각의 치료계획에서 선량부드럼강도를 증가시켰을 때, PCI는 $1.338{\pm}0.006$로 증가된 값을 보였다. 결 론 : 용적선량-조건강도는 절대적인 값보다 각 조건의 비율에 따라 최적화 알고리즘에 영향을 주었다. 절대 값이 다르더라도 같은 비율을 유지하면 유사한 치료계획이 수립되었다. 성공적인 치료계획을 수립하기 위해 특히 보호해야할 정상장기의 용적선량-조건강도는 치료용적의 용적선량-조건강도의 50%이상 되어야한다. 선량부드럼강도는 용적선량-조건강도에 따라 비례하여 증가하거나 감소하여야 한다. 단순히 절대 값으로 적용하면 용적선량-조건강도는 그 조건을 충분히 만족시키지 못한다.

• 대한방사선치료학회지
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• 제26권2호
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• pp.321-327
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• 2014

목 적 : FFF(Flatterning Filter Free)빔을 이용한 방사선치료계획 시 불균질 부위에서 TPS상의 선량분포와 실제측정 선량분포를 비교하여 TPS의 선량계산 알고리즘 AAA(Analytic anisotropic algorithm)의 불균질부 교정의 정확성을 검증하려한다. 대상 및 방법 : Solid water팬텀과 Cork, 파라핀으로 자체 제작한 흉부종양팬텀을 이용하여 종양의 위치별(반도형태/섬형태), 크기별 ($2cm{\time}2cm{\time}2cm/4cm{\time}4cm{\time}4cm$)로 각각 치료계획용 CT영상을 획득한 후, 본원의 흉부 SABR 치료계획시스템인 Ecilpse의 AAA(Analytic anisotropic algorithm)을 이용하여 6MV 광자선 치료계획을 수립하였다. 본원의 TrueBeam STx(Varian medical system, Palo Alto, CA)를 이용하여 완성된 치료계획에 따라 EBT2 필름을 삽입한 자체제작 흉부종양팬텀에 방사선을 조사하였고, 종양내부 및 경계부에서의 치료계획 선량값과 실제팬텀측정 선량값을 비교 평가 해보았다. 결 과 : 타겟내 중심측에서는 TPS상의 선량값과 측정값의 차이가 1.28~2.7%로 나타났으며, 불균질부를 포함한 타겟의 경계부들에서는 Ant측면에서 2.02%~7.40%, Post측면 4.46%~14.84%, Rt측면 0.98%~7.12%, Lt측면 1.36%~4.08%, Sup측면 2.38%~4.98%, Inf측면 0.94%~3.54%로 차이가 났다. 결 론 : 본 연구를 통하여 불균질부 SABR치료 시 FFF빔의 특성과 불균질부의 영향으로 인한 선량계산의 오차가 생길 가능성이 있음을 알게 되었다. 최신의 방사선 치료방법 중 가장 각광받고 있는 SABR치료는 환자에게 적은 횟수로 고선량의 방사선을 조사하기 때문에 고도의 정확성이 요구되는 만큼 불균질부와 같은 장기특성과 FFF빔의 선량분포의 특성을 더욱 연구하여 치료계획 알고리즘에 적용해야 치료계획 시 발생하는 오류를 최소화 하여 최적의 치료를 시행할 수 있을 것이다.

• 한국임상약학회지
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• 제33권3호
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• pp.153-167
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• 2023

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

• 한국화재소방학회논문지
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• 제6권1호
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• pp.17-22
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• 1992

We have derived the general transfer equation for governing the continuity, energy transfer, mass and momentum transfer, and turbulent energy dissipation rate within the fire compartment which has the 800t fire source at the center of the floor. The governing transfer equations have been descretized using the finite volume approach and numerically experimented under the SIMPLE algorithm. In order for the SIMPLE algorithm approach to be physically reliable, the test results are compared with those of Morita's SOR Method using Conjugate Residual Method and found to be close to physical values though the computational convergence time still remains to be upgraded. The treatment of source terms in the system of finite difference equations has been critical in order to converge the governing equations within the appropriate time steps. The criteria of convergence allowance for the whole domain have been checked and the sudden change of the non-linear effects from the source term have been avoided. The criteria has been allowed to be for 5$\times$10$^{-5}$ .

• 산업공학
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• 제20권1호
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• pp.58-68
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• 2007

This research deals with a vehicle scheduling problem for the sludge collection strategies which might be solved via quantitative analysis and cost evaluations schemes. This problem can be modeled as a kind of capacitated vehicle routing pick-up problems. With the aim of establishing operation schedule of vehicles and analyzing the total cost under considering various assumptions and realistic restrictions of the sludge collection problem, we propose a heuristic method based on the genetic algorithm in conjunction with the sweep algorithm and the 4-opt algorithm. Finally, we present the cost effective operation schedule that can be used as the managing tool for the sludge treatment plant of the multi-purpose dam.