국제학회

• 전 세계 요추 전문의들 방한…세계요추연구학회 정기학술대회 개최 전 세계 30개국 요추 전문의들이 방한하기로 해 관심이 모아지고 있다. 세계요추연구학회(International Society for the Study of the Lumbar Spine, 이하 ISSLS)가 오는 3일부터 7일까지 연세대 세브란스병원에서 제 41회 정기학술대회를 개최한다. 이번 학술대회에는 일본 162명, 미국 50명, 대한민국 45 명 등 30개국 380여명이 사전등록을 마치는 등 전 세계 요추 전문의들의 많은 관심을 받고 있다. 이번 학술대회에서는 추간판 탈출증, 추간판 변성, 요통 등 다양한 주제를 다루며, 영국 옥스퍼드(Oxford)대학 페어뱅크(Fairbank) 박사, 미국 Texas Back Institute의 가이어(Guyer) 박사 등이 주요 강연자로 참석한다. 역학, 생역학, 생화학 등 기초학 및 임상에 관한 최신 지견에 대해 81개의 구연 발표, 60개의 특별 포스터 발표, 250개의 일반 포스터 발표가 진행된다. 또 요추 연구상, 최우수 논문 및 포스터 상 등에 대한 시상도 함께 진행된다. 이번 학회 유치 및 진행을 책임지고 있는 세브란스병원 정형외과 이환모 교수는 “이번 국제학회는 강의, 토론과 함께 요추에 대한 최신연구에 관한 다양한 주제를 다룰 것이다”며 “요추의 기초 및 임상에 대한 최신 지식을 공유할 수 있는 자리가 될 것이다”고 말했다. 한편 세계요추연구학회(ISSLS)는 1974년 첫 학술대회를 개최한 이래 척추 중에서도 요추(허리뼈)에 관한 학문을 주로 연구해 왔으며, 의사들뿐 아니라 많은 기초학자들이 참여해 요추의 질환 및 외상에 대해 기초부터 임상에 이르기까지 다양한 정보를 제공하고, 토론의 장을 마련해 왔다. 현재 약 30개국에 250명의 정회원을 보유하고 있다.     2014-06-02 medicalworldnews
• 세계 혈액 및 수혈의학전문가들 방한 ‘눈길’ 세계적인 혈액 및 수혈의학전문가들이 방한해 눈길을 모으고 있다. 국제수혈학회(ISBT)가 5월 31일부터 6월 5일까지 서울 코엑스에서 개최되기 때문이다.   6월 2일 현재 83개국에서 약 2,060명이 참석했으며, 미국 162명, 중국 107명, 일본 84명 등 외국에서 대거 참석해 실질적인 국제학회라는 평가를 받고 있다.  조직위원회에 따르면 초록은 총 68개국에서 758편이 접수됐고, 한국 135편, 중국 63편, 일본 36편 등이 등록돼 풍성한 학술대회로 진행되고 있다. 한규섭 대회장은 이번 학술대회를 통해 ▲국내 수혈의학 및 세포치료의 역량을 세계적으로 홍보 ▲외국 연구자들과의 교류를 활성화하여 국내 젊은 연구자들의 연구역량을 강화하고 국제무대에서도 활발하게 활동할 수 있는 계기 마련 ▲수혈의학 및 세포치료와 관련된 우리나라 기업의 제품을 보다 적극적으로 홍보할 수 있는 기회로 삼아 국가경쟁력 확보에 기여 ▲수혈의학 수준이 낙후되어 있는 동남아시아 주변국들의 의료수준을 개선시킬 수 있는 계기 마련 등을 기대하고 있다.   한편 국제수혈학회(International Society of Blood Transfusion; ISBT)는 지난 1935년에 창립되었으며, 100여국에서 혈액사업 및 수혈의학에 종사하는 1800여명의 전문가들을 회원으로 두고 있다. 헌혈자와 환자의 권익을 위해서 수혈의학 분야에 대한 연구와 정보교류 활동을 벌이고 있으며 수혈의학에 대한 교육에 중점을 두고 있다. 2년에 한번씩 세계수혈학회를 개최하고 있으며 아시아권에서는 동경 및 마카오에 이어 한국이 세 번째로 세계학술대회 개최국으로 선정됐다. 2014-06-02 medicalworldnews
• 세계적 심장혈관영상석학들 방한…아시아심장혈관영상의학회 학술대회 개최 세계적 심장혈관영상석학들이 방한할 예정이어서 벌써부터 관심이 모아지고 있다. 제 8차 아시아심장혈관영상의학회 학술대회 (The 8th Congress of Asian Society of Cardiovascular Imaging, ASCI 2014, 대회장 - 삼성서울병원 영상의학과 최연현 교수/ 사무총장 – 강남세브란스병원 영상의학과 김태훈 교수)가 오는 6월 12일(목)부터 14일(토)까지 롯데호텔제주에서 개최된다. ◆아시아 지역 대표 학회로 성장 ‘Heartbeat for Quantum Jump in Cardiovascular Imaging’라는 주제로 개최되는 이번 학술대회는 전 세계 27여 개국 600여명(외국인 참가자: 250명, 국내참가자: 350명)의 심장혈관영상의학 관련 전문가들이 참석할 예정이다. 최연현 대회장은 “이번 학술대회 주제는 아시아지역의 심장혈관영상의학이 전 세계를 향해 한층 더 높은 도약을 한다는 의미를 담았다”며 “심장혈관영상의학 관련 세계적인 유관 학회들과의 공조를 통해 다양한 프로그램을 구성하여 참가자들의 폭넓은 견문 및 지식을 공유할 수 있는 장으로 마련했다”고 설명했다. 명실공히 심장혈관영상의학 분야의 학문적인 발전과 의학자들의 교류를 촉진하는 아시아 지역 대표 학회로 인정받고 있는 이번 학술대회는 아시아심장혈관영상의학회(Asian Society of Cardiovascular Imaging, ASCI)와 대한심장혈관영상의학회(Korean Society of Cardiovascular Imaging) 공동주최로 개최된다. ◆ ASCI2014 기대되는 4가지 특징들 이번 ASCI2014를 통해 기대할 수 있는 부분은 크게 4가지다. 우선 한국 심장혈관영상의학 분야의 위상 강화. 제 1차 학술대회 개최 후 7년 만에 대한민국 제주도에서 개최돼 아시아 지역 심장혈관영상의학 분야에서 선도적인 역할을 하고 있는 대한민국의 세계적 위상 강화 및 국위선양에 좋은 기회가 될 것이라는 점이다. 다음으로 세계 유관 학회와의 교류 확대. 실제 이번 학술대회에는 European Society of Cardiovascular Radiology(ESCR) 및 Society for Cardiovascular Magnetic Resonance(SCMR) 과의 Joint Session이 마련된다. 또 6월 12일(목) Plenary Session을 시작으로 심장혈관영상의학 분야의 과거와 현재를 돌아보며, 6월 14일(토)에는 Highlight Session을 통해 심장혈관영상의학 분야의 미래까지 조망한다. 특히 현재 가장 화두가 되고 있는 3D-Printing 기술을 통해 제작된 소아심장 모형을 이용한 Hands-on Session 등 참신하고 다채로운 프로그램도 마련됐다.  김태훈 사무총장은 “이는 전차 대회에 비해 질적, 양적 확대를 도모함으로써, 대한민국에서 개최되는 ASCI 2014를 통해 아시아심장혈관영상의학회(ASCI)가 명실상부 심장혈관영상 분야를 대표하는 학회로 도약할 것으로 기대하는 바이다”고 밝혔다. 이와 함께 역대 최대 기록을 달성하고 있다는 점. 이미 총 230편의 초록이 접수되어 역대 최대를 기록했고, 이는 대회 기간 동안 열띤 발표와 토론으로 이어질 예정이다. 또 양질의 풍부한 학술 활동을 위해 Best Young Presenter Award, Best Oral / Poster Presenter Award 및 Travel Award 등 다양한 학술상과 장학금이 마련돼 국내외 유능한 학자들의 적극적인 참여도 독려하고 있다. 또 공식 만찬인 6월 13일(금) Gala Dinner에서는 ASCI를 창설하는데 주도적인 역할과 아시아지역의 심장혈관영상의학 분야의 발전에 헌신적으로 노력을 한 임태환 원장(한국보건의료연구원, 서울아산병원 영상의학과 교수)에게 Special Honorary Award를 시상하고 Prof. Hajime Sakuma (Mie University Hospital, Japan)에게 ASCI Gold Medal을 수여한다. 국내외 18개 업체에서 51개의 부스가 전시되어 심장혈관영상 관련 최신 기기 및 제품을 체험하고 지식을 공유할 수 있는 기회도 제공한다. 이외에도 아시아심장혈관영상의학회의 종합예술축제의 장으로서의 가치 제고한다는 점. 브라스 밴드 공연 및 이번 학술 대회를 위해 특별히 준비된 제주 전통의 이어도 공연까지 더해져, 대한민국 제주의 아름다움을 전 세계 참가자들에게 알리는 좋은 계기가 될 것으로 기대된다. 최연현 대회장은 “이번 학술대회에는 학술 프로그램 외 다양한 제주도 관광 프로그램을 상시 운영해 제주 전통과 현대를 넘나드는 볼거리를 제공할 것이다”며 “ASCI 2014는 심장혈관영상의학 전문가들의 토론과 교류의 장이 될 것이며, 최신의 지식과 연구 성과를 공유함으로써 한국 심장혈관영상 의학이 글로벌 리더로 도약할 것으로 기대한다”고 밝혔다. 한편 아시아심장혈관영상의학회(Asian Society of Cardiovascular Imaging; 회장, Dr. John Hoe)는 2006년 4월 29일 아시아 심장혈관영상의학의 발전을 위해 아시아 지역 8개국 12명의 발기인을 중심으로 한국에 본부를 두고 설립했으며, 서울아산병원 임태환 교수를 초대회장으로 추대했다. 지난 2007년 4월 27~28일 제 1차 아시아심장혈관영상의학회(ASCI)를 한국에서 개최했으며, 매년 아시아 국가를 돌아가며 학술대회를 개최하고 있다. 현재는 명실공히 심장혈관영상의학 분야의 학문적인 발전과 의학자들의 교류를 촉진하는 아시아 지역 내 대표 학회이다. 1995년에 창설된 대한심장혈관영상의학회(Korean Society of Cardiovascular Imaging, KOSCI)는 심혈관 분야의 선두 학회로, 1995년에 창설되어 현재 회원 수 200명(연회비 납부자근거)에 육박하는 국제적 수준의 학회로 성장했다. 2006년 아시아심장혈관영상학회 (Asian Society of Cardiovascular Imaging, ASCI)의 창설에 주도적 역할을 한 것을 시작으로 유럽심장영상학회(ESCR), 심장혈관영상CT학회(SCCT) 등 많은 국제학회와 활발한 교류를 추진해오고 있다. 또 북미영상의학회(RSNA)와 유럽영상의학회(ECR)에서 대한심장혈관영상의학회의 회원들의 많은 학술발표와 수상으로 국제적 위상이 점차 높아지고 있다.   2014-05-25 medicalworldnews
• Molecular Tumour Board Helps in Advanced Cancer Cases With accelerating development of personalised cancer treatments matched to a patient's DNA sequencing, proponents say frontline physicians increasingly need help to maneuver through the complex genomic landscape to find the most effective, individualised therapy.   In a paper published in the May 5 online issue of The Oncologist, researchers at the University of California, San Diego School of Medicine and Moores Cancer Center detail their experience evaluating 34 patients between December 2012 and June 2013 using a molecular tumour board – a new type of advisory group comprised of multidisciplinary experts, including those in the fields of tumour genetics, basic science and bioinformatics.   "Next generation sequencing tools were used to profile patients' tumors," said Dr Razelle Kurzrock, director of the Center for Personalized Cancer Therapy at UC San Diego Moores Cancer Center. In the 34 cases examined, no two patients shared the same genomic abnormalities. "We found 74 genes with 123 aberrations involved in cancer growth. Technology is permitting us to look at the molecular level of tumors, but most physicians are not trained in advanced genomics. We need access to experts in fundamental molecular biology to translate the data."   The Moores Cancer Center's Molecular Tumor Board brought together medical, surgical and radiation therapy oncologists, biostatisticians, radiologists, pathologists, clinical geneticists, basic and translational science researchers, and bioinformatics and pathway analysis specialists to discuss the intricacies of tumour genetics and tailor a personalised treatment plan for patients with advanced cancer or who have exhausted standard therapies.   The median time from physician order to receipt of molecular diagnostic test results was 27 days (range: 14–77 days).   Of the 123 abnormalities found in the patients' genetic cancer profiles, 107 of these irregularities appeared only once. "Cancer can be different in every patient," said Dr Barbara Parker, Moores Cancer Center deputy director for Clinical Affairs. "Standard therapy can be very efficient for many patients, but for those who do not respond to conventional treatment we need to find alternatives that will work for their disease."   For 12 patients studied who had failed to respond to conventional therapy, treatment plans were modified according to the results of their genomic testing and the molecular tumour board's input.    Among the 11 evaluable patients whose treatment had been informed by molecular diagnostics, 3 patients achieved a partial response.   According to Dr Richard Schwab, Moores Cancer Center haematology oncologist and co-director of the Biorepository and Tissue Technology Shared Resource, "developing a plan tailored to a patient's genetic makeup is helping us treat patients who are not responding to standard care or whose disease may have become drug resistant."   Other patients in the study had their molecular profiling done while they were receiving treatment that was still working for them because their physicians anticipated that the therapy would become ineffective. The results of genomic matching in these patients are not yet available.   Some patients could not be treated on the basis of molecular tumour board discussions because there was no clinical trial for which they were eligible or could not travel to an appropriately targeted clinical trial or because insurance would not cover the discussed medications.   "We have found that molecular diagnostics play an important role in patient care when paired with the expertise of a molecular tumor board," said Maria Schwaederle, PharmD, lead author and a researcher in the Center for Personalized Cancer Therapy. "However, the immense complexity of tumors and their genomic aberrations will require sophisticated computer technologies for optimal interpretation, and patients need access to more clinical trials and to targeted drugs."   This research was funded, in part, by MyAnswerToCancer and the Joan and Irwin Jacobs Fund.   Schwaederle M, Parker BA, Schwab RB, et al. Molecular Tumor Board: The University of California San Diego Moores Cancer Center Experience. The Oncologist 2014; First Published Online May 5. doi: 10.1634/theoncologist.2013-0405 2014-05-08 medicalworldnews
• Higher Mortality and Complication Rates Associated with Surgery for Metastatic Breast Cancer than for Early Stage Disease Las Vegas--Metastatic breast cancer patients experience significantly more complications and mortality within 30 days of surgical treatment for their disease than patients with earlier stage cancer, according to a new study.  Lead researcher Erin Cordeiro, MD of the University of Toronto reported this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting that for metastatic patients, the 30-day morbidity was 7.5% and mortality was 1.54%, while the non-metastatic group experienced 3.7% morbidity and 1.8% mortality.   She noted that common post-operative problems in the metastatic setting included infectious, respiratory, thrombolic, cardiac and bleeding complications. The adjusted odds ratio of post-operative complications for metastatic disease was 1.6.    “These results are important,” says Dr. Cordeiro.  “We found that breast surgery in stage 4 patients is occurring frequently in North America.  Research on the survival benefits for breast surgery in metastatic patients has had conflicting results.  But whether these patients are at higher risk of post-operative complications has never been examined.  A patient with metastatic breast cancer likely has systemic changes that predispose them to other medical difficulties.”   The study analyzed National Surgical Quality Improvement Program (NSQIP) participant use files (PUF), a prospectively collected database of 30-day inpatient and outpatient morbidity and mortality.   From 2005 to 2012, 68,316 patients were identified who underwent surgical treatment for breast cancer.  Of these, 1031 or 1.5% had diagnosed metastatic cancer.   Patients undergoing bilateral breast surgery, and those with concurrent surgery that was not breast- and/or reconstruction-related were excluded. The study controlled for types of surgery performed, including axillary lymph node dissection and mastectomy.  It also controlled for associated co-morbidity, age, diabetes, smoking status, BMI, pre-operative chemo or radiation therapy and operative time.   Of the metastatic group, 71% underwent mastectomy, while 49% received the surgery in the non-metastatic group.  Metastatic patients were also more likely to receive full axillary lymph node dissection.  They had a longer median time in surgery and longer post-operative hospital stay.  “Research on the survival benefits of breast cancer surgery for metastatic patients is currently underway,” comments Dr. Cordeiro.  “But until those findings are clear, this study shows that the risks of surgery are something to seriously consider before deciding on a course of treatment.” 2014-05-08 medicalworldnews
• Lymph Node Radiotherapy Emerges as the Preferred Treatment for Breast Cancer Patients with Positive Nodes Las Vegas--A groundbreaking prospective international study presented this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting found that lymph node axillary radiotherapy (ART), an emerging treatment protocol for tumors affecting the lymph nodes, is associated with significantly fewer complications than traditional axillary lymph node dissection (ALND) or removal. The study was conducted by the European Organisation for Research and Treatment of Cancer (EORTC).   The 4806-patient trial found that at one year after treatment, lymphedema rates were 15% for the ART group, 25% for the ALND patients and 59% for those receiving both therapies.  At five post-treatment, the condition was present in only 10% of ART patients, compared to 21% of those treated with ALND and 58% of the combination therapy group.  Arm lymphedema is a debilitating condition involving lymph fluid retention and tissue swelling common among breast cancer patients following node dissection.    The study also found that the incidence of short-term side effects such as post-treatment infection, hemorrhage, early edema and persistent seroma among patients was 9% for the ART group and 23% for the ALND group.   Arm paresthesia was observed in 9% of ART and 10% of ALND patients.  The study was conducted between 2001 and 2010, with an average time to follow up of over six years.   “These are extremely important findings that may change surgical guidelines and offer better quality-of-life for many, many women.  This is particularly true for younger patients, who would otherwise live with the difficult side effects of node surgery, such as lymphedema, for a long time,” comments lead researcher Mila Donker, MD, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital. “The study involved almost 5,000 women from various countries with differing standards-of-care, so the study really reflects the real world clinical practice.  It has important implications for treatment going forward.”   In the study, shoulder mobility decreased temporarily in both treatment groups, particularly during the first year.  Those treated with more extensive ALND or specialized supraclavicular radiotherapy following surgery suffered greater mobility loss, compared to the ART group.  However, women with less extensive ALND showed superior shoulder movement compared to the ART group one year after their procedure.   The authors conclude that for patients with positive sentinel nodes, ART is the preferred treatment over ALND given the overall morbidity.  A combination of surgery and radiation increases side effects and should be avoided if possible.  “I believe that as a result of this trial, radiotherapy of the nodes will begin to replace surgery,” says Dr. Donker.  “The results are that definitive and significant for patients’ quality-of-life.” 2014-05-08 medicalworldnews
• Cryoablation Shows Promise as a Non-Surgical Alternative Treatment for Early Stage Breast Cancer Las Vegas--Non-surgical cryoablation of breast cancer – destruction of diseased tissue by exposure to freezing temperatures – shows promise as an alternative to surgery for selected women with early stage invasive ductal cancer (IDC), according to a new phase II clinical trial presented this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting.   The study found that 100% of patients’ tumors less than 1 cm in size treated with cryoablation had no residual invasive cancer on pathological examination of the targeted lesion. The success rate for cancers of any size was 80.5%.  For 69% of patients, cryoablation was successful when defined as no residual IDC or ductal cancer in situ (DCIS), a precursor to cancer.   “With cryoablation, a woman need not even enter the operating room for treatment, and the procedure can be as brief as 20 minutes,” comments Rache Simmons, MD, Chief of Breast Surgery at New York Presbyterian/Weill Cornell Medical Center and lead author of the study.  “Compared to surgery, cryoablation is far less invasive and provides better cosmetic results, shorter procedure time and faster recovery.”   The technique is well-established for treatment of non-cancerous breast fibroadenomas and has been routinely used for other cancers for some time.  Earlier studies also suggested that cryoablation is an effective non-surgical treatment for breast cancer in a certain early stage patients.    The new study examined 86 patients with 87 breast cancers from 19 treatment centers.  For the procedure, a cryoprobe was inserted under ultrasound guidance through the skin into the targeted lesion.  Patients underwent ablation using a freeze-thaw-freeze cycle lasting approximately 6-10-6 or 8-10-8 minutes, respectively.  Following ablation, the treated tumor was surgically removed for pathological evaluation to determine the procedure’s success.  “We found that the smaller the cancer, the greater the rate of complete cryoablation,” says Dr. Simmons.   A secondary study objective was to evaluate the accuracy of MRI in visualizing residual IDC or DCIS imaging following cryoablation to determine whether the patient was cancer-free.  In the study, MRI findings were consistent with subsequent pathology reports for 85.9% of patients with negative findings for IDC and 75% of patients with negative reports for both IDC and DCIS—suggesting an important role for MRI in evaluating cryoablation results.  “Clearly the benefits of cryoablation for breast cancer treatment are numerous. This study shows that it can be quite effective,” says Dr. Simmons.  “Possibly some women may be able to take advantage of the technique within the next few years by participating in a trial of cryoablation used without follow up surgery—perhaps even sooner.” 2014-05-07 medicalworldnews
• Increasing Prophylactic Mastectomy Rates: The Role of the Healthcare Environment Las Vegas-The surgeon and the surgical practice environment play an important role in a woman’s decision about the extent of her breast cancer surgery according to a study presented this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting.   The research explored the causes of the rapid growth in prophylactic mastectomies since 2003 among average risk early-stage breast cancer patients in the US and Canada.  It identified three factors in the healthcare environment as significant - physician treatment recommendations, physician consultation on post-diagnostic MRI exams and the availability of immediate reconstruction.   “We found that women were more likely to choose prophylactic surgery when physicians did not specifically recommend other treatments or counsel against it, explains lead study author Andrea Covelli, MD, University of Toronto department of surgery.  “They also opted for more surgery when MRI exams were done early in the consultative process and initial results were presented without detailed explanation.  Access to immediate reconstruction also meant women were more likely to choose prophylactic surgery.”   The study involved 45 one-on-one interviews with breast surgeons equally divided between the US and Canada, academic and community settings and gender of the surgeon.  The median length of physician practice was 15 years.    In the US, state legislation mandates that surgeons present all treatment options to patients.  The research found that surgeons interviewed from the 20 states with such legislation, complied, but generally did not recommend one procedure over another.  Instead, they encouraged patient choice.  Canadian surgeons discussed similar surgical options.  However, more often they specifically recommended breast conserving surgery and counseled against contralateral prophylactic mastectomy.   Focusing on MRI findings, Dr. Covelli notes, “This imaging exam has a high rate of false positive results. Exams presented to patients without detailed explanation often cause patient concern about new disease, in addition to the original diagnosed tumor.”  She notes that the study found that in Canada, MRI exams were ordered less frequently than in the US, and surgeons often had more opportunity to discuss potential for inaccuracies with patients.  As one surgeon participating in the study noted, “Most of the time, additional lesions seen on a pre-surgical MRI end up being benign tissue when biopsied. But patient fear remains even though the biopsy is negative.  Often these patients still want to have a mastectomy.”   Another participant adds, “It becomes difficult to counsel patients and undo the fear that an MRI has caused.”     The study also found that immediate reconstruction, which was associated with the choice of prophylactic mastectomy, is more widely available in the US than in Canada.  It also found that in both countries, many patients requested a contralateral prophylactic mastectomy after returning from a consult with a reconstructive surgeon.    “We need to look at what happens during that consult to better understand patient decision-making,” Dr. Covelli says.   The authors conclude that the healthcare milieu, including legislation, social values, management of MRI exams and availability of immediate reconstruction appear to influence the surgical consultation process and in turn a woman’s choice of prophylactic mastectomy.   Noting that breast cancer is one of the few major illnesses for which physicians often do not recommend a specific treatment option, Dr. Covelli says, “ Patients should ask for their doctor’s opinion if helpful to them.  After all, most surgeons have years of experience treating breast cancer and can provide valuable counsel and advice.” 2014-05-07 medicalworldnews
• A New Era in Interventional Radiology SEATTLE — A major shift is occurring in the United States in interventional radiology (IR) and how federal funding is allocated for it. IR is now being moved to a residency program and it is hoped that this change will lead to improved care, improved outcomes and a sea change in the field. IR was recognized as a subspecialty in diagnostic radiology, but that is no longer the case. Now, it is a true specialty and equal to surgery, psychiatry and other specialties. The U.S. government provides some support for primary specialty training, but none for sub-specialty fellowships. The new IR/DR certificate will change its stature within hospital hierarchy and interactions with payers.   “It took 7 years to come up with this,” said John A. Kaufman, MD, MS, who is Director of the Dotter Interventional Institute and the Frederick S. Keller Professor of Interventional Radiology at Oregon Health & Science University Hospital, Portland, Oregon.   Dr. Kaufman, who has been instrumental in helping develop the new IR/DR certificate, said IR was recognized as a primary specialty of medicine in the U.S. in September, 2012, after many years of work by a joint task force of the American Board of Radiology (ABR) and the Society of Interventional Radiology (SIR). Dr. Kaufman said the new specialty will reside within the ABR as the fourth primary specialty under its supervision, joining Diagnostic Radiology, Medical Physics, and Radiation Oncology. The American Board of Medical Specialties (ABMS) is the umbrella group overseeing all of the specialty boards, and this change came about through the support of Diagnostic Radiology (DR) and the approval of other specialties.   Dr. Kaufman said this change in certification overtime will have a huge impact on IR and may potentially improve patient outcomes. It will affect local organizational issues so that at a local institution an interventional radiologist will be listed independently and next to surgery and medicine. “There are ramifications from this in terms of how federal dollars are allocated for training. It allows for people over time to specialize then in cancer and other areas within IR. We can stand on our own,” explained Dr. Kaufman.   He said although referred to as a "Dual Certificate" during the submission to the ABMS, it is now the "IR/DR Certificate", and the residency will be an IR residency. The Accreditation Council of Graduate Medical Education (ACGME) is currently preparing the program description and requirements. (Readers can find current information at the ABR, SIR, and ACGME websites.) The format of the residency will be one year of internship, three years of Diagnostic Radiology, and then two years of IR. Dr. Kaufman said during the three years of Diagnostic Radiology the trainees will be indistinguishable from all other Radiology residents, and will have to pass the same core certification examination after the third year. “The IR residencies will therefore likely all be within Radiology Departments, closely integrated into the Diagnostic Radiology residencies, and reporting to the same Chair of Radiology. Graduates will be competent as both diagnostic radiologists and interventional radiologists. It will not be possible to train only in IR, or be certified only in IR,” said Dr. Kaufman.   One of the key features of this change in curriculum is the emphasis on non-procedural patient care. Dr. Kaufman said this was the aspect of the proposed training (increased exposure through clinics, admissions to IR services, consult services, and an extra year) that all of the member boards of the ABMS found compelling in approving the change in training and status of IR from sub-specialty to its own specialty.   The changes in curriculum will be phased in over many years. Currently, there is concern that small DR residencies, which do not have IR fellowships, may be disenfranchised because of their inability to offer an IR/DR certificate training program. This is an issue to many institutions because one-third of all DR residencies fall into this category. Mechanisms to prevent this from being a problem and ensuring flexibility in program design and entry points are being carefully considered by the ACGME.   Dr. Kaufman said this is a very exciting time for interventional radiologists. He said the first generation of innovators helped develop the fundamental techniques and devices. “We are now in a refinement period. The specialty has been growing explosively. We now are developing more sophisticated approaches and combing devices with medicines. Our specialty has now become more about the disease as a whole,” said Dr. Kaufman. 2014-05-07 medicalworldnews
• 국제소아종양학회 아시아회의, 무엇을 남겼나? 대한소아혈액종양학회(이사장 구홍회)가 지난 17~19일 그랜드힐튼호텔에서 ‘제8차 국제소아종양학회 아시아 회의(SIOP Asia Congress)’를 개최했다.   이번 회의에는 31개국에서 약 400명(외국의료진 참가자 약 120명, 소아암완치자 및 부모 약 100명)이 참석한 가운데 개최돼 눈길을 모았다. 그렇다면 이번 회의는 무엇을 남겼을까? 서종진(서울아산병원) 대회장은 본지와 단독으로 만난 자리에서 그동안 개최됐던 회의들과 달리 실제 실행방안을 제시, 움직이게 됐다는 점을 가장 큰 성과로 꼽았다. 서종진 대회장은 “그동안 관련 회의에서는 국제적으로 소아암 환자들이 죽어가고 있고, 심각하다는 문제제기만 많이 했다”며 “그러나 실제 이에 대해 도움을 줄 수 있는 방안을 제시한 경우는 없었다”고 설명했다.   하지만 이번 회의에서는 중위권 나라들이 저개발국가와 트윈프로그램으로 실제 도움을 받을 수 있는 방안을 마련한 것은 물론 별도의 ‘Asia Cancer Fund’를 모아서 제공하기 위한 프로그램도 시작할 수 있게 됐다. 서 대회장은 “이번 대회를 기점으로 이같은 프로그램들이 운영됨에 따라 많은 소아암환자들이 혜택을 받을 수 있을 것으로 기대된다”고 밝혔다. 특히 이번 대회에 참석한 사람들의 호평으로 국제소아종양학회 본 회의 개최 제안을 받기도 했다. 이에 대해 서 대회장은 “많은 운영위원들이 최선을 다한 결과다”며 “다만 본 회의 개최는 아시아 회의와는 다른 규모로 더 많은 노력이 필요한 만큼 쉽게 결정할 수 있는 문제는 아니다”고 말했다.   또 “현재로는 조금 시간을 두고 결정할 문제인 것 같다”며 유보적인 입장을 보였다. 한편 이 대회는 단순히 완치 성적을 올리는 것을 넘어 전인적인 치료를 통해 궁극적으로 사회 복귀와 적응에 도움을 주고, 사회의 훌륭한 일꾼으로 성장할 수 있도록 하는 것이 목표다.   2014-04-21 medicalworldnews