• Journal of Yeungnam Medical Science
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• 제9권1호
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• pp.102-109
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• 1992

1986년 5월부터 1991년 4월까지 만 5년간 영남대학교 의과대학 부속병원 치료방사선과에서 골 전이에 의한 통증제거를 목적으로 고식적 방사선치료를 시행한 결과는 다음과 같다. 대상환자의 남녀의 비는 2:3으로 여자가 많았으며, 40대이상의 환자가 전체의 80%를 차지하였다. 골 전이를 일으킨 원발병소는 유방암이 5명(25%)으로 가장 많았으며, 폐암과 위암은 각각 3명(15%), 비인강암은 2명(10%)으로 전체의 65%를 차지하였으며 원발병소를 알 수 없는 경우가 4명(20%)이었다. 골 전이의 해부학적인 분포는 척추 8명(40%), 늑골 2명(10%), 대퇴골 2명(10%)이었으며, 다발성 골 전이는 6명(30%)이었다. 병리조직화적 분류상 위선암 및 폐선암이 7명(35%), 침윤성 유방암이 5명(25%), 편평세포암이 4명(20%)이었다. 방사선치료는 20명중 9명(45%)에서 단독으로 시행되었으며, 항암제와 병용한 환자는 6명(30%), 수술후 방사선치료를 시행한 환자는 4명(20%)이었고, 외과적 절제술후 항암제와 방사선치료를 병용한 환자는 1명(5%)이었다. 시간변화에 따라 방사선 치료가 한 cycle동안만 시행된 환자는 10명(50%), 다른 부위에 추후 발생 하여 두 cycles동안 시행된 환자는 5명(25%), 3 cycles와 4 cycles동안 시행된 환자는 각각 2명(10%) 이었고, 5 cycles동안 시행된 환자는 1명(5%)이었다. 총 조사선량이 15Gy 미만이 2명(10%), 15에서 29Gy가 3명(15%), 30에서 44Gy가 12명(60%), 45Gy 이상이 3명(15%)이었다. 통증의 완전제거는 29Gy 미만에서는 없었고, 30Gy 이상에서는 무반응이 없었다. 30에서 44Gy치료한 경우에 12명중 9명(75%)에서 완전해소를 보였고 나머지 3명(25%)은 부분해소를 보였다. 한편 45Gy이상 치료한 경우에 3명 전원이 완전제거를 보였다(p>0.05). 방사선치료후 생존기간은 29Gy 미만에서는 3개월 미만이었으나, 30Gy이상에서는 모두 3개월이상을 생존하였다. 45Gy 이상 치료한 3명중 2명(66.7%)이 12개월 이상 생존하였다. 이상의 결과를 종합해보면, 골 전이에 의한 통증의 완화는 총 조사선량이 증가할수록 좋은 반응을 보였고, 총 조사선량이 증가할수록 생존기간의 연장에도 도움이 되었다. 비인강암에의한 늑골 전이의 수술적 제거후 항암제와 방사선치료를 병행하였던 1명의 환자는 36개월이상 생존하고 있으므로 말기암 환자에서도 보다 적극적인 치료를 시행하면 생존기간을 연장시킬 수 있으리라 사료된다.

• 가정간호학회지
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• 제13권1호
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• pp.54-60
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• 2006

This study, a quasi-experimental study using a nonequivalent control group pretest-posttest design. conducted a survey on 30 patients test group and control group of IS patients sampling an adjacent population at random - who are operated on the breast cancer and are in the A University Hospital located in Suwon, to examine into the effects of foot reflex zone massage on their pain and sleep satisfaction through the nursing interventions. It gave them a foot reflex zone massage for the total 30 minutes-basic massage 10 minutes and reflex massage 20 minutes required to alleviate their pain day in day out covering a two-month period from the first of July to the first of September 2004. for the purpose of collecting data. It launched into a two-round foot reflex zone massage at 6 and 24 hours since mastectomy through a direct visit at the hospital room to measure pain intensity, physiological index(pulse and blood pressure) and sleep satisfaction of them. The results are as follows. First, it showed that there is all the difference between pain intensity of test group and that of control group. In result, the first hypothesis, pain of test group. which measure at 6(p=.000) and 24 hours(p=.001) since mastectomies, will be bigger than that of control group, was established. Second, it showed that there is all the difference between physiological index of test group and that of control group. In result. the second hypothesis, pulse(p= .025, p= .002), systolic blood pressure(p= .004, p=.012) and diastolic blood pressure(p=.004. p= .003) of test group, which investigate at 6 and 24 hours since mastectomies, will be bigger than that of control group, was established. Third, it showed that there is a significant difference between sleep satisfaction of test group and that of control group(p=.000). In result, the fourth hypothesis, sleep satisfaction of test group. which examine in the morning after mastectomies, will be bigger than that of control group, was established. In the result. a foot reflex zone massage is seen to be effective in the pain reduction and sleep promotion of patients who are operated on breast cancer, and in providing them with more qualitative care by improving confidence between them and nurses through a physical touch. Also, it can be applied to a clinical examination through an independent nursing intervention.

• 한국전문물리치료학회지
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• 제22권1호
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• pp.9-18
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• 2015

This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, $n_1=30$), a shoulder surgery group (SS, $n_2=30$) and a control group ($n_3=30$). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.

• Journal of Chest Surgery
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• 제30권4호
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• pp.462-466
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• 1997

원발성으로 종격동에서 발생한 융모막암종은 드문 질환으로 젊은 남자에서 주로 발견되었으며, 기침, 흉통, 여성형 유방 등의 증상을 보이는 것으로 알려졌다. 33세 여자로 약 3개월 전부터 가벼운 기침으로 시작하였으나 심한 호흡곤란과흉통증 등 증상이 급격히 악화되어 내원하였다. 방사선학적 검사상 후종격에서 직경 13cm크기의 종양이 발견되었고, 혈중 $\beta$-HCG가 20만 mIU 이상 증가하였으며, 적출된 종양은 $\beta$-HCG에 대한 면역조직화학적 검사상 양성반응을 보였다. 융모막암종 절제술을 받고 EMA-CO투여 받은후 약 7개월만에 뇌에 전이된 종양 때문에 뇌출혈을 일으켜 다시 뇌종양 적출술을 받았다. 환자는 그 후 약 7개월동안 두통외의 증상은 없었고 흉부단순촬영상 종격종양의 재발소견도 없었다.

• PNF and Movement
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• 제16권1호
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• pp.133-141
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• 2018

Purpose: This study examined the effect of proprioceptive neuromuscular facilitation (PNF) rehabilitation exercise on postoperative range of motion (ROM), pain, and function of breast cancer patients. The purpose of this study was to provide fundamental data regarding the use of PNF rehabilitation exercise for patients with breast cancer. Methods: Fourteen patients who underwent surgery due to breast cancer were randomly divided into an experimental group (n=7) that performed PNF rehabilitation exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 4 weeks. For the measurement of ROM, the range of shoulder abduction was measured using a clinometer smartphone application. The shoulder pain and disability index (SPADI) was used to measure the level of pain and functional activity. A paired t-test was conducted to compare within-group changes before and after the PNF rehabilitation exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in the ROM and SPADI in both the experimental group and control group (p<0.01). There was also a significant between-group difference in the ROM and SPADI after the intervention (p<0.05). Conclusion: Rehabilitation exercise is generally applied as a treatment for patients with breast cancer after surgery and is relatively effective. The application of PNF rehabilitation exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.

• PNF and Movement
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• 제19권1호
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• pp.19-29
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• 2021

Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.

• 대한통합의학회지
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• 제9권4호
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• pp.19-28
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• 2021

Purpose : The purpose of this study was to apply manual lymphatic drainage (MLD) and high-frequency diathermy (HFD) to patients with axillary web syndrome (AWS), one of the side effects of breast cancer surgery, and to treat upper extremity pain, volume, function of the upper extremity, (joint range of motion; ROM, disabilities of the arm, shoulder and hand; DASH) and quality of life before and after treatment. It is to determine the effect of treatment by checking the level change. Methods : This study is a case series. A total of 5 patients diagnosed with AWS after breast cancer surgery voluntarily participated in this study. The intervention program consisted of stretching, MLD and HFD. It was conducted 3 times a week for 30 minutes for 4 weeks. In order to compare the effects of pain (numeric pain rating scale; NPRS), volume, upper limb function (ROM, DASH) and quality of life (the European organization for research and treatment of cancer quality of life questionnaire-breast, EORTC QLQ-BR23) evaluations were compared before and after 4 weeks of intervention. All measured variables were analyzed and expressed as mean, standard deviation and percentage. Results : The shoulder NPRS level of the subjects in all case groups decreased, the volume decreased and the shoulder flexion, abduction ROM increased. It showed improvement in DASH and quality of life, QLQ-BR23. Conclusion : After breast cancer surgery, we confirmed the possibility that MLD and HFD treatments could be effective in improving pain, decreasing volume, increasing upper extremity function, and quality of life for patients who have difficulties with AWS. The possibility has been confirmed, and additional research is needed by increasing the number of participants in the experiment in the future.

• 대한통합의학회지
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• 제9권1호
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• pp.49-57
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• 2021

Purpose: The purpose of this study was to investigate the effect of manual lymphatic drainage (MLD) methods on muscle tone, pain, and depression in patients with breast cancer. Methods: The study had a two-group pretest-posttest design. A total of 24 patients with breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD (n=12) and control (n=12) groups. Measurements of muscle tone, pain, and depression were taken prior to starting the intervention and after completing the 4 week program. The muscle tone, pain, and depression were measured using noninvasive muscle tone measuring equipment, the short-form McGill pain questionnaire, and the Beck depression inventory, respectively. The intervention was performed for 20 minutes a day, three times a week, for four weeks. A paired t-test was used to compare pretest and posttest values within each group, and an independent t-test was used to compare to pretest and posttest changes between the groups. Results: Comparison of the effects within the groups revealed significant reductions in muscle tone, pain, and depression in the MLD group after 4 weeks (p<.05), whereas the control group showed no differences. Comparison of the effects between the groups revealed significantly better reductions in muscle tone, pain, and depression in the MLD group than in the control group after 4 weeks (p<.05). Conclusion: These results suggest that MLD is an effective method for reducing muscle tone, pain, and depression in patients with breast cancer.

• Clinical Pain
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• 제20권1호
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• pp.25-29
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• 2021

Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

• Clinical Pain
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• 제20권2호
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• pp.99-104
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• 2021

Objective: To confirm the safety of Intra-articular (IA) injection on the ipsilateral adhesive capsulitis (AC) after breast cancer surgery. Methods: Between January 2017 and May 2020, we retrospectively studied 29 patients after breast cancer surgery who underwent IA injection in the glenohumeral joint for AC in aseptic procedure. Results: There were no side effects or complications such as lymphedema or cellulitis in the patients. There was a significant improvement in pain score and range of motion (ROM) at the 1st, 3rd, and 6th months visits compared to the baseline (p<0.05). The presence or absence of axillary lymph node dissection and radiation therapy had no significant difference in improvement of ROM. But, in rotator cuff syndrome (RCS) group, there was a significant difference in improvement of shoulder IR in patients without RCS. Conclusion: IA Injection on the ipsilateral AC after breast cancer surgery was safe and even effective to improve pain and shoulder ROM. Ipsilateral IA injection can be a good treatment for breast cancer surgery patients suffering from AC.