• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.86-94
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• 2024

Objective: To evaluate the changes in bladder capacity and storage through non-invasive neuromodulation by application of repetitive Trans magnetic stimulation (rTMS) and genital nerve stimulation (GNS) in traumatic spinal cord survivors. Design: A Single Case Study. Method: The Patient was registered in trail with the clinical trial registry of India (CTRI/2022/05/042431). The Patient was interposed with rTMS on lumbar area, from T11-L4 vertebrae with 1 Hz and the intensity was 20% below that elicited local paraspinal muscular contraction for 13 minutes. GNS was placed over dorsum of the penis with the cathode at the base and anode 2 cm distally at 20 Hz, 200 microseconds, Continuous and biphasic current was delivered and amplitude of stimulation necessary to elicit the genito-anal reflex. For assessment, Neurological examination was done for peri-anal sensation (PAS), voluntary anal contraction (VAC) and bulbocavernous reflex (BCR), deep anal pressure (DAP), and American Spinal Injury Association Impairment Scale (ASIA scale). Outcome assessment was done using Urodynamics, Spinal Cord Independence Measure Scale Version-III (SCIM-III), American Spinal Injury Association Impairment Score (ASIA Score), Beck's Depression Inventory Scale (BDI). The baseline evaluation was taken on Day 0 and on Day 30. Results: The pre-and post-data were collected through ASIA score, SCIM-III, BDI and Urodynamics test which showed significant improvement in bladder capacity and storage outcomes in the urodynamics study across the span of 4 weeks. Conclusion: rTMS along with GNS showed improvement in bladder capacity & storage, on sensory-motor score, in functional independence of individual after SCI.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.29 no.2
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• pp.180-186
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• 2016

Anal and perianal condyloma acuminatum(CA), which is a large cauliflower-like tumor, is a manifestation of human papillomavirus (HPV) infection. HPV may be acquired via sexual transmission, vertical transmission or nonsexual contact. It is an uncommon condition in children but the incidence in children has been increasing recently. There are many therapies for CA including chemical or physical destruction, immunological therapy, or a surgical excision. All these procedures have some degree of limitations such as limited clearance rate, high recurrence rate, pain, bleeding, release of potentially infectious aerosols and scar. It may be traumatic mentally to the children as well as physically. Korean Medicine included herbal treatment and herbal ointment for CA is no pain, and it doesn't need an anesthesia. We present a case of anal and perianal CA in a 2 years old boy that was treated successfully with Korean Medicine, with no recurrence during the follow up 3 months.

• Physical Therapy Rehabilitation Science
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• v.4 no.2
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• pp.103-107
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• 2015

Objective: Pelvic floor muscles (PFMs) form the base of the abdomino-pelvic cavity and also the PFMs function is important for urinary continence. PFMs training (PFMT) is considered to be the first method for PFM dysfunction. This study demonstrated correct PFMs contraction among commonly used different contraction methods for PFMT. Design: Cross-sectional study. Methods: In this study, nineteen middle-aged (40-70 years) women participated. To evaluate PFM function, ultrasonography was used to measure the distance of the bladder base movement. The distance of the PFM movements were calculated at rest and during the other contractions. The following four different contraction methods were performed randomly: (1) PFM contraction, (2) abdominal drawing-in maneuver (ADIM), (3) anal contraction, and (4) hip adductor muscle contraction. The participants held the contraction for 3 seconds for a total of 3 times with a 30 seconds rest period between each trial. The mean of three measurements in each position were obtained and compared with that in the resting position. Results: The bladder base movement values were significantly greater when comparing PFM with ADIM and hip adductor contractions (p<0.05). The bladder base movement values were significantly greater when comparing ADIM and anal contractions with hip adductor contractions (p<0.05). Conclusions: The results of this study suggest that performing PFM contractions is the best method among the common methods for PFMT. Performing PFM contractions was more effective than the other contraction methods.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.83-88
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• 2015

Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

• Journal of Oriental Neuropsychiatry
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• v.20 no.4
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• pp.185-196
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• 2009

Objectives : This case report presents a 7-year-old female patient diagnosed with conversion disorder improved by application of oriental medical psychotherapy, the Giungoroen. Her chief complaint was dysesthesia of anal. Methods : Through interview and several psychological testing such as HTP test, DAF test, JTCI 7-11, we assessed her psychological state and seek for the psychological reason induced her physical symptom, dysesthesia of anal. After assessment we concluded her main psychological problem was loss of love relationship with her parents. So we decided to use supportive psychological therapy and behavioral therapy-like changing upbringing attitudes of her parents, for example- with Herbal medicine treatment. Results : After 2-month of therapeutic period, chief physical symptom of patient-dysesthesia of anal-was reduced to 20% compared with first visit day. Conclusions : The Giungoroen corresponds to supportive psychotherapy and behavioral therapy. And this oriental medical psychotherapy is fairly effective on the treatment of conversion disorder in childhood.

• Radiation Oncology Journal
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• v.32 no.4
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• pp.213-220
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• 2014

Insufficiency fracture occurs when normal or physiological stress applied to weakened bone with demineralization and decreased elastic resistance. Recently, many studies reported the development of IF after radiation therapy (RT) in gynecological cancer, prostate cancer, anal cancer and rectal cancer. The RT-induced insufficiency fracture is a common complication during the follow-up using modern imaging studies. The clinical suspicion and knowledge the characteristic imaging patterns of insufficiency fracture is essential to differentiate it from metastatic bone lesions, because it sometimes cause severe pain, and it may be confused with bone metastasis.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.3
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• pp.219-228
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• 2008

Objectives : This study was designed to evaluate the effects of oriental medical treatments on the patient with agitation accompanied constipation. Methods : One patient was admitted who was constipation, agitation, headache, chilling sign, thirst, heat, nausea, insomnia. The patient was diagnosed as constipation and agitation that was caused by heat in the heart and alimentary tract, and was treated with herb-medication, acupuncture, moxa therapy, anal therapy and aroma therapy for about 4 months. And then, we investigated and analyzed the clinical symptoms of the patient. Results : Most of all the clinical symptoms related with agitation accompanied constipation were improved gradually after oriental medical treatments. Conclusions : From the above results, it could be suggested that oriental medical treatments have good effects on agitation and constipation. And it will be necessary to extensively research and develop oriental medical treatments for this disease.

• Radiation Oncology Journal
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• v.35 no.4
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• pp.368-379
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• 2017

Purpose: The purpose of this study was to explore the dosimetric difference between simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) and three-dimensional conformal radiotherapy (3DCRT), and the clinical outcomes of anal squamous cell carcinoma (ASCC) chemoradiotherapy featuring SIB-IMRT. Materials and Methods: This study included ten patients with ASCC who underwent chemoradiotherapy using SIB-IMRT with 5-fluorouracil and mitomycin C. SIB-IMRT delivered 54 Gy to each primary tumor plus metastatic lymph nodes and 45 Gy to regional lymph nodes, in 30 fractions. Four patients received additional boosts to the primary tumors and metastatic lymph nodes; the median total dose was 54 Gy (range, 54 to 60 Gy). We additionally created 3DCRT plans following the Radiation Therapy Oncology Group 9811 protocol to allow dosimetric comparisons with SIB-IMRT. Locoregional control, overall survival, and toxicity were calculated for the clinical outcome evaluation. Results: Compared to 3DCRT, SIB-IMRT significantly reduced doses to the external genitalia, bladder, and intestine, delivering the doses to target and elective nodal region. At a median follow-up time of 46 months, 3-year locoregional control and overall survival rates were 88.9% and 100%, respectively. Acute toxicities were treated conservatively. All patients completed radiotherapy with brief interruptions (range, 0 to 2 days). No patient experienced ${\geq}grade$ 3 late toxicity during the follow-up period. Conclusion: The dosimetric advantages of SIB-IMRT appeared to reduce the toxicity of chemoradiotherapy for ASCC achieving high locoregional control in the extended period.

• Proceedings of the PSK Conference
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• 2002.04a
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• pp.210.3-211
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• 2002

• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.