• Title/Summary/Keyword: Combined modality treatment

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The Effects of Mobilization on the Pain and Recovery of Function of Acute Low Back Pain Patients (관절가동기법이 급성요통환자의 통증과 기능회복에 미치는 영향)

  • Lee, In-Hak;Koo, Chang-Hoi;Park, Kyoung-Lee;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.18 no.1
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    • pp.41-51
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    • 2006
  • Purpose: The purpose of this study was to investigate effects of mobilization combined active movement(SNAGS) on the pain and recovery of function of acute low back pain patients. Methods: The subjects were consisted of 135 patients with acute low back pain. All subjects randomly assigned to mobilization group, stretching exercise group and modality treatment group. The mobilization group received mobilization combined active movement(SNAGS) with modality treatment, exercise group received stretching exercise with modality treatment and modality treatment group received modality treatment. Visual Analogue Scale(VAS) was used to measure patient's pain level and Patient Specific Functional Scale(PSFS) was used to measure patient's functional disability level. Results: The results of this study were summarized as follows : 1. Visual Analogue Scale(VAS) was mobilization group showed significantly decreased more than comparison group(p<.01) and active treatment group showed significantly decreased more than passive treatment group(p<.01). 2. Patient Specific Functional Scale(PSFS) was mobilization group showed significantly increased more than comparison group(p<.01) and active treatment group showed significantly increased more than passive treatment group(p<.01). Conclusion: It maybe suggested that mobilization combined active movement(SNAGS) is beneficial treatment for acute low back pain patient.

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The Result of Combined Modality Treatment for Non-Hodgkin's Lymphoma of Head and Neck (두경부 악성 임파종에 대한 병용치료의 결과)

  • Kim Jae Cheol;Kim Sang Bo;Ryu Samuel;Park In Kyu
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.255-260
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    • 1990
  • From April 1985 to September 1989, 26 patients with stage I and II non-Hodgkin's lymphoma of unfavorable histology localized in head and neck region were treated with combined modality (combination chemotherapy plus radiotherapy) at the Department of Therapeutic Radiology in Kyungpook National University Hospital. Of the 26 patients, 23 showed complete response and 3 partial response. Between these two groups there were no statistical differences according to the variables. Three-year survival and disease-free survival rate were $62.4{\%}$ and $65.2{\%}$, respectively. Unilateral involvement of neck node (p<0.05), radiation dose over 5000 cGy (p<0.01), and 6 or more cycles chemotherapy (p=0.06) had a favorable effect on 3-year survival rate. There were 8 recurrences including 3 partial responders, 1 local failure, 1 distant failure, 1 contiguous failure, and 2 simultaneous local and distant failure. It could be suggested that combined modality treatment might be necessary for the treatment of stage I and II Non-Hodgkin's lymphoma of unfavorable histology.

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A Combined Therapy of Steroid Injection, Silicone Gel Sheeting, and Laser for Hypertrophic Scar and Keloid (스테로이드 주사, 실리콘 겔 판, 레이져 병합요법을 이용한 부푼 흉터와 흉터종의 치료)

  • Choi, Sang Rok;Yoon, Min Ho;Dong, Eun Sang;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.700-705
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    • 2006
  • Purpose: For hypertrophic scars and keloids no universally effective treatment modality exists. Surgical revision, intralesional steroid injection, silicone gel sheeting, pressure, laser, and others have been used with variable success, but many treatments are associated with high recurrence rates. Although optimal treatment remains undefined, successful treatment can be obtained through a combined therapeutic approach. Methods: We used three therapeutic modalities in combination, which are intralesional injection of triamcinolone acetonide, silicone gel sheeting, and 585 nm flashlamp-pumped pulsed dye laser. Fifty-eight cases of hypertrophic or keloid scar were treated by combined therapeutic regimen for mean period of 18 months. The changes of thickness, color, and pliability of scars were evaluated with clinical photographs by grading scale. Results: As summing the grades and categorizing the result into three group, we obtained 28% good, 67% fair, and 5% poor results. There was a desirable improvement of scars with insignificant adverse effects. Conclusion: Combination of intralesional steroid injection, silicone gel sheeting, and pulsed dye laser can lead to successful treatment of hypertrophic scar and keloid.

Combined-Modality Treatment of Vocal Cord Atrophy with Thyroplasty Type I and Voice Therapy (제1형 갑상성형술과 음성치료에 의한 성대위축증의 치료)

  • 안철민;김현호
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.33-37
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    • 1997
  • Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

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Treatment Results of Hypopharyngeal Carcinoma (하인두암의 방사선치료 성적)

  • Lee Chang Gul;Loh John J.K.;Ryu Sam Youl;Park Kyung Ran;Suh Chang Ok;Kim Gew Earn;Hong Won Pyo;Kim Byung Soo
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.23-33
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    • 1988
  • A rerospective review of fifty patients with carcinoma of hypopharynx treated with $RT{\pm}surgery$ was studied for eleven-year period from 1974 to 1984. Of the 50 patients,46 were pyriform sinus in origin, 4 were posterior pharyngeal wall. Eighty-eight percent of patients were locoregionally advanced(stage III, IV) and 78% of patients presented conical lymphadenopathy. 5-year disease-free survival rate of the pyriform sinus ca. was $25.4\%$ in RT alone group, $80\%$ in combined modality group and $30.6\%$ in overall. Local control rate with RT alone in early stage (II) was excellent $(100\%)$, however combined modality appears to be better for local control$(80\%)$ in advanced stage (III, IV) as compared with that of RT alone group $(32\%).$ On basis of this study, RT alone is effective in terms of local control and functional preservation in treatment of early stage of pyriform sinus ca. while surgery can be reserved for salvage purpose when RT fails and combined modality is recommended in patients with locally advanced stage for better local control and survival.

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A Case Report of a Chronic Schizophrenia Treated with Combined Treatment of Korean and Western Medicine

  • Park, Na-Eun;Park, Jun-Hyun;Kim, Dae-Eok;Seo, Young-Min;Kim, Sang-Ho;Chung, Dae-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.4
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    • pp.349-356
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    • 2015
  • Objectives: Schizophrenia is difficult to treat effectively and the antipsychotics used have many side effects. However, few studies have focused on the combined treatment of Korean and Western medicine as an alternative. In this study, we reported an inpatient with chronic schizophrenia who was treated by a combination of Korean and Western medicine. Methods: We experienced a case of a diagnosed schizophrenia patient as whose chief complaint was avolition, diminished emotional expression and hallucination. The patient was treated with Western medicine and Korean traditional treatment including acupuncture, moxa and herbal medicine. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were used for assessment. Results: After treatment, symptoms involving avolition, diminished emotional expression and hallucination were improved; furthermore, the scores of the BPRS and the PANSS were decreased by approximately 50%, respectively. In addition, there were no notable side effects. Conclusions: The combined treatment of Korean and Western medicine can be an effective and well-tolerated treatment modality for patients with chronic schizophrenia.

Combined Treatment with 2-Deoxy-D-Glucose and Doxorubicin Enhances the in Vitro Efficiency of Breast Cancer Radiotherapy

  • Islamian, Jalil Pirayesh;Aghaee, Fahimeh;Farajollahi, Alireza;Baradaran, Behzad;Fazel, Mona
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8431-8438
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    • 2016
  • Doxorubicin (DOX) was introduced as an effective chemotherapeutic for a wide range of cancers but with some severe side effects especially on myocardia. 2-Deoxy-D-glucose (2DG) enhances the damage caused by chemotherapeutics and ionizing radiation (IR) selectively in cancer cells. We have studied the effects of $1{\mu}M$ DOX and $500{\mu}M$ 2DG on radiation induced cell death, apoptosis and also on the expression levels of p53 and PTEN genes in T47D and SKBR3 breast cancer cells irradiated with 100, 150 and 200 cGy x-rays. DOX and 2DG treatments resulted in altered radiation-induced expression levels of p53 and PTEN genes in T47D as well as SKBR3 cells. In addition, the combination along with IR decreased the viability of both cell lines. The radiobiological parameter (D0) of T47D cells treated with 2DG/DOX and IR was 140 cGy compared to 160 cGy obtained with IR alone. The same parameters for SKBR3 cell lines were calculated as 120 and 140 cGy, respectively. The sensitivity enhancement ratios (SERs) for the combined chemo-radiotherapy on T47D and SKBR3 cell lines were 1.14 and 1.16, respectively. According to the obtained results, the combination treatment may use as an effective targeted treatment of breast cancer either by reducing the single modality treatment side effects.

Combined Modality Therapy of Non-Hodgkin's Lymphoma of Waldeyer's Ring (Waldeyer's Ring 비호치킨 림프종의 병합요법)

  • Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.22-28
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    • 1999
  • Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

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The Role of FDG PET in Malignant Lymphoma (악성 림프종에서 FDG PET의 역할)

  • Yun, Mi-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.53-63
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    • 2002
  • FDG PET is a functional imaging modality whose ability to detect lesions is directly based on a change of the glycolytic metabolism of targeted tissues, may be advantageous over other techniques. Combined with excellent image qualify, high spatial resolution, and whole body imaging capability, it has become popular as a new approach in the evaluation of patients with various malignancies. Initial staging of nodal and extranodal lymphoma using FDG PET has been proven to be at least equal or superior to conventional imaging modalities. For the assessment of treatment responsiveness, FDG PET has a major impact on the management of patients in differentiating residual lymphoma from treatment related benign changes. Residual FDG uptake after the completion of chemotherapy is a good predictor of early relapse. However, it seems that the absence of FDG uptake in tumor mass may not exclude minimal residual disease causing later relapse. In the early evaluation of treatment response only after a few cycles of chemotherapy, FDG PET may have a promising role in identifying non-responders who could benefit from a different treatment strategy. At present, FDG PET appears to be the cost-effective, diagnostic modality of choice in the management of lymphoma patients. The role of FDG PET based-systems in terms of affecting long-term prognosis and survival benefit should be further elucidated in future prospective studios.

Nonoperative Management of Blunt Liver Trauma (둔상성 간 손상환자의 비수술적 치료)

  • Baik, Jung Ju;Kim, Jung Il;Choi, Seung Ho;Choi, Young Cheol;Jun, Si Youl;Lee, Jun Ho;Hwang, Seong Youn
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.161-171
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    • 2005
  • Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.