• Title/Summary/Keyword: Multi-therapy

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A Study of volumetric modulated arc therapy for stereotactic body radiation therapy in case of multi-target liver cancer using flattening filter free beam (다중표적 간암의 정위적체부방사선치료에서 무편평화여과기선질 용적변조회전치료의 유용성 평가)

  • Yeom, Misuk;Yoon, Inha;Hong, Donggi;Back, Geummun
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.31-43
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    • 2015
  • Purpose : Stereotactic body radiation therapy (SBRT) has proved its efficacy in several patient populations with primary and metastatic limited tumors. Because SBRT prescription is high dose level than Conventional radiation therapy. SBRT plan is necessary for effective Organ at risk (OAR) protection and sufficient Planning target volume (PTV) dose coverage. In particular, multi-target cases may result excessive doses to OAR and hot spot due to dose overlap. This study evaluate usefulness of Volumetric modulated arc therapy (VMAT) in dosimetric and technical considerations using Flattening filter free (FFF) beam. Materials and Methods : The treatment plans for five patients, being treated on TrueBeam STx(Varian$^{TM}$, USA) with VMAT using 10MV FFF beam and Standard conformal radiotherapy (CRT) using 15MV Flattening filter (FF) beam. PTV, liver, duodenum, bowel, spinal cord, esophagus, stomach dose were evaluated using the dose volume histogram(DVH). Conformity index(CI), homogeneity index(HI), Paddick's index(PCI) for the PTV was assessed. Total Monitor unit (MU) and beam on time was assessed. Results : Average value of CI, HI and PCI for PTV was $1.381{\pm}0.028$, $1.096{\pm}0.016$, $0.944{\pm}0.473$ in VMAT and $1.381{\pm}0.042$, $1.136{\pm}0.042$, $1.534{\pm}0.465$ in CRT respectively. OAR dose in CRT plans evaluated 1.8 times higher than VMAT. Total MU in VMAT evaluated 1.3 times increase than CRT. Average beam on time was 6.8 minute in VMAT and 21.3 minute in CRT. Conclusion : VMAT for SBRT in multi-target liver cancer using FFF beam is effective treatment techniqe in dosimetric and technical considerations. VMAT decrease intra-fraction error due to treatment time shortening using high dose rate of FFF beam.

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Substrate reduction therapy as a new treatment option for patients with Gaucher disease type 1: A review of literatures

  • Sohn, Young Bae;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.13 no.2
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    • pp.59-64
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    • 2016
  • Gaucher disease type 1 (GD1) is an inherited lysosomal storage disorder caused by deficiency of acid ${\beta}$-glucosidase. The diminished enzyme activity leads to the accumulation of substrates and results in multi-systemic manifestations including hepatosplenomegaly, anemia, thrombocytopenia, and bone diseases. Enzyme replacement therapy (ERT) by infusion of recombinant protein has been the standard treatment for over 20 years. Despite the successful long-term treatment with ERT, several unmet needs remain in the treatment of GD1 such as severe pulmonary and skeletal manifestations. Substrate reduction therapy (SRT) reduces the accumulation of substrates by inhibiting their biosynthesis. Eliglustat, a new oral SRT, was approved in United States and Europe as a first-line therapy for treating adult patients with GD1 who have compatible CYP2D6 metabolism phenotypes. Although eliglustat is not yet available in Korea, introduction and summary of this new treatment modality are provided in this paper by review of literatures. Despite the fact that there are only limited studies to draw resolute conclusions, the current data demonstrated that eliglustat is not inferior to ERT in terms of its clinical efficacy. The approval of eligustat enables eligible adult GD1 patients to have the option of oral therapy although it still needs further studies on long-term outcomes. The individual patient should be assessed carefully for the choice of treatment modality when eliglustat becomes available in Korea. Furthermore, the clinical guidelines for Korean patients with GD1 regarding the use of eliglustat needs to be developed in near future.

The Surveys of Satisfaction and Perception on Clinical Practice for Dept. of Health-related Students (보건계열 학생들의 임상실습에 대한 만족도 및 인식도 조사)

  • Lee, Najung;Park, Sungho
    • Journal of The Korean Society of Integrative Medicine
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    • v.1 no.1
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    • pp.77-85
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    • 2013
  • Purpose : The purpose of this study was to investigate the fieldwork satisfaction of Dept. of Health-related students, and to ascertain a change of perception on deciding on a course after fieldwork, and on a desired field and facility. Methods : Structured questionnaires were distributed to student of Dept. of Health-related(Occupational therapy, Physical therapy, Dental hygiene) from March 2 to April 30 of 2011. The questionnaires of 150 respondents were analyzed through frequency analyses, cross- and multi-reply analyses using SPSS ver. 12.0. Results : In fieldwork satisfaction, highly satisfied items were diversity of therapeutic equipment and tools, regular education, and recognition of the importance of fieldwork. The awareness of their decisions on employment and desired field changed positively for 52.7% students and negatively for 13.3%. Conclusion : Based on the results of this study, we identified that the awareness of one's decision on employment and desired field changes through fieldwork.

Effect of Calcaneal Taping on Peak Plantar Pressure of Forefoot and Rearfoot during Gait

  • Weon, Jong-Hyuck;Kim, Goen-Su;Jung, Do-Young
    • The Journal of Korean Physical Therapy
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    • v.27 no.6
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    • pp.434-438
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    • 2015
  • Purpose: The purpose of this study was to determine the effects of calcaneal taping on peak plantar pressure of rearfoot and forefoot while walking. Methods: Fifteen healthy subjects with normal feet participated in this study. Inclusion criteria were as follows: (1) no disturbance of gait and foot pain, (2) normal range of motion of ankle joint, (3) no foot deformity. Pedoscan was used for recording of plantar pressure data during walking. The participants walked along a 12-m walkway before and after application of calcaneal taping. The plantar pressure gait was measured 3 times under barefoot and calcaneal taping conditions randomly at a speed practiced with the metronome during gait. The peak plantar pressure data were calculated for medial and lateral areas of the rearfoot and forefoot. The paired t-test was used to determine significant differences in peak plantar pressure of rearfoot and forefoot before and after application of calcaneal taping. A p-value less than 0.05 was accepted as significant. Results: The calcaneal taping resulted in statistically significant decreases in peak plantar pressure of the rearfoot (medial side: p=0.03; lateral side: p=0.01). However, there were no significant changes in peak plantar pressure of the forefoot (medial side: p=0.45; lateral side: p=0.40). Conclusion: The calcaneal taping is recommended to reduce plantar pressure of the rearfoot in weight-bearing activities in subjects with plantar heel pain caused by atrophy of the fat pad.

Gene Therapy for Bovine Fatty Liver : Possibilities and Problems - A Review

  • Chen, Daiwen;Grummer, Ric
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.9
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    • pp.1331-1341
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    • 2001
  • Dairy cows are prone to fatty liver during the time of periparturient. Despite of the extensive studies, etiology and solutions for fatty liver are still not well known.The liver synthesizes triglycerides (TG) using precursors from bloodstream and secretes TG in form of very low density lipoprotein (VLDL) into bloodstream for the utilization by peripheral tissues. When the amount of TG synthesis exceeds the amount of secretion in VLDL-TG, TG accumulation within the liver occurs. Hepatic VLDL assembly and secretion involve multi-biochemical events.The availabilities of apolipoprotein B (apoB), E (apoE), microsomal triglyceride transfer protein (MTP) and soluble low density lipoprotein (LDL) receptor are now believed to be some of the main regulators for hepatic VLDL assembly and secretion. Studies in transgenic animals show that overexpression of these proteins stimulates VLDL production and secretion, which provides a possibility for alleviating bovine fatty liver by gene therapy. However, many problems remain to be solved to attain this goal. This review focuses on the molecular mechanisms of hepatic VLDL assembly and secretion, and the possibilities and problems of applying the knowledges to solve bovine fatty liver by gene therapy.

Internal Radiation Dosimetry using Nuclear Medicine Imaging in Radionuclide Therapy (방사성핵종 이용 치료에서 핵의학영상을 이용한 흡수선량평가)

  • Kim, Kyeong-Min;Byun, Byun-Hyun;Cheon, Gi-Jeong;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.265-271
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    • 2007
  • Radionuclide therapy has been an important field in nuclear medicine. In radionuclide therapy, relevant evaluation of Internally absorbed dose is essential for the achievement of efficient and sufficient treatment of incurable disease, and can be accomplish by means of accurate measurement of radioactivity in body and its changes with time. Recently, the advances of nuclear medicine imaging and multi modality imaging processing techniques can provide change of more accurate and easier measurement of the measures commented above, in cooperation of conventional imaging based approaches. in this review, basic concept for internal dosimetry using nuclear medicine imaging is summarized with several check points which should be considered In real practice.

Effects of Aromatherapy Massage on Edema Reduction in the Treatment of Lymphedema (아로마 마사지가 림프부종에 미치는 영향)

  • Kim, Sung-Joong;Shim, Jung-Myo;Park, Yong-Deok
    • Physical Therapy Korea
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    • v.14 no.3
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    • pp.1-8
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    • 2007
  • The purpose of this study was to determine whether aromatherapy massages with manual lymph drainage (MLD) are significantly more effective than sham massages with MLD in reducing edematous limb volume in lymphedema. This study was performed on 46 patients who had developed unilateral upper or lower lymphedema. Twenty-three patients served as the experimental group and were treated with complex decongestive physiotherapy (CDP) applications including aroma massages with MLD, multi layered compression bandages, remedial exercises and skin care. Twenty-three patients in the control group were treated with CDP applications including sham massages with MLD, bandages, exercises and skin care. Patients undergo a therapy program once a day; 5 days a week for 2 weeks. Percentage excess volume (PEV) and body mass index (BMI) were recorded before and after treatment. PEV and BMI were significantly decreased before and after treatment in the experimental as well as in the control groups (p<.05). However, the percentage excess volume and BMI were not significantly improved after treatment between the two groups (p>.05). This study there suggests that aroma massages is not effective in the edema of patients with lymphedema.

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Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.470-474
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    • 2019
  • Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

Comparison of Hip Extensor Muscles Activities According to Forward Trunk Lean Angles During Single-leg Deadlift

  • Saerin Lee;Duk-hyun An
    • Physical Therapy Korea
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    • v.30 no.1
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    • pp.8-14
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    • 2023
  • Background: Excessive hamstring (HS) activation due to the weakness of the gluteus maximus (GM) causes pain in the hip joint. A single-leg deadlift is a hip extensor exercise, especially GM, that includes functional movements in daily life and complex multi-joint training. In single-leg deadlift, the muscle activity depends on the forward trunk lean angle, and it's necessary to study which muscles are used dominantly depending on the angle. Objects: The purpose of this study was to compare the effect on the muscle activity of the GM and HS during single-leg deadlift according to different forward trunk lean angles and the ratio of the GM vs HS (GM/HS). Methods: Twenty-one healthy female participants were recruited. The muscles activities of the GM, HS and the GM/HS ratio were measured through electromyography during single-leg deadlift according to three condition of forward trunk lean angles (30°, 60°, and 90°). Results: The GM and HS activities significantly differed among three conditions (p < 0.05). GM/HS ratio was significantly higher at 30° and 60° of forward trunk lean compared to 90°. Moreover, the GM activity was significantly higher at 60° of forward trunk lean than at 30° (p < 0.05). Conclusion: The single-leg deadlift at 60° of forward trunk lean is a proper GM muscle strengthening exercise.

The Effect of Non-Pharmacological Intervention on Depressive Symptom in Elderly with Mild Cognitive Impairment : A Systematic Review of Randomized Controlled Trials (경도인지장애 노인의 우울증상을 위한 비약물적 중재 효과: 무작위 대조군 실험연구의 체계적 문헌고찰)

  • Jung, Jae-Hun
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.39-49
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    • 2022
  • The purpose of this study was to systematic review about randomized controlled trials the characteristics and effect of non-pharmacological intervention on depressive symptom in elderly with mild cognitive impairment. We searched studies published from January 2011 to July 2021 in 3 databases. A total 1,455 studies were found and included 11 studies in final analysis. Methodological quality was assessment with the Cochrane's RoB(risk of bias) tool. Geriatric Depression Scale(GDS) was the most used as the assessment tool for identifying the depressive symptom. Intervention were yoga, psychosocial intervention, cognitive training, health education, multi-component intervention, game training, aerobic/pulmonary physiotherapy, art therapy, music reminiscence activity, memory specificity training, cognitive stimulation therapy and SWTW(sleep well, think well) program. Among the intervention programs, yoga, multi-component intervention and game training were effective in improving depressive symptom. This study provided a clinical evidence for planning and implementing intervention on depressive symptom in elderly with mild cognitive impairment.