• Title/Summary/Keyword: Treatment outcomes

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Gender and Intentionality Disparities in the Epidemiology and Outcomes of Falls from Height in Korean Adults

  • Han, Seung Uk;Kim, Sun Pyo;Kim, Sun Hyu;Cho, Gyu Chong;Kim, Min Joung;Lee, Ji Sook;Han, Chul
    • Journal of Trauma and Injury
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    • v.32 no.4
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    • pp.226-237
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    • 2019
  • Purpose: This study investigated the characteristics of adult patients who had fallen from a height and presented to an emergency room (ER) according to gender and intentionality, with the goal of reducing the harm caused by these injuries. Methods: A retrospective analysis was conducted of fall-from-height patients aged ≥19 years from the in-depth surveillance study of injured patients visiting ERs conducted under the supervision of the Korea Centers for Disease Control and Prevention from 2011 to 2016. Patterns were analyzed according to gender and intentionality. Results: There were 29,838 men (68.5%) and 13,734 women (31.5%), with mean ages of 50.3±15.7 years and 57.2±19.9 years, respectively. The most common height of the fall was ≥1 m to 4 m in men (n=15,863; 53.2%) and <1 m in women (n=7,293; 53.1%). The most common location where the fall occurred was the workplace for men (n=10,500 male; 35.2%) and residential facilities for women (n=7,755; 56.5%). Most falls from height were unintentional (n=41,765; 97.1% vs. n=1,264; 2.9% for intentional falls). Suicide was the most frequent reason for intentional falls, and the age group of 19-30 years predominated in this category (n=377; 29.9%). For intentional falls, the most common interval before presentation to the ER was 0-6 hours (n=370; 29.3%) and the most common height was ≥4 m (n=872; 69.0%). Conclusions: Among men, falls from height most often occurred from ≥1 m to 4 m, at the workplace, and during the course of paid work, whereas among women, they were most common from <1 m, in residential facilities, and during daily activities. Intentional falls most often occurred with the purpose of suicide, in the age group of 19-30 years, with an interval of 0-6 hours until treatment, from ≥4 m, and in residential facilities. Alcohol consumption was more common in intentional falls.

Treatment of Acromioclavicular Joint Injuries Using Clavicle Hook Plates (Clavicle Hook Plate를 이용한 견봉 쇄골 관절 손상의 치료)

  • Kim, Myung-Ho;Seo, Joong-Bae;Moon, Sang-Young
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.92-98
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    • 2010
  • Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

The Follow Up Results of Residual Spinoglenoid Ganglion Cyst after Arthroscopic Decompression and Superior Labral Repair - Cases Report - (극관절와 결절성 낭포의 관절경적 감압술 및 상부관절와순 봉합술 후 잔존 낭포의 경과 - 증례 보고 -)

  • Sung, Chang-Meen;Lee, Sang-Hyuk;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.111-116
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    • 2010
  • Purpose: There are many known treatment modalities for spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy. However, to the author's knowledge, there is no report on the follow-up outcomes focused on remnant cysts. Materials and Methods: Six (n=6) patients with spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy, with a mean follow-up of 15 months (12-23months) following arthroscopic cyst decompression and superior labral repair, were enrolled. Residual cyst was investigated by ultrasonography and MRI. Results: Immediate postoperative ultrasonography revealed complete remission of ganglion cyst in one patient and reduced ganglion cyst size in five patients. Three-month follow-up ultrasonography showed spontaneous complete remission of the residual cysts in all patients. No recurrence on MRI was seen at one-year follow-up. Conclusion: Residual spinoglenoid ganglion cyst remaining after arthroscopic decompression and superior labral repair tends to resolve spontaneously within 3 months of surgery.

Prospective Comparative Study of Arthroscopic Repair Versus Debridement for the Full-Thickness Tear of Upper Subscapularis (상부 견갑하 건 완전파열의 관절경 하 봉합술과 변연절제술의 전향적 비교)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Lee, Chae-Chil;Park, Han-Chang;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.79-85
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    • 2010
  • Purpose: To evaluate the results from arthroscopic repair versus debridement for full-thickness tears of the upper subscapularis tendon. Materials and Methods: Ninety-nine patient outcomes were evaluated and compared prospectively. Sixty-nine patients with full-thickness tears of the upper subscapularis tendon underwent arthroscopic repair (group I) and thirty patients underwent simple debridement (group II) between May 2003 and October 2007. In all patients, the tear was localized to the superior one third of the upper subscapularis tendon. The results of the treatment were assessed by evaluating the UCLA, ASES, and VAS for pain and internal rotation strength scores before and after the operation. Results: In groups I and II, UCLA, ASES, VAS, and internal rotation muscle power (perfect score = 5) scores were improved after surgery. In comparing group I and group II, the UCLA and VAS scores were not significantly different (p>0.05), while the ASES and internal rotation strength scores were significantly different (p<0.05). Conclusion: The arthroscopic repair of full-thickness tears of the upper subscapularis tendon was a better surgical method than simple debridement.

Effect of Lumbar Stabilizing Exercise SEBT Training on Isometric Lumbar Strength, Dynamic Balance Ability and Range of Motion in Open Laser Lumbar Microdisectomy Patients (미세 현미경 레이저 요추 디스크 절제술 환자의 요부안정화운동과 SEBT 트레이닝이 등척성 요부근력과 동적균형능력, 관절가동범위에 미치는 영향)

  • Jeon, Ho-Min;Kim, Jung-Hoon;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.212-220
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    • 2020
  • This study examines the effects on isometric lumbar extension strength, dynamic balance ability, and range of motion, after administering 8 weeks SEBT exercise (dynamic balance exercise) and Lumbar Stabilizing exercise, to open laser lumbar microdiscectomy patients. Totally, 14 patients who underwent preservation treatment for 6 weeks after undergoing open laser lumbar microdiscectomy, were enrolled for the study. Patients were randomly assigned to the Lumbar Stabilizing Exercise Group (LSG, n=7) and SEBT Exercise + Lumbar Stabilizing Exercise Group (SGLS, n=7). Results indicate that isometric lumbar extension strength ratio significantly decreases after 8 weeks rehabilitation exercise in both the LSG (p=0.007) as well as SLSG (p=0.024) groups. Normalized reach distance of the three directions in the Y-balance test to examine the dynamic balance capability showed a significant increase in both groups. The dynamic balance capability showed significant increase to the left (LSG, p=0.010; SLSG, p=0.002) and right (LSG, p=0.002; SLSG, p=0.002). Moreover, significant increase was also obtained in the range of joint operation, in both LSG (p=0.006) and SLSG (p=0.017) groups. These results indicate that both groups of rehabilitation exercise achieve positive outcomes on the isometric lumbar extension strength, range of motion, and dynamic balance ability. However, some results suggest that the SEBT program is likely to have a better efficacy.

Factors affecting on Health-Related Quality Of Life Among Cancer Survivors: Focusing on Gender Difference (암생존자의 건강관련 삶의 질에 대한 영향 요인 -성차를 중심으로)

  • Lee, In-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.497-507
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    • 2018
  • Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

Efficacy of First-line Chemotherapy Affects the Second-Line Setting Response in Patients with Advanced Non-Small Cell Lung Cancer

  • Cao, Wa;Li, Ai-Wu;Ren, Sheng-Xiang;Chen, Xiao-Xia;Li, Wei;Gao, Guang-Hui;He, Ya-Yi;Zhou, Cai-Cun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6799-6804
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    • 2014
  • Background: Chemotherapy is the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC) without driver mutations and many receive therapies beyond first-line. Second-line chemotherapy has been disappointing both in terms of response rate and survival and we know relatively little about the prognostic factors. Materials and Methods: One thousand and eight patients with advanced NSCLC who received second-line chemotherapy after progression were reviewed in Shanghai Pulmonary Hospital, China, from September 2005 to July 2010. We analyzed the effects of potential prognostic factors on the outcomes of second-line chemotherapy (overall response rate, ORR; progression free survival, PFS; overall survival, OS). Results: The response and progression free survival of first-line chemotherapy affects the ORR, PFS and OS of second-line chemotherapy (ORR: CR/PR 15.4%, SD 10.1%, PD2.3%, p<0.001; PFS: CR/PR 3.80 months, SD 2.77 months, PD 2.03 months, p<0.001; OS: CR/PR 11.60 months, SD 10.33 months, PD 6.57 months, p=0.578, p<0.001, p<0.001, respectively). On multivariate analysis, better response to first-line therapy (CR/PR: HR=0.751, p=0.002; SD: HR=0.781, p=0.021) and progression within 3-6 months (HR=0.626, p<0.001), together with adenocarcinoma (HR=0.815, p=0.017), without liver metastasis (HR=0.541, p=0.001), never-smoker (HR=0.772, p=0.001), and ECOG PS 0-1 (HR=0.745, p=0.021) were predictors for good OS following second-line chemotherapy. Conclusions: Patients who responded to first-line chemotherapy had a better outcome after second-line therapy for advanced NSCLC, and the efficacy of first-line chemotherapy, period of progression, histology, liver metastasis, smoking status and ECOG PS were independent prognostic factors for OS.

Hypofractionated Radiotherapy for Breast Cancers - Preliminary Results from a Tertiary Care Center in Eastern India

  • Nandi, Moujhuri;Mahata, Anurupa;Mallick, Indranil;Achari, Rimpa;Chatterjee, Sanjoy
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2505-2510
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    • 2014
  • Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

Evaluation of Treatment Outcomes of Early-Stage Endometrial Cancer Radiotherapy: A Single Center Experience

  • Demiral, S.;Beyzadeoglu, M.;Sager, O.;Dincoglan, F.;Uysal, B.;Gamsiz, H.;Akin, M.;Turker, T.;Dirican, B.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9599-9602
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    • 2014
  • Background: Postoperative adjuvant radiotherapy (RT) in the management of early stage endometrial cancer (EC) is still controversial. Here we report our institutional experience with patients who received postoperative RT for stage I-II EC over a period of 35 years and assess potential predictors of local recurrence (LR), distant metastasis (DM), and overall survival (OS). Materials and Methods: A total of 188 patients undergoing postoperative RT for stage IA-II EC between 1977 and 2012 were evaluated. Some 96 received median 46 Gy whole pelvic radiotherapy (WPRT) (range: 40-60 Gy), 37 were given WPRT with vaginal cuff therapy (VCT), and 55 received only VCT either with brachytherapy (BT) or stereotactic body radiotherapy (SBRT). Chemotherapy was given to 5 patients with uterine papillary serous carcinoma (UPSC). Logistic regression analysis was used to assess the effect of clinicopathological factors on LR, DM, and OS. Results: Median follow-up time was 11 years (range: 1-35 years). At the time of analysis, 34 patients were not alive. Of the 15 patients with LR, 7 (46.7%) recurred in the vaginal stump, 5 (33.3%) in the pelvic region, and 3 (20%) in the paraaortic nodal region, while 12 had distant metastasis. UPSC histology (p=0.027), sole VCT (p=0.041), high histologic grade (p=0.034), and age ${\geq}71$ (p=0.04) were poor prognostic factors on univariate analysis. Conclusions: In our patients receiving radiotherapy for early-stage EC, grade III disease and age ${\geq}71$ were associated with shorter OS whereas UPSC histology was an independent predictor for both LR and DM.

The Relationship of Depressive Symptomatology with a Glycemic Control in Korean Women (한국 여성에서 우울증상과 혈당 조절의 연관성)

  • Yoon, Dae-Hyun;Park, Jin-Ho;Park, Min-Jeong;Shin, Chan-Soo;Cho, Sang-Heon;Oh, Byung-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.47-52
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    • 2006
  • Backgrounds : Depression has been prevalent in women and maintaining optimal glycemic control is an important goal of diabetes management. Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, espacilly in Korean women. The current study examined the relationship of depressive symptomatology with glycemic control in Korean women. Methods : Beck depression inventory (BDI), $HbA_{1c}$ as an index of long-term glycemic control, fasting glucose level and body mass index (BMI) were measured in sample of 4,567 women of whom 4.7%, 216 women had diabetes, and the relationship between depression and glycemic control was analyzed. BDI Scores of 16 and above is a cut off point to indicate possible clinical depression. Results The frequency of depressed women (p<0.001) and the mean score of BDI (p<0.001) were significantly higher in diabetic women. The mean level of $HbA_{1c}$ (p<0.01) and fasting glucose (p<0.05) were higher in depressed women. There was a graded relationship between the percentile of depressed women and a degree of glycemic control impairment (p=0.001). Conclusion : The current study found the relationship of depressive symptomatology with glycemic control in Korean women. This relationship may be mediated by decreased self-care behaviors or by neurobiological dysregulation. Improving identification and treatment of depression in women with diabetes might have favorable effects on diabetic outcomes.

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