• Title/Summary/Keyword: additional therapy

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Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: patient selection, practical aspects, and current evidence

  • Kim, Yeon Sil
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.1-15
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    • 2017
  • Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

Comparison of Diagonal Shoulder Exercises with and Without Distal Wrist and Finger Movement

  • Ann, So-Youn;Park, Se-Yeon;Kim, Jwa-Jun
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.1
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    • pp.1-7
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    • 2015
  • PURPOSE: The aim of this study was to investigate the effects of distal movement on shoulder muscle activation during diagonal pattern of exercises. METHODS: Seventeen healthy male participants volunteered to participate. Five muscles of shoulder were investigated during standing performance of diagonal shoulder exercises with and without visual trace. Two patterns of the diagonal exercises were used as diagonal 1 flexion and extension (D1F-E), and diagonal 2 flexion and extension (D2F-E). Two way repeated measures analysis of variance was used, which the factor was the presence of distal movement and exercise variations. RESULTS: The average muscle activity values of the lower trapezius and anterior deltoid are higher with the D2F-E, compared to the D1F-E (p<.05). The distal movement effect was observed within included all muscles except the lower trapezius, which the values are significantly greater in exercise with distal movement (P<.05). All significant increase of the muscles during the exercise with distal movement condition showed over 0.9 for the observed power in present study. CONCLUSION: Present result suggested that the diagonal pattern of exercise with distal movement has additional advantages of activating the scapulothoracic muscle as well as glenohumeral muscles. In addition, the D2F-E exercise pattern is effective for activating lower trapezius and anterior deltoid muscles.

The Study of Muscle Fatigue and Risks of Musculoskeletal System Disorders from Text Inputting on a Smartphone

  • Ko, Kyung;Kim, Hee-Soo;Woo, Ji-Hea
    • Journal of the Ergonomics Society of Korea
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    • v.32 no.3
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    • pp.273-278
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    • 2013
  • Objective: This study aims to analyze and evaluate fatigue in upper trapezius muscles of adults when inputting text on a smart phone, thereby examining the risk of cumulative trauma disorders in the musculoskeletal system of the upper extremity. Method: Forty-five healthy adults were divided equally into three groups: a smartphone group, a notebook group, and a desktop group. A surface electromyogram was placed on the upper trapezius muscle of each participant, after which they inputted text for ten minutes within an ergonomic setting; their side posture was recorded on video and analyzed. Results: The spectral edge frequency values for the smartphone group, as recorded from the upper right trapezius muscles on the surface electromyogram, showed a significant decrease(p<.05). Regarding the RULA, all three groups had results indicating "action level 2". Conclusion: All three groups had results indicating "action level 2" according to the RULA, which means that additional research on the posture of the participants while performing tasks is necessary, and their posture needs to be corrected. In particular, the smartphone group has the highest levels of fatigue in the upper trapezius muscles, suggesting that the task of inputting text on a smartphone is a high risk for causing cumulative trauma disorders.

FAILURE OF ODONTOGENESIS AFTER CHEMO-RADIATION THERAPY FOR RHABDOMYOSARCOMA (횡문근육종의 항암제-방사선치료 후 치아발육장애)

  • Choi Sun-Young;Hong Sung-Woo;Koh Kwang-Joon
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.28 no.1
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    • pp.285-297
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    • 1998
  • This report details a case of 8-year-old girl showing failure of odontogenesis after chemo-radiation therapy for the rhabdomyosarcoma at the age of 4. The observed results were as follows : 1. Past history revealed that she had received for a total radiation dose of 4430cGy, 29 fractions in 6 weeks and chemotherapy with vincristine, actinomycin D and cytoxan, followed as maintenance phase for 2 years. 2. The patient was symptom -free and appointed for the treatment of multiple dental caries. 3. Oral examination showed hypoplastic enamel on whole erupted permanent teeth and showed retarded eruption. 4. Conventional radiograms showed failure of root development including abrupt cessation of root formation and root agenesis, and microdontia, missing teeth, irregular enamel, dislocation of the impacted teeth. Additional finding showed good healing bone pattern on the left mandibular ramus and angle area. 5. Cephalometric analysis revealed failure of bite raising due to incomplete eruption of all the first molars and made it possible to suspect entrapped mandibular growth and then Class II tendency growth. 6. There was correlation between the time of chemo-radiation therapy and the damage of the teeth.

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Reassessing Statin Therapy in Elderly Dyslipidemia: A Literature Review

  • Lee, Kyung-Hwa
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.139-147
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    • 2011
  • Purpose: An integrative literature review was done to identify the best interventions for older adults with dyslipidemia in an effort to promote nursing involvement in the prevention of statin-induced symptoms (SIS). Such awareness could increase the capacity of interventions by geriatric nurses using evidence-based practices in the reassessment of statin therapy. Methods: CINAHL, Pubmed, and ProQuest were searched using these terms: dyslipidemia in, elderly, statins, adverse effects, and quality of life. Eleven articles fitting the inclusion criteria were identified and analyzed. Results: The findings indicate no evidence for the benefit of statin therapy for morbidity/mortality in a high-risk primary prevention set-up, specifically in the elderly population. Although SIS prevails among older adults, there are limited data that confidently support this observation along with nursing interventions specifically for the geriatric nursing community. Conclusion: Future research is necessary to shift nursing intervention with statin users (specifically in older adults) from an illness-based intervention to a preventive care plan to provide optimal care based on evidence. It is essential to involve self-reporting, cooperation, and communication with health care professionals, specifically with geriatric nurses. Additional studies are needed to further direct practice interventions in elderly statin users.

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A Study of the Education and Licensure System of California Regarding East Asian Medicine and Acupuncture (캘리포니아 침구 및 동양의학 교육과 면허관리 체계 연구)

  • Hong, Jiseong;Han, Raeun;Han, Changhyun;Kang, Yeonseok
    • The Journal of Korean Medical History
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    • v.30 no.1
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    • pp.43-50
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    • 2017
  • In the United States, California is well known for its rigorous education and licensing system regarding East Asian Medicine and acupuncture. As in most other states in America, the State government controls the practice of acupuncture, massage, acupressure therapy, food therapy, and natural therapy using a board established to set, maintain, and uphold licensing credentials for acupuncturists and practitioners of East Asian medicine. In California the system started in the 1970s when the State Legislature passed a bill to measure competency, and license acupuncturists. This study briefly describes the California Acupuncture Board (CAB), which is authorized to control the related education, examination, continuing education, and management of licenses already awarded. This study addresses the essential and minimum educational requirement established by the CAB for licensure, that is mandate classroom lecture with additional 950 hours clinic training, and the 50 hours of continuing education credits earned every two years, for maintaining the license.

Effects of Virtual Reality Exercise Program on Balance, Emotion and Quality of Life in Patients with Cognitive Decline

  • Lee, Geun-Ho
    • The Journal of Korean Physical Therapy
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    • v.28 no.6
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    • pp.355-363
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    • 2016
  • Purpose: In this study, we investigated the effectiveness of a 12-week virtual reality exercise program using the Nintendo Wii console (Wii) in improving balance, emotion, and quality of life among patients with cognitive decline. Methods: The study included 30 patients with cognitive decline (12 female, 18 male) who were randomly assigned to an experimental (n=15) and control groups (n=15). All subjects performed a traditional cognitive rehabilitation program and the experimental group performed additional three 40-minute virtual reality based video game (Wii) sessions per week for 12 weeks. The berg balance scale (BBS) was used to assess balance abilities. The short form geriatric depression scale-Korean (GDS-K) and the Korean version of quality of life-Alzheimer's disease (KQOL-AD) scale were both used to assess life quality in patients. Statistical significance was tested within and between groups before and after treatment, using Wilcoxon signed rank and Mann-Whitney u-tests. Results: After 36 training sessions, there were significant beneficial effects of the virtual reality game exercise on balance (BBS), GDS-K, and KQOL-AD in the experimental group when compared to the control group. No significant difference was observed within the control group. Conclusion: These findings demonstrate that a virtual reality-training program could improve the outcomes in terms of balance, depression, and quality of life in patients with cognitive decline. Long-term follow-ups and further studies of more efficient virtual reality training programs are needed.

Efficacy of Lumbar Segmental Stabilization Exercises and Breathing Exercises on Segmental Stabilization in Lumbar Instability Patients

  • Yang, Sung Rae;Kim, Young Mi;Park, Sun Ja;Kim, Cheol Yong
    • The Journal of Korean Physical Therapy
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    • v.29 no.5
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    • pp.234-240
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    • 2017
  • Purpose: The aim of this study was to determine the effectiveness of breathing exercises and lumbar segmental exercises on the segmental stability of patients with chronic back pain. Methods: Fifty-nine patients, who suffered from chronic low back pain, were enrolled in this examination. They were divided randomly into three groups: experiment group 1 underwent breathing and segmental stabilization exercises (n=20), experiment group 2 experienced segmental stabilization exercises (n=20), and the control group was given the modality treatment (n=19). The measurements were assessed through an Oswestry disability questionnaire (ODQ), as well as a lumbar segmental instability test (LSIT). Results: The ODQ results for experimental groups 1 and 2 were similar (p<0.05), both before and after six weeks of exercise, but different among the three groups (p>0.05). The differences in segmental instability of each of the three groups were similar (p<0.05), and also similar among the three groups (p<0.05). Conclusion: These findings suggest that lumbar segmental stabilization exercises are efficient in increasing the segmental stability and alleviating pain in patients with chronic back pain. Additional studies on this subject will be needed to improve the clinical applications in the future.

Effect of Motor Imagery Training on Somatosensory Evoked Potentials and Upper Limb Function in Stroke Patients

  • Choi, Jongbae;Yang, Jongeun
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.1
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    • pp.2005-2011
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    • 2020
  • Background: Motor imagery is the mental representation of an action without overt movement or muscle activation. However, few previous studies have demonstrated motor imagery training effects as an objective assessment tool in patients with early stroke. Objective: To investigate the effect of motor imagery training on Somatosensory Evoked Potentials (SSEP) and upper limb function of stroke patients. Design: A quasi-experimental study. Methods: Twenty-four patients with stroke were enrolled in this study. All subjects were assigned to the experimental or control group. All participants received traditional occupational therapy for 30 minutes, 5 times a week. The experimental group performed an additional task of motor imagery training (MIT) 20 minutes per day, 5 days a week, for 4 weeks. Both groups were assessed using the SSEP amplitude, Fugl-Meyer assessment of upper extremity (FMA UE) and Wolf motor function test. Results: After the intervention, the experimental group showed significant improvement in SSEP amplitude and FMA UE than did the control group. Conclusion: These findings suggest that the MIT effectively improve the SSEP and upper limb function of stroke patients.

Biomechanical Variances in the Development of Forward Head Posture

  • Yasemin Deniz;Esra Pehlivan;Eda Cicek
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.104-113
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    • 2024
  • Forward Head Posture (FHP) involves the anterior positioning of the head relative to the shoulders, often associated with muscular imbalances. It is known that individuals with FHP experience shortening of craniocervical extensors and cervical flexors. However, contrary to the understanding of flexion in the craniocervical extension subaxial region, a study has reported flexion in the craniovertebral spinal vertebrae among individuals with FHP. The aim of this study was to examine the consistency of biomechanical study results conducted for FHP. The relevant studies were investigated in PubMed and Google Scholar databases using the keywords "forward head posture OR cervical sagittal alignment OR cervical spine AND biomechanics OR kinetic analysis OR kinematic analysis." During the research selection process, only nine studies relevant to the purpose of our study were identified. Out of these nine studies, four conducted kinematic analysis related to FHP formation, while six conducted kinetic analysis. During the comparison of these studies, five inconsistencies were identified. Biomechanical studies on FHP reveal conflicting findings, suggesting potential variability in the biomechanics of FHP formation across individuals. However, drawing definitive conclusions requires further exploration through additional biomechanical investigations on FHP in the future.