• Title/Summary/Keyword: additional therapy

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Stress Fracture after Arthroscopic Lesser Trochanter Resection: Diagnosis and Therapy

  • Matthieu Baert;Maxence Vandekerckhove;Jan Vanlommel
    • Hip & pelvis
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    • v.36 no.1
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    • pp.70-75
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    • 2024
  • We report on the case of a 52-year-old female who presented with a stress fracture after undergoing an endoscopic resection of the lesser trochanter in ischiofemoral impingement, which was resistant to maximal conservative treatment. To the best of our knowledge, this complication has not been previously described. Non-weight-bearing and intravenous alendronic acid were prescribed for management. No additional surgery was required. The patient was pain free with the ability to perform sports on the same level as before and had no complaints.

Comparison of breast volume change between oncoplastic breast-conserving surgery with radiation therapy and a simultaneous contralateral balancing procedure through the inverted-T scar technique

  • Kim, Min Wook;Oh, Won Seok;Lee, Jae Woo;Kim, Hyun Yul;Jung, Youn Joo;Choo, Ki Seok;Nam, Kyung Jin;Bae, Seong Hwan;Kim, Choongrak;Nam, Su Bong;Joo, Ji Hyeon
    • Archives of Plastic Surgery
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    • v.47 no.6
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    • pp.583-589
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    • 2020
  • Background Reduction mammoplasty or mastopexy is performed as an additional balancing procedure in patients with large or ptotic breasts who undergo breast-conserving surgery (BCS). Radiation therapy on breasts that have undergone surgery may result in changes in the volume. This study presents a comparative analysis of patients who received post-BCS balancing procedures to determine whether volume changes were larger in breasts that received radiation therapy than on the contralateral side. Methods Thirty-six participants were selected among patients who received BCS using the inverted-T scar technique between September 2012 and July 2017, were followed up for 2 or more years, and had pre-radiation therapy computed tomography images and post-radiation therapy images taken between 12 and 18 months after completion. The average age of the participants was 53.5 years, their average body mass index was 26.62 kg/㎡. Results The pre- and post-radiation therapy volumes of the breasts receiving BCS were 666.08±147.48 mL and 649.33±130.35 mL, respectively. In the contralateral breasts, the volume before radiation therapy was 637.69±145.72 mL, which decreased to 628.14±166.41 mL after therapy. The volume ratio of the affected to the contralateral breasts was 1.05±0.10 before radiation therapy and 1.06±0.12 after radiation therapy. Conclusions The ratio of the volume between the two breasts immediately after surgery and at roughly 18 months postoperatively was not significantly different (P=0.98). For these reasons, we recommend a simultaneous single-stage balancing procedure as a reasonable option for patients who require radiation therapy after BCS without concerns regarding volume change.

Analysis of Current Traffic Signals for Pedestrians according to the Walking Times of Stroke Patients (뇌졸중 환자의 보행시간에 대한 현 신호체계 분석)

  • Lee, Dong-Jin;Na, Eun-Ye;Park, Sun-Mi;Park, Se-Jin;Park, El-Lim;Park, Wan-Seo;Bae, Woo-Ri;Baek, Hwa-Shin;Seo, Kyung-Tae;Seo, Dong-Hyun;Ahn, Sung-Woo
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.10 no.2
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    • pp.7-14
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    • 2012
  • Purpose : This study investigated the validity of crosswalk signal time length with regards to elderly stroke patients. Methods : We recruited 60 elderly adults sixty years of age or older for our study. The participants were divided into three groups.Group A consisted of 20 healthy participants with no walking aids. Group B consisted of 20 stroke patients with no walking aids. Group C consisted of 20 stroke patients using a cane as a walking aid. We measured the walking times of participants for 7 m, 14 m and 21 m lengths. Results : Using an independent t test, there was a statistically significant difference in the walking times between Group A and Group B for all lengths. There was a statistically significant difference in the walking times between Group A and Group C for all lengths. There was no statistically significant difference in the walking times between Group B and Group C. There was a statistically significant difference between the three group when using ANOVA. Conclusion : From the results of this study, we infer that the signal times at crosswalks are inappropriate for elderly stroke participants who use a cane as a walking aid. Therefore further research should be conducted to determine the appropriate amount of additional time needed for the elderly to safely cross the street.

Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Versus Placebo as Maintenance Therapy for Advanced Non-small-cell Lung Cancer: A Meta-analysis of Randomized Controlled Trials

  • Alimujiang, S.;Zhang, Tao;Han, Zhi-Gang;Yuan, Shuai-Fei;Wang, Qiang;Yu, Ting-Ting;Shan, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2413-2419
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    • 2013
  • Background: Use of epidermal growth factor receptor inhibitors (EGFR-TKIs ) is now standard for non-small-cell lung cancer (NSCLC). However, the effects of EGFR-TKIs in maintenance therapy for advanced NSCLC patients are still unclear. The preent meta-analysis was performed to examine pooled data of randomized control trials (RCT) where EGFR-TKIs were compared against placebo in maintenance regimens for patients with advanced NCSLC to quantify potential benefits and determine safety. Methods: Several data bases were searched, including PubMed, EMBASE and CENTRAL, and we performed an internet search of conference literature. The endpoints were objective response rates (ORR), progression-free survival (PFS) and overall survival (OS). We performed a meta-analysis of the published data, using Comprehensive Meta Analysis software (Version 2.0). with a fixed effects model and an additional random effects model, when applicable. The results of the meta-analysis are expressed as hazard ratios (HRs) or risk ratios (RRs), with their corresponding 95% confidence intervals (95%CIs). Results: The final analysis included six trials, covering 3,758 patients. Compared with placebo, EGFR-TKIs maintenance therapy improved ORR and PFS for patients with advanced NSCLC, the difference being statistically significant (P<0.05), but proved unable to prolong patients' OS. The main adverse reactions were diarrhea and rashes. Conclusion: EGFR-TKIs demonstrated encouraging efficacy, safety and survival when delivered as maintenance therapy for patients with advanced NSCLC after first-line chemotherapy, especially for the patients who had adenocarcinomas, were female, non-smokers and patients with EGFR gene mutations.

The Cortical Activation by Functional Electrical Stimulation, Active and Passive Movement (능동 및 수동 운동과 기능적 전기자극에 의한 대뇌 피질의 활성화)

  • Kwon, Yong-Hyun;Jang, Sung-Ho;Han, Bong-Soo;Choi, Jin-Ho;Lee, Mi-Young;Chang, Jong-Sung
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.73-80
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    • 2005
  • We investigated the activation of the cerebral cortex during active movement, passive movement, and functional electrical stimulation (FES), which was provided on wrist extensor muscles. A functional magnetic resonance imaging study was performed on 5 healthy volunteers. Tasks were the extension of right wrist by active movement, passive movement, and FES at the rate of .5 Hz. The regions of interest were measured in primary motor cortex (M1), primary somatosensory cortex (SI), secondary somatosensory cortex (SII), and supplementary motor area (SMA). We found that the contralateral SI and SII were significantly activated by all of three tasks. The additional activation was shown in the areas of ipsilateral S1 (n=2), and contralateral (n=1) or ipsilateral (n=2) SII, and bilateral SMA (n=3) by FES. Ipsilateral M1 (n=1), and contralateral (n=1) or ipsilateral SII (n=1), and contralateral SMA (n=1) were activated by active movement. Also, Contralateral SMA (n=3) was activated by passive movement. The number of activated pixels on SM1 by FES ($12{\pm}4$ pixels) was smaller than that by active movement ($18{\pm}4$ pixels) and nearly the same as that by passive movement ($13{\pm}4$ pixels). Findings reveal that active movement, passive movement, and FES had a direct effect on cerebral cortex. It suggests that above modalities may have the potential to facilitate brain plasticity, if applied with the refined-specific therapeutic intervention for brain-injured patients.

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The Study of Correlationship of the Fukuda Stepping Test to Determine Type of Idiopathic Scoliosis Curve (척주측만증 환자의 만곡과 후쿠다 검사의 상관성에 관한 연구)

  • Lee, Sang-Yeol;Jo, Marg-Eun;Ko, Min-Ji;Kim, Young-Ju;Lee, Seung-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.2
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    • pp.13-16
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    • 2016
  • PURPOSE: The Fukuda test can be used at home and in school to diagnose scoliosis at an early stage and prevent serious curvature of the spine. This study aimed to use the Fukuda test to detect scoliosis. An additional aim was to invoke the national interest in imbalanced postures and habits, which result in scoliosis, by providing data obtained in periodic assessments. METHODS: The study consisted of 35 idiopathic scoliosis patients (22 in right lumbar spinal region and 13 in the left lumbar spinal region). The distance of displacement and angle of displacement were measured following the Fukuda test. A correlation analysis was then used to examine the distance of displacement and angles of displacement and rotation with regard to the direction of the curve in scoliosis. RESULTS: There was a significant negative correlation (p<0.00) between the direction of the curve in scoliosis and the angle of displacement, but there was no correlation between the cobb's angle and distance of displacement or between the cobb's angle and angle of rotation. CONCLUSION: The Fukuda test did not capture changes in spinal curvature such as the cobb's angle, or subsequent changes in the muscles. Thus, the Fukuda test is not suited to examining the direction or status of the thoracic curve in scoliosis patients. Simple methods to objectively measure scoliosis need to be developed.

Isocenter Verification Using Linac-Gram Films Taken with Angiolocalizer : Improved Quality Assurance of Fractionated Stereotactic Radiation Therapy(FSRT) (Angiolocalizer를 사용하여 얻어진 Linac-Gram을 이용한 조사야 중심의 정확도 평가 (FSRT의 진보된 Quality Assurance))

  • Cho, Jung-Keun;Park, Young-Hwan;Ju, Sang-Kyu;Kim, Young-Gon;Cho, Hyun-Sang
    • The Journal of Korean Society for Radiation Therapy
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    • v.9 no.1
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    • pp.25-28
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    • 1997
  • With the advances in radiation therapy technology and equipment, the need for more accurate and safer radiation delivery to the target region has been continuously growing. Stereotactic Radiosurgery(SRS) is a good example of $^{\ast}Accuracy^{\ast}$ but has a substantial risk of causing severe late neurological damages. Fractionated Stereotactic Radiation Therapy(FSRT) is a modification of SRS enabling conventional fractionation with maintaining accuracy using noninvasive and relocatable frame. Verification of mechanical accuracy in FSRT has been done according to the manufacture's recommendations using RLPP, LTLF, and Depth-helmet. In order to reinforce this, we have developed additional novel verification procedure using Linac-grams with the Angiolocalizer attached on the GTC frame, which are then digitized into the planning software(X-Knife) to generate the three dimensional coordinates for cmoparison. This method has been successful in such ways that the anatomical landmarks are identifiable on the Linac-gram films and that the serial comparisons of the stereotactic coordinates of the isocenter are possible with more certainty a along the FSRT course than before.

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The Relationship Between the Expression of Estrogen Receptor ${\beta}$ and Recurrence in Breast Cancer (에스트로겐 수용체 ${\beta}$ 발현과 유방암 재발과의 관련성)

  • Kang, Su-Hwan;Choi, Jung-Eun;Lee, Soo-Jung
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.153-164
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    • 2011
  • Background: It has been reported that estrogen receptor beta ($ER{\beta}$) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha ($ER{\alpha}$) expression in breast cancer. The association of $ER{\beta}$ mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of $ER{\alpha}$ and $ER{\beta}$ via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between $ER{\beta}$ expression and recurrence in the hormonal therapy group, and between $ER{\beta}$ expression and known prognostic factors. Methods: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at $-70^{\circ}C$ until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. Results: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of $ER{\alpha}+/ER{\beta}+$, $ER{\alpha}+/ER{\beta}-$, $ER{\alpha}-/ER{\beta}+$, and $ER{\alpha}-/ER{\beta}$ group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. $ER{\beta}$ was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the $ER{\beta}$ expression tended to recur, but there was no clinical significance (p=0.084). Conclusion: The $ER{\beta}$ expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

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Intracranial Endodermal Sinus Tumor (두개강내 내배엽성 동종양(Endodermal Sinus Tumor))

  • Lim, Yong Chull;Cho, Kyung Gi;Lee, Seong Un;Park, Han Jun;Shin, Yong Sam;Yun, Soo Han;Cho, Ki Hong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1381-1387
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    • 2001
  • Objective : Endodermal sinus tumor or yolk sac tumor is an uncommon malignant germ-cell neoplasm. This tumor was originally described as a germ cell tumor of the ovary or the testis. Intracranial endodermal sinus tumor is extremely rare and usually develop in the pineal or suprasellar regions. The authors evaluated the effect of adjuvant therapy(chemotherapy combined with radiotherapy) and radical removal of intracranial endodermal sinus tumors. Material and Methods : Between 1996 and 2001, four patients of intracranial endodermal sinus tumor were diagnosed with tumor marker(AFP) and biopsy. Three patients were treated with surgical removal and chemotherapy with cisplatin($20mg/m^2$), etoposide($100mg/m^2$) and bleomycin($15mg/m^2$) as well as external beam radiation therapy. We compared the management problems for these tumors. Result : In all three patients the tumor size and the level of tumor marker decresed during initial adjuvant therapy. However, Tumors showed regrowth with elevated AFP of serum and CSF possibly related to delayed chemotherapeutic treatment or inadequate administration of chemotherapeutic drugs due to severe bone marrow suppression. An additional chemotherapy and external radiation therapy were given, but tumors could not be controlled with leptomeningeal seeding. Conclusion : Radiotherapy is considered to be less effective. The combination chemotherapy with PVB(cisplatin, vinblastine, bleomycine) or PE(cisplatin, etoposide) is considered to be value in prolongation of the survival rate. But the role of chemotherapy in this tumor has not yet been clarified due to bone marrow suppression and drug resistance. Further study with large series of this tumor is necessary to establish the optimal management.

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Analysis of Researches on the Warming Therapy for Surgical Patients (수술 환자에게 적용한 가온요법 연구논문 분석)

  • Jun, Jum-Yi
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.260-270
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    • 2010
  • Purpose: The main question is systematic review of the published in Korea and foreign countries on warming therapy for surgical patients. Methods: The researchers searched at Medline, CINAHL, KERIS, Adult Nursing Association, Korean Society of Nursing Science, Korean Academy of fundamentals of Nursing, and National Assembly Library web site for the published on warming therapy for surgical patients from 1980 to 2008. Words for search were operation/surgery, warming, operation/surgery and warming. Studies were included randomized controlled trial, and there were no restrictions regarding operative phase and outcome measures. Results: 36 published researches that met the criteria were mostly published in foreign countries between 2000 and 2008 and focused on surgery with general anesthesia. Sample size ranged from 21 to 60 subjects, age range between 21 and 60 years of age. Thirty different warming therapies were reported, fifty-two different dependent variables. Outcome indicators included active external warming, intra-operative, and body temperature. 'Positive effects' and 'no effects' equaled. The most frequently reported 'positive effects' were body temperature, shivering, and acid-base balance. No effects were more likely to be heart rate, blood pressure, and hemodynamics. Conclusion: Many types of warming therapy, are reported in the literature with little information about the efficacy of each, many different dependant variables were studied. There were no consistent reports as to length of time used for warming procedures. Overall, the effects of warming therapy are inconsistent. And additional research must be down before any particular method of warming can be used with confidence as to its effectiveness. Attention must be made as to the research design, better measurement of the dependent variables. This review may serve as a base.