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Fall prevention strategies in community-dwelling older adults aged 65 or over with type 2 diabetes mellitus: a systematic review and meta-analysis

  • Hwang, Sujin;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • v.7 no.4
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    • pp.197-203
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    • 2018
  • Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

Effects of MWM for Improving Ankle Dysfunction on Pain, Neck Disability, and Craniovertebral Angle in Patients with Neck Pain Accompanied by Forward Head Posture (발목 기능장애 개선을 위한 멀리건 관절가동술이 전방머리자세를 동반한 목통증 환자의 통증과 경부장애지수, 두개척추각에 미치는 영향)

  • Jae-nam, Lee;Sang-mo, Jung;Young-june, Jeong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.3
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    • pp.51-59
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    • 2022
  • Background: This study aimed to investigate the effect of mobilization with movement (MWM) applied to the ankle joint, on the craniovertebral angle (CVA), pressure pain threshold, and neck disability index (NDI) in asymptomatic adults with a forward head posture (FHP). Methods: A total of 32 subjects with FHP were assigned to either the MWM group (N=16) or the cranio-cervical flexion exercise (CCFE) group (n=16). The CVA, pressure pain threshold and NDI were measured before and 4 weeks after the intervention. Results: A significant improvement in the CVA was observed in the MWM group (p<.05), whereas no significant changes (p>.05) were observed in the CCFE group. Both groups showed significant differences in the pressure pain threshold and NDI before and after the intervention (p<.05). Conclusion: The results of the study suggest that MWM applied to the ankle joint can effectively improve the CVA, pressure pain threshold, and NDI of adults with a forward head posture. Based on this study, the ankle MWM technique for dorsiflexion can be used as an objective research method for additional studies targeting FHP patients in the future.

Growth Factor Receptor Expression on Brain Tumor Cell Lines : Preliminary Study for in vitro and in vivo Experiments of Immunotoxin Therapy (뇌종양세포주에서의 성장인자수용체의 발현 : 면역독소 치료의 연구를 위한 예비실험)

  • im, Ki-Uk;Ni, Hsiao-Tzu;Low, Walter C.;Hall, Walter A.
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.731-737
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    • 2000
  • Objective : Growth factor receptors on the tumor cells are known to be expressed highly allowing the tumor cells to bind growth factors to stimulate cellular division. Immunotoxin therapy is one of the novel approaches to the primary malignant brain tumor, and expression of cell-surface receptor is essential for the immunotoxin to have specific anti-tumor activity. Despite promising cytotoxic activity of immunotoxin, tumor responses are not curative on clinical trials, and additional studies are needed regarding various factors influencing the efficacy of the immunotoxin. The purpose of this study is to detect the expression of various growth factor receptors on brain tumor cell lines which are going to be used in these studies. Materials and Methods : The authors detected transferrin receptor(TR), insulin-like growth factor-1 receptor(IGF-1R), and interleukin-4 receptor(IL-4R) on medulloblastoma cell line(Daoy) and glioblastoma cell lines(U373 MG and T98 G) by flow cytometric analysis. Results : TR was expressed on Daoy, U373 MG, and T98 G. IGF-1R was expressed on Daoy and U373 MG, but not on T98 G. IL-4R was expressed on all cell lines tested. Conclusion : The transferrin and interleukin-4 receptors might be good targets for immunotoxin therapy. The results should be considered in additional in vitro and in vivo studies regarding immunotoxin and in establishing the proper treatment model of the immunotoxin therapy including selection of the adequate immunotoxin.

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Using MIM Software 3-D PET / CT imaging for the evaluation of radiation therapy on the clinical application of research (MIM 소프트웨어를 이용한 3-D PET/CT 영상의 방사선치료 평가를 위한 임상적용에 관한 연구)

  • Lee, SangHo
    • Journal of the Korean Society of Radiology
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    • v.9 no.4
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    • pp.249-255
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    • 2015
  • In this study, through the additional information of the PET / CT images by utilizing the basic data of TPS clinical application on the basis of the image re-forming synthetic function, the True-D technology and MIM software for continued research and development in combination, based on the combination-work between the respective images, reducing the time and cost of useful reading in clinical wide use of image width, efficient, effective tool for tumor targeting at diagnosis and radiation therapy by use as, by using the precise therapeutic effect determination, the time taken to read in the clinical, unnecessary and expect to a can reduce the additional examination by the creation of tumor patients read reports and PACS such asWe expect to be utilized for compatibility development with other software to evaluate the performance of PET / CT equipment.

Incidence and Risk Factors for Leptomeningeal Carcinomatosis in Breast Cancer Patients with Parenchymal Brain Metastases

  • Jung, Jong-Myung;Kim, Sohee;Joo, Jungnam;Shin, Kyung Hwan;Gwak, Ho-Shin;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.193-199
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    • 2012
  • Objective : The objective of study is to evaluate the incidence of leptomeningeal carcinomatosis (LMC) in breast cancer patients with parenchymal brain metastases (PBM) and clinical risk factors for the development of LMC. Methods : We retrospectively analyzed 27 patients who had undergone surgical resection (SR) and 156 patients with whole brain radiation therapy (WBRT) as an initial treatment for their PBM from breast cancer in our institution and compared the difference of incidence of LMC according to clinical factors. The diagnosis of LMC was made by cerebrospinal fluid cytology and/or magnetic resonance imaging. Results : A total of 27 patients (14%) in the study population developed LMC at a median of 6.0 months (range, 1.0-50). Ten of 27 patients (37%) developed LMC after SR, whereas 17 of 156 (11%) patients who received WBRT were diagnosed with LMC after the index procedure. The incidence of LMC was significantly higher in the SR group compared with the WBRT group and the hazard ratio was 2.95 (95% confidence interval; 1.33-6.54, p<0.01). Three additional factors were identified in the multivariable analysis : the younger age group (<40 years old), the progressing systemic disease showed significantly increased incidence of LMC, whereas the adjuvant chemotherapy reduce the incidence. Conclusion : There is an increased risk of LMC after SR for PBM from breast cancer compared with WBRT. The young age (<40) and systemic burden of cancer in terms of progressing systemic disease without adjuvant chemotherapy could be additional risk factors for the development of LMC.

Critical Use of Balloon Angioplasty after Recanalization Failure with Retrievable Stent in Acute Cerebral Artery Occlusion

  • Park, Jae Hyun;Park, Sang Kyu;Jang, Kyeong Sool;Jang, Dong Kyu;Han, Young Min
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.77-82
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    • 2013
  • Objective : Sudden major cerebral artery occlusion often resists recanalization with currently available techniques or can results in massive symptomatic intracranial hemorrhage (sICH) after thrombolytic therapy. The purpose of this study was to examine mechanical recanalization with a retrievable self-expanding stent and balloon in acute intracranial artery occlusions. Methods : Twenty-eight consecutive patients with acute intracranial artery occlusions were treated with a Solitaire retrievable stent. Balloon angioplasty was added if successful recanalization was not achieved after stent retrieval. The angiographic outcome was assessed by Thrombolysis in Cerebral Infarction (TICI) and the clinical outcomes were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Results : At baseline, mean age was 69.4 years and mean initial NIHSS score was 12.5. A recanalization to TICI 2 or 3 was achieved in 24 patients (85%) after stent retrieval. Successful recanalization was achieved after additional balloon angioplasty in 4 patients. At 90-day follow-up, 24 patients (85%) had a NIHSS improvement of ${\geq}4$ and 17 patients (60%) had a good outcome (mRS ${\leq}2$). Although there was sICH, there was one death associated with the procedure. Conclusion : Mechanical thromboembolectomy with a retrievable stent followed by additional balloon angioplasty is a safe and effective first-line therapy for acute intracranial artery occlusions especially in case of unsuccessful recanalization after stent thrombectomy.

Evaluation of Antiemetic Therapy for Breakthrough Nausea and Vomiting in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포 이식 환자의 돌발성 구역·구토에 대한 항구토제 사용 현황)

  • Kim, Jiyoon;Hong, So Yeon;Jeon, Su Jeong;Namgung, Hyung Wook;Lee, Eun Sook;Lee, Euni;Bang, Soo-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.224-229
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    • 2018
  • Background: The patients receiving hematopoietic stem cell transplantation (HSCT) are known to have a high incidence of breakthrough nausea and vomiting due to the conditioning regimen. The purpose of this study was to evaluate the adequacy of antiemetic therapy for breakthrough nausea and vomiting in patients receiving HSCT and to propose an effective treatment regimen. Methods: We retrospectively reviewed the electronic medical records of 109 adult patients. The collected data were used to identify (1) antiemetic and dosing regimens prescribed for controlling breakthrough nausea and vomiting, (2) the rate of patients who developed breakthrough nausea and vomiting, and (3) the percent of antiemetics prescribed on the day of symptom onset. Based on the National Comprehensive Cancer Network guideline, we assessed the suitability of antiemetics for breakthrough nausea and vomiting, and prescription timing. Results: All patients were prescribed pro re nata antiemetics. About 40.0%, 41.4%, and 18.6% of patients were using one, two, and three or more additional drugs for breakthrough nausea and vomiting, respectively. The most frequently administered drugs were intravenous metoclopramide (43.8%) and granisetron patch (36.2%). Breakthrough nausea and vomiting occurred in 87 patients (79.1%) and they developed symptoms 320 cases. About 220 cases (68.8%) were treated with additional antiemetics on the day of symptom onset and the rate of symptom resolution was only 10.3% (9 patients). Conclusion: The breakthrough nausea and vomiting in patients receiving HSCT occurred very frequently and was hard to control, thus requiring more rapid and aggressive treatments.

Effect of genistein administration on the recovery of spermatogenesis in the busulfan-treated rat testis

  • Chi, Heejun;Chun, Kangwoo;Son, Hyukjun;Kim, Jonghyun;Kim, Giyoung;Roh, Sungil
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.2
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    • pp.60-66
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    • 2013
  • Objective: Impairment of spermatogenesis has been identified as an inevitable side effect of cancer treatment. Although estrogen treatment stimulates spermatogenic recovery from the impaired spermatogenesis by suppressing the intra-testicular testosterone (ITT) level, side effects of estrogen are still major impediments to its clinical application in humans. Soybeans are rich in genistein, which is a phytoestrogen that binds to estrogen receptors and has an estrogenic effect. We investigated the effects of genistein administration on ITT levels, testis weight, and recovery of spermatogenesis in rats treated with a chemotherapeutic agent, busulfan. Methods: Busulfan was administered intraperitoneally to rats, and then a GnRH agonist was injected subcutaneously into the back, or genistein was administered orally. Results: The weight of the testes was significantly reduced by the treatment with busulfan. The testis weight was partially restored after busulfan treatment by additional treatment with either the GnRH agonist or genistein. Busulfan also induced atrophy of a high percentage of the seminiferous tubules, but this percentage was decreased by additional treatment with either the GnRH agonist or genistein. Treatment with genistein was effective at suppressing and maintaining ITT levels comparable to that in the GnRH agonist group. Conclusion: Genistein effectively suppressed ITT levels and stimulated the recovery of spermatogenesis in rats treated with a chemotherapeutic drug. This suggests that genistein may be a substitute for estrogens, for helping humans to recover fertility after cancer therapy without the risk of side effects.

A Case Report of Korean Medicine Treatment for Pleural Effusion due to Metastasis of Breast Cancer (유방암의 폐전이로 인한 흉막 삼출의 한의치료에 대한 증례보고)

  • Moon, Jiseong;Kim, Hakkyeom;Kim, Yeseul;Min, Seonwoo;Park, Jiyoon;Ahn, Lib
    • The Journal of Internal Korean Medicine
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    • v.42 no.3
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    • pp.420-430
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    • 2021
  • The survival time of breast cancer patients with lung metastasis has been prolonged as treatment methods have improved. However, there is yet no definitive therapy for the additional symptoms of lung metastasis to improve the quality of life of these patients. We report a patient who was suffering from pleural effusion due to metastasized breast cancer. She was treated with Korean medicine, including herbal medicine (Bojungikgi-tang-gami), combined with hormone therapy, for two months. We assessed her other symptoms, such as shortness of breath, generalized weakness, and lower extremity swelling, using a numeric rating scale (NRS). We also evaluated pleural effusion with chest X-rays. Shortness of breath was maintained at NRS 5, generalized weakness was slightly improved from NRS 6~7 to NRS 7~8 (10=healthy condition), and lower extremity edema was improved from NRS 3 to NRS 2 (10=highest score of discomfort). Malignant pleural effusion was maintained during the admission period. This report suggests that Korean medicine can help to maintain malignant pleural effusion and improve additional symptoms of lung metastasis.

Adjunctive Therapy of Pimecrolimus for Treatment of Facial Discoid Lupus Erythematosus in a Dog

  • Yeonhoo Jung;Moonseok Jang;Rahye Kang;Wanghui Lee;Seongjun Park
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.49-53
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    • 2024
  • A two-year-old, spayed female, 22.5 kg Pungsan was referred with chronic crusts and erosion on the nose. A referring veterinarian prescribed an anti-inflammatory dose (0.5-1 mg/kg/day) of oral glucocorticoids for 5 months, but skin lesions showed no meaningful improvement. A dermatological evaluation revealed a crust, depigmentation, erosion, and erythematous lesion over the nasal planum with a loss of the normal cobblestone texture. Also, firm and multifocal plaques over the thigh, groin, axilla, and dorsum were detected. A cytology examination on the nose, thigh, groin, axilla, and dorsum revealed moderate neutrophilic inflammation and bacterial infection. Abdominal radiography and ultrasonography revealed subcutaneous calcified materials along the thigh, groin, axilla, and dorsum. Calcinosis cutis was suspected because of the adverse effect of previous prolonged corticosteroid therapy. A histopathology examination of the nose lesion revealed moderate to severe degenerative or apoptotic changes of the basal layer and lymphoplasmacytic interface dermatitis. Facial discoid lupus erythematosus (FDLE) was diagnosed based on the history and the clinical, cytological, and histopathological results. Minocycline (7 mg/kg PO q 12 h) and niacinamide (500 mg/dog PO q 12 h) were prescribed as initial treatment. Glucocorticoids were not administered due to the presence of calcinosis cutis induced by previous corticosteroid treatment. After 6 weeks of treatment, the clinical signs on the nose were mildly improved. At this time, topical 1% pimecrolimus cream (twice daily) was initiated, while minocycline and niacinamide were continued at the same dose. The nasal planum markedly improved after 6 weeks of additional treatment, hence minocycline and niacinamide were prescribed for an additional 2 weeks and stopped, and the patient was continued solely on topical pimecrolimus. The dog's skin lesion has been maintained in clinical remission with topical 1% pimecrolimus twice daily for more than 5 months.