• 제목/요약/키워드: joint disease

검색결과 882건 처리시간 0.027초

Concurrent chemoradiotherapy improves survival outcome in muscle-invasive bladder cancer

  • Byun, Sang Jun;Kim, Jin Hee;Oh, Young Kee;Kim, Byung Hoon
    • Radiation Oncology Journal
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    • 제33권4호
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    • pp.294-300
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    • 2015
  • Purpose: To evaluate survival rates and prognostic factors related to treatment outcomes after bladder preserving therapy including transurethral resection of bladder tumor, radiotherapy (RT) with or without concurrent chemotherapy in bladder cancer with a curative intent. Materials and Methods: We retrospectively studied 50 bladder cancer patients treated with bladder-preserving therapy at Keimyung University Dongsan Medical Center from January 1999 to December 2010. Age ranged from 46 to 89 years (median, 71.5 years). Bladder cancer was the American Joint Committee on Cancer (AJCC) stage II, III, and IV in 9, 27, and 14 patients, respectively. Thirty patients were treated with concurrent chemoradiotherapy (CCRT) and 20 patients with RT alone. Nine patients received chemotherapy prior to CCRT or RT alone. Radiation was delivered with a four-field box technique (median, 63 Gy; range, 48.6 to 70.2 Gy). The follow-up periods ranged from 2 to 169 months (median, 34 months). Results: Thirty patients (60%) showed complete response and 13 (26%) a partial response. All patients could have their own bladder preserved. Five-year overall survival (OS) rate was 37.2%, and the 5-year disease-free survival (DFS) rate was 30.2%. In multivariate analysis, tumor grade and CCRT were statistically significant in OS. Conclusion: Tumor grade was a significant prognostic factor related to OS. CCRT is also considered to improve survival outcomes. Further multi-institutional studies are needed to elucidate the impact of RT in bladder cancer.

소아 추나에 대한 국내·외 연구 동향 (Domestic and Foreign Research Trend on the Pediatric Chuna Treatment)

  • 이진화;한재경;김윤희
    • 대한한방소아과학회지
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    • 제29권4호
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

한국 나장애인시설 나환자들에 대한 물리치료 실태조사 (A Survey on Physical Therapy for Leprosy Patients of Invalide Home in Korea)

  • 박래준;김용관
    • The Journal of Korean Physical Therapy
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    • 제10권1호
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    • pp.139-148
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    • 1998
  • The purpose of this study was to investigate the actual condition of physical therapy for leprosy patients of invalide home in Korea. The subjects were 928 leprosy patients who answered for the questionnaires kindly and lived in invalide homes such as An-Dong & San-Chung. The questionnaires survey was carried out from July to August 1997. The results of this study were as follows : 1. $67.6\%$ of the subjects said that they were knowing of physical therapy. 2. $88.4\%$ of the subjects who had been served physical therapy said that they were satisfied with it. 3. Between no physical therapy service group and physical therapy service group, treatment of pain was done in a different way. In physical therapy service group, for example, physical therapy treatment was most frequently used. But in no physical therapy service group, drug treatment was most frequently used. 4. The majority of the subjects responded that physical therapy was needed. 5. Each group expressed different kinds of difficulties with regard to physical therapy. No physical therapy service group, on the one hand, found it very difficult to visit physical therapy rooms. Physical therapy service group, on the other hand, complained of not having sufficient physical therapy appliance. 6. The situation of disability and disease was much worse in no physical therapy service group than in physical therapy service group. Especially, in case of low back pain and joint pain, no physical therapy service group complained of than suffering from these pains twice as often as physical therapy service group.

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척추에 발생한 단골성 섬유 이형성증 - 증례 보고- (Monostotic Fibrous Dysplasia in the Spine - A Case Report -)

  • 양준영;이준규;이준호;양재훈
    • 대한골관절종양학회지
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    • 제11권2호
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    • pp.188-193
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    • 2005
  • 섬유성 이형성증은 주로 장관골을 침범하는 것으로 알려졌으며, 수질골이 섬유성 조직으로 대치되는 질환을 가리킨다. 단골성 섬유성 이형성증이 다골성에 비해 흔한 것으로 알려져 왔다. 문헌 고찰에 따르면, 단골성 섬유성 이형성증이 척추를 침범한 례는 저자의 보고 이전에 23례가 보고되어 있다. 저자는 요통을 주소로 내원하였던 34세 남자환자에서 발생한 제3요추를 침범한 단골성 섬유성 이형성증의 예를 경험하였기에 이에 대한 방사선학적 소견 및 치료 경과에 관한 보고를 문헌고찰과 함께 보고하고자 본 논문을 계획하였다.

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원위 지골에서 발생한 골내 표피낭종: 증례 보고 (Intraosseous Epidermal Cyst of the Distal Phalanx: A Case Report)

  • 공규민;김주용;김정한;박대현;안광훈
    • 대한골관절종양학회지
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    • 제20권1호
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    • pp.22-26
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    • 2014
  • 골내 표피낭종은 드문 양성 낭성 병변이다. 이는 선천적인 요인이나 외상의 결과로 사료되며, 골 주변의 연부 조직에서 발생하기 때문에 골 파괴를 유발할 수 있다. 골내 표피낭종의 단순방사선 소견은 피질골의 팽대를 동반한, 경계가 명확한 방사선 투과성 병변이다. 임상적, 방사선학적 소견이 유사하기 때문에 원위 지골에서 발생한 다른 질환들과 골내 표피낭종을 감별하는 것이 중요하다. 저자들은 원위 지골에서 발생한 골내 표피낭종의 2개의 드문 증례를 보고하고자 한다.

악성 섬유성 조직구종에서 광배근피판을 이용한 견관절 재건술 (Reconstruction of the Shoulder using Rotational Latissimus Dorsi Flap in the Malignant Fibrous Histiocytoma)

  • 한정수;정덕환;이영호;임양진
    • Archives of Reconstructive Microsurgery
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    • 제10권2호
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    • pp.111-117
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    • 2001
  • Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

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원격재활 운동프로그램이 무릎골관절염 환자의 근 기능과 삶의 질에 미치는 영향 (Effect of a Telerehabilitation Exercise Program on the Gait, Knee function and Quality of life In Patients with Knee Osteoarthritis)

  • 김재윤;이동우;정모범
    • 대한물리의학회지
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    • 제15권1호
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    • pp.143-152
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    • 2020
  • PURPOSE: This study examined the effects of videoconferencing-based telerehabilitation exercise program on the gait, knee function, and quality of life of patients with knee osteoarthritis. METHODS: Forty-eight subjects, who were diagnosed with osteoarthritis of the knee by the radiologic findings, history, and a physical examination, were assigned randomly to a Control group, Experiment group I, and Experiment group II. The control group did not perform any exercise program and were educated in understanding and managing the disease of knee osteoarthritis for only one hour. Experimental groups I and II were provided with an exercise guidelines book for knee osteoarthritis, and the same exercise programs were conducted by face-to-face visits and non-face-to-face using telerehabilitation for eight weeks, respectively. To verify the effectiveness of each exercise program, the gait speed, knee disability index, and health related quality of life were measured. All assessments were conducted twice before and after the intervention. RESULTS: The participants who underwent both face-to-face and telerehabilitation exercise programs showed an improved gait speed, knee function, and health-related quality of life. In particular, there was no significant difference between the telerehabilitation exercise group and the direct face-to-face exercise group in improving the knee joint function and health related quality of life. CONCLUSION: A these findings the telerehabilitation exercise program for patients with knee osteoarthritis can alternate or supplement the face-to-face exercise program. Therefore, the telerehabilitation exercise program should be used not only as a substitute supplement program but also as an intervention for various diseases.

정보적군집 크기를 가진 군집화된 구간 중도절단자료 분석을 위한결합모형의 적용 (Statistical Analysis of Clustered Interval-Censored Data with Informative Cluster Size)

  • 김양진;유한나
    • Communications for Statistical Applications and Methods
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    • 제17권5호
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    • pp.689-696
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    • 2010
  • 구간중도 절단자료는 감염 자료, 종양 발생 자료등 그 발생 시간을 정확하게 관측할 수 없는 경우에 흔히 발생되는 자료로 정확한 사건 발생 시간대신에 발생 전 마지막 관측시점과 발생 후 첫 번째 관측시점으로 구성된다. 이러한 종류의 자료는 Sun (2006)에 의해 자세하게 논의되었으며 관측 개체간의 독립성 가정 하에서 여러 가지 방법들에 의해 분석되어져 왔다. 본 논문에서는 관측 개체들이 군집으로부터 발생하여 더 이상독립성 가정이 적절하지 못한 경우를 고려한다. 특히 반응변수인 사건 발생 시간이 군집의 크기와 연관되어 있을 때, 이를 고려하기 위한 결합 모형을 제시한다. 제안된 모형은 림프계 필라리아병의 실제 자료에 적용한다.

Locoregionally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy plus concurrent weekly cisplatin with or without neoadjuvant chemotherapy

  • Wee, Chan Woo;Keam, Bhumsuk;Heo, Dae Seog;Sung, Myung-Whun;Won, Tae-Bin;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.98-108
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    • 2015
  • Purpose: The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods: Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results: With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion: CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited.

골전이로 인한 장골의 병적 골절의 수술적 치료 (Surgical Treatment of Pathologic Fracture of the Long Bone due to Metastatic Tumor)

  • 신규호;김동수;한수봉;한대용
    • 대한골관절종양학회지
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    • 제1권1호
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    • pp.52-59
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    • 1995
  • Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

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