• 제목/요약/키워드: multimodal treatment

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베르톨로티 증후군의 다양한 임상 양상에 대한 포괄적 치료 (Multimodal Treatment for Various Clinical Features in Bertolotti's Syndrome)

  • 강동하;김다솔;원유희;박성희;고명환;서정환;김기욱
    • Clinical Pain
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    • 제19권2호
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    • pp.133-137
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    • 2020
  • Bertolotti's syndrome (BS) is a disease that should be differentiated from low back pain (LBP) in young patients. BS shows an anatomical abnormality in which elongated transverse processes of the last lumbar vertebra articulate or fuse with varying degrees to the sacrum or ilium according to radiologic findings, which is associated with the clinical feature of LBP or radiating pain. In this case report, we describe various clinical features such as a waddling gait with severe foot and triceps surae muscle pain, in addition to the typical symptom of BS such as LBP. We report the various clinical symptoms and treatment progress in this case and review the literature.

주타액선 종양의 임상적 고찰 (A Clinical Analysis of Major Salivary Gland Tumors)

  • 유영삼;우훈영;윤자복;최정환;조경래;정상원;한동훈
    • 대한두경부종양학회지
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    • 제18권1호
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    • pp.56-59
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    • 2002
  • Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

국한성 두경부 비호지킨스 림프종 환자에서의 다방면치료 (Multimodal Approaches in the Patients with Stage I,II Non-Hodgkin's Lymphoma of the Head and Neck)

  • 표홍렬;서창옥;김귀언;노재경
    • Radiation Oncology Journal
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    • 제13권2호
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    • pp.129-142
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    • 1995
  • Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

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적외선 체열촬영을 이용한 통증 치료효과의 평가 (Evaluation of the Therapeutic Effects in Pain Management Using Infrared Thermal Imaging)

  • 김민정;이승윤;김성협;임정애;강포순;우남식;이예철
    • The Korean Journal of Pain
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    • 제14권2호
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    • pp.164-170
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    • 2001
  • Background: Infrared Thermal Imaging (ITI) is an effective tool for the diagnosis of disease and evaluation of the therapeutic effects following pain treatment. Patients who were treated for pain in pain clinic described the intensity of pain and the degree of change of their pain using a visual analogue scale (VAS). In this study, the usefulness of ITI following multimodal methods for pain management were compared with the change of VAS. Methods: 1119 patients were evaluated. The patients were treated with stellate ganglion block, epidural block or trigger points injection. Before treatment, the temperature difference (${\Delta}T$) of the involved area and the corresponding area on the opposite side of the body was measured using ITI and VAS was assessed. After treatment, the temperature difference (${\Delta}T$) between the normal and involved areas, the change of ${\Delta}T$ (${\Delta}dT$), VAS and the change of VAS (${\Delta}VAS$) were measured. Statistic correlations between ${\Delta}dT$and ${\Delta}VAS$ were calculated in all groups. Results: Correlation of the ${\Delta}dT$ and ${\Delta}VAS$ was significant by contingency coefficient test. (SGB group, C = 0.358, Epi group, C = 0.377, TPI group, C = 0.374, P < 0.05) Conclusions: ITI is a reliable tool for the assessment of therapeutic effects following multidimensional management of painful disease.

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SP-8356, a (1S)-(-)-Verbenone Derivative, Inhibits the Growth and Motility of Liver Cancer Cells by Regulating NF-κB and ERK Signaling

  • Kim, Dong Hwi;Yong, Hyo Jeong;Mander, Sunam;Nguyen, Huong Thi;Nguyen, Lan Phuong;Park, Hee-Kyung;Cha, Hyo Kyeong;Kim, Won-Ki;Hwang, Jong-Ik
    • Biomolecules & Therapeutics
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    • 제29권3호
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    • pp.331-341
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    • 2021
  • Liver cancer is a common tumor and currently the second leading cause of cancer-related mortality globally. Liver cancer is highly related to inflammation as more than 90% of liver cancer arises in the context of hepatic inflammation, such as hepatitis B virus and hepatitis C virus infection. Despite significant improvements in the therapeutic modalities for liver cancer, patient prognosis is not satisfactory due to the limited efficacy of current drug therapies in anti-metastatic activity. Therefore, developing new effective anti-cancer agents with anti-metastatic activity is important for the treatment of liver cancer. In this study, SP-8356, a verbenone derivative with anti-inflammatory activity, was investigated for its effect on the growth and migration of liver cancer cells. Our findings demonstrated that SP-8356 inhibits the proliferation of liver cancer cells by inducing apoptosis and suppressing the mobility and invasion ability of liver cancer cells. Functional studies revealed that SP-8356 inhibits the mitogen-activated protein kinase and nuclear factor-kappa B signaling pathways, which are related to cell proliferation and metastasis, resulting in the downregulation of metastasis-related genes. Moreover, using an orthotopic liver cancer model, tumor growth was significantly decreased following treatment with SP-8356. Thus, this study suggests that SP-8356 may be a potential agent for the treatment of liver cancer with multimodal regulation.

Mixed Adenoneuroendocrine Gastric Carcinoma: A Case Report and Review of the Literature

  • Levi Sandri, Giovanni Battista;Carboni, Fabio;Valle, Mario;Visca, Paolo;Garofalo, Alfredo
    • Journal of Gastric Cancer
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    • 제14권1호
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    • pp.63-66
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    • 2014
  • We present a rare case of a gastric mixed adenoneuroendocrine tumor and review the related English literature. A 77-year-old Caucasian woman was admitted to our department with nausea, anorexia, weight loss, and anemia. Esophagogastroduodenoscopy showed a large (>7 cm) ulcerative mass in the greater curvature of the stomach. Biopsy showed the presence of an adenocarcinoma with moderate differentiation. The patient underwent D2 subtotal gastrectomy. Histopathological analysis revealed a diagnosis of mixed gastric adenoneuroendocrine carcinoma. The post-operative course was uneventful, and at the 6-month follow-up, the patient was alive without evidence of recurrence. Our review of the English literature suggested that such cases are most often reported from eastern countries. Multimodal treatment should be the aim for these patients because of the neuroendocrine component of the tumor.

Accuracy of image registration for radiation treatment planning using a brain phantom

  • Jin, Ho-Sang;Suh, Tae-Suk;Song, Ju-Young;Juh, Ra-Hyeong;Kwark, Chul-Eun;Lee, Hyoung-Koo;Choe, Bo-Young
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2002년도 제7차 학술대회 초록집
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    • pp.106-106
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    • 2002
  • Purpose: The purposes of our study are (1) to develop a brain phantom which can be used for multimodal image registration, (2) to evaluate the accuracy of image registration with the home-made phantom. Method: A brain phantom which could be used for image registration technique of CT-MR and CT-SPECT images using chamfer matching was developed. The brain phantom was specially designed to obtain imaging dataset of CT, MR, and SPECT. The phantom had an external frame with 4 N-shaped pipes filled with acryl rods for CT, MR imaging and Pb rods for SPECT imaging. 8 acrylic pipes were inserted into the empty space of the brain phantom to be imaged for geometric evaluation of the matching. Accuracy of image fusion was assessed by the comparison between the center points of the section of N-shaped bars in the external frame and the inserted pipes of the phantom. Technique with partially transparent, mixed images using color on gray was used for visual assessment of the image registration process.

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Feasibility Study of Determining the Healing Phase of Achilles Tendon Rupture in Rats Using Optical Coherence Tomography

  • Kim, Young-Sik;Chae, Yu-Gyeong;Jeon, Min Yong;Kim, Dong Kyu;Ahn, Yeh-Chan
    • Journal of the Optical Society of Korea
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    • 제19권2호
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    • pp.175-181
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    • 2015
  • Optical coherence tomography (OCT) is a noninvasive technique for microscopic investigation of tissue. We thought that the OCT method could be a potential tool for monitoring the healing process of a tendon. In this study we used two rat models, denervated and non-denervated groups, to observe a variety of healing phases of Achilles tendon (AT) injury. We made samples of AT injury lesions, to take OCT images and to make histopathological samples of serial sectional tissue. In an OCT image the denervated rat showed no specific finding, but the non-denervated rat showed a large defect lesion that was scaffolding tissue. OCT findings combined with pathologic findings showed advantages in visualization of tendon microstructure over other imaging modalities such as MRI and US, and OCT is beneficial to making a treatment plan, especially the timing and intensity of rehabilitation. Therefore a multimodal platform using OCT for evaluation of tendon injury may be potentially useful for many applications.

Fast MRI in Acute Ischemic Stroke: Applications of MRI Acceleration Techniques for MR-Based Comprehensive Stroke Imaging

  • You, Sung-Hye;Kim, Byungjun;Kim, Bo Kyu;Park, Sang Eun
    • Investigative Magnetic Resonance Imaging
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    • 제25권2호
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    • pp.81-92
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    • 2021
  • The role of neuroimaging in patients with acute ischemic stroke has been gradually increasing. The ultimate goal of stroke imaging is to make a streamlined imaging workflow for safe and efficient treatment based on optimized patient selection. In the era of multimodal comprehensive imaging in strokes, imaging based on computed tomography (CT) has been preferred for use in acute ischemic stroke, because, despite the unique strengths of magnetic resonance imaging (MRI), MRI has a longer scan duration than does CT-based imaging. However, recent improvements, such as multicoil technology and novel MRI acceleration techniques, including parallel imaging, simultaneous multi-section imaging, and compressed sensing, highlight the potential of comprehensive MR-based imaging for strokes. In this review, we discuss the role of stroke imaging in acute ischemic stroke management, as well as the strengths and limitations of MR-based imaging. Given these concepts, we review the current MR acceleration techniques that could be applied to stroke imaging and provide an overview of the previous research on each essential sequence: diffusion-weighted imaging, gradient-echo, fluid-attenuated inversion recovery, contrast-enhanced MR angiography, and MR perfusion imaging.

Relationship between Postural Balance Training and Fall Risks for Elderly: a Systematic Review of Randomized Controlled Trials

  • Kim, Heesuk;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • 제10권2호
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    • pp.185-196
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    • 2021
  • Objective: Falling is one of main accident to facilitate the physical injuries in order adults. The purpose of the systematic review was to determine the effects of postural balance training whether the recovery of falls in elderly with normal physical function or not throughout summing the selected studies quantitatively. Design: A systematic review Methods: MEDLINE and other four databases were searched up to April 20, 2021 and randomized controlled trials (RCTs) evaluating postural balance approaches on fall risks in elderly. The researched studies excluded the double studies, titles and abstract, and finally full-reported study. The selected RCTs studies were extracted characteristics of the studies and summary of results based on PICOS-SD (population, intervention, comparison, outcomes, and setting- study design) model to synthesize the papers qualitatively. Results: The review involved 22 RCT reports with 4,847 community older adults aged 65 years or over. Nineteen of the selected RCT studies reported dual or multimodal exercises show the beneficial effect for older adults compared to one-type treatment or no intervention. All of selected showed low risk in the selection, attrition, and reporting bias. However, detection bias showed low risk at 75% records of the involved RCTs and performance bias was low risk at only three records. Conclusions: The results of the systematic review propose that a standardized therapeutic approach and the intensity are needed for improving risk of falls in older adults.