• Title/Summary/Keyword: non-muscle-invasive

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Diabetes is an Important Risk Factor for Metastasis in Non-Muscle-Invasive Bladder Cancer

  • Ozer, Kutan;Horsanali, Mustafa Ozan;Gorgel, Sacit Nuri;Ozbek, Emin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.105-108
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    • 2016
  • Background: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by independent samples t test, and relations between categorical variables were investigated by non-parametric chi-square test. A p value of 0.05 was accepted as statistically significant in comparisons. Results: We analyzed 418 patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1) and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). Conclusions: Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may be necessary. Further prospective studies with more patients are needed to confirm these findings.

Results of Intravesical Chemo-Hyperthermia in High-risk Non-muscle Invasive Bladder Cancer

  • Ekin, Rahmi Gokhan;Akarken, Ilker;Cakmak, Ozgur;Tarhan, Huseyin;Celik, Orcun;Ilbey, Yusuf Ozlem;Divrik, Rauf Taner;Zorlu, Ferruh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3241-3245
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    • 2015
  • Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer. Materials and Methods: Between November 2011-September 2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermia in two centers were evaluated retrospectively. Treatment consisted of 6 weekly sessions, followed by 6 sessions. Recurrence and progression rate, recurrence-free interval and side effects were examined. Analyzed factors included age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CIS assets. The associations between predictors and recurrence were assessed using multivariate Cox proportional hazard analyses. Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosed with tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was 23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24 months were 82% and 61%. There was no statistically significant difference between patient subgroups. Cox hazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrence-free. Adverse effects were seen in 53% of patients and these were frequently grades 1 and 2. Conclusions: Intravesical therapy with combination of mitomycin-C and chemohyperthermia seems to be appropriate in high-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications for standard BCG therapy.

Review of Bladder cancer (방광암의 이해)

  • You, Hyun Wook
    • The Journal of the Korean life insurance medical association
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    • v.33 no.2
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    • pp.18-24
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    • 2014
  • Bladder cancer is one of the most common cancers affecting men and women and thus has a profound impact on health care. The majority of patients (75%) with newly diagnosed urothelial tumors have non-muscle invasive disease confined to the bladder mucosa or the lamina propria. The most important risk factors for the development of bladder cancer are smoking and occupational exposure to toxic chemicals. Painless visible hematuria is the most common presenting symptom of bladder cancer. Cystoscopy and urine cytology are currently the recommended tools for diagnosis of bladder cancer. Excluding muscle invasion is an important diagnostic step, as outcomes for patients with muscle invasive bladder cancer (MIBC) are less favorable. For non-muscle invasive bladder cancer (NMIBC), the high rate and frequency of recurrence and the concern for disease progression - especially in patients with high-risk tumors - mandate careful strategies for tumor surveillance. The surveillance strategies should be based on available prognostic factors and in particular data from the EORTC risk tables.

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Muscular Adaptations and Novel Magnetic Resonance Characterizations of Spinal Cord Injury

  • Lim, Woo-Taek
    • Physical Therapy Korea
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    • v.22 no.2
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    • pp.70-80
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    • 2015
  • The spinal cord is highly complex, consisting of a specialized neural network that comprised both neuronal and non-neuronal cells. Any kind of injury and/or insult to the spinal cord leads to a series of damaging events resulting in motor and/or sensory deficits below the level of injury. As a result, muscle paralysis (or paresis) leading to muscle atrophy or shrinking of the muscle along with changes in muscle fiber type, and contractile properties have been observed. Traditionally, histology had been used as a gold standard to characterize spinal cord injury (SCI)-induced adaptation in spinal cord and skeletal muscle. However, histology measurements is invasive and cannot be used for longitudinal analysis. Therefore, the use of conventional magnetic resonance imaging (MRI) is promoted to be used as an alternative non-invasive method, which allows the repeated measurements over time and secures the safety against radiation by using radiofrequency pulse. Currently, many of pathological changes and adaptations occurring after SCI can be measured by MRI methods, specifically 3-dimensional MRI with the advanced diffusion tensor imaging technique. Both techniques have shown to be sensitive in measuring morphological and structural changes in skeletal muscle and the spinal cord.

-On Acupoints & Trigger Points- Muscle fatigue evaluation using the Micro-electromagnetic stimulation (-경혈 및 트리거 포인트에서- 미약 자기장을 이용한 근피로 회복 평가)

  • Kim, Soo-Byung;Lee, Na-Ra;Shim, Tae-Kyu;Lee, Seung-Wook;Lee, Yong-Heum
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.14 no.5
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    • pp.1231-1239
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    • 2010
  • The aim of this study was developing the non-invasive focused magnetic stimulation system(NI_FMSS) that can stimulates acupoints which are small parts and knotted muscular tissues. To evaluate pain treatment effect of the NI_FMSS, we caused muscle fatigue to 25 subjects in biceps of the arm. Then, we stimulated acupoints(trigger points) HT2 using low frequency stimulator(10 subjects) and NI_FMSS(10 subjects). The other 5 subjects had not been stimulated. We analyzed muscle fatigue recovery with median frequency, RMS and median power in frequency domain for 5 days. We checked the magnetic stimulation effect on acupoint by evaluation of muscle fatigue recovery. Therefore, we identified that the NI_FMSS was more efficient system to relieve muscle pain than electric-stimulation system.

A Novel Molecular Grading Model: Combination of Ki67 and VEGF in Predicting Tumor Recurrence and Progression in Non-invasive Urothelial Bladder Cancer

  • Chen, Jun-Xing;Deng, Nan;Chen, Xu;Chen, Ling-Wu;Qiu, Shao-Peng;Li, Xiao-Fei;Li, Jia-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2229-2234
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    • 2012
  • Purpose: To assess efficacy of Ki67 combined with VEGF as a molecular grading model to predict outcomes with non-muscle invasive bladder cancer (NMIBC). Materials: 72 NMIBC patients who underwent transurethral resection (TUR) followed by routine intravesical instillations were retrospectively analyzed in this study. Univariate and multivariate analyses were performed to confirm the prognostic values of the Ki67 labeling index (LI) and VEGF scoring for tumor recurrence and progression. Results: The novel molecular grading model for NMIBC contained three molecular grades including mG1 (Ki67 $LI{\leq}25%$, VEGF $scoring{\leq}8$), mG2 (Ki67 LI>25%, VEGF $scoring{\leq}8$; or Ki67 $LI{\leq}25%$, VEGF scoring > 8), and mG3 (Ki67 LI > 25%, VEGF scoring > 8), which can indicate favorable, intermediate and poor prognosis, respectively. Conclusions: The described novel molecular grading model utilizing Ki67 LI and VEGF scoring is helpful to effectively and accurately predict outcomes and optimize personal therapy.

Magnetic Resonance Imaging as a Biomarker for Duchenne Muscular Dystrophy

  • Lim, Woo-taek
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.98-105
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    • 2015
  • Muscular dystrophy is a hereditary musculoskeletal disorder caused by a mutation in the dystrophin gene. Duchenne muscular dystrophy (DMD) is one of the most common, and progresses relatively faster than other muscular dystrophies. It is characterized by progressive myofiber degeneration, muscle weakness and ultimately ambulatory loss. Since it is an X-linked recessive inheritance, DMD is mostly expressed in males and rarely expressed or less severe in females. The most effective measurement tool for DMD is magnetic resonance imaging (MRI), which allows non-invasive examination of longitudinal measurement. It can detect progressive decline of skeletal muscle size by measuring a maximal cross-sectional area of skeletal muscle. Additionally, other techniques in MRI, like $T_2$-weighted imaging, assess muscle damage, including inflammation, by detecting changes in $T_2$ relaxation time. Current MRI techniques even allow quantification of metabolic differences between affected and non-affected muscles in DMD. There is no current cure, but physical therapist can improve their quality of life by maintaining muscle strength and function, especially if treatment (and other forms of medical intervention) begins in the early stages of the disease.

Effects of Swallowing Training Program for Nursing Home Residents with Stroke (요양시설 거주 뇌졸중 노인을 위한 연하 훈련 프로그램의 효과)

  • Kim, Haesook;Lim, Kyung-Choon
    • Journal of muscle and joint health
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    • v.30 no.3
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    • pp.230-241
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    • 2023
  • Purpose: This study aimed to verify the effects of a swallowing training program on swallowing function and depression for nursing home residents with dysphagia after stroke. Methods: This is a quasi-experimental study with non-equivalent control group pre-post test design. The program (oro-facial muscle strengthening exercises, swallowing exercises, expiratory muscle strengthening exercises, and brain stimulation exercises) applied to the experimental group three times per week for eight weeks, 40-45 minutes for each intervention. The final data from 42 people (21 experimental and 21 control) were analyzed by SPSS/WIN 25.0 using descriptive statistics. 𝜒2 test, t-test, Wilcoxon rank sum test, and Friedman test. Results: The experimental group was significantly improved than control group in oro-facial muscle strength, swallowing symptoms (Z=-2.22, p=.026), and oral intake function level (Z=-2.00, p=.046). However, there was no significant difference between two groups in depression. Conclusion: This study is meaningful in that it reorganized and mediated a swallowing training program as a safe, non-invasive exercise that nurses can implement in a nursing facility with limited medical personnel and it could be easily followed by older adults.

Demographic and Survivorship Disparities in Non-muscle-invasive Bladder Cancer in the United States

  • Seo, Munseok;Langabeer, James R. II
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.242-247
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    • 2018
  • Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

Age Related Analysis of Ultrasound Images of Normal Skeletal Muscle (연령에 따른 정상 골격근의 초음파 영상 분석)

  • Jeong, Jin-Gyu;Kim, Kye-Yoep;Kim, Jong-Man;Ki, Tae-Youl
    • Physical Therapy Korea
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    • v.13 no.1
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    • pp.47-53
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    • 2006
  • Since ultrasound has different reflections depending on components of organization, analysis of ultrasound images of skeletal muscle can offer both quantitative and qualitative reports as concerns skeletal muscle structure. This study is focused on the ultrasound method for evaluating the structural characteristics of skeletal muscle and also conducted to examine its practicality. After obtaining images of the elbow flexors from an ultrasound image device with 88 normal subjects whose ages were between twenty and seventy years old (44 men and 44 women), muscular density and white area index (WAI) which indicated structural characteristics of skeletal muscle were analyzed with gray scale analysis. The study examined correlations between subject's age and items which obtained from measuring ultrasound images and the differences in relations to sex and age. Muscular density and WAI had a high correlation with age and were significantly increased in men and women with greater age. The quantitative evaluation method of skeletal muscle structure which analyzed the ultrasound images has high practicality because it is a non-invasive method which complements physical therapy diagnosis and research methods and promotes functionality evaluation.

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