• Title/Summary/Keyword: Combined modality therapy

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The Effects of Mobilization on the Pain and Recovery of Function of Acute Low Back Pain Patients (관절가동기법이 급성요통환자의 통증과 기능회복에 미치는 영향)

  • Lee, In-Hak;Koo, Chang-Hoi;Park, Kyoung-Lee;Bae, Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.18 no.1
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    • pp.41-51
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    • 2006
  • Purpose: The purpose of this study was to investigate effects of mobilization combined active movement(SNAGS) on the pain and recovery of function of acute low back pain patients. Methods: The subjects were consisted of 135 patients with acute low back pain. All subjects randomly assigned to mobilization group, stretching exercise group and modality treatment group. The mobilization group received mobilization combined active movement(SNAGS) with modality treatment, exercise group received stretching exercise with modality treatment and modality treatment group received modality treatment. Visual Analogue Scale(VAS) was used to measure patient's pain level and Patient Specific Functional Scale(PSFS) was used to measure patient's functional disability level. Results: The results of this study were summarized as follows : 1. Visual Analogue Scale(VAS) was mobilization group showed significantly decreased more than comparison group(p<.01) and active treatment group showed significantly decreased more than passive treatment group(p<.01). 2. Patient Specific Functional Scale(PSFS) was mobilization group showed significantly increased more than comparison group(p<.01) and active treatment group showed significantly increased more than passive treatment group(p<.01). Conclusion: It maybe suggested that mobilization combined active movement(SNAGS) is beneficial treatment for acute low back pain patient.

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Combined-Modality Treatment of Vocal Cord Atrophy with Thyroplasty Type I and Voice Therapy (제1형 갑상성형술과 음성치료에 의한 성대위축증의 치료)

  • 안철민;김현호
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.33-37
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    • 1997
  • Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

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A Combined Therapy of Steroid Injection, Silicone Gel Sheeting, and Laser for Hypertrophic Scar and Keloid (스테로이드 주사, 실리콘 겔 판, 레이져 병합요법을 이용한 부푼 흉터와 흉터종의 치료)

  • Choi, Sang Rok;Yoon, Min Ho;Dong, Eun Sang;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.700-705
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    • 2006
  • Purpose: For hypertrophic scars and keloids no universally effective treatment modality exists. Surgical revision, intralesional steroid injection, silicone gel sheeting, pressure, laser, and others have been used with variable success, but many treatments are associated with high recurrence rates. Although optimal treatment remains undefined, successful treatment can be obtained through a combined therapeutic approach. Methods: We used three therapeutic modalities in combination, which are intralesional injection of triamcinolone acetonide, silicone gel sheeting, and 585 nm flashlamp-pumped pulsed dye laser. Fifty-eight cases of hypertrophic or keloid scar were treated by combined therapeutic regimen for mean period of 18 months. The changes of thickness, color, and pliability of scars were evaluated with clinical photographs by grading scale. Results: As summing the grades and categorizing the result into three group, we obtained 28% good, 67% fair, and 5% poor results. There was a desirable improvement of scars with insignificant adverse effects. Conclusion: Combination of intralesional steroid injection, silicone gel sheeting, and pulsed dye laser can lead to successful treatment of hypertrophic scar and keloid.

Combined Modality Therapy of Non-Hodgkin's Lymphoma of Waldeyer's Ring (Waldeyer's Ring 비호치킨 림프종의 병합요법)

  • Park In-Kyu;Yun Sang-Mo;Park Jun-Sik;Kim Jae-Cheol
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.22-28
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    • 1999
  • Purpose: We performed this study retrospectively to evaluate local control, survival, prognostic factors, and failure patterns in patients with non-Hodgkin's lymphoma of Waldeyer's ring. Materials and Methods: From April 1984 to November 1996,41 patients with non-Hodgkin's lymphoma of Waldeyer's ring were treated with combined chemotherapy and radiation therapy. Age was ranged from 19 to 73 years old with a median age of 55 years, and there were 26 male and 15 female patients. Primary site was tonsil in 26 and base of the tongue in 7 and nasopharynx in 8, and stage distribution showed stage I in 12 and stage II in 29 patients. Pathologic classification was done according to Working Formulation. There were 1 with follicular mixed small cleaved and large cell, 8 with diffuse small cleaved cell, 7 with diffuse mixed small and large cell, and 25 cases with diffuse large cell. All patients were treated with combination of chemotherapy and radiation therapy. Chemotherapy regimen consisted of either CHOP-Bleo(cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin) or COP-BLAM III(cyclophosphamide, vincristine, prednisolone, bleomycin, adriamycin, procarbazine). Radiation dose ranged from 3600cGy to 6620cGy with a median dose of 5040cGy. Follow-up time was ranged from 15 months to 159 months(median 55 months). Results: The complete response was achieved in 98%(40/41) and partial response in 2%(1/41). The complete response rate were the followings: 66.7% for stage I and 51.7% for stage II after chemotherapy, 100% for stage I and 96.6% for stage II after overall treatment respectively. The overall survival rate and disease-tree survival rates at 5 years were 82.6% and 79.5%, respectively. Prognostic factors for overall survival were age(p=0.007), stage(p=0.03), nodal status(p=0.006) and radiation dose(p=0.003). The factors associated with disease-tree survival were stage(p=0.04), nodal status(p=0.004) and radiation dose(p=0.009). The failure patterns were analized in evaluable 35 patients with complete response. Locoregional failure was noted in 2 patients and distant metastasis in 5 patients. Conclusion: Our results suggest that combined modality therapy is the appropriate treatment for stage I-II intermediate grade non-hodgkin's lymphoma of the Waldeyer's ring. However, our material is small and the analysis is retrospective. Randomized prospective studies for combined therapy, radiation therapy alone and chemotherapy alone are needed.

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Effects of Radiotherapy on the Risk of Developing Secondary Malignant Neoplasms in Hodgkin's Lymphoma Survivors

  • Abou-Antoun, Tamara;Mikhael, Rachelle;Massoud, Marcel;Chahine, Georges;Saad, Aline
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.749-754
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    • 2016
  • Extended follow-up of Hodgkin lymphoma (HL) survivors indicates that these patients are at high risk of secondary malignant neoplasms (SMNs) contributing to increased morbidity and mortality. This study examined the characteristics of HL survivors who developed SMNs with the aim to report any correlation with radiotherapy (RT) dose. In this retrospective multi-center cohort study of HL patients treated between 1990 and 2011 at three major teaching hospitals in Lebanon, classification was into two groups including those treated with combined modality (RT and chemotherapy-CHT) and those treated with CHT alone. Approval from the University Institutional Review Board (IRB) was obtained. Of the 112 patients evaluated, 52.7% (59) received the combined modality while 47.3% (53) received CHT alone. There were 6 cases of SMNs in the combined modality cohort and 5 cases in the CHT cohort. The mean RT dose in the combined modality cohort was 34.5 Gray (Gy) ($SD{\pm}5.3$). A statistically significant increase (1.5 fold) in the risk of developing SMNs was observed among patients who received a dose higher than 41 Gy compared to a dose between 20 to 30 Gy (OR= 1.5; 95% confidence interval= 0.674 to 3.339, p=0.012). The risk of SMNs was not significantly higher among patients who received extended field compared to involved field RT (p=0.964). This study showed that the risk of developing SMNs is higher among patients treated with RT dose greater than 31 Gy, independent of the RT type used.

Enhanced Susceptibility of Human Squamous Cell Carcinoma to Photodynamic Therapy Combined with Administration of Cisplatin

  • Ahn, Jin-Chul;Chung, Pil-Sang;Park, Byung-Kuhn
    • Biomedical Science Letters
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    • v.14 no.2
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    • pp.83-89
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    • 2008
  • We have compared the antitumor effect of photodynamic therapy (PDT), using 5-aminolevulinic acid (ALA) as the photosensitizer, combined with cisplatin (CDDP) on AMC-HN3 human squamous cell carcinoma. AMC-HN3 cells were cultured and then incubated with various concentrations of CDDP and ALA. 632 nm diode laser was given at $6.0J/cm^2$ followed by incubation for 24 hours. The evaluation of cell viability was done by MTT assay. In vivo CDDP was injected intraperitoneally 24 hours prior to PDT. The anti-tumor effects of each treatment were measured by tumor volume change. Cell viability were 44.29% for the cisplatin-mediated chemotherapy group $(6.25{\mu}g/ml)$, 77.22% for ALA-PDT group, and 15.06% for the Combination therapy group. In vivo, the antitumor effect of photodynamic therapy was enhanced by combination of Cisplatin-mediated chemotherapy. Photodynamic therapy combined with administration of Cisplatin appears to enhance antitumor effect and to be a useful treatment modality.

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Ewing's Sarcoma of the Stomach; Rare Case of Ewing's Sarcoma and Suggestion of New Treatment Strategy

  • Kim, Hyo-Sin;Kim, Sungsoo;Min, Young-Don;Kee, Keun-Hong;Hong, Ran
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.258-261
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    • 2012
  • Ewing's sarcoma is a neoplasm of the undifferenciated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. We present a case of gastric Ewing's sarcoma; a 35-year-old female who had no symptoms. While she was at a routine medical checkup, a protruding mass in her gastric antrum was incidentally found on esophagogastroduodenoscopy. Endoscopic ultrasonogram showed a submucosal mass on the same lesion and a laparosopic wedge resection was done. Pathologic gross findings showed a granular grape appearance tissue and histoloigc examination revealed a small round cell tumor with CD 99 immunoexpression positive. In general, a combined modality therapy for Ewing's sarcoma such as surgical resection with chemotherapy, is accepted as an effective method. However, this patient had no adjuvant chemotherapy after surgery and she has no recurrence for eleven months.

The Effect of Sit to Stand Training Combined with Ultrasound on Spasticity, Muscle Strength and Gait Speed in Patients with Stroke

  • Jung, Kyoungsim;In, Taesung
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.344-349
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    • 2022
  • Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.

The Evaluation of Radiation Therapy and Combined-modality Therapy for Non-small-cell Lung Cancer in Elderly (고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가)

  • Yoon, Won-Sup;Yang, Dae-Sik;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.101-108
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    • 2007
  • [ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.