• Title/Summary/Keyword: Multi-therapy

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Surgical Intervention of Undifferentiated Cardiac Sarcoma with Metastases (원격전이된 미분화성 심장육종의 수술치험)

  • 신재승;김학제;최영호;김현구;백만종
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.432-435
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    • 2000
  • We report a case of primary undifferentiated cardiac sarcoma. The tumor originated from the left atrial free wall with multi-organ metastases, e.g., lung, and adrenal gland. The patient gradually grew worse with dyspnea and hemoptysis because of the obstructed left atrial outflow. Surgical resection of the left atrial sarcoma was undertaken to save the patient's life, followed by chemotherapy and brain irradiation as adjuvant therapy. The prognosis of cardiac sarcoma with metastases is very poor. However, in patients with hemodynamic instability, surgical intervention could be a therapeutic modality as palliation.

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Effect of Home-based Multi-Component Activity Program (Home-MAP) for mild Alzheimer's Disease Patients and Caregivers (경도 알츠하이머 치매환자와 보호자를 위한 가정기반 다요인 활동 프로그램(Home-based Multi-component Activities Program: Home-MAP)의 효과)

  • Hwang, Yun-Jung;Jeong, Won-Mee;Lee, Dong-Young
    • The Korean Journal of Health Service Management
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    • v.9 no.3
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    • pp.255-266
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    • 2015
  • Objective : The aim of this study was to examine the effects of the Home-based Multi-component Activity Program (Home-MAP) for the maintenance activities of daily living (ADL) for patients with mild Alzheimer's disease (AD) and on caregiver burden for caregivers. Methods : Nine mild AD patients and family caregivers. The Home-MAP was performed 1d/wk, for a total of 10 times over 10 weeks. Results : After the 10 sessions, participants' motor and process skills scores on the AMPS were found to have significantly improved (p=.028 and p=.028, respectively). The BPSD frequency score on the R-MBPC was found to be significantly reduced (p=.017). The BPSD symptoms related to caregiver reaction score on the R-MBPC and distress score on the NPI-Q were significantly reduced (p=.039 and p=.018, respectively). Conclusions : The Home-MAP appears to have contributed to the improvement of patients' capabilities in performing in ADL, to a reduction of BPSD, and to a reduction of burden related to BPSD.

Comparison and Evaluation of radiotherapy plans by multi leaf collimator types of Linear accelerator (선형가속기의 다엽콜리메이터 형태에 따른 치료계획 비교 평가)

  • Lim, Ji Hye;Chang, Nam Joon;Seok, Jin Yong;Jung, Yun Ju;Won, Hui Su;Jung, Hae Youn;Choi, Byeong Don
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.129-138
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    • 2018
  • Purpose : An aim of this study was to compare the effect of multi leaf collimator(MLC) types for high dimension radiotherapy in treatment sites used clinically. Material and Method : 70 patients with lung cancer, spine cancer, prostate cancer, whole pelvis, head and neck, breast cancer were included in this study. High definition(HD) MLC of TrueBeam STx (Varian Medical system, Palo Alto, CA) and millenium(M) MLC of VitalBeam (Varian Medical system, Palo Alto, CA) were used. Radiotherapy plans were performed for each patient under same treatment goals with Eclipse (Version 13.7, Varian Palo Alto USA, CA). To compare the indicators of the radiotherapy plans, planning target volume(PTV) coverage, conformity index(CI), homogeneity index(HI), and clinical indicators for each treatment sites in normal tissues were evaluated. To evaluate low dose distribution, $V_{30%}$ values were compared according to MLC types. Additionally, length and volume of targets for each treatment sites were investigated. Result : In stereotatictic body radiotherapy(SBRT) plan for lung, the average value of PTV coverage was reduced by 0.52 % with HD MLC. With SBRT plan using HD MLC for spine, the average value of PTV coverage decreased by 0.63 % and maximum dose decreased by 1.13 %. In the test of CI and HI, the values in SBRT plan with HD MLC for spine were 1.144, 1.079 and the values using M MLC were 1.160, 1.092 in SBRT plan for lung, The dose evaluation of critical organ was reduced by 1.48 % in the ipsilateral lung mean dose with HD MLC. In prostate cancer volumetric modulated arc therapy(VMAT) with HD MLC, the mean dose and the $V_{30}$ of bladder and the mean dose and the $V_{25}$ of rectum were reduced by 0.53 %, 1.42 %, 0.97 %, and 0.69 %, respectively (p<0.05). The average value of heart mean dose was reduced by 0.83 % in breast cancer VMAT with M MLC. Other assessment indices for treatment sites showed no significant difference between treatment plans with two types of MLC. Conclusion : Using HD MLC had a positive impact on the PTV coverage and normal tissue sparing in usually short or small targets such as lung and spine SBRT and prostate VMAT. But, there was no significant difference in targets with long and large such as lung, head and neck, and whole pelvis for VMAT.

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Correction of Prompt Gamma Distribution for Improving Accuracy of Beam Range Determination in Inhomogeneous Phantom

  • Park, Jong Hoon;Kim, Sung Hun;Ku, Youngmo;Lee, Hyun Su;Kim, Young-su;Kim, Chan Hyeong;Shin, Dong Ho;Lee, Se Byeong;Jeong, Jong Hwi
    • Progress in Medical Physics
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    • v.28 no.4
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    • pp.207-217
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    • 2017
  • For effective patient treatment in proton therapy, it is therefore important to accurately measure the beam range. For measuring beam range, various researchers determine the beam range by measuring the prompt gammas generated during nuclear reactions of protons with materials. However, the accuracy of the beam range determination can be lowered in heterogeneous phantoms, because of the differences with respect to the prompt gamma production depending on the properties of the material. In this research, to improve the beam range determination in a heterogeneous phantom, we derived a formula to correct the prompt-gamma distribution using the ratio of the prompt gamma production, stopping power, and density obtained for each material. Then, the prompt-gamma distributions were acquired by a multi-slit prompt-gamma camera on various kinds of heterogeneous phantoms using a Geant4 Monte Carlo simulation, and the deduced formula was applied to the prompt-gamma distributions. For the case involving the phantom having bone-equivalent material in the soft tissue-equivalent material, it was confirmed that compared to the actual range, the determined ranges were relatively accurate both before and after correction. In the case of a phantom having the lung-equivalent material in the soft tissue-equivalent material, although the maximum error before correction was 18.7 mm, the difference was very large. However, when the correction method was applied, the accuracy was significantly improved by a maximum error of 4.1 mm. Moreover, for a phantom that was constructed based on CT data, after applying the calibration method, the beam range could be generally determined within an error of 2.5 mm. Simulation results confirmed the potential to determine the beam range with high accuracy in heterogeneous phantoms by applying the proposed correction method. In future, these methods will be verified by performing experiments using a therapeutic proton beam.

Determination of Self-Disposal date by the Analysis of Radioactive Waste Contamination for 1131I Therapy Ward (131I 치료입원실 폐기물 방사능 오염도 분석 및 자체처분가능일자 산출)

  • Kim, Gi-sub;Jung, Haijo;Park, Min-seok;Jeon, Gjin-seong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.3-6
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    • 2013
  • Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

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Anterior Talofibular Ligament and Superior Extensor Ankle Retinaculum Thicknesses: Relationship with Balance

  • Malloy, Brooke;Furrow, David;Cook, Haily;Smoot, Elizabeth;Cash, Lindsey;Aron, Adrian;Jagger, Kristen;Harper, Brent
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.173-182
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    • 2019
  • Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

A Comparative Study on the Working Memory and the Phonological Awareness between Children with Multi-cultural Families and General Families (다문화아동과 일반아동의 작업기억 및 음운인식 능력 비교 연구)

  • Park, Yoo Rin;Kwon, Do Ha
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5025-5032
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    • 2012
  • The purpose of this study is to compare the working memory and the phonological awareness between Children with multi-cultural families and general families. The research subjects were 15 multi-cultural and 15 general primary school students who were attending 1st-3rd grade in D city. Working memory tested K-TTFC-2 by standardized tool. Phonological awareness abilities was considering the age of the subjects, tested phoneme awareness. Data process was conducted by t -test and frequency test in SPSS program. The results were as follows. First, working memory comparison of both groups showed significant differences. Especially had significant difference in chapter 1, chapter 4. Second, comparison of phonological awareness between both groups showed significant statistic differences. Third, the Phonological awareness comparison of both groups showed that there are differences in sound matching(word medial coda), substituting middle sound in monosyllabic words, phoneme switching. This research result is considered that can be used as the fundamental data for the development of the therapy data considering the working memory and the phonological awareness of children with multi-cultural families.

The Clinical Study of 35 Admission Patients to Oriental Medical Hospital due to Thoraco-Lumbar Compression Fracture (흉요추부 압박골절 진단을 받고 한방병원에 입원한 환자 35명에 대한 임상적 고찰)

  • Jin, Eun-Seok;Koh, Dong-Hyun;Kim, Ha-Neul;Kim, Joo-Won;Hong, Soon-Sung;Kim, Han-Kyum;Lee, Jin-Hyuk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.19-27
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    • 2008
  • Objective : The purpose of this study is to investigate the results of korean traditional conservative therapy for thoraco-lumbar compression fracture and it's recovery rate and different result in accordance with sex, age, medical history. Method : We studied about 35 cases who were admitted to Jaseng Hospital of Oriental Medicine with diagnosis of 'Thoraco lumbar compression fracture' with X-ray examination. Result : Out of 35 patients 31 patients discharged with satisfying results. Most of the compression fracture occurred in age of $60{\sim}70$. And the single fractured patients recovered more easily than the multi-level fractured patients. It didn't affect the results whether the patient had another vertebral disease(such as Herniated intervertebral disc or osteoporosis) or not. And most of the patients who had vertebral compression fracture visited the western medicine hospital first. Conclusions : We analyzed the tendency of the patients who had vertebral compression fracture, and concluded that the conservative Korean traditional therapy is an effective means of treatment for the patients who have thoraco-lumbar compression fracture.

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