• Title/Summary/Keyword: Pelvic RT

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Case study of application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance (골반 불균형에 의한 편측체중지지 요통환자의 골반도수교정 적용사례)

  • Kim, Han-Il;Kim, Sang-Su;Kim, Gee-Sun;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.72-78
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    • 2009
  • Purpose: to recognized that influence of decrease low back pain, change pelvic structure and balance control on unilateral weight bearing after application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance. Methods: The patient with low back pain in unilateral weight bearing due to pelvic imbalance was 39year female. one subject received intervention of pelvic manipulation on sidelying position and reaching exercise on sitting position which during 2 weak at the 3 time per a weak, each 30 minutes. outcomes measured were Facia l Action Coding System(FACS), Radiograph(Lumbar-Spine Anteroposterior AP.), Pressure Scan. Results: The results of this study were summarized below : 1. FACS score were Pre: min.4 - max.6 and Post: min.2 - max.4. 2. Radiograph measured Ilium width were Pre: Lt.14cm, Rt.12.7cm and Post: Lt.13.4cm, Rt.13cm which discrepancy of Ilium height were Pre: 1cm and Post: 0.2cm. 3. Pressure scan measured Pre: Lt. 36.8%, Rt.40.2% and Post: Lt.41.3%, Rt.36.2%. Conclusion: Pelvic manipulation applied a patient with low back pain in unilateral weight bearing due to pelvic imbalance suggest that can decrease low back pain, change pelvic structure and balance control on unilateral weight bearing.

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Management for locally advanced cervical cancer: new trends and controversial issues

  • Cho, Oyeon;Chun, Mison
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.254-264
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    • 2018
  • This article reviewed new trends and controversial issues, including the intensification of chemotherapy and recent brachytherapy (BT) advances, and also reviewed recent consensuses from different societies on the management of locally advanced cervical cancer (LACC). Intensive chemotherapy during and after radiation therapy (RT) was not recommended as a standard treatment due to severe toxicities reported by several studies. The use of positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) for pelvic RT planning has increased the clinical utilization of intensity-modulated radiation therapy (IMRT) for the evaluation of pelvic lymph node metastasis and pelvic bone marrow. Recent RT techniques for LACC patients mainly aim to minimize toxicities by sparing the normal bladder and rectum tissues and shortening the overall treatment time by administering a simultaneous integrated boost for metastatic pelvic lymph node in pelvic IMRT followed by MRI-based image guided adaptive BT.

The Correlation of Foot Pressure with Spinal Alignment in Static Standing (정적 기립 자세에서 족저압 분포와 척추 정렬과의 상관관계 연구)

  • Lim, Jae-Heon;Ko, Hyo-Eun
    • PNF and Movement
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    • v.12 no.1
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    • pp.13-17
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    • 2014
  • Purpose: To determine the normative data for the correlation of spinal, pelvic parameters with foot pressure in the young subjects. Methods: The subjects of this study were 39 patients in healthy adults. The Formetric-III was used to measure of spinal alignment. The pedoscan was used to measure of foot pressure. The correlation of trunk imbalance, trunk inclination, lateral deviation with foot pressure. The foot pressure measurement was consisted of maximal/mean pressure, weight contribution. Result: There was a negative correlation of trunk inclination with Max_R. There was a negative correlation of trunk inclination with Max_R. There was a positive correlation of trunk imbalance with Max_L. There was a positive correlation of lumbar lordosis with Mean_R_front, Lt. posterior weight distribution. There was a negative correlation of lumbar lordosis with Lt., Rt. in distribution There was a negative correlation of pelvic tilt with Mean_R_front, Lt. posterior weight distribution. There was a positive correlation of pelvic tilting with Rt. weight distribution, Lt. posterior weight distribution. There was a negative correlation of pelvic torsion with Lt. weight distribution, Rt. posterior weight distribution. There was a negative correlation of pelvic rotation with Lt. weight distribution, Lt. posterior weight distribution. Conclusion: The data obtained from the study may be used for future studies related to correlation of the spinal, pelvic deviation with foot pressure.

Post Pelvic Radiotherapy Bony Changes (골반 방사선 치료후의 골 변화와 손상)

  • Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.1-9
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    • 2009
  • There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.

Endoscopic findings of rectal mucosal damage after pelvic radiotherapy for cervical carcinoma: correlation of rectal mucosal damage with radiation dose and clinical symptoms

  • Kim, Tae Gyu;Huh, Seung Jae;Park, Won
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.81-87
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    • 2013
  • Purpose: To describe chronic rectal mucosal damage after pelvic radiotherapy (RT) for cervical cancer and correlate these findings with clinical symptoms and radiation dose. Materials and Methods: Thirty-two patients who underwent pelvic RT were diagnosed with radiation-induced proctitis based on endoscopy findings. The median follow-up period was 35 months after external beam radiotherapy (EBRT) and intracavitary radiotherapy (ICR). The Vienna Rectoscopy Score (VRS) was used to describe the endoscopic findings and compared to the European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) morbidity score and the dosimetric parameters of RT (the ratio of rectal dose calculated at the rectal point [RP] to the prescribed dose, biologically effective dose [BED] at the RP in the ICR and EBRT plans, ${\alpha}/{\beta}$ = 3). Results: Rectal symptoms were noted in 28 patients (rectal bleeding in 21 patients, bowel habit changes in 6, mucosal stools in 1), and 4 patients had no symptoms. Endoscopic findings included telangiectasia in 18 patients, congested mucosa in 20, ulceration in 5, and stricture in 1. The RP ratio, $BED_{ICR}$, $BED_{ICR+EBRT}$ was significantly associated with the VRS (RP ratio, median 76.5%; $BED_{ICR}$, median 37.1 $Gy_3$; $BED_{ICR+EBRT}$, median 102.5 $Gy_3$; p < 0.001). The VRS was significantly associated with the EORTC/RTOG score (p = 0.038). Conclusion: The most prevalent endoscopic findings of RT-induced proctitis were telangiectasia and congested mucosa. The VRS was significantly associated with the EORTC/RTOG score and RP radiation dose.

Correlations of Forward Head Posture to Heart Rate Variability and Standing Posture Balance Factors (전방머리자세의 정도와 심박변이도 및 기립자세 균형요소와의 상관관계)

  • Ki, Sung-Hoon;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.163-176
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    • 2014
  • Objectives To investigate the relationship of forward head posture to heart rate variability and standing posture (pelvic tilt, knee flexion, calcaneal eversion). Methods In the present study, thirty two subjects were recruited by convenience sampling. The forward head posture was measured via the craniovertebral (CV) angle. The pelvic tilt angle, the knee flexion angle, the calcaneal eversion angle, and the heart rate variability were measured. The correlations of forward head posture to heart rate variability and standing posture (pelvic tilt, knee flexion, calcaneal eversion) were analyzed. Results In the present results, there was a significant negative correlation between X-ray CV angle and other regions except the headache. There was a weak positive correlation between Posture CV angle and SDNN. Significant positive correlation was found between KFA and difference between Lt. & Rt. CEA. Significant weak negative correlation was found between SDNN and difference between Lt. & Rt. CEA. Conclusions Biomechanical associated with physical pain and heart rate variability, and it is related to the forward head posture changes and also suggest that clinical care is needed for this.

Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

  • Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.48-54
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    • 2017
  • Purpose: This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was $22.8kg/m^2$ (range, 17.7 to $35.9kg/m^2$). Results: The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, $BMI{\geq}23kg/m^2$) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Conclusion: Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

The role of postoperative pelvic radiation in stage IV rectal cancer after resection of primary tumor

  • Lee, Joo Hwan;Jo, In Young;Lee, Jong Hoon;Yoon, Sei Chul;Kim, Yeon-Sil;Choi, Byung Ock;Kim, Jun-Gi;Oh, Seong Taek;Lee, Myeong A;Jang, Hong-Seok
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.205-212
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    • 2012
  • Purpose: To evaluate the effect of pelvic radiotherapy (RT) in patients with stage IV rectal cancer treated with resection of primary tumor with or without metastasectomy. Materials and Methods: Medical records of 112 patients with stage IV rectal cancer treated with resection of primary tumor between 1990 and 2011 were retrospectively reviewed. Fifty-nine patients received synchronous or staged metastasectomy whereas fifty-three patients did not. Twenty-six patients received pelvic radiotherapy. Results: Median overall survival (OS), locoregional recurrence-free survival (LRFS), and progression-free survival (PFS) of all patients was 27, 70, and 11 months, respectively. Pathologic T (pT), N (pN) classification and complete metastasectomy were statistically significant factors in OS (p = 0.040, 0.020, and 0.002, respectively). RT did not improve OS or LRFS. There were no significant factors in LRFS. pT and pN classification were also significant prognostic factors in PFS (p = 0.010 and p = 0.033, respectively). In the subgroup analysis, RT improved LRFS in patients with pT4 disease (p = 0.026). The locoregional failure rate of the RT group and the non-RT group were 23.1% and 33.7%, showing no difference in the failure pattern of both groups (p = 0.260). Conclusion: Postoperative pelvic RT did not improve LRFS of all metastatic rectal cancer patients; however, it can be recommended to patients with pT4 disease. A complete resection of metastatic masses should be performed if possible.

Modulation of $GABA_A$ Receptor by Protein Kinase C in Autonomic Major Pelvic Ganglion Neurons

  • Choi, Yeun-Jong;Cha, Seung-Kyu;Kim, Dae-Ran;Kong, In-Deok
    • Biomedical Science Letters
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    • v.14 no.2
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    • pp.69-76
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    • 2008
  • ${\gamma}$-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the central nervous system, and its actions are mediated by subtypes of GABA receptors named as $GABA_A$, $GABA_B,\;and\;GABA_C,\;GABA_A$, receptor consisting of ${\alpha},\;{\beta},\;{\gamma}\;and\;{\delta}$ subunits is a heterooligomeric ligand-gated chloride channel. This study was performed to investigate regulation of $GABA_A$ receptor by protein kinase C(PKC). Ion currents were recorded using gramicidine-perforated patch and whole cell patch clamp. mRNA encoding the subunits of PKC expressed in major pelvic ganglion (MPG) neurons was detected by using RT-PCR. The GABA-induced inward current was increased by PKC activators and decreased by PKC inhibitors, respectively. These effects were not associated with intracellular $Ca^{2+}$ and GAG (1-oleoyl-2-acetyl-sn-glycerol), a membrane permeable diacylglycerol (DAG) analogue. These results mean that the subfamily of PKC participating in activation of $GABA_A$ receptor would be an atypical PKC (aPKC). Among theses, ${\xi}$ isoform of aPKC was detected by RT-PCR. Taking together, we suggest that excitable $GABA_A$ receptor in sympathetic MPG neuron seemed to be regulated by aPKC, particular in ${\xi}$ isoform. The regulatory roles of PKC on excitatory $GABA_A$ receptors in sympathetic neurons of MPG may be an important factor to control the functional activity of various pelvic organs such as bowel movement, micturition and erection.

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Correlation Analysis between Plantar Pressure and Body Alignment According to the Dominant Hand of Elementary School Baseball Players (초등학교 야구선수들의 우세손에 따른 족저압과 신체 정렬간의 상관관계 분석)

  • Jeong, Mo-Beom
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.3
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    • pp.115-121
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    • 2021
  • PURPOSE: This study analyzed the correlation between the plantar pressure and body alignment according to the dominant hand of elementary school baseball players. METHODS: The subjects consisted of 32 elementary school baseball players. The 32 players were classified in the right-hand dominant group (Rt. Group, n = 22) and left-hand dominant group (Lt. group, n = 10). The plantar pressure was measured using a pedoscan to determine the maximum pressure and pressure distribution. The body alignment was measured using a fometric 4D to measure the trunk imbalance angle (TI), pelvic tilt angle (PTi), pelvic torsion angle (PTo), pelvis rotation angle (PR), kyphotic angle (Ky), lordotic angle (Lo), and trunk torsion angle (TT). RESULTS: Participants showed correlations in the Rt. group, according to the left maximum pressure, Lo (r = .592, p < .05), and TT (r = .514, p < .05); according to the right maximum pressure, PR (r = .539, p < .05), and Lo (r = .503, p < .05). In the left pressure distribution, the PR (r = -.521, p < .05) showed a negative correlation. In the Lt. group, the PT (r = -.591, p < .05) showed a negative correlation in the left pressure distribution. CONCLUSION: These results can be used as basic data for a body analysis study of elementary school baseball players in the future.