PURPOSE: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. MATERIALS AND METHODS: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. RESULTS: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. CONCLUSION: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymphedema ; Pelvis ; Recurrence ; Retrospective Studies ; Sepsis ; Skin ; Treatment Outcome ; Vulvar Neoplasms

PURPOSE: This randomized controlled trial was conducted to compare the effectiveness of global postural reeducation to segmental stretching in subjects with neck and shoulder pain. METHODS: Sixteen subjects with neck and shoulder pain were randomized into two intervention groups, a global posture reeducation group (n=8) that performed muscle chain stretching, and a segmental stretching group (n=8) that performed conventional static muscle stretching. The intervention program consisted of two 40 minutes individual sessions per week for four weeks. Subjects were evaluated pre-intervention, two-week after intervention and at a four-week follow-up appointment for pain intensity, disability and health-related quality of life. Two-way repeated analysis of variance was used for between-time and between-group comparisons. The significance level was 0.05. RESULTS: Significant pain relief and decreasing discomfort of the neck and shoulder were observed after intervention in both groups, and there was an interaction between time lapse and groups (pain, F=10.31, neck disability, F=25.45, shoulder disability, F=12.82, p<0.05). Quality of life also improved after intervention in both groups. Moreover, the physical components score improved, and a significant interaction was observed between time and groups (F=4.85, p<0.05). However, no significant improvement in mental component score of quality of life and no significant interaction between time and groups were observed (p>0.05). CONCLUSION: These findings suggest that a GPR intervention in subjects with neck and shoulder pain induces greater improvement of pain and disability and quality of life than segmental stretching.
Follow-Up Studies ; Muscle Stretching Exercises ; Neck Pain ; Neck* ; Posture ; Quality of Life ; Shoulder Pain* ; Shoulder*

PURPOSE: This study was conducted to identify the characteristics of physical therapy service utilization and user satisfaction depending on the experience with therapeutic exercise or ultrasound intervention among elderly persons using senior centers. METHODS: The subjects were adults aged over 60 years (total 215) recruited in 40 senior centers located in each province in South Korea. Subjects responded to questions concerning overall demographics factors, utilized characteristics of physical therapy service and 12 variety user satisfactions with effectiveness, facilities, and therapist using a survey instrument. The collected data were analyzed by Fishers' exact tests and t-tests using the SPSS 21.0 program to compare the results of elderly persons who had or had not experienced exercise therapy or ultrasound therapy. RESULTS: The participants that experienced ultrasound therapy or therapeutic exercise reported significantly higher overall results pertaining to effectiveness of physical therapy and a clear explanation from physical therapist's satisfaction than those who were non-experienced. Satisfaction with pain relief was significantly higher among elderly who experienced therapeutic exercise than those who did not. Those who underwent ultrasound therapy showed significantly higher satisfaction with facilities and location than those who did not. CONCLUSION: The results of this study suggest that satisfaction among users differs by type of physical therapy. In the future, physiotherapy services provided in senior centers needs to be designed to improve the effectiveness of physical therapy, professionalism of physical therapists and comfort of facility.
Adult ; Aged ; Demography ; Exercise Therapy ; Humans ; Korea ; Physical Therapists ; Professionalism ; Senior Centers* ; Ultrasonography

PURPOSE: This study examined the work-related musculoskeletal pain and quality of life of hospital workers.METHODS: Self-reported questionnaires were sent to 350 hospital workers at Seoul and Gyeonggi-do, of which 341 were returned. The questionnaire had four items that covered the demographic information, areas of musculoskeletal problems, pain rating scale, and quality of life. The analysis was completed using descriptive statistic, and the differences between pain and demographic variables were identified using a chi-square test. The differences between the type of occupation and quality of life were analyzed by one-way analysis of variance and a Kruskal-Wallis test.RESULTS: The 12-month prevalence of work-related musculoskeletal pain was 86.1% of physical therapists, 86.5% of occupational therapists, 77.1% of dental hygienists, and 75.8% of nurses. A significant difference in the general and work related variables was observed between the subject with a physical burden and type of occupation. The most affected pain sites of the physical therapist included low back, hand and wrist, shoulder, and neck. The occupational therapists included the hand and wrist, shoulder, neck, but the nurses and dental hygienists reported the shoulder, back, hand and wrist. A significant difference in the quality of life was noted between the subjects in physical therapists and dental hygienists and the subjects in the nurses and occupational therapists (p=0.00).CONCLUSION: These findings show that hospital workers appear to be high risk for work-related musculoskeletal pain, and the quality of life of physical therapists and nurses was higher than that of dental hygienists and occupational therapists.
Dental Hygienists ; Gyeonggi-do ; Hand ; Humans ; Musculoskeletal Pain ; Neck ; Occupations ; Physical Therapists ; Prevalence ; Quality of Life ; Seoul ; Shoulder ; Wrist

PURPOSE: To evaluate the prognostic value of metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) on initial positron emission tomography-computed tomography (PET-CT) and investigate the clinical value of SUVmax for early detection of locoregional recurrent disease after postoperative radiotherapy in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: A total of 100 patients with locally advanced HNSCC received primary tumor excision and neck dissection followed by adjuvant radiotherapy with or without chemotherapy. The MTV and SUVmax were measured from primary sites and neck nodes. The prognostic value of MTV and SUVmax were assessed using initial staging PET/CT (study A). Follow-up PET/CT scan available after postoperative concurrent chemoradiotherapy or radiotherapy were evaluated for the SUVmax value and correlated with locoregional recurrence (study B). A receiver operating characteristic (ROC) curve analysis was used to define a threshold value of SUVmax with the highest accuracy for recurrent disease assessment. RESULTS: High MTV (>41 mL) is negative prognostic factor for disease free survival (p = 0.041). Postradiation SUVmax was significantly correlated with locoregional recurrence (hazard ratio, 1.812; 95% confidence interval, 1.361 to 2.413; p < 0.001). A cut-off value of 5.38 from follow-up PET/CT was identified as having maximal accuracy for detecting locoregional recurrence by ROC analysis. CONCLUSION: MTV at staging work-up was significantly associated with disease free survival. The SUVmax value from follow-up PET/CT showed high diagnostic accuracy for the detection of locoregional recurrence in postoperatively irradiated HNSCC.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Disease-Free Survival ; Electrons ; Follow-Up Studies ; Head ; Head and Neck Neoplasms ; Humans ; Neck ; Neck Dissection ; Positron-Emission Tomography ; Radiotherapy, Adjuvant ; Recurrence ; ROC Curve ; Tumor Burden