Collagen is the most common structural protein in the connective tissues of vertebrates, playing a crucial role in maintaining the tissue structure and wound healing. Atelocollagen retains the original properties of collagen but does not induce inflammatory cytokines. Atelocollagen is extracted from various animals and humans, with bovine-derived collagen being the most commonly used. The safety and efficacy of atelocollagen have been demonstrated through multiple studies, but further research will be needed in the field of orthopedics regarding its range of use and effects. Foot and ankle diseases have attracted little research attention, highlighting the need for further studies.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced unresectable pancreatic cancer. However, the introduction of gemcitabine and the recognition of a benefit in patients with advanced disease stimulated the design of trials that compare chemotherapy alone to concurrent chemoradiation. Therefore, we evaluated role of CCRT for locally advanced unresectable pancreatic cancer. MATERIALS AND METHODS: We carried out a retrospective analysis of treatment results for patients with locally advanced unresectable pancreatic cancer between January 2000 and January 2008. The radiation was delivered to the primary tumor and regional lymph nodes with a 1~2 cm margin at a total dose of 36.0~59.4 Gy (median: 54 Gy). The chemotherapeutic agent delivered with the radiation was 5-FU (500 mg/m2). The patients who underwent chemotherapy alone received gemcitabine (1,000 mg/m2) alone or gemcitabine with 5-FU. The follow-up period ranged from 2 to 38 months. The survival and prognostic factors were analyzed using Kaplan-Meier method and log-rank test, respectively. RESULTS: Thirty-four patients received concurrent chemoradiotherapy, whereas 21 patients received chemotherapy alone. The median survival time was 12 months for CCRT patients, compared to 11 months for chemotherapy alone patients (p=0.453). The median progression-free survival was 8 months for CCRT patients, compared to 5 months for chemotherapy alone patients (p=0.242). The overall response included 9 partial responses for CCRT and 1 partial response for chemotherapy alone. In total, 26% of patients from the CCRT group experienced grade 3~4 bowel toxicity. In contract, no grade 3~4 bowel toxicity was observed in the chemotherapy alone group. The significant prognostic factors of overall survival were lymph node status, high CA19-9, and tumor location. CONCLUSION: The response rate and progression-free survival were more favorable in the CCRT group, when compared with the chemotherapy alone group. Therefore, radiation therapy seems to be an effective tool for local tumor control.
Chemoradiotherapy ; Contracts ; Deoxycytidine ; Disease-Free Survival ; Fluorouracil ; Follow-Up Studies ; Humans ; Lymph Nodes ; Pancreatic Neoplasms ; Retrospective Studies

The aim of this study was to investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) on the lateral epicondylitis of the elbow. Between March 2005 and March 2008, 66 patients who had been treated with extracorporeal shock wave therapy due to lateral epicondylitis of elbow formed the subjects. The subjects were divided into the 1st, 2nd and the 3rd treatment group and evaluated the clinical outcomes by visual analog scale (VAS) and a simple elbow test (SET) at immediate treatment, posttreatment 6 and 12 months, retrospectively. Changes in VAS score between the 2nd and 3rd treatment group and between the 1st and 3rd treatment group showed significant difference only at posttreatment 1 month group (p=0.001, 0.2, 0.1), (p=0.03, 0.08, 0.3), but Visual Analog Scale score at posttreatment 1 month showed no difference within the groups (p=1.0, 0.2, 0.07). SET within and between the groups showed significant difference at posttreatment 6 and 12 months (p<0.05).
Elbow ; Humans ; Retrospective Studies ; Shock

PURPOSE: To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) followed by radiotherapy (RT) in treatment-naive patients with locally advanced hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Eligibility criteria were as follows: newly diagnosed with HCC, the Barcelona Clinic Liver Cancer stage C, Child-Pugh class A or B, and no prior treatment for HCC. Patients with extrahepatic spread were excluded. A total of 59 patients were retrospectively enrolled. All patients were treated with TACE followed by RT. The time interval between TACE and RT was 2 weeks as per protocol. A median RT dose was 47.25 Gy10 as the biologically effective dose using the alpha/beta = 10 (range, 39 to 65.25 Gy10). RESULTS: At 1 month, complete response was obtained in 3 patients (5%), partial response in 27 patients (46%), stable disease in 13 patients (22%), and progressive disease in 16 patients (27%). The actuarial one- and two-year OS rates were 60.1% and 47.2%, respectively. The median OS was 17 months (95% confidence interval, 5.6 to 28.4 months). The median time to progression was 4 months (range, 1 to 35 months). Grade 3 or greater liver enzyme elevation occurred in only two patients (3%) after RT. Grade 3 gastroduodenal toxicity developed in two patients (3%). CONCLUSION: The combination treatment of TACE followed by RT with two-week interval was safe and it showed favorable outcomes in treatment-naive patients with locally advanced HCC. A prospective randomized trial is needed to validate these results.
Carcinoma, Hepatocellular* ; Humans ; Liver ; Liver Neoplasms ; Radiotherapy ; Retrospective Studies

No abstract available.
Adult* ; Humans ; Treatment Outcome*

BACKGROUND/AIMS: We assessed the clinical features and prognosis of acute viral hepatitis A (AHA) complicated with acute kidney injury (AKI) and elucidated predictive factors for AKI in patients with AHA. METHODS: We reviewed medical record of 391 patients with AHA admitted at our institution since 2000. RESULTS: AKI was present in 45 patients (11.5%). The proportion of the AKI group increased since 2008 (5.4% before 2008 vs. 15.9% since 2008, p=0.001). The AKI group was older than the non-AKI group (35.7+/-8.7 years vs. 31.3+/-7.8 years, p=0.002). Other baseline clinical characteristics were similar between two groups. Initial hemoglobin, platelet, and serum albumin were significantly low and prothrombin time, serum bilirubin, creatinine, AST, and ALT were significantly high in the AKI group. Hepatic encephalopathy, ascites, gastrointestinal bleeding, and sepsis were more frequently observed in the AKI group. While six patients (13%) in the AKI group received liver transplantation (LT) but three patients died within one month, one patient in the non-AKI group receiving LT is alive. Multivariate analysis showed that older age (OR 1.07, 95% CI 1.02-1.12), initial thrombocytopenia <150,000/mm2 (OR 2.85, 95% CI 1.24-6.57), prothrombin time (PT) prolongation (OR 5.34, 95% CI 2.55-11.19), and hypoalbuminemia (OR 8.24, 95% CI 2.53-26.86) were independently associated with the occurrence of AKI. CONCLUSIONS: AHA with AKI is an increasing problem showing significant morbidity and mortality in Korea. AKI is highly associated with older age, initial thrombocytopenia, PT prolongation, or low serum albumin, and has bad prognostic effect.
Acute Disease ; Acute Kidney Injury/complications/*diagnosis/therapy ; Adult ; Age Factors ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Creatine/blood ; Female ; Hemoglobins/analysis ; Hepatitis A/complications/*diagnosis ; Humans ; Hypoalbuminemia/complications ; Liver Transplantation ; Male ; Middle Aged ; Odds Ratio ; Platelet Count ; Predictive Value of Tests ; Prognosis ; Prothrombin Time ; Serum Albumin/analysis ; Thrombocytopenia/complications