Lenalidomide, an orally administered immune-modulating drug, has several mechanisms of action against multiple myeloma (MM).However, the mechanisms of action of immune-modulating drugs are not understood completely.Lenalidomide maintenance therapy prolongs the time to progression and increases the overall survival in patients with MM.However, secondary primary malignancy (SPM) has been noted as a serious adverse event in patients with MM treated with lenalidomide.Lenalidomide treatment is not covered by insurance.Consequently, physicians have little experience with the adverse events of lenalidomide treatment in patients with MM.Here, we describe a case of breast cancer after lenalidomide treatment for MM.To our knowledge, this is the first report of a lenalidomide-associated SPM in Korea.The risk factors associated with lenalidomide-associated SPM should be considered carefully when implementing chemotherapy regimens in patients with MM. (
A 55-year-old male underwent coronary artery intervention for an acute myocardial infarction of the inferior or lateral wall. The initial left coronary angiogram showed total occlusion of the proximal left circumflex artery (LCX). There was an abnormal coronary artery originating from the mid-portion of the left anterior descending artery (LAD) and running to the right ventricular side. However, we could not identify the anomalous right coronary artery (RCA). We tried to find the RCA in the right coronary cusp to confirm the infarction-related artery, but failed. A focused left coronary angiogram in the posteroanterior projection revealed the entire anatomy of the anomalous RCA. An anomalous origin of the RCA from the LAD is a rare coronary artery anomaly that might affect the physician’s decision during coronary intervention. We report an anomalous origin of the RCA from the mid-LAD and discuss the anatomy and clinical significance. (Korean J Med 2014;86:618-622)
Quantifying the trunk flexion angles at which wearable support systems (exoskeletons/exosuits) provide substantial trunk extension moment during posture maintenance tasks (such as those seen in surgical environments) can provide a deeper understanding of this potential intervention strategy. Understanding how time (i.e. adaptation/learning) might impact the reliance on wearable support is also of value. Sixteen participants were asked to maintain specific trunk flexion angles (range 0-60°) with and without an exosuit system while erector spinae and rectus abdominis muscle activity were captured using surface electromyography. The effects of the exosuit showed a statistically significant (
Objective To examine the effects of asymmetry and lower extremity mobility restrictions on the effectiveness of a passive back-support exosuit in short-duration, static trunk flexion postures. Background The effectiveness of trunk exoskeletons/suits for sagittally symmetric trunk posture maintenance has been investigated, but there has been limited study of the effects of asymmetric trunk postures or lower extremity motion restriction. Method Sixteen participants held trunk flexion postures involving trunk flexion (20°, 40°, 60°), asymmetry (0°, 30°), and lower extremity mobility (Free, Restricted) for 3 s. Participants held these postures with and without an exosuit while erector spinae and abdominal muscle activities were collected. Results There were no significant interactions between exosuit and asymmetry or exosuit and lower extremity motion restrictions, indicating no significant effects of these factors on the effectiveness of the exosuit at reducing trunk muscle activity. The exosuit was found to be effective at reducing erector spinae muscle activity regardless of asymmetry of posture or lower extremity restrictions (average 21%, from 11.2% MVC to 8.8% MVC). The magnitude of the erector spinae activity at 60° of trunk flexion with the exosuit was similar to that seen at 20° without the exosuit. Conclusion The exosuit consistently provided biomechanical benefit through reduced activation of the erector spinae muscles and neither asymmetry of trunk posture nor lower extremity restriction influenced this effectiveness. Application Trunk exoskeletons/suits can reduce trunk muscle activation and understanding how characteristics of the trunk postures assumed impact these responses may help target tasks wherein these devices may be effective.
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