Combined Radiation Therapy and Surgery Results in Improved Local Control for Patients with Extraskeletal Myxoid Chondrosarcomas Which Translates into Lower Risk of Distant Metastases
Andrew J. BishopJustin E. BirdAnthony P. ConleyChristina L. RolandBryan S. MoonRobert L. SatcherJ. Andrew LivingstonW.L. WangAlexander J. LazarValerae O. LewisPatrick P. LinB. Ashleigh Guadagnolo
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The trunk is the part of the human body that provides basic mechanical stabilization. It provides strength transmission between the upper and lower body regions. Body control is the ability of the body muscles to maintain the upright posture, to adapt to weight transfers, and to maintain selective trunk and limb movements by maintaining the support surface in static and dynamic postural adjustments. Good proximal trunk control provides better distal limb movements, balance, and functional motion. There are many evaluation methods, devices, and scales for trunk function and performance. 3D kinematic, electromyography, hand-held dynamometer, isokinetic dynamometer, trunk accelerometer are some devices that measure trunk function. The motor assessment scale-trunk subscale, the stroke impairment assessment set- trunk control subscale, trunk control test, trunk impairment scale are the most used scales. This chapter explores the effect of strokes on the trunk.
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Motor Control
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[Purpose] To explore the differences in bilateral trunk muscle activation between chronic stroke patients and healthy controls, this study investigated the symmetry index and cross-correlation of trunk muscles during trunk flexion and extension movements. This study also assessed the differences in trunk reposition error between groups and the association between trunk reposition error and bilateral trunk muscle activation. [Subjects and Methods] Fifteen stroke patients and 15 age- and gender-matched healthy subjects participated. Bilateral trunk muscle activations were collected by electromyography during trunk flexion and extension. Trunk reposition errors in trunk flexion and extension directions were recorded by a Qualisys motion capture system. [Results] Compared with the healthy controls, the stroke patients presented lower symmetrical muscle activation of the bilateral internal oblique and lower cross-correlation of abdominal muscles during trunk flexion, and lower symmetry index and cross-correlation of erector spinae in trunk extension. They also showed a larger trunk extension reposition error. A smaller trunk reposition error was associated with higher cross-correlation of bilateral trunk muscles during trunk movements in all subjects. [Conclusion] Trunk muscle function during symmetrical trunk movements and trunk reposition sense were impaired in the chronic stroke patients, and trunk position sense was associated with trunk muscle functions. Future studies should pay attention to symmetrical trunk movements as well as trunk extension position sense for patients with chronic stroke.
Stroke
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Objective:To study on whether radiotherapy affects on T cell subgroups,and to research on the effects of immunoenhancing agents on the immune side effects of radiotherapy.Methods:Sixty-six malignant tumour patients were divided into two groups,radiotherapy alone and radiotherpay plus immunoinhancing agents therapy groups.All patients were subjected to high energy X-rays and electronic rays outer local reginal therapy.T cell subgroups levels were measured before and after the radiotherapy.Results:CD 3,CD 4 and CD 8 decreased significantly after radiotherapy (P0.05) in radiotherapy alone group.There were no differences in CD 3,CD 4 and CD 8 before and after radiotherapy in the group of radiotherapy plus immunoinhancing agents therapy.Conclusions:Radiotherapy may cause the decrease in T cells of all subgroups and immunoinhancing agents may antagonize the side effects of radiotherapy. [
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[Purpose] The purposes of this study were to investigate differences between patients with chronic stroke and age matched healthy controls in trunk stability, by assessing the kinematics of the center of mass and moving body segments during voluntary limb and trunk movement, and the relationship between trunk stability and clinical measurements. [Subjects and Methods] Fifteen stroke patients and 15 age- and gender-matched healthy subjects participated. Each subject performed flexion of the hip and shoulder of the non-paretic or matched side as fast as possible, as well as trunk flexion and extension at a self-selected speed. A Qualisys motion system was employed to track the kinematics of the trunk and limbs. [Results] Patients presented larger mediolateral displacement of the center of mass during all limb and trunk movements, and larger velocity of center of mass during hip flexion movement. Healthy subjects showed greater movement velocity during shoulder flexion, trunk flexion and extension. Patients' clinical measurements only correlated with movement characteristics during voluntary trunk motions. [Conclusion] Trunk stability in patients with chronic stroke was compromised during voluntary trunk as well as non-paretic limb movements, and the voluntary trunk movements reflected the trunk deficits measured using clinical measurements. Rehabilitation of patients with chronic stroke should include programs to improve trunk stability.
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Background: Trunk function is considered important for stroke patients in rehabilitation, but the significance of this factoris unclear. In this study, we examined trunk function, defined as the ability to keep the trunk stable against gravity during movement. In addition, we aimed to elucidate the relationship between gait performance and trunk function.Methods: The subjects were 14 hemiplegic men and 20 healthy elderly men. Movement was assessed by a three-dimensional motion analysis system focusing on the trunk. The trunk was divided into three parts: the pelvis, the middle trunk, and the upper trunk. The parameters assessed were static standing, anterior tilt of the trunk in the standing position, and gait. We examined the relationship of each of these trunk movement factors with gait speed. All data was analyzed using SPSS program version 21 (p < 0.05).Results: Comparing data of hemiplegic patients to that of normal subjects, during trunk bending, a large rotation angle toward the non-affected side was found and that toward the affected side of the middle trunk at the toe off time of the affected limb during gait was found in hemiplegic patients (p < 0.01). The degrees of both rotation angles were related to the gait performance.Conclusion: The movement of the middle trunk during bending in hemiplegic patients affected gait performance. The results indicated that gravity and movements of lower limbs easily affected the middle trunk. This is an important factor to consider in the rehabilitation of hemiplegic patients.
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This study examined the effects of various seated trunk postures on upper extremity function. 59 adults were tested using the Jebsen Taylor Hand Function Test while in three different trunk postures. Significant mean differences between the neutral versus the flexed and laterally flexed trunk postures were noted during selected tasks. Specifically, dominant hand performance during the tasks of feeding and lifting heavy cans was significantly slower while the trunk was flexed and laterally flexed than when performed in the neutral trunk position. Performance of the nondomi nant hand during the tasks of picking up small objects, page turning, as well as the total score was slower while the trunk was flexed compared to performance in the neutral trunk position. These findings support the assumption that neutral trunk posture improves upper extremity performance during daily activities although the effect is not consistent across tasks. Findings are discussed along with limitations and recommendations for research.
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Female participants present a unique challenge as the design of the bra used to support the breasts occludes the correct positioning of many recommended trunk marker sets. This study aimed to compare the effect of two existing and one new trunk marker set on the calculation of trunk and breast kinematics. Twelve females had markers placed on their trunk and right nipple; these markers were tracked using infrared cameras during five running gait cycles and used to define three trunk calculation methods: Trunk 1: suprasternal notch, right and left ribs; Trunk 2: supersternal notch, processus xiphoideus, 7th cervical and 8th thoracic spinous process; Trunk 3: Trunk 2 plus a marker 33% from the suprasternal notch to the processus xiphoideus, and another 50% between the 7th cervical and 8th thoracic spinous process. Trunk segment capture success, segment origin instability, segmental residual, trunk kinematics, and breast range of motion (relative to the trunk segment), were calculated for each trunk segment. Segment capture success varied from 88% (Trunk 1) to 100% (Trunk 2 and 3). Segment origin instability ranged from 0.2 cm (Trunk 2 and 3) to 1.5 cm (Trunk 1). Maximum trunk extension differed by 7° and breast range of motion varied by 41% (anterioposterior), 54% (mediolateral), and 21% (superioinferior) between trunk calculation methods. The selection of marker set used to construct the trunk segment is critical before recommending improvements to bra design to improve breast support. The Trunk 3 marker set is recommended for subsequent breast research.
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I have often found that in making a diagnosis based on lesion type, shape, arrangement, and distribution, the latter is the least reliable criterion to rely on. So, I was somewhat skeptical about a classification based on distribution. When I saw the table of contents with trunk lesions divided over nine chapters such as ''Trunk''; ''Trunk, Annular''; ''Trunk, Blisters''; ''Trunk, Papulonodules''; ''Trunk, Papulosquamous''; ''Trunk, Pigmented''; ''Trunk, Pustules''; ''Trunk, Red''; ''Trunk, Red Scaly''; ''Trunk, Scar''; and ''Trunk, White''; I was afraid that such an approach would be too muddled and difficult to grasp for the dermatology student. However, when I read this atlas I found it thoroughly enjoyable. It is clinically oriented. The color photographs are excellent and the descriptions are brief, containing the salient points on each entity. The treatment suggestions are practical and up-to-date, and references are included. I particularly enjoyed the great number of diverse entities covered in
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