Therapy-related myeloid neoplasm in early breast cancer patients treated with adjuvant chemotherapy.

BACKGROUND: Long-term complications are becoming more important as the survival rate of breast cancer improves. Treatment-related myeloid neoplasm is an important long-term complication in breast cancer survivors as it has a poor prognosis. OBJECTIVE: We evaluated the incidence and risk factors for the development of treatment-related acute myeloid leukaemia (AML)/myelodysplastic syndrome (MDS) in patients treated with early breast cancer. METHODS: We accessed the national Korean database to identify 153,565 patients diagnosed with breast cancer between January 2007 and October 2016 who underwent surgery for breast cancer. We estimated the cumulative incidence of AML/MDS and analysed the risk factors for developing AML/MDS. RESULTS: Of 153,575 patients, 79,321 received anthracycline-based adjuvant therapy, 14,317 received adjuvant therapy without anthracyclines and 46,657 did not receive adjuvant chemotherapy. Overall, 120 developed AML (105 in the anthracycline group, 9 in the non-anthracycline group and 6 in the control group), and 128 developed MDS (96, 9 and 23 in each group). The 10-year cumulative incidence of AML/MDS was the highest in the anthracycline group (0.221% and 0.199%), followed by the non-anthracycline group (0.122% and 0.163%) and the control group (0.024% and 0.089%). The risk of developing AML/MDS was significantly higher in patients treated with anthracyclines (hazard ratio [HR] 9.531; p < 0.0001 for AML and HR 2.559; p < 0.0001 for MDS) compared to patients in the control group. CONCLUSION: This study found that anthracycline-based adjuvant therapy significantly increased the risk of AML/MDS in Korean breast cancer patients, with the risk persisting for at least 10 years. While the cumulative incidence was low, the long-term risks of AML/MDS should be taken into account considering the poor outcomes associated with these neoplasms.

PIK3CA Mutation is Associated with Poor Response to HER2-Targeted Therapy in Breast Cancer Patients.

PURPOSE: Mutations in the PIK3CA gene occur frequently in breast cancer patients. Activating PIK3CA mutations confer resistance to human epidermal growth factor receptor 2 (HER2)-targeted treatments. In this study, we investigated whether PIK3CA mutations were correlated with treatment response or duration in patients with HER2-positive (HER2+) breast cancer. Materials and Methods: We retrospectively reviewed the clinical information of patients with HER2+ breast cancer who received HER2-targeted therapy for early-stage or metastatic cancers. The pathologic complete response (pCR), progression-free survival (PFS), and overall survival were compared between patients with wild-type PIK3CA (PIK3CAw) and those with mutated PIK3CA (PIK3CAm). Next-generation sequencing was combined with examination of PFS associated with anti-HER2 monoclonal antibody (mAb) treatment. RESULTS: Data from 90 patients with HER2+ breast cancer were analyzed. Overall, 34 (37.8%) patients had pathogenic PIK3CA mutations. The pCR rate of the PIK3CAm group was lower than that of the PIK3CAw group among patients who received neoadjuvant chemotherapy for early-stage cancer. In the metastatic setting, the PIK3CAm group showed a significantly shorter mean PFS (mPFS) with first-line anti-HER2 mAb. The mPFS of second-line T-DM1 was lower in the PIK3CAm group than that in the PIK3CAw group. Sequencing revealed differences in the mutational landscape between PIK3CAm and PIK3CAw tumors. CONCLUSION: Patients with HER2+ breast cancer with activating PIK3CA mutations had lower pCR rates and shorter PFS with palliative HER2-targeted therapy than those with wild-type PIK3CA. Precise targeted-therapy is needed to improve survival of patients with HER2+/PIK3CAm breast cancer.

The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.

[Purpose] This study aimed to examine the effects of self-mobilization techniques for the sciatic nerves on the quality of life in patients with chronic low back pain in the lower limbs accompanied by radiating pain. [Subjects and Methods] The subjects were divided into two groups: a group receiving of lumbar segmental stabilization exercise training including sciatic nerve mobilization techniques, which included 8 males and 7 females, and a group receiving lumbar segmental stabilization exercise training, which included 8 males and 7 females. [Results] There were statistically significant differences in comparison of measurement results between the groups before and after the intervention. [Conclusion] Application of mobilization techniques for the sciatic nerves may promote healing of the soft tissues by stimulating the functions of the nervous system to improve nervous system adaptability and decrease sensitivity, helping to alleviate the symptoms.

Influence of the application of inelastic taping on shoulder subluxation and pain changes in acute stroke patients.

[Purpose] The purpose of this study was to investigate the impact on the shoulder joints of performing inelastic taping and bed physical therapy for acute stroke. [Subjects and Methods] The intervention was conducted for eight weeks with an experimental group of 18 stroke patients who received bed physical therapy and inelastic taping and a control group of 18 stroke patients who received only bed physical therapy. [Results] After the intervention, the subluxation degree of the experimental group, which received bed physical therapy and inelastic taping, was found to be significantly different from that of the control group, which received only bed physical therapy. [Conclusion] In conclusion, the application of inelastic taping for acute stroke patients was confirmed to be effective at reducing shoulder subluxation and pain, and was confirmed to be a good physical therapy intervention, based on its efficacy.

Comparison of physical function according to the lumbar movement method of stabilizing a patient with chronic low back pain.

[Purpose] The purpose of this study was to examine the changes caused by lumbar stabilization exercises in chronic low back pain patients. [Subjects and Methods] Swiss ball exercise regimen group and sling exercise regimen group exercised for 30 minutes a day, 5 days a week, for 12 weeks. The control group was to continue performing their usual daily living activities. [Results] We obtained significant results in both the Swiss ball and sling exercise groups, but not in the control group. The best effect was obtained in the sling exercise group. [Conclusion] The Oswestry Low Back Pain Disability Index and visual pain scale scores of the patients with low back pain decreased in both the Swiss ball exercise group and the sling exercise group, and these patients experienced an increase in waist isometric muscular strength after 12 weeks of exercise compared with those doing no exercise (the control group).

The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients.

[Purpose] The aim of this study was to examine the effects of exercise to strengthen the muscles of the hip together with lumbar segmental stabilization exercise on the lumbar disability index, lumbar muscle strength, and balance. [Subjects and Methods] This study randomly and equally assigned 40 participants who provided written consent to participate in this study to a lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus group (SMG + LES group) and a lumbar segmental stabilization exercise group. [Results] Each evaluation item showed a statistically significant effect. [Conclusion] Clinical application of exercise in this study showed that lumbar segmental stabilization exercise plus exercise to strengthen the muscles of the gluteus resulted in a greater decrease in low back pain disability index and increase in lumbar muscle strength and balance ability than lumbar segmental stabilization exercise in chronic low back pain patients receiving the exercise treatments during the same period.

Comparison of the Effects of Hollowing and Bracing Exercises on Cross-sectional Areas of Abdominal Muscles in Middle-aged Women.

[Purpose] The purpose of this study was to examine the effects of hollowing and bracing exercises on cross-sectional areas of abdominal muscles. [Subjects] Thirty healthy female adults participated in this study. The exclusion criteria were orthopedic or neurologic diseases. [Methods] The subjects of this study were assigned randomly to one of two groups, each with 15 people. Each group performed a 60-minute exercise program, one performed a bracing exercise, and the other performed a hollowing exercise, with both groups performing the exercise three times a week for six weeks. [Results] The changes in cross-sectional areas after the bracing exercise showed statistically significant differences in the left rectus abdominis and both internal and external obliques. The changes in cross-sectional areas after the hollowing exercise showed statistically significant differences in the left and right transversus abdominis and left rectus abdominis. [Conclusion] Performing bracing exercises rather than hollowing exercises is more effective for activating the abdominal muscles.

Effects of vibratory stimulations on maximal voluntary isometric contraction from delayed onset muscle soreness.

[Purpose] The aim of this study was to investigate the effect of vibratory stimulation on maximal voluntary isometric contraction (MVIC) from delayed onset muscle soreness (DOMS). [Subjects] Sixty healthy adults participated in this study. The exclusion criteria were orthopedic or neurologic disease. [Methods] The researchers induced DOMS in the musculus extensor carpi radialis longus of each participant. Subjects in the control group received no treatment. The ultrasound group received ultrasound treatment (intensity, 1.0 W/cm(2;) frequency 1 MHz; time, 10 minutes). The vibration group received vibration stimulation (frequency, 20 MHz; time, 10 minutes). Maximal voluntary isometric contraction (MVIC) was recorded at baseline, immediately after exercise, and 24, 48, and 72 hours after exercise. [Results] MVIC measurements showed statistically significant differences in the vibration group compared with the control group. [Conclusion] Vibratory stimulation had a positive effect on recovery of muscle function from DOMS.

The Changes of Electromyography in the Upper Trapezius and Supraspinatus of Women College Students According to the Method of Bag-carrying and Weight.

[Purpose] The purpose of this study was to investigate differences in upper extremity muscle activities of women college students' due to method of bag-carrying and weight. [Subjects] Thirty healthy adult females participated in this study. The exclusion criteria were orthopedic or neurologic disease, or a dominant left side. [Methods] Electromyographic activities of the supraspinatus and upper trapezius were recorded bilaterally under two conditions: crossbody bag, ipsilateral bag. [Results] There were no significant differences in the supraspinatus and upper trapezius muscles according to the weight carried; however, there was significant difference in the right supraspinatus and both upper trapezius muscles according to the method of carrying. [Conclusion] An effective backpack safety program for female college students is necessary to educate them how to prevent possible musculoskeletal pain related to the weight carried and the method of carrying from the perspective of an ergonomical approach.