• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.167-174
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• 2012

Purpose: The respiration is one of the most important factors in respiratory gating radiation therapy (RGRT). We have developed an unique respiratory guidance system using an audio-visual system in order to support and stabilize individual patient's respiration and evaluated the usefulness of this system. Materials and Methods: Seven patients received the RGRT at our clinic from June 2011 to April 2012. After breathing exercise with the audio-visual system, we measured their spontaneous respiration and their respiration with the audio-visual system respectively. With the measured data, we yielded standard deviations by the superficial contents of respiratory cycles and functions, and analyzed them to examine changes in their breathing before and after the therapy. Results: The PTP (peak to peak) of the standard deviations of the free breathing, the audio guidance system, and the respiratory guidance system were 0.343, 0.148, and 0.078 respectively. The respiratory cycles were 0.645, 0.345, and 0.171 respectively and the superficial contents of the respiratory functions were 2.591, 1.008, and 0.877 respectively. The average values of the differences in the standard deviations among the whole patients at the CT room and therapy room were 0.425 for the PTP, 1.566 for the respiratory cycles, and 3.671 for the respiratory superficial contents. As for the standard deviations before and after the application of the PTP respiratory guidance system, that of the PTP was 0.265, that of the respiratory cycles was 0.474, and that of the respiratory superficial contents. The results of t-test of the values before and after free breathing and the audio-visual guidance system showed that the P-value of the PTP was 0.035, that of the cycles 0.009, and that of the respiratory superficial contents 0.010. Conclusion: The respiratory control could be one of the most important factors in the RGRT which determines the success or failure of a treatment. We were able to get more stable breathing with the audio-visual respiratory guidance system than free breathing or breathing with auditory guidance alone. In particular, the above system was excellent at the reproduction of respiratory cycles in care units. Such a system enables to reduce time due to unstable breathing and to perform more precise and detailed treatment.

• Progress in Medical Physics
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• v.24 no.3
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• pp.135-139
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• 2013

We evaluated the effect of two kinds of breathing biofeedback technique such as audio-instruction and audio-visual biofeedback on breathing reproducibility and the CTV coverage during repeated treatment regimes in respiration-gated radiotherapy. In this study, the breathing data of nineteen lung cancer patients acquired from Medical College of Virginia (MCV) during five weeks were used. The dose evaluation algorithm was programmed in MATLAB. In the result, the CTV coverage was decreased as 30.0% due to the breathing irreproducibility for free-breathing. For audio-visual biofeedback, the CTV coverage was improved as 20.0% because patients can learn how control their breathing stably. And the audio-instruction was effective to preserve the breathing reproducibility.

• Journal of Life Science
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• v.19 no.12
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• pp.1829-1835
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• 2009

Hyperventilation (HV) is routinely induced in order to activate brain waves during an electroencephalogram (EEG). The aim of this study was to examine the effects of HV conditions on EEG and suggested basic data for the standardized procedure. Three degrees of HV were induced for 5 minutes with a ventilation volume of 160 ml/min (control group), 240 ml/min, and 300 ml/min in rats. Powers of delta, theta, alpha, and beta waves were examined by a quantitative EEG. The results showed that there was no significant difference in the powers of all EEG waves between the control and 240 ml/min groups. However, a notable change in EEG powers during HV induced by a ventilation volume of 300 ml/min was observed in the frontal cerebral region as follows: power of the delta was increased by 12.8% (p<0.01), powers of the theta, alpha and beta were decreased by 41.3% (p<0.01), 48.6% (p<0.05), and 41.9% (p<0.05), respectively. Therefore, it is concluded that an increase of about 90% of the normal ventilation volume might be adequate for the hyperventilation, and a useful parameter for evaluation of the qualified hyperventilation might be an alteration of the frontal EEG powers.

• Progress in Medical Physics
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• v.23 no.1
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• pp.1-7
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• 2012

The purpose of this study was to develop the respiratory training system using individual characteristic guiding waveform to reduce the impact of respiratory motion that causes artifact in radiotherapy. In order to evaluate the improvement of respiratory regularity, 5 volunteers were included and their respiratory signals were acquired using the in-house developed belt-type sensor. Respiratory training system needs 10 free breathing cycles of each volunteer to make individual characteristic guiding waveform based on Fourier series and it guides patient's next breathing. For each volunteer, free breathing and guided breathing which uses individual characteristic guiding waveform were performed to acquire the respiratory cycles for 3 min. The root mean square error (RMSE) was computed to analyze improvement of respiratory regularity in period and displacement. It was found that respiratory regularity was improved by using respiratory training system. RMSE of guided breathing decreased up to 40% in displacement and 76% in period compared with free breathing. In conclusion, since the guiding waveform was easy to follow for the volunteers, the respiratory regularity was significantly improved by using in-house developed respiratory training system. So it would be helpful to improve accuracy and efficiency during 4D-RT, 4D-CT.

• Progress in Medical Physics
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• v.25 no.4
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• pp.264-270
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• 2014

This study developed a portable respiratory training device to improve breathing stability, which is an important element in using the CyberKnife Synchrony respiratory tracking device, one of the typical Stereotactic Radiation Therapy (SRT) devices. It produced an interface for users to be able to select one of two displays, a graph type and a bar type, supported an auditory system that helps them expect next respiration by improving a sense of rhythm of their respiratory period, and provided comfortable respiratory inducement. By targeting 5 applicants and applying individual respiratory period detected through a self-developed program, it acquired signal data of 'guide respiration' that induces breathing through signal data gained from 'free respiration' and an auditory system, and evaluated the usability by comparing deviation average values of respiratory period and respiratory amplitude. It could be identified that respiratory period decreased $55.74{\pm}0.14%$ compared to free respiration, and respiratory amplitude decreased $28.12{\pm}0.10%$ compared to free respiration, which confirmed the consistency and stability of respiratory. SBRT, developed based on these results, using the portable respiratory training device, for liver cancer or lung cancer, is evaluated to be able to help reduce delayed treatment time due to respiratory instability and improve treatment accuracy, and if it could be applied to developing respiratory training applications targeting an android-based portable device in the future, even use convenience and economic efficiency are expected.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.33-40
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• 2013

Purpose: The purpose of this study was to evaluate the possibility to optimize the gated treatment delivery time and maintenance of stable respiratory by the introduction of breath with the assistance of auditory-visual-tactile sense. Materials and Methods: The experimenter's respiration were measured by ANZAI 4D system. We obtained natural breathing signal, monitor-induced breathing signal, monitor & ventilator-induced breathing signal, and breath-hold signal using real time monitor during 10 minutes beam-on-time. In order to check the stability of respiratory signals distributed in each group were compared with means, standard deviation, variation value, beam_time of the respiratory signal. Results: The stability of each respiratory was measured in consideration of deviation change studied in each respiratory time lapse. As a result of an analysis of respiratory signal, all experimenters has showed that breathing signal used both Real time monitor and Ventilator was the most stable and shortest time. Conclusion: In this study, it was evaluated that respiratory gated radiation therapy with auditory-visual-tactual sense and without auditory-visual-tactual sense feedback. The study showed that respiratory gated radiation therapy delivery time could significantly be improved by the application of video feedback when this is combined with audio-tactual sense assistance. This delivery technique did prove its feasibility to limit the tumor motion during treatment delivery for all patients to a defined value while maintaining the accuracy and proved the applicability of the technique in a conventional clinical schedule.

• Journal of Veterinary Clinics
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• v.27 no.3
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• pp.257-261
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• 2010

The development of blood ionic changes could be precipitated in acid-base disorder and subsequent treatment. As technology for detecting circulating ionized $Mg^{2+}$ (the most interesting form with respect to physiological and biological properties) is now available in veterinary clinical medicine. This present study investigated the changes of whole blood ionized $Mg^{2+}$ correlated with acute metabolic and respiratory alkalosis in rodent model. Metabolic alkalosis was induced by intravenous infusion with $NaHCO_3$ and mechanical hyperventilation was applied for respiratory alkalosis. We founded that the blood ionized $Mg^{2+}$ could be reversibly decreased by the $NaHCO_3$-induced acute metabolic alkalosis but irreversibly increased by the mechanical hyperventilation-induced respiratory acidosis and respiratory acidosis. We suggested that the potential change in blood suggested that the potential change in blood ionized $Mg^{2+}$ should be counted in treatment of acid-base disorders.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2014.05a
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• pp.833-835
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• 2014

On this study, we have developed respiratory training system to improve stability of respiration, one of the most important factors of Respiratory Gated Radiation Therapy, RGRT. Respiratory training system that we developed was applied to personal respiratory cycle so that it could provide comfortable respiratory triggering to patients. To give sufficient time for practice, we used modular portable device to practice easily and to be undetered by time and place. We have intended to improve efficiency and accuracy by providing it to patients. We are now planning to conduct experiment of 10 peoples to find out stability, degree of durability betterment and regularity of respiration when patients are using respiratory training system. There are three kinds of breathing style. First is free breathing that Individual patients can breathe freely. Second is guide breathing that patients apply to personal respiration cycle through the guiding sight and hearing program. Third is prediction breathing that patients breathe after respiratory training without guiding sight and hearing program. By using these 3 data of respiration method, we have evaluated usability of respiratory training system by quantitatively analyzing respiration period, amplitude and area's variation.

• Proceedings of the Korean Society of Computer Information Conference
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• 2024.01a
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• pp.195-198
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• 2024

이 연구의 목적은 EMG 바이오피드백을 이용한 가로막 호흡 재교육 운동이 전방머리자세 성인의 들숨 기능의 효과를 알아보고자 하였다. 이연구 결과 EBDBEG에서 최대들숨압(PIP) 유의하게 증가하였다(P<.0.5). 따라서 바이오피트백을 적용한 시각적 되먹임을 통해 가로막호흡운동 시 보다 정확하게 가로막의 수축과 이완의 움직임을 인지하고 호흡 보조근을 억제를 유도할 수 있을 거라 생각되며 좀 더 장시간의 적용은 호흡기능 및 전방머리자세에도 긍정적인 역할을 할 것이다.

• The Journal of the Korea Contents Association
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• v.14 no.9
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• pp.362-370
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• 2014

This study measured and analyzed the correlation coefficient between movements of thoracoabdominal tumors and external respiration in a free-breathing state, using cyberknife image guided radiotherapy(IGRT). This study subjects included a total of 30 patients with lung tumors(n=10), liver tumors(n=10) and pancreatic tumor(n=10) who underwent radiotherapy, and the movements of tumors were analyzed using converted log data of the tumor motion tracking system(MTS). In a free-breathing state, In relation to Peason's correlation coefficient between external respiration and lung tumors in the entire treatment process, the correlation coefficient was 0.646(p<0.05) in the cranio-caudal direction, 0.365(p<0.088) in the left and right direction and 0.196(p<0.115) in the antero-posterior direction. The correlation coefficient of liver tumors was 0.841(p<0.000) in the cranio-caudal direction, 0.346 (p<0.179) in the left and right direction and 0.691(p<0.001) in the antero-posterior direction. The correlation coefficient of Pancreatic tumors was 0.683(p<0.000) in the cranio-caudal direction, 0.397(p<0.006) in the left and right direction and 0.268(p<0.127) in the antero-posterior direction. In conclusion, the measurement findings of thoracoabdominal tumor movement using IGRT would be helpful in determining an accurate target volume. Moreover, the analysis of correlation between external respiration and movements of internal tumors would provide important information to correct movements of tumors for diverse radiotherapy techniques.