• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.250-258
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• 1993

Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.513-517
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• 2010

Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.29-35
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• 1998

Rats were studied during 45 minutes treadmill exercise to determine the effects of hyperglycemia and hyperlipidemia on the utilization of cardiac muscle glycogen, and the utilization of diaphragm muscle glycogen was also studied for comparing to cardiac muscle. The hyperglycemia was produced by ingestion of 25% glucose solution(lml/100gm, BW) and the hyperlipidemia by 10% intralipose ingestion(lml/l00gm, BW) with intraperitoneal injection of heparin(500 IU) 15 minutes before treadmill exercise. The mean blood glucose concentrations(mg/dL) in control and hyperglycemic rats were 110 and 145, respectively, and the mean plasma free fatty acid concentrations(${\mu}Eq/L$) in control, control exercise(control-E) and hyperlipidemia exercise(HL-E) rats were 247, 260 and 444, respectively. In the hyperglycemic trial, the cardiac muscle glycogen concentration was not significantly decreased by the exercise but the concentration in control rats was decreased to 73.9%(p<0.05). The glycogen concentration of diaphragm was significantly decreased in both groups by the exercise, but the hyperglycemia decreased the glycogen utilization by approximately 10% compared to the control. The cardiac muscle glycogen concentration was not decreased by the exercise in control and hyperlipidemic rats but the utilization of glycogen in hyperlipidemic rats is lower than that of the control. These data illustrate the sparing effect of hyperglycemia on cardiac muscle glycogen usage during exercise, but the effect of hyperlipidemia was not conclusive. In the skeletal muscle, the usage of glycogen by exercise was spared by both hyperglycemia and hyperlipidemia.

• Horticultural Science & Technology
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• v.32 no.5
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• pp.628-635
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• 2014

The large amount of $CO_2$ emitted from mushrooms during incubation and developmental stages can be utilized in plant production systems as a $CO_2$ source. The objectives of this study were to measure the $CO_2$ emission and absorption rates of mushroom and lettuce, respectively, and to analyze the $CO_2$ concentrations at various ratios of mushroom and lettuce in a closed production system. The $CO_2$ emission rate of king oyster mushrooms (Pleurotus eryngii ( DC.) Qu$\acute{e}$l) and $CO_2$ absorption rate of lettuces (Lactuca sativa L. cv. Asia Heuk Romaine) were measured by using two closed acryl chambers ($1.0m{\times}0.8m{\times}0.5m$) in which indoor temperatures were maintained at $18^{\circ}C$ and $22^{\circ}C$, respectively. The lettuce was grown at a light intensity of PPF $340mol{\cdot}m^{-2}{\cdot}s^{-1}$ and with nutrient solution at EC $1.2dS{\cdot}m^{-1}$. The air was periodically circulated between the two chambers using a diaphragm pump. The $CO_2$ emission rate of the mushroom increased until the $15^{th}$ day after scratching (DAS) and then decreased. The rate also increased with increased indoor temperature. In particular, the $CO_2$ emission rate per fresh weight of fruit body increased by about 3.1 times after thinning compared to before thinning. In terms of $CO_2$ balance, the $CO_2$ emission rates from a bottle (950 mL) of the mushroom at 9, 12, and 14 DAS were equivalent to those of 3, 4.5, and 5.5 lettuce plants at 7, 10, and 12 DAT (days after transplanting), respectively. This work shows that balance in $CO_2$ concentration could be achieved using an appropriate ratio of the two crops in a closed production system.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.251-256
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• 2000

Purpose : To evaluate efficacy and complication of stereotactic radiosurgery using stereotactic body frame. Methods and Materials :From December 1997 to June 1999, 11 patients with primary and metastatic tumors were treated with stereotactic radiosurgery using stereotactic body frame(Precision TherapyTu). Three patients were treated with primary hepatoma and seven with metastatic tumor from liver, lung, breast, trachea and one with arteriovenous malformation on neck. We used vacuum pillow for immobilization and made skin marker on sternum and tibia area with chest marker and leg marker. Diaphragm control was used for reducing movement by respiration. CT-simulation and treatment planning were peformed. Set-up error was checked by CT-Simulator before each treatment. Dose were calculated on the 80$\~$90$\%$ isodose of isocenter dose and given consecutive 3 fractions for total dose of 30 Gy (10 Gy/fraction). Results :Median follow-up was 12 months. One patient (9$\%$) showed complete response and four Patients (36$\%$) showed partial response and others showed stable disease. Planning target volumes (PTV) ranged from 3 to 111 cc (mean 18.4 n). Set-up error was within 5 mm in all directions (X, Y, Z axis). There was no complication in all patients. Conclusion :In Primary and metastatic tumors, stereotactic body frame is very safe, accurate and effective treatment modality.

• Korean Journal of Veterinary Research
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• v.36 no.4
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• pp.949-966
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• 1996

To establish the method for the most effective radiography and fluoroscopy, the abdominal organs of cats were investigeted using omnidirectional angles with the center of the body as the axis using an omnidirectional protective shielding X-ray system and a $360^{\circ}$ rotary restraint unit for use in small animals. The organs examined were the diaphragm, liver, stomach, colon, spleen and kidney. The results obtained in the present study were as follows: 1. Regardless of gas in the stomach present or not, it was feasible to distinguish the left and right crura in the lumbar portion of diaphragm in the oblique projection inclined over $30^{\circ}$ and under $90^{\circ}$ from the lateral projection. 2. Outlines of the exterior left lobe and the interior right lobe of the liver were observed in the oblique image inclined up to $60^{\circ}$ from the lateral image, while that of the exterior right lobe was noted in the oblique image inclined up to $60^{\circ}$ from the ventrodorsal-dorsoventral images. 3. It was necessary to have gas present in the stomach for detailed morphological observations of the stomach. It was most clearly observed in the right $30^{\circ}$ ventral-left dorsal oblique projection($120^{\circ}$ image) and the left $60^{\circ}$ dorsal-right ventral oblique projection($300^{\circ}$ image). 4. Morphology of the colon was observable in detail by the oblique projection inclined over $30^{\circ}$ from the lateral projection. 5. To observe the whole spleen it was required to have images from the ventrodorsal projection ($90^{\circ}$ image) to the right $60^{\circ}$ ventral-left dorsal oblique projection ($150^{\circ}$ image) as well as those from the dorsoventral projection ($270^{\circ}$ image) to the left-right lateral projection $0^{\circ}$ image). 6. Dorsal and ventral sides of the kidney were observable in the oblique images inclined $30^{\circ}$ from the lateral image. 7. Considering above findings collectively, it was thought that the results of present study might be useful for the analysis of abnormalies in each organ of cat.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.138-146
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• 2024

Purpose To evaluate whether the image quality of chest radiographs obtained using a camera-type portable X-ray device is appropriate for clinical practice by comparing them with traditional mobile digital X-ray devices. Materials and Methods Eighty-six patients who visited our emergency department and underwent endotracheal intubation, central venous catheterization, or nasogastric tube insertion were included in the study. Two radiologists scored images captured with traditional mobile devices before insertion and those captured with camera-type devices after insertion. Identification of the inserted instruments was evaluated on a 5-point scale, and the overall image quality was evaluated on a total of 20 points scale. Results The identification score of the instruments was 4.67 ± 0.71. The overall image quality score was 19.70 ± 0.72 and 15.02 ± 3.31 (p < 0.001) for the mobile and camera-type devices, respectively. The scores of the camera-type device were significantly lower than those of the mobile device in terms of the detailed items of respiratory motion artifacts, trachea and bronchus, pulmonary vessels, posterior cardiac blood vessels, thoracic intervertebral disc space, subdiaphragmatic vessels, and diaphragm (p = 0.013 for the item of diaphragm, p < 0.001 for the other detailed items). Conclusion Although caution is required for general diagnostic purposes as image quality degrades, a camera-type device can be used to evaluate the inserted instruments in chest radiographs.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.41-52
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• 2002

Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.8
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• pp.1297-1304
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• 2007

We conducted a series of investigations in order to elucidate role of nutritional status in regulating GLUT expression and energy metabolism in porcine muscle. Firstly, the role of mild undernutrition in regulating muscle GLUT gene expression and function was studied in growing pigs (3 wk of age) on a high (H) or low (L) food intake (H = 2L) at $35^{\circ}C$ or $26^{\circ}C$. Low food intake selectively upregulates GLUT1 and GLUT4 gene expression; mRNA levels were elevated in longissimus dorsi (L. dorsi) and rhomboideus muscles but not in diaphragm or cardiac muscles. Our next step was to determine whether dietary lysine, a major primary limiting amino acid in diets for pigs, affects muscle GLUT4 expression. Pigs of 6 wk of age were pair-fed a control or low lysine (LL) diet. The control diet contained optimal amounts of all essential amino acids, including 1.15% lysine. The LL diet was similar but contained only 0.70% lysine. GLUT4 mRNA expression was upregulated by the LL diet in L. dorsi and rhomboideus muscles, whereas that in cardiac muscle was unaffected. GLUT4 protein abundance was also higher in rhomboideus muscle of animals on the LL diet. We conducted another investigation in order to elucidate effects of the LL diet on post-GLUT4 glucose metabolism. Activity of hexokinase was unaffected by dietary lysine levels while that of citrate synthase was higher both in L. dorsi and rhomboideus muscles of pigs fed on the LL diet. Glucose 6-phosphate content was higher in L. dorsi msucle in the LL group. Glycogen content was higher both in L. dorsi and rhomboideus muscles in the LL group. Further, we determined the effects of dietary lysine levels on accumulation of intramuscular fat (IMF) in L. dorsi muscle of finishing pigs. A low lysine diet (lysine content was 0.40%) meeting approximately 70% of the requirement of lysine was given to finishing pigs for two months. IMF contents in L. dorsi of the pigs given the low lysine diet were twice higher than those of the pigs fed on a control diet (lysine content was 0.65%). Finally, we proved that a well known effect of breadcrumbs feeding to enhance IMF of finishing pigs could be attributed to shortage of amino acids in diets including breadcrumbs.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.286-291
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• 2004

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for lipesarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondresarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.