• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.130-134
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• 2023

A 12-year-old Standard Poodle presented with intermittent weakness and occasional dyspnea at the Veterinary Medicine Teaching Hospital of Kangwon National University. A grade of 4 out of 6 systolic murmur with an irregular tachycardic rhythm was auscultated on both sides of the chest. Systolic blood pressure was 140 mmHg. Panting was noticed in the hospital, but there was no crackle sound. Blood analysis revealed mild increases in liver panel levels (alanine aminotransferase 149 [reference interval, 19-70] U/L; and alkaline phosphatase, 185 [reference interval, 15-127] U/L) and severe increases in cardiac biomarker levels (n-terminal pro-brain natriuretic peptide, 4169 [reference interval, 50-900] pmol/L; and cardiac troponin I, 0.22 [reference interval, 0.03-0.12] ng/mL). On electrocardiography, irregularly irregular supraventricular tachycardic rhythm with an f-wave and no distinct p-wave was observed. Generalized cardiomegaly with an enlarged right atrium and left ventricle was confirmed on thoracic radiography. Moreover, hepatomegaly and an enlarged caudal vena cava were observed. Echocardiographic evaluation revealed a fibromuscular diaphragm in the right ventricle. Because of the obstructive lesion in the right ventricle, the right atrium and ventricle were enlarged (right atrial area index, 38.82 cm²/m² [reference interval, 4.2-10.2 cm²/m²]; right ventricle end-diastolic area index, 14.152 cm²/m² [reference interval, 4.9-10.92 cm²/m²]). Accordingly, the patient was diagnosed with double-chambered right ventricle (DCRV). Pimobendan, furosemide, enalapril, diltiazem, and S-adenosylmethionine (SAMe) were prescribed, and all symptoms were relieved. DCRV is a right-sided congenital heart defect resembling pulmonic valve stenosis. If symptoms are not severe, medical therapy can be facilitated without surgery or the balloon dilation.

• Progress in Medical Physics
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• v.25 no.2
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• pp.72-78
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• 2014

The aim of the study is to test a hypothesis that quasi-breath-hold (QBH) biofeedback improves the residual respiratory motion management in gated 3D thoracic MR imaging, reducing respiratory motion artifacts with insignificant acquisition time alteration. To test the hypothesis five healthy human subjects underwent two gated MR imaging studies based on a T2 weighted SPACE MR pulse sequence using a respiratory navigator of a 3T Siemens MRI: one under free breathing and the other under QBH biofeedback breathing. The QBH biofeedback system utilized the external marker position on the abdomen obtained with an RPM system (Real-time Position Management, Varian) to audio-visually guide a human subject for 2s breath-hold at 90% exhalation position in each respiratory cycle. The improvement in the upper liver breath-hold motion reproducibility within the gating window using the QBH biofeedback system has been assessed for a group of volunteers. We assessed the residual respiratory motion management within the gating window and respiratory motion artifacts in 3D thoracic MRI both with/without QBH biofeedback. In addition, the RMSE (root mean square error) of abdominal displacement has been investigated. The QBH biofeedback reduced the residual upper liver motion within the gating window during MR acquisitions (~6 minutes) compared to that for free breathing, resulting in the reduction of respiratory motion artifacts in lung and liver of gated 3D thoracic MR images. The abdominal motion reduction in the gated window was consistent with the residual motion reduction of the diaphragm with QBH biofeedback. Consequently, average RMSE (root mean square error) of abdominal displacement obtained from the RPM has been also reduced from 2.0 mm of free breathing to 0.7 mm of QBH biofeedback breathing over the entire cycle (67% reduction, p-value=0.02) and from 1.7 mm of free breathing to 0.7 mm of QBH biofeedback breathing in the gated window (58% reduction, p-value=0.14). The average baseline drift obtained using a linear fit was reduced from 5.5 mm/min with free breathing to 0.6 mm/min (89% reduction, p-value=0.017) with QBH biofeedback. The study demonstrated that the QBH biofeedback improved the upper liver breath-hold motion reproducibility during the gated 3D thoracic MR imaging. This system can provide clinically applicable motion management of the internal anatomy for gated medical imaging as well as gated radiotherapy.

• Tuberculosis and Respiratory Diseases
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• v.51 no.3
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• pp.240-247
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• 2001

Background : Tuberculous pleurisy treatments improve symptoms such as fever, chest pain, cough, and prevents the progression to active pulmonary tuberculosis and the development of residual pleural thickening that decrease diaphragm and rib cage movement This study investigated how the degree of residual pleural thickening affects the pulmonary function. Methods : Fifty seven patients who were initially diagnosed as having tuberculous pleurisy, were treated with anti-tuberculous medication for 6 months and had residual pleural thickening between May 1998 and January 2000 at the Eulji university hospital were reviewed. A chest X-ray and pulmonary function test(PFT, Sensormedics 2200) were performed. The predicted value(%) of the forced vital capacity(FVC), forced inspiratory vital capacity(FNC) and total lung capacity(TLC) were measured. The residual pleural thickening was defined the average of the summation in the lateral chest at the level of the imaginary line intersecting from the cardiophrenic angle to the diaphragmatic dome and the lowest part of the costophrenic angle between them. The results were sorted into three grades according to pleural thickness ; <2mm(grade I), 2~10mm(grade II), 10mm(grade III). Results : 1. FVC(% pred) and FIVC(% pred) were statistically different between grade I and III, and II and III. However, there was no difference between the TLC(% pred) between each of the groups. 2. The pleural thickness that cause restrictive dysfunction(FVC<80%) and a statistically difference, is 3mm. Conclusion : The larger the extent of the residual pleural thickness after antituberculous medication, the greater the reduction in the FVC, FIVC, TLC. A pleural thickness of 3mm is recommended as a guideline for diagnosing a restrictive pulmonary dysfunction.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.138-148
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• 2004

Purpose: Regardless of the underlying diseases, the proteinuric condition demonstrates ultrastructural changes in podocytes with retraction and effacement of the highly specialized interdigitating foot processes. We examined the molecular basis for this alteration of the podocyte phenotypes, including quantitative and distributional changes of ZO-1 protein as a candidate contributing to the pathogenic changes in the barrier to protein filtration. Methods: To investigate whether high glucose and advanced glycosylation endproduct(AGE) induce podocyte cytoskeletal changes, we cultured rat GEpC under 1) normal glucose(5 mM=control) or 2) high glucose(30 mM) or 3) AGE-added or 4) high glucose plus AGE-added conditions. The distribution of ZO-1 was observed by confocal microscope and the change of ZO-1 expression was measured by Western blotting and RT-PCR. Results: By confocal microscopy, we observed that ZO-1 moves from peripheral cytoplasm to inner actin filaments complexes in both AGE-added and high glucose condition. In Western blotting, high glucose or AGE-added condition decreased the ZO-1 protein expression by 11.1%(P>0.05) and 2.3%(P>0.05), respectively compared to the normal glucose condition. High glucose plus AGE-added condition further decreased ZO-1 protein expression to statistically significant level(12%, P<0.05). No significant change was seen in the osmotic control. In RT-PCR, high glucose plus AGE-added condition significantly decreased the expression of ZO-1 mRNA by 12% compared to normal glucose condition. Conclusion: We suggest that both high glucose and AGE-added condition induce the cytoplasmic translocation and suppresses the production of ZO-1 at transcriptional level and these changes may explain the functional changes of podocytes in diabetic conditions.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.469-472
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• 2015

A 10-year-old, castrated poodle dog presented with a cough for 2 weeks, and the cough initially developed since very young age. On radiographs, pneumothorax was noticed by characteristics of radiolucent area without pulmonary markings along the thoracic wall and diaphragm, retracted lung lobes from the thoracic wall and severely decreased volume of the left cranial lung lobe with disconnected bronchus. Computed tomography (CT) findings identified several pulmonary air-filled cysts and collapsed lung with abnormal shape and non-tapered end of bronchus, bronchioles at the accessory lobe and left cranial lobe. Also, pneumothorax, pneumomediastinum and subcutaneous emphysema were found. Imaging diagnosis was the spontaneous pneumothorax caused by ruptured emphysematous bullae associated with congenital bronchial cartilage abnormality or bronchial tree malformation. On surgery, hypoplasia of the left cranial lobe, right middle lobe, and accessory lobe with a bulla where air was leaking was identified. The accessory lobe was partially resected and bronchial cartilage hypoplasia was confirmed by histopathologic examination.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.479-485
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• 1997

We investigated changes of the size of neoaortic annulus, root, and aortic anastomosis after arterial switch operation for complete transposition of the great arteries performed in infancy. A total of 23 patients were included in this study. Age ranged from 6 to 153 days. Body weight averaged 3.9$\pm$0.8kg and 17 patients were male. The preoperative angiocardiographic dimensions of the pulmonary annulus, the pulmonary root, and the sinotubular junction, standardized to the diameter of descending aorta at the level of diaphragm, were compared to the size of postoperative measurements of the neoaortic annulus, the neoaortic root, and the aortic an stomosis at a mean interval of 17.2$\pm$ 9.4 months. Mean dimensions of the neoaortic annulus and the neoaortic root were significantly increased postoperatively(n=23, annulus; p<0.01, root; p<0.01), however, those of the aortic anastomosis did not reveal significant change(n=23, p=0.06). There were no significant differences in changes of diameters of the neoaortic annulus, the root, and the aortic anastomosis between patients with(n=8) and without(n=15) postoperative neoaortic regurgitation(annulus; p=0.32, root; p=0.29, anastomosis; p=0.86). Postoperative dimensions of the neoaortic root and annulus between patients with ventricular septal defect(n: 10) and without ventricular septal defect(ni 13) were not significantly changed compared to the preoperative measurements(annulus; p=0.09, root; p=0.07) but mean diameters of the aortic anastomosis decreased significantly after operation in patients with ventricular septal defect(p=0.04). This study revealed that the site of the aortic an stomosis grows in proportion to patient's somatic growth after arterial switch operation. Although we could not demonstrate the relation between the aortic root dilatation and the postoperative neoaortic regurgitation in this study, a continuous close follow-up might be necessary to detect a possible progression of the aortic root dilatation and the resulting significant aortic valve regurgitation.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.57-67
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• 2013

Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.123-129
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• 2007

Purpose: CT scan shows that significant tumor movement occurs in lesions located in the proximity of the heart, diaphragm, and lung hilus. There are differences concerning three kinds of type to get images following the Scan type called Axial, Helical, Cine (4D-CT) mode, when the scanning by CT. To know how each protocol describe accurately, this paper is going to give you reappearance using the moving phantom. Materials and Methods: To reconstruct the movement of superior-inferior and anterior-posterior, the manufactured moving phantom and the motor following breathing were used. To distinguish movement from captured images by CT scanning, a localizer adhered to the marker on the motor. The moving phantom fixed the movement of superior-inferior upon 1.3 cm /1 min. The motor following breathing fixed the movement of anterior-posterior upon 0.2 cm /1 min. After fixing each movement, CT scanning was taken by following the CT protocols. The movement of A localizer and volume-reappearance analyzed by RTP machine. Results: Total volume of a marker was 88.2 $cm^3$ considering movement of superior-inferior. Total volume was 184.3 $cm^3$. Total volume according to each CT scan protocol were 135 $cm^3$ by axial mode, 164.9 $cm^3$ by helical mode, 181.7 $cm^3$ by cine (4D-CT) mode. The most closely describable protocol about moving reappearance was cine mode, the marker attached localizer as well. Conclusion: CT scan should reappear concerning a exact organ-description and target, when the moving organ is being scanned by three kinds of CT protocols. The cine (4D-CT) mode has the advantage of the most highly reconstructible ability of the three protocols in reappearance of the marker using a moving phantom. The marker on the phantom has always regular motion but breathing patients don't move like a phantom. Breathing education and devices setting patients were needed so that images reconstruct breathing as exactly as possible. Users should also consider that an amount of radiation to patients is being bombed.

• Korean Journal of Veterinary Research
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• v.9 no.1
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• pp.1-9
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• 1969

The experimental studies were performed to observe the characteristics of the myelinated nerve fibers of the tradiaphragmatic branches of phrenic nerves in dog In the work to be reported five mixed breed Korean dog were used, they were one year old and he body eights were about 12 Kgm. in average with healthy conditions. The specimens (nerve) were taken at the point of 1.5 cm posterior part from the left and right phrenic nerves entrance to the diaphragm, and the dorso-lateral and dorso-medial branches of phrenic nerves vere also, taken at the point of 0.5 cm distal part from their branching portion. The specimens were fixed for 24 hrs. in Flemming's solution, and embedded in paraffin. The paraffin section. were cut at 6 microns and stained with Walter's modification of Weigert-pal method for the myelinated fibers. Microphotographs were taken and enlarged into 750 times of the actual size, and the diameter of the photographic images of the myelinated fibers were measured by the scale on the transparent Percepex Plate. The following conclusions were made: 1. The percentage of distribution of the several intradiaphragmatic branches of phrenic nerves were as follows. Ventral branches were 34.97%, lateral branches were 37.90%, dorsal branches were 27.13%, and the dorsal branches were branched again into dorso-lateral branches(54.22%) and dorso-medial branches (45. 78%). 2. The mean value and S.D. of the total numbers of the myelinated nerve fibers at the left ventral branches were $490.80{\pm}12$, and at the right ventral branches were $486.6{\pm}13$. Total average cross sectional area on the left ventral branches were 38,000. $6{\pm}136{\mu}^2$, and the right ventral branches were $37,150.2{\pm}1.782{\mu}^2$. 3. The mean value and S.D. of the total numbers of the myelinated nerve fibers at the left lateral branches were $533.8{\pm}8$, and at the right lateral branches were $525.6{\pm}7$. Total average cross sectional area of the left lateral branches were $41,582{\pm}1,170{\mu}^2$, and the right lateral branches were $40,454.8{\pm}812{\mu}^2$. 4. The mean value and S.D. of the total numbers of the myelinated nerve fibers at the left dorsal branches were $378.2{\pm}14$, and at the right dorsal branches were $380.2{\pm}8$. Total average cross sectional area of the left dorsal branches were $27,771{\pm}1,256{\mu}^2$, and the right dorsal branches were $27,507.2{\pm}645{\mu}^2$. 5. The mean value and S.D. of the total numbers of the myelinated fibers at the left dorso-lateral branches were $205.4{\pm}15$, and at the right dorso-lateral branches were $210.6{\pm}17$. Total average cross sectional area of the left dorso lateral branches were $15,354. 8{\pm}1,519{\mu}^2$, and the right dorsal branches were $15,887{\pm}1,297{\mu}^2$. 6. The mean value and S.D. of the total numbers of the myelinated nerve fibers at the left dorso-medial branches were $175{\pm}14$, and at the right dorso-medial branches were $176.2{\pm}17$. Total average cross sectional area of the left dorso-medial branches were $13,037.4{\pm}944{\mu}^2$, and at the right dorso-medial branches were, $13,103{\pm}1,373{\mu}^2$. 7. The highest frequent distribution of the intradiaphragmatic branches of phrenic nerves were found in the $10-12{\mu}^2$ groups, and they were almost 30% of the total groups. 8. The largest fibers diameter were in the $14-16{\mu}^2$ groups, and these were shown the lowest frequent distribution. 9. The largest cross sectional area of the intradiaphragmatic branches of phrenic nerves were found in the $10-12{\mu}^2$ groups. 10. All of the intradiaphragmatic branches of phrenic nerves were unimodal which has a peak in the $10-12{\mu}^2$ groups.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.31 no.3A
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• pp.235-249
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• 2011

A new form of I-type PSC bridge girder, which has hole in the web, is proposed in this paper. Three different concepts were combined and implemented in the design. First of all, a girder was precast at a manufacturing plant as divided pieces and assembled at the construction site using post-tensioning method, and the construction period at the site will be reduced dramatically. In this way, the quality of concrete can be assured at the manufacturing factory and concrete curing can be well controlled, and the spliced girder segments can be moved to the construction site without a transportation problem. Secondly, a numerous number of holes was made in the web of the girder. This reduces the self-weight of the girder. But more important thing related to the holes is that about half of the total anchorages can be moved from the girder ends into individual holes. The magnitude of negative moment developed at girder ends will be reduced. Also, since the longitudinal compressive stresses are reduced at ends, thick end diaphragm is not necessary. Thirdly, Prestressing force was introduced into the member through multiple stages. This concept of multi-stage prestressing method overcomes the prestressing force limit restrained by the allowable stresses at each loading stage, and maximizes the magnitude of applicable prestressing force. It makes the girder longer and shallower. Two 50 meter long full scale girders were fabricated and tested. One of them was non-spliced, or monolithic girder, made as one piece from the beginning, and the other one was assembled using post-tensioning method from five pieces of segments. It was found from the result that monolithic and spliced girder show similar load-deflection relationships and crack patterns. Girders satisfied specific girder design specification in flexural strength, deflection, and live load deflection control limit. Both spliced and monolithic holed web post-tensioned girders can be used to achieve span lengths of more than 50m with the girder height of 2 m.