• Journal of Biomedical Engineering Research
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• v.19 no.5
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• pp.511-518
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• 1998

In order to develop the aerosol bolus technique which is thought to be a potential tool for probing geometries or abnormalities of small airways, an experimental system of measuring fast time variations of particle concentration in the inhaled and exhaled breathing air was developed. The system generates monodisperse sebacic acrid particles of 1 micron size and 1.2 of geometric standard deviation in high concentration of $10^8$ particles/cc, delivers a short pulse of particles at the controlled instant during inhalation using a solenoid valve, and measures the fast change of particle concentration in using the laser light scattering. Successful operation of the generator and the measuring system was confirmed by smooth concentration profiles in inhalation. It was also confirmed that maintaining a constant breathing rate is essential to stable outputs and any disturbance in flow rate near the mode (maximum concentration) induces a large number of spurious peaks in the exhalation. Experimental data without strict control of breathing flow rate showed a substantial amount of scatter. The measured results showed an improvement in scatter over the existing results. When compared with theoretical predictions from 1-D convective diffusion equation and other experiments, general characteristics of dispersion for several penetration depths showed a good agreement, but there exists some difference in absolute values, which is attributed to the difference in body conditions. Improvements are needed in the theory, especially in relation to correcting for the effect of breathing flow rate.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.123-135
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• 2012

Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.509-519
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• 2013

Through the study on judgment of Body form and settle Energy flow(立形定氣) before diagnose the patients, the results are as follows. The observation of the body form is to determine prosperity and deficiency of each internal organ. It is necessary to distinguish Body form loss(形脫) and Body form fullness(形充). Fat man(肥人), Thin man(瘦人), Creamy man(膏人), Muscular man(肉人), Small Fat man(脂人) are discriminated by fat distribution, fat content, and muscle mass. The observation of the body form means the observation of structure disorder, color change, develop part at body, head and face. The observation of the body form that is to determine prosperity and deficiency of each internal organ is from the limited knowledge of the anatomy. The observation of face color is considered by blood perfusion, blood oxygenation and accumulation of carotinoid, bilirubin and change of melanin in the facial skin. The prosperity and the deficiency of energy flow is considered by symptom combined with growth (<40 years) and aging (>40 years). The prosperity of energy flow includes the anger, anxious emotion and the deficiency of energy flow includes the fear, depressive emotion. The breathing type is expiratory exhalation like asthma patients in the prosperity of energy flow. The deficiency of energy flow is weakness to overcome the disease. The prosperity and the deficiency of energy flow are considered by body metabolic ratios (Basal metabolic Rate: BMR, Resting metabolic rate: RMR, Physical activity ratios: PASs). Development of subcutaneous fat is good in the person of prosperous energy flow. The person of prosperous energy flow is hard to overcome to heat weather than cold weather. The person of deficiency of energy flow has tendencies of low blood pressure, insufficiency of blood flow in the peripheral and being shocked. The person of deficiency of energy flow has tendencies of chronic fatigue syndrome or automatic nerve disorder. If the patient who has deficiency of energy flow has severe weight loss should be checked for the presence of disease. The observation of small and large of bone is to check the development and disorder of bone growth and aging. The observation of thickness and weakness of muscle is to check the development of muscle, particularly biceps, gastrocnemius, and rectus abdominal muscle. The observation of thickness and weakness of skin is to check the ability of regulating body temperature by sweating.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.555-568
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• 1995

Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.