• Progress in Medical Physics
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• v.25 no.4
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• pp.242-247
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• 2014

To see the discrepancies between the calculated and the delivered dose distribution of IMRT fields for respiratory-induced moving target according to the motion ranges. Four IMRT plans in which there are five fields, for lung and liver patients were selected. The gantry angles were set to $0^{\circ}$ for every field and recalculated using TPS (Eclipse Ver 8.1, Varian Medical Systems, Inc., USA). The ion-chamber array detector (MatriXX, IBA Dosimetry, Germany) was placed on the respiratory simulating platform and made it to move with ranges of 1, 2, and 3 cm, respectively. The IMRT fields were delivered to the detector with 30~70% gating windows. The comparison was performed by gamma index with tolerance of 3 mm and 3%. The average pass rate was 98.63% when there's no motion. When 1.0, 2.0, 3.0 cm motion ranges were simulated, the average pass rate were 98.59%, 97.82%, and 95.84%, respectively. Therefore, ITV margin should be increased or gating windows should be decreased for targets with large motion ranges.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.125-130
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• 2008

Endobronchial actinomycosis is a rare chronic suppurative granulomatous infection of the bronchus, and this is sometimes related with a foreign body or a broncholith. The traditional treatment of endobroncial actinomycosis is intravenous antibiotics for 2 to 6 weeks and then oral antibiotics therapy for 6 to 12 months. We report here on 2 cases of endobronchial actinomycosis that were associated with a broncholith and a foreign body, respectively. Surgery followed by short term antibiotics therapy for only 20 days and 34 days, respectively, was effective as treatment for the endobronchial actinomycosis in our cases. After treatment, there were no complications or recurrence during the following period. We suggest that short term antibiotics therapy combined with a surgical operation might be effective as treatment for primary endobronchial actinomycosis, and especially when this illness is combined with a foreign body or a broncholith, as compared with traditional long term antibiotic therapy.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.293-297
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• 2008

Mycobacterium fortuitum usually causes colonization or transient infection in patients with underlying lung disease, such as prior tuberculosis or bronchiectasis. The majority of these patients may not need to receive antibiotic therapy for M. fortuitum isolates. We report here on a patient with M. fortuitum lung disease and who was successfully treated with combination oral antibiotic therapy. A 53-year-old woman was referred to our institution because of purulent sputum and dyspnea. A chest radiograph and computed tomography scan revealed cavitary consolidation in the left upper lobe and multiple small cavities in the left lower lobe. Numerous acid-fast bacilli (AFB) were seen in multiple sputum specimens and M. fortuitum was identified by culture from the sputum specimens. The patient received antibiotic treatment including clarithromycin, ciprofloxacin and sulfamethoxazole, because her symptoms were worsening despite conservative treatment. Sputum conversion was achieved after one month of antibiotic therapy. Both the patient's symptoms and radiographic findings improved after 10 months of antibiotic therapy.

• Journal of Korean Physical Therapy Science
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• v.18 no.3
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• pp.1-7
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• 2011

Background : Respiratory muscle weakness has serious clinical consequences. Vital Capacity is the volume of air that is normally exchanged in a single breath. It varies widely with pulmonary health and overall fitness. Purpose : The purpose of this study was to investigate the variation of vital capacity(VC) according to the effects of Kinesio taping and balloons blowing. Methods : Twenty-one non-smokers were participated in this research and these subjects were randomly assigned into three groups; a balloons blowing group(n=7), a Kinesio taping group(n=7), and a balloons blowing and Kinesio taping group(n=7). This experiment was done from June 22, 2009 to July 5, 2009. In order to measure the VC variation effects of Kinesio taping, balloons blowing, and both intervention, an windmill type spiropet was used. The collected data were analyzed statistically by using a paired t-test and ANCOVA. Results : The results of this study were as follows; 1) In the case of balloons blowing, there was a significant difference, 3.35% increase of VC, between before and after 2 weeks experiments(p<.01). 2) In the case of Kinesio taping, there was a significant difference, 11.66% increase of VC, between before and after 2 weeks taping intervention(p<01). 3) In the case of both balloon blowing and Kinesio taping, there was a significant difference, 15.84% increase of VC, between before and after 2 weeks both interventions(p<.01). 4) After 2 weeks experiment, the improvement of VC was shown a significant difference with intergroup(p<.05). Conclusion : From these results, it was revealed that balloons blowing or Kinesio taping, or both interventions were effective to improve VC of healthy adults.

• Tuberculosis and Respiratory Diseases
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• v.82 no.4
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• pp.328-334
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• 2019

Background: Although the frequency of respiratory viral infection in patients with pulmonary acute respiratory distress syndrome (ARDS) is not uncommon, clinical significance of the condition remains to be further elucidated. The purpose of this study was to compare characteristics and outcomes of patients with pulmonary ARDS infected with influenza and other respiratory viruses. Methods: Clinical data of patients with pulmonary ARDS infected with respiratory viruses January 2014-June 2018 were reviewed. Respiratory viral infection was identified by multiplex reverse transcription-polymerase chain reaction (RT-PCR). Results: Among 126 patients who underwent multiplex RT-PCR, respiratory viral infection was identified in 46% (58/126): 28 patients with influenza and 30 patients with other respiratory viruses. There was no significant difference in baseline and clinical characteristics between patients with influenza and those with other respiratory viruses. The use of extracorporeal membrane oxygenation (ECMO) was more frequent in patients with influenza than in those with other respiratory viruses (32.1% vs 3.3%, p=0.006). Co-bacterial pathogens were more frequently isolated from respiratory samples of patients with pulmonary ARDS infected with influenza virus than those with other respiratory viruses. (53.6% vs 26.7%, p=0.036). There were no significant differences regarding clinical outcomes. In multivariate analysis, acute physiology and chronic health evaluation II was associated with 30-mortality (odds ratio, 1.158; 95% confidence interval, 1.022-1.312; p=0.022). Conclusion: Respiratory viral infection was not uncommon in patients with pulmonary ARDS. Influenza virus was most commonly identified and was associated with more co-bacterial infection and ECMO therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.1-6
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• 2011

Purpose: Immobilizations used in order to maintain the reproducibility of a patient set-up and the stable posture for a long period are important more than anything else for the accurate treatment when the stereotactic body radiotherapy is underway. So the purpose of this study is to adapt the optimum immobilizations for the stereotactic body radiotherapy by comparing two commercial immobilizations with the self-manufactured immobilizations. Materials and Methods: Five people were selected for the experiment and three different immobilizations (A: Wing-board, B: BodyFix system, C: Arm up holder with vac-lock) were used to each target. After deciding on the target's most stable respiratory cycles, the targets were asked to wear a goggle monitor and maintain their respiration regularly for thirty minutes to obtain the respiratory signals. To analyze the respiratory signal, the standard deviation and the variation value of the peak value and the valley value of the respiratory signal were separated by time zone with the self-developed program at the hospital and each tie-downs were compared for the estimation by calculating a comparative index using the above. Results: The stability of each immobilizations were measured in consideration of deviation changes studied in each respiratory time lapse. Comparative indexes of each immobilizations of each experimenter are shown to be A: 11.20, B: 4.87, C: 1.63 / A: 3.94, B: 0.67, C: 0.13 / A: 2.41, B: 0.29, C: 0.04 / A: 0.16, B: 0.19, C: 0.007 / A: 35.70, B: 2.37, C: 1.86. And when all five experimenters wore the immobilizations C, the test proved the most stable value while four people wearing A and one man wearing D expressed relatively the most unstable respiratory outcomes. Conclusion: The self-developed immobilizations, so called the arm up holder vac-lock for the stereotactic body radiotherapy is expected to improve the effect of the treatment by decreasing the intra-fraction organ motions because it keeps the respiration more stable than other two immobilizations. Particularly in case of the stereotactic body therapy which requires the maintenance of set-up state for a long time, the self-developed immobilizations is thought to more useful for stereotactic body radiotherapy rather than the rest two immobilizations with instable respiratory cycle as time passes.

• Tuberculosis and Respiratory Diseases
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• v.52 no.5
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• pp.519-528
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• 2002

Background : Steroid therapy has been shown to improve the clinical outcome in acute respiratory distress syndrome (ARDS) patients with histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. Because the histopathological features of acute interstitial pneumonia(AIP) are identical with that of ARDS, early steroid therapy was used in AIP patients who had histological evidence of fibroproliferation in the lung tissue and no identifiable source of infection. We analyzed seven years of our experience to evaluate the efficacy of early steroid therapy in AIP. Materials and Methods : A retrospective review was performed on AIP patients who received steroid therapy within 7 days of mechanical ventilatory support in Dankook university Hospital between May 1995 and May 2002. AIP was diagnosed clinically by ARDS without a known cause of the etiology and pathologically by a lung biopsy showing a fibroproliferative stage of diffuse alveolar damage. The clinical response and physiologic parameters were evaluated during steroid therapy. Results : Five AIP patients received intravenous methylprednisolone (1-2 mg/kg every 6 hours) after $0.6{\pm}1.7$ days of mechanical ventilatory support. Lung biopsies were performed after $1.8{\pm}1.4$ days of mechanical ventilatory support. Four patients(80%) survived and were extubated after $2.8{\pm}0.4$ days of steroid therapy with improvement in the $PaO_2/FiO_2$ ratio ($127.4{\pm}10.0$ at day 0 to $223.8{\pm}37.6$ at day 7) by steroid therapy. However, one patient(20%) died of respiratory failure after 15 days of steroid therapy. Conclusion : Early steroid therapy sppears to be beneficial in AIP patients without evidence of infection. However, as our study group was too small, further large scale studies to define the effectiveness of steroids are required.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.193-196
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• 2004

Acute respiratory distress syndrome after silicone fluid injection is uncommon. Reasons that organic silicone is inactive in the human body and has low surface tension and is not affected by physical factors such as time or temperature make this material to be widely used as a medical product. However, lately some of its side effects have been noted and also cause respiratory problems in rare occasions. The mechanism is not clear but silicone injection cause one to cough, produce hemoptysis, fever, pleuritic chest pain, and dyspnea, and may even lead to acute respiratory failure. In other countries, these side effects were reported from 1970s and several cases started to appear in Korea from 1990s. We report a 58 years-old female who recovered from acute respiratory distress syndrome after injection of silicone fluid into vaginal wall by a conservative therapy.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.74-78
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• 2011

Herein, we report a case of recurrent pleural metastasis after complete resection of invasive thymoma that was successfully treated with surgical resection. Thymoma and thymic carcinoma are uncommon neoplasms derived from the epithelial cells of the thymus. Approximately 30% to 50% of thymomas are asymptomatic at the time of diagnosis. However, these cancers may present with constitutional or local pressure symptoms and sometimes with paraneoplastic syndromes, especially myasthenia gravis. Surgical resection is the mainstay of thymoma treatment and has been shown to remarkably improve long-term survival. Despite complete resection, local recurrences are frequent, and surgery is the cornerstone of therapy even in cases of recurrent thymoma. We experienced a 67-year-old male patient with pleural metastasis that developed 6 years after complete surgical resection of invasive thymoma. The pleural mass was excised by video-assisted thoracoscopic surgery. Histopathological examination revealed an invasive World Health Organization (WHO) type B2 thymoma.