• 대한의용생체공학회:의공학회지
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• 제36권4호
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• pp.115-122
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• 2015

A standard air flow generator system was developed to generate air flows of various levels simultaneously applied to two different air flow transducer modules. Axes of two identical standard syringes for spirometer calibration were connected with each other and driven by a servo-motor. Linear displacement transducer was also connected to the syringe axis to accurately acquire the volume change signal. The user can select either sinusoidal or square waveform of volume change and manually input any volume as well as maximal flow rate levels ranging 0~3 l and 0~15 l/s, respectively. Various volume and flow levels were input to operate the system, then the volume signal was acquired followed by numerical differentiation to obtain the air flow signal. The measured volumes and maximal air flow rates were compared with the user input data. The relative errors between the user-input and the measured stroke volumes were all within 0.5%, demonstrating very accurate driving of the system. In case of the maximal flow rate, relatively large error was observed when the syringe was driven very fast within a very short time duration. However, except for these few data, most measured flow rates revealed relative errors of approximately 2%. When the measure and user-input stroke volume and maximal flow rate data were analyzed by linear regression analysis, respectively, the correlation coefficients were satisfactorily higher than 0.99 (p < 0.0001). These results demonstrate that the servo-motor controls the syringes with enough accuracy to generate standard air flows. Therefore, the present system would be very much practical for calibration process as well as performance evaluation and comparison of two different air flow transducer modules.

• 대한물리의학회지
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• 제12권4호
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• pp.29-37
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• 2017

PURPOSE: This study investigated the immediate effect of inspiratory muscle training with whole-body vibration on the pulmonary function of subacute stroke patients. METHODS: All participants (n=30) were allocated to the following groups: (1) the inspiratory muscle training group with whole-body vibration (n=10), wherein the patients received inspiratory muscle training with whole-body vibration comprising 3minutes of vibration per session and respiratory training of 30 times and 2 sessions for one day. (2) the inspiratory muscle training group with visual feedback (n=10), wherein the patients received inspiratory muscle training with visual feedback. (3) the inspiratory muscle training group (n=10), wherein the patients received inspiratory muscle training. RESULTS: After the experiment, the inspiratory muscle training group with whole-body vibration exhibited significantly higher forced vital capacity, forced expiratory volume at 1 second, peak inspiratory flow rate, maximal inspiratory pressure, and chest expansion (p<.05), compared to the other groups. Inspiratory muscle training group with whole-body vibration had significantly higher peak expiratory flow rate and maximal voluntary ventilation than the other groups (p<.05). CONCLUSION: These results show that pulmonary function, maximal inspiratory pressure, and chest expansion were significantly better in the inspiratory muscle training group with whole-body vibration than in the other groups. Thus, this treatment will help recovery of pulmonary function in stroke patients.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3030-3036
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• 2012

본 연구는 강제 양압식 호흡훈련이 기관절개관을 삽입한 뇌졸중 환자의 호흡능력 및 기침능력에 미치는 효과에 대하여 알아보고자 실시하였다. 연구대상은 기관절개관을 삽입한 뇌졸중 환자 10명으로 하였으며, 대상자는 강제 양압식 호흡훈련을 20분씩 주 5회 8주간 실시하였다. 훈련 전, 훈련 4주 후 그리고 8주 후 대상자의 노력성 폐활량, 1초간 노력성 호기량, 노력성 폐활량비 그리고 도수 보조 최대 기침유량을 측정하였으며 기간에 따른 호흡능력과 기침능력을 알아보고자 반복측정 분산분석법을 이용하였다. 연구 결과 훈련기간에 따라 대상자의 노력성 폐활량, 1초간 노력성 호기량, 도수 보조 최대 기침유량은 유의하게 증가하였다. 따라서 강제 양압식 호흡훈련은 기관절개관을 삽입한 뇌졸중 환자의 호흡능력 및 기침능력을 증진시켜 기관절개관을 제거하는데 유용한 훈련방법이라 할 수 있다.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.147-153
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• 2015

Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.

• Annals of Rehabilitation Medicine
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• 제42권6호
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• pp.798-803
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• 2018

Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke. Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups. Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups. Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.

• 한국의학물리학회지:의학물리
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• 제18권3호
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• pp.149-160
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• 2007

초급성 허혈성 뇌졸중 환자를 대상으로 관류 전산화단층촬영(CT)의 임상적 적용을 평가하였다. 뇌졸중 증상 발현 62명의 환자를 대상으로 하였고, 관류 CT는 소뇌 기저부위에서 8 cm 상방으로 스캔하여 후처리 과정을 거쳐 뇌혈용적(cerebral blood volume, CBV), 뇌혈류량(cerebral blood flow, CBF), 평균 조영제 통과시간(mean transit time, MTT) 및 조영제 최고 도달시간(time to peak, TTP) 등의 네 가지 지도의 영상을 얻었다. 관류 CT의 CBV, CBF, MTT, TTP 지도에서 병변을 평가하였으며, 병변 부위와 정상측 대칭부위에서 MTT와 TTP를 측정하여 차이를 비교하였다. 관류 CT의 네 가지 지도 모두에서 관류결손을 인지할 수 있었고, 관류 결손이 인지되는 부위에서 MTT와 TTP의 현저한 지연이 있었다. 관류 CT의 MTT와 TTP영상이 초급성 허혈성 경계부위의 페넘브라를 반영하였다. 관류 CT의 네 가지 지도를 이용하면 뇌졸중의 조기 진단, 허혈 중심부, 허혈 페넘브라를 알 수 있게 되어 관류결손 부위의 혈류역동학적 평가가 가능함으로써, 허혈성 뇌졸중 환자의 진단 및 효과적인 치료를 위해 관류 CT가 유용하여 임상적 적용이 가능하다.

• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.333-344
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• 2024

Objective : Markers of neuroinflammation during ischemic stroke are well characterized, but additional markers of neural damage are lacking. The study identified associations of behavioral disorders after stroke with histologic neural damage and molecular biological change. Methods : Eight-week-old, 25 g male mice of the C57BL/6J strain were subjected to middle cerebral artery occlusion (MCAO) to induce ischemic stroke. The control group was a healthy wild type (WT), and the experimental group were designed as a low severity MCAO1 and a high severity MCAO2 based on post-stroke neurological scoring. All groups underwent behavioral tests, realtime polymerase chain reaction, triphenyltetrazolium chloride (TTC) staining and Hematoxylin and Eosin staining. One-way analysis of variance was used to analyze statistical significance between groups. Results : In TTC staining, MCAO1 showed 29.02% and MCAO2 showed 38.94% infarct volume (p<0.0001). The pro-inflammatory cytokine interleukin (IL)-1β was most highly expressed in MCAO2 (WT 0.44 vs. MCAO1 2.69 vs. MCAO2 5.02, p<0.0001). From the distance to target in the Barnes maze test, WT had a distance of 178 cm, MCAO1 had a distance of 276 cm, and MCAO2 had a distance of 1051 (p=0.0015). The latency to target was 13.3 seconds for WT, 27.9 seconds for MCAO1, and 87.9 seconds for MCAO2 (p=0.0007). Prospero homeobox 1 (Prox1) was most highly expressed in MCAO2 (p=0.0004). Doublecortin (Dcx) was most highly expressed in MCAO2 (p<0.0001). Conclusion : The study demonstrated that histological damage to neural cells and changes in brain mRNA expression were associated with behavioral impairment after ischemic stroke. Prox1 and Dcx may be biomarkers of neural damage associated with long-term cognitive decline, and increased expression at the mRNA level was consistent with neural damage and long-term cognitive dysfunction.

• Korean Circulation Journal
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• 제53권6호
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• pp.406-417
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• 2023

Background and Objectives: Pathophysiological changes of right ventricle (RV) after repair of tetralogy of Fallot (TOF) are coupled with a highly compliant low-pressure pulmonary artery (PA) system. This study aimed to determine whether pulmonary vascular function was associated with RV parameters and exercise capacity, and its impact on RV remodeling after pulmonary valve replacement. Methods: In a total of 48 patients over 18 years of age with repaired TOF, pulmonary arterial elastance (Ea), RV volume data, and RV-PA coupling ratio were calculated and analyzed in relation to exercise capacity. Results: Patients with a low Ea showed a more severe pulmonary regurgitation volume index, greater RV end-diastolic volume index, and greater effective RV stroke volume (p=0.039, p=0.013, and p=0.011, respectively). Patients with a high Ea had lower exercise capacity than those with a low Ea (peak oxygen consumption [peak VO₂] rate: 25.8±7.7 vs. 34.3±5.5 mL/kg/min, respectively, p=0.003), while peak VO₂ was inversely correlated with Ea and mean PA pressure (p=0.004 and p=0.004, respectively). In the univariate analysis, a higher preoperative RV end-diastolic volume index and RV end-systolic volume index, left ventricular end-systolic volume index, and higher RV-PA coupling ratio were risk factors for suboptimal outcomes. Preoperative RV volume and RV-PA coupling ratio reflecting the adaptive PA system response are important factors in optimal postoperative results. Conclusions: We found that PA vascular dysfunction, presenting as elevated Ea in TOF, may contribute to exercise intolerance. However, Ea was inversely correlated with pulmonary regurgitation (PR) severity, which may prevent PR, RV dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis.

• Korean Journal of Radiology
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• 제21권4호
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• pp.450-461
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• 2020

Objective: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters. Materials and Methods: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods. Results: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (-5.7 to 11.8 mL), 3.6 mL (-4.0 to 11.2 mL), -0.4 mL (5.7 to 5.0 mL), and -1.8% (-5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87-0.93). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA. Conclusion: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

• 대한수의학회지
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• 제44권2호
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• pp.317-322
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• 2004

This study was performed to evaluate echocardiographic parameters in dogs with experimental mitral regurgitation subjected to dobutamine stress testing. In 8 beagle dogs, a 4-prong grasping forceps was inserted into the left ventricle through the carotid artery with fluoroscopic guidance. The disruption of chordae or mitral valve leaflet was performed. Echocardiographic protocols included quantitative Doppler echocardiography and M-mode measurement for evaluating left ventricle function. After all measurement was obtained at rest, dobutamine was infused incrementally. In stress testing, all measurement also was performed at rest as the same method. In stress Doppler echocardiography, regurgitant fraction and aortic stroke volume was increased significantly (P<0.001). Effective regurgitant orifice and regurgitant volume was not changed. In M-mode examination, fractional shortening was increased significantly at stress test (P<0.001). From the results obtained in this study, it could be suggested that dobutamine stress echocardiography increase left ventricle performance in non-functional mitral regurgitation and quantitative Doppler echocardiography is non-invasive, accurate method in valvular regurgitation.