• Radiation Oncology Journal
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• 제31권4호
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• pp.239-246
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• 2013

Purpose: We explored whether the deep inspiration breath hold (DIBH) technique using Abches during left-sided breast irradiation was effective for minimizing the amount of radiation to the heart and lung compared to free breathing (FB). Materials and Methods: Between February and July 2012, a total of 25 patients with left-sided breast cancer underwent two computed tomography scans each with the DIBH using Abches and using FB after breast-conserving surgery. The scans were retrospectively replanned using standardized criteria for the purpose of this study. The DIBH plans for each patient were compared with FB plans using dosimetric parameters. Results: All patients were successfully treated with the DIBH technique using Abches. Significant differences were found between the DIBH and FB plans for mean heart dose (2.52 vs. 4.53 Gy), heart V30 (16.48 vs. $45.13cm^3$), V20 (21.35 vs. $54.55cm^3$), mean left anterior descending coronary artery (LAD) dose (16.01 vs. 26.26 Gy, all p < 0.001), and maximal dose to $0.2cm^3$ of the LAD (41.65 vs. 47.27 Gy, p = 0.017). The mean left lung dose (7.53 vs. 8.03 Gy, p = 0.073) and lung V20 (14.63% vs. 15.72%, p = 0.060) of DIBH using Abches were not different significantly compared with FB. Conclusion: We report that the use of a DIBH technique using Abches in breathing adapted radiotherapy for left-sided breast cancer is easily feasible in daily practice and significantly reduces the radiation doses to the heart and LAD, therefore potentially reducing cardiac risk.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.9033-9038
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• 2014

Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). Materials and Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock. Two thermoplastic masks were prepared for each patient, one for normal free breathing and a second made with breath-hold to maintain reproducibility. DIBH CT scans were performed in the prospective mode of the Varian real time position management (RPM) system. The planning target volume (PTV) included the left chest wall and supraclavicular nodes and PTV prescription dose was 5000cGy in 25 fractions. DIBH-3DCRT planning was performed with the single iso-centre technique using a 6MV photon beam and the field-in-field technique. VMAT plans for FB and DIBH contained two partial arcs ($179^{\circ}-300^{\circ}CCW/CW$). Dose volume histograms of PTV and OAR's were analyzed for DIBH-VMAT, FB-VMAT and DIBH-3DCRT. In DIBH mode daily orthogonal ($0^{\circ}$ and $90^{\circ}$) KV images were taken to determine the setup variability and weekly twice CBCT to verify gating threshold level reproducibility. Results: DIBH-VMAT reduced the lung and heart dose compared to FB-VMAT, while maintaining similar PTV coverage. The mean heart $V_{30Gy}$ was $2.3%{\pm}2.7$, $5.1%{\pm}3.2$ and $3.3%{\pm}7.2$ and for left lung $V_{20Gy}$ was $18.57%{\pm}2.9$, $21.7%{\pm}3.9$ and $23.5%{\pm}5.1$ for DIBH-VMAT, FB-VMAT and DIBH-3DCRT respectively. Conclusions: DIBH-VMAT significantly reduced the heart and lung dose for left side chest wall patients compared to FB-VMAT. PTV conformity index, homogeneity index, ipsilateral lung dose and heart dose were better for DIBH-VMAT compared to DIBH-3DCRT. However, contralateral lung and breast volumes exposed to low doses were increased with DIBH-VMAT.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.49-53
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• 2016

Background: General anesthesia is frequently considered for pediatric patients, as they often find it difficult to cooperate and stay calm during administration of potentially painful treatments. Sedation can overcome these adversities; however, this is challenging while maintaining unobstructed airways. Methods: The study involved 11 pediatric dental patients treated with LMA under deep sedation with sevoflurane, from 2011 through 2015. LMA size, sevoflurane concentration, and the vital signs of patients were assessed through a chart review. Results: The age distribution of the patients ranged from 6 to 10 years old. A total of 3 patients underwent mesiodens extraction, while the remaining 8 underwent an surgically assisted orthodontic forced tooth eruption The average sedation period was approximately 45 minutes and the LMA size was $2\small{^1/_2}$. The sevoflurane concentration was maintained at 2% on average, and overall, the measurements of vital signs were within the normal range; the patients had an average blood pressure of 98/49 mmHg, breathing rate of 26 times/min, pulse frequency of 95 times/min, $SpO_2s$ level of 99 mmHg, and $ETCO_2$ level of 41.2 mmHg. Conclusions: Deep sedation with sevoflurane coupled with LMA may be applied successfully in pediatric patients who undergo mesiodens extraction or a surgically assisted orthodontic forced tooth eruption

• International Journal of Computer Science & Network Security
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• 제22권5호
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• pp.175-181
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• 2022

COVID-19 is an acute respiratory syndrome that affects the host's breathing and respiratory system. The novel disease's first case was reported in 2019 and has created a state of emergency in the whole world and declared a global pandemic within months after the first case. The disease created elements of socioeconomic crisis globally. The emergency has made it imperative for professionals to take the necessary measures to make early diagnoses of the disease. The conventional diagnosis for COVID-19 is through Polymerase Chain Reaction (PCR) testing. However, in a lot of rural societies, these tests are not available or take a lot of time to provide results. Hence, we propose a COVID-19 classification system by means of machine learning and transfer learning models. The proposed approach identifies individuals with COVID-19 and distinguishes them from those who are healthy with the help of Deep Visual Embeddings (DVE). Five state-of-the-art models: VGG-19, ResNet50, Inceptionv3, MobileNetv3, and EfficientNetB7, were used in this study along with five different pooling schemes to perform deep feature extraction. In addition, the features are normalized using standard scaling, and 4-fold cross-validation is used to validate the performance over multiple versions of the validation data. The best results of 88.86% UAR, 88.27% Specificity, 89.44% Sensitivity, 88.62% Accuracy, 89.06% Precision, and 87.52% F1-score were obtained using ResNet-50 with Average Pooling and Logistic regression with class weight as the classifier.

• 한국안전학회지
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• 제33권2호
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• pp.52-60
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• 2018

This study compares the differences of the fit factor by the order of wearing preference between Particulate filtering facepiece respirators(PFFR) and glasses when participants wore simultaneously and a survey of physical and visual complaint. Recognition level about fit of respirators was investigated and the educational (before- and after-) effect of the fit factor. When participants wore PFFR and glasses, physical complaints were nose pressure, slipping, nose and ear pressure, ear pressure and rim loosen, the most highly physical complaints were nose pressure. Visual complaints were demister, blurry vision, dizziness, visual field, and lens dirty, the most highly visual complaints were demister. But, there was significant difference in physical complaint such as nose pressure(10.3%), slipping (23.0%), nose and ear pressure(14.3%), and rim loosen(16.2%), visual complaint such as visual field(13.8%) and lens dirty(32.4%). For the recognition of fit of respirators, respirators fitness, leak site, an initial point and an object, faulty factor, recognition level was higher. Fit factor was increased after education of proper wearing of respirator. Change of the fit factor was smaller compared to the normal breathing and after 6 actions in case of after education. Questionnaire consisted of general characteristics and physical/visual complaint, recognition of fit. Complaints were measured after the QNFT with multiple choices. Quantitative fit factor was measured by device and compared the result of (before- and after-) educational effect. Also, we selected to 6 actions (Normal breathing, Deep breathing, Bending over, Turning head side to side, Moving head up and down, Normal breathing) among 8 actions OSHA QNFT (Quantitative Fit testing) protocol to measure the fit factors. The fit factor was higher after the training (p=0.000). Descriptive statistics, paired t-test, and Wilcoxon analysis were performed to describe the result of questionnaire and fit test. (P=0.05) Therefore, it is necessary to investigate the quantitative research such as training program and glasses fitting factor about the wearing of PFFR and glasses simultaneously.

• 한국컴퓨터정보학회:학술대회논문집
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• 한국컴퓨터정보학회 2022년도 제66차 하계학술대회논문집 30권2호
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• pp.57-58
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• 2022

Sleep apnea (SA) is a common chronic sleep disorder that disrupts breathing during sleep. Clinically, the standard for diagnosing SA involves nocturnal polysomnography (PSG). However, this requires expert human intervention and considerable time, which limits the availability of SA diagnoses in public health sectors. Therefore, ECG-based methods for SA detection have been proposed to automate the PSG procedure and reduce its discomfort. We propose a preprocessing method to convert the one-dimensional time series of ECG into two-dimensional images using the Gramian Angular Field (GAF) algorithm, extract temporal features, and use a two-dimensional convolutional neural network for classification. The results of this study demonstrated that the proposed method can perform SA detection with specificity, sensitivity, accuracy, and area under the curve (AUC) of 88.89%, 81.50%, 86.11%, and 0.85, respectively. Our experimental results show that SA is successfully classified by extracting preprocessing transforms with temporal features.

• Annals of Clinical Neurophysiology
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• 제16권2호
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• pp.49-54
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• 2014

Heart rate variability is significantly associated with cardiovascular complications in various neurological disorders with cardiac impairment. Measures of spontaneous heart rate variability might be different from provocating tests of heart rate variability such as deep breathing and Valsava maneuver. Methods for analysis are divided into time domain methods and frequency domain methods. There are standard deviation of NN interval, standard deviation of average NN interval, root mean square of the successive differences, NN50, and pNN50 in time domain methods. Frequency domain bands can be divided into very low, low, and high frequency. Each variables are influenced by sympathetic and/or parasympathetic activity.

• The Korean Journal of Pain
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• 제2권2호
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• pp.167-173
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• 1989

Inadequate pain relief after upper abdominal surgery increases the incidence of pulmonary complications due to the difficulty in coughing and deep breathing. Kvalheim and Reiestad (1984) introduced intrapleural administration of local anesthetic solutions to produce analgesia following cholecystectomy performed through a subcostal incision, unilateral breast surgery and renal surgery. We studied continuous intrapleural administration of bupivacaine and epinephrine, and its effect in controlling pain after cholecystectomy. In 9 patients, an intermittent dosage technique was used. An intrapleural catheter was inserted and 20 ml of 0.5% bupivacaine and 1:100,000 epinephrine was administered. Results were as following: 1) Mean analgesic duration from the initial intrapleural injection to secondary administration of supplementary bupivacaine was 13.5 hours. 2) No specific changes were noted on vital signs and arterial blood gases. 3) Effective analgesia, produced by intrapleural bupivacaine resulted in significant improvement in tidal volume as measured by spirometry. 4) No signs of systemic toxicity and complications were encountered. 5) Intrapleural administration of a local anesthetics after cholecystectomy provides a satisfactory duration of analgesia.

• Radiation Oncology Journal
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• 제37권4호
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• pp.254-258
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• 2019

Purpose: Deep inspiration breath hold (DIBH) is a well-established technique that enables efficient cardiac sparing in patients with left-sided breast cancer. The aim of the current study was to determine if DIBH is effective for reducing radiation exposure of of liver and other organs at risk in right breast radiotherapy (RT). Materials and Methods: Twenty patients with right-sided breast cancer were enrolled in this study. Three-dimensional conformal RT plans were generated for each patient, with two different computed tomography scans of free breathing (FB) and DIBH. Nodes were contoured according to the Radiation Therapy Oncology Group contouring guidelines. Dose-volume histograms for the target volume coverage and organs at risk were evaluated and analyzed. Results: DIBH plans showed significant reduction in mean liver dose (5.59 ± 2.07 Gy vs. 2.54 ± 1.40 Gy; p = 0.0003), V_20Gy (148.38 ± 73.05 vs. 64.19 ± 51.07 mL; p = 0.0003) and V_10Gy (195.34 ± 93.57 vs. 89.81 ± 57.28 mL; p = 0.0003) volumes compared with FB plans. Right lung doses were also significantly reduced in DIBH plans. Heart and left lung doses showed small but statistically significant improvement with application of the DIBH technique. Conclusion: We report that the use of DIBH for right-sided breast cancer significantly reduces the radiation doses to the liver, lungs, and heart.

• 대한한의학회지
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• 제39권3호
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• pp.41-50
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• 2018

Objectives: The study is aimed to utilize Taesikbub and Lung-doyinbub described in "Dong-Ui-Bo-Gam" as a Korean Traditional Pulmonary Rehabilitation Exercise. Methods: We preliminary researched pulmonary rehabilitation exercise using domestic and international databases and old literatures of Korean Medicine. Then made a draft of Korean Traditional Pulmonary Rehabilitation Exercise based on "Dong-Ui-Bo-Gam". After organizing expert group for verifying the draft of the exercise, we developed the final Korean Traditional Pulmonary Rehabilitation Exercise. Results: The Korean Traditional Pulmonary Rehabilitation Exercise is composed of 5 actions including breathing method, flexibility exercise, percussion and hitting teeth. This exercise is recommended twice a day for at least 5 days per week under the supervision of specialist. It is expected to improve physical activity, dyspnea, health-related quality of life (HRQoL) as well as psychiatric symptoms by breathing deep and slow and exercising the thorax and upper limb muscles. Conclusion: Taesikbub, Lung-doyinbub in "Dong-Ui-Bo-Gam" may be suggested as a better pulmonary rehabilitation exercise for patients of chronic lung disease.