• Radiation Oncology Journal
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• v.28 no.4
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• pp.238-248
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• 2010

Purpose: To compare the dose distributions between three-dimensional (3D) and four-dimensional (4D) radiation treatment plans calculated by Ray-tracing or the Monte Carlo algorithm, and to highlight the difference of dose calculation between two algorithms for lung heterogeneity correction in lung cancers. Materials and Methods: Prospectively gated 4D CTs in seven patients were obtained with a Brilliance CT64-Channel scanner along with a respiratory bellows gating device. After 4D treatment planning with the Ray Tracing algorithm in Multiplan 3.5.1, a CyberKnife stereotactic radiotherapy planning system, 3D Ray Tracing, 3D and 4D Monte Carlo dose calculations were performed under the same beam conditions (same number, directions, monitor units of beams). The 3D plan was performed in a primary CT image setting corresponding to middle phase expiration (50%). Relative dose coverage, D95 of gross tumor volume and planning target volume, maximum doses of tumor, and the spinal cord were compared for each plan, taking into consideration the tumor location. Results: According to the Monte Carlo calculations, mean tumor volume coverage of the 4D plans was 4.4% higher than the 3D plans when tumors were located in the lower lobes of the lung, but were 4.6% lower when tumors were located in the upper lobes of the lung. Similarly, the D95 of 4D plans was 4.8% higher than 3D plans when tumors were located in the lower lobes of lung, but was 1.7% lower when tumors were located in the upper lobes of lung. This tendency was also observed at the maximum dose of the spinal cord. Lastly, a 30% reduction in the PTV volume coverage was observed for the Monte Carlo calculation compared with the Ray-tracing calculation. Conclusion: 3D and 4D robotic radiotherapy treatment plans for lung cancers were compared according to a dosimetric viewpoint for a tumor and the spinal cord. The difference of tumor dose distributions between 3D and 4D treatment plans was only significant when large tumor movement and deformation was suspected. Therefore, 4D treatment planning is only necessary for large tumor motion and deformation. However, a Monte Carlo calculation is always necessary, independent of tumor motion in the lung.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.169-176
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• 2022

Purpose : The purpose of this study is to investigate the effect of squat, bracing and aerobic exercise on lung function, which is known to be effective for strength training, on lung function. Methods : The study was conducted with 33 students from Busan K university. Eleven students were assigned to squats, bracing, and aerobic exercise, six weeks three times a week. In order to measure lung activity, pony Fx manufactured the change amount of FVC (forced vital capacity), FEV₁ (Forced expiratory volume at one second), and FEV₁/FVC % (forced vital capacity/forced expiratory volume at one second) was analyzed after inputting the information of experimental group A and B controls. As a method of measurement, the difference between the three groups was analyzed using repeated ANOVA. Results : As a result of analyzing the effects of squat, bracing, and aerobic exercise for 6 weeks, all values of FVC, FEV₁, FEV₁/FVC % were increased from 0 weeks to 6 weeks except FEV₁/FVC %. There was no significant difference in FVC from week 3 to week 6. In the squat, bracing, and aerobic exercise, the changes in spirometry showed that the FVC, FEV₁, and FEV₁/FVC % values in bracing exercise were significantly increased with time than before exercise. As a result of analyzing the changes in the spirometry of squat, bracing, and aerobic exercise, the FVC, FEV₁, FEV₁/FVC % values in the squat exercise showed statistically significant difference according to the period, but the lowest increase among the three groups. Conclusion : In conclusion, aerobic, bracing and squat exercises all had a significant impact on improving lung function. Therefore, even without aerobic exercise, squat or bracing exercise alone can be expected to improve lung function.

• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1088-1095
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• 2018

Purpose: Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this study was to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation. Materials and Methods: We retrospectively reviewed the medical records of lung transplantation patients between October 2012 and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lung transplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range of FEV1 (FEV1 ${\geq}80%$ of predicted value vs. <80%). We compared the two groups and analyzed factors associated with lung function recovery. Results: Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ${\geq}80%$ of the predicted value, whereas 30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87-0.98; p=0.010], longer duration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03-1.26; p=0.015), and high-grade primary graft dysfunction (OR, 8.08; 95% CI, 1.67-39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery of lung function at 1 year after lung transplantation. Conclusion: Immediate postoperative status may be associated with recovery of lung function after lung transplantation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.115-126
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• 2006

Background and Objectives : Training of breath support and laryngeal muscles control are important components in the development of the singing voice. The purpose of this study is to compare characteristics of respiratory and phonatory control on pitch, loudness, register change with untrained males and trained male singers. Materials and Methods : The 11 untrained males and 11 trained male singers participated. Closed Quotient(CQ), fundamental frequency (fo) and relative volume contribution of the rib cage (in percentage rib cage, % RC) and relative volume contribution of abdomen (in percentage abdomen, % AB) were measured during various pitch, loudness, register tasks using /a/ vowel phonation : Legato, staccato with C3-D3-E3-F3-G3 notes and crescendo and decrescendo with C3 note as well as modal register with C3 and falsetto register with C4 note using an integrated analysis system of Respiration, EGG and Voice. Results : (1) When pitch increased with legato task, loudness also increased in untrained male group but maintained in trained male singers. CQ was also increased both untrained and trained male singers but it was not significantly different ($p>.05$). The abdomen contribution to lung volume were significantly predominant both in inhalation and exhalation in trained males singers ($p<.05$). (2) When pitch increased with staccato task, CQ was not significantly different in untrained but significantly different in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$) (3) When loudness increased with crescendo, fo was significantly increased with increasing CQ in untrained males but fo was relatively consistent with increasing CQ in trained male singers. The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). (4) Most male singers were able to change register from modal to falsetto register, but untrained males were not. Thus, CQ was significantly different between modal and falsetto register in trained male singers ($p<.05$). The respiratory function of male singers were characterized by significantly predominant abdomen contribution to lung volume in exhalation except for inhalation ($p<.05$). Conclusion : Male singers were superior to untrained males in coordination of respiratory and phonatory control on pitch, loudness, register change. Implication are offered regarding how the results might be applied to the voice therapy as well as singing training.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1633-1636
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• 2015

Background: The advantages of Rapid Arc plans versus Intensity modulated radiotherapy plans for Carcinoma left breast were analyzed. Materials and Methods: In this study 20 Post mastectomy carcinoma left breast patients were analyzed. Both Intensity modulated Radiotherapy and Rapid Arc plans were generated for these patients. IMRT plans with 7 beams in an arc fashion and VMAT plans with two semi arcs were made to achieve 95% dose coverage to 100% volume. The plans were evaluated using Dose volume Histograms. Results: The mean Conformity and Homogeneity index in VMAT is found to be 1.05 and 0.065 respectively whereas in IMRT it was 1.07 and 0.069. The 20% volume of Heart received a mean dose of 960cGy in VMAT and 1300cGy in IMRT. The mean dose was 1236cGy in VMAT and 1870cGy in IMRT. The ipsilateral Lung received 3395cGy to 5% volume and 1840cGy to 20% volume on an average and the mean dose was 1205cGy in VMAT, while the same were found to be 3525cGy, 2012cGy and 1435cGy respectively in IMRT. The Contralateral Lung received a mean dose of 505cGy in VMAT and 553cGy in IMRT. The mean Monitor units in VMAT were 512MU and 1170MU in IMRT. The NTID in VMAT is $108.8{\times}10^5Gycm^3$ and $110.1{\times}10^5Gycm^3$ in IMRT. Conclusions: The target coverage, homogeneity and Conformity index were better in VMAT plans. The Ipsilateral Lung and heart dose were very less in VMAT plans. The Contralateral Lung dose and the Normal Tissue Integral Dose were also lesser in VMAT plans however the difference is not very appreciable. The MU in VMAT plans is almost 50% that of the IMRT plans which results in the reduction of treatment time. On the whole VMAT proves to be a better modality for treating Ca. Left Breast Patients.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.21-32
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• 1997

• Proceedings of the KTCVS Conference
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• 1996.04a
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• pp.20-23
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• 1996

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.97-101
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• 1996

• The Journal of Korean Society for Radiation Therapy
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• v.9 no.1
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• pp.56-60
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• 1997