• 대한방사선치료학회:학술대회논문집
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• 대한방사선치료학회 2005년도 춘계학술대회 초록집
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• pp.13-17
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• 2005

Lung cancer 환자 중 호흡에 의한 종양의 움직임이 큰 lung lower lobe에서 stetreotactic radiosurgery(SRS)시 호흡 주기 중 종양의 움직임이 적은 호흡 주기에서만 방사선을 조사하기 위해 respiratory gating system을 사용함으로써 그 유용성에 대하여 알아보고자 한다. lung lower lobe의 SRS 환자 2명을 대강으로 하였으며, 환자의 복부에 maker block(sensor)을 부착하고 tracking camera와 real time position management(RPM)를 이용하여 호흡 주기를 측정하면서 1회 호흡주기에서 10 phases의 4D-CT를 촬영 하였다. 종양의 위치 변화가 급격하지 않은 percent($\%$)의 phases를 치료 phases로 결정하였고, 치료 phases의 CT image를 maximum intensity projection(MIP) 기법으로 재구성 후 volume contouring을 하였다. set up 의 재현성 및 GTV의 위치 변화를 확인하기 위해 치료 전과 치료 중 2회의 4D-CT 촬영을 하였다. GTV의 움직임이 가장 큰 Y(longitudinal)축에서 A환자 full($0\%\~90\%$) phases의 9.4mm가 치료 ($30\%\~60\%$) phases 에서는 2.6mm로, B환자 full($0\%\~90\%$) phases의 11.7mm가 치료($30\%\~70\%$) phases 에서는 2.3mm로 줄었다. 2회의 4D-CT 비교 결과 Set up의 X, Y, Z축 오차는 모두 3mm 이내였다. 호흡에 의한 종양의 움직임이 큰 lung lower lobe에서 SRS 시행 시 respiratory gating system의 사용은 종양의 움직임을 5mm 이내로 감소시킬 수 있어 유용하였다.

• Current Optics and Photonics
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• 제2권1호
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• pp.1-6
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• 2018

Our previous study showed that switching the inhaled gas from hypoxic gas to hyperoxic gas for 10 minutes increased tumor oxygenation and that the magnitude of oxyhemoglobin increase responded earlier than tumor volume change after chemotherapy. During 10 minutes of inhaled-oxygen modulation, oxyhemoglobin concentration first shows a rapid increase and then a slow but gradual increase, which has been fitted with a double-exponential equation in this study. Two amplitude values, amplitudes 1 and 2, respectively represent the magnitudes of rapid and slow increase of oxyhemoglobin. The trends of changes in amplitudes 1 and 2 were different, depending on tumor volume when chemotherapy started. However, both amplitudes 1 and 2 changed earlier than tumor volume, regardless of when chemotherapy was initiated. These results imply that by observing amplitude 1 changes post chemotherapy, we can reduce the time of a respiratory challenge from 10 minutes to less than 2 minutes, to see the chemotherapy response. We believe that by reducing the time of the respiratory challenge, we have taken a step forward to translating our previous study into clinical application.

• 한국방사선학회논문지
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• 제7권2호
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• pp.157-163
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• 2013

본 연구는 각 호흡 위상에 따른 계획용표적체적(planning target volume. PTV)의 움직임 및 체적(PTV volume)의 변화를 횡격막(diaphragm)의 움직임을 이용하여 정량적으로 분석함으로써 폐암의 호흡 동기 방사선치료를 위한 최적화된 호흡 위상을 알아보고자 하였다. 비특이적 호흡이나 불규칙적인 호흡에 의한 체계적 오류(system error)를 화하기 위하여 모의 호흡 훈련을 시행하였다. 정규화된 호흡 동기 방사선치료 절차에 따라 각 호흡 위상 i에 따른 4차원 전산화치료계획(4-dimensional computed tomography. 4DCTi)을 시행하였으며 0~90%, 30~70%, 40~60% 호흡 위상으로 재구성된 4DCTi 영상에서 PTV를 정의하고 PTVi의 움직임 및 체적의 변화를 정략적으로 분석하였다. 모의호흡 훈련에 의한 평균 호흡 주기는 $3.4{\pm}0.5$초로 나타났으며 임상적으로 유도되는 예상 값과 실제 측정값의 일치 정도를 나타내는 R-제곱 값은 1에 근접하여 유의하였다. 또한 각 호흡 위상 i에 따른 PTVi의 움직임은 0~90% 호흡 위상의 경우 $13.4{\pm}6.4mm$, 30~70% 호흡 위상의 경우 $6.1{\pm}2.9mm$, 40~60% 호흡 위상의 경우 $4.0{\pm}2.1mm$ 이었으며 PTVi의 체적 변화는 30~70% 호흡 위상의 경우 $32.6{\pm}8.7%$, 40~60% 호흡 위상의 경우 $41.6{\pm}6.2%$ 감소되었다. 결론적으로 짧은 호흡 위상(40~60%: 30% duty cycle) 폭을 적용하였을 때 PTV의 움직임 및 체적의 변화가 감소되어 호흡을 고려한 PTV 마진이 4mm 이내이면서 PTV 내 선량의 균일성을 얻을 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제45권5호
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• pp.1022-1030
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• 1998

연구배경: Volume controlled ventilation(VCV)시 inspiratory pause의 사용은 흡기시간을 연장하여 평균기도압을 상승시키고 가스교환을 호전시키는 것으로 알려져 있다. 그러나 같은 흡기시간을 유지하더라도 inspiratory pause를 사용하였을 경우 평균기도압과 가스교환의 변화에 대하여는 잘 알려지지 않았다. 방 법: 저자들은 VCV으로 기계호흡을 받는 12명의 환자를 대상으로 흡기산소농도, 상시호흡량, 호흡수 및 I : E ratio(1 : 3)는 변화시키지 않고 5%의 pause를 사용한 경우와 사용하지 않은 경우의 기도압 및 가스교환의 변화를 관찰하여 비교하였다. 결 과: 동맥혈 이산화탄소분압은 pause를 사용한 경우 $38.6{\pm}7.4$ mmHg로 시용하지 않은 경우의 $41.0{\pm}7.7$ mmHg보다 유의하게 낮았다 (p<0.01). 동맥혈 산소분압은 pause를 사용한 경우 $94.4{\pm}23.2$ mmHg로 사용하지 않은 경우의 $91.8{\pm}19.7$ mmHg보다 높은 경향이 있었으나 (p=0.054), 폐포-동맥혈 산소분압차$(P(A-a)O_2)$는 pause 유무에 따른 차이가 없었다 ($185.3{\pm}86.5$ mmHg vs. $184.9{\pm}84.9$ mmHg, P=0.766). 평균기도압은 pause를 사용한 경우 $9.7{\pm}4.0\;cmH_2O$로 사용하지 않은 경우의 $8.8{\pm}4.0\;cmH_2O$보다 유의하게 높았다 (p<0.01). Pause를 사용했을 때의 pause pressure와 pause를 사용하지 않을 때의 최고흡기압의 차이는 호흡기계의 저항과 역상관관계를 보였으나 (r=-0.777, p<0.01), pause가 없을 때의 최고흡기압에서 pause를 사용했을 때의 최고흡기압으로의 증가는 호흡기계의 저항과 정상관관계를 보여 (r=0.811, p<0.01), 평균기도압의 차이는 호흡기계의 저항과 유의한 정상관관계를 보였다(r=0.681, p<0.05). 평균기도압의 변화는 $PaCO_2$의 변화와 상관관계를 보이지 않았다. 결 론: Volume control ventilation시 동일한 1:3 의 I:E ratio하에서라도 5%의 inspiratory pause를 사용하는 것이 평균기도압을 더 높게 유지할 수 있으며 폐환기를 호전시킬 수 있는 것으로 사료되었다. 또한 호흡기계의 저항이 증가되어 있을수록 평균기도압의 상승이 많았으나 평균기도압의 상승 정도는 폐환기의 변화와 상관관계를 보이지 않았다.

• 대한통합의학회지
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• 제5권1호
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• pp.85-92
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• 2017

Purpose : The purpose of this study was to investigate the effect of posture difference on respiratory function in cerebral palsy patients. Methods : Twenty-two cerebral palsy childrens were recruited this study. Respiratory Function test was measured with Cardio Touch 3000 and Micro Respiratory Pressure Meter. Cardio Touch 3000 was used to assess cerebral palsy childrens' forced vital capacity and forced expiratory volume at one second. Micro Respiratory Pressure Meter was to assess Maximum inspiratory pressure and Maximum expiratory pressure. Subjects had four respiratory functions measured in supine, slouched sitting, and elected sitting postures. Statistical analysis was used Paired t-test for within-group comparisons and Independent t-test for between-group comparisons. SPSS statistics Ver 20.0 was used for statistical anlysis and statistical significance was defined as a p-value less than 0.05. Result : The subjects' respiratory function according to posture showed significant difference in Forced Vital Capacity(FVC), Maximum Expiratory Pressure(MEP) and Maximum inspiratory pressure(MIP)(p<.05). Elected sitting posture had a positive effect on respiratory function than slouched sitting, supine. Conclusion : In conclusion, We could see that change of posture in children with cerebral palsy affects respiratory function and Elected sitting can be a positive help for the respiratory function of children with cerebral palsy.

• 대한통합의학회지
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• 제8권3호
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• pp.43-52
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• 2020

Purpose : The aim of this study was to investigate the change of the respiratory function of chronic low back pain patients after the thoracic manipulation and the trunk stability exercise on chronic low back pain patients. Methods : For this study, the group of the experiment was consisted of 44 patients suffering from the low back pain chronically. The participants were divided into two groups: the control group, which was assigned for core stabilization exercise (CSE), and the experimental group, which was randomly assigned for core stabilization exercise after thoracic manipulation (CSE+TM). Both groups carried out each assigned treatment on three times a week for 8 weeks. To study the change related to measurement variable from each test groups before and after intervention, paired t-test was performed. Further, the statistics for an intergroup comparison was analyzed by covariance analysis, ANCOVA. The measurement was conducted by the respiratory function, the respiratory function was measured by forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Results : As a result, forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) showed significant differences not only by each groups but also between those groups before and after the test. Conclusion : In conclusion, both experiments, the core stabilization exercise and the core stabilization exercise conducted after thoracic manipulation, on chronic low back pain patients resulted in the significant level of difference in the respiratory function. This result indicates that the thoracic manipulation is an efficient treatment for improving the respiratory function for chronic low back pain patients.

• 동의신경정신과학회지
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• 제27권2호
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• pp.89-101
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• 2016

Objectives In human, there is a diversity in the breathing pattern, for instance inspiratory and expiratory time, volume, breathing frequency, and breath-to-breath variation. Expecially, respiratory variability can provide important information about breathing regulation and physiological flexibility. it is significant to not only breathing index but also physiological index.Methods Thus this paper reviews the literature on respiratory variability with the aim of clinical application.Results We could find the interrelationships and respiratory variability between emotions, psychopathy, sighing, mental and physical activity.Conclusions As a result, respiratory variability can serve an important physiological index in the clinical area and reflects how our bodies act in diverse environments under various condition.

• 국제물리치료학회지
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• 제8권2호
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• pp.1146-1151
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• 2017

The purpose of this study was to compare the effects of respiratory exercise on cardiopulmonary function and muscle activity of rectus abdominis in smokers and non-smokers with elderly people. All the participants were older than 65 years, and twenty non-smokers, and twenty smokers participated. Non-smokers and smokers were randomly divined into 10 feedback breathing exercises (FBE) and a balloon-blowing exercise (BBE) group. The FBE and the BBE were performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1), forced expiratory volume at one second/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and vital capacity (VC) were measured as pulmonary function. EMG was used to measure the activity of the rectus abdominis. In the FBE and BBE groups, $FEV_1$ was significantly lower in non-smokers compared to smokers at two and four weeks (p<.05), $FEV_1/FVC$, PEF and VC were significantly lower in non-smokers compared to smokers to pre-test, two weeks, four weeks and six weeks (p<.05). Muscle activity of rectus abdominis was significantly difference in the BBE group at pre-test, two weeks, four weeks, and six weeks (p<.05). These results suggest that respiratory exercise was effective in improving pulmonary function and rectus muscle activity.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.261-265
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• 2019

Purpose: This study examined the effects of Vojta therapy on the respiratory function in young male smokers. Methods: Three subjects were tested using the ABA design for Single-subject Experimental Research Design. This study was conducted with the baseline, intervention, and follow-up phase. Intervention was conducted three to four times a week for 20 minutes per times and a total of 25 sessions. The respiratory function was measured using a Spirometer. Results: The results of Forced Vital Capacity and Forced Expiratory Volume at one second for all subjects showed improvements in the intervention phase over the baseline phase. In the follow-up phase, the improved ability was still maintained or slightly reduced. Conclusion: Vojta therapy used on young male smokers was effective in both FVC and FEV1. In other words, the Vojta therapy worked effectively in improving the respiratory function. In future studies, it is necessary to have a control group and increase the number of trials in order to generalize the effect of Vojta therapy.

• Tuberculosis and Respiratory Diseases
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• 제40권2호
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• pp.91-97
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• 1993

Pulmonary surfactant is a lipoprotein complex composed primarily of phospholipid and lung specific apoproteins that reduces surface tension in the alveolus and maintains alveolar stability at low lung volume. Adult respiratory distress syndrome still carries a very high morbidity and mortality. The surfactant system is vital to the maintenance of proper lung function, any type of surfactant deficiency, whether primary or secondary, will contribute significantly to the development of pulmonary pathophysiology. Various mechanisms in adult respiratory distress syndrome may be responsible for such alterations in the surfactant system. Surfactant replacement is now an established treatment for neonatal respiratory distress syndrome, reducing both incidence of complications and mortality. With the current knowledge of surfactant physiology and the pathophysiology of the adult respiratory distress syndrome exogenous surfactant treatment or stimulation of endogenous surfactant synthesis and secretion will prove to be beneficial in preventing and treating the adult respiratory distress syndrome. The study of clinical surfactant therapy for adult respiratory distress syndrome is just beginnig and this can be viewed as an area with exciting potential. As soon as surfactant preparations become more widely available trials should begin to define the role of surfactant treatment in the adult respiratory distress syndrome as an adjunct to available treatment techniques.