• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.109-117
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• 2011

Purpose: To analyze the accuracy of tumor volume dose following field width change, to check the difference of dose change by using self-made moving car, and to evaluate practical delivery tumor dose when tomotherapy in the treatment of organ influenced by breathing. Materials and Methods: By using self-made moving car, the difference of longitudinal movement (0.0 cm, 1.0 cm, 1.5 cm, 2.0 cm) was applied and compared calculated dose with measured dose according to change of field width (1.05 cm, 2.50 cm, 5.02 cm) and apprehended margin of error. Then done comparative analysis in degree of photosensitivity of DQA film measured by using Gafchromic EBT film. Dose profile and Gamma histogram were used to measure degree of photosensitivity of DQA film. Results: When field width were 1.05 cm, 2.50 cm, 5.02 cm, margin of error of dose delivery coefficient was -2.00%, -0.39%, -2.55%. In dose profile of Gafchromic EBT film's analysis, the movement of moving car had greater motion toward longitudinal direction and as field width was narrower, big error increased considerably at high dose part compared to calculated dose. The more field width was narrowed, gamma index had a large considerable influence of moving at gamma histogram. Conclusion: We could check the difference of longitudinal dose of moving organ. In order to small field width and minimize organ moving due to breathing, it is thought to be needed to develop breathing control unit and fixation tool.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.96-101
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• 2007

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

• The Journal of the Acoustical Society of Korea
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• v.23 no.2
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• pp.134-145
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• 2004

The study aims to develop the underwater wireless telephone system. The system is designed based on the underwater acoustic communication channel parameters such as ambient noise, multipath effect and diver breathing noise. The system adopts SSB modem and its carrier frequency is about 33 kHz in which ambient noise level is low and therefore a high S/N ratio is easily obtained. The source level of the transmitter is designed as 131 dB re 1μPa. Its intelligibility index of sentence shows as 80% or mure in the range of less than 300m in the sea trial.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• Journal of Korean Physical Therapy Science
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• v.19 no.4
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• pp.27-34
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• 2012

The aim of study was to assess the effectiveness of dementia elderly persons on the cognitive function, Activities of Daily Living(ADL) and balance-performing ability the group therapeutic exercise programs. Fifteen community-dwelling subjects participated in this study. An 4-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-korean(MMSE-K), Modified Barthel Index(MBI), Berg Balance Scale(BBS), and Timed Up & Go (TUG) test were measured during before and after exercise points The results of this study were as follows : 1) After eight weeks, the MMSE-K and MBI total scores were significantly increased to more after than before(p<.05, p<.01). 2) in the MBI contents, personal hygiene, dressing, ambulation and chair, bed transfers scores were significant increased to after. 3) after BBS, TUG scores were statistically significant higher than the before scores(p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise program can be used to improve the cognitive function, ADL and balance-performing ability in dementia elderly persons.

• Journal of Biomedical Engineering Research
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• v.40 no.4
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• pp.132-136
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• 2019

This study proposes an auto-titrating algorithm for auto-titrating positive airway pressure (APAP). The process of the proposed algorithm is as follows. First, sleep apnea-hypopnea and snoring events were detected using nasal pressure. Second, APAP base pressure and SDB events were used for automatic titration of optimal pressure. And, auto-titrating algorithm is built into M3 (MEK-ICS CO. Ltd., Republic of Korea) for evaluation. The detection results of SDB showed mean sensitivity (Sen.) and positive predictive value (PPV.) of 85.7% and 87.8%, respectively. The mean pressure and apnea-hypopnea index (AHI) of auto-titrating algorithm showed $13.0{\pm}5.2cmH_2O$ and $3.0{\pm}2.4$ events/h, respectively. And, paired t-test was conducted to verify whether the performance of our algorithm has no significant difference with AutoSet S9 (p>0.05). These results represent better or comparable outcomes compared to those of previous APAP devices.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.78-87
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• 2022

Objective: The purpose of this study was to investigate the effect of high-intensity complex exercise program using whole-body vibration (WBV) and respiratory resistance on pain and dysfunction, psychosocial level, balance ability, and pulmonary function in low back pain (LBP) patients with high obesity. Design: A randomized controlled trial Methods: A total of 44 LBP patients withhigh obesity (body mass index, BMI≥30kg/m²) were randomly assigned to an experimental group (n=22) and a control group (n=22). Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the high-intensity complex exercise program combined with WBV and respiratory resistance. In order to compare the effects depending on the intervention methods, numeric pain rating scale (NRPS), Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire (FABQ), balance ability, and pulmonary function were used for measurement. Results: Both groups showed significant differences in NRPS, RMDQ, FABQ, balance ability before and after intervention (p<0.05). In addition, the experimental groupshowed significant difference in the amount of change in RMDQ, balance ability and pulmonary function values than the control group (p<0.05). Conclusions: High-intensity complex exercise program using WBV and respiratory resistance has been proven to be an effective and clinically useful method to decrease dysfunction, increase balance ablilty, and pulmonary function for LBP patients with high obesity.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.164-171
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• 1997

Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.137-147
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• 2014

Purpose : The purpose of this study is to verify the accuracy of dose delivery according to the patient's breathing cycle in Gated Volumetric Modulated Arc Therapy Materials and Methods : TrueBeam STxTM(Varian Medical System, Palo Alto, CA) was used in this experiment. The Computed tomography(CT) images that were acquired with RANDO Phantom(Alderson Research Laboratories Inc. Stamford. CT, USA), using Computerized treatment planning system(Eclipse 10.0, Varian, USA), were used to create VMAT plans using 10MV FFF with 1500 cGy/fx (case 1, 2, 3) and 220 cGy/fx(case 4, 5, 6) of doserate of 1200 MU/min. The regular respiratory period of 1.5, 2.5, 3.5 and 4.5 sec and the patients respiratory period of 2.2 and 3.5 sec were reproduced with the $QUASAR^{TM}$ Respiratory Motion Phantom(Modus Medical Devices Inc), and it was set up to deliver radiation at the phase mode between the ranges of 30 to 70%. The results were measured at respective respiratory conditions by a 2-Dimensional ion chamber array detector(I'mRT Matrixx, IBA Dosimetry, Germany) and a MultiCube Phantom(IBA Dosimetry, Germany), and the Gamma pass rate(3 mm, 3%) were compared by the IMRT analysis program(OmniPro I'mRT system software Version 1.7b, IBA Dosimetry, Germany) Results : The gamma pass rates of Case 1, 2, 3, 4, 5 and 6 were the results of 100.0, 97.6, 98.1, 96.3, 93.0, 94.8% at a regular respiratory period of 1.5 sec and 98.8, 99.5, 97.5, 99.5, 98.3, 99.6% at 2.5 sec, 99.6, 96.6, 97.5, 99.2, 97.8, 99.1% at 3.5 sec and 99.4, 96.3, 97.2, 99.0, 98.0, 99.3% at 4.5 sec, respectively. When a patient's respiration was reproduced, 97.7, 95.4, 96.2, 98.9, 96.2, 98.4% at average respiratory period of 2.2 sec, and 97.3, 97.5, 96.8, 100.0, 99.3, 99.8% at 3.5 sec, respectively. Conclusion : The experiment showed clinically reliable results of a Gamma pass rate of 95% or more when 2.5 sec or more of a regular breathing period and the patient's breathing were reproduced. While it showed the results of 93.0% and 94.8% at a regular breathing period of 1.5 sec of Case 5 and 6, it could be confirmed that the accurate dose delivery could be possible on the most respiratory conditions because based on the results of 100 patients's respiratory period analysis as no one sustained a respiration of 1.5 sec. But, pretreatment dose verification should be precede because we can't exclude the possibility of error occurrence due to extremely short respiratory period, also a training at the simulation and careful monitoring are necessary for a patient to maintain stable breathing. Consequently, more reliable and accurate treatments can be administered.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.576-587
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• 2020

Objectives: This study calculated local residents exposures to VOCs (Volatile Organic Compounds) released into the atmosphere using the CalTOX model and carried out uncertainty analysis and sensitivity analysis. The model validity was analyzed by comparing the predicted and the actual atmospheric concentrations. Methods: Uncertainty was parsed by conducting a Monte Carlo simulation. Sensitivity was dissected with the regression (coefficients) method. The model validity was analyzed by applying r² (coefficient of determination), RMSE (root mean square error), and the Nash-Sutcliffe EI (efficiency index) formula. Results: Among the concentrations in the atmosphere in this study, benzene was the highest and the lifetime average daily dose of benzene and the average daily dose of xylene were high. In terms of the sensitivity analysis outcome, the source term to air, exposure time, indoors resting (ETri), exposure time, outdoors at home (ETao), yearly average wind speed (v_w), contaminated area in ㎡ (Area), active breathing rate (BRa), resting breathing rate (BRr), exposure time, and active indoors (ETai) were elicited as input variables having great influence upon this model. In consequence of inspecting the validity of the model, r² appeared to be a value close to 1 and RMSE appeared to be a value close to 0, but EI indicated unacceptable model efficiency. To supplement this value, the regression formula was derived for benzene with y=0.002+15.48x, ethylbenzene with y ≡ 0.001+57.240x, styrene with y=0.000+42.249x, toluene with y=0.004+91.588x, and xylene with y=0.000+0.007x. Conclusions: In consequence of inspecting the validity of the model, r² appeared to be a value close to 1 and RMSE appeared to be a value close to 0, but EI indicated unacceptable model efficiency. This will be able to be used as base data for securing the accuracy and reliability of the model.