• Title/Summary/Keyword: Breathing variability

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Sleep Apnea Detection using Estimated Stroke Volume (추정된 일회심박출량을 이용한 수면 무호흡 검출)

  • Lee, Junghun;Lee, Jeon;Lee, Hyo-Ki;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.34 no.2
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    • pp.97-103
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    • 2013
  • This paper proposes a new algorithm for sleep apnea detection based on stroke volume. It is very important to detect sleep apnea since it is a common and serious sleep-disordered breathing (SDB). In the previous studies, methods for sleep apnea detection using heart rate variability, airflow and blood oxygen saturation, tracheal sound have been proposed, but a method using stroke volume has not been studied. The proposed algorithm consists of detection of characteristic points in continuous blood pressure signal, estimation of stroke volume and detection of sleep apnea. To evaluate the performance of algorithm, the MIT-BIH Polysomnographic Database provided by Phsio- Net was used. As a result, the sensitivity of 85.99%, the specificity of 72.69%, and the accuracy of 84.34%, on the average were obtained. The proposed method showed comparable or higher performance compared with previous methods.

Dosimetric Evaluation of Amplitude-based Respiratory Gating for Delivery of Volumetric Modulated Arc Therapy (진폭 기반 호흡연동 체적변조회전방사선치료의 선량학적 평가)

  • Lee, Chang Yeol;Kim, Woo Chul;Kim, Hun Jeong;Park, Jeong Hoon;Min, Chul Kee;Shin, Dong Oh;Choi, Sang Hyoun;Park, Seungwoo;Huh, Hyun Do
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.127-136
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    • 2015
  • The purpose of this study is to perform a dosimetric evaluation of amplitude-based respiratory gating for the delivery of volumetric modulated arc therapy (VMAT). We selected two types of breathing patterns, subjectively among patients with respiratory-gated treatment log files. For patients that showed consistent breathing patterns (CBP) relative to the 4D CT respiration patterns, the variability of the breath-holding position during treatment was observed within the thresholds. However, patients with inconsistent breathing patterns (IBP) show differences relative to those with CBP. The relative isodose distribution was evaluated using an EBT3 film by comparing gated delivery to static delivery, and an absolute dose measurement was performed with a $0.6cm^3$ Farmer-type ion chamber. The passing rate percentages under the 3%/3 mm gamma analysis for Patients 1, 2 and 3 were respectively 93.18%, 91.16%, and 95.46% for CBP, and 66.77%, 48.79%, and 40.36% for IBP. Under the more stringent criteria of 2%/2 mm, passing rates for Patients 1, 2 and 3 were respectively 73.05%, 67.14%, and 86.85% for CBP, and 46.53%, 32.73%, and 36.51% for IBP. The ion chamber measurements were within 3.5%, on average, of those calculated by the TPS and within 2.0%, on average, when compared to the static-point dose measurements for all cases of CBP. Inconsistent breathing patterns between 4D CT simulation and treatment may cause considerable dosimetric differences. Therefore, patient training is important to maintain consistent breathing amplitude during CT scan acquisition and treatment delivery.

Feasibility Study of Deep Inspiration Breath-Hold Based Volumetric Modulated Arc Therapy for Locally Advanced Left Sided Breast Cancer Patients

  • Swamy, Shanmugam Thirumalai;Radha, Chandrasekaran Anu;Kathirvel, Murugesan;Arun, Gandhi;Subramanian, Shanmuga
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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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.

Emotion Recognition Method Using Heart-Respiration Connectivity (심장과 호흡의 연결성을 이용한 감성인식 방법)

  • Lee, Dong Won;Park, Sangin;Whang, Mincheol
    • Science of Emotion and Sensibility
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    • v.20 no.3
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    • pp.61-70
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    • 2017
  • Physiological responses have been measured to recognize emotion. Although physiological responses have been interrelated between organs, their connectivities have been less considered for emotion recognizing. The connectivities have been assumed to enhance emotion recognition. Specially, autonomic nervous system is physiologically modulated by the interrelated functioning. Therefore, this study has been tried to analyze connectivities between heart and respiration and to find the significantly connected variables for emotion recognition. The eighteen subjects(10 male, age $24.72{\pm}2.47$) participated in the experiment. The participants were asked to listen to predetermined sound stimuli (arousal, relaxation, negative, positive) for evoking emotion. The bio-signals of heart and respiration were measured according to sound stimuli. HRV (heart rate variability) and BRV (breathing rate variability) spectrum were obtained from spectrum analysis of ECG (electrocardiogram) and RSP (respiration). The synchronization of HRV and BRV spectrum was analyzed according to each emotion. Statistical significance of relationship between them was tested by one-way ANOVA. There were significant relation of synchronization between HRV and BRV spectrum (synchronization of HF: F(3, 68) = 3.605, p = 0.018, ${\eta}^2_p=0.1372$, synchronization of LF: F(3, 68) = 5.075, p = 0.003, ${\eta}^2_p=0.1823$). HF difference of synchronization between ECG and RSP has been able to classify arousal from relaxation (p = 0.008, d = 1.4274) and LF's has negative from positive (p = 0.002, d = 1.7377). Therefore, it was confirmed that the heart and respiration to recognize the dimensional emotion by connectivity.

Day-to-Day and Movement-Dependent Variations of Quantitative Fit Tests for an Individual Wearing A Respirator (호흡기 보호구 착용시 움직임과 매일 착용에 따른 Fit Factors의 변화)

  • Han, Don-Hee;Willeke, Klaus
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.6 no.2
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    • pp.176-186
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    • 1996
  • The fit of a respirator to the face of an individual can be determined by a qualitative fit test (QLFT) or a quantitative fit test (QNFT). The pass/fail decision from a QLFT or QNFT for the same respirator on the same individual may vary from one wearing to the next, because the human facial features are complex and the respirator may not fit to the face in the same way every time it is worn. This study reports how the fit factors (FF) resulting from a QNFT on an individual vary from day to day and depend on the movements in the six fit test exercises. The reported FFs provide an objective and numerical basis (FF) which does not depend on the subject's voluntary or involuntary response. Four half-mask (H1-H4) and four full-facepiece respirators (F1-F4) were fit tested on one wearer 10 times a day for 5 days with a PortaCount (model 8010, TSI). The FFs obtained for each set of 10 fit tests on a specific day and 50 fit tests on five days involving one of the six exercise regimes have been recorded as log-normal distributions. All of the geometric standard deviations (GSD) of the overall FFs varied widely among every wearing and day except for H1 and F3, and the variability of the half-mask respirators was larger than that of the full-facepiece respirators. Among the six exercise regimes, reading or talking (RT) had markedly the lowest exercise FFs on the tested individual. Generally, there were significant differences between the first normal breathing (NB1) FFs and the remaining exercise FFs.

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Difference in Patient's Work of Breathing Between Pressure-Controlled Ventilation with Decelerating Flow and Volume-Controlled Ventilation with Constant Flow during Assisted Ventilation (보조환기양식으로서 감속형유량의 압력-조절환기와 일정형유량의 용적-조절환기에서 환자의 호흡일의 차이)

  • Kim, Ho-Cheol;Park, Sang-Jun;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.803-810
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    • 1999
  • Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

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The Effects of Acute Respiratory Training Feedback upon a Change on HRV-Autonomic Nervous System in Middle-aged Women (일회성 호흡훈련 피드백이 중년여성의 HRV-자율신경시스템 변화에 미치는 영향)

  • Kim, Ji-Sun
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.2
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    • pp.445-453
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    • 2018
  • The purpose of this study was to analyze the effect of acute respiratory training feedback upon a change on HRV-Autonomic nervous system in middle-aged women. The research subjects were totally 24 middle-aged women(40-60 years old), were randomly allocated 12 people to the respiratory training group and 12 people to the control group, and then were carried out the acute respiratory training. The feedback exercise in the respiratory training group was conducted for totally 15 minutes. Following the 10-minute breath awareness training according to the expert's guidance, the 5-minute autonomous breathing exercise was implemented. The data analysis was carried out Repeated Measures ANOVA with SPSS WIN 20.0. The conclusions that were obtained through this are as follows. The middle-aged women got significantly higher in SDNN, RMSSD, LF, HF after the acute respiratory training. Compared to the control group. the respiratory training group was indicated to have gotten higher significantly in SDNN, RMSSD, LF, HF. Mean HR and LF/HF were not shown a significant difference in both the main effect of group & period and the interaction effect of group & period. Above of a result the acute respiratory training feedback is effective for SDNN, RMSSD, sympathetic activity, parasympathetic activity in the middle-aged women. Thereby, the respiratory training program improves autonomic nervous system, being considered to be possibly expected the effective value of exercise intervention available for relieving stress and recovering autonomic dysfunction in the middle-aged women.