• 한국동물위생학회지
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• 제30권4호
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• pp.533-538
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• 2007

A 16-year-old female mixed dog was submitted for examination at the pathology division of national veterinary research and quarantine service (NVRQS). Grossly, white or grayish spherical, multinodular, firm to friable masses were present in the tibiofibula to the pharenge area of the right limb, and dysphagia, breathing difficulties and tachypnea were shown. Various-sized white or grayish black masses were scattered in lungs and diaphragm and one mass was observed in the trachea and in the jejunum, respectively. Histopathologically, the neoplastic cells were composed of polygonal or spindle shaped cells with various sized round to oval nuclei and abundant cytoplasm. These cells formed lobules or nests separated by fine connective tissue and contained little amount of melanin pigments. Melanin pigments were stained dark gray or black with Fontana-Masson method. Melanosomes were also ultrastructurally demonstrable by electron microscopy. Based on above results, the present case was diagnosed as canine malignant melanoma originating from the lower limb and digit.

• The Journal of Korean Physical Therapy
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• 제12권2호
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• pp.133-144
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• 2000

The purpose of this study was to determine whether respiratory physical therapy might increase the pulmonary function of the patients with stroke or not. Twenty patients with stroke were randomly assigned to experimental and control group. During four weeks, both groups participated in the conventional physical therapy and only the experimental group added in a program of respiratory physical therapy. Respiratory physical therapy consisted of chest mobilization, resistive ventilatory muscle training used the method of PNF technique and relaxed diaphragm breathing. Baseline and post-test measurements were made of vital capacity. inspiratory capacity, expiratory reserve volume, farced vital capacity, forced expiratory volume at one second, $FE1/FVC(\%)$ and maximal voluntary ventilation. Ater four weeks, the experimental group showed the significant improvement in VC(p<.05). FVC(p<.05), FFV1(p<.05) md MVV(p<.05). However, the controll group showed no significant differnece. As compared th the relationship of dependent variables between the experimental group and control group. experimental group showed the significant difference in VC(p<.01), FEV1(p<.05) and MVV(p<.05). These findings suggest that respiratory physical therapy can be used to improve pulmonary function in stroke patients. Also, respiratory physical therapy should be performed for at least four weeks and be followed by the continuous respiratory exercise programs.

• 대한방사선치료학회지
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• 제19권2호
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• pp.123-129
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• 2007

목 적: 전산화 단층촬영방법(Computed Tomography, CT)에 따라 고식적(Axial), 나선식(Helical), 연속(Cine) 주사방법으로 획득되어진 영상은 주사방법이 다르므로 각각의 재현되는 이미지 상에서 차이가 존재한다. 각각의 전산화 단층촬영 주사방법(scan type)이 움직임을 얼마나 정확히 묘사하는지 알아보고자 구동 팬톰을 이용하여 재현성에 대해 고찰해 보고자 한다. 대상 및 방법: 상 하 방향, 위 아래 방향 움직임을 재현하기 위해 자체 제작한 구동 팬톰과 호흡동조 구동 motor를 이용한다. 구동 motor 위에 표지자를 올려놓고 전산화 단층촬영 시 움직임을 구별하기 위해 표지자에 위치 표시를 위한 방사선 비투과성 물질(Localizer)을 부착한다. 자체 제작한 구동 팬톰을 이용하여 위 아래 움직임은 1.3 cm (16회/1분당)으로 고정 시키고, 호흡동조 구동 motor을 이용하여 상 하 움직임은 0.2 cm (8 rot/1분당)으로 고정 한다. 각각의 움직임을 고정 시키고 난 후, 전산화 단층 촬영 방법에 따라 고식적(Axial), 나선식(Helical), 연속(Cine) 주사방법으로 촬영한다. RPT 장비를 이용하여 움직임을 나타내는 표지자에 부착한 방사선 비투과성 물질과 볼륨 재현성이 정확한지 비교, 분석 한다. 결 과: 표지자의 전체 체적은 88.2 $cm^3$로 위 아래 방향 3 cm, 상 하 방향 0.3 cm 이동을 고려했을 때는 전체 체적이 184.3 $cm^3$이었다. 각각의 전산화 단층촬영방법에 따른 전체 체적은 고식적 주사방법에서는 135 $cm^3$, 나선식 주사방법에서는 164.9 $cm^3$, 연속 주사방법에서는 181.7 $cm^3$였다. 움직임에 대한 재현성을 나타내는 데 있어 연속 주사방법에서 가장 근접하게 표지자를 묘출하였다. 또한, 표지자에 부착한 방사선 비투과성 물질의 재현성에서도 연속 주사방법에서 가장 근접하게 나타내었다. 결 론: 전산화 단층촬영방법에 따른 고식적, 나선식, 연속 주사방법은 움직임에 영향을 많이 받는 장기를 촬영할 때, 움직임에 따른 정확한 장기 묘사 및 종양 조직의 움직임을 재현해야 한다. 본 실험에서 사용한 구동 팬톰을 이용한 표지자를 재현하는데 있어 전산화 단층촬영 시 연속 주사방법에서 촬영 할 때 가장 재현성이 높았다. 하지만, 임상 적용 시 환자의 호흡이나 움직임이 팬톰처럼 일정하지 않기 때문에 이를 위한 환자 교육 및 호흡을 일정하게 해줄 수 있는 장치의 사용 및 개발이 필요하며, 각각의 전산화 단층촬영방법에 대한 피폭선량에 대해서도 고려해야 할 것이라 사료 된다.

• 대한방사선기술학회지:방사선기술과학
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• 제35권2호
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• pp.173-181
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• 2012

본 연구의 목적은 호흡 위상을 고려한 4DCT 자료를 토대로 자동영상변조등록 프로그램인 MIMVista에서 계산한 최대강도투영 영상에서 폐종양의 발생위치와 유착여부에 따른 종양의 움직임 특성을 분석하고 3DCT 결과 값과 비교하였으며 호흡 위상 간 종양의 도심변화 등 기하학적 변형 특성를 분석했다. 분석결과 폐하부에 위치한 종양에서 Y축으로의 평균 도심 변화가 $7.32{\pm}6.88mm$로 가장 크게 나타났으며 HU값의 차이를 분석한 결과에서도 평균 $7.7{\pm}4.97%$로 가장 큰 차이를 보였다. 유착성 종양보다는 비유착성 종양에서 호흡 간 변화가 크게 나타났다. 3DCT 영상과 MIP 영상간에 종양 용적의 연관성을 분석한 결과 상관계수가 0.998로 매우 높게 나타났다. 종양의 기하학적 변화에 영향을 미치는 요인분석결과 종양의 위치와 유착여부가 큰 영향을 미치는 것으로 분석되었으나 횡격막의 움직임 정도에 따른 차이는 없었으며 환자 간 호흡 위상에 따른 편차가 매우 크기 때문에 종양의 움직임과 관련한 특정 경향성을 파악할 수는 없었다.

• 한국방사선학회논문지
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• 제17권1호
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• pp.91-98
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• 2023

본 논문에서는 자체 제작한 움직임 팬텀을 이용하여 다양한 호흡모사를 하고, PET/CT 장비 내의 데이터기 기반 보정프로그램을 적용하여 영상을 획득하고, 영상의 SUVmax 및 병변 부피를 분석하여 호흡에 따른 장기 또는 종양의 움직임으로 인한 인공물의 감소효과를 확인하였다. 이동거리 3 cm에서 데이터 기반 게이팅을 적용한 영상이 데이터 기반 게이팅을 적용하지 않은 영상보다 SUVmax가 팬텀 구의 지름이 10 mm, 13 mm, 17 mm, 22 mm, 28 mm, 37 mm에서 각각 2.37, 2.02, 1.44, 1.20, 0.42, 0.52 향상시키는 것으로 나타났고, 향상률로 표시하면 각각 72.5%, 73.3%, 51.3%, 25.8%, 8.6%, 7.2%이었다. 크기가 작은 병소의 SUVmax의 개선효과가 크게 나타났다. 데이터 기반 게이팅을 적용하지 않았을 때에 비하여 적용하였을 때에 1 cm, 2 cm, 3 cm에서 각각 5%, 12%, 18%의 영상의 면적이 감소하는 개선효과가 있었고, 그리고 움직임에 의한 인공물이 클 때 감소 효과도 커졌다. 데이터 기반 게이팅을 적용하면 검사절차가 간소화되고, 사술자의 피폭선량 감소효과와 더불어 호흡으로 인한 인공물을 감소시켜 영상의 질을 개선할 수 있음을 확인하였다.

• 대한수의학회지
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• 제49권4호
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• pp.351-354
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• 2009

Diaphragmatic hernias, whether congenital or acquired (traumatic), are rarely observed in the horse. Acquired diaphragmatic hernias typically occur secondary to trauma or an increase in intraabdominal pressure due to falling, heavy exercise, or parturition. Diaphragmatic herniorrhaphy is difficult to perform in adult horses and the horses with symptomatic diaphragmatic hernias usually die. A 10- year old, 340 kg, Jeju horse (crossbred) broodmare with sudden onset of gait disorder and a moderate emaciation was examined. Findings on physical examination included conjunctivitis, dehydration, shallow breathing, dyspnea, weaken heart beat, lack of auscultatable sounds from the gastrointestinal tract, and anorexia. Rectal temperature was $38.4^{\circ}C$ and respiratory rates were moderately increased. There were slight signs of acute colic. The broodmare died one day after non-specific treatment of fluids, nutriment, antibiotics and non-steroidal anti-inflammatory drug. The cause of death was strangulation of the small intestine through a diaphragmatic hernia. The rent was about 2 cm in diameter and located in the central right part of diaphragm. Around 60 cm of small intestine was protruded into thoracic cavity through the rent. The cause of the hernia could not be ascertained. The broodmare had been pastured with many other horses, and the groom had not noticed any aggressive behavior among them. It was, however, speculated that trauma by stallion's attack may have been the cause of the diaphragmatic hernia, because the new horse may be the object of behaviors ranging from mild threats to seriously aggressive kicking, squealing, rearing, and biting.

• Clinical and Experimental Pediatrics
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• 제61권3호
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• pp.78-83
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• 2018

Purpose: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. Methods: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-square (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. Results: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. Conclusion: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.

• Radiation Oncology Journal
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• 제35권1호
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• pp.65-70
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• 2017

Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

• 대한물리의학회지
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• 제17권3호
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• pp.79-86
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• 2022

PURPOSE: By virtue of its location, the iliopsoas muscle has the potential to affect the function of the diaphragm. Therefore, the purpose of this study was to investigate the effects of passive stretching of the iliopsoas muscles on pulmonary function. METHODS: Twenty male university students participated in this study. Subjects with low back pain, negative results on the modified Thomas test, and chest breathing patterns not directly related to the function of the iliopsoas muscles were excluded from this study. A digital pulmonary function measuring device (Pony FX, COSMED Inc, Italy) was used to test pulmonary function. The test was performed three times: the first test before passive stretching, the second test 10 minutes after the first test, and the third after passive stretching. Passive stretching was performed 5 times for each of the left and right iliopsoas muscles. Passive stretching was carried out for 20 seconds followed by a 10-second break. The SPSSWIN (ver. 27.0) statistics program was used for data analysis, and the significance level was α =.05. RESULTS: Among slow vital capacity (SVC) parameters, tidal volume (VT), inspiratory reserve volume (IRV), inspiratory capacity (IC) and vital capacity (VC) improved significantly after passive stretching. Also, among the maximal effort vital capacity (MEVC) parameters, forced vital capacity(FVC) and forced expiratory volume in one second(FEV1) improved significantly after passive stretching. CONCLUSION: The results showed that among the various pulmonary function parameters measured, passive stretching of the iliopsoas muscles can improve the SVC and MEVC. Therefore, passive stretching of the iliopsoas muscles may be considered for use as a treatment method to improve pulmonary function.

• 대한한의학원전학회지
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• 제21권1호
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• pp.1-11
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• 2008

Jangjahwa(張子和) was influenced by "Hwangjenaegyeong(黃帝內經)" and Yuhagan(劉河間)'s theory, and other classics. Also, his clinical experience was helpful to theorize his thought. Thus, he improved medical theory by combining previous medical theory and his own experience. The essence of his thought is the importance of pathogenic Gi[邪氣] as the cause of disease and is Sambeop(三法) of Hantoha(汗吐下) as the methodology for removing pathogenic Gi[邪氣] away. He regarded pathogenic Gi as the cause of disease, and eliminated pathogenic Gi for the remedy. Namely, Sambeop(三法) of Hantoha(汗吐下) was selected as the best efficient method for driving pathogenic Gi away. Sambeop of Jangjahwa(張子和) have different meaning from previous one. Traditionally, Diaphoretic Therapy[汗法] was regarded as therapy for exogenous disease[外感病], and its effect was regarded as Balhanhaepyo(發汗解表). Emetic therapy[吐法] was throwing up Dameumsuksik(痰飮宿食) of stomach and above diaphragm. Purgation therapy[下法] means Tongbyeon(通便), Hajeok(下積), Sasil(瀉實), Chuksu(逐水) were regarded as therapy for Yangmyeongsiljeung(陽明實證) of Sanghan(傷寒). He submitted a new extensive concept of Sambeop adding traditional one, and expanded the application range of Sambeop. All methods, can cause circulation of Gihyeol(氣血) by opening the 'Hyeonbu(玄府)', like Moxibution therapy[灸薰], Steaming[蒸], Washing[洗],Heat therapy[慰], Cauterization[烙], Acupuncture therapy[鍼刺], Stone needling, Physical and breathing exercise[導引], Massage[按摩] were regarded as Diaphoretic Therapy[汗法]. Especially, he thought that Diaphoretic Therapy and venesection[瀉血] have same medical implication. If we examine the process of pushing out pathogenic Gi[邪氣] by means of Sambeop(三法), we can find the intermediation, that is circulation of Gihyeol(氣血). Its meaning is implied in the word of 'opening Hyeonbu(玄府)'. He thought that the circulation of Gihyeol(氣血) is the key to control health. Gihyeol(氣血) was circulated well under the physiological balance, but it was not circulated well under the invasion of pathogenic Gi[邪氣]. In other words, pathogenic Gi is the immediate cause of bad circulation of Gihyeol(氣血) and disease. Naturally, the doctor must remove pathogenic Gi that cause bad circulation for healing by means of Sambeop(三法). In my opinion, because the ultimate goal of Jangjahwa(張子和) was circulation of Gihyeol(氣血) by removing pathogenic Gi[邪氣], the concept of Sarnbeop(三法) could be expanded.