• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.54-59
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• 2017

Purpose The present study aimed at assessing the effectiveness of the respiratory gating method used in the flow mode and additional localized respiratory-gated imaging, which differs from the step and go method. Materials and Methods Respiratory gated imaging was performed in the flow mode to twenty patients with lung cancer (10 patients with stable signals and 10 patients with unstable signals), who underwent PET/CT scanning of the torso using Biograph mCT Flow PET/CT at Bundang Seoul University Hospital from June 2016 to September 2016. Additional images of the lungs were obtained by using the respiratory gating method. SUVmax, SUVmean, and Tumor Volume ($cm^3$) of non-gating images, gating images, and additional lung gating images were found with Syngo,bia (Siemens, Germany). A paired t-test was performed with GraphPad Prism6, and changes in the width of the amplitude range were compared between the two types of gating images. Results The following results were obtained from all patients when the respiratory gating method was applied: $SUV_{max}=9.43{\pm}3.93$, $SUV_{mean}=1.77{\pm}0.89$, and $Tumor\;Volume=4.17{\pm}2.41$ for the non-gating images, $SUV_{max}=10.08{\pm}4.07$, $SUV_{mean}=1.75{\pm}0.81$, and $Tumor\;Volume=3.56{\pm}2.11$ for the gating images, and $SUV_{max}=10.86{\pm}4.36$, $SUV_{mean}=1.77{\pm}0.85$, $Tumor\;Volume=3.36{\pm}1.98$ for the additional lung gating images. No statistically significant difference in the values of $SUV_{mean}$ was found between the non-gating and gating images, and between the gating and lung gating images (P>0.05). A significant difference in the values of $SUV_{max}$ and Tumor Volume were found between the aforementioned groups (P<0.05). The width of the amplitude range was smaller for lung gating images than gating images for 12 from 20 patients (3 patients with stable signals, 9 patients with unstable signals). Conclusion In PET/CT scanning using the respiratory gating method in the flow mode, any lesion movements caused by respiration were adjusted; therefore, more accurate measurements of $SUV_{max}$, and Tumor Volume could be obtained from the gating images than the non-gating images in this study. In addition, the width of the amplitude range decreased according to the stability of respiration to a more significant degree in the additional lung gating images than the gating images. We found that gating images provide information that is more useful for diagnosis than the one provided by non-gating images. For patients with irregular signals, it may be helpful to perform localized scanning additionally if time allows.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.69-76
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• 2023

Purpose : This study aimed to compare lung capacity measures (forced vital capacity; FVC, forced expiratory volume at 1 second; FEV1, and FEV1/FVC) and the activities of rectus femoris (RF) and gastrocnemius (GCM) muscles between young adults prescribed aerobic exercise combined with lower limb strength exercise (complex exercise) and those prescribed only aerobic exercise. Methods : We randomly divided 22 young adults into 2 groups: the complex exercise group that combined the leg strengthening and aerobic exercises (n = 11) and the aerobic-exercise-only group (n=11). Before the intervention, the FVC, FEV1, and FEV1/FVC values and the activities of RF and GCM muscles were measured. Measurements were in triplicates, and the average of the 3 measurements was used. The complex exercise group performed the treadmill exercise followed by squats and lunges, and the group performed only the treadmill exercise. Both groups were allocated the same time. Both groups performed the assigned exercise thrice a week for 3 weeks. After the intervention, the FVC, FEV1, and FEV1/FVC values and the activities of RF and GCM muscles were measured again. Results : The FVC and FEV1 values increased significantly in both groups after the intervention (p<.05). RF activity increased significantly after the intervention in the complex exercise group (p<.05), and the magnitude of change in RF activity after the intervention was significantly higher in the complex exercise group than in the aerobic-exercise-only group (p<.05). GCM activity also significantly increased after the intervention in both groups (p<.05). Conclusion : On the basis of our results, we recommend combining leg strengthening and aerobic exercise to improve leg muscle activity along with lung function.

• Tuberculosis and Respiratory Diseases
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• v.54 no.3
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• pp.330-337
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• 2003

Background : Low spirometric forced vital capacity(FVC) in conjunction with a normal or high ratio of the forced expiratory volume at 1 second to the forced vital capacity($FEV_1$/FVC%) has traditionally been classified as a restrictive abnormality. However, the gold-standard diagnosis of a restrictive pulmonary impairment requires a measurement of the total lung capacity (TLC). This study was performed to determine the predictive value of spirometric measurements of the FVC for diagnosing a restrictive pulmonary abnormality. Methods : Test results from 1,371 adult patients who undertook both spirometry and lung volume measurements on the same visit from January 1999 to December 2000 were enrolled in this study. The test values for the FVC, the TLC that was below 80% of predicted value, and a $FEV_1$/FVC% that was below 70%, were classified as being abnormal. Results : Of the 1,371 patients, 353 patients had a reduced a FVC. Of these patients, 186 patients had a reduced TLC. Therefore, the positive predictive value was 52.7%. Of the 196 patients with a normal $FEV_1$/FVC% and a reduced FVC, 148(75.5%) patients had a lower TLC. Thirty eight (24.2%) patients out of 157 patients with a low $FEV_1$/FVC% and a low FVC showed a restrictive defect. Conclusion : Spirometry is useful to rule out a restrictive pulmonary abnormality, but a restrictive pattern on the spirometry dose not mean there is a true restrictive disease. For the patients with a low FVC, TLC measurements are essential for diagnosing a restrictive pulmonary impairment.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.1-8
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• 1974

Acute pulmonary edema was induced by intravenous injection of epinephrine, intravenous infusion of dextran and intratracheal instillation of acid solution index was determined from pressure volume curves in excised lungs. Surface activity was also investigated with measurements of maximum and minimum surface tension and stability index on saline extracts of same lungs. The results were as follows. 1. The expansion index of excised lung in which pulmonary edema was induced by intravenous injection of epinephrine, intravenous infusion of dextran and intratracheal instillation of acid solution was ignificantly decreased as compared with the normal control of $0.86{\pm}0.017$ to $0.74{\pm}0.03$, $0.71{\pm}0.081$and $0.76{\pm}0.02$, respectively. 2. The deflation curves of excised lungs in which pulmonary edema was induced were significantly decreased as compared with the normal controls. 3. The minimum surface tension of excised lung in which pulmonary edema was induced was significantly increased in each groups and stability index was significantly decreased as compared with the normal controls 0.78 to $0.35{\pm}0.039$, $0.29{\pm}0.02 $ and $0.31{\pm}0.083$, respectively. 4. The decrease of pulmonary surface activity in acute pulmonary edema was in proportion to the degree of pulmonary edema regardless of their etiology.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.379-388
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• 1994

Background : In sleep apnea syndrome, arterial oxygen saturation($SaO_2$) decreases at a variable rate and to a variable degree for a given apneic period from patient to patient, and various kinds of cardiac arrythmia are known to occur. Factors supposed to affect arterial oxygen desaturation during apnea are duration of apnea, lung voulume at which apnea occurs, and oxygen consumption rate of the subject. The lung serves as preferential oxygen source during apnea, and there have been many reports related with the influence of lung volume on $SaO_2$ during apnea, but there are few, if any, studies about the influence of oxygen consumption rate of an individual on $SaO_2$ during breath holding or about the profile of arterial oxygen resaturation after breathing resumed. Methods : To investigate the changes of $SaO_2$ and heart rate(HR) during breath holding(BH) and rebreathing(RB) and to evaluate the physiologic factors responsible for the changes, lung volume measurements, and arterial blood gas analyses were performed in 17 healthy subjects. Nasal airflow by thermistor, $SaO_2$ by pulse oxymeter and ECG tracing were recorded on Polygraph(TA 4000, Gould, U.S.A.) during voluntary BH & RB at total lung capacity(TLC), at functional residual capacity(FRC) and at residual volume(RV), respectively, for the study subjects. Each subject's basal metabolic rate(BMR) was assumed on Harris-Benedict equation. Results: The time needed for $SaO_2$ to drop 2% from the basal level during breath holding(T2%) were $70.1{\pm}14.2$ sec(mean${\pm}$standard deviation) at TLC, $44.0{\pm}11.6$ sec at FRC, and $33.2{\pm}11.1$ sec at RV(TLC vs. FRC, p<0.05; FRC vs. RV, p<0.05). On rebreathing after $SaO_2$ decreased 2%, further decrement in $SaO_2$ was observed and it was significantly greater at RV($4.3{\pm}2.1%$) than at TLC($1.4{\pm}1.0%$)(p<0.05) or at FRC($1.9{\pm}1.4%$)(p<0.05). The time required for $SaO_2$ to return to the basal level after RB(Tr) at TLC was not significantly different from those at FRC or at RV. T2% had no significant correlation either with lung volumes or with BMR respectively. On the other hand, T2% had significant correlation with TLC/BMR(r=0.693, p<0.01) and FRC/BMR (r=0.615, p<0.025) but not with RV/BMR(r=0.227, p>0.05). The differences between maximal and minimal HR(${\Delta}HR$) during the BH-RB manuever were $27.5{\pm}9.2/min$ at TLC, $26.4{\pm}14.0/min$ at RV, and $19.1{\pm}6.0/min$ at FRC which was significantly smaller than those at TLC(p<0.05) or at RV(p<0.05). The mean difference of 5 p-p intervals before and after RB were $0.8{\pm}0.10$ sec and $0.72{\pm}0.09$ sec at TLC(p<0.001), $0.82{\pm}0.11$ sec and $0.73{\pm}0.09$ sec at FRC(p<0.025), and $0.77{\pm}0.09$ sec and $0.72{\pm}0.09$ sec at RV(p<0.05). Conclusion Healthy subjects showed arterial desaturation of various rates and extent during breath holding at different lung volumes. When breath held at lung volume greater than FRC, the rate of arterial desaturation significantly correlated with lung volume/basal metabolic rate, but when breath held at RV, the rate of arterial desaturation did not correlate linearly with RV/BMR. Sinus arrythmias occurred during breath holding and rebreathing manuever irrespective of the size of the lung volume at which breath holding started, and the amount of change was smallest when breath held at FRC and the change in vagal tone induced by alteration in respiratory movement might be the major responsible factor for the sinus arrythmia.

• Journal of Veterinary Clinics
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• v.25 no.2
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• pp.96-101
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• 2008

This study was performed to quantify the pleural effusion in radiography, ultrasonography and computed tomography(CT) and to evaluate and compare the usefulness of these methods. Normal saline of 10 ml/kg was infused into the pleural space until a final loading volume of 60 ml/kg body weight was reached in six Beagle dogs. The radiographic examination was performed for the detection and quantification of pleural effusion. On the ultrasonographic study, the maximum perpendicular distance was measured between the surface of the lung and the thoracic wall to evaluate pleural effusion. On the CT image, pleural effusion was evaluated as the perpendicular distance to the thoracic surface in the maximum pleural effusion volume on any transverse images with soft tissue window. Statistical analysis was performed using linear regression test. The volume of pleural effusion and measurements of radiography and ultrasonography had no statistical relationship. However, a significant correlation was identified between the volume of pleural effusion and the depth at right ($r^2=0.715$), left ($r^2=0.745$), and mean right and left depth ($r^2=0.844$) on the CT images. All of the thoracic radiographs, ultrasonography, and CT are useful in recognition of pleural effusion. In quantification of pleural effusion, the CT measurement method is superior to radiographic and ultrasonographic measurements.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.8-14
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• 2012

Background: Although airway obstruction in chronic obstructive pulmonary disease (COPD) is due to pathologic processes in both the airways and the lung parenchyma, the contribution of these processes, as well as other factors, have not yet been evaluated quantitatively. We therefore quantitatively evaluated the factors contributing to airflow limitation in patients with COPD. Methods: The 213 COPD patients were aged >45 years, had smoked >10 pack-years of cigarettes, and had a post-bronchodilator forced expiratory volume in one second ($FEV_1$)/forced vital capacity (FVC) <0.7. All patients were evaluated by medical interviews, physical examination, spirometry, bronchodilator reversibility tests, lung volume, and 6-minute walk tests. In addition, volumetric computed tomography (CT) was performed to evaluate airway wall thickness, emphysema severity, and mean lung density ratio at full expiration and inspiration. Multiple linear regression analysis was performed to identify the variables independently associated with $FEV_1$ - the index of the severity of airflow limitation. Results: Multiple linear regression analysis showed that CT measurements of mean lung density ratio (standardized coefficient ${\beta}$=-0.46; p<0.001), emphysema severity (volume fraction of the lung less than -950 HU at full inspiration; ${\beta}$=-0.24; p<0.001), and airway wall thickness (mean wall area %; ${\beta}$=-0.19, p=0.001), as well as current smoking status (${\beta}$=-0.14; p=0.009) were independent contributors to $FEV_1$. Conclusion: Mean lung density ratio, emphysema severity, and airway wall thickness evaluated by volumetric CT and smoking status could independently contribute to the severity of airflow limitation in patients with COPD.

• Journal of Veterinary Science
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• v.21 no.2
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• pp.27.1-27.10
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• 2020

The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO₂ (ETCO₂) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO₂ > 45 mmHg) were compared using Fisher's exact test. A significance level of p < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; p = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH₂O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH₂O/L/sec; p < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; p = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; p < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.

• Journal of Sensor Science and Technology
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• v.17 no.2
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• pp.133-142
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• 2008

Respiration is induced by muscular contraction of the chest and abdomen, resulting in the abdominal volume change. Thus, continuous measurement of the abdominal dimension enables to monitor breathing activity. Conductive rubber cord has been previously introduced and tested to develop wearable application for respiratory measurements. The present study implemented wireless wearable respiratory monitoring system with the conductive rubber cord in the patient's pants. Signal extraction circuitry was developed to obtain the abdominal circumference changes reflecting the lung volume variation caused by respiratory activity. Wireless transmission was followed based on the zigbee communication protocol in a size of 65mm${\times}$105mm easily put in pocket. Successful wireless monitoring of respiration was performed in that breathing frequency was accurately estimated as well as different breathing patterns were easily recognized from the abdominal signal. $CO_2$ inhalation experiment was additionally performed in purpose of quantitative estimation of tidal volume. Air mixed with $0{\sim}5%\;CO_2$was inhaled by 4 normal males and the respiratory air flow rate, abdominal dimension change, and end tidal $CO_2$ concentration were simultaneously measured in steady state. $CO_2$ inhalation increased the tidal volume in normal physiological state with a correlation coefficient of 0.90 between the tidal volume and the end tidal $CO_2$ concentration. The tidal volume estimated from the abdominal signal linearly correlated with the accurate tidal volume measured by pneumotachometer with a correlation coefficient of 0.88 with mean relative error of approximately 8%. Therefore, the tidal volume was accurately estimated by measuring the abdominal dimension change.

• Journal of Power Electronics
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• v.15 no.2
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• pp.309-318
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• 2015

This study proposes a dual-output single-stage bridgeless single-ended primary-inductor converter (DOSSBS) that can completely remove the front-end full-bridge alternating current-direct current rectifier to accomplish power factor correction for universal line input. Without the need for bridge diodes, the proposed converter has the advantages of low component count and simple structure, and can thus significantly reduce power loss. DOSSBS has two uncommon output ports to provide different voltage levels to loads, instead of using two separate power factor correctors or multi-stage configurations in a single stage. Therefore, this proposed converter is cost-effective and compact. A magnetically coupled inductor is introduced in DOSSBS to replace two separate inductors to decrease volume and cost. Energy stored in the leakage inductance of the coupled inductor can be completely recycled. In each line cycle, the two active switches in DOSSBS are operated in either high-frequency pulse-width modulation pattern or low-frequency rectifying mode for switching loss reduction. A prototype for dealing with an $85-265V_{rms}$ universal line is designed, analyzed, and built. Practical measurements demonstrate the feasibility and functionality of the proposed converter.