• 한국방사선학회논문지
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• 제17권5호
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• pp.767-773
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• 2023

본 연구에서는 폐용적에 영향을 미치는 관련 인자들과 폐기능 환기장애에 대한 유의성을 평가하고자 하였다. 실험대상으로는 저선량 흉부 CT검사와 폐활량검사를 동시에 수행한 정상 성인 남·여 206명을 선정하였으며 실험방법으로는 저선량 흉부 CT검사로 획득한 폐 CT 영상을 이용하여 폐용적을 딥러닝 기반의 AVIEW LCS 자동진단 프로그램을 이용하여 측정하였다. 그리고 폐활량계를 이용하여 폐기능을 측정한 결과를 획득하였으며 폐용적에 영향을 미치는 관련 인자로 성별 및 BMI를 선정하여 폐용적과의 독립표본 T-test를 통하여 유의성을 평가하고자 하였다. 실험결과 성별에 따른 폐용적의 평가에서 남성의 모든 폐용적이 여성의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 성별 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 남성이 여성보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내었다(p<0.001). 그리고 BMI 지수에 따른 폐용적의 평가에서 BMI 지수 24 이상의 성인의 모든 폐용적이 BMI 지수 24 미만의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 그러나 BMI 지수 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 BMI 지수 24 이상이 BMI 지수 24 미만보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내지 않았다(p<0.055). 폐기능 환기장애 유무에 따른 폐용적의 평가에서 폐기능 환기 정상성인의 모든 폐용적이 폐기능 환기 장애성인의 모든 폐용적보다 크다는 것을 확인할 수 있었다. 그리고 폐기능 환기장애 유무 및 폐용적에 대한 각각의 평균값을 이용한 독립표본 T-test 결과 폐기능 환기 정상성인이 폐기능 환기 장애성인보다 모든 폐용적이 더 크다는 결과는 유의한 결과를 나타내었다(p<0.001). 폐용적과 폐활량 검사 결과는 폐 건강을 평가하는데 가장 중요한 지표이며, 이 두 지표를 함께 사용하여 폐 기능을 평가하는 것이 가장 정확한 평가 방법이다. 그러므로 본 연구에서는 폐용적과 폐활량 검사에 대한 향후 유사 연구 시 폐기능 환기 정상 성인과 폐기능 환기 장애 성인에 대한 폐용적 평균값을 제시하여 기초자료로 활용될 것이라고 사료된다.

• The Korean Journal of Physiology
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• 제1권1호
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• pp.77-82
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• 1967

The normal lung volumes were determined and subdivided under sitting position in 48 middle school girls, 49 high school girls and 44 house wives. All subjects were free of pulmonary and vascular diseases. The vital capacity was measured by Mckessons spirometer and the residual volume was determined by Rahn's three breathing method. 1. The lung volumes (BTPS) of middle school girls determined were: $RV\;0.59{\pm}0.11l\;FRC\;1.45{\pm}2.22l\;VC\;2.68{\pm}0.29l$ 2. The lung volumes (BTPS) of high school girls determined were: $RV\;0.83{\pm}0.19l\;FRC\;1.9{\pm}0.25l\;VC\;3.15{\pm}0.24l$ 3. The lung volumes (BTPS) of house wives determind were: $RV\;0.95{\pm}0.61{\ell}\;FRC\;2.1{\pm}0.25{\ell}\;VC\;3.06{\pm}0.29l$ 4. The calculated residual ratio $(RV/TLC{\times}100)$ were: $17.7{\pm}2.57%$ in middle school girls and $20.6{\pm}3.65%$ in high school girls and $24.0{\pm}2.31%$ in house wives 5. The functional residual ratio $(FRC/TLC{\times}100)$ were: $43.7{\pm}5.98%$ in middle school girls and $48.8{\pm}4.41%4 in high school girls and $52.6{\pm}5.38%$ in house wives. 6. The correlation coefficients between vital capacity and total lung capacity were r=0.96 in middle school girls and r=0.986 in high school girls and r=0.856 in house wives. 7. The regression equations were obtained follows: $TLC(l) =1.105{\times}VC+0.304$ (in middle school girls) $TLC(l) =1.551{\times}VC-0.902$ (in high school girls) $TLC(l) =0.999{\times}VC+0.954$ (in house wives)

• 대한의용생체공학회:의공학회지
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• 제11권2호
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• pp.195-202
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• 1990

The hypothesis of asymmetric resistance to explain the phenomenon of lung hyperinflation (LHI) during hlgh frequency ventilation (HFV) was quantitatively studied. LHI was predicted by modeling the ism-volume pressure-flow (IVPF) data from 5 human subjects using the empirical Rohrer's equation. Non-steadiness during HFV was compensated by em- ploying recently proposed volume-frequency diagram. Tidal volume and ventilation frequency were 100 ml and 20 Hz, respectively. Airflow pattern was a symmetric sinusoid. The predic- tion results of mean pressure drop across the airways were averaged for those 5 subjects, and compared with zero by one-sided student's t-test. A marginally significant (P<0.1) increase in mean pressure drop was observed during HFV at low lung volumes (below FRC) , which could increase mean lung volume up to one liter When the lung volume was above FRC, no significant LHI (P >0.25) was resulted. LHI seemed to be inversely related to the lung volume. These results recommend to clinically apply HFV only at lung volumes above FRC.

• 대한의용생체공학회:의공학회지
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• 제13권3호
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• pp.209-216
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• 1992

A new experimental technique is proposed to localize the flow limiting segment(FLS) during forced expiration. The present technique is based on the pressure drip across FLS and a consequent change in airway resistance, which can provide an accurate and objective location of FLS. During forced expiratory maneuver artificially induced by a strong negative pressure (-100mmHg) applied at the trachea in an anesthetized open chest dog, airway resistance( R) was calculated from air flow and airway pres- sure signals at various airway locations and lung volumes, At the lung volumes above 10 % VC, FLS located in the trachea 6cm lower from the larynx. With the lung volume decreased below 8% VC, FLS jumped upstream to End-3rd generation of the airway. These results were similar with the previous reports from excised dog lungs, which demonstrated the validity of the present technique. Since the present technique provides a more objective measure of FLS location, it would be useful in future studies of expiratory flow limitation.

• 한국정보과학회논문지:소프트웨어및응용
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• 제32권1호
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• pp.41-49
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• 2005

본 논문에서는 동일 환자에 대하여 시간차론 두고 촬영한 복부 CT 영상에서 환자의 움직임에 따른 두 영상 간 차이를 보정하기 위하여 지역적 거리전파를 이용한 자동 폐 정합 방법을 제안한다. 본 제안방법은 다음과 같은 세 단계로 구성된다 첫 번째, 일련의 두 볼륨데이타에서 폐 경계를 추출한 후, 폐를 포함하는 최적경계볼륨을 생성하여 초기정합을 수행한다 두 번째, 초기에 촬영한 볼륨데이타에서 지역적 거리전파를 이용하여 폐 경계로부터 3차원 거리맵을 생성한다. 세 번째, 선택적 거리 측정을 통해 두 경계간에 거리차이가 최소인 위치로 영상을 정합한다. 실험으로 3명의 환자 데이타에 대하여 영상정합을 하였고, 기존의 챔퍼매칭 정합 방법과 수행속도와 견고성 측면에서 비교 평가하였다. 본 제안방법은 지역적 거리전파를 사용하여 생성된 3차원 거리맵을 이용한 선택적 거리측정을 통하여 최적의 위치로 빠르고 견고하게 정합된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4727-4732
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• 2014

Background: Breast cancers are becoming more frequently diagnosed at early stages with improved long term outcomes. Late normal tissue complications induced by radiotherapy must be avoided with new breast radiotherapy techniques being developed. The aim of the study was to compare dosimetric parameters of planning target volume (PTV) and organs at risk between conformal (CRT) and intensity-modulated radiation therapy (IMRT) after breast-conserving surgery. Materials and Methods: A total of 20 patients with early stage left breast cancer received adjuvant radiotherapy after conservative surgery, 10 by 3D-CRT and 10 by IMRT, with a dose of 50 Gy in 25 sessions. Plans were compared according to dose-volume histogram analyses in terms of PTV homogeneity and conformity indices as well as organs at risk dose and volume parameters. Results: The HI and CI of PTV showed no difference between 3D-CRT and IMRT, V95 gave 9.8% coverage for 3D-CRT versus 99% for IMRT, V107 volumes were recorded 11% and 1.3%, respectively. Tangential beam IMRT increased volume of ipsilateral lung V5 average of 90%, ipsilateral V20 lung volume was 13%, 19% with IMRT and 3D-CRT respectively. Patients treated with IMRT, heart volume encompassed by 60% isodose (30 Gy) reduced by average 42% (4% versus 7% with 3D-CRT), mean heart dose by average 35% (495cGy versus 1400 cGy with 3D-CRT). In IMRT minimal heart dose average is 356 cGy versus 90cGy in 3D-CRT. Conclusions: IMRT reduces irradiated volumes of heart and ipsilateral lung in high-dose areas but increases irradiated volumes in low-dose areas in breast cancer patients treated on the left side.

• Tuberculosis and Respiratory Diseases
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• 제46권4호
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• pp.489-499
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• 1999

연구배경: 기관지확장증은 폐쇄성환기장애와 더불어 반복적인 폐감염으로 인한 주위 폐실질의 섬유화 및 흉막유착 등으로 인하여 경한 제한상 환기장애가 동반될 수 있다. 그리고 주위 폐실질의 과팽창이나 폐기종성변화도 관찰되어 이로 인한 폐용량 및 폐확산능의 변화가 예상된다. 방 법: 저자들은 1994년 1월부터 1996년 12월까지 경북대학교병원 호흡기내과에서 고해상전산화단층촬영으로 기관지확장증으로 진단된 40예를 대상으로 기관지확장증의 형태, 중증도, 범위 및 동반된 폐기종유무와 폐기량, 폐확산능의 관계를 후향적으로 조사하여 다음과 같은 결과를 얻었다. 결 과: 남자가 18예, 여자가 22예였으며 연령은 평균 53세였다. 고해상전산화단층촬영소견상 원통형이 24예, 낭종형이 16예였으며, 기관지확장증이 있는 평균 폐 구역수는 원통형과 낭종형에서 각각 4.7개 및 7.0개로 낭종형에서 유의하게 많았다 (p<0.05). 확장증의 형태 및 중증도에 따른 VC는 낭종형에서 그리고 기관지확장증의 중증도가 심할수록 감소하는 경향이 있었고 RV, TLC, RV/TLC는 유의한 차이가 없었다. LCI는 원통형에 비해 낭종형에서 유의하게 증가하였으며(p<0.05), 기관지확장증의 중증도에 따를 차이는 없었다. $\triangle$N2/L은 확장증의 형태 및 중증도에 따른 차이가 없었으며 개인차가 심하였다. $D_{LCO}$ 및 $D_{LCO}/V_A$는 원통형에 비해 낭종형에서 유의하게 감소하였으며(각각 p<0.1, p<0.05), 확장증의 중증도에 따라서 뚜렷히 감소하였다 (p<0.05). 기관지확장증의 범위와 폐기능성적들과의 상관계수는 VC, $D_{LCO}$ 및 LCI가 각각 -0.322, -0.339, 0.487로 유의한 관계가 있었으나 RV, TLC, RV/TLC, $\triangle$N2/L와 $D_{LCO}/V_A$는 유의한 관계가 없었다. 고해상전산화단층촬영상의 폐기종의 범위와 폐기능성적들과의 상관계수는 VC 및 $D_{LCO}$는 각각 -0.574, -0.381로 유의한 관계가 있었으며 RV, RV/TLC, LCI와 $\triangle$N2/L도 각각 0.435, 0.552, 0.333과 0.427로 유의한 관계가 있었다. 결 론: 이상의 결과로 낭종형과 기관지확장증의 중증도에 따른 폐활량 및 폐확산능의 감소와 흡기의 폐내분포는 기관지확장증의 범위 및 동반된 폐기종의 범위와 관계가 있고, 잔기량은 동반된 폐기종과 관련이 있음을 알 수 있었다.

• 한국대기환경학회지
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• 제19권5호
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• pp.551-560
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• 2003

Particle deposition in human lungs was investigated theoretically by using asymmetric five-lobe lung model. The volumes of each of the five lobes were different, thereby forming an asymmetric lung structure. The tidal volume and flow rate of each lobe were scaled according to lobar volume. The total and regional deposition with various breathing patterns were calculated by means of tracking volume segments and accounting for particle loss during inhalation and exhalation. The deposition fractions were obtained for each airway generation and lung lobe, and dominant deposition mechanisms were investigated for different size particles. Results show that the tidal volume and flow rate have a characteristic influence on particle deposition. The total deposition fraction increases with an increase in tidal volume for all particle sizes. However, flow rate has dichotomous effects: a higher flow rate results in a sharp increase in deposition for large size particles, but decreases deposition for small size particles. Deposition distribution within the lung shifts proximally with higher flow rate whereas deposition peak shifts to the deeper lung region with larger tidal volume. Deposition fraction in each lobe was proportional to its volume. Among the three main deposition mechanisms, diffusion was dominant for particles < 0.5 ${\mu}{\textrm}{m}$ whereas sedimentation and impaction were most influential for larger size particles. Impaction was particularly dominant for particles> 8 ${\mu}{\textrm}{m}$. The results may prove to be useful for estimating deposition dose of inhaled pollutant particles at various breathing conditions.

• Radiation Oncology Journal
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• 제38권1호
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• pp.68-76
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• 2020

Purpose: The present study was conducted to compare dosimetric parameters for the heart and left lung between free breathing (FB) and deep inspiration breath hold (DIBH) and determine the most important potential factors associated with increasing the lung dose for left-sided breast radiotherapy using image analysis with 3D Slicer software. Materials and Methods: Computed tomography-simulation scans in FB and DIBH were obtained from 17 patients with left-sided breast cancer. After contouring, three-dimensional conformal plans were generated for them. The prescribed dose was 50 Gy to the clinical target volume. In addition to the dosimetric parameters, the irradiated volumes and both displacement magnitudes and vectors for the heart and left lung were assessed using 3D Slicer software. Results: The average of the heart mean dose (D_mean) decreased from 5.97 to 3.83 Gy and V₂₅ from 7.60% to 3.29% using DIBH (p < 0.001). Furthermore, the average of D_mean for the left lung was changed from 8.67 to 8.95 Gy (p = 0.389) and V₂₀ from 14.84% to 15.44% (p = 0.387). Both of the absolute and relative irradiated heart volumes decreased from 42.12 to 15.82 mL and 8.16% to 3.17%, respectively (p < 0.001); however, these parameters for the left lung increased from 124.32 to 223.27 mL (p < 0.001) and 13.33% to 13.99% (p = 0.350). In addition, the average of heart and left lung displacement magnitudes were calculated at 7.32 and 20.91 mm, respectively. Conclusion: The DIBH is an effective technique in the reduction of the heart dose for tangentially treated left sided-breast cancer patients, without a detrimental effect on the left lung.

• Radiation Oncology Journal
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• 제36권1호
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• pp.71-78
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• 2018

Purpose: To compare the dose distribution of three-dimensional conformal radiation therapy (3DCRT) with intensity-modulated radiation therapy (IMRT) for post-mastectomy radiotherapy (PMRT) to left chest wall. Materials and Methods: One hundred and seven patients were randomised for PMRT in 3DCRT group (n = 64) and IMRT group (n = 43). All patients received 50 Gy in 25 fractions. Planning target volume (PTV) parameters-$D_{near-max}$ ($D_2$), $D_{near-min}$ ($D_{98}$), $D_{mean}$, $V_{95}$, and $V_{107}$-homogeneity index (HI), and conformity index (CI) were compared. The mean doses of lung and heart, percentage volume of ipsilateral lung receiving 5 Gy ($V_5$), 20 Gy ($V_{20}$), and 55 Gy ($V_{55}$) and that of heart receiving 5 Gy ($V_5$), 25 Gy ($V_{25}$), and 45 Gy ($V_{45}$) were extracted from dose-volume histograms and compared. Results: PTV parameters were comparable between the two groups. CI was significantly improved with IMRT (1.127 vs. 1.254, p < 0.001) but HI was similar (0.094 vs. 0.096, p = 0.83) compared to 3DCRT. IMRT in comparison to 3DCRT significantly reduced the high-dose volumes of lung ($V_{20}$, 22.09% vs. 30.16%; $V_{55}$, 5.16% vs. 10.27%; p < 0.001) and heart ($V_{25}$, 4.59% vs. 9.19%; $V_{45}$, 1.85% vs. 7.09%; p < 0.001); mean dose of lung and heart (11.39 vs. 14.22 Gy and 4.57 vs. 8.96 Gy, respectively; p < 0.001) but not the low-dose volume ($V_5$ lung, 61.48% vs. 51.05%; $V_5$ heart, 31.02% vs. 23.27%; p < 0.001). Conclusions: For left sided breast cancer, IMRT significantly improves the conformity of plan and reduce the mean dose and high-dose volumes of ipsilateral lung and heart compared to 3DCRT, but 3DCRT is superior in terms of low-dose volume.