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Effects of Breathing Exercise Interventions on Lung Function in COVID-19 Survivors (호흡운동 중재방법이 COVID-19 생존자의 폐기능에 미치는 영향)

  • Chung-Yoo Kim;Hyeon-Su Kim;Yeon-Su Kim;Ki-Jeoung Ahn
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.133-140
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    • 2024
  • Purpose : People who have suffered from COVID-19 suffer from decreased pulmonary function and various side effects. This study aims to present three respiratory exercise intervention methods to improve pulmonary function in COVID-19 survivors. Therefore, the purpose of this study will investigate the effects of breathing exercise interventions (aerobic exercise, diaphragm breathe exercise, and inspiratory muscle training on resistance) on pulmonary function in COVID-19 survivors. Methods : The subjects who participated in this study were 35 male and female college students confirmed with COVID-19. All subjects were randomly assigned to A, D, and I groups according to breathing exercise intervention method. Groups A, D, and I each performed aerobic exercise, diaphragm breathing exercise, and inspiratory muscle training on resistance, 3 times a week for 6 weeks. Pulmonary function was measured using a spirometer, and FVC (forced vital capacity), FEV1 (forced expiratory volume in one second), FEV1/FVC % (forced expiratory volume in one second / forced vital capacity ratio), and PEF (peak expiratory flow) were measured at 0, 3, and 6 weeks. Data analysis was compared by repeated measures analysis of variance, and post hoc tests for time were compared and analyzed using paired t-tests. Results : In the results of this study, FVC values showed statistically significant improvement in all groups. FEV1 values also showed statistically significant improvement in all groups. And the FEV1/FVC % value also showed statistically significant improvement in all groups. And the PEF values also showed statistically significant improvement in all groups. Conclusion : The results of this study reported that aerobic exercise, diaphragm breathing exercise, and resistance inspiratory muscle training were all effective in improving pulmonary function in COVID-19 survivors. Therefore, application of the three breathing exercise intervention methods presented in this study will help improve pulmonary function in COVID-19 survivors.

Quality Assurance of Patients for Intensity Modulated Radiation Therapy (세기조절방사선치료(IMRT) 환자의 QA)

  • Yoon Sang Min;Yi Byong Yong;Choi Eun Kyung;Kim Jong Hoon;Ahn Seung Do;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.81-90
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    • 2002
  • Purpose : To establish and verify the proper and the practical IMRT (Intensity--modulated radiation therapy) patient QA (Quality Assurance). Materials and Methods : An IMRT QA which consists of 3 steps and 16 items were designed and examined the validity of the program by applying to 9 patients, 12 IMRT cases of various sites. The three step OA program consists of RTP related QA, treatment information flow QA, and a treatment delivery QA procedure. The evaluation of organ constraints, the validity of the point dose, and the dose distribution are major issues in the RTP related QA procedure. The leaf sequence file generation, the evaluation of the MLC control file, the comparison of the dry run film, and the IMRT field simulate image were included in the treatment information flow procedure QA. The patient setup QA, the verification of the IMRT treatment fields to the patients, and the examination of the data in the Record & Verify system make up the treatment delivery QA procedure. Results : The point dose measurement results of 10 cases showed good agreement with the RTP calculation within $3\%$. One case showed more than a $3\%$ difference and the other case showed more than $5\%$, which was out side the tolerance level. We could not find any differences of more than 2 mm between the RTP leaf sequence and the dry run film. Film dosimetry and the dose distribution from the phantom plan showed the same tendency, but quantitative analysis was not possible because of the film dosimetry nature. No error had been found from the MLC control file and one mis-registration case was found before treatment. Conclusion : This study shows the usefulness and the necessity of the IMRT patient QA program. The whole procedure of this program should be peformed, especially by institutions that have just started to accumulate experience. But, the program is too complex and time consuming. Therefore, we propose practical and essential QA items for institutions in which the IMRT is performed as a routine procedure.

Effects of Several Cooling Methods and Cool Water Hose Bed Culture on Growth and Microclimate in Summer Season Cultivation of Narrowhead Goldenray 'Ligularia stenocephaia' (곤달비 여름재배 시 냉각방법과 냉수호스베드재배가 생육 및 미기상에 미치는 영향)

  • Kim, Ki-Deog;Lee, Eung-Ho;Kim, Won-Bae;Lee, Jun-Gu;Yoo, Dong-Lim;Kwon, Young-Seok;Lee, Jong-Nam;Jang, Suk-Woo;Hong, Soon-Choon
    • Journal of Bio-Environment Control
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    • v.20 no.2
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    • pp.116-122
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    • 2011
  • This study was carried out to investigate the effects of several cooling methods such as water hose cooling, mist, fog and control on growth and microclimate, and to develop a simple nutriculture bed for production of fresh leaves of narrowhead goldenaray 'Ligularia stenocephala'. When the root-zone was cooled with 240 L/hr flow rate of $13^{\circ}C$ ground water using water hose, the temperature was lowered approximately by 2 to $3^{\circ}C$ than that of control. The growth of narrowhead goldenaray were favorable in the water hose cooling compared with the other cooling methods. Nutrient culture system having part cooling effect around plant canopy was developed. The system was composed of 15 cm diameter of water hose on side wall of beds, cooling hose, and expanded rice hull media as organic substrate. When cool water which the temperature changed in the range of 14 to $22^{\circ}C$ diurnally with 240 L/hr of flow rate through water hose, the air temperature around canopy and root-zone temperature were dropped by $0.5^{\circ}C$ and $3^{\circ}C$ compared with that of conventional styrofoam bed, respectively. These results showed that newly devised bed system using water hose was simple and economical for the production of high quality narrowhead goldenaray leaves. This system might be practically used both at summer and winter season for the cultivation of narrow head goldenaray by part cooling or heating around root-zone and plant canopy.

Development of Rain Shelter for Chinese Cabbage Rainproof Cultivation (배추재배용 비가림하우스 개발)

  • Yu, In Ho;Lee, Eung Ho;Cho, Myeong Whan;Ryu, Hee Ryong;Moon, Doo Gyung
    • Journal of Bio-Environment Control
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    • v.23 no.4
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    • pp.293-302
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    • 2014
  • This study was carried out to develop rain shelter which can make an appropriate size and environment for Chinese cabbage rainproof cultivation. Fifty three farms with chinese cabbage rainproof cultivation system have been investigated to set up width and height of rain shelter. Mostly the width of 6m was desired for rain shelter and the height of 1.6m for their eaves, so these values were chosen as the dimensions for rain shelter. After an analysis of their structural safety and installation costs by the specifications of the rafter pipe, Ø$25.4{\times}1.5t$ and 90cm have been set as the size of rafter that such size costs the least. This size is stable with $27m{\cdot}s^{-1}$ of wind velocity and 17cm of snow depth. Therefore it is difficult to apply this dimension to area with higher climate load. In order to sort out such problem, the rain shelter has been designed to avoid damage on frame by opening plastic film to the ridge. Once greenhouse band is loosen by turning the manual switch at the both sides of rain shelter and open button of controller is pushed then switch motor rises up along the guide pipe and plastic film is opened to the ridge. Chinese cabbage can be damaged by insects if rain shelter is opened completely as revealed a field. To prevent this, farmers can install an insect-proof net. Further, the greenhouse can be damaged by typhoon while growing Chinese cabbage therefore the effect of an insect-proof net on structural safety has been analyzed. And then structural safety has been analyzed through using flow-structure interaction method at the wind condition of $40m{\cdot}s^{-1}$. And it assumed that wind applied perpendicular to side of the rain shelter which was covered by insect-proof net. The results indicated that plastic film was directly affected by wind therefore high pressure occurred on the surface. But wind load on insect-proof net was smaller than on plastic film and pressure distribution was also uniform. The results of structural analysis by applying pressure data extracted from flow analysis indicated that the maximum stress occurred at the end of pipe which is the ground part and the value has been 54.6MPa. The allowable stress of pipe in the standard of structural safety must be 215 MPa or more therefore structural safety of this rain shelter is satisfied.

Quantitative Assessment using SNR and CNR in Cerebrovascular Diseases : Focusing on FRE-MRA, CTA Imaging Method (뇌혈관 질환에서 신호대 잡음비와 대조도대 잡음비를 이용한 정량적평가 : FRE-MRA, CTA 영상기법중심으로)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.11 no.6
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    • pp.493-500
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    • 2017
  • In this study, data analysis has been conducted by INFINITT program to analyze the effect of signal to noise ratio(SNR) and contrast to noise ratio(CNR) of flow related enhancement(FRE) and computed tomography Angiography(CTA) on cerebrovascular diseases for qualitative evaluations. Based on the cerebrovascular image results achieved from 63 patients (January to April, 2017, at C University Hospital), we have selected 19 patients that performed both FRE-MRA and CTA. From the 19 patients, 2 were excluded due to artifacts from movements in the cerebrovascular image results. For the analysis conditions, we have set the 5 part (anterior cerebral artery, right and left Middle cerebral artery, right and left Posterior cerebral artery) as the interest area to evaluate the SNR and CNR, and the results were validated through Independence t Test. As a result, by averaging the SNR, and CNR values, the corresponding FRE-MRA achieved were: anterior cerebral artery ($1500.73{\pm}12.23/970.43{\pm}14.55$), right middle cerebral artery ($1470.16{\pm}11.46/919.44{\pm}13.29$), left middle cerebral artery ($1457.48{\pm}17.11/903.96{\pm}14.53$), right posterior cerebral artery ($1385.83{\pm}16.52/852.11{\pm}14.58$), left posterior cerebral artery ($1318.52{\pm}13.49/756.21{\pm}10.88$). by averaging the SNR, and CNR values, the corresponding CTA achieved were: anterior cerebral artery ($159.95{\pm}12.23/123.36{\pm}11.78$), right middle cerebral artery ($236.66{\pm}17.52/202.37{\pm}15.20$), left middle cerebral artery ($224.85{\pm}13.45/193.14{\pm}11.88$), right posterior cerebral artery ($183.65{\pm}13.47/151.44{\pm}11.48$), left posterior cerebral artery ($177.7{\pm}16.72/144.71{\pm}11.43$) (p < 0.05). In conclusion, MRA had high SNR and CNR value regardless of the cerebral infarction or cerebral hemorrhage observed in the 5 part of the brain. Although FRE-MRA consumed longer time, it proved to have less side effect of contrast media when compared to the CTA.

Effect of ST 36-ST 41 Electro-acupuncture on Regional Cerebral Blood Flow in Normal Volunteers Evaluated by $^{99m}Tc$-ECD SPECT (족삼리-해계 전침치료가 정상인의 국소 뇌혈류에 미치는 영향 -Brain SPECT와 SPM을 이용하여-)

  • Moon, Sang-Kwan;Min, In-Kyu;Park, Sung-Uk;Jung, Woo-Sang;Park, Jung-Mee;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Young-Suk;Kim, Deok-Yoon
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.130-137
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    • 2010
  • Objectives: So far it has been reported that acupuncture increases cerebral blood supply and stimulates the functional activity of brain nerve cells. Previous studies have demonstrated that frequently used electro-acupuncture (EA) therapies for stroke increased regional cerebral blood flow (rCBF) in normal volunteers. Though ST 36-ST 41 EA is another prevailing therapy for stroke, there had been no report about its effect on rCBF. This study was to evaluate the effect of ST 36-ST 41 EA on rCBF in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc$-ECD brain SPECT scans were performed on 10 normal volunteers (5 males, 5 female, mean age $23.6{\pm}0.5$ years). On the other study day, 7 days after the resting examination, 15 minutesEA were applied at ST 36 and ST 41 on the right side of the subjects. Immediately after ST36-ST41 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by SPM with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: EA applied at the right ST36-ST41 significantly increased rCBF in the right inferior parietal lobule (Brodmann area [BA] 40), right retrosubicular area (BA 48), left inferior parietal lobule (BA 40), left middle temporal gyrus (BA 21), left fusiform gyrus (BA 37), left inferior parietal lobule (BA 39), left inferior temporal gyrus (BA 20), and left somatosensory association cortex (BA 7). However, right ST36-ST41 EA significantly decreased rCBF in the right parahippocampal gyrus (BA 35), right cerebellum, left frontopolar area (BA 10), left orbitofrontal area (BA 11), left dorsolateral prefrontal cortex (BA 9), and left dorsal anterior cingulate cortex (BA 32). Conclusions: These results demonstrate that rightST36-ST41 EA increased rCBF prominently in both inferior parietal lobule (BA 40) and right retrosubicular area (BA 48), which suggest that there be correlation between specific EA and corresponding rCBF.

The Relation between Collateral Circulation and $^{99m}Tc$-MIBI Heart SPECT (심근경색에서 측부순환 유무에 따른 $^{99m}Tc$-MIBI 심근 SPECT 소견)

  • Kim, Jae-Man;Na, Deug-Young;Park, Eun-Kyung;Yang, Hyung-In;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.37-43
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    • 1994
  • The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

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Site Selection for Geologic Records of Extreme Climate Events based on Environmental Change and Topographic Analyses using Paleo Map for Myeongsanimni Coast, South Korea (고지도 기반 환경변화연구 및 지형분석을 통한 명사십리 해안의 제4기 연안지대 이상기후 퇴적기록 적지선정)

  • Kim, Jieun;Yu, Jaehyung;Yang, Dongyoon
    • Economic and Environmental Geology
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    • v.47 no.6
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    • pp.589-599
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    • 2014
  • This study selected optimal sites in Myeongsasimni located in west coast of Korea for stratigraphic research containing extreme climate event during quaternary period by spatio-temporal analyses of changes in sedimentary environment and land use employing 1918 topographic map, 2000 digital terrain map, 1976 and 2012 air photographies. The study area shows no significant changes in topographic characteristics that hilly areas with relatively large variations in elevation are distributed over north and south part of the study area, and sand dues are developed along the coast line. Moreover, flat low lying areas are located at the back side of the sand dues. The movement of surface run off and sediment loads shows two major trends of inland direction flow from back sides of sand dunes and outland direction flow from high terrains inland, and the two flows merge into the stream located in the center of the study area. Two sink with individual area of $0.2km^2$ are observed in Yongjeong-ri and Jaryong-ri which are located in south central part and south part of the study area, respectively. In addition, sea level change simulation reveals that $3.4km^2$ and $3.64km^2$ are inundated with 3 m of sea level rise in 1918 and 2000, respectively, and it would contribute to chase sea level change records preserved in stratigraphy. The inundated areas overlaps well with sink areas where it indicates the low lying areas located in south cental and south part of the study area are identical for sediment accumulation. The areas with minimal human impact on sediment records over last 100 years are $3.51km^2$ distributed over central and south part of the study area with the land use changes of mud and rice field in 1918 to rice field in 2012. The candidate sites of $0.15km^2$ in central part and $0.09km^2$ in south part are identified for preferable locations of geologic record of extreme climate events during quaternary period based on the overlay analysis of optimal sedimentary environment and land use changes.

Simulation of Detailed Wind Flow over a Locally Heated Mountain Area Using a Computational Fluid Dynamics Model, CFD_NIMR_SNU - a fire case at Mt. Hwawang - (계산유체역학모형 CFD_NIMR_SNU를 이용한 국지적으로 가열된 산악지역의 상세 바람 흐름 모사 - 화왕산 산불 사례 -)

  • Koo, Hae-Jung;Choi, Young-Jean;Kim, Kyu-Rang;Byon, Jae-Young
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.11 no.4
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    • pp.192-205
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    • 2009
  • The unexpected wind over the Mt. Hwawang on 9 February 2009 was deadly when many spectators were watching a traditional event to burn dried grasses and the fire went out of control due to the wind. We analyzed the fatal wind based on wind flow simulations over a digitized complex terrain of the mountain with a localized heating area using a three dimensional computational fluid dynamics model, CFD_NIMR_SNU (Computational Fluid Dynamics_National Institute of Meteorological Research_Seoul National University). Three levels of fire intensity were simulated: no fire, $300^{\circ}C$ and $600^{\circ}C$ of surface temperature at the site on fire. The surface heat accelerated vertical wind speed by as much as $0.7\;m\;s^{-1}$ (for $300^{\circ}C$) and $1.1\;m\;s^{-1}$ (for $600^{\circ}C$) at the center of the fire. Turbulent kinetic energy was increased by the heat itself and by the increased mechanical force, which in turn was generated by the thermal convection. The heating together with the complex terrain and strong boundary wind induced the unexpected high wind conditions with turbulence at the mountain. The CFD_NIMR_SNU model provided valuable analysis data to understand the consequences of the fatal mountain fire. It is suggested that the place of fire was calm at the time of the fire setting due to the elevated terrain of the windward side. The suppression of wind was easily reversed when there was fire, which caused updraft of hot air by the fire and the strong boundary wind. The strong boundary wind in conjunction with the fire event caused the strong turbulence, resulting in many fire casualties. The model can be utilized in turbulence forecasting over a small area due to surface fire in conjunction with a mesoscale weather model to help fire prevention at the field.

Pulmonary Arterial Growth Pattern after Shunt Operation in Patients of Pulmonary Atresia with Ventricular Septal Defect Associated with Juxtaductal Stenosis (Juxtaductal stenosis가 동반된 PA/VSD환자에서 체폐단락술 부위에 따른 폐동맥 크기의 변화)

  • 이교준;박영환;최재영;조범구
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.861-866
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    • 1998
  • Background: Pulmonary atresia (PA) with ventricular septal defect has various morphology of pulmonary arteries and pulmonary blood flow sources, so pulmonary arterial hypoplasia and arborization abnormality make this anomaly difficult to manage surgically. In cases associated with juxtaductal stenosis, we evaluated the change of the pulmonary arterial and juxtaductal stenotic site after shunt operations, and would like to find useful information in surgical planning and methodology of these patients. Material and Method: Among 59 cases diagnosed as PA with ventricular septal defect associated with juxtaductal stenosis, 29 cases who had cardiac catheterization before and after shunt operation were selected from July, 1991 to July, 1996. In 10 cases of right shunt operation(Group I) and 19 cases of left shunt operation (Group II), the diameters of the descending aorta, both pulmonary arteries, and the juxtaductal stenosis site were measured before and after the shunt operation. Result: In both Group I and II, the pre- and postoperative ratio of diameters of the ipsilateral pulmonary artery to the descending aorta was from 0.78${\pm}$0.31 units to 1.01${\pm}$0.26 units and from 0.67${\pm}$0.18 units to 0.84${\pm}$0.27 units respectively, showing a signigicant increase. The contralateral pulmonary artery index was increased from 0.92${\pm}$0.28 units to 1.05${\pm}$0.15 units and from 0.94${\pm}$0.27 units to 1.08${\pm}$0.37 units respectively, but could not be confirmed statistically. In both groups, the change of juxtaductal stenosis showed an aggravating tendency but of no statistical significance from 0.43${\pm}$0.27 units to 0.39${\pm}$0.25 units and from 0.32${\pm}$0.10 units to 0.30${\pm}$0.16 units respectively, and we experienced 2 total obstruction in Group II. Because the increased pulmonary blood flow by shunt operation has a favorable effect to the pulmonary arterial growth, the shunt operation is a recommended treatment in patients with hypoplastic pulmonary arteries. But in PA with ventricular septal defects, the change of juxtaductal stenosis is very important. In conclusion, the growth of ipsilateral (shunt site) pulmonary artery was promoted by shunt operation, but there is a tendency for the juxtaductal stenosis to be aggravated. And we experienced 2 total obstruction in Group II. Conclusion: Thus, in cases operated with shunt method, much careful postoperative follow up study including angiographic evaluation is needed, and after the shunt operation on the side of pulmonary artery associated with juxtaductal stenosis, early precise planning for total correction is recommended.

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