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A Study of Upper Airway Resistance Syndrome : Clinical and Polysomnographic Characteristics (상기도저항 증후군에 대한 연구 : 임상 및 수면다원검사 특징)

  • Yang, Chang-Kook;Clerk, Alex
    • Sleep Medicine and Psychophysiology
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    • v.3 no.2
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    • pp.32-42
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    • 1996
  • Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.

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Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule (고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구)

  • Cheon, Eun Mee;Kim, Byung-Tae;Kwon, O. Jung;Kim, Hojoong;Chung, Man Pyo;Rhee, Chong H.;Han, Yong Chol;Lee, Kyung Soo;Shim, Young Mog;Kim, Jhingook;Han, Jungho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.882-893
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    • 1996
  • Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

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Effects of Nitrogen Fertilization Increment on Forage Crops Cultivation in Saemangum Reclaimed Land (새만금간척지 사료작물 재배시 질소증비 효과)

  • Yang, Chang-Hyu;Kim, Sun;Lee, Jang-Hee;Baek, Nam-Hyun;Kim, Taek-Kyum;Choi, Weon-Young;Jeong, Jae-Hyuk;Lee, Sang-Bok;Lee, Gyeong-Bo
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.2
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    • pp.235-240
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    • 2012
  • This study was conducted to find out the optimum cropping system for the stable production of forage crops in the newly reclaimed land located at Gwanghwal region of Saemangum reclaimed land in which the soil is sandy loam (Munpo series). There were two treatments of nitrogen fertilization 20% increment based on the standard fertilization of 150, $200kg\;ha^{-1}$. Whole crop barley as the winter crop sowed on 27 October. After the whole crop barley was harvested at the end of May. Corn and sorghum${\times}$sudangrass as the summer crop sowed at the early of June successively on the same field. Emergence rate the whole crop barley was high while the summer crops were low. Soil salinity was increased during cultivation of summer crops. However, corn and sorghum${\times}$sudangrass were not damaged by salt. Increase of nitrogen fertilization made the growth of cultivation crops good, stem and leaf tended to have a lot of the mineral nutrients at heading stage and silking stage. After experiment, among soil chemical properties pH, content of exchangeable sodium were decreased and content of organic matter, available phosphate were increased. Dry matter yield were showed whole crop barley $13,170kg\;ha^{-1}$ and sorghum${\times}$sudangrass $19,440kg\;ha^{-1}$ by increment of nitrogen fertilization. Therefore, to improve the product and nutrient balance of reclaimed saline land comprehensive soil management should be considered.

The effect of surface treatment conditioning on shear bond strength between zirconia and dental resin cements (지르코니아 세라믹의 표면처리에 따른 치과용 접착제의 전단결합강도)

  • Kim, Ji-Hye;Seo, Jae-Min;Ahn, Seung-Geun;Park, Ju-Mi;Song, Kwang-Yeob
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.2
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    • pp.73-81
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    • 2013
  • Purpose: The purpose of this study was to evaluate the effect of surface treatment on the shear bond strength of zirconia ceramic to 3 resin cements. Materials and methods: A total of 143 disk-shaped Zirconia blocks (HASS Co., Gangneung, Korea) were randomly divided into three treatment groups: (1) only 50 ${\mu}m$ $Al_2O_3$ sandblasting, (2) 50 ${\mu}m$ $Al_2O_3$ sandblast and zircona liner, (3) 50 ${\mu}m$ $Al_2O_3$ sandblasting and Rocatec (3M ESPE, Seefeld, Germany). Bistite II (Tokuyama Dental Co., Japan), Panavia F (Kuraray Medical, Japan), and Superbond C&B (Sun Medical, Japan) were used to cement onto the zirconia. After 24h of storage in distilled water, shear bond strength was evaluated. High value group was re-tested after thermocycling at 5,000 cycles(5-$55^{\circ}C$). Shear bond strength data were analyzed with one-way ANOVA, two-way ANOVA test and Post Hoc Test (${\alpha}$=.05). Shear bond strength data before and after thermocycling were analyzed with Independent sample T test (${\alpha}$=.05). Results: Super-bond C&B treated with Rocatec showed the most high shear bond strength. Super-bond C&B groups resulted in significantly higher than other cement groups (P<.05). Rocatec groups resulted in significantly higher than other surface treatment groups (P<.05). Shear bond strength has increased in Panavia F treated with Zirconia liner (P<.05). After thermocycling, shear bond strength was increased in Super-bond C&B treated with Rocatec but decreased in other groups (P<.05). Conclusion: Super-bond C&B cement resulted the highest shear bond strength and Rocatec system enhanced the shear bond strength. After thermocycling, shear bond strength has decreased in most resin cements except Super-bond C&B treated with Rocatec.

Enhanced antimicrobial effectiveness of Omija (Schizamdra chinesis Baillon) by ClO2 (chlorine dioxide) treatment (오미자 수확 후 이산화염소수를 이용한 표면 세척에 따른 미생물 저감 효과)

  • Lee, Seul;Moon, Hey-Kyung;Lee, Su-Won;Moon, Jae-Nam;Lee, Sun-Ho;Kim, Jong-Kuk
    • Food Science and Preservation
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    • v.20 no.6
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    • pp.871-876
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    • 2013
  • The purpose of this study was to investigate antimicrobial effectiveness of Omija (Schizandra chinensis Baillon) treated with $ClO_2$ (chlorine dioxide) concentration (10, 15, 20, 25 and 30 ppm), washing time (30, 60 and 90 sec) and multiple proportion (x1, x2, x3 and x4). The seven groups were divided into control (Omija without washing water treatment), W-T (Omija treated by tap water ($20{\pm}1^{\circ}C$) for 30 seconds), $ClO_2$-10 (Omija treated by 10 ppm $ClO_2$), $ClO_2$-15 (Omija treated by 15 ppm $ClO_2$), $ClO_2$-20 (Omija treated by 20 ppm $ClO_2$), $ClO_2$-25 (Omija treated by 25 ppm $ClO_2$), $ClO_2$-30 (Omija treated by 30 ppm $ClO_2$), and then they were detected number of total aerobic bacteria, yeast and mold. The rate of inactivation was found, for microorganisms of total aerobic bacteria, yeast and mold, to increase with a increase of $ClO_2$ treatment concentration and multiple proportion. No total aerobic bacteria, yeast and mold in $ClO_2$-30 sample treated for 30 sec, $ClO_2$-15 treated for 60 sec and $ClO_2$-10 treated for 90 sec were detected, and in $ClO_2$-30 Omija with multiple proportion ${\times}1$ (Omija : 30 ppm $ClO_2$ solution ratio was 1:1 (w/w)), $ClO_2$-20 with ${\times}2$ (Omija : 20 ppm $ClO_2$ solution ratio was 1:2 (w/w)) and $ClO_2$-15 with ${\times}4$ (Omija : 15 ppm $ClO_2$ solution ratio was 1:4 (w/w)) respectively.

The Comparative Studies on the Urban and Rural Landscape for the Plant Diversity Improvement in Pond Wetland (농촌과 도시지역 비교를 통한 연못형습지의 식생다양성 증진방안 연구)

  • Son, Jin-Kwan;Kong, Min-Jae;Kang, Dong-Hyeon;Nam, Hong-Shik;Kim, Nam-Choon
    • Journal of Wetlands Research
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    • v.17 no.1
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    • pp.62-74
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    • 2015
  • Urban areas are variously under threat including deterioration of ecological functions. Many pond wetland types have been created as part of an effort to improve and restore this urban environment. This study was arranged to examine improvement plans of wetlands in urban areas by analyzing semi-natural wetlands in farm areas. As for environment for water quality, it suggested the inflow of natural water neighboring rivers or the direct inflow of rain as the improvement plans. The result which analyzed soil pH, OM, and T-N content of the soil environment mentioned that urban areas supplied artificial sluices, removed apoptotic bodies, and used artificial soil and waterproofing materials and use of natural materials in design and construction, the sluice state of the natural form, and negligence of autumn plants were suggested as the improvement plans. Florae appeared in the subject sites of the study have found that there are 35 families 69 species in urban areas and 53 families 142 species in rural areas. As the average has found that there are 18.5 families 29.3 species in 4 urban areas and 26.3 families 53.5 species in 4 rural areas, the big difference between them was analyzed. As the cause has found that there are differences in yearly plants in farming areas when compared to urban areas, creation of various basic environments including soil and water quality was suggested to make yearly plants settle down widely. Naturalized plants have found that there are no big differences between urban areas and rural areas. However, the average of the naturalized ratio in urban areas is 17.4% as the naturalized plants are about 1/4 of the appeared plants. As it was analyzed to be higher than 7.7%, the average of the naturalized ratio in farming areas as the big difference, creation of various inhabiting environments was suggested to make more yearly plants appear like the analyzed result of the life type. Consideration of placement, materials, and inhabiting environments was suggested to make creation of wetlands well appreciated to improve functions of wetlands in urban areas. It is expected that the above results of the study will be utilized in creation and improvement of the pond wetlands which can play a huge role in increase and improvement of biological diversity in urban areas.

Inactivation of Pathogenic Bacteria by Addition of Thermophilic Bacteria in the Thermophilic Aerobic Oxidation(TAO) System (고온호기산화장치의 고온미생물 첨가에 의한 병원성 미생물의 불활성화)

  • Lee W. I.;H. Tsujii;T. Maki;Lee M. G.
    • Journal of Animal Environmental Science
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    • v.10 no.2
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    • pp.111-118
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    • 2004
  • This study analyzed temperature increase, microorganism changes, and inactivation of pathogenic microorganisms in pig slurry when treated with thermophilic microorganisms in Thermophilic Aerobic Oxidation(TAO) system. An amount of $6 m^3$ of pig slurry was treated in an $18 m^3(3.0\times2.5\times2.4 m)$ reactor for 5 to 7 days in two groups: the control of pig slurry only and the treatment of pig slurry with 6 liters of thermophilic microorganism(Bacillus sp.). To study the microorganism changes in the reactor, the populations of aerobic mesophilic microorganisms, thermophilic microorganisms and general pathogens were analyzed. To study the inactivation of pathogenic microorganisms, the levels of E. coli, Salmonella sp, Crytosporidium parvum and Giardia lamblia were analyzed. The temperature inside the reactor ranged from 18 to $62^{\circ}C$ for the control while far the treatment group it ranged from 18 to $66^{\circ}C$, showing a slightly higher array. With regard to changes in microorganisms, both mesophilic and thermophilic organisms decreased from $3.1\times10^6$ to $1.2\times10^2$ CFU/ml and from $1.0\times10^4$ to $8.0\times10^1$ CFU/ml, respectively, in the control. In the treatment, on the other hand, mesophilic organisms decreased from $3.0\times10^8$ CFU/ml to $8.6\times10^5$ CFU/ml while thermophilic organisms increased sharply from $2.0\times10^6$ to $1.2\times10^8$ CFU/ml. For pathogens, Salmonella and Giardia were not detected either before or after the treatment, while E. coli and C. parvum were found to be $10^5$ CFU/ml each before treatment and negative after it. From this experiment, it was concluded that thermophilic microorganisms could effectively sanitize liquid compost by generating high temperature in the TAO system, which in turn would inhibit the growth of pathogenic organisms.

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Relationship between The Age and Chemical components of Ginseng Root's Portion(Panax ginseng C.A.Meyer) (인삼(人蔘)의 부위별(部位別) 및 연근별(年根別) 성분함량(成分含量)에 관(關)한 연구(硏究))

  • Lee, C.H.;Nam, K.Y.;Choi, K.J.
    • Korean Journal of Food Science and Technology
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    • v.10 no.2
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    • pp.263-268
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    • 1978
  • To find out the possible variation in chemical composition among ginseng products, the amount of saponin, extract and other basic components in different age and portion of ginseng roots(Panax ginseng Meyer) were investigated and compared with. (1) Great difference in the amount of ash, crude protein, fiber, fat, total sugar and reducing sugar was observed among different portion of the root comparing with those of different age of the root. That of ash, crude fiber, saponin and extract produced was higher in epidermis, fiber roots and subterranean stems, while that of crude protein, total sugar, panaxadiol/panaxatriol was higher in central portion and branch of the root. (2) The amount of extract produced was affected by the solvent used. Higher amount was obtained when water was employed. It was decreased as the increase of the concentration of alcohol solvent. Futhermore, the composition and physical properties were greatly varied by the concentration of alcohol solvent. (3) The amount of total-N, $P_2O_5,\;K_2O$, and ash was higher in two to three years old roots, while those of crude $SiO_2,\;CaO,$ crude fiber, and total sugar was higher in order roots. No difference was found in amount of MgO, Fe, Zn, and Na among age of the root.

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Estimation of Evaporation Rate of Swine Slurry Using the Natural Evaporation System(NES) in summer (여름철 자연증발시스템(NES)의 腞슬러리 증발효율 평가)

  • Kim, K.Y.;Choi, H.L.;Kim, J.G.
    • Journal of Animal Science and Technology
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    • v.44 no.4
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    • pp.459-474
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    • 2002
  • The purpose of this study was to establish the optimal operation condition of the natural evaporation system(NES) which was used for reducing swine slurry. Especially the main point of this study is to estimate the effect of climate condition(clear & rainy) and spray type(batch & flow) for the evaporation rate of swine slurry applying the NES in summer. Experiment was performed from June to August, which was generally regarded as summer in Korea, with the spray type of batch in 2000 and that of flow in 2001. As a result of experiment for batch and flow type, the averaged evaporation rate was measured into 2.71 and 3.59 l/ton . $m^2$ . day on clear days and 0.62 and 0.66 l/ton . $m^2$ . day on raint days, respectively. Based on the calculated evaporation rate by the climate condition and the spray type, it was proved that the averaged reduction rate for total input(1t/day) were 15.99% and 3.19% on clear and rainy days and the evaporation rate of the flow type was superior to that of the batch type by 5%, approximately. Therefore, it was concluded that the supplementary equipment, such as fan, should by operated in rainy days and the spray type of flow rather than that of batch should be recommended to increase the evaporation rate in the natural evaporation system(NES).

Effectiveness of Soft Stimulation Protocol, Compared with Conventional GnRH Antagonist Multiple dose Protocol in Patients Undergoing Controlled Ovarian Stimulation with Intrauterine Insemination (과배란유도하 자궁강내 인공수정시술을 받는 환자에서 연성자극요법과 성선자극호르몬 길항제 다회투여법의 효과 비교)

  • Kim, Chung-Hoon;Kang, Hyuk-Jae;Kim, So-Ra;Jeon, Gyun-Ho;Lee, Hyang-Ah;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.135-142
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    • 2010
  • Objective: To evaluate the effectiveness of soft stimulation protocol using GnRH antagonist/clomiphene citrate (CC)/recombinant FSH (rFSH) in patients undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI), compared with GnRH antagonist multiple dose protocol (MDP) using GnRH antagonist/rFSH. Methods: Eighty infertile women were randomized to soft stimulation protocol group (n=40) or GnRH antagonist MDP group (n=40). In both groups, IUI was performed 36~40 hours after hCG injection. Statistical analysis was performed using Student's t-test, $\chi^2$ test or Fisher's exact test as appropriate. Results: Total dose and days of rFSH required for COS were significantly fewer in soft stimulation protocol group (p<0.001, p<0.001). A premature LH surge did not occur in any patients of both groups. Clinical pregnancy rate per cycle was similar between the two groups. Conclusion: Soft stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP despite fewer total dose and days of rFSH, and so can become one of the patient-friendly, cost-effective alternatives for infertile patients undergoing COS with IUI.