• Sleep Medicine and Psychophysiology
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• v.6 no.2
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• pp.110-115
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• 1999

Objectives: To investigate the effect of mandibular repasitioning device on airway sige and airway collapsibility in patients with obstructive sleep apnea syndrome(OSAS). Methods: Cine CT with polysomnographic monitoring was performed during sleep in nine(OSAS) patients before and after manibular repositioning device(MRD) application. Axial CT images were obtained in five upper airway levels(retropalatal-high, retroalatal-low, retroglossal, epiglottis, and hypopharynx levels). In each airway level, one axial CT image was obtained during sleep apnea period and 10 serial axial CT images were scanned every 1 second during normal sleep breathing. After wearing MRD, all CT images were obtained by the same method. The cross-sectional areas of airway were measured by automatic tracing method. The changes of minimum airway size and maximum airway size after MRD were evaluated. The airway collapsibility was calculaed before and after MRD. Results: During sleep apnea, the airway of retropalatal-low level was the most frequently narrowest site. During normal sleep breahing the minimum airway size was increased significantly after MRD at retropalatal-low level(p=0.011). The mean airway collapsibility was the highest at retropalatal-low level. MRD decreased the airway collapsibility significantly at retropalatal-low level(p=0.021) and epiglottis level(p=0.038). Conclusions: The enlargement of the minimum airway size and decreased airway collapsibility may be the therapeutic mechanism of MRD in obstructive sleep apnea.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.628-635
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• 1999

Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.371-377
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• 2009

Objectives: The aim of this study was to evaluate the differences in the polysomnography data between positional and non-positional obstructive sleep apnea (OSA) patients. Methods: Forty-seven patients diagnosed with OSA were evaluated using full night polysomnography. According to the criteria of Cartwright et al., the patients were classified into two groups with 37 positional (supine apnea-hypopnea index [AHI] $\geq$ 2x's the lateral AHI) and 10 non-positional (supine AHI < 2x's the lateral AHI) OSA patients, and the differences of polysomnography data between the two groups were evaluated. Results: There were no significant differences in demographic variables (age, gender, and BMI), daytime sleepiness, overall AHI, total arousal index, and percent time of snoring between two groups. However, AHI, arousal index, and mean oxygen saturation ($SpO_2$) of the REM sleep stage were significantly more severe in the positional OSA group than the non-positional OSA group. Mean $SpO_2$ and the lowest $SpO_2$ during overall sleep stage were also significantly lower in the positional OSA group than the non-positional OSA group. Conclusions: Our results of differences in the polysomnography data of REM sleep stage suggest that non-positional OSA patients may have higher collapsibility of the oropharyngeal airway during sleep than positional OSA patients.