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The Mechanism of Interferon-$\gamma$ Induced Cytotoxicity on the Lung Cancer Cell Line, A549 (인터페론감마에 의한 A549 폐암세포주 세포독성의 기전)

  • Oh, Yeon-Mok;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.63-68
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    • 1996
  • Background: Interferon-$\gamma$ has various biologic effects, including antiviral effect, antitumor proliferative effect, activation of macrophage and B lymphocyte, and increased expression of major histocompatibility complex. Especially, antitumor proliferative effect of interferon-$\gamma$ has already been proved to be important in vivo as well as in vitro. And, clinical studies of interferon-$\gamma$ have been tried in lung cancer patients. However, the mechanism of antitumor effect of interferon-$\gamma$ has not yet been established despite of many hypotheses. "Necrosis" is a type of cell death which is well known to occur in the circumstances of severe stresses. In contrast, "apoptosis" is another type of cell death which occurs in such biological circumstances as embryonic development, regression of organs, and self-tolerance of lymphocytes. And, apoptosis is an active process of cell death in which cells are dying with fragmentations of their cytoplasms and nuclei. And, in the process of apoptosis the DNAs of cells are cleaved between nucleosomes by unidentified endonuclease and therefore DNAs of apoptotic cells result in a typical electrophoresis pattern known as DNA ladder pattern. Recently it has been suggested that cytotoxic effect of interferon-$\gamma$ occurs via apoptosis. To elucidate the mechanism of antitumor cytotoxic effect of interferon-$\gamma$, we microscopically observed a lung cancer cell line, A549 which was treated with interferon-$\gamma$. We observed A545 treated with interferon-$\gamma$ was dying fragmented. And so, we performed this study to find out that the mechanism of antitumor cytotoxic effect of interferon-$\gamma$ be apoptosis. Method: We treated A549, human lung cancer cell line with various concentration of interferon-$\gamma$ and quantified its cytotoxic effect of various periods, 24 hours, 72 hours and, 120 hours by MTT(dimethylthiazolyl diphenyltetrazolium bromide) bioassay. Also, after we treated A549 with 100 units/mi of interferon-$\gamma$ for 120 hours, we observed the pattern of cell death with inverted microscope and we extracted DNAs from the dead A549 cells and observed the pattern of 1.5% agarose gel electrophoresis with ethidium bromide staining. Result: 1) Cytotoxic effect of interferon-$\gamma$ on A549: For the first 24 hours, threre was little cytotoxic effect and for between 24 hours and 72 hours, there was the beginning of cytotoxic effect and for 120 hours there was increased cytotoxic effect. 2) Pattern of A549 cell death by interferon-$\gamma$: We observed with inverted microscope that A549 cells were dying fragmented. 3) DNA ladder pattern of gel electrophoresis: We observed DNA ladder pattern of gel electrophoresis of extracted DNAs from dead A549 cells. Conclusion: We concluded that the mechanism of interferon-$\gamma$induced cytotoxicity on lung cancer cell line, A549 be via apoptosis.

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Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

Relationships between Eating Behavior, Dietary Self-Efficacy, and Nutrition Knowledge of Elementary School Students by Food Service Type in Gangwon Province (강원지역 초등학생들의 급식유형(도시형, 농어촌형 및 도서벽지형) 별식행동과 식이자기효능감 및 영양지식과의 관계)

  • Won, Hyang-Rye;Shin, Gi-Beum
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.5
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    • pp.638-646
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    • 2012
  • The purpose of this study was to find a relationship between eating behavior, dietary self-efficacy and nutrition knowledge by comparing these items in elementary school students according to food service type. The survey was made through a questionnaire from 759 students in the 6th grade of elementary school in 39 Gangwon Province. The average score of eating behaviors according to food service type was highest for urban type, followed by agri-fishery type, and finally remote island and country type, for the questions asking about the application of nutrition knowledge and the frequency of eating out. The average score of nutrition knowledge according to food service type showed significant differences for the questions about eating snacks before going to sleep and weight increase as well as calorie comparisons between foods. For the correlation of eating behavior, dietary self-efficacy and nutrition knowledge, the agri-fishery type showed positive in all of the three items with significant differences. In the remote island and country type, there was a positive relationship between nutrition knowledge and dietary self-efficacy, and between eating behavior and dietary self-efficacy. However, there was no significant difference of correlation between nutrition knowledge and eating behavior. In order to confirm the predictable variables for eating behavior, a regression analysis was made by injecting variables in every stage with independent variables of dietary self-efficacy and nutrition knowledge, which showed a significant relationship with eating behavior. The results showed that, in the urban type, dietary self-efficacy and nutrition knowledge affected the eating behavior and, in the agriculture type and the remote island and country type, only dietary self-efficacy affected the eating behavior.

INDIVIDUALIZED RECONSTRUCTION OF THE LOWER OCCLUSAL PLANE ACCORDING TO SKELETAL PATTERN (안면 골격 형태에 따른 하악 교합평면의 재구성)

  • Hyun, Seong-Wook
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.465-485
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    • 1995
  • The purpose of this study is to locate the proper position of the lower occlusal plane according to individual skeletal pattern. Cephalometric films of 234 subjects of the control group, 358 of the pretreatment group and 358 of the treated group were analyzed to study proper relationships between vertical dimension ratio(VDR) and lower occlusomandibular plane angle(LOM). The control group was divided into two subgroups by the age. The first subgroup consisted of 113 subjects of the age 14 years and under and with the mean age of 10.82 years. The other subgroup consisted of 113 subjects of the age 18 years and above with the mean age of 23.76 years. The pretreatment group was divided into three subgroups by the age. The first subgroup consisted of 274 subjects of the age 14 years and under with the mean age of 11.36 years. The second subgroup consisted of 54 subjects of the age 14 through 18 years with the mean age of 15.4 years. The last subgroup consisted of 30 subjects of the age 18 years and above with the mean age of 21.35 years. The treated group was also divided into three subgroups by the age. The first subgroup consisted of 145 subjects of the age 14 years and under with the mean age of 12.91 years. The second subgroup consisted of 166 subjects of the age 14 through 18 years with the mean age of 15.64 years. The last subgroup consisted of 47 subjects of the age 18 years and above with the mean age of 21.61 years. Cephalometric films of the sample were traced. Measurements were made to a hundredth using a program specifically prepared for this study, and the results were entered into a 486DX PC. Means and Standard deviations of all the veriables were calculated for each group. Correlation coefficients between pertinent variables were calculated. Significance tests on those coefficients, one-way ANOVA and t-tests between variables or groups were performed. On the basis of the results studied above, certain subjects were selected from the control and the treated groups to locate the proper position of the occlusal plane, and designated as the optimal occluaion group. The subjects of this optimal occlusion group had 1-3 mm overbite, 1-3 mm of overjet and less than 1.75 mm of curve of Spee. A total subjects of 187 in this group consisted 104 treated subjects and 83 control group. Regression analysis was carried out between VDR and LOM, and regression equations were tabulated for this optimal occlusion group. The results were as follows : 1. Highly significant correlations were observed between various variables useful for identifying vertical component of skeletal frame, but any one particular variable did not accurately indicate the magnitude of anterior vertical overbite. 2. Of the variables useful identifying vertical component of skeletal frame, The VDR showed the highest correlation to the LOM. 3. Of the total sample, 80 percent had overbite within the normal range, irrespective of VDR. 4. The optimal occlusion group was divided into 9 subgroups by the age and the anteroposterior skeletal pattern, and correlation coefficient and determination coefficient between VDR and LOM of each group were calculated. Correlation coefficients and determination coefficients were found to be significantly high in all groups. 5. Regression equation was induced for each of the optimal occlusion group to find proper LOM according to the VDR. 6. It was found that the mean value of the cant of occlusal plane itself is not enough for a diagnosis and a treatment plan. Rather, It is very important to locate the proper occlusal plane for an Individual skeletal pattern.

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Development and application of prediction model of hyperlipidemia using SVM and meta-learning algorithm (SVM과 meta-learning algorithm을 이용한 고지혈증 유병 예측모형 개발과 활용)

  • Lee, Seulki;Shin, Taeksoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.111-124
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    • 2018
  • This study aims to develop a classification model for predicting the occurrence of hyperlipidemia, one of the chronic diseases. Prior studies applying data mining techniques for predicting disease can be classified into a model design study for predicting cardiovascular disease and a study comparing disease prediction research results. In the case of foreign literatures, studies predicting cardiovascular disease were predominant in predicting disease using data mining techniques. Although domestic studies were not much different from those of foreign countries, studies focusing on hypertension and diabetes were mainly conducted. Since hypertension and diabetes as well as chronic diseases, hyperlipidemia, are also of high importance, this study selected hyperlipidemia as the disease to be analyzed. We also developed a model for predicting hyperlipidemia using SVM and meta learning algorithms, which are already known to have excellent predictive power. In order to achieve the purpose of this study, we used data set from Korea Health Panel 2012. The Korean Health Panel produces basic data on the level of health expenditure, health level and health behavior, and has conducted an annual survey since 2008. In this study, 1,088 patients with hyperlipidemia were randomly selected from the hospitalized, outpatient, emergency, and chronic disease data of the Korean Health Panel in 2012, and 1,088 nonpatients were also randomly extracted. A total of 2,176 people were selected for the study. Three methods were used to select input variables for predicting hyperlipidemia. First, stepwise method was performed using logistic regression. Among the 17 variables, the categorical variables(except for length of smoking) are expressed as dummy variables, which are assumed to be separate variables on the basis of the reference group, and these variables were analyzed. Six variables (age, BMI, education level, marital status, smoking status, gender) excluding income level and smoking period were selected based on significance level 0.1. Second, C4.5 as a decision tree algorithm is used. The significant input variables were age, smoking status, and education level. Finally, C4.5 as a decision tree algorithm is used. In SVM, the input variables selected by genetic algorithms consisted of 6 variables such as age, marital status, education level, economic activity, smoking period, and physical activity status, and the input variables selected by genetic algorithms in artificial neural network consist of 3 variables such as age, marital status, and education level. Based on the selected parameters, we compared SVM, meta learning algorithm and other prediction models for hyperlipidemia patients, and compared the classification performances using TP rate and precision. The main results of the analysis are as follows. First, the accuracy of the SVM was 88.4% and the accuracy of the artificial neural network was 86.7%. Second, the accuracy of classification models using the selected input variables through stepwise method was slightly higher than that of classification models using the whole variables. Third, the precision of artificial neural network was higher than that of SVM when only three variables as input variables were selected by decision trees. As a result of classification models based on the input variables selected through the genetic algorithm, classification accuracy of SVM was 88.5% and that of artificial neural network was 87.9%. Finally, this study indicated that stacking as the meta learning algorithm proposed in this study, has the best performance when it uses the predicted outputs of SVM and MLP as input variables of SVM, which is a meta classifier. The purpose of this study was to predict hyperlipidemia, one of the representative chronic diseases. To do this, we used SVM and meta-learning algorithms, which is known to have high accuracy. As a result, the accuracy of classification of hyperlipidemia in the stacking as a meta learner was higher than other meta-learning algorithms. However, the predictive performance of the meta-learning algorithm proposed in this study is the same as that of SVM with the best performance (88.6%) among the single models. The limitations of this study are as follows. First, various variable selection methods were tried, but most variables used in the study were categorical dummy variables. In the case with a large number of categorical variables, the results may be different if continuous variables are used because the model can be better suited to categorical variables such as decision trees than general models such as neural networks. Despite these limitations, this study has significance in predicting hyperlipidemia with hybrid models such as met learning algorithms which have not been studied previously. It can be said that the result of improving the model accuracy by applying various variable selection techniques is meaningful. In addition, it is expected that our proposed model will be effective for the prevention and management of hyperlipidemia.

Automatic Quality Evaluation with Completeness and Succinctness for Text Summarization (완전성과 간결성을 고려한 텍스트 요약 품질의 자동 평가 기법)

  • Ko, Eunjung;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.125-148
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    • 2018
  • Recently, as the demand for big data analysis increases, cases of analyzing unstructured data and using the results are also increasing. Among the various types of unstructured data, text is used as a means of communicating information in almost all fields. In addition, many analysts are interested in the amount of data is very large and relatively easy to collect compared to other unstructured and structured data. Among the various text analysis applications, document classification which classifies documents into predetermined categories, topic modeling which extracts major topics from a large number of documents, sentimental analysis or opinion mining that identifies emotions or opinions contained in texts, and Text Summarization which summarize the main contents from one document or several documents have been actively studied. Especially, the text summarization technique is actively applied in the business through the news summary service, the privacy policy summary service, ect. In addition, much research has been done in academia in accordance with the extraction approach which provides the main elements of the document selectively and the abstraction approach which extracts the elements of the document and composes new sentences by combining them. However, the technique of evaluating the quality of automatically summarized documents has not made much progress compared to the technique of automatic text summarization. Most of existing studies dealing with the quality evaluation of summarization were carried out manual summarization of document, using them as reference documents, and measuring the similarity between the automatic summary and reference document. Specifically, automatic summarization is performed through various techniques from full text, and comparison with reference document, which is an ideal summary document, is performed for measuring the quality of automatic summarization. Reference documents are provided in two major ways, the most common way is manual summarization, in which a person creates an ideal summary by hand. Since this method requires human intervention in the process of preparing the summary, it takes a lot of time and cost to write the summary, and there is a limitation that the evaluation result may be different depending on the subject of the summarizer. Therefore, in order to overcome these limitations, attempts have been made to measure the quality of summary documents without human intervention. On the other hand, as a representative attempt to overcome these limitations, a method has been recently devised to reduce the size of the full text and to measure the similarity of the reduced full text and the automatic summary. In this method, the more frequent term in the full text appears in the summary, the better the quality of the summary. However, since summarization essentially means minimizing a lot of content while minimizing content omissions, it is unreasonable to say that a "good summary" based on only frequency always means a "good summary" in its essential meaning. In order to overcome the limitations of this previous study of summarization evaluation, this study proposes an automatic quality evaluation for text summarization method based on the essential meaning of summarization. Specifically, the concept of succinctness is defined as an element indicating how few duplicated contents among the sentences of the summary, and completeness is defined as an element that indicating how few of the contents are not included in the summary. In this paper, we propose a method for automatic quality evaluation of text summarization based on the concepts of succinctness and completeness. In order to evaluate the practical applicability of the proposed methodology, 29,671 sentences were extracted from TripAdvisor 's hotel reviews, summarized the reviews by each hotel and presented the results of the experiments conducted on evaluation of the quality of summaries in accordance to the proposed methodology. It also provides a way to integrate the completeness and succinctness in the trade-off relationship into the F-Score, and propose a method to perform the optimal summarization by changing the threshold of the sentence similarity.

A Study on the Meaning of Plant Material in the 2016 Korea Garden Show Designer's Garden (2016년 코리아가든쇼 작가정원의 식물 의미에 관한 연구)

  • Lee, Chung-Hee;Jin, Hye-Young;Lee, You-Mi;Song, Yu-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.3
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    • pp.41-53
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    • 2017
  • This study was performed to determine what the plant material were selected to reflect in the 2016 Korea Garden Show designer's garden. It was analyzed that plant material was used to display the theme of the garden and to create a specific space. Under the given theme of 'K-Garden, Shinhallyu Garden(new style garden culture) with the most Korean taste', the plants were used to highlight the theme in two types: 'representation' and 'expression'. There were two 'representation' gardens that imitate a particular space of Korean taste and four 'expression' gardens that showcase the designer's thoughts with abstract concepts and concrete objects. Three gardens included both types of garden. The way of revealing the subject with plants was used more for 'expression' than for 'representation'. There were eleven spaces for 'representation' of the Korean taste, a vegetable garden, faucet, pond, field, nature, a Hanok court garden, groves of bamboo, tile roof, stone wall, rock and backyard of a Hanok connected to the mountain. The planting material was used in two ways: reflecting only the ecological characteristics of the plant, and considering the ecological and visual characteristics together. Vegetation plantings reflecting the ecological characteristics were observed in all eleven spaces. Nine of the spaces reflected the growth environment of the plants, but the other two did not reflect the ecological characteristics of the plants, unlike the designer's intention. In the case of the four spaces that considered the ecological and visual characteristics together, color and size were considered visual characteristics. The plants in the seven spaces that included 'expression' as the theme were selected to reflect the visual characteristics in the order of color, shape, texture, and size, rather than reflecting ecological characteristics. A group planting method was applied. When the plants were used as materials for creating space, Norman(1989) analyzed three enclosure factors(overhead, vertical, ground plane). Only two deciduous trees were used in the overhead plane while five species of evergreen shrubs and thirty species of various deciduous plants were used in the vertical plane. There were forty-five species (nine trees and thirty-six herbaceous plants) forming the ground plane, and various herbaceous plants were utilized without duplication in each garden. The designer's garden of the Garden Show played a role in introducing new groundcover plants to the public. Three of the nine gardens did not include ornamental plants, and the use of decorative plants in other gardens was few compared to the number of plantings. In the Korea Garden Show designer's garden, most of the plants were being used with the intention of exposing the theme or architectural uses. In the 2016 Korea Garden Show designer's garden, many species of plants were used as materials for showcasing themes rather than for creating spaces. Also, the method of 'expression' was used more than the method of 'representation' in order to highlight the theme. This indicates that the planting materials reflect visual characteristics such as color, shape, texture, size rather than ecological characteristics.

Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix (다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究))

  • Kim, Ho-Kyoung;Ma, Jin-Yeul;Cheon, Won-Kyung;Yun, Su-Young;Kang, Eun-Jung;Joo, Hye-Jeong;Ko, Byoung-Seob
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.183-197
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    • 1997
  • In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri (足三里) of rat, repeatedly. We compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days(p<0.05) and after 7 days(p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight : In Palkang aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of Hwanggum aqua-aqupuncture$({\times}10\;group)$ was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture$({\times}100\;group)$, D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound(CPA group) and HG, there were significant value iii statistically. The diluted solution was more significant decrease than Hwanggum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupunture tended to decrease level of TG, regardless of its concentration. In acupunture guoup, we gained some interesting result In meaningful decrease in 7G. 5. Haematological examination showed significant increment of granulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

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A Development of Cholesterol Removed Cheese (콜레스테롤을 제거한 치즈의 개발에 관한 연구)

  • 정청송
    • Proceedings of the Korea Hospitality Industry Research Society Conference
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    • 2002.11a
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    • pp.83-98
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    • 2002
  • The old testament of the Bible has written the milk and curd. God said, I will ive you to how the milk and honey. The present study was designed to examine the effects of different homogenization pressure, homogenization temperature and $\beta$-cyclodextrin concentration on cholesterol removal rate of cheese, and to optimize the factors of cheese manufacture Process. In addition, the characteristics from cholesterol removed cheese and control are compared in the rheological and ensory analysis. The optimized process condition for cholesterol removal was for homogenization pressure, 74$^{\circ}C$ for homogenization temperature and 2% for $\beta$-cyclodextrin concentration, it showed 875% of the highest cholesterol removal rate in milk. Therefore, manufacture conditions of cholesterol removed cheese were chosen 74$^{\circ}C$ for homogenization temperature, for homogenization pressure, and I or 2% for $\beta$-cyclodextrin concentration. Cholesterol removed cheese and control were compared with yield, cholesterol removal, meltability, stretchability, textural properties and sensory analysis. Cholesterol content of control cheese containing 23.8% milk fat was cheese made from milk treated with 2% $\beta$-cyclodextrin and homogenization pressure was cholesterol removal. Yield of cholesterol removed cheese. As the homogenization pressure increased, oiling off reduced with showed better surface appearance. Stretchability of cholesterol removed cheese was lower 5~10cm than over 30cm of control. Meltability of cholesterol removed cheese also was lower than control. The hardness, gumminess, chewiness reduced to respectively. In the result of sensory analysis, treatment of homogenization for cholesterol removed cheese improved appearance and flavor, however texture fell. In addition, the resent result of the study indicated that about 75% of cholesterol in cheese could be removed, and the possibility of development of cholesterol removed cheese was observed. We have hope to research manufacture cheese global wide.

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Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.24-33
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    • 2002
  • Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

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