• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.40-44
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• 2011

Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

• Korean Journal of Food Science and Technology
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• v.30 no.5
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• pp.1229-1235
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• 1998

To see the correlation between the rate of in vitro starch hydrolysis and the glycemic index, an in vitro digestion was carried out by incubating the cereal samples for 2 hours with ${\alpha}-amylase$ in dialysis tubing. Also the levels of blood glucose were measured over 2 hours after feeding healthy volunteers with 50 g carbohydrate portions. Hydrolysis area, hydrolysis index (HI) and the dialysate content of carbohydrate throughout the digestion time for barley was significantly below those for other cereals (p<0.05), and unpolished glutinous rice was significantly above (p<0.05). The GI-glucose of barley $(57%{\pm}7)$ to glucose as standard was significantly (p<0.05) lower than those of other cereals whereas the GI-glucose of glutinous rice $(110%{\pm}8)$ was significantly higher (p<0.05) than other cereals. The GI-rice values to rice as standard were $122%{\pm}4$ for glutinous sorghum, $116%{\pm}13$ for job's tear, $115%{\pm}13$ for glutinous millet, $106%{\pm}6$ for unpolished glutinous rice, $102%{\pm}7$ for glutinous rice, $100%{\pm}0$ for rice, $90%{\pm}12$ for unpolished rice, $85%{\pm}6$ for foxtail millet, $79%{\pm}5$ for buckwheat and $63%{\pm}6$ for barley. The GI-rice was significantly correlated to hydrolysis area and HI (r=0.75, p<0.01). It suggests that the in vitro starch hydrolysis offers good potential to predict the in vivo glycemic response of starch foods.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.86-96
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• 2017

Objectives: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. Methods: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. Results: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. Conclusion: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.

• Journal of Animal Science and Technology
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• v.45 no.1
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• pp.33-40
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• 2003

The present study was undertaken to find relationships of plasma insulin-like growth factor (IGF)-I and IGF-II concentrations to litter size and lactation performance. Sixty pure-bred Landrace and Yorkshire pigs having similar farrowing weeks which had been selected from a large number of pregnant gilts and sows were divided into low- (<${\mu}$－0.5SD) and high-litter size (>${\mu}$+0.5 SD) lines under a 2 (breed)${\times}$2 (line) factorial arrange of treatments. After adjusting the litter size to nine piglets per sow at farrowing, total litter weight was measured at three weeks postpartum at weaning as an index of milk yield. Blood samples were obtained from the jugular vein at day (d)-90 pregnancy (Px) and at d-15 postpartum. The litter size or the number of piglets born during the present experiment and the average litter size during the entire parities up to the present one were greater in the high-line than in the low-line by 3.7 and 2.4 piglets, respectively (P<0.01); effect of the breed on litter size was not significant. Plasma IGF-II concentration at d-90 Px was greater in the high-line than in the low-line. Litter size and d-90 Px IGF-I concentration were negatively correlated in Landrace (r=－0.46; P<0.05) and tended to be negatively correlated in Yorkshire (r=－0.31; P=0.09), which resulted in a significant negative correlation between these two variables in total animals (r=－0.35; P<0.01). Litter weight at weaning was not different between the two breeds or lines. Relationships between the litter weight and IGF concentration were not consistent across the breed ${\times}$ physiological stage combinations. Results suggest that d-90 Px IGF concentrations may be indicative of the litter size at impending farrowing.

• Sleep Medicine and Psychophysiology
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• v.22 no.2
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• pp.64-69
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• 2015

Objectives: We investigated whether sleep behaviors, severity of insomnia and circadian typology are associated with quality of life among Gyeongsang National University (GNU) medical students. Methods: Questionnaires were distributed to 46 fourth-year students of GNU Medical School. The hospital anxiety-depression scale, insomnia severity index (ISI), morningness-eveningness questionnaire (MEQ) and WHO Quality of Life-BREF (WHOQOL-BREF) were used. Results: Quality of life in terms of physical health was associated with age, weekday total sleep time (TST), weekend TST, catch up sleep, depression, ISI score, and MEQ score. Quality of life in terms of psychological health was correlated to weekday and weekend TST, anxiety, ISI score and MEQ score. Sex, weekday TST, depression, and ISI score were revealed to influence the social aspect of quality of life, and weekday and weekend TST, and ISI score were associated with quality of life in terms of environment. Multiple regression analysis showed that better sleep quality predicted to a higher quality of life in terms of physical, psychological and environmental health, and eveningness was associated with a better quality of life in terms of physical and psychological health. Conclusion: It is concluded that physical, psychological, and environmental aspects of quality of life were associated with quality of sleep and that physical and psychological aspects of quality of life were related to eveningness in GNU medical students. Therefore, it is equally important to treat emotional problem as well as improve sleep quality.

• Sleep Medicine and Psychophysiology
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• v.14 no.2
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• pp.86-91
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• 2007

Background: Actigraphy is a reliable and valid method for assessing sleep in normal, healthy populations, but it may be less reliable and valid for detecting disturbed sleep in patients. In this study, we attempted to assess the utility of actigraphy in the estimation of sleep quality in patients with obstructive sleep apnea syndrome (OSAS), a major sleep disorder. Method: We analyzed the data of patients who underwent polysomnography (PSG) and actigraphy simultaneously for one night at the Center for Sleep and Chronobiology, Seoul National University Hospital from November 2004 to March 2006. Eighty-nine subjects with OSAS alone and 21 subjects with OSAS and periodic limb movement disorder (PLMD) were included for final data analyses between groups. Polysomnographic and actigraphic data were also compared. Results: In subjects with mild OSAS (RDI<15), modretae ($15{\leq}RDI$<30), and OSAS with PLMD, PSG and actigraphy did not show significant difference in total sleep time and sleep efficiency. However in severe ($30{\leq}RDI$) OSAS subjects, PSG and actigraphy showed significant difference in total sleep time and sleep efficiency. In all patients, no correlations were found between sleep parameters from PSG and from those using actigraphy. Conclusions: We suggest that in severe OSAS patients, PSG is the diagnostic tool. In mild and moderate cases, actigraphy might be used as a screening tool.

• Sleep Medicine and Psychophysiology
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• v.13 no.1
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• pp.27-32
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• 2006

Objectives: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. Methods: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. Results: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. Conclusions: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.766-771
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• 2009

Purpose : The objective of this study was to compare the levels of adipocytokines in obesity group with those in control group and examine their correlation with insulin resistance. Methods : We enrolled 36 obese children (male:female [M:F]=17:19; age, $9.3{\pm}1.9yrs$) with ${\geq}95^{th}$ percentile body mass indexes (BMIs) (obesity group) and 35 healthy children (M:F=16:19; age, $9.1{\pm}2.1yrs$) with $25^{th}-75^{th}$ percentile BMIs (control group). We measured the serum leptin, adiponectin, and resistin levels and insulin resistance in both the groups. Results : The weights, heights, BMIs, fasting sugar levels, insulin levels, and homeostasis model assessment for insulin resistance (HOMA-IR) values were higher in the obesity group than in the control group. As compared to the control group, the obesity group showed significantly higher leptin levels and lower adiponectin levels; no significant difference was observed in the resistin levels. The leptin/adiponectin (L/A) ratio was higher in the obesity group than in the control group. In the obesity group, HOMA-IR showed significant positive correlations with weight, height, BMI, and leptin level. However, it was not correlated with age and adiponectin and resistin levels. In the obesity group, leptin level showed significant positive correlations with age, weight, height, and BMI, while adiponectin and resistin levels showed no such correlations with the other variables. Conclusion : We suggest that adiponectin plays an important protective role against weight gain in obese children. Further, L/A ratio can be used as a parameter for predicting the prognosis of obese children.

• Exercise Science
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• v.21 no.2
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• pp.231-242
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• 2012

The purpose of this study was to develop the prediction model of VO₂max using submaximal metabolic responses from the Bruce protocol, HR responses at several stages and 1,200 m running record, and to compare and analyse the validity of these prediction models. The subjects were consisted of 255 male(133 male for 1,200 m running). They were participated maximal exercise testing with Bruce protocol, and the metabolic responses were measured in the end of the first(3 minute), second stage(6 minute), and 1,200 m running record. Measurement items were VO₂(㎖/kg/min), VCO₂(㎖/kg/min), VE(L/min), HR(bpm) of 3 and 6 minute, time to HR 150 bpm and 170 bpm, HR difference between Bruce protocol 6 and 3 minute, 1,200 m running record. Analyzing with all variables using enter method, the multiple R of total variable model was 0.642(p<.01), SEE was 4.38 ㎖/kg/min, CV was 10.8 %, but multicolinearity was appeared. The multiple R of 3 minutes model 1 and model 2 were 0.341 and 0.461, SEE was 6.05 and 5.72 ㎖/kg/min, CV was 14.9 and 14.1%, and multicolinearity did not appeared. The multiple R of 6 minutes model 1 and model 2 were 0.350 and 0.456, SEE was 6.03 and 5.74 ㎖/kg/min, CV was 14.9 and 14.2%, and multicolinearity did not appeared. The R of HR 170 and HR 170 model were 0.151 and 0.154, SEE were 6.36~6.37 ㎖/kg/min, CV were 15.7%. The R of 1,200 m running model was 0.444, SEE was 4.82 ㎖/kg/min, CV were 11.9%. In conclusion, with considering usefulness and convenience through the validity of these prediction models, the prediction model of VO₂max recommended 6 and 3 minute model, and the validity of HR model and 1,200 m running model were moderately low.