• Title/Summary/Keyword: 중증

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Has Snoring Significance for Predicting Obstructive Sleep Apnea Severity? (코골이가 수면무호흡증의 중증도를 예측할 수 있을까?)

  • Kim, Si Eun;Park, Bong Soo;Park, Si Hyung;Shin, Kyong Jin;Ha, Sam Yeol;Park, Jin Se;Park, Kang Min
    • Annals of Clinical Neurophysiology
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    • v.17 no.2
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    • pp.61-67
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    • 2015
  • Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

A study on the realization of community care for the developmentally disabled: Focusing on Japanese community practice (발달장애인 커뮤니티 케어 실현방안 연구: 일본의 지역사회 실천을 중심으로)

  • Shin, Kyung-An;Lee, Eun-A;Kim, Do-Hoon
    • Journal of Industrial Convergence
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    • v.18 no.5
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    • pp.88-96
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    • 2020
  • The rate of admission to facilities for people with developmental disabilities in Korea is very high for other types of disabilities. Therefore, 'community care', which supports life in the community for people with developmental disabilities, is very important compared to other types of disabilities. However, in Korea, families with disabilities are the problem of care and are appealing for the burden of support. This study analyzed practical cases through welfare institutional visits and interviews on support for community independence in Japan. As a result of the study, the transition of people with developmental disabilities to communities in Japan was centered on group home. The private sector is providing support for people with severe disabilities in group home to live in communities, and Sapporo City Hall is conducting private connections to solve the problem of caring for the developmentally disabled elderly parents. Accordingly, as Korean policy recommendations, it is proposed to expand group home, switch functions of living facilities for the disabled, cope with the problem of caring for the disabled by elderly parents, and provide preventive services through surveys on the actual condition of adults living alone. As practical suggestions, it is necessary to develop and distribute educational textbooks such as pictures to improve daily life skills for self-reliance, expand sufficient manpower and facilities in vocational training for self-reliance, and operate shelters for adults with developmental disabilities and their guardians.

Sleep Paralysis in Schizophrenia and Mood Disorder (정신분열병과 기분장애에서의 수면마비)

  • Park, Jae-Hong;Yang, Chang-Kook
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.115-121
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    • 2002
  • Objectives: Although sleep paralysis (SP) has been known as one of the symptoms of narcolepsy, recently it has become recognized as occurring frequently in the general population. However, the prevalence of SP and its associated factors in patients with major psychiatric disorders remain unknown. This study investigated the prevalence of SP and a variety of associated experiences in those patients. Methods: The subjects were 160 psychiatric patients and 143 age- and sex-matched controls. The Korean version SP questionnaire as well as the Sleep-Wake Schedule, Epworth Sleepiness Scale and Insomnia Severity Index were administered to all the subjects. The patients were referred from Dong-A University Hospital and consisted of 74 diagnosed as schizophrenia (47.7%), 26 as bipolar disorder (16.8%) and 55 as major depression (35.5%). Results: Nearly 42% of the patient group and 39% of the control group had experienced at least one episode of SP in their lifetime, with no significant difference between the groups. However, the patient group had experienced SP more frequently than the control group. Among all subjects, no gender difference in SP incidence was found. The peak age of onset was in the range of 16-25 years for both groups. Over eight tenths of both groups reported hallucinations and over seven tenths of both groups experienced fear accompanying SP. Conclusion: This study shows that there is no difference in the lifetime prevalence of SP between psychiatric patients and the general population, whereas frequency of SP experience is higher in psychiatric patients. Terrifying hallucinations and fearful feelings frequently accompany SP in both groups.

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Personal Assistance Services (PAS) : Outcomes and Influential Factors (활동보조서비스 성과 및 영향요인에 관한 연구)

  • Lee, Ick-Seop;Kim, Kyung-Mee;Kim, Dong-Ki
    • Korean Journal of Social Welfare
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    • v.59 no.1
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    • pp.117-143
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    • 2007
  • The purpose of this study was to investigate the outcomes and the influential factors that predict outcomes of Personal Assistance Services (PAS). A phone survey was conducted with 201 people with severe disabilities who used PAS services through 10 Centers for Independent Living. Participants reported an increase in subjective health perceptions associated with use of PAS. Participants also reported increased psychological self-reliance as a consequence of using PAS, and high satisfaction with PAS in general. Additionally, the participants reported increased active participation in their communities, increased employment, and high self-confidence in getting or maintaining jobs as outcomes of PAS. Among influential factors predicting the outcomes of PAS, high monthly income and more mean hours of for PAS were positive predictors of psychological self-reliance. Younger age, lower income, and longer duration of service were positively associated with community participation. Longer duration of disability and service use were positive predictors of employment status. Less severe disability and high monthly income were associated with higher self-confidence related to getting or maintaining a job. The results highlight the importance of ensuring the availability of PAS to all Koreans with disabilities who are interested in these services.

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Continuous Positive Airway Pressure Therapy in a Obstructive Sleep Apnea Syndrome associated with Active Acromegaly (지속적 양압공급치료로 임상적 호전을 보인 활동성 선단거대증에 동반된 폐쇄성 수면 무호흡증후군 1예)

  • Moon, Hwa-Sik;Choi, Young-Mee;Ahn, Seog-Ju;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.610-617
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    • 1995
  • Sleep apnea occurs in approximately 50% of patients with acromegaly, and sleep apnea is associated with increased cardiovascular diseases and mortality. In view of these findings, sleep apnea may be a factor in the increased incidence of cardiovascular deaths in acromegaly patients. We experienced a case of active acromegaly patient, 54-yr-old man, associated with obstructive sleep apnea syndrome, congestive heart failure with dilated cardiomyopathy and serious cardiac arrhythmias. He was treated for obstructive sleep apnea syndrome, diagnosed by overnight polysomnography, with nasal continuous positive airway pressure(CPAP) for 4 months, which successfully controlled his loud snoring, sleep apnea, nocturnal hypoxemia and apnea-related symptoms. And also he was treated for underlying acromegaly and cardiac complications with bromocriptine and cardiogenic drugs for 4 months, but still had elevated growth hormone(GH) and insulin like growth factor-1(IGF-1) levels and serious cardiac arrhythmias. We describe our experience about the effect of CPAP treatment in an active acromegaly patient associated with obstructive sleep apnea syndrome and cardiac complications with review of literature.

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A Survey of Deaths in Hospitalized Patients for Pulmonary Tuberculosis (폐결핵으로 사망한 환자들의 치료경력)

  • Oh, Seung-Joon;Yoon, Ki-Heon;Yoo, Jee-Hong;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.694-699
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    • 1993
  • Background: After the introduction of more potent antituberculous drugs and the nation-wide tuberculosis management the prevalence rate and mortality rate of pulmonary tuberculosis has been reduced continuously. But we still experienced many patients who succumbed to this disease. So we investigated the causes of treatment failure and death of patients with pulmonary tuberculosis to delineate the problems in the management of these patients. Methods: Retrospective analysis of medical records of 55 patients who died of pulmonary tuberculosis in Kyung-Hee University Hospital during the period of Mar. 1979-Feb. 1990. Results: 1) Average duration of illness was $11.9{\pm}10.1$ years. 2) The mortality rate of in-patients with pulmonary tuberculosis was 2.09%. 3) 47.3% of patients had been treated more than twice and the sputum positive rate was 52.7%. 4) Causes of death were acute respiratory failure(56.4%), asphyxia by hemoptysis(14.6%), cor pulmonale(9.1%), tension pneumothotax(7.3%), vital organ involvement(9.1%) and coexisting diseases(3.5%). Conclusion: Many of these patients had long duration of illness, persistant sputum AFB and high incidence of acute respiratory failure as a fatal complication. It seemed that patient's neglect of their disease and inadequate treatment had caused aggravation of tuberculosis.

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Interrelationship of Matrix Metalloproteinase and $TNF-{\alpha}$ in Human Gingiva with Chronic Periodontitis associated to Type 2 Diabetes Mellitus (단순 만성 치주염 환자 및 2형 당뇨병을 가진 만성 치주염 환자의 치은조직에서 Matrix Metalloproteinase와 $TNF-{\alpha}$ 의 발현 양상 비교)

  • Kim, Doe-Heun;Park, Eei-Kyun;Shin, Hong-In;Cho, Je-Yeol;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.36 no.2
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    • pp.409-425
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    • 2006
  • 치주질환의 병원균은 세포벽의 항원에 의하여 조직내 존재하는 mononuclear phagocytes가 활성화되어 cytokine들이 생성됨 으로써 치주 결체조직의 파괴를 진행시킨다. 이런 관련된 cytokine들은 순차적으로 상주하는 치은세포 및 대식세포가 Matrix metalloproteinase 합성을 하도록 유도하여 조직파괴를 시작한다. 이들 Matrix metalloproteinase중 MMP-2, MMP-9 (Gelatinase A,B)는 type IV collagen 및 변성된 interstitial collagen을 파괴하며 치주환자의 치은 열구액, 치은조직, 타액 네에서 높게 보고 되어왔다. 당뇨병은 치주질환의 위험요소중 하나로 달뇨 환자에서는 치주질환의 유병율이 일반인에 비해 높고 치주질환의 중증도도 더 심하여 진행도 빠르다고 알려져 있다. 그 병리 기전 중 하나로는 당뇨 환자에서는 치은 열구액 내 중성구 유래의 Matrix metalloproteinase의 활성 증가 및$TNF-{\alpha}$ 의 활성 증가가 추정되고 있다. 본 실험에서는 제2형 당뇨병 환자와 비당뇨 환자들에서 만성 치주염 부위의 치은 및 건강한 치은에서 염증매개체 중 하나인 MMP-2, MMP-9 및 $TNF-{\alpha}$ 의 발현에 대해 상호 비교 분석함으로서 염증, 혈당이 미치는 영향을 밝히고 제 2형 당뇨병 환자에서 심한 치주조직 파괴의 기전을 연구하고자 하였다. 경북대학교병원 치주과 내원환자 중 제2형 당뇨병 환자와 비당뇨 환자들 및 치주질환이 없는 건강인 대조군을 대상으로 여러 가지 환자요소, 임상 치주상태를 기록하고, 전신적으로 건강한 환자의 건강한 부위(n=8,Group 1), 전신적으로 건강한 환자으 만성 치주염 부위(n=8, Group 2), 제2형 당뇨병 환자의 만성 치주염 부위 (n=8,Group 3)에서 각각 변연치은을 채득하고 액화질소에 급속 동결하였다. Western blotting을 이용하여 각 조직 내 MMP-2, MMP-9 및 $TNF-{\alpha}$ 의 발현을 관찰, densitometer를 이용하여 상대적 발현을 정량, 각 조직의${\beta}-actin$을 이용하여 표준화하여 실험군과 대조군들의 평균치를 비교하였다. 비당뇨 환자들의 만성 치주염 부위 및 제2형 당뇨병 환자의 만성 치주염 부위에서 모두 건강 대조군에 비해 MMP-2와 MMP-9 의 발현이 증가되었다. 또한 MMP-2와 MMP-9는 2형 당뇨 환자의 만성 치주염 부위가 비당뇨 환자의 만성 치주염 부위보다 증가된 발현양상을 보였으며, $TNF-{\alpha}$ 발현 비교시 각 군간 유의성 있는 변화는 없었으나 2형 당뇨환자군에서 MMP-2 및 MMP-9의 증가와 함께 다소 증가 양상을 보였다. 결론적으로 본 실험에서 MMP-2 및 MMP-9의 증가가 만성 치주염 및 2형 당뇨 환자에서의 만성치주염에서 비당뇨환자 보다 MMP-2, MMP-9의 증가양상을 보여 주었으며 $TNF-{\alpha}$ 가 2형 당뇨환자의 만성치주염 진행과정에 기여인자로써 역할을 하는 것으로 생각된다.

A study on Ability and Utilization of Smart Devices for the Disabled: Focusing on the Effect of Education for Smart Device Utilization (장애인의 스마트기기 사용능력 및 활용도에 관한 연구 - 스마트기기 활용교육의 효과를 중심으로 -)

  • Song, Jihyang;Kim, Dongwook
    • Informatization Policy
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    • v.21 no.2
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    • pp.67-88
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    • 2014
  • The research hypothesis of this paper is that education for smart device utilization has a positive effect on ability and utilization of smart devices for the disabled. The data for disabled of NIA's 2012 survey about digital divide is used, and the research method is "Heckman's 2-stage method" which considers the problem of selection bias. As a research result, this paper says that the disabled who had experience of education for smart device utilization have higher level of ability and utilization of smart devices. Also, a high level of education and family income, professional career and young generation have been very positive effect on the high level of ability and utilization of the disabled. The level of ability and utilization of the blind tend to be lower than those of the physically disabled. These results remind that the education for smart device utilization for the disabled is important and effective. And various contents and methods of education which are appropriate for the disability types should be developed.

Inhibition of Intimal Hyperplasia by Perivascular Delivery of Paclitaxel Using Poly(n-butylmethacrylate) or Poly(3-hydroxybutyrate-co-4-hydroxybutyrate) in Balloon-Injured Rat Carotid Arteries (쥐 경동맥 손상 모델에서 Poly(n-butylmethacrylate) 혹은 Poly(3-hydroxybutyrate-co-4-hydroxybutyrate)를 이용한 Paclitaxel 국소 전달 요법의 신생내막 형성 억제 효과)

  • Kwon, Jin-Sook;Lee, Ho-Yeon;Heo, Shin-Haeng;Park, Rho-Kwan;Shim, Tae-Jin;Kim, Yu-Kyug;Kim, Beom-Soo;Kim, Dong-Woon
    • Polymer(Korea)
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    • v.32 no.3
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    • pp.284-289
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    • 2008
  • Polymer is a critical component of local drug delivery to prevent restenosis. This study tested whether poly(n-butylmethacrylate)(PBMA) and poly(3-hydroxybutyrate-co-4-hydroxybutyrate)(PHA) was candidates for this purpose. In vitro release of paclitaxel from PBMA and PHA loaded with 10% paclitaxel exhibited a triphasic release profile, with a fast initial and intermediate second phase followed by a slow release phase. Perivascular delivery of paclitaxel using these films inhibited neointimal hyperplasia in balloon-injured rat carotid arteries. The paclitaxel-loaded PBMA or PHA groups showed significant neointimal formation reductions versus the control groups (PBMA vs control: $0.03{\pm}0.02$ vs $0.10{\pm}0.01\;mm^2$, p<0.05; PHA vs control: $0.04{\pm}0.03$ vs $0.09{\pm}0.01\;mm^2$, p<0.05). This study suggests that PBMA and PHA could be good candidate polymers of local drug delivery to prevent restenosis. Perivascular delivery using these films represents a possible approach for prevention of restenosis. These can be candidate polymers for drug eluting stents.

Living and Behavioral Differentials of the Elderly's Dementia in Daegu (대구시 노인들의 치매 실태 및 치매노인들의 생활 습관적 특성)

  • Kim, Han-Gon
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.165-182
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    • 2005
  • The main purposes of this study are to describe the elderly dementia, and to explore characteristics of the elderly dementia among the aged 65 and over in Daegu area. In this study, 1,120 subjects which were 0.6 percent of the population were selected and face-to-face interviews were conducted. The face-to-face interviews were conducted from July 1, 2004 to August 31, 2004. KMMSE was introduced to measure the status of the interviewees' dementia. The findings of this study are as follows: 8.9 percent of respondents turns out to be dementia patients. Among the dementia patients, 52.5 percent are mild dementia patients, 35.0 percent are mid-level symptoms and 12.5 percent are severe symptoms of dementia patients. Cross-tabulation analyses and logistic regression analysis were introduced to explore the demographic, living, and behavioral differentials of the elderly's dementia. According to the logistic regression analysis, it turns out that white educational attainment, participating in the leisure activities for both physical exercise and mental activities, having meals regularly, adequate amount of meals, and high economic status decrease the odds ratio of elder dementia among the elderly who are 65 and above in Daegu area and are statistically significant. On the other hand, age increases the odds ratio of the elder dementia of the elder among Koreans above 65 in Daegu area. Finally, policy implications and some suggestions for the improvement of the elder dementia are introduced and discussed.