• Title/Summary/Keyword: Disturbance Index

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Polysomnographic Results before and after Uvulopalatopharyngoplasty

  • Kim, Cheon-Sik;Kim, Dae-Sik;Lee, Yong-Seok;Cho, Cheon-Ung;Pae, Sang-Ho;Kim, Won-Tae
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.2
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    • pp.73-76
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    • 2013
  • Uvulopalatopharyngoplasty (UPPP) is one possibility for the treatment of Obstructive Sleep Apnea (OSA). The aim of this study was study the analysis of polysomnography of pre-UPPP and post-UPPP. All patients were evaluated by means of a physical examination, the epworth sleepiness scale (ESS), the beck depression inventory (BDI) and the nocturnal polysomnography (PSG) before surgery, and 6~12 months after surgery. A total of 15 patients were investigated. All underwent UPPP. The patients were between 26 and 62 years old ($mean{\pm}SD$; $39.7{\pm}10.9$) with a lean body mass index (BMI) of $mean{\pm}SD$; $26.2{\pm}3.0kg/m^2$. The comparison of sleep questionnaires showed that after UPPP, the patients had a significantly lower BMI ($26.2{\pm}3.0kg/m^2$ vs $26.0{\pm}3.4kg/m^2$, p=0.241), ESS ($10.0{\pm}5.4$ vs $6.9{\pm}3.2$, p=0.022), BDI ($9.2{\pm}8.2$ vs $4.2{\pm}4.3$, p=0.343) and higher blood pressure ($127.5{\pm}12.1$ vs $123.7{\pm}12.0$, p=0.272) compared to before UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly lower stage N1 ($108.8{\pm}53.1$ vs $82.2{\pm}48.9$, p=0.016), lower sleep latency ($4.9{\pm}4.4$ vs $2.0{\pm}1.7$, p=0.083), a lower total arousal number ($210.6{\pm}90.3$ vs $147.1{\pm}87.3$, p=0.019), lower oxygen desaturation index (ODI) ($30.2{\pm}20.9$ vs $10.2{\pm}15.1$, p=0.006), lower apnea-hypopnea index (AHI) ($31.6{\pm}22.4$ vs $10.9{\pm}15.4$, p=0.005), and a lower respiratory disturbance index (RDI) ($37.4{\pm}21.3$ vs $18.5{\pm}16.5$, p=0.008) compared to after UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly higher stage N2 ($154.0{\pm}39.9$ vs $180.5{\pm}49.5$, p=0.017), higher REM ($58.5{\pm}29.7$ vs $72.6{\pm}34.0$, p=0.249), higher $meanSaO_2$ ($94.3{\pm}2.0$ vs $95.9{\pm}0.9$, p=0.043), and higher $meanSaO_2$ ($79.3{\pm}8.5$ vs $83.1{\pm}7.9$, p=0.116) than before UPPP. After UPPP, 6 patients were cured, 2 showed marked improvement, and 7 did not improve. After surgery, the success of the treatment was at 53%. The subjective patient satisfaction was higher than before the surgery.

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Preliminary Study of The Periodic Limb Movement Disorder Following Nasal CPAP : Is It Associated With Supine-Sleeping Position? (지속적 양압술과 수면중 주기적 사지운동 장애의 관계에 대한 예비적 연구 : 앙와위가 주기적 사지운동 장애와 관련되는가?)

  • Yang, Chang-Kook;Clerk, Alex A
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.164-171
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    • 1997
  • Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

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Characteristics of Fraxinus chiisanensis Distibution and Community Structure of Mt. Minjuji on Chungcheongbuk-do (충북 민주지산 물들메나무 분포 및 군락구조 특성)

  • Choi, Dong-Suk;An, Ji-Young;Oh, Choong-Hyeon
    • Korean Journal of Environment and Ecology
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    • v.35 no.6
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    • pp.632-643
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    • 2021
  • The objective of this study was to examine vegetation community structure and distribution of Fraxinus chiisanensis in Mt.Minjuji of Chungcheongbuk-do by setting up and surveying 8 plots (400 m2 each). Mean Importance Value (MIV) of Fraxinus chiisanensis in 8 plots was 35.19% in average (ranging from 26.07~42.74%). Since it is the dominant species in all plots, it is expected to maintain the present vegetation structure. The analysis of the DBH (diameter at breast height) showed that the diameter of Fraxinus chiisanensis in Mt.Minjuji ranges from 2 to 43cm. The majority of Fraxinus chiisanensis is expected to maintain current state unless disturbance or rapid environmental change occurs. The Species Diversity (H') was 0.8498~1.0261, Evenness (J') was 0.8160~0.9256, Dominance Index (D) was 0.0789~0.1840, Maximum Diversity (H'max) was 1.0414~1.2041. The analysis of annual ring and radial growth showed that the average age of Fraxinus chiisanensis in Mt.Minjuji was 29.1years(ranging from 22~58years). The average annual radial growth of Fraxinus chiisanensis was the highest in community G with 5.84mm and the lowest in community B with 2.80mm. The similarity index analysis revealed that the similarity index between community B and E, C and F, H was the highest with 69.0%, and the similarity index between community E and F was the lowest with 29.6%. Both the area of Fraxinus chiisanensis community of Mt.Minjuji and its population size are very small. Therefore, this area needs to be designated as Forest Genetic Resource Reserve.

Decreased Nocturnal Blood Pressure Dipping in Patients with Periodic Limb Movements in Sleep (수면중 주기성 사지 운동에서 나타나는 야간 혈압 강하의 감소)

  • Lee, Mi Hyun;Choi, Jae-Won;Oh, Seong Min;Lee, Yu Jin
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.51-57
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    • 2018
  • Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.

Health Status and Factors related to Health Behaviors of Older Adults Using a Senior Center (복지관 이용 노인의 건강상태와 건강행위 관련요인)

  • Ha, Ji-Yeon;Park, Yeon-Hwan
    • Korean Journal of Adult Nursing
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    • v.27 no.4
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    • pp.428-437
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    • 2015
  • Purpose: The aim of this study was to describe health status and to identify the factors related to health behavior in older adults in South Korea. Methods: A cross-sectional survey was conducted with a convenience sample of 186 older people (mean age =68.2yrs, 65.1% Female) registered at one senior center. Data were collected by self-report questionnaires or through face to face interview. The instruments were the Modified Health Behavior Assessment Scale, Stanford Research Instruments for Chronic Disease, Self-Efficacy, SOF Frailty Index and Quality of life questionnaire. The data were analyzed using t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Results: 58.6% older adults perceived their health status positively. Education level and economic status were significantly related to health behaviors of older adults. Self-rated health, sleep, stress, quality of life, health distress, depression, and frailty were significantly correlated with the health behaviors of older adults. Frailty, education level, and sleep disturbance were the significant factors predicting the health behaviors. Conclusion: The findings from this study suggest that nurses should take into consideration education level of older adults to promote their health behaviors and health promotion program which focuses on maintaining the quality of sleep and preventing frailty.

The Prevalence and Factors of Irritable Bowel Syndrome in University Students (일대학교 대학생의 과민성 장 증후군 유병률 및 영향요인 연구)

  • Lee, Kyung-Sook
    • Journal of Korean Biological Nursing Science
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    • v.11 no.2
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    • pp.167-175
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    • 2009
  • Purpose: The purpose of this study was to examine the prevalence and factors on Irritable Bowel Syndrome (IBS) symptoms in university students. Methods: This study was descriptive survey research. The subjects were 187 university students from one university. The exclusion criteria were 1) had GI surgery 2) had severe physiologic or psychologic problems 3) had liver, bile duct, pancreatic, and intestinal disease that required treatment. The ROME III was used to diagnose IBS. Sociodemographic characteristics, general health state by SF-36, psychological health by SCL-90-R, stress by perceived stress scale, sleep disturbance by Korean sleep scale, and diet habits were measured. Data were analyzed by using SPSS 17.0. Results: Seventeen students (9.1%) had IBS by ROME III criteria, but 46% had some GI problems at that time. Abdominal pain or discomfort continued for last six months or more in 14.3%. Fiber intake, obsessive-compulsiveness, hostility, psychoticism, global severity index, positive symptom distress, role physical, bodily pain, social functioning, and mental health were significantly different between IBS group and Non IBS group. Conclusion: Over nine percent of the students were diagnosed by Rome III criteria, and almost half of them had some GI problems. Diet, personality, general health state, and psychological health were factors of IBS.

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A Case Study of Spinal Cord Stimulation Acupuncture for Lower Limb Numbness Induced by Lumbar Herniated Intervertebral Disc (하지 비증을 주소증으로 한 요추 추간판 탈출증 환자에 대한 척수 자극 침술의 임상 증례 보고)

  • Seo, Ha-Ra;Park, Jung-Oh;Lee, Han-Gil
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.87-95
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    • 2015
  • Objectives : The purpose of this study was to evaluate the effects of spinal cord stimulation acupuncture therapy for lower limb numbness resulting from lumbar herniated intervertebral disc(HlVD). Methods : From 8th August, 2015 to 30th October, 2015, 1 male patient diagnosed as herniated intervertebral disc at L5/S1(Diffuse bulging disc with smooth ventral thecal sac indentation at L5-S1) was treated with spinal cord stimulation acupuncture and general Korean medicine therapy(acupuncture, herbal injection). Numerical Rating Scale(NRS) and Oswestry Disability Index(ODI) were recorded during the treatment. Results : 1. The patient's chief complaints were remarkably improved - Rt. lower limb numbness remained 15% compared before treatment, Rt. lower limb paresthesia and gait disturbance almost disappeared after 25 times of treatment during 3 months. 2. NRS score decreased from 7 to 3, ODI decreased from 16 to 7. Conclusions : This study demonstrates that spinal cord stimulation acupuncture therapy with Korean medicine treatment has notable effect in improving lower limb numbness induced by lumbar HlVD.

Real-time Active Vibration Control of Smart Structure Using Adaptive PPF Controller (적응형 PPF 제어기를 이용한 지능구조물의 실시간 능동진동제어)

  • Heo, Seok;Lee, Seung-Bum;Kwak, Moon-Kyu;Baek, Kwang-Hyun
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.14 no.4
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    • pp.267-275
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    • 2004
  • This research is concerned with the development of a real-time adaptive PPF controller for the active vibration suppression of smart structure. In general, the tuning of the PPF controller is carried out off-line. In this research, the real-time learning algorithm is developed to find the optimal filter frequency of the PPF controller in real time and the efficacy of the algorithm is proved by implementing it in real time. To this end, the adaptive algorithm is developed by applying the gradient descent method to the predefined performance index, which is similar to the method used popularly in the optimization and neural network controller design. The experiment was carried out to verify the validity of the adaptive PPF controller developed in this research. The experimental results showed that adaptive PPF controller is effective for active vibration control of the structure which is excited by either impact or harmonic disturbance. The filter frequency of the PPF controller is tuned in a very short period of time thus proving the efficiency of the adaptive PPF controller.

Analysis of Global Oscillation via Sync Search in Power Systems (전력계통에서 동조탐색과 광역진동해석)

  • Shim, Kwan-Shik;Nam, Hae-Kon;Kim, Yong-Gu;Moon, Young-Hoan;Kim, Sang-Tae
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.58 no.7
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    • pp.1255-1262
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    • 2009
  • The present study explained the phenomenon that low frequency oscillation is synchronized with discrete data obtained from a wide area system, and a sync search method. When a disturbance occurs in an power system, various controllers operate in order to maintain synchronization. If the system's damping is poor, low frequency oscillations continue for a long time and the oscillations are synchronized with one another at specific frequency. The present study estimated dominant modes, magnitude and phase of signals by applying parameter estimation methods to discrete signals obtained from an power system, and performed sync search among wide area signals by comparing the estimated data. Sync search was performed by selecting those with the same frequency and damping constant from dominant oscillation modes included in a large number of signals, and comparing their magnitude and phase. In addition, we defined sync indexes in order to indicate the degree of sync between areas in a wide area system. Furthermore, we proposed a wide area sync search method by normalizing mode magnitude in discrete data obtained from critical generator of the wide area. By applying the sync search method and sync indexes proposed in this study to two area systems, we demonstrated that sync scanning can be performed for discrete signals obtained from power systems.

Decoupled SVPWM for Five-Phase Permanent Magnet Machines with Trapezoidal Back-EMF

  • Lin, Zhipeng;Liu, Guohai;Zhao, Wenxiang;Chen, Qian
    • Journal of Power Electronics
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    • v.18 no.5
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    • pp.1424-1433
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    • 2018
  • This paper presents a novel space vector pulse-width modulation (SVPWM) to synthesize an arbitrary non-sinusoidal phase voltage. The key of the proposed method is that the switching vectors used to comprise the reference vectors in the ${\alpha}_1-{\beta}_1$ frame and the ${\alpha}_3-{\beta}_3$ frame are decoupled. In the ${\alpha}_1-{\beta}_1$ frame, the reference vector is comprised by near two large vectors. The corresponding vector comprised by the two vectors in the ${\alpha}_3-{\beta}_3$ frame is considered as a disturbance, which is restrained by close-loop control. In the ${\alpha}_3-{\beta}_3$ frame, there are two methods to comprise the reference vector. Method I is a near two middle vectors method. Method II uses near four vectors (two middle and two little vectors). The proposed SVPWM using decoupled switching vectors can guarantee a maximum modulation index in the ${\alpha}_1-{\beta}_1$ frame. The effectiveness of the proposed method is verified by simulated and experimental results under various operation conditions.