• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.2
• /
• pp.108-113
• /
• 2016

Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

• Korean Journal of Ecology and Environment
• /
• v.42 no.3
• /
• pp.364-373
• /
• 2009

We evaluated stream health, based on integrative approaches of qualitative habitat evaluation index (QHEI), chemical water quality and the index of biological integrity (IBI) using fish assemblages in Daejeon Stream during August 2004 - October 2007. The QHEI values in this study averaged 78.2 (n=28, range: 47$\sim$124), indicating "fair" condition based on the criteria of US EPA (1993). The highest value was in the headwater site (S1) that was 112 (good), whereas the value in S3, mid and downstream was SS (fair-poor) that was the lowest owing to a disturbance on the bed and an artificial bank. Concentrations of chemical parameters such as BOD, TP and conductivity increased from the upstream to the downstream due to higher inputs of organic matters and nutrients from the urban area. Conductivity and TP showed a dilution of stream water by rainwater during summer monsoon. Analysis of fish compositions showed that total number of species was 24 and Zacco platypus was predominated (82%). The mean IBI was 17 (range: 12$\sim$30) during four years and the IBI values also decreased from S1 to S4. These results indicated that ecological health was degradated distinctly as the stream goes down through the city-center. We concluded that Daejeon Stream running through the city are influenced by chemical impact such as an influx of domestic sewage as well as the quality of habitat.

• Journal of Wetlands Research
• /
• v.16 no.4
• /
• pp.371-378
• /
• 2014

The subject of this study is the Gongchon-cheon which is one of the largest streams in Incheon and is closely related to lives of citizen. Comparative analysis is made on the changes of the environment and the ecological condition of Gongchon-cheon after the stream naturalization construction which is completed in July 2009. From the results of the survey, 32 species in 2004, 22 species in 2009 and 46 species in 2010 have been recorded. The number of the species decreased from 2004 to 2009 due to the disturbance of the river environment, and it increased in a short time from 2009 to 2010 because of the recovery of the environment. It demonstrates the stream naturalization construction providing enough environments (dikes and rapids) for the benthic macro invertebrates. The result of the present study is similar with the river's biology index, ESB index, and KSI index, and also it is similar with the pattern of the appearance, which illustrates that the species decreased during the naturalization construction, and increased after the stabilization since the finish of the naturalization construction, and it has been confirmed that the naturalization construction provides the better environment for the inhabitation of organisms.

• Journal of Oral Medicine and Pain
• /
• v.42 no.1
• /
• pp.1-7
• /
• 2017

Purpose: The aims of this study were to evaluate the clinical characteristics and polysomnographic results of patients visited the Seoul National University Dental Hospital (SNUDH) and to suggest guidelines for the management of sleep disordered-breathing patients in a dental clinic. Methods: Five hundred sixty-two patients who visited the Snoring and Sleep Apnea Clinic of SNUDH were evaluated for clinical characteristics including associated comorbidities, age, gender, body mass index (BMI), neck circumference, and daytime sleepiness and among them 217 patients were performed nocturnal polysomnography for evaluating respiratory disturbance index, apnea-hypopnea index (AHI), oxygen saturation levels, and sleep stages. The associations among clinical characteristics, sleep parameters, and positional and rapid eye movement (REM) dependencies of the patients were analyzed. Results: The most common co-morbidities of the patients were cardiovascular (30.2%), endocrine (10.8%), and respiratory diseases (7.9%). Age (${\beta}=0.394$), total AHI (${\beta}=0.223$), and lowest $O_2$ saturation levels (${\beta}=0.205$) were significantly associated with the number of co-morbidities in patients with obstructive sleep apnea (OSA). Mean $O_2$ saturation was not significantly associated with number of co-morbidities. Non-positional OSA patients had higher BMI, longer neck circumferences, more severe AHI values, and lower mean and lowest $O_2$ saturation levels compared to positional OSA patients. Not-REM-related patients were older and had more severe AHI values compared to REM-related patients. Not-REM-related patients have longer duration of stage I sleep and shorter stage II, III, and REM sleep than REM-related patients. There were no significant differences in each sleep stage between positional and non-positional patients. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA. Conclusions: Age, total AHI, and lowest $O_2$ saturation level were significantly associated with the number of co-morbidities in patients with OSA. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA.

• Journal of the Korean Society for Aeronautical & Space Sciences
• /
• v.33 no.9
• /
• pp.56-65
• /
• 2005

A dynamic analysis method that freezes a time domain by discretization and solves the spatial propagation equation has a unique feature that provides a degree of freedom on spatial domain compared with the space discretization or space-time discretization finite element method. Using this feature, the time finite element analysis can be effectively applied to optimize the spatial characteristics of distributed type actuators. In this research, the time domain finite element method was used to discretize the model. A state variable vector was used in the discretization to include arbitrary initial conditions. A performance index was proposed on spatial domain to consider both potential and vibrational energy, so that the resulting shape of the distributed actuator was optimized for dynamic control of the structure. It is assumed that the structure satisfies the final rest condition using the realizable control scheme although the initial disturbance can affect the system response. Both equations on states and costates were derived based on the selected performance index and structural model. Ricatti matrix differential equations on state and costate variables were derived by the reconfiguration of the sub-matrices and application of time/space boundary conditions, and finally optimal actuator distribution was obtained. Numerical simulation results validated the proposed actuator shape optimization scheme.

• Sleep Medicine and Psychophysiology
• /
• v.13 no.2
• /
• pp.52-58
• /
• 2006

Objectives: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. Methods: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. Results: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). Conclusions: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggest that some education and support are needed at the early stage of the CPAP treatment.

• Journal of Wetlands Research
• /
• v.25 no.4
• /
• pp.315-325
• /
• 2023

This study analyzed the disturbance process of river wetlands based on modern and contemporary maps and aerial photographs, and analyzed land cover and NDVI changes in the hydro-ecological impact zone around the Wangjin District. A stable sandbar was formed near Wangjinnaru and was naturally connected to the agricultural land within inland, but after the sandbar and river wetland were destroyed due to heavy floods, embankment construction, land readjustment, and comprehensive river management, artificial replaced wetlands and ecological parks were created, and sandbars in the form of river island were restored again. The change in land cover in the hydro-ecological impact zone showed that rice paddies and fields in agricultural areas decreased from 36.3% in 2013 to 22.9% in 2022, with the largest change in area to 814,476m². It was confirmed that the land cover was undergoing vegetation over time. Since the vegetation condition is good, a healthy food chain is formed in the waterfront ecosystem, which can be expected to be biodiversity-positive. Summarizing seasonal changes in the vegetation index, the overall change in the vegetation index was the largest in spring (March), followed by summer (June), and the change in autumn (September) was the smallest except for water. By land use, the overall vegetation index (NDVI) increased, including 39.1% improvement in alternative wetlands, 38.2% improvement in load, 44.3% improvement in ecological parks, 35.6% improvement in agricultural areas, and -8.1% decrease in water.

• Sleep Medicine and Psychophysiology
• /
• v.8 no.2
• /
• pp.113-120
• /
• 2001

Objectives: Obstructive sleep apnea syndrome is common and may produce various symptoms and serious complications. A substantial number of research articles on obstructive sleep apnea syndrome have been published in Korea. However, we found such limitations as lack of sufficient sample size and lack of polysomnography-proven cases. Therefore, we aimed at studying clinical features and sleep structure in a sufficient number of Korean patients with obstructive sleep apnea syndrome diagnostically confirmed with polysomnography. Methods: We studied 801 subjects referred to the Division of Sleep Studies, Seoul National University Hospital, who were diagnosed as having obstructive sleep apnea syndrome with polysomnography. Subjects were excluded if they had central sleep apnea syndrome, periodic limb movement disorder, narcolepsy or REM sleep behavior disorder. Foreign patients were also excluded. First of all, we studied the clinical features of the subjects. Secondly, we compared sleep-related parameters of the study subjects with those of age/sex-matched normal values. Thirdly, correlations of respiratory disturbance index (RDI) with each of the sleep-related parameters were calculated. Results: Among the 801 subjects, 668 were male subjects (83.4%) and 133 female subjects (16.4%). Their mean age was 46.6 years (${\pm}13.5$). The mean body mass index (BMI) was 25.8 (${\pm}3.8$) and subjects with BMI was over 28.0 accounted for 22.8% of the total. Fifty subjects (6.2%) were found to take benzodiazepines. Mean RDI and mean nocturnal oxygen saturation of all subjects was 31.2 (${\pm}24.4$) and 94.5% (${\pm}3.6$), respectively. In comparison with normal values, the subjects showed longer sleep latency, lower sleep efficiency, decreased total slow wave sleep % (TSWS %), and decreased total REM sleep % (TREM %)(p<0.01 in all). RDI had a negative correlation with each TSWS % and TREM % (p<0.01, p<0.01). However, RDI did not have significant correlation with either sleep latency or sleep efficiency. Conclusion: In this study, 6.2% of patients diagnosed as having obstructive sleep apnea syndrome were found to take benzodiazepines, although they are generally considered to be of litte benefit or even dangerous because of the respiratory suppressing effect. The proportion of obese subjects was only 22.8% and Korean patients with obstructive sleep apnea syndrome seem to be less obese than those described in foreign journals. This study also suggests that the severity of obstructive sleep apnea syndrome may have a more significant effect on sleep architecture defined as TSWS % and TREM % than on sleep efficiency.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.1
• /
• pp.39-44
• /
• 2005

Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.

• Korean Journal of Environment and Ecology
• /
• v.28 no.1
• /
• pp.24-32
• /
• 2014

Our study is purposed to understand effect on spatio-temporal variability of macroinvertebrate community 11 sampling times at 4 sites between two streams (Shinchon stream and Gongji stream in Chuncheun City) from May 2011 to October 2013. In this study, the possible physical factors on spatio-temporal variability of macroinvertebrate community were discussed. After stream improvement project, the effects of anthropogenic disturbance in study sites appeared as increased water temperature more than $30^{\circ}C$ and the difference of water temperature between Shinchon stream and Gongji stream was by maximum $9^{\circ}C$ on 2012. The monsoon rainfall decreased number of species, individuals and biodiversity index of macroinvertebrate community, particularly, in Shincheon stream compare to Gongji stream. Dominant species of macroinvertebrate taxa was caddisfly in Shincheon stream and Diptera in Gongji stream but on August 2013, it was dominated by Diptera, Chironomidae spp. in all study sites. The spatio-temporal variability of macroinvertebrate community in the streams may be useful as bio-indicator influencing anthropogenic factors such as soil erosion (landslide or cultivation) or monsoon rainfall.