• 대한임상검사과학회지
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• 제45권2호
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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.

• 수면정신생리
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• 제4권2호
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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.

• 한국환경생태학회지
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• 제35권6호
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• pp.632-643
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• 2021

본 연구는 충청북도 민주지산의 물들메나무 분포 및 식물군락구조 특성을 밝히고자 시행되었다. 민주지산 내 8개의 조사구(단위면적 400m²)를 설치하여 물들메나무 우점군락을 조사하였다. 상대우점치는 8개 군락 모두 물들메나무 (35.19%; 26.07~42.74%)가 우점하고 있어 지속적으로 세력을 유지할 것으로 판단된다. 흉고직경급별 분석 결과 물들메나무는 2~43cm까지 비교적 다양한 직경급으로 생육하고 있으며, 개체수가 많아 교란이나 급격한 환경의 변화가 발생하지 않는다면 지속적으로 세력을 유지할 것으로 판단된다. 종다양도(H')는 0.8498~1.0261, 균재도(J')는 0.8160~0.9256, 우점도(D)는 0.0789~0.1840, 최대종다양도(H'max)는 1.0414~1.2041로 분석되었다. 물들메나무의 연륜 및 생장량 분석 결과 평균 29.1년(22~58년)의 수령을 보였으며, 연평균 생장량은 군락 G가 5.84mm로 가장 높았으며, 군락 B가 2.80mm로 가장 낮았다. 유사도 분석 결과 군락 B와 E, 군락 C와 F, H 간의 유사도지수가 69.0%로 가장 높았으며, 군락 E와 F 간의 유사도지수가 29.6%로 가장 낮았다. 연구대상인 물들메나무군락지는 분포지가 매우 협소하고, 개체군 크기가 작아 산림유전자원보호지역으로 보전하는 것이 필요하다.

• 수면정신생리
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• 제25권2호
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• pp.51-57
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• 2018

목 적 : 주기성 사지운동(periodic limb movement syndrome, PLMS)은 수면 중 팔다리를 비롯한 신체 일부가 불수의적이고 주기적으로 움직이는 현상을 말한다. 여러 연구에 의하면 PLMS는 고혈압의 위험인자로 잘 알려져 있고 각각의 PLMS 이후의 혈압이 20 mm Hg까지 증가한다는 연구도 있다. 본 연구에서는 PLMS가 수면 전후 혈압의 변화에 미치는 영향을 알아보고자 하였다. 방 법 : 야간 수면다원검사상 수면무호흡증이 없고(respiratory distress index < 5), 렘수면행동장애, 기면병 등의 수면장애가 없는 358명(남자 176명, 여자 182명)의 18세 이상 성인을 대상으로 하였다. 이들의 수면다원검사 기록과 수면다원검사 전 저녁 수축기, 이완기 혈압, 수면다원검사 후 아침 수축기, 이완기 혈압, body mass index, 음주, 흡연, 혈압강하제 복용 유무, 벡우울척도(Beck Depression Index), 엡워스졸음척도(Epworth Sleepiness Scale), 피츠버그수면질지수(Pittsburgh Sleep Quality Index)를 포함하는 임상 기록들을 수집하였다. 주기성 사지운동지수(Periodic Leg Movement Index) 15를 기준으로 15 이하인 군과 15 초과인 군으로 나누어 비교하였다. 두 군의 임상적 변수 비교는 t-test와 카이제곱 검정을 사용하였으며 repeated measure ANOVA를 사용하여 각 군에서의 검사 전후 혈압 변화 및 두 군의 혈압 변화 양상을 비교하였다. 결 과 : 대상자 전체에서 PLMS가 시간당 15초과한 군이 PLMS 15이하인 군에 비하여 수면 전후 수축기 혈압이 덜 감소하였다. 이러한 결과는 성별과 연령을 보정하였을 때에도 유의하게 나타났으나 BMI, 음주, 흡연, 혈압강하제 사용, sleep efficiency 변수들을 보정하였을 때에는 통계적으로 유의하지 않았다(0.098). 여성에서 두 군간 연령 이외의 다른 변수들은 유의한 차이를 보이지 않았다($49.0{\pm}14.6$세, $57.1{\pm}14.8$세, p = 0.001). 여성의 경우, 두 군 모두 검사 전, 후 수축기 혈압은 유의한 감소를 보였다(p < 0.001). PLMI 15 이하군의 수축기 혈압이 9.7 mm Hg 감소한 것에 비해 PLMI 15 초과군의 수축기 혈압은 2.9 mm Hg 정도만이 감소하여 수면 전, 후 수축기 혈압 변화 양상이 유의하게 차이가 났다($135.2{\pm}20.3mm\;Hg{\rightarrow}125.5{\pm}18.3mm\;Hg$, $133.5{\pm}17.9mm\;Hg{\rightarrow}130.6{\pm}14.8mm\;Hg$, p = 0.010) 이러한 결과는 연령, BMI, 음주, 흡연, 혈압강하제 복용 유무, sleep efficiency 변수를 보정하여도 유의하게 나타났다(p = 0.024). 남성의 경우 두 군 모두에서 수축기 혈압이 수면 전, 후 유의하게 감소하였지만 PLMS에 의한 교호작용(interaction effect)은 나타나지 않았다. 결 론 : PLMS는 수면 중의 정상 혈압 강하 패턴의 감소와 유의한 연관성이 있었으며 혈압과 관련된 임상 변수를 보정하였을 때에는 여성에서만 유의한 연관성을 보였다. 여성에서 PLMS와 관련하여 발생할 수 있는 고혈압 및 심혈관 질환의 임상적 의미를 확인할 수 있었다.

• 성인간호학회지
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• 제27권4호
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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.

• Journal of Korean Biological Nursing Science
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• 제11권2호
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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.

• 척추신경추나의학회지
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• 제10권2호
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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.

• 한국소음진동공학회논문집
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• 제14권4호
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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.

• 전기학회논문지
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• 제58권7호
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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.

• Journal of Power Electronics
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• 제18권5호
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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.