Obstructive sleep apnea (OSA) syndrome disrupts normal sleep. However, there were few studies to evaluate the asymmetric distribution, the one of the important factors of normal sleep in OSA subjects. We hypothesized that asymmetry would be broken in OSA patients. 49 male subjects with the complaint of heavy snoring were studied with polysomnography. We divided them into two groups based on the apnea-hypopnea index (AHI) fifteen: 13 simple snoring group (SSN, average AHI $5.9{\pm}4.4$) and 32 OSA group (average AHI $47.3{\pm}23.9$). We compared split sleep variables between the first half and the second half of sleep within each group with paired t-test for the evaluation of asymmetry. Changes of sleep architecture of OSA were higher stage 1 sleep% (S1), total arousal index (TAI), AHI, and mean heart rate (HR) and lower stage 2 sleep% (S2), REM sleep%, and mean arterial O2 saturation (SaO2) than SSN subjects. SWS and wake time after sleep onset (WASO) were not different between two groups. In split-night analysis, OSA subjects showed higher S2, slow wave sleep% (SWS), spontaneous arousal index (SAI), and mean HR in the first half, and higher REM sleep% and mean SaO2 in the second half. Those were same pattern as in SSN subjects. Mean apnea duration and longest apnea duration were higher in the second half only in the OSA. No differences of AHI, ODI, WASO, and S1 were found between the first and the second half of sleep in both groups. TAI was higher in the first half only in the SSN. SWS and WASO seemed to be influenced sensitively by simple snoring as well as OSA. Unlike our hypothesis, asymmetric distributions of major sleep architecture variables were preserved in OSA group. Losing asymmetry of TAI might be related to pathophysiology of OSA. We need more studies that include large number of subjects in the future.
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.
Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.
Lee, Su Yeon;Ryu, Soo Hyeong;Kim, Hong Guk;Ryoo, Dek Woo;Kim, Sung Jin;Jeong, Seong Mok;Goo, Bon Hyuk;Kim, Min Jeong;Park, Yeon Cheol;Baek, Yong Hyeon;Nam, Sang Soo;Seo, Byung Kwan
Journal of Acupuncture Research
/
v.33
no.3
/
pp.197-205
/
2016
Objectives : To report the clinical application and safety of Traditional Korean Medical treatment for patients with low back pain during pregnancy. Methods : Three patients who suffered from low back pain during pregnancy were treated with acupuncture, pharmacopuncture, moxibustion, and herbal medicine for 12 to 21 days. Numeric rating scale (NRS) of low back pain and Oswestry Disability Index (ODI) were checked to measure the outcome. A liver function and renal function test was carried out to identify any drug-induced liver or renal injury, and any adverse events were monitored thoroughly until delivery. Results : Low back pain reduced on NRS in all cases, and no serious adverse effects were found in the patients or infants. Conclusion : This study suggests that Traditional Korean Medical treatment is a candidate therapy for relieving low back pain during pregnancy, and also is safe for both patients and infants.
Ahn, Ji Hoon;Kim, Hyun Ho;Youn, Woo Suck;Lee, Sun Ho;Shin, You Bin;Kim, Sang Min;Park, Young Jae;Park, Young Bae
Journal of Acupuncture Research
/
v.31
no.1
/
pp.61-73
/
2014
Objectives : The purpose of this study is to estimate the test-retest reliability and the intratest repeatability in measuring the lumbar range of motion of healthy volunteers with wireless microelectromechanical system inertial measurement unit(MEMS-IMU) system and to discuss the feasibility of this system in the clinical setting to evaluate the lumbar spine movement. Methods : 19 healthy male volunteers were participated, who got under 21 points at oswestry disability index(ODI) were adopted. Their lumbar motion were measured with IMU twice in consecutive an hour for the test-retest reliability study. Intratest repeatability was calculated in the two tests separately. The calculated intraclass correlation coefficients(ICC) were discussed and compared with the those of the previous studies. Results : Lumbar range of motion of flexion $41.45^{\circ}$, extension $16.34^{\circ}$, right lateral bending $16.41^{\circ}$ left lateral bending $13.63^{\circ}$ right rotation $-2.47^{\circ}$, left rotation $-0.61^{\circ}$. ICCs were 0.96~1.00(intratest repeatability) and 0.61~0.92(test-retest reliability). Conclusion : This study shows that MEMS-IMU system demonstrates a high test-retest reliability and intratest repeatability by calculated intraclass correlation coefficients. The results of this study represents that wireless inertial sensor measurement system has portable and economical efficiency. By MEMS-IMU system, we can measures lumbar range of motion and analyze lumbar motion effectively.
Kim, Ae Ra;Seo, Bo Byoung;Kim, Jin Mo;Bae, Jung In;Jang, Young Ho;Lee, Yong Cheol;Kang, Chul Hyung;Jung, Sung Won;Hong, Ji Hee
The Korean Journal of Pain
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v.20
no.2
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pp.138-142
/
2007
Background: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. Methods: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N ($BDI{\leq}14$, n = 43) and group 0 (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55,7% had a high BDI score. Results: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores ($9.4{\pm}2.5$, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. Conclusions: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.5
no.2
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pp.103-111
/
2010
Objectives : This study was performed to report the effect of oriental medical treatment in the lower back pain(LBP) with amyotrophic lateral sclerosis(ALS). Methods : A 32-years-old man who diagnosed as ALS was admitted with LBP. We treated him by burning acupuncture, herbal medicine, acupuncture, electroacupuncture, moxibustion, cupping therapy and physical therapy from 11th May 2010 to 10th June 2010. Results : After treatment, there was improvement in LBP. Pain Intensity estimated by visual analog scale(VAS) as percentile Pain Intensity Difference(PID), Korean Owestry Disbility Index(KODI) was also improved. Korean version of Amyotrophic lateral sclerosis Functional rating scale-revised(K-ALSFRS-R) shows that the patient's physical ability has been improved. Conclusions : Our study suggests that oriental medical treatment are significantly effective in the LBP due to ALS. And further studies will be aid to identify underlying mechanism of treatment.
Hwang, Sung Hwan;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon;Choi, Yunhee;Yoon, Joonho
Journal of Korean Neurosurgical Society
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v.65
no.5
/
pp.719-729
/
2022
Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.
This study was investigated to evaluate the morphologic characteristics of openbite and deep bite in Class I malocclusion patients and to find skeletodental factors which contributed to vertical discrepancy in Class I malocclusion. The subjects were consisted of 40 control subjects (male 20, female 20) and 40 Class I openbite patients and 40 Class I deep bite patients. Lateral cephalograms in centric occlusion were taken, traced and digitized lot each subjects. The computerized statistical analysis were carried out with SPSS program. The results were as follows. 1. The pattern of vortical discrepancy in Class I malocclusion is mainly influenced by the skeletodental factors under palatal plane. 2. In openbite group, vortical discrepancy is prominent on anterior lower face and is closely related with skeletal factors such as mandibular form and inclination. 3. In deep bite group, dental factors such as ewe of Spee, vertical height of maxillary molar and skeletal factor such as articular angle were contributed to the vertical discrepancy. 4. The multiple regression analysis showed that overbite in Class I molar relationship was determined mainly by dental factors such as lower incisor to occlusal plane angle, curve of Spee, interincisal angle, and ODI.
Sella turcica contains pituitary gland that has influence on craniofacial growth. So, if the volume of sella turcica correlate to the function of Pituitary gland, we can assume that the volume of sella turcica in skeletal Class III patients has some difference to that of normal occlusion group. The purpose of this study was to evaluate the difference of shape and volume of sella turcica between normal occlusion group and Class III patients. The shape of sella turcica was Classified by Inaba method and the volume of sella turcica was measured in lateral and P-A cephalograms by Di Chiro method. To find out the possibility of the volume of sella turcica as diagnostic aid to predict Class III growth pattern, the correlation coefficients between the volume of sella and cephalometric variables were calculated. The results were as follows. 1. The volume of sella turcica in Class III patients is larger than that of normal occlusion groups 2. The volume of sella turcica in female was larger than that of male in Class III patients 3. The volume of sella turcica has close correlation with APDI, ANB, SNA, SNB, ODI, gonial angle, post. cranial base length 4. Sella Index (volume of sella / ant. cranial base length) can be a more accurate indicator that represent Class III growth pattern than volume of sella itself. 5. The morphologic pattern of sella turcica had no significant difference between two groups.
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