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The Effect of Nasal CPAP in Obstructive Sleep Apnea Syndrome (폐쇄형 수면무호흡증후군 환자에서 Nasal CPAP의 치료 효과)

  • Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.501-508
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    • 1993
  • Background: Sleep apnea syndrome is a common disorder which is estimated to affect about 1~4% of adult male population. And if untreated, sleep apnea can cause significant sequelae, such as hypertension, nocturnal cardiac arrhythmia, daytime hypersomnolence, and cognitive impairment. Various kinds of treatment for obstructive sleep apnea (OSA) have been developed. Among them nasal CPAP, first introduced by Sullivan et al in 1981, has received widespread interest and acclaim as a treatment of OSA, and is currently recommended as first-line treatment for OSA. We evaluated the effect of nasal CPAP in OSA and the side effects of nasal CPAP hindering patients from using nasal CPAP. Methods: We performed sleep studies in 20 OSA patients at 2 consecutive nights; baseline night at first day and CPAP night at second day. We compared apnea index, lowest oxygen concentration during apnea, maximal apnea time, and total apnea duration per total sleep time before and after CPAP. We also evaluated the side effects of CPAP with inquiry to the patients. Results: 1) Apnea index was significantly decreased after CPAP in 17 out of 20 OSA patients (85%) and increased in 3 patients (15%). 2) Average apnea index was significantly decreased after CPAP ($34.1{\pm}18.9/h{\rightarrow}15.4{\pm}10.3/h$, p<0.01). 3) Total apnea duration per total sleep time was also significantly decreased after CPAP ($28.5{\pm}16.0%{\rightarrow}11.9{\pm}9.3%$, p<0.05). 4) The lowest oxygen satuation and maximal apnea time were not significantly changed after CPAP. 5) The most frequent side effect of nasal CPAP was mask discomfort (80%), and the next was drying of nasal passages (65%). Conclusion: Nasal CPAP is an effective treatment for OSA. Futher studies should be concentrated on long term follow up of nasal CPAP for its therapeutic effects and the study of methods to enhance patients' compliance.

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The Effect of Midazolam As Sedative Agent in Bronchoscopy (기관지내시경 검사시 전처치로서 Midazolam의 효과)

  • Lee, Sang-Haak;Hyun, Dae-Sing;Lee, Sook-Young;Kim, Seok-Chan;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.612-618
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    • 2002
  • Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.

The Relationship of Serum Angiotensin Converting Enzyme(ACE), Angiotensin II and Clinical Markers in the Idiopathic Interstitial Pneumonia (특발성 간질성 폐렴 환자에서 임상적 지표와 혈청 Angiotensin Converting Enzyme(ACE) 및 Angiotensin II와의 관계)

  • Kyung, Sung-Young;Hahn, Hye-Sook;Song, Suk-Ho;Hwang, Jun-Kyu;Lim, Young-Hee;An, Chang-Hyeok;Park, Gye-Young;Park, Jung-Woong;Jeong, Seong-Hwan;Ha, Seung-Yeon;Lee, Jae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.506-518
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    • 2002
  • Background : There have been several studies showing that angiotensin II and the angiotensin converting enzyme (ACE) contribute to the activation of fibroblast including the pulmonary fibrosis, and apoptosis of the alveolar epithelium in idiopathic intersititial pneumonia. This study was performed to identify the relationship between the serum angiotensin II, ACE and the pulmonary function test (PFT), the dyspnea score, and the cell fraction of the bronchoalveolar lavage fluid(BALF). Materials and Methods : Twenty three patients with idiopathic interstitial pneumonia from March, 1999 to October, 2001 at Gachon medical school were enrolled in this study. They were divided into IPF(UIP) (16) and NSIP (7) groups. Twelve of the idiopathic interstitial pneumonia patients (UIP : 5, NSIP : 7) were diagnosed by an open lung biopsy, 11 of IPF patients were diagnosed by the American Thoracic Society (ATS) diagnostic criteria. The PFT values, dyspnea score, serum ACE and angiotensin II were measured, and a bronchoscopy was performed to obtain the BALF. Results : Of all the patients, 7 were in the normal range and 14 showed an increase in the serum level of angiotensin II. In terms of the serum ACE level, 14 patients had an increased level. The DLCO% of the angiotensin II in increased group was significantly lower than the not-increased group (p=0.021). Other factors did not correlate with the serum ACE or the angiotensin II increased group and not-increased group. Conclusion : These results suggest that an increased angiotensin II serum level may be associated with increase in the of alveolar capillary block in the progression of pulmonary fibrosis in idiopathic interstitial pneumonia.

Diagnostic Performance of Routine Objective Tests and Cost-Effective Approach for Chronic Cough (만성 기침의 진단 성적과 경제적 접근 모델)

  • Jeon, Gang;Jang, Seung Hun;Song, Hae Geun;Ha, Jun-Wook;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Park, Yong Bum;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.535-542
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    • 2004
  • Background : Despite the clinical clues of bronchial asthma, some chronic coughers fail to be diagnosed due to negative test results. This study was aimed at evaluating the diagnostic performance of routine objective tests and identifying a cost-effective approach for asthmatics with a chronic cough. Methods : Patients with a chronic cough of more than 3 weeks duration, and showing normal chest radiograph and spirometry were enrolled. On the first visit, objective tests, composed of serum total IgE, peripheral blood eosinophil count, spontaneous sputum eosinophil count, methacholine bronchial provocation test (MBPT) and paranasal sinus radiograph, were performed, with the simultaneous administration of oral prednisolone (0.5mg/kg) for one week. The final diagnoses were made on the basis of the test results, and the patients grouped according to their steroid responsiveness. The role of the etiologic diagnosis tests was evaluated, and the medical costs of the final management plan simulated with respect to three assumed models. Results : Sixty chronic coughers were finally analyzed. The final diagnoses were as follows: bronchial asthma 21.7%, eosinophilic bronchitis 6.7%, paranasal sinusitis 18.3%, presumptive allergy 8.3% and non-diagnostic case 45.0%. Ninety percent were steroid responder. With the bronchial asthma cases, the positive rate of MBPT was 38.5%, with sputum eosinophil count in 84.6%, serum total IgE in 38.5%, and a peripheral blood eosinophil count rate of 30.8%. When the test results and steroid responsiveness data were applied to the 3 models, the chest radiograph, spirometry, sputum eosinophil count and paranasal sinus radiograph test results, and simultaneous short term steroid treatment seemed to have acceptable diagnostic performances, which could be used as a further guide to cost-effective planning. Conclusion : Objective tests, composed of chest radiograph, spirometry, paranasal sinus radiograph and sputum eosinophil count, with simultaneous short term steroid treatment, are suggested as cost-effective approaches for asthmatics with a chronic cough.

The Effect of Epigallocatechin-3-gallate on HIF-1 α and VEGF in Human Lung Cancer Cell Line (비소세포폐암주에서 저산소상태에 의해 유발된 HIFa-1 α와 VEGF의 발현증가에 미치는 Epigallocatechin-3-gallate의 억제 효과)

  • Song, Joo Han;Jeon, Eun Joo;Kwak, Hee Won;Lee, Hye Min;Cho, Sung Gun;Kang, Hyung Koo;Park, Sung Woon;Lee, Jae Hee;Lee, Byung Ook;Jung, Jae Woo;Choi, Jae Cheol;Shin, Jong Wook;Kim, Ki Jeong;Kim, Jae-Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.178-185
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    • 2009
  • Background: Epigallocatechin-3-gallate (EGCG) is the major catechin in green tea, and has shown antiproliferative, antiangiogenic, antimetastatic and cell cycle pertubation activity in various tumor models. Hypoxia can be induced because angiogenesis is insufficient for highly proliferating cancer. Hypoxia-inducible factor-1$\alpha$ (HIF-1$\alpha$) and its downstream target, vascular endothelial growth factor (VEGF), are important for angiogenesis, tumor growth and metastasis. The aim of this study was to determine how hypoxia could cause changes in the cellular phenomena and microenvironment in a non-small cell culture system and to examine the effects of EGCG on a HIF-1$\alpha$ and VEGF in A549 cell line. Methods: A549 cells, a non-small cell lung cancer cell line, were cultured with DMEM and 10% fetal bovine serum. A decrease in oxygen tension was induced using a hypoxia microchamber and a $CO_2-N_2$ gas mixture. Gas analysis and a MTT assay were performed. The A549 cells were treated with EGCG (0, 12.5, 25, 50 ${\mu}mol/L$), and then examined by real-time-PCR analysis of HIF-1$\alpha$, VEGF, and $\beta$-actin mRNA. Results: Hypoxia reduced the proliferation of A549 cells from normoxic conditions. EGCG inhibited HIF-1$\alpha$ transcription in A549 cells in a dose-dependent manner. Compared to HIF-1$\alpha$, VEGF was not inhibited by EGCG. Conclusion: HIF-1$\alpha$ can be inhibited by EGCG. This suggests that targeting HIF-1$\alpha$ with a EGCG treatment may have therapeutic potential in non-small cell lung cancers.

Differences in CT Findings According to Sputum Smear Results in Patients with Active Pulmonary Tuberculosis Having a Single Cavity (한 개의 공동이 있는 활동성폐결핵 환자에서 객담도말검사 결과에 따른 흉부CT 소견의 차이)

  • Song, In Sup;Lee, Hwa Yeun;Yoo, Seung Min
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.479-485
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    • 2007
  • Background: The purpose of this study was to evaluate the differences in CT findings according to sputum smear-positive or -negative results in patients with active pulmonary tuberculosis having a single cavity. Methods: A total of 32 patients with active pulmonary tuberculosis having a single cavity on CT were classified into two groups: smear-positive (n=19) and smear-negative (n=13). The CT findings were reviewed retrospectively. The presence of consolidation, the number of lobes showing consolidation, ground-glass opacity, micronodules and nodule, the maximum diameter of the cavity, and the shape and maximum thickness of the cavity wall were assessed. Result: The maximum diameter of the cavity was $33.84{\pm}13.65mm$ and $27.08{\pm}9.04mm $ in the smear-positive and -negative groups, respectively (p>0.05). The amount of consolidation and the number of lobes with consolidation were found to be 89.5% and 30.8% (p=0.01) and $1.37{\pm}0.90$ and $0.31{\pm}0.48$ (p=0.0002) in the smear-positive and -negative groups, respectively. Consolidations in two or more lobes were only noted in 31.6% of in the sputum smear- positive group (p< 0.05). There were no other significant differences between the two groups. The sensitivity, specificity, positive and negative predictive values for the presence of consolidation were 89.5%, 69.2%, 73.9%, and 81.8%, respectively. Conclusion: While the absence of consolidation on CT may be associated with sputum smear-negative results in patients with active pulmonary tuberculosis having a single cavity, the presence of consolidation in two or more lobes on CT may be associated with spear-positive results in these patients.

Gonad Ontogeny in Relation to Somatic Growth in the Brown Croaker Miichthys miiuy (Basilewsky) (민어, Miichtys miiuy (Basilewsky)의 성장과 연관된 생식소 발달)

  • Park, In-Seok;Seol, Dong-Won;Im, Soo-Yeon;Park, Min Ouk;Hur, Woo June;Cho, Sung Woan;Song, Young-Chae;Kim, Jea-Soo;Jo, Hyo-Jae;Noh, Choong Hwan;Choi, Hee Jung
    • Korean Journal of Ichthyology
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    • v.19 no.2
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    • pp.107-111
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    • 2007
  • Sex differentiation of the brown croaker Miichthys miiuy (Basilewsky) is described from hatching to the 120th day post-hatching (dph) (water temperature $24^{\circ}C$). Primordial germ cells (PGCs) were observed on the 20th dph (10.4 mm total length (TL), 0.14 g body weight (BW), and began to protrude into the peritoneal cavity from the 40th dph (19.4 mm TL, 0.39 g BW). On the 65th dph (31.3 mm TL, 0.93 g BW, $1,560D^{\circ}$ (degree-days)), initial ovarian differentiation was identified by the PGCs with condensed chromatin, and their transformation into meiotic oocytes. By the 120th dph (4.60 mm TL, 1.38 g BW, $2,880D^{\circ}$), the oocytes were in the perinucleolus stage and had increased from 20 to $40{\mu}m$ in diameter. While ovaries gradually grew after sex was differentiated, testes continued to multiply from the 65th dph. On the 80th dph (37.9 mm TL, 1.39 g BW, $1,920D^{\circ}$), the beginning of testis lobule formation was indicated by the occurrence of spermatogonial cysts enveloped by somatic cells in some of the testes. On the 120th dph, the testis lobules of some of the fish contained all germ cell stages through to the spermatocytes. Therefore, the sex differentiation type of the brown croaker is identified as gonochoristic.

Dental Care Utilization Patterns and Its Related Factors of the Rural Residents (경상북도 일부 농촌지역 주민의 치과의료이용양상 및 관련요인)

  • Chang, Bun-Ja;Kim, Ji-Young;Song, Keun-Bae;Kam, Sin;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.171-182
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    • 2003
  • Objectives: This study was conducted to analyze the dental care utilization patterns and related factors of the rural residents. Methods: The data collected by interview and self-administered questionnaire survey of 524 peoples of Seongju county in Gyeongsanbuk-do. The summarized results are as follows. Results: The rate of persons who experienced the oral disease was 52.5% during 1 year and it was at most in the age group of 40-49. The rate of persons who had experienced the oral disease were investigated according to general characteristics, perception of oral health, being of regular treatment facility. Therefore the rate of persons who had experienced the oral disease was significantly higher the younger peoples, worse oral health status and being of the regular treatment source than the other groups. During 1 year period, 64.0% of the cases had treated the perceived oral disease, 36.0% did no action at all during last year. Among respondents, 49.4% had treated their oral disease at dental clinics, 8.0% had treated at community health center or subcenter and remains did not treated at all. The results of logistic regression analysis suggested that statistically significant factors in dental health care utilization were educational level, degree of pain, oral health status and regular treatment facility. Therefore the dental health care utilization rate was higher at groups with the high educational level, serious pain, better oral health status and being of the regular treatment source than other groups. 45.5% of the rural residents did not treat their oral disease immediately due to the no identified need, limitation of time(19.2%), economic limitation(19.2%), and geographical limitation(9.0%). Conclusions: In consideration of above findings, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically.

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Relationship Between Reflective Light and Traffic Accidents Involving Power-Tillers (경운기의 반사등 유무와 교통사고와 관련성)

  • Lee, Kyung-Eun;Lee, Heun-Ji;Gwak, Won-Gun;Ji, Myung-Gu;Song, Hyun-Seok;Hong, Sun-Yeong;Kang, Mi-Jin;Ju, Seok;Lee, Kwan;Cheong, Kwan-Hae;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.61-70
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    • 2003
  • Objectives: Traffic accidents often occur to power tillers without reflective light in the dawn, evening and night. Because of this reason, there has been a 'campaign to attach reflective lights' to power-tillers in recent years. Therefore, the authors investigated the relationship between reflective light and traffic accidents involving power-tillers. Methods: We defined traffic accidents of power tillers as those cases of rear-end collision by a car in the dawn, evening or night. According to our definition, four cases were confirmed in Hyungok-myeon, Gyeongju and five cases in Gigye-myeon, Pohang. We selected a control group from people in the same village with similar age, sex, driving history and education. Results: The study group contained 9 accidents and 36 non-accidents. Power tillers with reflective light were 32 cases (72.7%) of 44 cases (excluded one case due to death). Of those, the status of reflective light was 'clean' in 18 cases (56.3%). The recognition that reflective light can prevent accidents was 'Yes' in 26 cases of 44 cases (59.1%). The recognition of the 'campaign to attach reflective lights' to power tillers was 'Yes' in 38 cases of 44 cases (86.4%). The recognition about the safety regulation of driving power-tillers was 'Yes' in 32 cases of 44 cases (72.7%). Odds ratio of traffic accidents for no reflective light was 7.00 (95% CI: 1.06-58.37). Conclusions: Although the 'campaign to attach reflective lights' to power tillers are going on, its effectiveness may unknown. Therefore, more extensive epidemiologic study is needed into the relationship between reflective light and power tiller traffic accidents, with effective administration of the government and the attention of medical persons.

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Crown Shape Control of Pinus koraiensis S. et Z. (VII) - The Influence of Thinning and Stem Pruning on Seed Component(The First Report) - (잣나무의 수형조절(VII) - 잣나무의 간벌과 수형조절이 종자의 성분에 미치는 영향(제1보) -)

  • Song, Jae-Mo;Shim, Tae-Heum;Yi, Jae-Seon
    • Journal of Forest and Environmental Science
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    • v.18 no.1
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    • pp.87-96
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    • 2001
  • In order to investigate the influence of increased seed production of Korean white pine(Pinus koraiensis S. et Z.), component of seeds, produced from trees in the thinned stand and the stem-pruned trees in the seed orchard, were analyzed. The results obtained were as follows: 1. General component analysis of seed There is no significant influence of thinning on the seed component in moisture content (thinned- 4.10%, unthinned- 3.74% ), ash (thinned- 2.95%, unthinned- 2.94%), crude lipid (thinned- 67.62%, unthinned- 71.94%), and crude protein (thinned- 17.27%, unthinned- 17.50%). There is no significant influence of stem-pruning on the seed component in moisture content (unpruned- 4.26%, 1m stem-pruned- 4.10%, and 2m stem-pruned- 3.99%), ash (unpruned- 2.08%, 1m stem-pruned- 2.09%, and 2m stem-pruned- 2.15%) crude lipid(unpruned- 68.59%, 1m stem-pruned- 69.52%, and 2m stem-pruned- 72.53%), and crude protein (unpruned- 18.13%, 1m stem-pruned- 17.96%, and 2m stem-pruned- 17.56%) 2. Fatty acid analysis Seeds of tree from thinned and unthinned stands contained two essential fatty acids, i.e., linoleic acid (18:2) (thinned- 54.92%, unthinned- 55.40%) and linolenic acid (18:3) (thinned- 0.19%, and unthinned- 0.23%). Over 94% of fatty acids consisted of linoleic acid (18:2)(55%), oleic acid (18:1) (32%), and palmitic acid (16:0)(7%). T-test showed difference of content at 1% significance level for palmitoleic acid (16:1), stearic acid (18:0) and 8.11, 14-eicosatrienoic acid (20:3) and at 5% for linolenic acid (18:3), but no significant difference for three major fatty acids mentioned above, between two types of trees. Thus thinning may give no influence in fatty acid content. Seeds of three types of trees contained two essential fatty acids, i.e., linoleic acid (18:2)(unpruned- 55.25%, 1m stem-pruned- 54.74%, and 2m stem-pruned- 55.00%), and linolenic acid (18:3)(0.21% for three kinds of trees). Linoleic acid (18:2)(55%), oleic acid (18:1) (32%), and palmitic acid (16:0)(6%) consisted of more than 93% of all fatty acid content. At 5% significance level in F-test, difference was observed in the content of palmitoleic acid (16:1) and 8.11, 14-eicosatrienoic acid (20:3), but not in three major types of fatty acids above mentioned. It is observed that stem-pruning gave no significant influence in fatty acid content in general.

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