• Imaging Science in Dentistry
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• v.53 no.4
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• pp.283-289
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• 2023

The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly cone-beam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient's airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.126-132
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• 2016

Purpose: The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy. Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-$1{\beta}$, IL-6, IL-10, and tumor necrosis factor (TNF)-${\alpha}$ levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ${\leq}5$) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels. Results: Plasma TNF-${\alpha}$, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-${\alpha}$ levels. Percentage time of $SpO_2$ <90 and lowest $SpO_2$ were significantly correlated with plasma TNF-${\alpha}$ level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of $SpO_2$ <90, lowest $SpO_2$, and mean $SpO_2$ were significantly improved after the MAD therapy. Plasma TNF-${\alpha}$ level was significantly decreased after MAD therapy. Conclusions: We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.2
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• pp.82-88
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• 2011

Mandibular advancement devices (MAD) are therapeutic options for obstructive sleep apnea (OSA). The aim of study was to investigate treatment outcomes of before and after insertion of MAD in OSA patients. We retrospectively selected a total of 13 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea-hypopnea index (AHI), oxygen desaturation index (ODI), wake after sleep onset (WASO), total arousal were measured by before and after MAD. The use of MAD proves to be efficient in reducing snoring, apnea-hypopne index ($17.2{\pm}14.6$ vs $20.9{\pm}14.6$), WASO ($27.4{\pm}28.8$ vs $47.9{\pm}43.6$), oxygen desaturation index ($9.0{\pm}11.6$ vs $16.4{\pm}11.7$), stage N3 ($54.8{\pm}45.2$ vs $36.6{\pm}22.0$), REM sleep times ($73.3{\pm}19.4$ vs $66.0{\pm}31.0$) and increases sleep efficiency ($92.6{\pm}6.6$ vs $87.2{\pm}11.2$). The decreases in apnea index based on a reduction in the overall and supine AHI values after MAD therapy were significantly greater for the positional OSA than nonpositional OSA patients. The use of MAD proves to be efficient in snoring, WASO, sleep efficiency, reduced AHI and associated with good compliance of patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.58.1-58.8
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• 2019

Background: The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods: We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results: Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion: Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.167-171
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• 2016

Purpose: Obstructive sleep apnea (OSA) is a common medical disorder with serious complications if untreated. Dentists play a vital role in the early diagnosis of this condition, thereby improving patients' prognoses. The purpose of this study was to identify patients with a high risk of OSA using simple cephalometric measurements in patients receiving routine dental care. Materials and Methods: The present study was conducted on 206 patients divided into a high-risk group and a control group after answering the Berlin questionnaire. Cephalometric analysis of a digital cephalogram was performed to measure the upper airway diameter (UAD) and mandibular-to-hyoid bone distance (MP-H) by 2 observers at 2 different times. Results: Among 206 patients, 93 (45%) were included in the high-risk group and 113 (55%) were in the control group. No significant difference was present between the groups with regard to gender, and the patients ranged in age from 18 to 65 years. The UAD measurements in the high-risk group were significantly lower than in the control group, and the MP-H measurements were significantly higher in the high-risk group than in the control group. The UAD was lower in middle-aged patients in both groups. Conclusion: Our study found that the UAD was lower in individuals with a high risk of OSA. Also, we found that middle-aged individuals of both genders were more likely to develop OSA. Dentists play a vital role in diagnosing patients at a high risk for OSA via thorough clinical examinations, risk factor analyses, and simple cephalometric analyses.

• Proceedings of the Korea Technical Association of the Pulp and Paper Industry Conference
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• 2001.04a
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• pp.88-88
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• 2001

최근 들어 초지기의 고속화, 원료의 저급화, 가공작업의 온라인화에 따라 초지기 상에서 안 정된 조업성이 더욱 중요하게 부각되고 있다. 이러한 초지 시스랩의 변화에 따라 사이징 효과의 발현 속도에 대한 관심이 고조되고 있다. 중성 사이징 시스템으로 ASA를 적용할 경우에는 초지기상에서 사이즈도의 대부분이 발현되기 때문에 온라인 후가공 작업의 안정성이 향상되며 사이즈프레스에서 조업성 역시 개선될 수 있을 것으로 기대된다. 본 연구에서는 가격이 저렴하고 국내 수급이 용이한 옥수수 양성전분을 ASA 유화안정제로 이용하기 위해서 OSA (Octenyl Succinic Anhydride)를 이용한 에스테르화 및 산가수분해를 통하 여 ASA 에멀션의 안정성 및 사이징 효과를 개선시킨 전분을 개발하고 그 효과를 규명하고자 하였 다. 이를 위해 전분을 FT-IR을 이용하여 분석하고 호액의 pH, 전기전도도, 전하밀도, 점도 변화 등 을 측정하였을 뿐 아니라 ASA 유화액의 pH, 전기전도도, 시간에 따른 가수분해 안정성 등을 평가 하였다. 또한 ASA 에멀션의 입도 변화 섬유에 대한 흡착특성과 수초지의 사이즈도를 평가하였다. 그 결과는 다음과 같았다. 첫째,OSA 전분의 사용에 따라 전분 호화액의 pH와 전기전도도의 변화는 나타나지 않았 다. 전하밀도는 첨가량이 증가할수록 감소하였으며 호화액의 점도는 상숭하였다. 또 OSA 전분의 적 용이 수초지의 사이즈도에는 영향을 주지 않았다. 그러나 OSA 전분을 사용하여 제조된 ASA 유화 액의 가수분해 안정성은 향상되었다. 이것은 콜로이드 상의 ASA 입자를 캡슐화 하는데 있어 소수성 을 띠고 있는 OSA 전분이 보다 강하고 안정하게 흡착하기 때문인 것으로 판단되었다. 둘째, 전분의 호화 시 H2S04을 사용하여 전분의 산 가수분해를 유도할 수 있었다. 이를 통 하여 전분 호화액의 pH는 낮아지고 전기전도도는 증가하였으나 전하밀도의 변화는 없었다. 또한 겔 화 온도가 낮아지고 저온에서의 점도가 상승하는 변화를 나타냈다. IN-H2S04를 2.3%까지 첨가하였 을 때 ASA 에멀션의 입도가 더욱 감소하였고 섬유에 대한 흡착량이 증가하였으며 수초지의 사이즈 도가 향상되었다. 특히 기존에 사용되어 오던 감자 양성전분에 비해 최대 90%까지 사이즈도의 향상 이 있었다.

• Journal of Korean Society on Water Environment
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• v.31 no.6
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• pp.599-609
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• 2015

In order to investigate why OSA (oxic-settling-anaerobic) process produces less sludge than CAS (conventional activated sludge) process, sequential cultivation through 1^st aerobic-anaerobic-2^nd aerobic conditions, were carried out. Then, the intracellular concentrations of adenosine triphosphate (ATP), nicotinamide adenine dinucleotide (NAD and NADH), and nicotinamide adenine dinucleotide phosphate (NADP and NADPH) were monitored for these three stages. Results showed that the concentrations of these energy substances rapidly decreased through time in both aerobic and anaerobic conditions but the anaerobic culture contained the lower energy level than aerobic culture. The 2^nd aerobic culture that experienced anaerobic condition showed lower concentration of these energy substances than those of the 1^st aerobic culture. Meanwhile, the anaerobic culture corresponding to the sludge holding stage of OSA was subjected to different soluble chemical oxygen demand (SCOD) levels, detention time, and temperature to evaluate the effects of these variations on the energy level difference between the 1^st and 2^nd aerobic stages. The lower the SCOD concentration, the longer detention time; and the higher temperature in the anaerobic stage tended to further reduce the intracellular level of the 2^nd aerobic culture. On the average, the intracellular energy level of the anaerobic and 2^nd aerobic stage were 57.73% and 39.12% of the 1st aerobic culture, respectively. These indicated that the insertion of an anaerobic stage between two aerobic stages could lower the intracellular energy levels, hence the lower the sludge in OSA than CAS process. Moreover, manipulation of the operating conditions of the intervening anaerobic stage can change intracellular energy levels thereby controlling sludge production.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.371-377
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• 2009

Objectives: The aim of this study was to evaluate the differences in the polysomnography data between positional and non-positional obstructive sleep apnea (OSA) patients. Methods: Forty-seven patients diagnosed with OSA were evaluated using full night polysomnography. According to the criteria of Cartwright et al., the patients were classified into two groups with 37 positional (supine apnea-hypopnea index [AHI] $\geq$ 2x's the lateral AHI) and 10 non-positional (supine AHI < 2x's the lateral AHI) OSA patients, and the differences of polysomnography data between the two groups were evaluated. Results: There were no significant differences in demographic variables (age, gender, and BMI), daytime sleepiness, overall AHI, total arousal index, and percent time of snoring between two groups. However, AHI, arousal index, and mean oxygen saturation ($SpO_2$) of the REM sleep stage were significantly more severe in the positional OSA group than the non-positional OSA group. Mean $SpO_2$ and the lowest $SpO_2$ during overall sleep stage were also significantly lower in the positional OSA group than the non-positional OSA group. Conclusions: Our results of differences in the polysomnography data of REM sleep stage suggest that non-positional OSA patients may have higher collapsibility of the oropharyngeal airway during sleep than positional OSA patients.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.29 no.12 s.243
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• pp.1629-1637
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• 2005

Optimum sensitivity analysis (OSA) is the process to find the sensitivity of optimum solution with respect to the parameter in the optimization problem. The prevalent OSA methods calculate the optimum sensitivity as a post-processing. In this research, a simple technique is proposed to obtain optimum sensitivity as a result of the original optimization problem, provided that the optimum sensitivity of objective function is required. The parameters are considered as additional design variables in the original optimization problem. And then, it is endowed with equality constraints to penalize the additional variables. When the optimization problem is solved, the optimum sensitivity of objective function is simultaneously obtained as Lagrange multiplier. Several mathematical and engineering examples are solved to show the applicability and efficiency of the method compared to other OSA ones.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.105-110
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• 2005

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.