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Differential Factors of Obstructive Sleep Apnea in Subjects whose Main Sleep Complaint was Insomnia (불면증을 호소하는 환자에서의 폐쇄성 수면 무호흡증 감별 인자)

  • Kim, Seog-Ju;Lee, Yu-Jin;Kim, Eui-Joong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.22-28
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    • 2004
  • Objective: The purpose of this study is to investigate the prevalence rate of OSA in subjects whose main sleep complaint is insomnia and to find differential factors of OSA in these insomniac subjects. Method: We reviewed the medical records and polysomnographic findings of patients referred to the Sleep Laboratory at Seoul National University Hospital from January 1996 to December 2002. Four-hundred and seventy subjects complained of insomnia as their main sleep problem (235 males and 235 females, mean age $53.6{\pm}12.4\;years$). First, we investigated the prevalence rate of OSA in these insomniac patients. Second, we compared the clinical and demographic characteristics of the OSA-associated group with those of the non-associated group. Third, we examined whether the degree or presence of differential factors within the OSA group correlate with severity of OSA, as determined by the respiratory disturbance index (RDI). Results: Among 470 insomniac subjects, 125 subjects (26.6%) were diagnosed as OSA by nocturnal polysomnography. OSA-associated subjects were significantly older ($58.4{\pm}12.3\;years$ vs. $51.8{\pm}11.2\;years$, p<0.01), and had significantly higher body mass index (BMI) ($23.4{\pm}3.3\;kg/m^2$ vs. $22.5{\pm}3.1\;kg/m^2$, p=0.44) than non-associated subjects. The OSA-associated group had more subjects with male gender (64.0% vs. 44.9%, p<0.01), hypertension (20.0% vs. 9.3%, p<0.01) or snoring (96.0% vs. 63.5%, p<0.01). Within the OSA-associated group, age had a significant positive correlation with RDI (p=0.01). Conclusion: We found that a considerable portion of patients complaining of insomnia as their main sleep problem were diagnosed as OSA. Snoring, old age, male gender, obesity, and comorbid hypertension were found to be differential factors of OSA in insomniac patients. We suggest that diagnostic efforts including nocturnal polysomnography are needed for insomniac patients with any of the above risk factors of OSA.

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Study on Hospital Environmental Causes Affected the Mother′s Comfort After Her Child Birth (산욕부 안위에 영향을 미치는 병원환경 요인에 관한 연구)

  • 변수자
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.1-15
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    • 1978
  • The Purpose of this study is to examine closely the causes influenced upon the comfort and recovery of the woman delivered of a child in the hospital at the same time to understand environmental status of hospitals in order to promote mother's health recovery, and to improve hospital environment by emphasizing the meaning of environment and health before the medical staff and hospital administrative authority. In the method of servery of the research, 165 post paestum patients have been randomly selected who were accommodated and delivered their babies at OB(obstetric ) & GY (Gynecologic) unit the 7 general hospitals for the period of 6 December 1976 through 17 December 1976. As for the survey, it has been used of Questionnaire where we have 65 items in the respect of personal environment in the hospital such as trusting nurse, ability, reliability, kindness and etiquette of nurse and tile character of nurse the relationship with patients the other respect of physical environment included 9f temperature, moisture. air-ventilation lightening noise, cleanness. facilities, and the third realm being of mother's hearth ground to have the following conclusion 1. The feature of the collected personnel they are from OB or GY sects of from OB unit of the other 5 hospitals except the two general hospitals of the college or school Otherwise the rate of the patients to nurses would be 9 : 1. As for the nurses'ground it would be appeared of 20-25 years of age as the 76%. either 3 year course or 4 year course in the education would be each 50% and less than 2 year experience case would record as of 60 %. In the respect of hospital physical environmental status, there we have two hospitals without any thermometers, on the other han4 nowhere there's hygrometer, otherwise, the lightening is normal or over than normal As for the structure of noise protection the corridors're, generally speaking worse than rooms, nerver hueless, there's no ventilating system in the hospitals. The rooms'repainted in white and yellow, light green white, or green color. The patient's clothing were in green pink blue, light green or in white co for. There're not anything special in both decoration and equipments. Most of them used tall beds except in one hospital 2. To the extent of perception of patient's hatch 9round and hospital environment it is presented that they perceived nurse's ability in highest in total human variable, though perceived kindness or etiquette in the lowest otherwise, comparatively high in total average. 3. In the respect of physical environment it is highest perceived of lightening terms, otherwise, lowest perceived of air ventilation and total average became lowest than the one of the original record 4. To ages, in the respect of hatch ground rather old aged mother than the younger one has perceived that nurse would be trusting, in good service character, able, at the same time, liable, Otherwise, in physical environment regardless of age, they perceived lightening in high and remarkably lower in ventilation As a result of the examination of the difference in hospital environment to each age it is appeared of statistical difference at 5% level of ability in the personal environment otherwise little difference as for physical environment 5. In the respect of perceiving level to educational standard it is highly perceived of personal environment for higher ranking group rather than lower group in the educational standard. In case of physical environment it is highly perceived for lower level group rather than higher level group in educational background. The variables which have statistical significance at 5% level are from trusting kindness, etiquette and total kindness, etiquette and total all significance at 5% level are from trusting, kindness, etiquette and total human environment variable in personal environment, otherwise, there's little difference in the physical environment. 6. The perceiving level due to times of admission and accommodation at the hospital would be cleared out as gradual higher perception both physical and personal environment in the hospital. At 5% significant level of the ventilation condition in physical environmental variable it is presented of meaningful difference otherwise, there we have little difference both in Personal variable and other one. 7. In accordance with living standard, the perception degree of personal environment in tee hospital would be inclined to increase to higher living standard on the other hand, in case of the physical environment, the perception level world increase to lower living standard At 5 % level, the trustuariable and total scores in the personal eicuironmectal variable there appeared a meaningful/ significant difference otherwise, there presented little difference both in physical environmental and other variable to the living standard 8. Pertaining to family unit, the mother of an independent family unit perceived highly in all respect of the personal and the physical environment in the hospital rather than the woman of succeeding family unit. At 5 % level there appeared a difference in the respect of kindness and etiquette both in personal environment variable, on the other hand, there hardly marked a difference between other variable and physical environmental one. 9. The degree of perception to comforting level has little connection with a statistical difference the age, educational level hospital admitting times, living standard or family unit. 10. The most effective variable to mother's comforting level will be nurse's ability, reliability, trusting manner, and total physical environment variable in order.

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A Comparison on the Characteristics of Cerebrovascular Disease Patients Admitted to Some Western and Oriental Hospitals (일부 양·한방 병원에 입원한 뇌혈관질환 환자의 특성 비교)

  • Yu, Dae-Jin;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.65-79
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    • 2001
  • Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

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The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Research on the Prototype Landscape of Former Donam SeoWon Located in YeonSan (연산 돈암서원(豚巖書院) 구지(舊址)의 원형경관 탐색)

  • Rho, Jae-Hyun;Choi, Jong-Hee;Shin, Sang-Sup;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.4
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    • pp.14-22
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    • 2012
  • The position, size and landscape of the former Donam SeoWon as well as the physical organization of the old site, are studied to extract data for the enhancement of the authenticity of Donam SeoWon since its registration as a world heritage site. The results are as follows. The 'Donam(豚巖)' encaved rock, the tombstone of teacher Sagye(沙溪), Kimjipsadang(金集祠堂), the head of the Gwangsan Kim family, the Sagye stream in front of them, and the Gyeryong and Daedun mountains in the distance are united in the former Donam SeoWon as landscape elements that clearly show the characteristics of the former site, which was called 'Donam-Wollim(豚巖園林).' Moreover Yangseongdangsipyoung(養性堂十詠), adds the garden elements of a medical herb field, twins pond, a bamboo forest, a school, and a peach field. On this site, one can also engage in activities that are related to the land and are closely related to Neo-Confucianism such as fish watching, conferencing, visit in seclusion(訪隱), looking for monks, and overseeing farming. The former site facing east is assumed to have Sau(祠宇) - Eungdodang(凝道堂) - Ipdeokmum(入德門) - Sanangru(山仰樓: estimated). Jeonsacheong seems to have been located to the left of the Sau area, Yangseongdang, which contained upper and lower twin lotus ponds, on the right and was surrounded by various plants. As it has been used as a lecture hall for the past 250 years, the former Donam SeoWon, located 1.8km away from the current area, must be preserved, and the landscape should be formed to establish the authenticity of Donam SeoWon.

Latarjet Operation for Anterior Shoulder Instability with Glenoid Bone Defect (관절와 골 결손을 동반한 견관절 전방 불안정증에 대한 Latarjet 술식)

  • Cho, Seung-Hyun;Cho, Nam-Su;Yi, Jin-Woong;Choi, Il-Hun;Kwack, Yoon-Ho;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.189-198
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    • 2009
  • Purpose: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. Materials and Methods: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. Results: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of $8^{\circ}$ and $16^{\circ}$ less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. Conclusion: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.

Gait Analysis of a Pediatric-Patient with Femoral Nerve Injury : A Case Study (대퇴신경 손상 환아의 보행분석 : 사례연구)

  • Hwang, S.H.;Park, S.W.;Son, J.S.;Park, J.M.;Kwon, S.J.;Choi, I.S.;Kim, Y.H.
    • Journal of Biomedical Engineering Research
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    • v.32 no.2
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    • pp.165-176
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    • 2011
  • The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

Analysis of Utilization Characteristics, Health Behaviors and Health Management Level of Participants in Private Health Examination in a General Hospital (일개 종합병원의 민간 건강검진 수검자의 검진이용 특성, 건강행태 및 건강관리 수준 분석)

  • Kim, Yoo-Mi;Park, Jong-Ho;Kim, Won-Joong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.1
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    • pp.301-311
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    • 2013
  • This study aims to analyze characteristics, health behaviors and health management level related to private health examination recipients in one general hospital. To achieve this, we analyzed 150,501 cases of private health examination data for 11 years from 2001 to 2011 for 20,696 participants in 2011 in a Dae-Jeon general hospital health examination center. The cluster analysis for classify private health examination group is used z-score standardization of K-means clustering method. The logistic regression analysis, decision tree and neural network analysis are used to periodic/non-periodic private health examination classification model. 1,000 people were selected as a customer management business group that has high probability to be non-periodic private health examination patients in new private health examination. According to results of this study, private health examination group was categorized by new, periodic and non-periodic group. New participants in private health examination were more 30~39 years old person than other age groups and more patients suspected of having renal disease. Periodic participants in private health examination were more male participants and more patients suspected of having hyperlipidemia. Non-periodic participants in private health examination were more smoking and sitting person and more patients suspected of having anemia and diabetes mellitus. As a result of decision tree, variables related to non-periodic participants in private health examination were sex, age, residence, exercise, anemia, hyperlipidemia, diabetes mellitus, obesity and liver disease. In particular, 71.4% of non-periodic participants were female, non-anemic, non-exercise, and suspicious obesity person. To operation of customized customer management business for private health examination will contribute to efficiency in health examination center.

Difference in the Quality of Life and Related Factors according to the Employment Status (경제활동 상태에 따른 삶의 질 차이와 관련요인)

  • Gim, Mi-Seon;Han, Ji-Yeon;Kim, Chul-Woung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6080-6088
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    • 2015
  • The purpose of study is to find difference in the quality of life and related factors according to the employment status. Using data from the fifth National Health and Nutrition Survey, economically active population of 20-69 years old 3,429 participants who said to questions of 'economic activity status' were finally used as analysis subjects in Korea. According to economic activity status, individuals were divided by the six different employment status and their quality of life was inspected using the EQ-5D dimensions and index score as well as analyzing the factors affecting the quality of life. As a result, unemployed compared to full-time workers, had significantly higher needs of four dimensions and Unpaid family workers had in the dimensions of Mobility, Self-care and Usual activities and temporary job had in the dimensions of Self-care and Usual activities. After figuring out life quality factors according to employment status, it was found that compared to full-time workers greater age(${\beta}=-0.089$, p<0.001), more stress(${\beta}=-0.143$, p<0.0001), hyperlipidemia(${\beta}=-0.064$, p<0.0001), stroke, arthritis(${\beta}=-0.160$, p<0.0001), respiratory diseases(${\beta}=-0.055$, p<0.001) and chronic health conditions were more influential to low quality of life for temporary job(${\beta}=-0.034$, p<0.05), day workers(${\beta}=-0.078$, p<0.0001) and unemplyed(${\beta}=-0.052$, p<0.01). The study is reported that it is to find difference in the quality of life and related factors according to the employment status and it is considered to provide basis for health evaluation of utilization in the same field of study.

Radiation Therapy for Superior Vena Cava Syndrome (상대정맥증후군의 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.78-84
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    • 2005
  • Purpose: The studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). Materials and Methods: From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy The follow-up periods were from 1 to 180 months with a median of 5.6 months. Results: The main clinical manifestations were dyspnea ($84.7\%$), facial edema ($81.9\%$), arm edema ($22.2\%$), neck vein distension ($25\%$), hoarseness ($12.5\%$) and facial plethora ($5.6\%$). Eighty percent of patients achieved excellent to good symptom improvement and $19.4\%$ experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were $17.7\%$ at 2 years (2YOS) and $14.8\%$ at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, $16.7\%$ and $13.4\%$ for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, $25.6\%$, $\leq$ 30 Gy $6.7\%$, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p > 0.05), Conclusion: Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.