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Relationship Between Sleep and Alzheimer's Dementia (수면과 알츠하이머 치매의 관계)

  • Kyoung Hwan Lee;Ho Chan Kim
    • Sleep Medicine and Psychophysiology
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    • v.29 no.1
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    • pp.1-3
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    • 2022
  • Sleep is associated with Alzheimer's dementia. Many previous researches have shown that inadequate sleep is one of the risk factors that predict Alzheimer's dementia. The causal mechanism of this association is not clear. Slow wave sleep and REM sleep are critical stages in memory consolidation, and by sequential hypothesis both stages are important. Deposition of amyloid beta and tau, the main pathology of Alzheimer's dementia, are also associated with sleep. This review provides the association of sleep and Alzheimer's dementia, and future research is necessary to examine the specific mechanism of this association between sleep and Alzheimer's dementia, which may lead to an early intervention in sleep.

Polysomnographic Assessment of Nocturnal Enuresis in Adults: A Case Study of Parasomnia Overlap Syndrome With Obstructive Sleep Apnea

  • Jiyeon Moon;Wooyoung Im;Hyeyun Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.173-175
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    • 2023
  • Enuresis nocturia is more prevalent in children than in adults. Using polysomnography (PSG), we investigated the causes of adult enuresis nocturia in a 20-year-old female patient with nighttime bedwetting. In spite of normal urological examinations, her detailed medical history disclosed frequent sleep paralysis and urination during dreams. During PSG, two electromyograms were attached to her anus to assess the tone of her bladder's sphincter while she slept. During REM sleep, the EMG tone of the mandible decreased, but the anal and bladder sphincter tones did not. The polysomnogram revealed moderate obstructive sleep apnea. Consequently, she was diagnosed with adult parasomnia (nocturnal enuresis) overlap syndrome with OSA. This study demonstrates the value of PSG with simultaneous anal tone EMG for diagnosing NREM parasomnia and nocturnal enuresis.

The Clinical Significance of Periodic Limb Movements During Sleep in Various Sleep Disorders (다양한 수면장애의 주기성사지운동증의 임상적 의의)

  • So-Jin Lee
    • Sleep Medicine and Psychophysiology
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    • v.30 no.1
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    • pp.9-12
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    • 2023
  • Periodic limb movements during sleep (PLMS) are prevalent in various sleep disorders, such as restless legs syndrome (RLS), periodic limb movements disorder, obstructive sleep apnea (OSA), REM sleep behavior disorder (RBD), and narcolepsy. PLMS has been hypothesized to be related to the decline of dopaminergic transmission. In RLS, PLMS is suggested to be related to iron deficiency and symptom severity. PLMD is a rare sleep disorder, and the role of PLMS in PLMD has not been clearly investigated yet. PLMS in OSA, which remain after proper PAP therapy, may need further management. The clinical relevance of PLMS in RBD and narcolepsy have not been investigated thoroughly and need further studies. Whether PLMS are to be considered as a mere symptom of individual sleep disorders or not can be elucidated through studies investigating the efficacy of therapeutic approaches to reduce PLMS in various sleep disorders.

Nasal Continuous Positive Airway Pressure Titration and Time to Reach Optima1 Pressure in Sleep Apnea Syndrome (수면 무호흡 증후군에서 지속적 양압 치료시의 최적압 및 그 도달기간)

  • Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.84-92
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    • 1995
  • Background: Nasal applied continuous positive airway pressure(CPAP) is a highly effective method of treatment for obstructive sleep apnea syndrome. More than a decade of accumulated experience with this treatment modality confirmed that it is unquestionably the medical treatment of choice for patients with obstructive sleep apnea syndrome. However it takes long time to reach optimal CPAP pressure. To save the time to reach optimal pressure, it is necessary to clarify the time to reach optimal pressure for treatment of obstructive sleep apnea syndrome. Method: CPAP pressure is titrated during an overnight study according to a standardized protocol. Just before the presleep bio-calibration procedures, the technician applies the nasal mask and switches on the clinical CPAP unit. Initial positive for pressure is typically 3.0 centimeters of water pressure. After sleep onset, the technician gradually increases the pressure until sleep-disordered breathing events disappear or become minimal. The pressure must maintain maximal airway patency during both NREM and REM sleep to be considered effective. Before recommending a final pressure setting, sleep recording and oximetry data are reviewed by an American Board of Sleep Medicine certified Sleep Specialist and a Registrered Polysomnographic Technologist. Results: We examined the time required to reach optimal pressure during routine CPAP titration in 127 consecutively evaluated individuals diagnosed with sleep-disordered breathing. Results indicate that 33% of patients required more than four hours to attain satisfactory titration. This indicates that a four-hour session is marginally enough time, at best, to determine a proper CPAP pressure setting. Moreover, 60 of 127 patients required further adjustment after optimal pressure was reached. These additional pressure trials were needed to confirm that higher pressures were not superior for eliminating sleep-disordered breathing events. Conclusions: The data presented underscore the logistical difficulty of titrating CPAP during split-night studies without modifying the titration procedure. Futhermore, the time needed to reach optimal pressure makes it improbable that proper CPAP titration can be performed during a 2-3 hour nap study.

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Expression of Human Leukocyte Antigen DQB1*0602 in Korean Patients with Narcolepsy (한국인 기면병 환자의 Human Leukocyte Antigen(HLA) DQB1*0602 발현 빈도)

  • Hong, Seung-Chul;Woo, Young-Sub;Park, Soo-A;Jeong, Jong-Hyun;Han, Jin-Hee;Kim, Leen;Lee, Sung-Pil
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.107-112
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    • 2001
  • Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

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Comparison of Clinical Characteristics and Polysomnographic Features between Manifest and Latent REM Sleep Behavior Disorders (발현성 렘수면 행동장애와 잠재성 렘수면 행동장애의 임상적 특성 및 수면다원검사 소견 비교)

  • 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.37-43
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    • 2004
  • Objective: The purpose of this paper is to study the possible differences in clinical and polysomnographic findings, depending on the presence or absence of subjective complaints of abnormal sleep behavior, in patients with RWA on polysomnography. Method: We reviewed patient records and polysomnographic data of patients referred to the Sleep Laboratory at Seoul National University Hospital from June 1996 through October 2002. We defined the manifest RBD group (n=32) as patients having both complaints of abnormal sleep behavior and RWA on polysomnography. The latent RBD group (n=20) consisted of patients who exhibited RWA on polysomnography but did not complain of abnormal sleep behavior. The clinical characteristics and polysomnographic findings between the two groups were compared and analyzed. Results: Fifty-two subjects had RWA, as detected by polysomnography (42 males and 10 females, mean age of $55.1{\pm}19.1\;years$). Subjects in the manifest RBD group were significantly older than those in the latent RBD group ($61.59{\pm}13.5$ vs. $44.70{\pm}2.76\;years$, independent t-test, p<0.01). More subjects in the manifest RBD group exhibited abnormal REM behavior on polysomnography than did subjects in the latent RBD group (81.3 vs. 50.0%, Fisher's exact test, p<0.05). No significant differences between the groups were found in the prevalence of brain disorders and primary sleep disorders, gender proportion, and sleep architecture. Conclusion: No difference in sleep architecture was found between the manifest and the latent RBD groups. Only age and the presence of abnormal sleep behavior on polysomnography differentiated the two groups. We suggest that RWA on polysomnography without complaints of abnormal sleep behavior may be early manifestation of manifest RBD. Attention to RWA on polysomnography is necessary to help prevent full-blown RBD from developing.

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Technological Synergy Effect of Business Portfolio : Panel Data Analysis on 50 Largest Chaebols in Korea (사업포트폴리오의 기술시너지효과 :50대 재벌의 패널자료분석)

  • 김태유;박경민
    • Proceedings of the Technology Innovation Conference
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    • 1996.12a
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    • pp.265-295
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    • 1996
  • This paper investigates empirically the relationship between various business portfolio properties (particularly technological properties) and chaebol′s performance using data on the 50 largest chaebols in Korea. In addition to the traditional indexes to measure diversification such as entropy index we calculated inter-industry technological similarity using R&D expenditure data by industry and 1990 Input-output Table in Korea, and obtained chaebol-level technological relatedness and internal transaction proportion from chaebols′business profile, inter-industry technological similarity and 1990 input-output table. We applied factor analysis on 13 business portfolio property indexes and showed that they could be grouped into 3 dimensions, diversification scope, inter-business relatedness and degree of vertical integration. In this paper, using 50 largest chaebols′financial data (1989-1994), we analyzed empirically the effect of business portfolio properties on ROS (Return On Sales) which is conventional index for firm performance and on TFP(Total Factor Productivity) growth which is a pure measure of firm performance. To utilize the advantage of panel data, FEM(Fixed Effect Model) and REM(Random Effect Model) were used. The empirical result shows that the entropy index as a measurement of inter-business relatedness is not significant but technological relatedness index is significant. OLS estimates on pooled data were considerably different from FEM or REM estimates on panel data. By introducing interaction effect among the three variables for business portfolio properties, we obtained three findings. First, only VI (Vertical integration) has a significant positive correlation with ROS. Second, when using TFP growth as an dependent variable, both TR(Technological Relatedness) and f[ are significant and positively related to the deepened variable. Third, the interaction term between TR and VI is significant and negatively affects TFP growth, meaning that TR and VI are substitutes. These results suggest strategic directions on restructuring business portfolio. As VI is increased, chaebols will get more profit. A higher level of either TR or W will increase TFP growth rate. but increase in both TR and VI will have a negative effect on TFP growth. To summarize, certain business portfolio properties such as VI and TR can be considered "resources" themselves since they can affect profit rate and productivity growth. VI and TR have a synergy effect of change in profit rate and productivity growth. VI increases ROS and productivity growth, while TR increases productivity growth representing a technological synergy effect.

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Comparison of Anaerobic Digestion for food wastewater and food waste by HADS Pilot Plant (HADS Pilot Plant를 이용한 음폐수와 음식물쓰레기의 혐기성 소화 비교)

  • Ju, Donghun;Lee, Jungmin;Park, Seongbum;Sung, Hyunje
    • 한국신재생에너지학회:학술대회논문집
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    • 2010.06a
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    • pp.245-245
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    • 2010
  • 우리나라 생활폐기물 중 음식물쓰레기는 가장 많은 부분을 차지하고 있다. 또한, 음식물쓰레기에서 발생되는 음폐수의 발생량은 8,926톤/일에 달하고 있지만, 이 중 극히 일부만이 하수처리장 등에서 병합 처리되고 있고 대부분은 해양 투기되고 있는 실정이다. 이에 본 연구에서는 독일 GBU사로부터 중온/습식/이상 혐기성 소화 기술을 도입하여 HADS Pilot Plant를 설치하였고, 2008년 3월부터 국내 음폐수 및 음식물쓰레기에 적합한 최적의 운전기술을 확보하기 위한 Pilot Test를 실시하였다. 본 실험에 사용된 HADS Pilot Plant는 산발효조($6m^3$), 메탄발효조($50m^3$), 안정화조/가스저장조($40m^3$)그리고 가스 소각기로 구성되어 있다. 그리고 적용 음폐수 및 음식물쓰레기는 경기도 Y군에 위치한 사료화 시설에 반입되는 것을 이용하였는데 음폐수는 평균 TS 13.5%, VS 80%, pH $3.7{\pm}0.2$의 성상을 나타내었다. 이를 이용해 계단식으로 유기물 부하를 증가시키면서 $4kgVS/m^3/d$까지 적용하며 중온 상태에서 혐기성 소화를 실시한 결과, $0.8Nm^3/kgVS_{rem}/d$의 바이오가스 회수 및 85%의 VS 감량이 가능함을 확인하였다. 그리고 음식물쓰레기는 음폐수와 달리 1차 파쇄/선별기 및 배관상에 설치되는 2차 미세파쇄/선별기를 통한 전처리를 실시하였고, 1차 파쇄/선별 후 평균적으로 TS가 17.4%, VS는 81%, pH는 $3.85{\pm}0.2$의 성상을 나타내는 음식물쓰레기를 2차 미세파쇄/선별기를 거쳐 Pilot Plant의 산발효조에 투입하여 중온상태에서 혐기성 소화를 실시하였다. 음폐수 적용시와 마찬가지로 계단식으로 유기물 부하를 증량하면서 $4kgVS/m^3/d$까지 적용하여 운전하였고, 그 결과 약 $0.9{\sim}1.2Nm^3/kgVS_{rem}/d$의 바이오가스 회수와 85~87%의 VS 감량 효율을 확인하였다. 음폐수와 음식물쓰레기의 혐기성 소화 실험 결과, 제거된 VS량을 기준으로 보았을 때, 음식물쓰레기에서 더 많은 바이오가스 발생하였는데 이는 음식물쓰레기에 존재하는 고형물이 미생물들의 서식 공간으로 활용됨에 따라 혐기성 소화 과정에서 일어나는 혼합 발효 및 공영양 대사가 음폐수 대비 좀 더 수월하게 일어날 수 있게 된 데에 따른 결과라고 생각된다. 당사의 HADS Pilot Plant test에서는 계단식의 순차적인 유기물 부하 증량과 총VFA/총 알카리도 비율을 0.3~0.4 수준이하로 유지하며 운전함에 따라 음폐수와 음식물 모두에서 안정적으로 $4kgVS/m^3/d$까지의 유기물 부하 적용이 가능하였다. 또한, 생산된 바이오가스 내 메탄의 함량은 60~65%를 유지하였으며, 메탄발효조의 pH는 별도의 조절이 없이도 운전기간 동안 평균 7.8~7.9 수준을 유지하였다. 이처럼 pH 3.7~3.8의 음폐수 또는 음식물쓰레기의 투입에도 안정적인 완충능력을 보여준 것은 소화조 내에서 기질로부터 분해되어져 나오는 암모니아와 이산화탄소가 강력한 버퍼 시스템을 구축하고 있음에 따른 결과로 사료된다. 그리고 음폐수와 음식물쓰레기의 경우 모두 85%이상의 높은 VS 제거율을 보여주었는데 이는 당사의 HADS Pilot Plant 소화조의 구조가 내통과 외통으로 구분되어져 있음에 따라 plug flow + CSTR의 특징을 가짐에 따른 결과로 판단된다. 상기한 결과를 바탕으로 향후에는 $5kgVS/m^3/d$ 수준의 유기물 부하 적용운전도 계획하고 있다.

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Treatment of Seafood Wastewater using an Improved High-rate Anaerobic Reactor (개선된 고율혐기성 공정을 이용한 수산물 가공폐수처리)

  • Choi, Byeong-Yeong;Choi, Yong-Bum;Han, Dong-Jun;Kwon, Jae-Hyeok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.12
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    • pp.7443-7450
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    • 2014
  • To resolve shortcomings of high-rate anaerobic processes, such as high upward flow velocity, this study sought to improve the structure of the high-rate anaerobic reactor and evaluate its performance. The improved reactor was manufactured by adjusting the diameter and dividing the reactor into three parts. The evaluation of the structurally improved reactor revealed that the reactor could stabilize a single circuit, and prevent the accumulation of solid matter and leakage of microbes, thereby stabilize the microbes. In the process of anaerobic digestion, an increase in pH and alkalinity within the reactor was presumably attributed to bicarbonate created in the process of organic matter decomposition and due to the re-dissolution of some biogas. To maintain a high rate of organic matter removal, the reactor should be operated with more than 9 hrs of HRT and an organic matter load of under $10.kgTCODcr/m^3{\cdot}d$. The methane gas generated in the anaerobic digestion process showed a high content of 65~83 % at the organic matter load of over $7.7kgTCODcr/m^3{\cdot}d$. per removal of CODcr. The methane quantity was generated at $0.10{\sim}0.23m^3CH_4/kgCOD_{rem}$, showing that it was smaller than the theoretical methane generation amount (0.35) in the STP state. In the latter part of high-rate anaerobic process, an advanced treatment process was required to remove nitrogen.

Recycling Water Treatment of Aquaculture by Using Trickling Filter Process (살수여상공법을 이용한 양어장 순환수처리)

  • KIM Jeong-Sook;LEE Byung-Hun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.29 no.2
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    • pp.230-237
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    • 1996
  • The objective of the present study is to evaluate organic removal efficiencies, nitrogen removal efficiencies, kinetic constant, sludge production rates, oxygen requirements, and optimum treatment renditions for recycling water treatment of aquaculture by using a trickling filter process. When the loading rates were $0.500\~0.082kg\;COD/m^3/day$ and $0.271\~0.044kg\;NH_4^+-N/m^3/day$, SCOD and ammonia removal efficiencies were $74.5\~84.0\%$ and $43.7\~61.8\%$, respectively. The maximum removal rate of ammonia was 119.5 mg/L/day. Observed cell yield coefficient in the trickling filter reactor was 0.572 kg VSS/kg $BOD_{rem}$. When the hydraulic loading rate was $6.712\~40.341m^3/m^2/day$, oxygen uptake rate was $1.33\~7.22\;mg\;O_2/L/hr$.

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