• Korean Journal of Clinical Laboratory Science
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• v.51 no.1
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• pp.119-123
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• 2019

Obstructive sleep apnea (OSA) is a sleep disorder with no breathing symptoms due to repetitive upper airway resistance. OSA is a disease that can have significant effects on the cerebral cardiovascular system. Active treatment is needed to prevent these complications. The use of continuous positive airway pressure (CPAP), the standard therapy of OSA, has comparative therapeutic effects. On the other hand, there is no comparison report of the polysomnography (PSG) results before and after CPAP therapy without using a mask. This paper reports a patient who was diagnosed as OSA and used CPAP every night for more than 2 years. The patient showed a decrease in the apnea-hypopnea index from 64.7/h to 12.9/h. In addition, other sleep-related indicators improved significantly. The daily use of CPAP as a treatment for OSA for more than 2 years may improve the PSG results. Constant follow up of PSG will be needed to adjust the appropriate CPAP pressure to patients because there might be a change in the Apnea-Hypopnea Index and other sleep-related indicators for constant CPAP users for at least 2 years.

• 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.

• KIPS Transactions on Computer and Communication Systems
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• v.12 no.5
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• pp.171-180
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• 2023

The three major sleep disorders in Korea are snoring, sleep apnea, and insomnia. Lack of sleep is the root of all diseases. Some of the most serious potential problems associated with sleep deprivation are cardiovascular problems, cognitive impairment, obesity, diabetes, colitis, prostate cancer, etc. To solve these problems, the Korean government provided low-cost national health insurance benefits for polysomnography tests in July 2018. However, insomnia patients still have problems getting treated in terms of time, space, and economic perspectives. Therefore, it would be better for insomnia patients to be allowed to test at home. The measuring device can measure six biosignals (eye movement, tossing and turning, body temperature, oxygen saturation, heart rate, and audio). A gyroscope sensor (MPU9250, InvenSense, USA) was used for eye movement, tossing, and turning. The input range of the sensor was in 258°/sec to 460°/sec, and the data range was in the input range. Body temperature, oxygen saturation range, and heart rate were measured by a sensor (MAX30102, Analog Devices, USA). The body temperature was measured in 30 ℃ to 45 ℃, and the oxygen saturation range was 0% for the unused state and 20 % to 90 % for the used state. The heart rate measurement range was in 40 bpm to 180 bpm. The measurement of audio signal was performed by an audio sensor (AMM2742-T-R, PUIaudio, USA). The was -42 dB ±1 dB frequency range was 20 Hz to 20 kHz. The measured data was successfully received in wireless network conditions. The system configuration was consisted of a PC and a mobile app for bio-signal measurement and data collection. The measured data was collected by mobile phones and desktops. The data collected can be used as preliminary data to determine the stage of sleep and perform the screening function for sleep induction and sleep disturbances. In the future, this convenient sleep measurement device could be beneficial for treating insomnia.

• 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.

• (The) Research of the performance art and culture
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• no.32
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• pp.651-700
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• 2016

The keyword of contemporary art in 21st is audience participation. London has emphasized the importance of audience participation since 2000. The National Theater of London is trying a new method, which is live performance to search new audiences. Also, they are trying to cross the boundaries between 'stage' and 'spectator'. This leads the other theaters to search new audiences and try new genre of performance. Therefore, they establish a new form of performance, which is that audience actively moves and find a new story in a theater. For example, "environmental theater" is the one. This theater escapes from the traditional stage, but it is based on "site-specific performance." Lots of new forms of theater have emerged. In this study, I focused on one of these new forms of theater, which is "Punchdrunk." "Punchdrunk" was founded by few students graduated from London University's Laban Center in 1999. They started at an empty stage in small school with only three audiences. 7 years after, it became one of major theaters in London. 10 years after, it showed their performances in the United state. Since then, their performances in New York have never been stopped. More strikingly, for last decades, this theater has been always full. In this study, I reasoned that the key of "Punchdrunk" success is audience participation. Therefore, I investigated the features of Punchdrunk theater and how they engage their audience in this performance. In this study, I focused on one of their performances, . Also, I categorized the audiences in three different ways: narrative visitor, walking visitor, and engaging visitor with mask. Three-part transition of Disney Theme Park from Louis Marin was applied to study "narrative visitor." For "walking visitor", Normadism from Gilles Deleuze was applied. For "engaging visitor with mask", Voyeurism was applied.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.418-431
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• 2022

Purpose: The aims of this study were to examine the rate of depression among older adults living alone and to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Methods: A secondary data analysis was performed using data from the 2020 Korea Community Health Survey. The study participants were 18,824 older adults aged 65 years and over living alone. The data of the complex sample design was analyzed with consideration for weights, stratification, and clustering. Complex sample multiple logistic regression was conducted to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Results: The results showed that the rate of depression in older adults living alone was 6.3%. Older adults living alone with decreased physical activity, decreased hours of sleep, and an increased or similar frequency of meeting with friends or neighbors were found to be more likely to have depression. In terms of factors related to the practice of COVID-19 infection prevention and control rules, not disinfecting regularly and not wearing a mask indoors were related to depression. For health-related factors, fair or poor self-rated health status, not having breakfast every day, and feeling stressed were related to depression. Conclusion: It is recommended to develop tailored interventions to prevent depression among older adults living alone by considering the factors related to their depression during the COVID-19 pandemic.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.723-730
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• 1995

Background: Noninvasive ventilation has been used extensively for the treatment of patients with neuromuscular weakness or restrictive chest wall disorders complicated by hypoventilatory respiratory failure. Recently, noninvasive positive pressure ventilation has been used in patients with alveolar hypoventilation, chronic obstructive pulmonary disease(COPD), and adult respiratory distress syndrome. Sanders and Kern reported treatment of obstructive sleep apnea with a modification of the standard nasal CPAP device to deliver seperate inspiratory positive airway pressure(IPAP) and expiratory positive airway pressure(EPAP). Bi-level positive airway pressure(BiPAP) unlike nasal CPAP, the unit delivers a different pressure during inspiration from that during expiration. The device is similar to the positive pressure ventilator or pressure support ventilation. Method and purpose: Bi-level positive airway pressure(BiPAP) system(Respironics, USA) was applied to seven patients with acute respiratory failure and three patients on conventional mechanical ventilation. Results: 1) Two of three patients after extubation were successfully achieved weaning from conventional mechanical ventilation by the use of BiPAP ventilation with nasal mask. Five of seven patients with acute respiratory failure successfully recovered without use of conventional mechanical ventilation. 2) $PaO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients significantly improved more than baseline values(p<0.01). $PaCO_2$ 1hour after BiPAP ventilation in acute respiratory failure patients did not change significantly more than baseline values. Conclusion: Nasal mask BiPAP ventilation can be one of the possible alternatives of conventional mechanical ventilation in acute respiratory failure and supportive method for weaning from mechanical ventilation.

• Journal of Technologic Dentistry
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• v.22 no.1
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• pp.89-112
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• 2000

Although dental laboratory technicians are prone to be exposed to various work-related health hazardous materials such as dusts, chemicals, etc., the prevalence and nature of work-related health problems of them have not been a matter of great concern in the field of occupational health service in Korea. The purpose of the present investigation was to describe a collected profile of subjective health symptoms and their attributable factors in Korean dental laboratory technicians. A questionnaire listing five groups of health symptoms and five health symptom-related factors was mailed to randomly selected 1,900 dental laboratory technicians. Among them, 1,344 dental laboratory technicians filled out the questionnaires and returnde them. Five groups of health symptoms included musculoskeletal symptom, dermal symptoms, respiratory symptoms, eys symptoms, and ear symptoms. Five health symptom-related factors were occupational environment-related health risk factors, work history, health related habits and status, use of personal protective equipment and general characteristics. Detailed parameters of health risk factors were work posture, vibration, and chemical or physical hazards such as dust, fume, vapor, solvent, light, and noise for occupational environment-related factors; work place, area, number of employees, work hours, career, work part, and work load for work history; Broca's index, hours of sleep, eating, smoking, alcohol, exercise, health examination, and self assessed health status for health habits and status; face masks, goggles, and so on for use of personal protective equipment, and; age, sex, marital status, and education for general characteristics. Before the start of main survey, a pilot survey was carried out for validity and reliability tests of the questionnaire. All the data obtained were coded and analyzed with PC/SAS 6.12 program. The prevalence of health symptoms was the highest in musculoskelton (87.3%), and followde by eyes (78.9%), respiratory organs (64.3%), ears (57.8%), and skin (52.2%) in descending order. Statistically significant risk factors by multiple logistic regression analyses were sex, health examination, self assessed health status, and hand/finger posture in musculoskeletal symptoms; sex, self assessed health status, career, acid gas, and hand contact with resin mixture in deraml symptoms; Broka's smoking, exercise, self assessed health status, and face mask in respiratory symptoms; sex, hours of sleep, self assessed health status, work hours, work load, plaster dust, inadequate lighting, and goggle in eys symptoms, and eating, smoking, self assessed health status, and work load in ear symptoms. With the above considerations in mind, prevalence of subjective symptoms among Korean dental laboratory technicians was relatively high, and they were attributable to most of the occupational environment-related factors, work history, use of personal protective equipment, health habits and status, and general characteristics. Particularly, it is suggested that health promotion programs for promoting self- assessed health status and smoking cessation, preventive measures for protection of the female technicians’health, and reducing work load be necessary, since those factors were associated with more than one subjective symptom.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.242-250
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• 2019

Background: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results: A total of 156 patients treated with NIV were enrolled (mean age, $71.9{\pm}11.6years$). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.