• 수면정신생리
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• 제24권1호
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• pp.32-37
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• 2017

목 적 : 폐쇄성 수면무호흡 증후군(obstructive sleep apnea syndrome, OSAS)에서 앙와위는 비앙와위보다 수면무호흡을 증가시키는 것으로 알려져 있다. 앙와위 자세시간(supine position time, SPT)과 OSAS의 무호흡-저호흡 지수(apnea-hypopnea index, AHI)의 관련성에 대해서 많은 연구가 있었으나, SPT가 OSAS에서 어떤 변수의 영향을 받는지는 알려져 있지 않다. OSAS에서 수면다원검사상 어떤 변수가 SPT과 관련이 있는지를 평가하였다. 방 법 : 수면다원검사로 진단된 치료받지 않은 365 명의 OSAS 남자 환자를 선정하였다. SPT($276.4{\pm}92.3$ 분)가 인구 통계학적 데이터, 수면구조 관련변수, OSAS 관련변수 및 심박변이도(Heart rate variability, HRV)와 상관관계가 있는지 분석했다. SPT에 영향을 주는 요인을 알아보기 위해 SPT에 대해 다중회귀분석을 시행하였다. 결 과 : 전체 대상군의 상관분석에서 SPT는 총수면시간(total sleep time, TST) (r = 0.443, p < 0.001)과 수면 효율(r = 0.300, p < 0.001)과 가장 유의한 상관관계가 있었고, 코골이 시간(r = 0.238, p < 0.001), 산소포화도 90 % 미만시간(r = 0.188, p < 0.001), AHI (r = 0.180, p = 0.001), 산소탈포화지수(oxygen desaturation index, ODI), (r = 0.149, p = 0.004), NN50 count(r = 0.137, p = 0.036)와 SPT 간에 유의한 상관관계가 있었다. 다중회귀분석 결과 SPT에 유의한 영향을 끼치는 요인으로 TST (t = 7.781, p < 0.001), 코골이 시간(t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001), NN50 count (t = 1.993, p = 0.047)가 있었다. 결 론 : SPT는 OSAS 관련변수보다 수면구조 관련변수와 더 높은 상관관계를 보였다. 특히 SPT는 TST과 AHI 뿐만 아니라 NN50 count와도 밀접하게 관련되어 있었다. 이것은 SPT가 OSAS의 심각도뿐만 아니라 수면구조와 심박변이도에 의해서도 결정될 가능성이 있음을 시사한다.

• Journal of Nutrition and Health
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• 제35권1호
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• pp.60-68
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• 2002

Purpose of this study was to compare serum phospholipid fatty acid composition of obese children with that of normal weight children reside in Kangnung area. Subjects were consisted of 56(41 boys and 15 girls) moderately or severely obese elementary school children, and age and sex-matched normal weight children as a control group. Level of serum phospholipid fatty acids was measured by thin layer chromatography(TLC) followed by gas chromatography(GLC). for male subjects, serum triglyceride(121 $\pm$ 4.7mg/dl) and total cholesterol(180 $\pm$ 37.1mg/dl) concentrations were significantly(p < 0.05) higher in obese group than those for control group(81.5 $\pm$ 2.5mg/dl and 161 $\pm$ 32.0mg/dl, respectively). Obese group showed significantly higher percentage of serum phospholipid myristic acid(C14:0) than the value for control group in both male and female subjects. Obese male subjects had significantly higher percentages of palmitoleic acid(16 : 1), oleic acid(18 : 1), dihomo-${\gamma}$-linoleic acid(20 : 3, $\omega$6) and docosatetraenoic acid(22 : 4, $\omega$6), and lower percentages of eicosenoic acid(20 : 1, $\omega$6), docosapentaenoic acid(22 : 5, $\omega$6), EPA(22 : 5, $\omega$3) and DHA (22 : 6, $\omega$3) compared to values for control male subjects. For male subjects, obese group showed significantly higher ratios of 16 : 1($\omega$9)/16 : 0 and 18 : 1($\omega$9)/18 : 0, and significantly lower ratios of 22 : 5($\omega$6)/22 4($\omega$6), and 22 : 6($\omega$3)/22 : 5($\omega$3) compacted to values for the control group. But there was not significant differences in elongation and desaturation indices of serum phospholipids fatty acid metabolism between obese and control group in female subjects. Most of anthropometric measurements related to obesity were negatively correlated with the percentages of PUFA, $\omega$3 fatty acids or DHA(22 : 6, $\omega$3), and positively correlated with the percentage of myristic acid(14 : 0) or $\omega$6/$\omega$3 ratio in serum phospholipids. Serum triglyceride concentration was negatively correlated with the percentage of PUFA or $\omega$3 fatty acids, and positively correlated with $\omega$6/$\omega$3 ratio in serum phospholipids. These results indicate that obesity related changes in blood lipid levels and metabolism are more significant in male subjects than in female subjects. Also changes in serum phospholipid fatty acid composition observed in obese children appear to demonstrate the increased susceptibility of these children to cardiovascular disease and other related chronic diseases.

• 한국식품영양과학회지
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• 제33권10호
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• pp.1626-1633
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• 2004

$\omega$3계 지방산이 부족한 50군과 P/M/S 및$\omega$6/$\omega$3비율이 적절한 MO군으로 생후 9주까지 사육한 흰쥐의 적혈구와 뇌조직의 시냅토솜, 미토콘드리아 및 마이크로솜내 oleic acid 조성 비율은 생후 3주에는 두 군간에 유의한 차이를 보이지 않고 일정한 수준으로 유지되는 것으로 나타났으나 생후 9주에는 MO군에서 SO군보다 높게 나타났다. 실험식이내 oleic ac:인 조성은 SO군이 MO군보다 매우 낮으나, SO군의 모유에서 oleic acid 조성비율이 식이에 비해 크게 증가된 것으로 나타나, 모유가 뇌 성장$.$발달기간중의 뇌조직내 oleic acid의 주요 급원이 될 수 있음을 나타내주고 있다. 18:0에서 oleic acid의 de novo 합성 정도를 나타내는 간접지표인 -9 desaturation index는 생후 3주에는 실험군간(시냅토솜 예외)에 유의한 차이를 보이지 않았으나, 생후 9주에는 식이내 oleic acid가 풍부한 MO군의 시냅토솜에서 높게 나타났다. 한편 생후 9주 마이크로솜 분획 에서 olelc acid 수준은 실험군 간에 차이를 보이지 않았으나, -9 desaturation index는 SO군에서 MO군보다 높아 뇌조직 에서 oleic acid가 생합성될 수 있음을 간접적으로 설명 해주고 있다. 따라서 흰쥐 뇌조직의 oleic acid는 식이와 모유 등의 이미 합성된 oleic acid가 뇌로 우선적으로 유입되는 부분과 뇌조직 자체에서 합성되는 부분에 의한다고 생각된다. 그러나 식이중 oleic acid가 부족하면 뇌 세포분획내의 oleic acid수준이 유의하게 감소하였으므로, 식이중 적절한 수준의 oleic acid가 정상적인 뇌발달에 필수적임을 다시 한번 강조하게 한다. 

• 대한임상검사과학회지
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• 제45권2호
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• pp.73-76
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• 2013

Uvulopalatopharyngoplasty (UPPP) is one possibility for the treatment of Obstructive Sleep Apnea (OSA). The aim of this study was study the analysis of polysomnography of pre-UPPP and post-UPPP. All patients were evaluated by means of a physical examination, the epworth sleepiness scale (ESS), the beck depression inventory (BDI) and the nocturnal polysomnography (PSG) before surgery, and 6~12 months after surgery. A total of 15 patients were investigated. All underwent UPPP. The patients were between 26 and 62 years old ($mean{\pm}SD$; $39.7{\pm}10.9$) with a lean body mass index (BMI) of $mean{\pm}SD$; $26.2{\pm}3.0kg/m^2$. The comparison of sleep questionnaires showed that after UPPP, the patients had a significantly lower BMI ($26.2{\pm}3.0kg/m^2$ vs $26.0{\pm}3.4kg/m^2$, p=0.241), ESS ($10.0{\pm}5.4$ vs $6.9{\pm}3.2$, p=0.022), BDI ($9.2{\pm}8.2$ vs $4.2{\pm}4.3$, p=0.343) and higher blood pressure ($127.5{\pm}12.1$ vs $123.7{\pm}12.0$, p=0.272) compared to before UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly lower stage N1 ($108.8{\pm}53.1$ vs $82.2{\pm}48.9$, p=0.016), lower sleep latency ($4.9{\pm}4.4$ vs $2.0{\pm}1.7$, p=0.083), a lower total arousal number ($210.6{\pm}90.3$ vs $147.1{\pm}87.3$, p=0.019), lower oxygen desaturation index (ODI) ($30.2{\pm}20.9$ vs $10.2{\pm}15.1$, p=0.006), lower apnea-hypopnea index (AHI) ($31.6{\pm}22.4$ vs $10.9{\pm}15.4$, p=0.005), and a lower respiratory disturbance index (RDI) ($37.4{\pm}21.3$ vs $18.5{\pm}16.5$, p=0.008) compared to after UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly higher stage N2 ($154.0{\pm}39.9$ vs $180.5{\pm}49.5$, p=0.017), higher REM ($58.5{\pm}29.7$ vs $72.6{\pm}34.0$, p=0.249), higher $meanSaO_2$ ($94.3{\pm}2.0$ vs $95.9{\pm}0.9$, p=0.043), and higher $meanSaO_2$ ($79.3{\pm}8.5$ vs $83.1{\pm}7.9$, p=0.116) than before UPPP. After UPPP, 6 patients were cured, 2 showed marked improvement, and 7 did not improve. After surgery, the success of the treatment was at 53%. The subjective patient satisfaction was higher than before the surgery.

• 대한소아치과학회지
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• 제47권4호
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• pp.377-388
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• 2020

이 연구의 목적은 수면호흡장애를 가진 어린이들을 선별하기 위해 휴대용 간이수면검사를 이용한 무호흡 저호흡 지수(apneahypopnea index, AHI)를 기준으로, 치과 진료실에서 사용 가능한 측모두부계측 방사선 사진, 임상 검사, 소아수면설문지(pediatric sleep questionnaire, PSQ)에서 유용한 수치들을 찾아내고 평가하는 것이었다. 교정치료를 위해 전북대학교 소아치과에 내원한 5 - 10세의 어린이들을 대상으로 하였다. 총 61명이 이 연구에 포함되었으며, AHI 값이 1보다 크게 나타난 어린이들을 SDB군으로, 1 이하로 나타난 어린이들은 정상군으로 분류하였다. 61명의 어린이 중 49(80%)명이 SDB군에 포함되었다. SDB군과 정상군과의 통계 분석 결과, 휴대용 간이수면검사의 ODI(oxygen dehydration index)와 코골이 시간, 설문지를 통한 PSQ scale, 측모두부계측 방사선 사진에서 아데노이드 비대율과 하악평면에서 설골까지의 거리 그리고 gonial angel이 통계적으로 유의한 차이를 보였다. 이 연구를 통해 잠재적인 SDB 환자를 선별해내기 위해 측모두부계측 방사선 사진을 통한 아데노이드 비대, 설골의 위치, gonial angle과 소아수면설문지를 평가하는 것이 유용할 것으로 보인다.

• 대한임상검사과학회지
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• 제39권2호
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• pp.141-146
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• 2007

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a disorder characterized by the repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation, daytime sleepiness, and increased risk for hypertension and stroke. We investigated the clinical factors related to the severity of OSAHS. Polysomnography was performed in three hundred and ninety five consecutive adult patients with clinical symptoms of obstructive sleep apnea syndrome. All patients completed the sleep questionnaire and the Epworth Sleepiness Scale before polysomnography. Patients were classified into four groups based on the severity of their polysomnographic data: Non-OSA group, characterized by Apnea-Hypopnea Index (AHI) < 5; mild OSA group, by AHI 5-15; moderate OSA group, by AHI 16-30; and severe OSA group, by AHI > 30. Neck circumference was also measured at the cricothyroid level. A total of 395 patients (336 men and 59 women) were studied. In the non-OSA group, there were 55 patients; their mean neck circumference was $39.63{\pm}4.24cm$ and mean BMI was $24.48{\pm}3.53$. In the mild group, there were 101 patients; their mean neck circumference was $41.93{\pm}3.75cm$ and mean BMI was $25.33{\pm}2.94$. In the moderated group, there were 93 patients; their mean neck circumference was $43.27{\pm}3.50cm$ and BMI was $25.90{\pm}2.88$. In the severe group, there were 146 patients; their mean neck circumference was $44.94{\pm}3.93cm$ and mean BMI was $26.81{\pm}3.76$. Men had significantly larger neck circumference than women ($Mean{\pm}SD$, $43.72{\pm}3.83$ vs $39.17{\pm}4.30$, p < 0.001), and higher AHI than women ($29.12{\pm}22.65$ vs $14.63{\pm}14.11$, p < 0.001). Multiple regression analysis revealed that neck circumference was the most significant predictor of AHI. Neck circumference and BMI were positively correlated with the severity of OSAHS. The severity of OSAHS was greater in men than in women.

• Journal of Nutrition and Health
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• 제33권7호
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• pp.745-754
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• 2000

Effects of oral taurine supplementation (6g/day)for 2-4 weeks on activities of red blood cell(RBC)total superoxide dismutase (SOD) and plasma glutathione peroxidase(GSH-Px) and the level of malondialdehyde(MDA) were evaluated in healthy female adults (23.6$\pm$0.3 years old). Compared to the value for 0 week plasma GSH-Px activity of the subjects was significantly lower after 2 weeks of taurine supplementation(p<0.05) and recovered to the value similar to 0 week after 4 weeks of taurine supplementation. RBC total SOD activity tended to be decreased after 2 weeks of taurine supplmentation compared to the values for 0 week although the difference between the means of the two group was not statistically significant. Plasma MDA level was not significantly decreased by taurine supplementation most probably due to the fact that the subjects participated in the present study were healthy and their antioxidant defense system had been in the 'normal' range. Plasma MDA concentration was negatively correlated with plasma taurine concentration(r=-0.2003m p<0.05) but tended to be positively correlated with plasma cholesterol concentration(r=0.2465, p=0.0645) as expected Plasma GSH-Px activity was positively associated with the percentage of 22:0 (r=0.2892, p<0.05) or 20:4w6(r=0.2939, p<0.05). On the other hand plasma MDA concentration was positively correlated with the percentage of 20:5w3 in plasma total lipids(r=0.2635 p<0.05) and negatively correlated with $\Delta$5 desaturation index of w6 fatty acids(20:3w6⇒20:4w6) in plamsa total lipids(r=-0.2714, p<0.05) as well as in phospholipids(r=-0.2864, p<0.05). From these results protective effect of taurine supplementation against lipid peroxidation and antioxidant defense system in humans appears to be minimal when the subjects are in a relatively healthy state. Further studies concerning the antioxidant efficacy of taurine should be conducted in human subjects under various disease states related to oxidative stress such as diabetes and artheroxclerosis.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.335-340
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• 2019

Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.506-511
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• 2016

Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

• 수면정신생리
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• 제15권2호
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• pp.71-76
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• 2008

목 적：본 연구에서는 소아 수면무호흡증 환자의 수면구조와 뇌파특성을 성별, 연령이 짝 지워진 정상군과 비교하여 수면무호흡의 영향을 비교 분석하였다. 방 법：코골이 증상을 호소하고 소아과 의사의 임상소견상 수면무호흡증이 의심되는 15명(남：여=4：11)와 정상군 15명(남：여=5：10)을 대상으로 수면다원검사를 시행하였다. 두 군의 수면다원검사에서 얻어진 수면구조관련 변인, 수면무호흡관련 변인과 스펙트럼 분석을 통해서 얻어진 뇌파 주파수별 스펙트럼을 비교하였다. 결 과：수면무호흡증군은 정상군에 비해 무호흡지수, 호흡장애지수, 혈중산소포화도 최저값 등에서 뚜렷한 차이를 보였다. 수면무호흡증군은 수면구조 분석상 1단계 수면의 비율증가, 렘수면 비율 감소 소견을 보였으며 뇌파 스펙트럼 분석상 O1채널의 델타파 증가 소견 외에는 정상군과 차이를 보이지 않았다. 결 론：소아수면 무호흡의 경우, 진단기준의 특성상 수면 무호흡이 심하지 않은 경우가 많이 포함될 수 있으며, 그 결과 무호흡으로 인한 수면구조의 와해가 뚜렷하지 않았다. 또 각성 횟수도 성인수면 무호흡에 비해 적어서 뇌파변화도 뚜렷하지 않았다. 본 연구를 통해 소아수면 무호흡증의 일반적인 양상과 특수성을 관찰할 수 있었다.