• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.307-312
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• 2019

Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.

• Journal of Korea Multimedia Society
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• v.21 no.12
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• pp.1370-1378
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• 2018

There is a problem to measure neutral bio-signals during sleep because of inconvenience of attaching lots of sensors. In this study, we measured single electrocardiogram(ECG) signal and analyzed the correlation with sleep. After R-peak detection from ECG signal, we extracted 9 features from time and frequency domain of heart rate variability(HRV). Mean of HRV, RR intervals differing more than 50ms(NN50), and divided by the total number of all RR intervals(pNN50) have significant differences in each sleep stage. Specially, the mean HRV has an average of 87.8% accuracy in classifying sleep and awake status. In the future, the measurement ECG signal minimizes inconvenience of attaching sensors during sleep. Also, it can be substituted for the standard sleep measurement method.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.3
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• pp.99-103
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• 2021

The purpose of this review is to examine the clinical use of functional near-infrared spectroscopy (fNIRS) in children and adolescents with psychiatric disorders. Many studies have been conducted using objective evaluation tools for psychiatric evaluation, such as predicting psychiatric symptoms and treatment responses. Compared to other tools, fNIRS has the advantage of being a noninvasive, inexpensive, and portable method and can be used with patients in the awake state. This study mainly focused on its use in patients with attention-deficit/hyperactivity disorder and autism spectrum disorder. We hope that research involving fNIRS will be actively conducted in various diseases in the future.

• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.3
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• pp.213-217
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• 2024

Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.103-110
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• 1994

To find out the predictors of nocturnal arterial oxygen desaturation in patients with respiratory diseases, transcutaneous oxygen saturation($StcO_2$) monitoring studies using a pulse oximeter were performed during sleep in 20 patients. $StcO_2$ was decreased more than 4% from the baseline value in 18 patients(90%) and more than 10%("Desaturator") in 8(40%). Five of the seven patients(71.4%) with awake $PaO_2$<60mmHg and three of the thirteen patients(23.1%) with awake $PaO_2{\geq}60mmHg$ were "desaturators". The awake $PaO_2/FIO_2$ and $PaO_2/PAO_2$ could distinguish "desaturator" from "nondesaturator", and $PaO_2,\;SaO_2$ or $StcO_2$ could not. These results suggest that the nocturnal oxygen desaturation depends on the severity of the underlying disease rather than the baseline $PaO_2$. Anthropomorphic and lung function factors could not separate between "desaturator" and "non-desaturator", and about a quater of patients with a wake $PaO_2{\geq}60mmHg$ developed significant desaturation. Therefore, it is necessary to monitor the nocturnal arterial oxygen saturation in patients with respiratory diseases regardless of their severity of airflow obstruction or awake $PaO_2$.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.57-65
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• 1997

As jet lag of modern travel continues to spread, there has been an exponential growth in popular explanations of jet lag and recommendations for curing it. Some of this attention are misdirected, and many of those suggested solutions are misinformed. The author reviewed the basic science of jet lag and its practical outcome. The jet lag symptoms stemed from several factors, including high-altitude flying, lag effect, and sleep loss before departure and on the aircraft, especially during night flight. Jet lag has three major components; including external de synchronization, internal desynchronization, and sleep loss. Although external de synchronization is the major culprit, it is not at all uncommon for travelers to experience difficulty falling asleep or remaining asleep because of gastrointestinal distress, uncooperative bladders, or nagging headaches. Such unwanted intrusions most likely to reflect the general influence of internal desynchronization. From the free-running subjects, the data has revealed that sleep tendency, sleepiness, the spontaneous duration of sleep, and REM sleep propensity, each varied markedly with the endogenous circadian phase of the temperature cycle, despite the facts that the average period of the sleep-wake cycle is different from that of the temperature cycle under these conditions. However, whereas the first ocurrence of slow wave sleep is usually associated with a fall in temperature, the amount of SWS is determined primarily by the length of prior wakefulness and not by circadian phase. Another factor to be considered for flight in either direction is the amount of prior sleep loss or time awake. An increase in sleep loss or time awake would be expected to reduce initial sleep latency and enhance the amount of SWS. By combining what we now know about the circadian characteristics of sleep and homeostatic process, many of the diverse findings about sleep after transmeridian flight can be explained. The severity of jet lag is directly related to two major variables that determine the reaction of the circadian system to any transmeridian flight, eg., the direction of flight, and the number of time zones crossed. Remaining factor is individual differences in resynchmization. After a long flight, the circadian timing system and homeostatic process can combine with each other to produce a considerable reduction in well-being. The author suggested that by being exposed to local zeit-gebers and by being awake sufficient to get sleep until the night, sleep improves rapidly with resynchronization following time zone change.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.751-757
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• 2007

Objectives : The aim of this study was to provide basic background information on stroke by evaluating various etiological factors on the basis that the onset time of cerebral infarction varies according to its cause. Methods : We studied hospitalized patients within 4 weeks after their ictus who were admitted at Kyunghee OMC, Kyungwon OMC, or Donguk Ilsan OMC from [month] $1^{st}$, 2005 to June $30^{th}$, 2007. We compared the general characteristics of acute stroke patients according to onset time. Results : Regardless of the onset time, the distribution of cerebral infarction patterns showed high SVO. The onset time did not show significant difference for average age, height, weight, BMI, waist measurement, hip measurement, or waist/hip ratio between onset during sleep and awakening. Patients whose stroke occurred while awake were more likely to have a past history of HTN, DM, ischemic heart disease, or atrial fibrillation but did not show significant difference according to their onset time. Conclusions : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their onset time. This study was carried out on the basis of previous findings that cerebral infarctions that occurred during sleep were more likely to have been caused by cerebral thrombosis, and strokes that occurred while awake were more likely to have been caused by cerebral embolism. However, there were no statistically relevant results, so a larger study group is needed to research the tendency of stroke patients.

• Journal of Chest Surgery
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• v.52 no.6
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• pp.392-399
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• 2019

Background: The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA). Methods: Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group. Results: There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period. Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.

• Journal of the Korean Society of Food Culture
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• v.27 no.3
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• pp.240-250
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• 2012

This study was performed to investigate the consumption of coffee beverages and energy contribution ratios of coffee beverages and accompanying snacks by college students in Deajeon City and Chungnam Province in Korea. Questionnaire survey, dietary survey, and snack survey using food record method during 3-days were carried out. As a result, we found that 86.9% of male students and 75.6% of female students consumed coffee beverages usually, with no differences between the two groups. However, the frequency of coffee beverages consumed by female students out-numbered that of male students by 1 cup a day to 1-2 cups a week (p<0.05). Furthermore, male students most likely consumed coffee beverages at schools or academies, but female students consumed them at coffee shops (p<0.01). The reasons male students gave to consume coffee beverages were for scent, taste, fatigue, and to stay awake. Similarly, the reasons female students gave to consume coffee beverages were for scent, taste, habit, and to stay awake (p<0.01). Fully 58.1% of male students and 80.0% of female students ate snacks along with coffee beverages (p<0.01). Most male students substituted a coffee beverage and accompanying snack for a regular meal once a month. Female students were doing it at most 2-3 times a month (p<0.05). The mean daily dietary energy intake of male students was 1,924 kcal/d, and of female students was 1,518 kcal/d (p<0.001), which both were below the estimated energy requirements. Male students obtained 285.6 kcal/d and female students obtained 289.5 kcal/d from coffee beverages and accompanying snacks. There was a significant different in dietary intake of energy (p<0.05), calcium, and iron (p<0.001) for each ratio of reference intake between male and female students. The students who ate larger amounts of coffee beverages and accompanying snacks consumed less dietary energy, protein, calcium, and iron, respectively (p<0.05). These results show that many students consume coffee beverages regularly and obtain large amounts of energy from coffee beverages and accompanying snacks. It also shows that student's dietary nutrient intake tends to be poorer, as he or she obtains more energy from coffee beverages and accompanying snacks. Therefore, it is critical to monitor the influence of consumption of coffee beverages and accompanying snacks on the dietary nutrient intakes and health of college students, and to provide nutrition education about the proper consumption of coffee beverages and accompanying snacks based on scientific evidence.

• Journal of Korean Medicine for Obesity Research
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• v.20 no.1
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• pp.40-51
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• 2020

Objectives: We aimed to compare the quality of sleep, tongue diagnosis, oral microbiology differences in insomnia of Liver qi stagnation (LQS) and Non-Liver qi stagnation (NLQS). Methods: 56 patients were classified as LQS or NLSQ type insomnia through the insomnia differentiation questionnaire. The depression scores between the groups were compared through beck depression inventory (BDI), and the sleep quality was compared through Pittsburgh sleep quality index (PSQI) and Insomnia Severity Index (ISI). We analyzed the sleep efficiency, total sleep time, total awake frequency, total and average awake time through actigraph. For the tongue diagnosis, the distribution of tongue coating in six areas were measured through Winkel tongue coating index (WTCI). Linear discriminant analysis was performed to observe the differences in composition of microbial strains between the groups. Results: The scores of BDI, ISI and PSQI were significantly higher in LQS group. The total sleep time in LQS group was significantly less than that of NLQS group. Among the areas of tongue, according to the WTCI, the amount of tongue coating in zones A and C was significantly small. In oral microbial analysis, there was no significant difference between the groups at the phylum level. At the genus level, Prevotella, Veillonella, and Streptococcus were predominant in LQS group, whereas Prevotella, Neisseria, and Streptococcus in NLQS group. Conclusions: It was meaningful that insomnia was more likely in LQS group than in NLQS group, and the composition of oral microorganisms was significantly different, which could lead to the diseases caused by stress.