• Title/Summary/Keyword: control analysis

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The Effects of Modafinil on Clinical Features and Sleep Structure of Narcolepsy Patients and Healthy Controls (모다피닐이 기면병 환자와 대조군의 임상 양상과 수면구조에 구조에 미치는 영향)

  • Shin, Hong-Beom;Jeong, Do-Un;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.67-74
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    • 2006
  • Introduction: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. Methods: Twelve narcoleptic patients (7 male, age: $22.9{\pm}2.6\;yrs$) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. Results: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. Discussion: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.

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Analysis of rpoB Gene in Rifampin-Resistant M. Tuberculosis by Direct Sequencing and Line Probe Assay (염기서열결정과 Line Probe 분석법에 의한 Rifampin내성 결핵균의 rpoB 유전자 분석)

  • Lee, Min-Ki;Kim, Yun-Seong;Lee, Hyo-Jin;Cheon, Du-Su;Yun, Sang-Myung;Park, Sam-Seok;Kim, Cheol-Min;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.251-263
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    • 1997
  • Background : The emergence of multidrug-resistant strains of Mycobacterium tuberculosis presents a significant challange to the treatment and control of tuberculosis, and there is an urgent need to understand the mechanisms by which strains acquire multidrug resistance. Recent advances in molecular methods for the detection of M. tuberculosis genetic targets have approached the sensitivity of culture. Furthermore the prospect of determining resistance in mycobacteria at the nucleic acid level particulary to first-line drugs like rifampin, isoniazid has provided a glimps of the next generation of sensitivity test for M. tuberculosis. Previous studies in RMP resistant M. tuberculosis have shown that mutation in $\beta$subunit of RNA polymerase is main mechanism of resistance. Method : In this study, rpoB gene for the $\beta$subunit of RNA polymerase from M. tuberculosis of 42 cultured samples (32 were RMP resistant and 10 were sensitive cases) were isolated and characterised the mutations. Direct sequencing data were compared with the results of INNO-LiPA Line Probe Assay (LiPA, Innogenetics, Belgium), commercial RMP resistance detecting kit using reverse hybridization method. Results : All of the RMP resistant samples were revealed the presence of mutation by LiPA. In 22 samples (68.8%) out of 32 RMP resistant cases, the mutation types were confirmed by the positive signal at one of 4 mutation bands in the strip. The most frequent type was R5 (S531L) which were 17 cases (77.3%). Results of direct sequencing were identified the exact characteristics of 8 mutations which were not confirmed by LiPA. S522W type point mutation and 9 base pair deletion at codon 513~515 were new identified mutations for the first time. Conclusion : Mutations in rpoB gene is the main mechanism of RMP resistance in M. tuberculosis and LiPA is a very useful diagnostic tool for the early diagnosis of RMP resistance in M. tuberculosis.

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Dysfunction of Autonomic Nervous System in Patients with Chronic Obstructive Pulmonary Diseases (만성 폐쇄성 폐질환 환자의 자율신경 장애)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.317-326
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    • 1999
  • Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.

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Vascular Endothelial Growth Factor and Matrix Metalloproteinase-9 in Acute Asthma (급성 천식환자에서 Vascular Endothelial Growth Factor와 Matrix Metalloproteinase-9)

  • Park, Kang-Seo;Jin, Hung-Yong;Choi, Eu-Gene;Lee, Heung-Bum;Rhee, Yang-Keun;Lee, Yong-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.530-539
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    • 2001
  • Background : Bronchial asthma is an inflammatory disease of the airways that is associated with airway remodeling. The vascular endothelial growth factor (VEGF) is a potent, multifunctional cytokine that contributes to angiogenesis and inflammation. Matrix metalloproteinase-9 (MMP-9) is a major proteolytic enzyme that in duces bronchial remodeling in asthma. However, there is no data available on the possible role of the VEGF or on the potential relationship between the VEGF and MMP-9 in acute asthma. Therefore, the VEGF was studied to determine whether or not it participates in airway inflammation during acute asthma. An additional aim of this study was to determine whether or not the VEGF levels correlated with the MMP-9 levels in the sputum of acute asthma patients. Methods: Both the VEGF and MMP-9 levels were measured by an enzyme immunoassay and zymographic analysis in the sputum of patients with either stable asthma or with acute asthma. The VEGF and MMP-9 levels were also evaluated during a spontaneous asthma attack. Results : The VEGF levels were significantly higher in the sputum of acute asthmatic patients than in either the stable patients the control subjects. The VEGF levels in the sputum during asthma exacerbation were significantly higher than those on the remission days, and those levels decreased after asthma therapy. In acute asthmatic patients, the VEGF levels in the sputum correlated with the number of neutrophils and eosinophils. In addition, a significant correlation was established between the VEGF and MMP-9 levels in the sputum. Conclusion : These results suggest that VEGF overproduction is associated with airway inflammation during acute asthma and is related to the MMP-9 function.

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Effects of Heat, pH, and Gamma Irradiation Treatments on Lipase Inhibitory Activity of Sargassum thunbergii Ethanol Extract (지충이(Sargassum thunbergii) 에탄올 추출물의 Lipase 저해활성에 미치는 열, pH 및 감마선 조사의 영향)

  • Kim, Dong-Hyun;Kim, Koth-Bong-Woo-Ri;Kim, Min-Ji;SunWoo, Chan;Jung, Seul-A;Kim, Hyun-Jee;Jeong, Da-Hyun;Kim, Tae-Wan;Cho, Young-Je;Ahn, Dong-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.4
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    • pp.566-570
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    • 2012
  • Inhibitory activity of $Sargassum$ $thunbergii$ (ST) against porcine pancreatic lipase was assessed after heat treatment, pH changes, and gamma irradiation. This analysis revealed that the ST ethanol extract exhibited high lipase inhibitory activity (37.37%) at 5 mg/mL. The ST ethanol extract was treated with heat at $60^{\circ}C$ for 10, 30, and 60 min; 80 and $100^{\circ}C$ for 10 and 20 min; and $121^{\circ}C$ for 15 min, pH (2, 4, 6, 8 and 10) and ${\gamma}$-irradiation (3, 7 and 20 kGy). The lipase inhibitory activity of the ST ethanol extract increased in all heat treatments, especially at $121^{\circ}C$ for 15 min (51.55%) compared with the control. With regard to pH stability, the ST ethanol extract showed no significant changes at pH 4~8, but somewhat decreased inhibitory activity was revealed at pH 2 (26.25%) and 10 (29.93%). On the other hand, the ST ethanol extract was not affected by ${\gamma}$-irradiation treatment conditions used in this study. These results suggest that ST has a potential role as a functional food agent.

Learning Material Bookmarking Service based on Collective Intelligence (집단지성 기반 학습자료 북마킹 서비스 시스템)

  • Jang, Jincheul;Jung, Sukhwan;Lee, Seulki;Jung, Chihoon;Yoon, Wan Chul;Yi, Mun Yong
    • Journal of Intelligence and Information Systems
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    • v.20 no.2
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    • pp.179-192
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    • 2014
  • Keeping in line with the recent changes in the information technology environment, the online learning environment that supports multiple users' participation such as MOOC (Massive Open Online Courses) has become important. One of the largest professional associations in Information Technology, IEEE Computer Society, announced that "Supporting New Learning Styles" is a crucial trend in 2014. Popular MOOC services, CourseRa and edX, have continued to build active learning environment with a large number of lectures accessible anywhere using smart devices, and have been used by an increasing number of users. In addition, collaborative web services (e.g., blogs and Wikipedia) also support the creation of various user-uploaded learning materials, resulting in a vast amount of new lectures and learning materials being created every day in the online space. However, it is difficult for an online educational system to keep a learner' motivation as learning occurs remotely, with limited capability to share knowledge among the learners. Thus, it is essential to understand which materials are needed for each learner and how to motivate learners to actively participate in online learning system. To overcome these issues, leveraging the constructivism theory and collective intelligence, we have developed a social bookmarking system called WeStudy, which supports learning material sharing among the users and provides personalized learning material recommendations. Constructivism theory argues that knowledge is being constructed while learners interact with the world. Collective intelligence can be separated into two types: (1) collaborative collective intelligence, which can be built on the basis of direct collaboration among the participants (e.g., Wikipedia), and (2) integrative collective intelligence, which produces new forms of knowledge by combining independent and distributed information through highly advanced technologies and algorithms (e.g., Google PageRank, Recommender systems). Recommender system, one of the examples of integrative collective intelligence, is to utilize online activities of the users and recommend what users may be interested in. Our system included both collaborative collective intelligence functions and integrative collective intelligence functions. We analyzed well-known Web services based on collective intelligence such as Wikipedia, Slideshare, and Videolectures to identify main design factors that support collective intelligence. Based on this analysis, in addition to sharing online resources through social bookmarking, we selected three essential functions for our system: 1) multimodal visualization of learning materials through two forms (e.g., list and graph), 2) personalized recommendation of learning materials, and 3) explicit designation of learners of their interest. After developing web-based WeStudy system, we conducted usability testing through the heuristic evaluation method that included seven heuristic indices: features and functionality, cognitive page, navigation, search and filtering, control and feedback, forms, context and text. We recruited 10 experts who majored in Human Computer Interaction and worked in the same field, and requested both quantitative and qualitative evaluation of the system. The evaluation results show that, relative to the other functions evaluated, the list/graph page produced higher scores on all indices except for contexts & text. In case of contexts & text, learning material page produced the best score, compared with the other functions. In general, the explicit designation of learners of their interests, one of the distinctive functions, received lower scores on all usability indices because of its unfamiliar functionality to the users. In summary, the evaluation results show that our system has achieved high usability with good performance with some minor issues, which need to be fully addressed before the public release of the system to large-scale users. The study findings provide practical guidelines for the design and development of various systems that utilize collective intelligence.

Manufacturing and Establishment of the 2nd National Standard for Varicella Vaccine (수두생바이러스백신 국가표준품 (2차) 제조 및 확립에 관한 연구)

  • Kim, Yeon-Hee;Kim, Do-Keun;Sohn, Yeo-Won;Han, Eui-Ri;Kim, Seok-Hwan;Lim, Jong-Mi;Won, Yun-Jung;Yoon, Heui-Seong;Jo, Moon-Hee;Kim, Kwan-Soo;Kim, Jae-Ok
    • KSBB Journal
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    • v.25 no.6
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    • pp.572-576
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    • 2010
  • Biological products, such as live varicella vaccine, are composed of biological substances derived from biological organisms. It is very difficult to identify these biologics' characteristics by analysis of simple physical and chemical methods alone. So the reference material is essential in order to evaluate the quality of bilogics. The 1'st national standard for varicella live vaccine was manufactured, established in 2002 and 2003, and have been used for the manufacturer's quality control and national lot release since then. As the lack of its availability and the decrease of its stability, this study was initiated by National Institute of Food and Drug Safety Evaluation (NiFDS) in 2008 to manufacture and establish the 2nd national standard for varicella live vaccine. The candidate material was manufactured from one of domestic manufacterers and the joint research of the NiFDS and manufacturers of varicella live vaccine was conducted to estimate of the reliable virus content. In the collaborative study, 3 laboratories including NiFDS performed the virus content test more than 7 times and all assay results were statistically analyzed. The mean coefficient of variation (CV) was 1.24%, and the geometric mean titre (GMT) variation range of each laboratory was low. On the basis of the results of this study, the candidate material of 2nd national standard for varicella live vaccine was assigned a potency of 4.26 log10 pfu/0.5 mL, when reconstituted in 0.7 mL.

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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Influence of Dental Hygienists' Core Competencies on Job Performance (치과위생사의 핵심역량이 직무성과에 미치는 영향)

  • Park, Jung Hyun;Lee, Yu Hee
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.142-149
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    • 2017
  • This study targeted 123 dental hygienists working at the university and dental hospital as well as the dental clinic in Busan. The study ran for 5 months beginning July 23, 2016. The purpose of the study was to understand the relationship between core competencies and job performance for dental hygienists. The major core competencies of dental hygienists were interpersonal relation competency (3.61) was the highest, followed by management and educational competency (3.59), organizational relation competency (3.57), and basic dental hygiene management competency (3.56). Regarding the subjects' job performance, 'the task requested by a boss could be finished by the deadline' (3.93) was the highest, followed by 'there has been no case where others were harmed owing to carelessness' (3.76). 'The performance exceeding the targets set by the boss' (3.11) was relatively low. The group working for dental hospitals showed higher job performance than the group working for dental clinics (p=0.009) while there were high correlations between core competencies and job performance (p=0.733). Also, analysis for understanding relevant variables of core competencies that affected job performance revealed that the interpersonal relation competency (p=0.25), self-control competency (p=0.32), and basic dental hygiene competency (p=0.15) were significant. In summary, reinforcement of the dental hygienists' core competencies has a positive effect on job performance. Improved job performance in turn should improve patient care as well as the performance of the healthcare organization overall which will be eventually helpful to the provision of high-quality medical service to patients, and helpful for the hospital organization Helpful in making their performance better. Therefore, it would be necessary to establish administrative/educational support to facilitate dental hygiene education to develop major competencies and vocational basic abilities, as well as reinforce diverse competency educational programs for the current dental hygienists.

Ecological Management of Sangnim Woods in Hamyang-gun, Korea by Analysis of Ecological Structure (함양 상림의 환경생태적 구조 분석 및 생태적 관리방안1)

  • 한봉호;김종엽;조현서
    • Korean Journal of Environment and Ecology
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    • v.17 no.4
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    • pp.324-336
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    • 2004
  • This study was achieved to present ecological administration plan by analyzing vegetation structure and condition rating class(environmental damage degree) of Sangnim Woods Natural Monument in Hamyang-gun, Korea. In vegetation structure part, actual vegetation was classified by 22 patterns and Quercus serrata Carpinus tschonoskii community(31.8%), Quercus serrata community(14.6%) ranged extensively. Main plant community was 8 types, and is fractionated by 13 plant communities according to stratigraphy development degree it is Quercus serrata community, Quercus serrata Carpinus tschonoskii community, Quercus aliena community, Quercus acutissima community, Carpinus tschonoskii community, Carpinus tschonoskii Quercus serrata community, Zelkova serrata-Quercus serrata community, and Planted area with korean landscape woody plants. Age of old growth trees that diameter of breast height over 38cm was 61∼77years. In condition rating class, area of class 3 was 51,960$m^2$(32.8%), area of class 4 was 6,583$m^2$(3.5%), and area of class 5 was 4,086$m^2$(2.6%) and gross area of class 3∼6 need artificial restoration was 61,619$m^2$(38.9%). Considering actual vegetation, plant community structure, and condition rating class biotope was classified by total 14 types. While distribution area of Queens spp. old growth forest of shrub damaged(51,246$m^2$, 32.4%) and deciduous broad leaved old growth forest of simple-layer structure(19,906$m^2$, 12.6%) is large and that of deciduous broad-leaved old growth forest of multi-layer structure(2,085$m^2$, 1.3%) and Queens spp. old growth forest of multi-layer structure may have to manage with user control by administration plan for stabilization of Sangnim Woods ecosystem for long-term. Also, both vegetation of shrub damaged and simple-layer structure as negative restoration area should be restored for ecological succession and both grassland and planted area with korean woody plants as positive restoration area should be revegetated by using ecological planting model of native vegetation structure in Sangnim Woods.