• 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.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.66-76
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• 1997

Objectives : The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. Methods : Epidemiological survey was performed at home by means of semi structured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. Results : (1) The mean retiring time was 10.28 h (SD 1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h). The mean sleep onset time was 44.51 min. The mean frequency of daytime napping was 2.49 (SD 3.23). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. Conclusions : The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.290-297
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• 1997

Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

• Tuberculosis and Respiratory Diseases
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• v.64 no.5
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• pp.356-361
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• 2008

Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.

• Journal of the Korean Society of Marine Environment & Safety
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• v.23 no.1
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• pp.91-97
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• 2017

This study contains research on a bio-monitoring system (BMS) capable of detecting abnormal high water temperatures, the shell valve movements (SVMs) of Pacific oysters (Crassostrea gigas), which were measured at four different temperature (5, 10, 20 and $30^{\circ}C$) under laboratory conditions. All the Pacific oysters were kept under fasting conditions for 3 days to prevent the influence of food and excretions before the onset of the experiments. SVMs did not detect at $5^{\circ}C$. However, SVMs increased with an increase in temperature (at $10^{\circ}C$ : $6.31{\pm}2.18times/hr$ and at $20^{\circ}C$: $22.0{\pm}10.0times/hr$). At $30^{\circ}C$, SVMs were divided into two groups: those with no SVMs as at $5^{\circ}C$ and those with SVMs similar to conditions at $20^{\circ}C$($23.9{\pm}9.35times/hr$). This indicates oyster shells maintain a closed condition due to a decrease in metabolism at $30^{\circ}C$, although some Pacific oysters had active SVMs due to an increase in metabolism. If a BMS using the SVM status of Pacific oysters was installed to monitor abnormal high water around oyster farms, early warning levels and serious alerts might be made available more rapidly for SVMs of more than ca. 30 times/hr and closing conditions in a matter of hours, respectively. Therefore, a BMS using the SVMs of Pacific oysters might be an effective early warning system for abnormal high water temperatures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.6.2-7
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• 1977

Hoarseness, caused by any condition that interfers with normal phonatory function of larynx, is the most important symtom of the laryngeal disease. The air pollution is the serious social problom today due to irritation of the respiratory mucosa and secondary respiratory disease. It is significant to study whether, in resent years, the patients with complant of hoarseness has being increased or decreased, compare to past years. The authors report a statistical analysis on 400 cases with chief complain of horseness at the Department of Otolaryngology, Hanil Hospital during past 7 years from Jan. I, 1970 to Dec. 31, 1976. The results were as follows; 1) Among total out patients of 14, 731 who visited to the department of otolaryngology, the patients with hoarseness numbered to 400(2.7%). 2) Among total of 400 cases, male were 211 and female were 189. The incidence was slightly higher in male than female with ratio 1.1 to 1 in sex distribution. 3) The uderlying diseases causing hoarseness in order of frequency were Acute Laryngitis (158 cases, 39.5%), Chronic Laryngitis (103 cases, 27.3 %), Vccal Nodule (37 cases, 9.3%), Vocal cord paralysis (34 cases, 8.5%), Laryngeal Polyp (32 cases, 8%), Laryngeal Ca. (13 cases, 3.5%), and Laryngeal Tbc. (9 cases, 2.3%). Particulary, Laryngeal Ca., Laryngeal polyp and Laryngeal Papilloma were extremely high in male but the remainings were equally distributed in sex group distribution. 4) The highest incidence occurred in 3rd decade (113 cases, 28.5%), the next 4th and 2nd decade in the age group distribution. Acute and Chronic Laryngitis were widely distributed in age group distribution but the highest incidence was noted between 3rd and 4th decade (145 cases, 55.5%). The highest incidence was 3rd decade in Laryngeal polyp, 3rd and 4th decade in Vocal Nodule, 4th and 5th decade in Laryngeal Tbc. and Vocal cord paralysis and 5th decade in Laryngeal Ca. 5) The underlying disease causing hoarsness were evenly occurred in monthly distribution but relatively high incidence was observed between April and June (35.5%) compared to winter. 6) In durational distribution, the highest incidence was within 10 days (26%) from onset to consultation. 317 cases (80%) were visited to the clinic within 1 year.

• Journal of agricultural medicine and community health
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• v.26 no.1
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• pp.65-79
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• 2001

Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

• Tuberculosis and Respiratory Diseases
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• v.39 no.6
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• pp.474-483
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• 1992

Background: Regardless of its causes, acute lung injury is characterized pathophysiologically by increased pulmonary arterial pressure and the protein-rich edema. Many inflammatory mediators are known to be involved in the pathogenesis of acute lung injury, including oxygen free radicals (OFR). But the changes in pulmonary capillary pressure in the OFR-induced acute lung injury is not clear. While the pulmonary edema characterized by the movement of fluid and solutes is dependent on the pressure gradient and the alveolar-capillary permeability, the role of pulmonary capillary pressure in the development of pulmonary edema is also not well understood. Method: Male Sprague-Dawley rats were divided into 5 groups: normal control (n=5), xanthine/xanthine oxidase (X/XO)-treated group (n=7), catalase-pretreated group (n=5), papaverine-pretreated group (n=7), and indomethacin-pretreated group (n=5). In isolated perfused rat lungs, the sequential changes in pulmonary arterial pressure, pulmonary capillary pressure by double occlusion method, and lung weight as a parameter of pulmonary edema were determined. Results: Pulmonary arterial pressure and pulmonary capillary pressure were increased by X/XO. This increase was significantly attenuated by catalase and papaverine, but indomethacin did not prevent the X/XO-induced increase. Lung weight gain was also observed by X/XO perfusion. It was prevented by catalase. Papaverine did not completely block the increase, but significantly delayed the onset. Indomethacin had no effect on the increase in lung weight. Conclusion: These data suggest that increased pulmonary capillary pressure by OFR may aggravate pulmonary edema in the presence of increased alveolar-capillary permeability and this may not be mediated by cyclooxygenase metabolites.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.774-779
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• 2000

Pseudomembranous colitis, although uncommon, is an important complication of antibiotics that is related to a variety of deleterious effects on the gastrointestinal tract. Rifampicin is one of the 1st line agents in the treatment of tuberculosis and a large number of patients are exposed to its potential adverse effects. We report upon a patient that had diarrhea due to pseudomembranous colitis after receiving antitubeculous medication, and which was probably caused by rifampicin. A 77-year-old man was admitted with diarrhea of three weeks duration. One month previously, he suffered from left pleuritic chest pain and left pleural effusion was noticed at chest X-ray. One week prior to the onset of diarrhea, he was started on empirically isoniazid, rifampicin, ethambutol and pyrazynamide as antituberculous medication. On admission, he complained of diarrhea, left pleuritic chest pain, dyspnea and sputum. On physical examination, breathing sound was decreased in the left lower lung field and bowel sound increased. Pleural biopsy revealed chronic granulomatous inflammation, which was compatible with tuberculosis, Sigmoidoscopy showed whitish to yellowish pseudomembrane with intervening normal mucosa, and his stool was positive for C.difficle toxin. He was diagnosed as pseudomembranous colitis and treated with oral metronidazole and vancomycin. The diarrhea did not recur after reinstitution of the anti-tuberculous medication without rifampicin inpatients with severe diarrhea receiving anti-tuberculous medication, rifampicin induced pseudomembranous colitis should be excluded.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.1
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• pp.55-60
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• 2010

Purpose: The shrinkage of dental resin cement may cause several clinical problems such as distortion that may jeopardize the accurate fit to the prepared tooth and internal stress within the restorations. It is important to know the polymerization shrinkage-strain of dental resin cement to reduce clinical complications. The purpose of this study was to investigate the polymerization shrinkage-strain kinetics of six commercially available dental resin cements. Material and methods: Three self-cure resin cements (Fujicem, Superbond, M-bond) and three dual-cure resin cements (Maxcem, Panavia-F, Variolink II) were investigated. Time dependent polymerization shrinkage-strain kinetics of the materials were measured by the Bonded-disk method as a function of time at $23^{\circ}C$, with values particularly noted at 1, 5, 10, 30, 60, 120 min after mixing. Five recordings were taken for each materials. The data were analyzed with one-way ANOVA and Scheffe post hoc test at the significance level of 0.05. Results: Polymerization shrinkage-strain values were 3.72%, 4.19%, 4.13%, 2.44%, 7.57%, 2.90% for Fujicem, Maxcem, M bond, Panavia F, Superbond, Variolink II, respectively at 120 minutes after the start of mixing. Panavia F exhibited maximum polymerization shrinkage-strain values, but Superbond showed minimum polymerization shrinkage-strain values among the investigated materials (P < .05). There was no significant differences of shrinkage-strain value between Maxcem and M bond at 120 minutes after the start of mixing (P > .05). Most shrinkage of the resin cement materials investigated occurred in the first 30 minutes after the start of mixing. Conclusion: The onset of polymerization shrinkage of self-cure resin cements was slower than that of dual-cure resin cements after mixing, but the net shrinkage strain values of self-cure resin cements was higher than that of dual-cure resin cements at 120 minutes after mixing. Most shrinkage of the dental resin cements occurred in the first 30 minutes after mixing.