This study aimed to investigate the levels of Obstructive Sleep Apnea (OSA), health behavior and sleep quality and to examine the predictors of OSA in patients with ischemic cardio-cerebrovascular disease. 141 patients who were admitted to the vascular unit were recruited and surveyed using structured questionnaires. Saturation of Peripheral Oxygen (SpO2) was measured at three time points using a pulse oximeter. Data were analyzed using SPSS/WIN 20.0. The mean age of the subjects was $64.4{\pm}11.1$ years and 61% was men. The 21.3%(n=30) of the subjects were classified as high-risk for OSA by the cut point and 71.6%(n=101) had low sleep quality. OSA high-risk group showed significant difference in SpO2 in the middle of sleep (p=.006) and at the end of sleep (p=.004) compared to the low-risk group. Multiple logistic regression analysis showed that perceived frequent snoring, smoking, obesity, lack of exercise among health behavior were found as predicting factors on OSA. OSA or persistent snoring should be recognized as a cardiovascular risk factor in the cardiovascular nursing practice. In addition to early treatment of OSA, education and counseling should be provided to patients and their family for prevention of secondary recurrence.
We investigated the effect of brown-rice vinegar (BRV) ingestion after strenuous Wingate tests on energy substrates during a 2 hr recovery period. For this, seven healthy male adolescents were chosen as subjects. They performed 3 Wingate tests to induce fatigue, after which they ingested brown-rice vinegar (BRV) drink and/or water as a control (CON) after 15 min of the test. Blood was obtained pre-exercise and 30 min, 60 min, and 120 min post-exercise, and blood glucose, lactate, free fatty acids, ammonia, and cortisol were analyzed. After 120 min of recovery period, the 4th Wingate test was conducted to calculate the power recovery ratio of the 3rd and 4th trials. Breathing frequency, oxygen saturation, and heart rate did not show significant changes. Blood glucose level was lower in CON than BRV after 120 min of recovery, and blood lactate and ammonia levels were lower in BRV at 60 and 120 min. The higher free fatty acids were found at 60 and 120 min in BRV. In addition, Wingate power recovery ratio of peak power and peak power/body weight was significantly higher in BRV compared to CON. These results suggested that BRV ingestion after strenuous exercise facilitates fatigue recovery. Therefore, BRV might be effectively used as an ergogenic aid for events in which competitors compete two or more times a day.
Biogeochemical characteristics involving redox processes in groundwater from a riverine alluvial aquifer was investigated using multi-level monitoring wells (up to 30m in depth). Anaerobic conditions were predominant and high Fe ($14{\sim}37mg/L$) and Mn ($1{\sim}4mg/L$) concentrations were observed at 10 to 20 m in depth. Below 20 m depth, dissolved sulfide was detected. Presumably, these high Fe and Mn concentrations were derived from the reduction of Fe- and Mn-oxides because dissolved oxygen and nitrate were nearly absent and Fe and Mn contents were considerable in the sediments. The depth range of high Mn concentration is wider than that of high Fe concentration. Dissolved organics may be derived from the upper layers. Sulfate reduction is more active than Fe and Mn reduction below 20 m in depth. Disparity of calculated redox potential from the various redox couples indicates that redox states are in disequilibrium condition in groundwater. Carbonate minerals such as siderite and rhodochrosite may control the dissolved concentrations of Fe(II) and Mn(II), and iron sulfide minerals control for Fe(II) where sulfide is detected because these minerals are near saturation from the calculation of solubility equilibria.
Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. Methods This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 ${\mu}g/mL$ remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 ${\mu}g/mL$ and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Results Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Conclusions Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.
Glucose fed-batch culture was studied to improve cellulose productivity by Acetobacter xylinum BRC5. When initial glucose concentrations in batch cultures were less than 20 g/L, yield coefficients of cellulose (Yp/s) remained a constant value of 0.21 g cellulose/g glucose. But a low yield coefficient, Yp/s=0.13 was obtained from an initial glucose concentration of 40 g/L. Since initial high glucose concentrations in batch culture resulted in low yields of cellulose, constant fed-batch cultures were carried out. The optimal feed rate for fed-batch culture was 2.22 g glucose/L.h. In constant fed-batch culture without DO control, 10 g/L of cellulose was obtained from 40 g/L of glucose with this feed rate, which was approximately two fold higher than that of the batch culture with the same initial glucose concentration. In DO stat plus fed-batch culture, the highest cellulose productivity could be obtained when dissolved oxygen level was controlled at 10% of air saturation, and cellulose productivity increased about 1.5 times compared with that of the culture without DO control.
Shin, Dong-Whan;Cho, Jin-Yong;Han, Yoon-Sic;Sim, Hye-Young;Kim, Hee-Sun;Jung, Da-Un;Lee, Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.43
no.4
/
pp.229-238
/
2017
Objectives: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. Materials and Methods: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study. The initial dose of MDZ was determined by body mass index (BMI) and weight. In the case of insufficient sedation at the beginning of surgery, additional doses were injected. During surgery, peripheral oxygen saturation, bispectral index score (BIS), heart rate, and blood pressure were monitored and recorded. The predictor variables were sex, age, BMI, sleeping time ratio, dental anxiety, Pederson scale, and initial dose of MDZ. The outcome variables were additional administration of MDZ, observer's assessment of alertness/sedation, intraoperative amnesia, and patient satisfaction. Descriptive statistics were computed, and the P-value was set at 0.05. Results: Most patients had an adequate level of sedation with only the initial dose of MDZ and were satisfied with the treatment under sedation; however, 19 patients needed additional administration, and 13 patients were unsatisfied. In multivariable logistic analysis, lower age (odds ratio [OR], 0.825; P=0.005) and higher dental anxiety (OR, 5.744; P=0.003) were related to additional administration; lower intraoperative amnesia (OR, 0.228; P=0.002) and higher BIS right before MDZ administration (OR, 1.379; P=0.029) had relevance to patient dissatisfaction. Conclusion: The preoperative consideration of age and dental anxiety is necessary for appropriate dose determination of MDZ in the minor oral surgery under IVS. The amnesia about the procedure affects patient satisfaction positively.
Purpose: The purpose was to assess the usefulness of midazolam in patients undergoing minor oral surgery under conscious sedation. Materials and methods: Bispectral index was examined in 20 patients receiving oral minor surgery with conscious sedation supplemented with local anesthesia. All patients included were ASA I and had no contraindications to the study medications. The patients were escorted to the day surgery operation room where, before the commencement of the sedation and surgical procedures, routine monitoring was applied, including the noninvasive monitoring of arterial blood pressure, arterial oxygen saturation, and 3-lead electrocardiogram (Electrocardiogram). Bispectral index electrodes were applied on the frontotemporal region after cleansing the skin with alcohol. Bispectral index was calculated with the Electrocardiogram monitor (A-2000; Aspect Co.). Midazolam was then titrated (initially 3mg wait 2min and 2mg). Vital sign and Bispectral index checked every 5 minute until the end of the procedure. The results were then compared. Results: The Bispectral index index values throughout the sedation study period alter many level. The index was dropped at 5 minutes after administration, but raised at injection and odontomy procedure. During the operation, mean Bispectral index index was higher than conscious sedation index range($60{\sim}80$). The amnesic effect was shown 17 cases out of 20 cases(85%). Conclusion: Conscious sedation technique using midazolma is a safe and effective method of controlling behavior in oral and maxillofacial surgery.
This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.
Kim, Jong-Min;Heo, Seong-Nam;Noh, Hye-Ran;Yang, Hee-Jeong;Han, Myung-Soo
Korean Journal of Ecology and Environment
/
v.36
no.2
s.103
/
pp.124-138
/
2003
This paper aimed to analyze the relationship between alga3 bloom patterns and hydrological, limnological data which were collected from major reservoirs in Korea for 8 years (1990${\sim}$1997). Water temperature of river-type reservoirs showed wider seasonal fluctuations than that of lake-type. pH of lake-type reservoirs was low in winter season but high in summer season. In contrast, river-type reservoirs showed high pH in spring and autumn seasons as well, and very low in summer season. COD of lake-type reservoirs and Paldang reservoir was lower (2${\sim}$3 mg/L) than that of Geumgang and Nagdonggang reservoirs (6${\sim}$9 mg/L). Dissolved oxygen (DO) of river-type reservoirs was higher than that of lake-type reservoirs. Seasonal fluctuation pattern of DO saturation in river-type reservoirs was high (80 ${\sim}$100%) and remained relatively constant whereas lake-type reservoirs showed the highest level (93%) in late spring or early summer, which gradually decreased entering winter season(46${\sim}$06%). And monthly variation of DO saturation showed inverse proportion to water volume in lake-type reservoirs. Nutrients concentration in river-type lake is higher than lake-type. Seasonal fluctuation of nutrients (T-N, T-P) in lake-type reservoirs was relatively small than that of river-type reservoirs. Annual mean N/P mass ratio of lake-type reservoirs was higher than that of river-type. Transparency tended to related with the suspended solid concentration in river-type reservoirs. Algal bloom of lake-type and river-type reservoirs occurred at any time except rainfall and winter periods. And it dominated in summer and early autumn, respectively. Algal bloom of river-type reservoirs was higher than that of lake-type. Relationship between rainfall and chlorophyll- a in lake-type reservoirs was relatively high, however river-type reservoirs showed insignificant.
Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.
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