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Supplemental Value of the Wrist-Worn Actigraphy in Diagnosing the Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 진단에서 손목부착형 활동기록기의 보조적 진단가치)

  • Im, Mee-Hyang;Shin, Hong-Beom;Lee, Yu-Jin;Lee, Seung-Hi;Won, Chang-Yeon;Lee, Myung-Hee;Lee, Soo-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.32-38
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    • 2005
  • Objectives: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. Methods: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male:female 20: 7;age $47.6{\pm}12.9$ years old;age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. Results: Mean total sleep time on polysomnography was $401.4{\pm}57.8\;min$ (range of 274.0 to 514.1 min). Mean RDI was $21.7{\pm}20.4/hour$. Mean FI was $21.9{\pm}13.0/hour$. RDI and FI showed significant correlation (r=0.55, p<0.01). Conclusions: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.

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Superoxide Dismutase Gene Expression in the Endotoxin-Treated Rat Lung (내독소에 의한 백서 폐장의 Superoxide Dismutase 유전자 발현에 관한 연구)

  • Yoo, Chul-Gyu;Suh, Gee-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.215-221
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    • 1994
  • Background: It is well known that oxygen free radicals(OFR) play a vital role in the various type of acute lung injury. Among various antioxidant defense mechanisms, the superoxide dismutases(SOD) are thought to be the first line of antioxidant defense by catalyzing the dismutation of two superoxide radicals to yield hydrogen peroxide and oxygen. Eukaryotic cells contain two types of intracellular SOD : cytosolic, dimeric copper/zinc- containing enzyme(CuZnSOD) and mitochondrial, tetrameric manganese-containing enzyme(MnSOD). The purpose of this study is to evaluate the time-dependent gene expression of MnSOD and CuZnSOD in the endotoxin-treated rats, and to compare with the manifestations of LPS-induced acute lung injury in rats. Methods: Total RNA from rat lung was isolated using single step phenol extraction 0, 1, 2, 4, 6, 12, 18, 24 hours after E. coli endotoxin injection(n=3, respectively). RNA was separated by formaldehyde-containing 1.2% agarose gels elctrophoresis, transblotted, baked, prehybridized, and hybridized with $^{32}P$-labeled cDNA probes for rat MnSOD and CuZnSOD, which were kindly donated by Dr. Ho(Duke University, Durham, NC, USA). The probes were labeled by nick translation. Blots were washed and autoradiography were quantitated using laser densitometry. Equivalent amounts of total RNA/gel were assessed by monitoring 28S and 18S rRNA. Results: Endotoxin caused a rise in steady-state MnSOD mRNA levels by 4h with peak mRNA accumulation by 6h. Continued MnSOD mRNA expression was observed at 12h. CuZnSOD mRNA expression was observed from 1h to 24h with peak levels by 18h. Conclusion: These results suggest that SOD palys an important defensive role in the endotoxin-induced acute lung injury in rats.

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Efficacy of deferoxamine on paraquat poisoning (파라쿼트 중독 환자에서 deferoxamine의 치료 효과)

  • Huh, Jin Won;Jegal, Yangjin;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.113-118
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    • 2007
  • Background: Paraquat is known to induce oxidant injury that results in multiorgan failure and lung fibrosis. Iron has been considered to play a key role in paraquat-induced oxidant lung injury. This study examined the effect of deferoxamine, an iron-chelating agent, in the treatment of paraquat poisoning. Methods: From September, 2001 to April, 2005, 28 patients with paraquat poisoning who were admitted at a medical intensive care unit of a University-affiliated hospital, were enrolled in this study. Sixteen patients were treated according to the paraquat poisoning treatment guidelines and 12 received an intravenous infusion of deferoxamine in addition to the treatment guidelines. Results: There were no differences between the two groups in terms of age, gender, severity of paraquat poisoning, and the time elapsed from ingestion to presentation at hospital. There was no difference in overall mortality between the two groups but the incidence of respiratory failure in the deferoxamine group was higher than in the conventional group(4/7 versus 0/9, p=0.019). Conclusion: Deferoxamine seems to have no clinical benefit compared with the conventional treatment.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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GRO-${\alpha}$, IL-8 and ENA-78 : Expressed by Stimulated Endothelial Cells and Increased PMN Adhesion (활성화된 내피세포에서 GRO-${\alpha}$, IL-8 및 ENA-78의 발현양상과 호중구 부착에 미치는 영향)

  • Ryu, Ki-Chan;Kim, Yun-Seong;Kim, Yong-Ki;Kim, In-Ju;Kim, Young-Dae;Lee, Chang-Hun;Park, Do-Youn;Kim, Ji-Yeon;Ha, Tae-Jeong;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.145-155
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    • 2002
  • Background: Inflammation, where vascular endothelial cells are activated by cytokines, recruits circulating leukocytes such as neutrophils into the tissues. Mononuclear phagocytes as well as tissue cells activated by these stimuli produce these chemokines. In this study, thr effects of IL-1 and LPS on the expression of CXC chemokines such as GRO-${\alpha}$, IL-8 and ENA-78 in vascular endothelial cells and the neutrophil adhesion effects of ENA-78 and GRO-${\alpha}$ was investigated. Methods: Human umbilical vein endothelial cells were cultured and stimulated with various concentrations of IL-1 and LPS. The concentrations of the GRO-${\alpha}$, IL-8 and ENA-78 secreted were measured using enzymelinked immunosorbent assay. The effects of ENA-78 and GRO-${\alpha}$ on neutrophil adhesion to the endothelial cells were also investigated. Results: The addition of IL-1 and LPS to the vascular endothelial cells induced GRO-${\alpha}$ IL-8 and ENA-78 secretion in a time- and dose-dependent manner. The neutrophil adhesion was also increased by induction of ENA-78 and GRO-${\alpha}$ to the vascular endothelial cells in a dose-dependent manner. Conclusion: CXC chemokines such as GRO-${\alpha}$, IL-8 and ENA-78 secreted by the vascular endothelial cells play an important role in the acute inflammatory responses by stimulating neutrophil adhesion to the vascular endothelial cells, raising the possibility that the CXC chemokines are one of the targets in the clinical application of acute inflammation.

Structural Features of Various Trichomes in Vitex negundo during Development (방향성 좀목형(Vitex negundo)모용의 구조적 분화발달)

  • Lee, Seung-Hee;Kim, In-Sun
    • Applied Microscopy
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    • v.36 no.1
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    • pp.35-45
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    • 2006
  • Plants of Vitex negundo are known to develop numerous trichomes throughout their body, where certain trichome types have been believed to be one of the plausible structures for the unique scents. In the current study. structural aspects of the trichomes have been examined in leaves and stems of Vitex negundo using TEM and SEM. Trichome types as well as structural changes that occurred in certain trichomes during secretion have been mainly focused. Three type of glandular trichomes and two types of non-glandular trichomes were developed in the epidermis of young and mature Vitex negundo plants. The glandular trichomes included the peltate type (Type 1), the capitate type (Type 2), and degraded capitate type (Type 3), whereas the non-glandular warty trichomes contained the multicellular (Types 4) and unicellular type (Type 5). Type 1 and 2 consisted of head and stalk cells, but their number and size were different. One secretory cavity was formed from the four head cells in the former, but only two head cells were involved in the latter. The cytoplasmic density in the head cell was quite high and in particular, sER and Golgi bodies were well developed. At initiation of their development, the cuticle layer of the head cells separated from the outer tangential wall to form a secretory cavity. Subsequently the cavity expanded acropetally and a large number of secretory vesicles continuously produced from the head cells until they filled the entire cavity. The cavity contained materials that would be soon discharged into intercellular spaces and/or into the air. The cavity began to decrease the volume by contracting at initial secretion but degrade rapidly within short time. It has been suggested that the mode of secretion in V. negundo is probably the eccrine secretion, since no break or rupture of the cavity has been observed during examination. Contrastingly Type 3 exhibited deterioration of the head cell at early stage. Type 4 was about $110{\sim}190{\mu}m$ long, consisting of $2{\sim}3$ cells, and distributed more in the adaxial epidermis compared to the abaxial surface. However, $20{\sim}30{\mu}m$ long Type 5 was extremely dense in both epidermis. Among several trichome types, Type 1 and 2 probably play an important role in discharging unique aromatic scents in plants of V. negundo.

Tendency of 'a Cartoon Image' Appearing in Korean Modern Fine Arts - Ocusing on 'Atomouse' of Lee Dong-gi - (한국 현대 미술에 나타나는 '만화 이미지'의 경향성 -이동기의 <아토마우스>를 중심으로-)

  • Jeon, Young Je
    • Cartoon and Animation Studies
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    • s.36
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    • pp.669-702
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    • 2014
  • Today, in Korean modern fine arts, 'cartoon images' are utilized for their roles of the 'personas' of the artists, and as the 'texts' for the artistic discourses, while they play a role as a bridgehead between the public and art. In this study, we made a study, focusing on 'Atomouse' of Lee Dong-gi, in order to examine how the borrowing of the 'cartoon images' was made in the Korean modern fine arts, and what its period context is. 'Atomouse' of Lee Dong-gi is the first cartoon character that appeared in Korean modern fine arts, and it has acquired a symbolism of a subculture being acknowledged as art. In this study, we tried to find out what period contexts the changes of 'Atomouse' have, focusing on the private exhibitions of Lee Dong-gi, such as 'Smoking' Exhibition (2006), 'Bubble' Exhibition (2008), 'Double Vision' Exhibition (2008), 'The Garden of Uncertainty' Exhibition (2012) and 'Do Not Look Back with Angry Face' Exhibition (2013). Atomouse was born in the era of 'lack of pop' a change was attempted of it in the era of 'excess of pop' and its proceeding ended along with the 'settlement of the neo-pop'. From Atomouse started from the unconsciousness of the artist, we can find the 'identity' of the Republic of Korea, which was being influenced by the 'American and Japanese' culture, as well as the symbolism of a subculture being acknowledged as art, while it emerged as an icon to represent the Korean pop art of the time. Then, as the agony and self-examination of the artist was contained in it, its use was changed into the role as a persona and it was utilized as a tool to connect the and figurative worlds. In the end, the artist put an end to the proceeding of the 'Atomouse' at the boundaries of a persona and an alter ego, removing the creation with his own hands. In the process in which Lee Dong-gi created and changed 'Atomouse', the start-up and growth of the pop art are included in the history of the Korean modern fine arts, apart from a study of an artist. 'Atomouse' was not only painted on the walls of the subway stations in the form of public art, but it tried to closely communicate with the public through the collaboration with diverse media. It made the best use of the 'marketability' which a 'cartoon character' had at first, so that pure art was made a step closer to the public. So 'Atomouse' of Lee Dong-gi not only raised a subculture into the realm of high art, but lowered the door sill to high art. Through the study we could confirm what position 'Atomouse' of Lee Dong-gi, which started absurdly between parody and Hommage, takes in Korean modern art of today.

Design and Implementation of Web Based Instruction Based on Constructivism for Self-Directed Learning Ablity (구성주의 이론에 기반한 자기주도적 웹 기반 교육의 설계와 구현)

  • Kim Gi-Nam;Kim Eui-Jeong;Kim Chang-Suk
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.855-858
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    • 2006
  • First of all, Developing information technology makes it possible to change a paradigm of all kinds of areas, including an education. Students can choose learning goals and objects themselves and acquire not the accumulation of knowledge but the method of their learning. Moreover, Teachers get to be adviser, and students play a key role in teaming. That is, the subject of leaning is students. Constructivism emphasizes the student-oriented environment of education, which corresponds to the characteristics of hypeimedia. In addition, Internet allows us to make a practical plan for constructivism. Web Based Internet provides us with a proper environment to make constructivism practice md causes an education system to change. Sure Web Based Instruction makes them motivated to learn more, they can gain plenty of information regardless of places or time. Besides, they are able to consult more up-to-date information regarding their learning use hypermedia such as an image, audio, video, and test, and effectively communicate with their instructor through a board, an e-mail, a chatting etc. A school and instructors have been making effort to develop a new model of a teaching method to cope with a new environment change. In this thesis, with 'Design and Implementation of Web Based Instruction Based on Constructivism', providing online learner-oriented and indexed video lesson, learners can get chance of self-oriented learning. In addition, learners doesn't have to cover all contents of a lesson but can choose contents they want to have from a indexed list of a lesson, and they ran search contents they want to have with a 'Keyword Search' on a main page, which can make learners improve learner's achievement.

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A study on the changes of the Screen quota system as a Film policy in Korea (한국의 영화정책과 스크린 쿼터제의 변천에 대한 연구)

  • Cho, Hee-Moon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.7 no.5
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    • pp.982-991
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    • 2006
  • The screen quota system is one of the most controversial issues in the Korean film industry. There are two different points of view regarding the system. Some say it is highly effective to protect and nurture Korean movies. However, others argue that it hurts the duality of the Korean movies. The number of days, for which Korean movies have to play on local screens, has been reduced to 73, starting on July 1st, 2006. Actually, it is 50 percent fewer than the previous year. In facL Korea has implemented the screen quota. system two times. First, it was practiced from 1935 to 1945, during the Japanese colonial period. This was to regulate imported movies, especially American ones, as the Japanese government was to use movies for the political propaganda. In 1935, the number of foreign movies screened had to be less than three fourths of the total. And they gradually reduced the size by two thirds in 1936, and again by half in 1937. After the attack on Pearl Harbor when the Pacific War happened, Japan completely banned importing American movies in Korea. The reason why it regulated the imported foreign films is to increase the number of domestic movies, both Japanese and Korean. It was for making propaganda films fur carrying the war. The second practice of the screen quota is from 1967 to the present year. It was designed to boom the Korean film industry. However, the competitive power of Korean films has not been improved in spite of the practice of the system. Moreover, the film industry has gone through the depression. Korean film agencies have occupied the Korean film market thanks to the protection by government. The founding of the film agencies has been strongly regulated. So has importing foreign movies. Under the special protection like this, Korean film agencies have been enjoying the monopoly In the mean time, they have pursued income not by making quality movies but by importing foreign movies. As a result, cinema audiences turn away form Korean films and prefer foreign movies. Furthermore, the screen quota system hurts the relationship between film producers and distributors, imposing the duties only on theaters. In short, the screen quota system has satisfied neither film producers, theater runners, nor film goers. In other words. the excessive protection has weakened the competitive power of Korean film industry.

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Effects of Lycopene on the Expression of Lipid Metabolism, Glucose Transport and Pro-Inflammatory Related Genes in Chickens (라이코펜 첨가 급여가 닭의 지방대사, 포도당 수송 및 친염증 유전자 발현에 미치는 영향)

  • Jang, In Surk;Moon, Yang Soo
    • Korean Journal of Poultry Science
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    • v.42 no.3
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    • pp.231-238
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    • 2015
  • The present study aimed to investigate the effects of lycopene on hepatic metabolic- and immune-related gene expression in laying hens. A total of 48 25-week-old White Leghorn hens were randomly allocated into four groups consisting of four replicates of three birds: control (basal diet), T1 (basal diet + 10 mg/kg of tomato powder-containing lycopene), T2 (basal diet + 10 mg/kg of micelles of tomato powder-containing lycopene), and T3 (basal diet + 10 mg/kg of purified lycopene). Chickens were fed ad libitum for 5 weeks, and then total RNA was extracted from the livers for quantitative RT-PCR analysis. Peroxisome proliferator-activated receptor ${\gamma}$ (PPAR${\gamma}$) expression was decreased in the liver of chickens after lycopene supplementation (P<0.05). Micellar lycopene supplementation decreased the expression of PPAR${\gamma}$ target genes including fatty acid binding protein 4 (FABP4) and fatty acids synthase (FASN) in the T2 group (P<0.05). Sterol regulatory element-binding protein 2 (SREBP2) and C/EBP-${\alpha}$ were also downregulated in hens fed with micellar lycopene (P<0.05). Glucose transporter 8 (GLUT-8) was upregulated in the T2 and T3 groups (P<0.05). However, the expression of carnitine palmitoyltransferase 1 (CPT-1) was not changed by lycopene supplementation. Pro-inflammatory cytokines such as tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) and interleukin 6 (IL-6) were downregulated by lycopene supplementation (P<0.05). These data suggest that the type of lycopene supplementation is critical and that micelles of tomato powder-containing lycopene may play an important role in the modulation of lipid metabolism and immunity in chickens.