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Clinical and Polysomnographic Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea (REM 수면 의존성 폐쇄성 수면무호흡증 환자의 임상적 특성과 수면 변인에 관한 연구)

  • Lee, Yu-Jin;Lee, Soon-Jeong;Kang, Dong-Jin
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.77-81
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    • 2008
  • Introduction: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. Methods: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (5$53.7{\pm}16.7$ years, 42 males). REM-dependent OSA was defined as AHI-REM/AHI-NREM ratio>2. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. Results: Among 56 patients, 37.5% (n=21, average age of $52.3{\pm}19.7$ years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). Conclusion: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.

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The Relationship among Returns, Volatilities, Trading Volume and Open Interests of KOSPI 200 Futures Markets (코스피 200 선물시장의 수익률, 변동성, 거래량 및 미결제약정간의 관련성)

  • Moon, Gyu-Hyen;Hong, Chung-Hyo
    • The Korean Journal of Financial Management
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    • v.24 no.4
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    • pp.107-134
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    • 2007
  • This paper tests the relationship among returns, volatilities, contracts and open interests of KOSPI 200 futures markets with the various dynamic models such as granger-causality, impulse response, variance decomposition and ARMA(1, 1)-GJR-GARCH(1, 1)-M. The sample period is from July 7, 1998 to December 29, 2005. The main empirical results are as follows; First, both contract change and open interest change of KOSPI 200 futures market tend to lead the returns of that according to the results of granger-causality, impulse response and variance decomposition with VAR. These results are likely to support the KOSPI 200 futures market seems to be inefficient with rejecting the hypothesis 1. Second, we also find that the returns and volatilities of the KOSPI 200 futures market are effected by both contract change and open interest change of that due to the results of ARMA(1,1)-GJR-GARCH(1,1)-M. These results also reject the hypothesis 1 and 2 suggesting the evidences of inefficiency of the KOSPI 200 futures market. Third, the study shows the asymmetric information effects among the variables. In addition, we can find the feedback relationship between the contract change and open interest change of KOSPI 200 futures market.

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Factors Affecting Complete Fetal Loss Following Multifetal Pregnancy Reduction (다태임신 감수술 (Multifetal Pregnancy Reduction) 후 완전태아손실에 영향을 미치는 인자)

  • Kim, Hye-Ok;Kim, Mun-Young;Song, Hyun-Jeong;Park, Chan-Woo;Hur, Girl;Kim, Jin-Yeong;Yang, Kwang-Mun;You, Keun-Jae;Song, In-Ok;Jun, Jong-Young;Koong, Mi-Kyoung;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.39-45
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    • 2003
  • Objective : To identify the factors affecting the complete fetal loss following multifetal pregnancy reduction (MFPR). Design: Retrospective clinical study. Methods : A total of 256 consecutive treatments of MFPR in IVF-ET cycles performed between 1992 through 2000 in Samsung Cheil hospital were analyzed. MFPR was done around 8 weeks of gestation by transvaginal ultrasono-guided aspiration in multiple pregnancies and reduced to singleton or twins. Stepwise logistic regression was performed to identify the factors affecting the final outcome of pregnancy after MFPR. Dependent variable was complete fetal loss and the independent variables were maternal age, paternal age, initial number of gestational sac (iGSNO), initial number of fetal heart beat, the number of remaining live fetus after MFPR, and chorionicity. Results: The total survival rate was 87.9%, and total fetal loss rate after MFPR was 12.1%. Total fetal loss occurred within four weeks from MFPR procedure was 1.95%. Total loss occurred after four weeks of procedure and before 24 gestational weeks was 8.2%. Seventy nine percent (202/256) of pregnancies delivered after 34 weeks of gestation. The survival rate of pregnancies reduced to singleton was significantly higher than that of pregnancies reduced to twins (93.5% vs. 86.7%, p<0.05). The mean ($\pm$SEM) gestational age at delivery was $36.2{\pm}1.0$ and $34.1{\pm}0.5$ weeks for pregnancies reduced to singletons and twins, respectively (p=0.065). Logistic regression analysis revealed that the maternal age, the number of initial gestational sac (iGSNO), and the number of remaining live fetus after MFPR significantly affected the rate of total fetal loss (Z = 0.174'age + 0.596'iGSNO + 1.324'remaining fetuses -12.07), (p<0.05). Conclusions: MFPR seems to be a relatively safe and efficient method to improve the obstetric outcome in high order multiple pregnancy. Because the maternal age, the number of initial gestational sac and the remaining live fetuses after MFPR affect the total fetal loss rate, restriction of the number of transferred embryos according to the age and MFPR to singleton fetus could be considered for the better obstetric outcome in IVF pregnancy.

What Factors Affect Mortality over the Age of 40? (40세 이후의 사망에 영향을 주는 요인에 관한 코호트내 환자-대조군 연구)

  • Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae;Park, Kee-Ho;Wang, Seung-Jun;Chang, Sei-Jin;Sin, Soon-Ae;Kang, Myung-Guen
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.383-394
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    • 1999
  • Objectives: This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. Methods: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. Results : In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. Conclusions: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.

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A 15-year clinical retrospective study of Br${\aa}$nemark implants (Br${\aa}$nemark 임플란트의 15년 임상적 후향 연구)

  • Park, Hyo-Jin;Cho, Young-Ye;Kim, Jong-Eun;Choi, Yong-Geun;Lee, Jeong-Yol;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.61-66
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    • 2012
  • Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.

The Relation of Residual Pleural Thickening with Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases of Pleural Effusion in Patients with Tuberculous Pleuritis (결핵성 흉막염 환자에서 흉수 내 Matrix Metalloproteinases 및 Tissue Inhibitors of Metalloproteinases 농도와 잔여 흉막비후와의 관계)

  • Choi, Youngkwon;An, Chang Hyeok;Kim, Yu Jin;Kyung, Sun Young;Lee, Sang Pyo;Park, Jeong Woong;Jeong, Sung Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.7-14
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    • 2008
  • Background: Residual pleural thickening (RPT) is the most frequent complication of tuberculous pleurisy (TP), and this can happen despite of administering adequate anti-tuberculous (TB) therapy. Yet there was no definite relation between RPT and other variables. The aim of this study was to examine matrix metalloproteinases (MMPs) and the inhibitors of metalloproteinases (TIMPs) and to identify the factors that can predict the occurrence of RPT. Methods: The patients with newly-detected pleural effusions were prospectively enrolled in this study from January 2004 to June 2005. The levels of MMP-1, -2, -8 and -9, and TIMP-1 and -2 were determined in the serum and pleural fluid by ELISA. The residual pleural thickness was measured at the completion of treatment and at the point of the final follow-up with the chest X-ray films. Results: The study included 39 patients with pleural fluid (PF). Twenty-three had tuberculous effusion, 7 had parapneumonic effusion, 7 had malignant effusion and 2 had transudates. For the 17 patients who completed the anti-TB treatment among the 23 patients with TP, 7 (41%) had RPT and 10 (59%) did not. The level of PF TIMP-1 in the patients with RPT ($41,405.9{\pm}9,737.3ng/mL$) was significantly higher than that of those patients without RPT ($29,134.9{\pm}8,801.8$) at the completion of treatment (p=0.032). In 13 patients who were followed-up until a mean of $8{\pm}5$ months after treatment, 2 (15%) had RPT and 11 (85%) did not. The level of PF TIMP-2 in the patients with RPT ($34.4{\pm}6.5ng/mL$) was lower than that of those patients without RPT ($44.4{\pm}15.5$) at the point of the final follow-up (p=0.038). Conclusion: The residual pleural thickening in TP might be related to the TIMP-1 and TIMP-2 levels in the pleural fluid.

Simulation of Pension Finance and Its Economic Effects (연금재정(年金財政) 시뮬레이션과 경제적(經濟的) 파급효과(波及效果))

  • Min, Jae-sung;Kim, Yong-ha
    • KDI Journal of Economic Policy
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    • v.13 no.1
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    • pp.115-134
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    • 1991
  • The role of pension plans in the macroeconomy has been a subject of much interest for some years. It has come to be recognized that pension plans may alter basic macroeconomic behavior patterns. The net effects on both savings and labor supply are thus matters for speculation. The aim of the present paper is to provide quantitative results which may be helpful in attaching orders of magnitude to some of the possible effects. We are not concerned with the providing empirical evidence relating to actual behavior, but rather with deriving the macroeconomic implications for a alternative possibilities. The pension plan interacts with the economy and the population in a number of ways. Demographic variables may thus affect both the economic burden of a national pension plan and the ability of the economy to sustain the burden. The tax transfer process associated with the pension plan may have implications for national patterns of saving and consumption. The existence of a pension plan may have implications also for the size of the labor force, inasmuch as labor force participation rates may be affected. Changes in technology and the associated changes in average productivity levels bear directly on the size of the national income, and hence on the pension contribution base. The vehicle for the analysis is a hypothetical but broadly realistic simulation model of an economic- demographic system into which is inserted a national pension plan. All income, expenditure, and related aggregates are in real terms. The economy is basically neoclassical; full employment is assumed, output is generated by a Cobb-Douglas production process, and factors receive their marginal products. The model was designed for use in computer simulation experiments. The simulation results suggest a number of general conclusions. These may be summarized as follows; - The introduction of a national pension plan (funded system) tends to increase the rate of economic growth until cost exceeds revenue. - A scheme with full wage indexing is more expensive than one in which pensions are merely price indexed. - The rate of technical progress is not a critical element in determining the economic burden of the pension scheme. - Raising the rate of benefits affects its economic burden, and raising the age of eligibility may decrease the burden substantially. - The level of fertility is an element in determining the long-run burden. A sustained low fertility rate increases the proportion of the aged in total population and increases the burden of the pension plan. High fertility has inverse effects.

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A Study on the Knowledge, Attitude and Practice of Handwashing of Middle School Students (일부 중학생의 손씻기 지식, 태도 및 실천에 관한 연구)

  • Jang, Yun-Jeong;Na, Bak-Ju;Kim, Keon-Yeop;Bae, Seok-Hwan;Kim, Chul-Woung;Kim, Eun-Young;Lee, Moo-Sik
    • Korean Journal of Health Education and Promotion
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    • v.24 no.4
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    • pp.1-22
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    • 2007
  • Objectives: This study attempted to understand the relationship between handwashing knowledge, attitude and practice of middle school students and to provide the basic information for handwashing training of the students and help them to form a healthy habit. Methods: Data was collected by a standardized self-administered questionnaire between Sep. 20 to Oct. 6 2006 with a total of 710 students in 1, 2, 3 grades at 6 middle schools in metropolitan cities(490 students from four schools situated in an urban center, 220 from 2 in a suburban district). The data was then analyzed using the SPSS WIN 12.0 program, employing many statistical techniques such as chi-square($x^2$) test, t-test, ANOVA analysis with post hoc test, correlations analysis, and regression analysis. Results: The results of the study were as follows. First, total number of handwashing times of middle school students is 6.69 per day. 66.1% of the students used soap and most of the students washed hands for $6{\sim}10$ seconds(44.7%). Second, in the knowledge of handwashing, "both of the parents"(p<0.01), "catholic", "city"(p<0.05) were the highest and the practice of handwashing was active with "city", "high economic level"(p<0.05) and "both of the parents"(p<0.01). In the experience of teaching handwashing, "Yes" was 24.3% which was statistically significant with handwashing knowledge(p<0.05), attitude and practice(p<0.01). Third, in the correlation of handwashing knowledge, attitude and practice, there was statistical significancy between handwashing attitude and knowledge(p<0.01) and showed positive correlation with the knowledge(.534). The practice of handwashing has meaningful difference from the knowledge and the attitude and the coefficient of correlation shows positive co-relation in knowledge(.335) and attitude(0525). Fourth, based on the result for regression analysis with handwashing knowledge, attitude and practice as dependent variables, handwashing knowledge showed statistical significancy with sex, type of school(p<0.05) and residential area(p<0.01). There were also statistical significancy between handwashing attitude and knowledge(p<0.01) and between handwashing practice and religion, knowledge(p<0.05) and economic level, attitude(p<0.01). Conclusion: There were consistent results with handwashing knowledge, attitude and practice. If they had better knowledge, their attitude was more positive and if they had better knowledge and more positive attitude, their practice was active. The knowledge, attitude and practice of the students who learned about handwashing were higher than those of the students who had no experience of learning handwashing. To enhance handwashing habit of middle school students, the handwashing environment should be maintained. The training plans should also be made according to sex, type of school, economic level, residential area, and the consistent study on handwashing training is required.

Hearing Loss in the Workers Exposed to Organic Solvents and Noise (유기용제와 소음에 폭로된 근로자들의 청력 손실)

  • 김영기;이용환
    • Journal of Life Science
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    • v.9 no.2
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    • pp.136-145
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    • 1999
  • The purpose of this study was to evaluate the effect of organic slovents and noise on hearing loss. We selected organic solvents exposed group of 32 cases, noise exposed group of 31 cases, both noise and solvent exposed group of 31 cases, and control group of 53 cases and studied the relation between exposure level of noise and organic solvents and degree of hearing loss. The results were as follows. The subjects under investigation were exposed to noise and organic solvents under threshold limit values and the amount of urinary hippuric acid excretion were also under biological exposure indices. In case of noise, both noise and organic solvents exposed group and noise exposed group were more exposed than organic solvents exposed group(p<0.05). When urinary hippuric acid excretion were concerned, both noise iud organic solvents exposed group and organic solvents exposed group showed higher values than noise exposed group(p<0.05). In comparison of mean auditory threshold values by frequency, on the air conduction test, both noise and organic solvents exposed group showed significantly higher hearing loss than noise exposed group in 500Hz of right ear, 500 and 2000Hz of left ear(p<0.05). Forty-three cases among 147 subjects were regarded as hearing loss group and average age(42.6years) of hearing loss group was higher than normal groups average age of 38.0 years. Urinary hippuric acid excretions of hearing loss group were significantly higher than normal group(p<0.05). Thirty-eight percent(12cases) of noise exposed group, 40.6 $\%$(13cases) of organic solvents exposed group, 51.6 $\%$(16cases) of both noise and organic solvents exposed group, and 3.8 $\%$(2cases) of unexposed group were regarded as hearing losers. Exposed groups showed higher incidence of hearing loss than unexposed group but there were no significant differences among the exposed groups. The variables showing significant correlation with hearing loss were age and the amount of hippuric acid in urinary excretion. When age were adjusted for the purpose of seeing the effects of hearing losses due to organic solvent, urinary excretion of hippuric acids was the only variable with significant correlation with hearing loss (p<0.05). When odds ratio to hearing loss between control and exposed groups was considered, noise exposed group showed 6.1 times (95 $\%$ CI: 3.3-8.7), organic solvents exposed group showed 7.4 times (95 $\%$ CI: 3.5-14.6) and both noise and organic solvents exposed group showed 17.2 times(95% CI: 5.6-31.8) higher values than unexposed group(p<0.01). Above results suggest that health screening test of hearing loss is also needed in organic solvents exposed workers.

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Effects of Dietary Intake of Agarum cribrosum Ethanol Extract on Lipid Level in Diet-induced Obese Rats (구멍쇠 미역 에탄올 추출물의 섭취가 비만유도 흰쥐의 지질농도에 미치는 영향)

  • Park, Sung-Jin;Lee, Sang-Ah;Song, Hyo-Nam;Park, Tae-Gil
    • Korean journal of food and cookery science
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    • v.29 no.4
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    • pp.361-366
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    • 2013
  • This research was performed to investigate the effect of Agarum cribrosum ethanol extracts on the levels of lipids in the serum of rats fed a high-fat diet for 10 weeks. Experimental groups were divided into basal diet only (BDG), high fat diet control (HFDCG), high-fat diet and 5% Agarum cribrosum ethanol extract powder (HF5S), and high-fat diet and 10% Agarum cribrosum ethanol extract powder(HF10S) groups. The levels of hematological variables were not significantly different among the four groups. Compared with the control group's serum total cholesterol level of 89.14 mg/dL, the levels of the HF5S and HF10S groups were significantly lowered to 77.26 and 75.47 mg/dL, respectively. Compared with the control group's LDL-cholesterol leve of 27.41 mg/dL, the LDL-cholesterol levels of the HF5S and HF10S groups were significantly lowered to 20.64 and 20.17 mg/dL, respectively. Also, compared to the control group's serum triglyceride level of 98.36 mg/dL, the triglyceride levels of the HF5S and HF10S groups were significantly lowered to 87.94 and 87.39 mg/dL, respectively. These results indicate that dietary intake of Agarum cribrosum ethanol extracts might have beneficial effects on obesity by reducing body weight and improving blood lipid profile.