• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2010년도 춘계 종합학술대회 논문집
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• pp.200-203
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• 2010

원활한 교통을 방해하는 요인으로 도로공사, 도로와 인접한 곳에서의 건축공사, 대규모 상업시설(백화점,대형마트,경기장,콘서트장 등), 주차장 이용을 위한 차량의 빈번한 출입 등을 들 수 있으며, 이러한 요인으로 발생한 인명사고 및 교통정체는 결국 사회적 경제적으로 막대한 비용 지출이라는 결과를 초래하게 된다. 이러한 문제점을 해결하기 위해 일본은 1972년 교통유도경비 업무라는 경비업무를 도입하였다. 업무내용으로는 앞서 언급한 문제요인 발생 지역에 해당 업무를 실시함으로써 교통정체지역의 원활한 교통흐름 유도, 보행자 및 차량의 유도로 사고위험 경감 등의 효과를 나타내고 있다. 또한, 2009년 12월 기준 일본 전체 경비업체 8,924개 중 59.6%(5,317개)가 교통유도경비업체로 등록되어 있을 정도로 도입이후 급신장한 일본의 경비업무이다. 반면 한국은 원활한 교통을 방해하는 요인에 대한 대책마련 요구가 있음에도 불구하고 제도 및 안전 관리대책에 한계를 들어내고 있다. 따라서 본 연구에서는 일본에서 시행되고 있는 교통유도경비 제도를 한국의 현재 실태 분석과 함께 향후 민 관상호가 협력적으로 협의하여 실현 가능토록하기 위한 법적제도 및 교육제도에 대하여 방안을 제안하였다.

• 생물정신의학
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• 제20권2호
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• pp.54-60
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• 2013

Objectives The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. Methods We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. Results A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). Conclusions The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.

• Tuberculosis and Respiratory Diseases
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• 제66권3호
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• pp.186-191
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• 2009

연구배경: 골다공증은 만성폐쇄성폐질환 환자의 중요한 동반질환 중 하나이다. 저자들은 COPD 환자에서 골다공증의 유병률과 위험인자를 알아 보고자 하였다. 방 법: 안정 상태인 COPD 환자 51명과 이들과 나이와 성별을 일치시킨 대조군 41명에서 요추골과 대퇴골의 골밀도를 측정하였다. 임상기록과 검사결과를 검토하여, COPD 환자에서 골다공의 위험인자를 분석하였다. 결 과: COPD 환자에서, T점수가 -2.5 이하인, 골다공증의 유병률은 47%였고, 대조군에서 32%였다. 특히 대퇴골목의 T점수를 기준으로 한 골다공증의 유병률은 COPD 환자에서 대조군에 비해 유의하게 높았다(26% vs. 5%; p=0.006). COPD 환자의 요추와(p=0.025) 대퇴골목의 평균 T 점수는 대조군보다 유의하게 낮았다(p=0.001). COPD 환자에서 $FEV_1$의 정상예측치에 대한 비율과(p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) 연령이 골다공증 발생과 관련된 독립적인 위험인자였다(p=0.024; OR, 1.144; 95% CI, 1.018-1.287). 결 론: COPD 환자에서 골다공증의 유병률은 연령과 성별을 일치시킨 대조군보다 높다. 특히 대퇴골의 T점수가 요추보다 COPD 환자와 대조군의 골밀도의 차이를 더 분명하게 보여 주었다. COPD 환자에서 $FEV_1$이 낮을수록, 나이가 많을수록 골다공증 발생 위험이 크게 증가한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권3호
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• pp.161-166
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• 2013

Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

• Journal of the Korean Data and Information Science Society
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• 제27권5호
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• pp.1349-1360
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• 2016

본 연구는 국내 COPD 환자의 삶의 질 정도 및 삶의 질과 관련이 있는 요인을 확인하기 위해 시도되었다. 2013년도 국민건강영양조사의 일반적 및 질병관련 변수, 폐기능검사 결과, 삶의 질(EuroQol-5Dimension) 자료를 이용하여 가중치를 적용한 후 복합표본 교차분석과 복합표본 회귀분석으로 분석하였다. 연구결과, EQ-5D Index는 COPD 환자 0.916점, 정상인 0.941점으로 COPD 환자가 정상인보다 통계적으로 유의하게 낮았다. 삶의 질 하부 영역인 이동, 자가간호, 일상활동, 통증/불편감, 불안/우울 모두 COPD 환자는 정상인과 비교하여 문제 없음의 비율이 낮고 문제 있음의 비율이 높았지만, 기도폐쇄 정도에 따른 삶의 질은 자가간호 영역만 유의한 차이가 있었다 (${\chi}^2=9.50$, p=.013), COPD 환자의 삶의 질과 관련이 있는 요인은 연령, 성별, 교육수준, 가구당 수입, 흡연상태, 동반질환 수이었다. 본 연구결과를 바탕으로, COPD 환자의 삶의 질에 대한 관심과 함께 이동, 자가간호, 일상생활을 증진하고 통증/불편감, 불안/우울을 감소하는 등 삶의 질을 향상시키기 위한 포괄적인 접근이 이루어져야 할 것이다.

• 한국산업보건학회지
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• 제31권3호
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• pp.286-293
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• 2021

Objectives: Inorganic dust is known to be a risk factor for chronic obstructive pulmonary disease (COPD) regardless of smoking and pneumoconiosis. Adaptive and innate immunity, including lymphocyte infiltrate, are involved in the pathogenesis of COPD. The purpose of this study was to analyze the lymphocyte subsets in the blood of workers exposed to inorganic dust and confirm the influencing factors. Methods: The general characteristics of the subjects (n=107) were analyzed through a personal questionnaire. Diagnosis of COPD was established according to pulmonary function tests with FEV₁/FVC post bronchodilator lower than 70%, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. For lymphocyte analysis, blood was stained with a fluorescent CD marker and analyzed by flow cytometry. Results: The increase in CD4⁺ T lymphocytes was associated with a decrease in age (𝛽=-0.273, p=0.008) and an increase in the cumulative smoking amount (𝛽=0.205, p=0.034). The increase in NK cells was associated with an increase in age (𝛽=0.325, p=0.001) and a decrease in cumulative smoking (𝛽=-0.220, p=0.019). The period of exposure to dust, %FVC predicted and %FEV₁/FVC, and the relative population of peripheral blood lymphocytes did not show a statistically significant relationship. Conclusions: CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells in peripheral blood were more related to age and cumulative smoking than the duration of dust exposure. Age and smoking are major risk factors for the development of COPD, so it can be predicted that peripheral blood CD4⁺ T lymphocytes and CD56⁺CD16⁺ NK cells are related to the development of COPD in workers exposed to inorganic dust.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.155-164
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• 2024

Background: Exercise capacity is associated with lung function decline in chronic obstructive pulmonary disease (COPD) patients, but a discrepancy between exercise capacity and airflow limitation exists. This study aimed to explore factors contributing to this discrepancy in COPD patients. Methods: Data for this prospective study were obtained from the Korean COPD Subgroup Study. The exercise capacity and airflow limitation were assessed using the 6-minute walk distance (6-MWD; m) and forced expiratory volume in 1 second (FEV₁). Participants were divided into four groups: FEV₁ >50%+6-MWD >350, FEV₁ >50%+6-MWD ≤350, FEV₁ ≤50%+6-MWD >350, and FEV₁ ≤50%+6-MWD ≤350 and their clinical characteristics were compared. Results: A total of 883 patients (male:female, 822:61; mean age, 68.3±7.97 years) were enrolled. Among 591 patients with FEV₁ >50%, 242 were in the 6-MWD ≤350 group, and among 292 patients with FEV₁ ≤50%, 185 were in the 6-MWD >350 group. The multiple regression analyses revealed that male sex (odds ratio [OR], 8.779; 95% confidence interval [CI], 1.539 to 50.087; p=0.014), current smoking status (OR, 0.355; 95% CI, 0.178 to 0.709; p=0.003), and hemoglobin levels (OR, 1.332; 95% CI, 1.077 to 1.648; p=0.008) were significantly associated with discrepancies in exercise capacity and airflow limitation in patients with FEV₁ >50%. Meanwhile, in patients with FEV₁ ≤50%, diffusion capacity of carbon monoxide (OR, 0.945; 95% CI, 0.912 to 0.979; p=0.002) was significantly associated with discrepancies between exercise capacity and airflow limitation. Conclusion: The exercise capacity of COPD patients may be influenced by factors other than airflow limitation, so these aspects should be considered when assessing and treating patients.

• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.180-187
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• 2016

Purpose: The aims of this study were to evaluate the differences of clinical and polysomnographic features between rapid eye movement (REM)-related obstructive sleep apnea (OSA) and not-REM-related OSA, and to suggest the pathogenesis according to the REM dependency of OSA. Methods: One hundred ninety consecutive patients diagnosed with OSA were evaluated clinical features and performed full night polysomnography. The patients were divided into REM-related (REM apnea-hypopnea index [AHI] at least two times higher than their non-REM AHI) and not-REM-related (a REM AHI less than two times higher than their non-REM AHI) OSA groups and evaluated the differences in age, body mass index (BMI), neck circumference, Ep-worth Sleepiness Scale score, and parameters of polysomnography. Results: REM-related patients were younger and showed higher sleep efficacy, low percentage of light sleep stage (stage 1 sleep), and low rate of positional OSA. Age was significantly associated with REM dependency of OSA and REM AHI were significant correlated with BMI, neck circumference, percentage of sleep in supine position, and percentage time of snoring. Conclusions: Our results showed that REM-related OSA patients showed less severe polysomnographic parameters than not-REM-related patients. However, significant risk factors were differed depending on the REM dependency and OSA severity, and the clinical features correlated with REM AHI and non-REM AHI were also showed differently. We suggest that the occurrence of OSA according to the REM dependency can be based on different mechanisms.

• Clinical and Experimental Pediatrics
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• 제53권10호
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• pp.863-871
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• 2010

The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• Tuberculosis and Respiratory Diseases
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• 제81권3호
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• pp.198-215
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• 2018

Bronchodilators provide improvements in lung function and reductions in symptoms and exacerbations, and are the mainstay of pharmacological management of chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease strategy recommends the use of a combination of long-acting ${\beta}_2-agonist$/long-acting muscarinic antagonists (LABA/LAMA) as the first-line treatment option in the majority of symptomatic patients with COPD. This review provides an indirect comparison of available LABA/LAMA fixed-dose combinations (FDCs) through discussion of important efficacy and safety data from the key literature, with the objective of providing physicians with a framework for informed decision-making. LABA/LAMA FDCs provided greater benefits compared with placebo and similar or greater benefits compared with tiotropium and salmeterol/fluticasone in improving lung function, dyspnea, health-related quality of life, reducing rescue medication use and preventing exacerbations, although with some variability in efficacy between individual FDCs; further, tolerability profiles were comparable among LABA/LAMA FDCs. However, there is a disparity in the amount of evidence generated for different LABA/LAMA FDCs. Thus, this review shows that all LABA/LAMA FDCs may not be the same and that care should be taken when extrapolating individual treatment outcomes to the entire drug class. It is important that physicians consider the efficacy gradient that exists among LABA/LAMA FDCs, and factors such as inhaler devices and potential biomarkers, when choosing the optimal bronchodilator treatment for long-term management of patients with COPD.