• 사상체질의학회지
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• 제22권3호
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• pp.98-109
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• 2010

1. Objectives: This study is to investigate the association of Sasang Constitution and chronic obstructive pulmonary disease(COPD). 2. Methods: One thousand five hundred forty five persons, more than 40 years old, participated in the community based cohort in Wonju City and Pyeongchang City of South Korea from October 29th in 2007 to February 26th in 2008. The diagnosis of COPD was confirmed by spirometry and based on the diagnostic criteria developed by GOLD (Global Initiative for Chronic Obstructive Lung Disease) standard. Relating items like height, weight, BMI(Body Mass Index), martial status, income, drinking, smoking and education were checked using questionnaires and Sasang Constitution was diagnosed by a specialist using PSSC(Phonetic System for Sasang Constitution), facial photos and check-up lists. 3. Results: There were 88 persons(5.7%) who had mild COPD. Old age(more than 60's) and male were significant risk factors of COPD. But smoking, drinking and Sasang Constitution were not risk factors of COPD. But there were many Soeumin who had mild COPD in terms of Sasang Constitution irrespective of sex. 4. Conclusions: Low BMI(<23kg/m2) and low income also were significant risk factors. And Sasang Constitution might be the variable to manage COPD patients, but more researches are needed.

• Imaging Science in Dentistry
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• 제51권4호
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• pp.439-446
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• 2021

Purpose: The aim of this study was to identify correlations between the STOP-Bang score and upper airway dimensions using cone-beam computed tomography (CBCT) scans. Materials and Methods: This study included 101 subjects (46 men, 55 women) from dental patients who received CBCT scans from 2014 to 2020. The patients were divided into those with a low obstructive sleep apnoea (OSA) risk (STOP-Bang score<3) and those with an intermediate to high OSA risk (STOP-Bang score≥3), and their upper airway dimensions were then analysed on CBCT scans. Comparisons between the low-risk and intermediate/high-risk groups were conducted using the t-test and the Mann-Whitney test. Correlations between the total STOP-Bang score and upper airway dimension parameters were established using Spearman correlation coefficients. P values≤0.05 were considered to indicate statistical significance. Results: Intermediate/high-risk subjects were predominantly male and over 50 years of age, with a higher body mass index. They had significantly longer upper airways, smaller average airway volumes, and smaller widths and antero-posterior dimensions of the narrowest upper airway segment. The total upper airway length was positively correlated with the STOP-Bang score (r_s=0.278). The average volume (r_s= -0.203) and width of the narrowest upper airway segment(r_s= -0.305) were both negatively correlated with STOP-Bang scores. Conclusion: Subjects with higher STOP-Bang scores had upper airways that were longer, narrower, and smaller in terms of average volume. CBCT scans taken for dental patients as part of investigative procedures could be correlated with STOP-Bang scores to screen for patients at risk of OSA.

• Journal of Yeungnam Medical Science
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• 제21권2호
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• pp.133-142
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• 2004

Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

• 수면정신생리
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• 제3권1호
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• pp.31-37
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• 1996

Uvulopalatopharyngoplasty(UPPP) is an operation that is frequently performed for the patient of obstructive sleep apnea(OSA). A major problem has been to select those patients who will have a good response to UPPP. We compared preoperative and postoperative polysomnography(PSG) in 20 patients to evaluate the success rate of the operation. Each subject underwent a cephalometric roentgenogram, and fiberoptic nasopharyngoscopy with Mueller maneuver was applied in roentgenogram and fiberoptic nasopharyngoscopy with Mueller maneuver was applied in preop evaluation of patients with OSA. No PSG parameter could accurately predict the changes in sleep after UPPP. There were no significant differences between the responders and the nonresponders concerning the cephalometric analysis, the type of obstruction by Mueller maneuver, and body mass index(BMI). The conclusions of this study are thus that UPPP is an effective treatment for the OSAS with a high success rate, but that there is no single useful parameter predicting the success of the operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.7.1-7.8
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• 2020

Maxillomandibular advancement (MMA) is effective for the treatment of obstructive sleep apnea (OSA). In previous studies, the airway was increased in the anteroposterior and transverse dimensions after MMA. However, the effect of the opposite of mandibular movement (mandibular setback) on the airway is still controversial. Mandibular setback surgery has been suggested to be one of the risk factors in the development of sleep apnea. Previous studies have found that mandibular setback surgery could reduce the total airway volume and posterior airway space significantly in both the one-jaw and two-jaw surgery groups. However, a direct cause-and-effect relationship between the mandibular setback and development of sleep apnea has not been clearly established. Moreover, there are only a few reported cases of postoperative OSA development after mandibular setback surgery. These findings may be attributed to a fundamental difference in demographic variables such as age, sex, and body mass index (BMI) between patients with mandibular prognathism and patients with OSA. Another possibility is that the site of obstruction or pattern of obstruction may be different between the awake and sleep status in patients with OSA and mandibular prognathism. In a case-controlled study, information including the BMI and other presurgical conditions potentially related to OSA should be considered when evaluating the airway. In conclusion, the preoperative evaluation and management of co-morbid conditions would be essential for the prevention of OSA after mandibular setback surgery despite its low incidence.

• Clinical and Experimental Reproductive Medicine
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• 제48권1호
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• pp.91-94
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• 2021

A 28-year-old woman presented with a 1-year history of severe progressive dysmenorrhea following suction evacuation and tubal ligation. Sonography showed a bicornuate uterus with hematometra in the left horn. Hysteroscopy ruled out a diagnosis of a congenital Müllerian anomaly, as both ostia appeared normal. Under laparoscopy, a mass was seen on the left fundal region near the insertion of the round ligament, and needle aspiration of a chocolate-colored fluid confirmed the diagnosis of an adenomyotic cyst. The cyst was excised. The patient recovered well and has been symptom-free since surgery. Adenomyotic cyst is a rare entity in young women and must be differentiated from obstructive Müllerian anomaly. Laparoscopy is the preferred minimally invasive modality for managing this rare disorder.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.335-340
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• 2019

Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.281-288
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• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• 대한임상검사과학회지
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• 제39권2호
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• pp.141-146
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• 2007

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a disorder characterized by the repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation, daytime sleepiness, and increased risk for hypertension and stroke. We investigated the clinical factors related to the severity of OSAHS. Polysomnography was performed in three hundred and ninety five consecutive adult patients with clinical symptoms of obstructive sleep apnea syndrome. All patients completed the sleep questionnaire and the Epworth Sleepiness Scale before polysomnography. Patients were classified into four groups based on the severity of their polysomnographic data: Non-OSA group, characterized by Apnea-Hypopnea Index (AHI) < 5; mild OSA group, by AHI 5-15; moderate OSA group, by AHI 16-30; and severe OSA group, by AHI > 30. Neck circumference was also measured at the cricothyroid level. A total of 395 patients (336 men and 59 women) were studied. In the non-OSA group, there were 55 patients; their mean neck circumference was $39.63{\pm}4.24cm$ and mean BMI was $24.48{\pm}3.53$. In the mild group, there were 101 patients; their mean neck circumference was $41.93{\pm}3.75cm$ and mean BMI was $25.33{\pm}2.94$. In the moderated group, there were 93 patients; their mean neck circumference was $43.27{\pm}3.50cm$ and BMI was $25.90{\pm}2.88$. In the severe group, there were 146 patients; their mean neck circumference was $44.94{\pm}3.93cm$ and mean BMI was $26.81{\pm}3.76$. Men had significantly larger neck circumference than women ($Mean{\pm}SD$, $43.72{\pm}3.83$ vs $39.17{\pm}4.30$, p < 0.001), and higher AHI than women ($29.12{\pm}22.65$ vs $14.63{\pm}14.11$, p < 0.001). Multiple regression analysis revealed that neck circumference was the most significant predictor of AHI. Neck circumference and BMI were positively correlated with the severity of OSAHS. The severity of OSAHS was greater in men than in women.

• Tuberculosis and Respiratory Diseases
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• 제63권1호
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• pp.94-99
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• 2007

악성 종양의 자연 퇴행은 아주 드물게 보고되고 있으며 그 중 폐에 발생한 육종의 자연 퇴행의 경우 국내 보고로 처음이다. 여러 보고들에서 자연 퇴행에 대한 원인 기전을 밝히려는 많은 노력들이 있었으나 아직 정확히 규명된 기전은 없으며 최소한 한 가지 이상의 기전이 관여할 것으로 추정하고 있다. 저자들은 기관지내 육종을 진단하고 2개월 후 폐쇄성 폐렴과 부폐렴 흉수로 치료한 것을 제외하고 특별한 치료 없이 지내던 중 폐렴 발생 1년째 기관지경 검사상 기관지내 육종이 완전히 자연 퇴행되었음을 보여준 1예를 경험하여 이를 보고하는 바이다.