Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.
Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.
Background : The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate information regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. Methods : The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. Results : Weaning sucess was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes. previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, $PaO_2$, $PaCO_2$, $FEV_1$ duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. Conclusion : While weaning success from mechanical ventilation can be predicted by APACHE II score in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.
Background : Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-mall cell lung cancer to get evaluate its clinical implication. Methods : Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish pemxidase complex in the formalin-fixed, paraffin-embedded tissue $4{\mu}m$ section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. Results : Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in tumor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the ∞π'elation between survivin expression and p53 expression, but found none. Conclusion: We confirmed the tumor specific expression of survival in non-small cell lung canær. But this expression was not correlated with clinical parameters as well as histology, tumor stage, recurrence, and survival rate. Also it was not statistically correlated with the expression of p53.
Kim, Ji-Youn;Kim, Cheol-Hong;Park, Sunghoon;Lee, Chang-Youl;Hwang, Yong Il;Choi, Jeong-Hee;Shin, Taerim;Park, Yong-Bum;Jang, Seung-Hun;Lee, Jae Young;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
Tuberculosis and Respiratory Diseases
/
v.67
no.3
/
pp.205-211
/
2009
Background: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. Methods: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (${\geq}10^4$ cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. Results: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5${\pm}$6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ${\geq}$0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level ${\geq}$0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level ${\geq}$0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. Conclusion: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.
Kim, Hye-Suk;Park, Chan-Ho;Choi, Seung-Geal;Han, Byung-Wook;Kang, Kyung-Tae;Shim, Nam-Hyuk;Oh, Hyeon-Seok;Kim, Jin-Soo;Heu, Min-Soo
Journal of the Korean Society of Food Science and Nutrition
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v.34
no.7
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pp.1077-1081
/
2005
The objective of this study was to investigate the components and nutritional quality of red-tanner crab (Chionoecetes japonicus) paste in order to explore possibility for food processing source such as surimi gel containing crab paste. Yield of crab paste was $30\%$ from whole body after crushing and dehydrating. Crude protein contents $(9.5\%)$ of crab paste was lower than that $(13.1\%)$ of crab muscle, but fat $(0.5\%)$ and ash contents $(8.0\%)$ of paste were higher than $0.2\%\;and\;1.3\%$ of crab muscle, respectively. Volatile basic nitrogen (VBN) content of the crab paste was lower than those of the edible parts. Total amino acid content (9,497mg/l00g) of paste was lower than that (12,980mg/100g) of muscle. Aspartic acid, glutamic acid, lysine and leucine were the predominant amino acids in the protein fraction. The calcium content (6,539mg/l00g) was higher than those of phosphorus (579mg/100g), and potassium (793mg/100g) while manganese and iron were present in trace amounts. Major fatty acids of total lipid were 16:0, 18:1n-9, 20:5n-3 and 22:6n-3, and no difference of composition between paste and muscle. Sensory evaluation showed that scores of color and flavor of $15\%$ substituted surimi gel increased significantly when compared to surimi gel without crab paste (p<0.05). From the above results, the addition of crab paste enhanced nutrition and functionality of surimi gel.
Journal of the Korean Society of Food Science and Nutrition
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v.34
no.7
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pp.1000-1007
/
2005
The aim of the present study was to examine the relationship of maternal factors such as knowledge, attitude and practice of weaning with infant feeding. The subjects were 103 mothers visiting a public health center in Gumi, Kyungbook who filled out self-administered Questionnaires. First of all, about $90\%$ of the participants recognized the importance of complementary foods and proper weaning practices. The response for the recognition of the importance of infant weaning process showed a significant difference by education levels. Concerning an appropriate time for the introduction of weaning foods, $53\%$ of mothers had commenced weaning at age $4\~6$ months, while $38\%$ had done so at age $6\~8$ months. Approximately $76\%$ of mothers fed their babies without the knowledge of age-related weaning method and type of weaning foods. There were no statistical differences in maternal weaning knowledges between levels of education and house income. Mothers with higher levels of education and family income tended to show high perception scores regarding possibility of food allergies caused by baby foods. A demand for reliable sources and education related to nutritious weaning foods and weaning practices were strong in the group with higher education. Knowledge of weaning method and baby foods were obtained by 59 of the 103 mothers from mass media, 35 from friends caring babies, and 9 obtained advice from health professionals or family. Advice from the heath professionals was not the main influence on their decision to introduce weaning foods. Although commercial baby foods are the most commonly used as first weaning foods, those with higher education groups considered commercial baby food are not nutritionally better than home-maid foods. The current findings suggest to us that to improve weaning process, mothers should be educated on the selection and preparation of nutritious, balanced weaning foods and on good weaning practices. It is advised that supportive health professionals from community public health centers should lead the education of infant feeding practices based on maternal characteristics and on basic food and nutritional knowledge.
Journal of the Korean Society of Food Science and Nutrition
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v.37
no.2
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pp.245-250
/
2008
The purpose of this study was to evaluate quality of abalone porridge prepared with different sizes of rice and amounts of added water. pH of porridge was mostly stable from 6.3 to 6.8 but as more water was added, pH increased. Increase of added water resulted in higher TBARS value, but most of TBARS value was generally low, and there wasn't any significant difference. Lightness of the rice powder porridge was 53 to 59 and it was higher than that of round rice porridge. Redness tended to be high as rice size was bigger and less amount of water was added. Yellowness of round rice porridge and half rice porridge was higher than that of rice powder porridge. Also, yellowness of porridge had a tendency to decrease as amount of water was increased. Consistency, viscosity, and firmness was higher in round rice porridge and half rice porridge than in rice powder porridge, and increase in added water amount led to decrease of all textural properties. In the measurement of texture properties that is only present in rice grain, the hardness, gumminess, and chewiness of round rice grain porridge was significantly higher than that of half rice. In the sensory evaluation result, all sensory properties was significantly different (p<0.05) among the abalone porridges prepared with different rice sizes and added water. The viscosity, flavor, texture, and taste of half rice abalone porridge added 1000 mL water showed the highest sensory scores.
Journal of the Korean Society of Food Science and Nutrition
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v.40
no.8
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pp.1164-1171
/
2011
The purpose of this study was to compare service quality between local and global coffee brand shops and to investigate improvement. Of 350 questionnaires distributed to customers of six brand coffee shops (three local brands, three global brands) located in Daejeon, 330 complete questionnaires (94.3%) were analyzed. The questionnaire included a seven-point multiple-item scale for measuring service quality. The 21 items measuring service quality were grouped into four factors, and the mean scores for the levels of "representativeness", "coffee sensory and beverage features", "employee attitude" and "physical environment" were 5.42, 4.77, 4.74, and 4.13, respectively. The levels of "coffee sensory and beverage features" and "employee attitude" of the high income customers were significantly lower than those of the low income customers. The results showed that the levels of "employee attitude" of local coffee brand shops was significantly higher (p=0.050) than that of global coffee brand shops. Whereas, the levels of "representativeness" of global coffee brand shops was significantly higher (p=0.003) than that of local coffee brand shops. Based on the results, the global coffee brand shops should pay attention to internal marketing and the local coffee brand shops must strive to improve service quality through strategies such as improving brand awareness and developing representative beverages and foods.
Chang, Jisoon;Kim, Nam Young;Lee, Suk Hee;Kim, Bongseog
Journal of Korean Society of Forest Science
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v.104
no.1
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pp.127-132
/
2015
Aim of this study was to investigate the influence of forest experience program on depression, anxiety, and self concept in adolescents living in urban area. A total of 47 adolescents living in Seoul, South Korea were recruited for the study and participated in a series of forest experience programs that the Korea National Park Service had developed. Before and after applying the program, their depression, anxiety, and self concept were evaluated using Children's Depression Inventory (CDI), Revised Child Manifest Anxiety Scale (RCMAS), and Offer Self Image Questionnaire-Revised (OSIQ). The outcome measures were analyzed using paired-t tests. CDI score was significantly reduced after the program (before:$12.41{\pm}8.34$, after:$8.65{\pm}9.48$). Excluding 16 participants whose scores of Lie Scale in the RCMAS were more than 8 on the analysis, the total RCMAS score showed significant reduction after the program (before:$14.87{\pm}7.30$, after:$10.81{\pm}7.81$). There was no significant difference in the total score of the total self-image scale in the OSIQ. However, the Self-confidence (SC) which was used as subscale of the OSIQ was significantly higher after the program (before:$29.94{\pm}3.71$, after:$38.11{\pm}6.45$), and the Idealism scale (I) in the OSIQ increased significantly after the program (before:$21.03{\pm}3.80$, after:$23.17{\pm}3.89$). On our analysis, the forest experience program showed considerable positive effects on depression and anxiety in adolescents. This result leads the postulation that the program might be helpful for adolescents to adapt to their surrounding experiences and to achieve improvement in interpersonal relationship.
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