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The Effects of Obstructive Sleep Apnea Syndrome on Periodic Limb Movements in Sleep (폐쇄성 수면무호흡증이 주기성 사지운동증에 미치는 영향)

  • Seo, Cheon-Seok;Youn, Tak;Kim, Eui-Joong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.34-42
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    • 2000
  • Objectives: Periodic limb movements in sleep(PLMS) is a moderately prevalent disorder, of which pathophysiology remains largely unknown. PLMS has been reported to be common in patients with obstructive sleep apnea syndrome(OSAS), but reports on their relationship have been inconsistent in previous studies. Inconsistency of results may be attributable to insufficient number of the study subjects. We attempted to explore the influence of OSAS on PLMS in a large number of subjects. Methods: Three hundred and twenty subjects(M : F=192:128) with PLMS, as identified by the nocturnal polysomnography, were studied. Sample mean age was 53.1(SD=15.1) years and their mean periodic limb movement index(PLMI) is 25.2/hr (SD=24.8). PLMS subjects were divided into two groups, based on the presence or absence of OSAS. Periodic limb movement indices and sleep parameters between two groups were analyzed to evaluate the effects of OSAS on PLMS. Results: Each of PLMI and PLMI with arousal(PLMAI) correlated positively with age. PLMI of men was larger than that of women (p<0.01). The presence of comorbid OSAS independently had influence on PLMI(t=-2.20, p<0.05), but not PLMAI. There were no significant differences between the two groups in their PLMI, PLMAI and sleep parameters. However, the two groups differed in PLMI-correlated sleep parameters. In PLMS subjects with comorbid OSAS, PLMI was negatively correlated with each of slow wave sleep time and REM sleep time. In subjects without comorbid OSAS, PLMI was negatively correlated with sleep efficiency. Conclusion: PLMS patients with OSAS turned out to have increased PLMI than those without OSAS We suggest that OSAS patients may have subtle autonomic arousals and these arousals could, in part, express themselves as PLM.

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Usefulness of MRCP in the Diagnosis of Common Bile Duct Dilatation caused by Non-stone or Non-tumorous Conditions (비결석, 비종양성 총담관 확장의 진단에 있어서 자기공명담췌관조영술(MRCP)의 유용성)

  • 정재준;양희철;김명진;김주희;이종태;유형식
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.129-136
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    • 2002
  • Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

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Tc-99m ECD Brain SPECT in Patients with Traumatic Brain Injury: Evaluating Distribution of Hypoperfusion and Assesment of Cognitive and Behavioral Impairment in Relation to Thalamic Hypoperfusion (뇌외상 환자의 Tc-99m ECD 뇌 SPECT에서 뇌 혈류감소의 분포 및 시상의 혈류감소에 대한 인지 및 행동장애 평가)

  • Park, Soon-Ah;Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.445-455
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    • 2000
  • Purpose: We evaluated the distribution of hypoperfusion in patients with traumatic brain injury (TBI) and the relationship of thalamic hypoperfusion to severity of cognitive and behavioral sequelae. Materials and Methods: Tc-99m ECD SPECT and MRI were performed in 103 patients (M/F=81/22, mean age $34.7{\pm}15.4$ yrs) from 0.5 to 55 months (mean 10.3 months) after TBI. The patients were divided into three groups showing no abnormalities (G1), focal (G2) and diffuse injury (G3) on MRI. Psychometric tests assessed 11 cognitive or behavioral items. In all patients, we evaluated the distribution of hypoperfused areas in SPECT, and in 57/103 patients, neuropsychological (NP) abnormalities in patients with thalamic hypoperfusion were compared with those of patients without thalamic hypoperfusion. Results: The perfusion deficits were most frequently located in the frontal lobe (G1, 42.3%: G2 34.5%: G3 33.3%), temporal lobe ($24{\sim}26%$) thalami ($21{\sim}22.4%$), parietal and occipital lobe (${\leq}10%$). Numbers of NP abnormalities in the cases of cortical hypoperfusion with or without concomitant thalamic hypoperfusion were following: the former $4.7{\pm}1.5$ and the latter $3.2{\pm}1.4\;in\;G1,\;5.0{\pm}1.1\;and\;4.8{\pm}1.2\;in\;G2,\;6.8{\pm}1.8\;and\;6.3{\pm}1.1\;in\;G3$, respectively. This difference according to thalamic hypoperfusion was significant in G1 (p=0.002), but was not significant in G2 or G3. Conclusion: SPECT in patients with TBI had demonstrated hypoperfusion mostly involving the frontal, temporal and thalami. In normal group on MRI, frontal hypoperfusion was more prominent than that of any other group, Furthermore in this group, SPECT could predict severity of NP outcome by concomitant thalamic hypoperfusion with cerebral cortical abnormalities.

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Evaluation of the Bite Forces in Patients with Unilateral Temporomandibular Disorders (편측성 측두하악장애 환자의 교합력 평가)

  • Lee, Woo-Jung;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.347-354
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    • 2006
  • Most patients suffering from TMD appear to have unsatisfactory masticatory function and compromised values of bite force. The purposes of this study were to investigate and compare bite force between affected and unaffected sides of patients with unilateral TMD and to evaluate its relation with duration of TMD. 42 patients with unilateral TMD, from Department of Oral Medicine, Dankook University Dental Hospital, were selected for this study. The ratio of men to women was 9:33 and their mean age of $27.2{\pm}10.4$ years. The bite forces were measured over both canines (for anterior bite force) and $1^{st}$ molars (for posterior bite force) using a bite force recorder while all the subjects were asked to clench successively for 3 seconds not until pain was felt. They were compared with those measured from bilateral TMD patients(N=6, M:F=1:5, mean age: $23.0{\pm}27.3$ years). The unilateral TMD patients were divided into time groups according to duration of TMD on the basis of 1 and 6 months, respectively. Paired and unpaired t-tests were used for statistical analysis. Unilateral TMD patients in this study showed that the affected sides had significantly lower bite force than the unaffected sides(force difference of about 7-8 kgf, p<0.05) while there was no significant sides difference in the bilateral patients. Nor did bite force on the affected sides reveal significant difference between unilateral and bilateral TMD patients. With regards to TMD duration, there was significant difference between the patients with TMD < 6 months and $\geq$ 6 months (p<0.05) while no significant difference existed between < 1 month and $\geq$ 1 month. The results of this study indicated that unilateral TMD patients can exhibit more reduced bite force on the affected sides compared with that on the unaffected sides and that bite force on the unaffected sides might be deteriorated more as longer did TMD last.

Clinical Features of Oromandibular Dystonia (하악운동이상증의 임상양태)

  • Kang, Shin-Woong;Choi, Hee-Hoon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.169-176
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    • 2011
  • Oromandibular dystonia (OMD) is a form of focal dystonia that affects the masticatory, facial and lingual muscles in any variety of combinations, which results in repetitive involuntary and possibly painful jaw opening, closing, deviation or a combination of these movements. This study aimed to investigate clinical features and treatment type of OMD patients. By retrospective chart review, the study was conducted to consecutive OMD patients who visited a department of Oral Medicine and Orofacial Pain Clinic in a university dental hospital during Aug 2007 to Apr 2010. 78 OMD patients were identified with female preponderance (M:F=1:3.6) and a mean age of 72 years. Their mean duration of OMD was about 10 months. The most common chief complaints at the first visit was jaw ache, followed by uncontrolled, repetitive movement of the jaw and/or oral tissues, pain in the oral region(p=0.000). The most common subtype of OMD was lateral jaw-deviation dystonia, followed by combination and jaw-closing dystonia(p=0.001). While no apparent cause was recognized in over 60% of the OMD patients, peripheral trauma including dental treatment such as prosthetic treatment and extraction was the most frequently reported as precipitating factor(p=0.000). Medication was the 1st line therapy for our patients and anxiolytics such as clonazepam was given to most of them. Based on the results of this study, OMD is the disease of the elderly, particularly of women and causes orofacial pain and compromises function of orofacial region. Some patients considered dental treatment a precipitating factor. Dentists, therefore, should have knowledge of symptoms and treatment of OMD.

The effects of fluoride releasing orthodontic sealants on the prevention and the progressive inhibition of enamel demiheralization in vitro (광중합형 및 자가중합형 교정용 전색제의 치아우식예방 및 진행억제효과에 관한 실험적 연구)

  • Chae, Seung-Won;Cho, Jae-O;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.27 no.6 s.65
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    • pp.979-995
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    • 1997
  • The purpose of this study was to identify the preventive and the progressive inhibitory effects of enamel demineralization with fluoride releasing light-and self-cured orthodontic sealants(FluoroBond), in vitro, under the polarizing light microscope and the scanning electon microscope. The polarizing light microscopic group was subdivided into seven groups(Group A-Group G). The scanning electron microscopic group was also subdivided into seven groups(Group A'-Goup G'). For polarizing light microscopic evaluation, longitudinal sections were made longitudinally by Maruto cutter(Maruto Co., Japan) and Maruto grinding machine(Maruto Co., Japan). Sections were examined and photographed by the polarizing light microscope(Olympus Optical Co., Japan) using crossed polars and with the enamel rod longitudinal axis oriented at $45^{\circ}$ to the extinction position. For scanning electron microscopic evaluation, the specimens were coated with a highly conducting layer of gold palladium in a model Hus-4 high-vacuum evaporator and examined in an ISI-100B scanning electron microcope operated at 20kV. The results of this study were as follows : 1. The mean depths of artificial carious lesions under a polarized light microscope were $Group\;A(5.08{\mu}m),\;Group\;B(47.82{\mu}m,\;Group\;C(8.42{\mu}m),\;Group\;D(7.20{\mu}m),\;Group\;E(85.41{\mu}m),\;Group\;F(60.38{\mu}m),\;Group\;G(60.13{\mu}m)$. 2. There were statistically significant differences in Group B compared with Group A, C, and D(p<0.05), and also, in Group I compared with Group F and Group G(p<0.05). 3. Light-and self-cured orthodontic sealants had the preventive effects of enamel demineralization. 4. Light-and self-cured orthodontic sealants had the progressive inhibitory effects of enamel demineralization. 5. The time progress of demineralizing agent had no influence on the samples of light-and self-cured orthodontic sealants under the scanning electron microscope. 6. There was no difference between the specimens of light-and self-cured orthodontic sealants both in the polarized light microscopic group and in the scanning electron microscopic group.

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Usefulness of Blood Pool Half Body in Three Phase Bone Scan in Patients with R/O Reflex Symphathetic Dystrophy Syndrome (반사성교감신경 이영양증후군 환자의 삼상 골 스캔 시 Half Body 혈액 풀 영상의 적용)

  • Lee, Moo-Seok;Lee, Hyo-Yeong;Yun, Jong-Jun;Lee, Hwa-Jin;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.105-110
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    • 2010
  • Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.

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Twelve-year Incidence of Hypertension and Its Risk Factors in a Lean Population: the Kangwha Study (강화지역 성인남녀의 12년간 고혈압 발생률과 위험요인: 강화연구)

  • Kim, Hyeon-Chang;Jee, Sun-Ha;Lee, Kang-Hee;Kim, Chang-Soo;Nam, Chung-Mo;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.435-442
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    • 1999
  • Objectives: The purpose of this study was to examine the twelve-year incidence of hypertension, and to find risk factors for the incidence in adult population in Kangwha County, Korea. Methods: In 1986, 413 males(mean age 37 years) and 434 females(mean age 33 years) were examined in the Kangwha Study, Among 764 non-hypertensive participants, 164 males and 214 females were reexamined in 1998. Blood pressure(BP) was measured with standard mercury sphygmomanometers. Multiple logistic regression analysis was used to estimate the relative risk of risk factors on the incidence of hypertension. Results: During the 12-year period, 68 of 164 males and 53 of 2f4 females developed hypertension. In a multiple logistic model adjusted for age and pulse rate, baseline BP, baseline body mass index(BMI) and BMI change during the follow-up period were significantly related to the incidence of hyperiension. Adjusted relative risk(RR)s of baseline high-normal BP were 3.90(95% CI: 1.81-7.84) in males, and 12.72(95% CI: 3.70-30.73) in females. Compared with lower baseline BMI group, adjusted RRs of middle baseline BMI group were 2.66(95% CI: 1.19-5.70) in males, and 2.33(95% CI: 0.95-5.55) in females. Adjusted RRs of upper baseline BMI group were 3.52(95% CI: 1.53-7.67) in males and 3.63(95% CI: 1.50-8.43) in females. Increase of BMI was positively related to the incidence in males(adjusted RR=2.71, 95% CI: 1.00-6.71) and females(adjusted RR=3.05, 95% CI: 1.29-6.88). Conclusions: The twelve-year incidence of hypertension was 41.5% in males, and 25.8% in females. Baseline BP, baseline BMI, and BMI change were strongly related to the incidence of hypertension.

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The Study of Driving Fatigue using HRV Analysis (HRV 분석을 이용한 운전피로도에 관한 연구)

  • 성홍모;차동익;김선웅;박세진;김철중;윤영로
    • Journal of Biomedical Engineering Research
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    • v.24 no.1
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    • pp.1-8
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    • 2003
  • The job of long distance driving is likely to be fatiguing and requires long period alertness and attention, which make considerable demands of the driver. Driving fatigue contributes to driver related with accidents and fatalities. In this study, we investigated the relationship between the number of hours of driving and driving fatigue using heart rate variability(HRV) signal. With a more traditional measure of overall variability (standard deviation, mean, spectral values of heart rate). Nonlinear characteristics of HRV signal were analyzed using Approximate Entropy (ApEn) and Poincare plot. Five subjects drive the four passenger vehicle twice. All experiment number was 40. The test route was about 300Km continuous long highway circuit and driving time was about 3 hours. During the driving, measures of electrocardiogram(ECG) were performed at intervals of 30min. HRV signal, derived from the ECG, was analyzed using time, frequency domain parameters and nonlinear characteristic. The significance of differences on the response to driving fatigue was determined by Student's t-test. Differences were considered significant when a p value < 0.05 was observed. In the results, mean heart rate(HRmean) decreased consistently with driving time, standard deviation of RR intervals(SDRR), standard deviation of the successive difference of the RR intervals(SDSD) increased until 90min. Hereafter, they were almost unchanging until the end of the test. Normalized low frequency component $(LF_{norm})$, ratio of low to high frequency component (LF/HF) increased. We used the Approximate Entropy(ApEn), Poincare plot method to describe the nonlinear characteristics of HRV signal. Nonlinear characteristics of HRV signals decreased with driving time. Statistical significant is appeared after 60 min in all parameters.

Macrobenthic Community of the Subtidal Soft Bottom of Aenggang Bay in the Southern Coast of Korea (남해 앵강만 조하대 연성저질 저서동물 군집)

  • Lim, Hyun-Sig;Park, Heung-Sik;Choi, Jin-Woo;Je, Jong-Geel
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.4 no.1
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    • pp.80-92
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    • 1999
  • This study was conducted to describe the community structure of macrobenthos in Aenggang Bay, the southern coast of Korea. Sampling was performed seasonally using van Veen grab from October 1994 to August 1995. A total of 233 species occurred; polychaetes accounted for 90 species, crustaceans 66 species, and mollusks 46 species. The mean density of macrobenthos was 1,358 ind./$m^2$, and polychaetes accounted for 64% of total abundance with its density of 874 ind./$m^2$. Mean macrobenthic biomass was 261.96 gWWt/$m^2$, and echinoderms accounted for 52.6% of total biomass with its biomass of 137.76 gWWt/$m^2$. Dominant species were a serpulid worm, Ditrupa arientina (245 ind./$m^2$), a cirratulid worm, Tharyx sp. (166 ind./$m^2$), and a scaphopod Fustaria nipponica (132 ind./$m^2$). Ditrupa arientina and Fustaria nipponica were distributed mainly in the mouth of Aenggang Bay, whereas Tharyx sp. showed its high density in the central region of the bay. The study area showed a regional difference in species richness, abundance, and biomass; the eastern region of the bay sustained relatively more abundant and richer macrobenthos than the western part. The study area could be divided into 5 regions by the cluster analysis based on the species composition of macrobenthos; the inner bay, two central regions, and two mouth areas of the bay.

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