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.
The purpose of the paper is to research issues and implications on a large-scale enlargement of urban area in city management plan. This study investigated laws and regulations in force and carried out case study for three cities such as Yangju-si, Gimpo-si, Whaseong-si. As a result of analysis, three points at issue were abstracted and improvement ideas for each of them were suggested as follows. First, to set up adequate size of urban area, it is necessary to consider resonable planning for population, spatial structure, zone of life and land use in city comprehensive plan and city management plan. Second, to decrease arguments about scope and bounds of urban area, it is important to make general and specific guidelines to set up them. Third, to manage new urban area and its surroundings efficiently, it is necessary to subdivide zoning of non-urban area strictly, to restraint individual location of factories or cattle sheds, to make a proper infrastructure plan in advance, to administer strongly the permission of development behavior and to control strictly consecutive and joining development in non-urban area.
Hyunji Ju;Seungho Lee;Minjung Kim;Gabeen Lee;Young-Seoub Hong
Journal of Environmental Health Sciences
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v.50
no.3
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pp.181-190
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2024
Background: Air pollutants have been reported to have harmful effects on human health. Busan is a vulnerable area in terms of air quality due to the installation of various industrial complexes, particularly the port industry. However there is limited research data on the ambient air quality of residential areas near ports and industrial complexes. Objectives: This study aimed to determine the quarterly levels of air pollutants near industrial complexes and ports and to identify trends and characteristics of air pollutant exceedances. Methods: Air measurements were conducted quarterly. The measured air pollutants included O3, SO2, CO, NO2, PM10, and PM2.5. PM10 and PM2.5 were measured using BAM-1020 equipment, while O3, SO2, CO, and NO2 were measured using AP-370 Series equipment. The quarterly concentration levels of air pollutants were determined, and the influence of precipitation and commuting hours on fine particulate matter was examined. Analysis of variance (ANOVA) was conducted to determine if there was significance between the concentrations of fine particulate matter during commuting hours and non-commuting hours. Results: The concentrations of air pollutants were generally higher in the first and second quarters. Furthermore, the concentrations of PM10 and PM2.5 tended to decrease continuously following consecutive rainfall, with concentrations at the end of rainfall periods lower than those observed at the beginning. The frequency of exceeding average concentrations of PM10 and PM2.5 was higher on weekdays. Moreover, the average concentrations of PM10 and PM2.5 during weekday commuting hours were higher compared to non-commuting hours. Conclusions: The concentrations of air pollutants in the survey area were found to be higher than the overall average in Busan. Based on this study, continuous air quality monitoring is necessary for residential areas near industrial complexes and ports. For further research, health biomonitoring of residents in these areas should be conducted to assess their exposure levels.
Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBFratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBFratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.
We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.
Kim, Kang-Woong;Kim, Sung-Sam;Kim, Jae-Won;Son, Maeng-Hyun;Kim, Kyoung-Duck;Bai, Sung-Shul C.;Lee, Kyeong-Jun
Korean Journal of Fisheries and Aquatic Sciences
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v.44
no.5
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pp.490-498
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2011
Two consecutive feeding trials investigated the effects of feeding rate and pellet expansion by water-soaking on the growth performance, blood components and histology of olive flounder Paralichthys olivaceus. The first two experiments were carried out to determine the effects of pellet expansion and feeding rate. In the first experiment, growth performance, feed utilization and survival of fish were not significantly affected by pellet expansion for six weeks. There were no significant differences in hematocrit, hemoglobin, aspartate aminotransferase, alanine aminotransferase, glucose and total protein of fish fed the expanded pellet. However, whole-body lipid content of fish in the non-expanded group was significantly higher than that in the expanded group. Histological analysis of the anterior intestine revealed that fish in the expanded group had shorter and smaller mucous folds. These results indicate that pellet expansion had no beneficial effect in terms of growth performance, feed utilization and fish health. In the second experiment, weight gain and feed efficiency were significantly increased as feeding rate increased from 0 to 2.5% body weight per day (BW/d), but there were no significant differences in weight gain or feeding efficiency in fish fed the expanded pellet at ratios of 2.5% BW/d and satiation for three weeks. Plasma aspartate aminotransferase activity of fish fed the expanded pellet at a ratio of 2.5% was significantly lower than that of starved fish. Histological analysis of the anterior intestine revealed that fish in the 0% group had shorter mucous folds. Broken-line regression analysis suggested that the optimum juvenile olive flounder feeding rate was 3.5% BW/d during the low temperature season ($16-17^{\circ}C$).
Dong Young Jeong;Tae Wook Kang;Ji Hye Min;Kyoung Doo Song;Min Woo Lee;Hyunchul Rhim;Hyo Keun Lim;Dong Hyun Sinn;Heewon Han
Korean Journal of Radiology
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v.21
no.9
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pp.1077-1086
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2020
Objective: To evaluate the effect of perfluorobutane microbubbles (Sonazoid®, GE Healthcare) on steam popping during radiofrequency (RF) ablation for treating hepatocellular carcinoma (HCC), and to assess whether popping affects treatment outcomes. Materials and Methods: The institutional review board approved this retrospective study, which included 90 consecutive patients with single HCC, who received percutaneous RF ablation as the first-line treatment. The patients were divided into two groups, based on the presence or absence of the popping phenomenon, which was defined as an audible sound with a simultaneous sudden explosion within the ablation zone as detected via ultrasonography during the procedure. The factors contributing to the popping phenomenon were identified using multivariable logistic regression analysis. Local tumor progression (LTP) and disease-free survival (DFS) were assessed using the Kaplan-Meier method with the log-rank test for performing comparisons between the two groups. Results: The overall incidence of the popping phenomenon was 25.8% (24/93). Sonazoid® was used in 1 patient (4.2%) in the popping group (n = 24), while it was used in 15 patients (21.7%) in the non-popping group (n = 69). Multivariable analysis revealed that the use of Sonazoid® was the only significant factor for absence of the popping phenomenon (odds ratio = 0.10, p = 0.048). There were no significant differences in cumulative LTP and DFS between the two groups (p = 0.479 and p = 0.424, respectively). Conclusion: The use of Sonazoid® has a suppressive effect on the popping phenomenon during RF ablation in patients with HCC. However, the presence of the popping phenomenon may not affect clinical outcomes.
Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.
Purpose: 4DCT scans performed for radiotherapy were retrospectively analyzed to assess the possible benefits of respiratory gating in non-small cell lung cancer (NSCLC) and established the predictive factors for identifying patients who could benefit from this approach. Materials and Methods: Three treatment planning was performed for 15 patients with stage I~III NSCLC using different planning target volumes (PTVs) as follows: 1) PTVroutine, derived from the addition of conventional uniform margins to gross tumor volume (GTV) of a single bin, 2) PTVall phases (patient-specific PTV), derived from the composite GTV of all 6 bins of the 4DCT, and 3) PTVgating, derived from the composite GTV of 3 consecutive bins at end-exhalation. Results: The reductions in PTV were 43.2% and 9.5%, respectively, for the PTVall phases vs. PTVroutine and PTVgating vs. PTVall phases. Compared to PTVroutine, the use of PTVall phases and PTVgating reduced the mean lung dose (MLD) by 18.1% and 21.6%, and $V_{20}$ by 18.2% and 22.0%, respectively. Significant correlations were seen between certain predictive factors selected from the tumor mobility and volume analysis, such as the 3D mobility vector, the reduction in 3D mobility and PTV with gating, and the ratio of GTV overlap between 2 extreme bins and additional reductions in both MLD and $V_{20}$ with gating. Conclusion: The additional benefits with gating compared to the use of patient-specific PTV were modest; however, there were distinct correlations and differences according to the predictive factors. Therefore, these predictive factors might be useful for identifying patients who could benefit from respiratory-gated radiotherapy.
This fMRI study is aim to investigate effects of competitive environment in cognitive empathic process in human brain. Empathy is known as a crucial factor for human's adaptive behavior in aspects of social cognition and it is almost automatic process, on the other hand competitive situation is psychologically devastated environment to win someone for getting rewards. We hypnotized that reading and understanding of other person's mind are a specific characteristic related to survival evolutionarily, however competition would have an effect on the empathic cognitive process because of mechanisms of competition. To manipulate the competitive atmosphere, one researcher took a role of competitor against participants and they were instructed to get monetary rewards when their performance was better than a competitor. 21 participants(9 males and 12 females) performed to judge the emotional valence of the empathic task consisted of illustrated images with various situation could be experienced in real world as on $1^{st}$ person perspective in both competitive and non-competitive condition, and did same performance with objects stimulus in control condition. In order to examine the competition effects on empathic process,, hemodynamic response were obtained during fMRI session and the imaging data were analyzed to identify brain regions where responses to each condition across the two consecutive runs. Participants' reaction time in competitive condition was faster statistically significant than non-competitive one. Activation for competitive condition increased in the following areas: ACC, mPFC, SMG, thalamus extended caudate and Nacc, parahippocampal gyrus, and for non-competitive condition increased paracingulate gyrus, temporal pole, vmPFC, superior occipital gyrus. As a result of regression analysis using empathic scores as covariance, the rSMG, IFG, fusiform gyrus, thalamus, putamen were correlated with higher empathic levels, and TPJ were correlated with lower empathic scores. We suggest that these observations could mean competitive environment have an effect on neural base of cognitive empathic process.
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