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Nasal Continuous Airway Pressure Titration Unmasks Periodic Limb Movements in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증에서 지속적 상기도 양압술에 따른 주기성 사지운동증의 표출)

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.103-110
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    • 1998
  • Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.

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Analysis of Relationship Between Dental Health Condition and Eating Habit (치아건강상태와 식습관과의 상관관계 분석)

  • kim, Jeong-Sook;Lee, Jong-Do;Jung, Hyo-Kyung
    • Journal of Technologic Dentistry
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    • v.29 no.1
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    • pp.103-119
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    • 2007
  • The survey on dental health condition and eating habit of local residents in Daegu and Kyungbuk had been conducted. Through the analysis of influence of dental health condition on eating habit I could get the following result. The number of subjects of survey is 630. The period of survey is from June 2006 to September 2006. 1. General quality of subjects is that forty-four point four percent of subjects are male and fiftyfive pointsix percent are female. The age of thirty point one percent of subjects is between 20 and 29. Fifty-six point two percent of subjects are married. Fifty-one point four percent of subjects have above bachelor degree. Monthly income of forty-four point eight percent of subjects is less than one million won. Twenty-four point four percent of subjects are students. Fifty-five point seven percent of subjects are living in big cities. 2. Forty-seven point seven percent of male and fifty-one point eight percent of female answered their subjective dental health condition is bad. Marital status, age and academic background have relationship with answer. Forty-three point nine percent of married subjects and forty-one point five percent of divorced or bereaved subjects said they have bad dental health condition. The older he is or the lower academic background he has subjects think they have bad dental health condition. Forty-seven point four percent of non-educated subjects answered their dental health condition is bad. Forty-six percent of self-employed subjects and subjects who live in the country have tendency to think their dental health condition is bad. 3. About eating habit knowledge, male's knowledge of 2.03$\pm$0.20 is lower than female's of 2.08$\pm$0.21. This shows there is statistically significant difference(p<0.01). 4. There is significant relationship between subjective dental health condition and health condition of subjective. This means subject who has better health condition has also better dental health condition(37.5%). About subjective dental health condition, subject who eats restoratives has worse dental health condition. This shows there is a relationship between dental health condition and eating restoratives(p=0.004) and subject who works out steadily has better dental condition. 5. About relation between dental health condition and eating habit, subject who eats vegetables has worse dental health condition by fifty point seven percent. As cross tabulation result, p-value is 0.002. In level of significance of 0.05, there is statistically significant difference in eating habit. 6. It seems that eating habit has an effect on marital status, age, academic background, income and also on dental prosthetic treatment situation. Many subjects think their dental health condition is bad. About eating habit, subjects who eat meat have better dental health condition. Subjects who drink green tea and fruit juice has better dental health condition than who drink coffee and Balanced diet is good for dental health condition. As eating habit is important for developing dental health, government should make a proper program. Dental health education program especially for elderly, low-eduacted, residents in the country and poor people should be developed. Government, dental health organization, dental health specialist, associated research institution and people work in the press should be concerned and devote to improve quality of life. Primary prevention education will help for dental health.

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

Association between Normal-tension Glaucoma and Allergic Rhinitis in a Korean Population-based Study (정상안압녹내장과 알레르기비염과의 연관성: 제5기 국민건강영양조사 자료)

  • Jeong, Areum;Cha, Soon Cheol
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.10
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    • pp.960-967
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    • 2018
  • Purpose: The purpose of this study was to investigate the association between normal-tension glaucoma (NTG) and allergic rhinitis in a population-based setting using data from the Korea National Health and Nutrition Exam Survey (2010-2012). Methods: The authors selected a total of 8,614 participants aged 40 years and older for this study. All participants completed an ophthalmic examination required for diagnosis of NTG based on the International Society for Geographical and Epidemiological Ophthalmology criteria. An interview regarding nasal symptoms was also performed. The included participants were classified into NTG (n = 604) and control (n = 8,010) groups. The authors compared the groups in terms of prevalence of allergic rhinitis and identified risk factors of NTG. Results: In NTG patients, allergic rhinitis prevalence was 29.1% (176/604), which was significantly higher than that of the control group (25.0%, 2,000/8,010; p = 0.023). There were significant associations between NTG and allergic rhinitis (odds ratio [OR]=1.34, 95% confidence interval [CI] = 1.12-1.62, p = 0.002), even after adjusting for potential confounders (age, sex, diabetes, hypertension, number, of family members, household income quartile, frequency of eating out, and smoking status). In particular, patients with NTG aged 60-69 years, those aged 70-79 years, and those who were male had significantly higher ORs for prior allergic rhinitis compared with control subjects (OR = 1.62, 95% CI = 1.16-2.26, p = 0.005; OR = 1.52, 95% CI = 1.06-2.18, p = 0.024; and OR = 1.42, 95% CI = 1.10-1.83, p = 0.007, respectively). Conclusions: This study showed a significant association between NTG incidence and allergic rhinitis, especially in males and elderly patients (>60 years of age). These results suggested that allergic rhinitis may have a potential role in the development of NTG. Therefore, ophthalmologists and allergic rhinitis patients should remain vigilant to this potential risk factor.

Ethanol Extract of Glycyrrhiza uralensis Protects Against Oxidative Stress-induced DNA Damage and Apoptosis in Retinal Pigment Epithelial Cells (망막색소상피세포에서 감초 추출물의 산화적 스트레스에 의한 DNA 손상 및 apoptosis 유발의 차단 효과)

  • Kim, So Young;Kim, Jeong-Hwan;Kim, Sung Ok;Park, Seh-Kwang;Jeong, Ji-Won;Kim, Mi-Young;Lee, Hyesook;Cheong, JaeHun;Choi, Yung Hyun
    • Journal of Life Science
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    • v.29 no.11
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    • pp.1273-1280
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    • 2019
  • Age-related macular degeneration (AMD) is one of the leading causes of blindness in the elderly population, and damage to retinal pigment epithelial (RPE) cells due to oxidative stress contributes to the development of AMD. Glycyrrhiza uralensis Fischer is one of the most widely used herbal medicines for the treatment of various diseases in Asian countries. Although recent studies indicated that treatment with G. uralensis can protect cells from oxidative stress, its mechanisms in RPE cells remain unknown. We evaluated the effect of a G. uralensis ethanol extract (GU) on $H_2O_2$-induced oxidative injury in ARPE-19 RPE cells. The GU pretreatment attenuated reactive oxygen species (ROS) generation induced by $H_2O_2$, which was associated with induced expression of nuclear factor erythroid-derived-2-like 2 (Nrf2) and heme oxygenase-1 (HO-1). GU also suppressed $H_2O_2$-induced DNA damage and mitochondrial dysfunction. The inhibitory effect of GU on $H_2O_2$-induced apoptosis was associated with the protection of caspase-3 activation. Overall, GU appeared to protect RPE cells from oxidative injury by inhibiting DNA damage and reducing apoptosis. Further studies are needed to determine the regulation of Nrf2-mediated HO-1 expression, but our results suggest the possibility of using GU to reduce the risk of AMD.

Need Assessment for Enlargement of Oriental Medical Care Service Room in Rural Community Health Center (농촌지역 보건소 한방진료실 확대설치 요구도 및 관련요인 - 일개 군 보건소 한방진료실 내소자를 대상으로 -)

  • Kim, Dae-Feel;Song, Mi-Sook;Song, Hyun-Jong
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.39-51
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    • 2003
  • Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.

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An Analysis of Age Estimation Cases in Korea from the View of Social Aspects (사회적 측면에서 본 한국 연령 감정 대상자 사례의 분석)

  • Kwon, Choonik;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.235-246
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    • 2013
  • Age estimations by forensic odontology play a great role in personal identification. The purpose of this study was to analyze the characteristics of age estimation cases in Korea. Surveying clients who requested age estimation at the Department of Oral Medicine, Kyungpook National University Dental Hospital from March 2012 to March 2013. The results were as follows: 1. On gender distribution, females(57.14%) were more than males(42.86%). The elderly with 50's and over 60's were majorities(89.28%) of clients, and no clients were below 40's. Most of clients were equal to and lower than elementary school graduate(69.64%). 2. The most frequent reason for age discrepancy between registered age and alleged age was mistakes by family or relatives(80.36%). The purposes of age estimation were welfare(62.50%), social relationship problem(12.50%), to find right age(10.71%), and occupation(8.93%). 3. In order of route to visit at Department of Oral Medicine, they were via government office(48.21%), acquaintances(21.43%), mass media(14.29%), and clinic(10.71%). Clients had high degree of comprehension on age estimation with forensic odontology (scored 7.03 out of 10). The 2/3 of clients were satisfied with present fee for age estimation. 4. The percentage on the proximity of estimated age to alleged age was 69.81%. 4(11.43%) clients were approved on age correction by court.

Influence of Cerebral Protection Methods in Thoracic Aortic Surgery Using Hypothermic Circulatory Arrest (저체온 순환정지를 이용한 흉부 대동맥 수술 시 뇌관류 방법에 따른 수술결과)

  • Kim, Jae-Hyun;Na, Chan-Young;Oh, Sam-Sae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.229-238
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    • 2008
  • Background: Protection of the brain is a major concern during thoracic aortic surgery using hypothermic circulatory arrest (HCA). This study compares the surgical outcomes of two different cerebral protection methods in thoracic aortic surgery using HCA: retrograde cerebral protection (RCP) and antegrade cerebral protection (ACP). Material and Method: We retrospectively reviewed data on 146 patients who underwent thoracic aortic surgery from May 1995 to February 2007 using either RCP (114 patients, Group 1) or ACP (32 patients, Group 2) during HCA. There were 104 dissections (94 acute and 10 chronic) and 42 aneurysms (41 true aneurysms and 1 pseudoaneurysm), and all patients underwent ascending aortic replacement. There were 33 cases of hemiarch replacement, 5 of partial arch replacement, and 21 of total arch replacement. Result: The two groups were similar in preoperative and operative characteristics, but Group 2 had more elderly (over 70 years old) patients (34.4% vs. 10.5%), more coronary artery diseases (18.8% vs. 4.4%), more total arch replacements (46.9% vs. 5.3%) and longer HCA time ($50{\pm}24$ minutes vs. $32{\pm}17$ minutes) than Group 1. The operative mortality was 4.4% (5/114) and 3.1% (1/32), the incidence of permanent neurologic deficits was 5.3% (6/114) and 3.1% (1/32), and the incidence of temporary neurologic deficits was 1.8% (2/114) and 9.4% (3/32) in Groups 1 and 2, respectively. There were no statistical differences between the two groups in operative mortality, postoperative bleeding, or neurologic deficits (permanent and temporary). Conclusion: The early outcomes of aortic surgery using HCA were favorable and showed no statistical difference between RCP and ACP. However, the ACP patients endured longer HCA times and more extended arch surgeries. ACP is the preferred brain protection technique when longer HCA time is expected or extended arch replacement is needed.

Population Strategy for Physical Activity in Korea (우리나라 신체활동 및 운동사업에서의 인구집단 전략)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.227-240
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    • 2005
  • Health promotion has more comprehensive approaches in recent years. Nevertheless we accept the concept of health promotion differently, we are agree on that community is the most important field in health promotion which includes population at the aspect of health policy, individual skill and, environment. And there are a number of different approaches to health promotion. In them, 'population approaches' and 'high -risk group approaches' has the most different characteristics. 'Population approaches' is equally important or more important than 'individual approaches' for maintaining and promoting population health. Almost part of this article contents is the summary of the guideline and population strategy of health promotion in Korea, 1999 - 2005. Community based health promotion program should be reinforced, integrated, comprehensive, collaborative through efficiently utilizing community resources. Recent new orientation of community health program is integrated health program, we can find this orientation at Ottawa charter 1986. Comprehensive approaches with the determinant factors for health are essential task. Physical activity is a key health determinant. The population-health approach suggests that educating people about physical activity is not enough. Individual behavior changes are important too, but need to be balanced with strategies for environmental change. Population strategy with physical activity for health promotion should be developed through improving social and physical supportive environment, linking and integrating community resources between public and private sectors in national, regional and local level. Continuous public education and social marketing should be provided through collaborating with community physical activity organization, facilities, work-places and school for increasing concern of all the people of community about physical activity. Governments, agencies and citizens should held and participate to building movement. And the strategy that various 'active for life' program should be developed, delivered, maintained and reinforced continuously. Basically, adequate and sufficient financing, developing human resources, policies and legislation would be provided and supported fully too. At last, research development and knowledge exchange are required domestically and internationally. In Korea, we had classified the category of strategic priority of physical activity programs by environmental support, life-course approach, high-risk group approach and disease group approach for physical activity program based on community health center. Community based core programs for physical activity that includes infrastructure building and establishment of supporting environment, community campaign, health promotion education and public service announcement, physical activity programs for elderly and obesity, exercise prescription program.

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Nutritional Adequacy of Target Pattern in Dietary Guidance System - Dietary Reference Intakes for Koreans 2015 - (식사구성안 권장식사패턴의 영양 적정성 평가 - 2015 한국인 영양소 섭취기준 -)

  • Kim, Youngnam
    • Journal of Korean Home Economics Education Association
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    • v.29 no.3
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    • pp.77-88
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    • 2017
  • Nutritional adequacy of Target patterns in Dietary Guidance System were evaluated. Study subjects were 18 Target patterns designed for 2 children groups, 4 adolescent and 4 adult male and female groups in Dietary Reference Intakes for Koreans 2015. Nutrients examined were 4 macro-nutrients(protein, fat, carbohydrate, and dietary fiber), 5 minerals(Ca, P, Fe, Na, and K), and 5 vitamins(vitamin A, thiamin, riboflavin, niacin, and vitamin C). Energy and nutrients contents were calculated based upon assigned multiples of single serving in Target pattern and Representative Food Composition Table by Excel program. Among the 18 Target patterns, only 5 were mean adequacy ratio(MAR) of 1.0, fulfilled the expectations of Dietary Guidance System. Protein and Na contents were more than dietary reference intakes(DRI) in all 18 Target patterns. Dietary fiber, Ca, and K were deficient nutrient in 15, 10, and 9 Target patterns, respectively. The units of vitamin A were not same in Target pattern and DRI, retinol equivalent(RE) in Target pattern and retinol activity equivalent(RAE) in DRI. When calculate RE content of vitamin A in Target pattern to RAE content, 15 Target patterns did not reach to DRI of vitamin A. The Target pattern of elderly women showed the lowest mean adequacy ratio(MAR), 7 nutrients were less than DRI, need to be revised. Average energy contribution ratio of protein, fat, and carbohydrate were 16.04%, 24.35%, and 60.91%, respectively, fulfilled the adequate acceptable macro-nutrient distribution range(AMDR). To improve the nutritional inadequacy of dietary fiber, Ca, K, and vitamin A in Target pattern, effective mean may be the increasing vegetable group assignment. Also decreasing the meat fish egg legume group assignment in some Target pattern may be the way of preventing of protein overconsumption. The energy in adequate amount for condiment use also need to be considered.