Treatment Outcomes of Mandibular Advancement Devices in Obstructive Sleep Apnea Patients

( Cheon-sik Kim ),( Yong-seok Lee ),( Cheon-ung Cho ),( Dae-sik Kim ) 대한임상검사과학회 2011 대한임상검사과학회지(KJCLS) Vol.43 No.2

Mandibular advancement devices (MAD) are therapeutic options for obstructive sleep apnea (OSA). The aim of study was to investigate treatment outcomes of before and after insertion of MAD in OSA patients. We retrospectively selected a total of 13 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea-hypopnea index (AHI), oxygen desaturation index (ODI), wake after sleep onset (WASO), total arousal were measured by before and after MAD. The use of MAD proves to be efficient in reducing snoring, apnea-hypopne index (17.2±14.6 vs 20.9±14.6), WASO (27.4±28.8 vs 47.9±43.6 ), oxygen desaturation index (9.0±11.6 vs 16.4±11.7), stage N3 (54.8±45.2 vs 36.6±22.0), REM sleep times (73.3±19.4 vs 66.0±31.0) and increases sleep efficiency (92.6±6.6 vs 87.2±11.2). The decreases in apnea index based on a reduction in the overall and supine AHI values after MAD therapy were significantly greater for the positional OSA than nonpositional OSA patients. The use of MAD proves to be efficient in snoring, WASO, sleep efficiency, reduced AHI and associated with good compliance of patients.

The Prevalence and Characteristics of Positional Obstructive Sleep Apnea

( Cheon-sik Kim ),( Yong-seok Lee ),( Cheon-ung Cho ),( Sang-ho Pae ),( Sang-ahm Lee ) 대한임상검사과학회 2012 대한임상검사과학회지(KJCLS) Vol.44 No.2

Patients with obstructive sleep apnea (OSA) often have more aggravated symptoms in the supine position. We tried to investigate the clinical characteristics and the predictive factors for positional OSA. Polysomnographic data were reviewed for OSA patients (apnea hypopnea index, AHI≥5) from April, 2008 to April, 2011 at the Asan Medical Center. Clinical data, comorbid medical condition data and questionnaires (SF-36, MFI-20, ESS, BDI, STAI) were assessed. All patients were classified into two groups: positional patients (PP) group and non-positional patients (NPP) group. PP was defined as a patient who had the AHI in the supine position was at least twice as high as that in the lateral position. The body position of patients was confirmed by sleep position sensor and video monitor. All patients had at least 30 minutes of positional and 30 minutes of non-positional sleep. We compared clinical, medical, polysomnographic data, and questionnaire results between two (PP and NPP) groups and investigated predictive factors for the PP group using binary logistic regression analysis. In total, 371 patients were investigated. 265 (71.4%) was categorized as PP group and 106 (28.5%) as NPP group. The mean age (mean±SD) was higher in the PP group (52.4±9.8) than in the NPP group (49.5±11.9) (p<0.05). Comparison of sleep parameters between the PP and the NPP group showed that the PP group had significantly lower BMI (PP: 26.1±3.2 kg/m2; NPP: 27.8±4.3kg/m2, p<0.001), neck circumference (PP: 39.7±2.8 cm; NPP: 41.5±3.7 cm, p<0.001) and hypertension rate (PP: n=89/265 (33.5%); NPP: n=48/106 (45.2%), p=0.0240). In the PP group, the percentage of deep sleep (PP: 8.7±8.1%; NPP: 5.6±7.0%, P=0.001) and rapid eye movement (REM) (PP: 17.5±6.1%; NPP: 14.0±6.9%, p<0.001) were significantly higher whereas the percentage of light sleep (stage N1) was significantly lower than the NPP group (PP: 30.4±12.3; NPP: 44.5±20.8%, p<0.001). During the sleep, the AHI in the supine position (PP: 48.6±19.5; NPP: 60.5±22.6, p<0.001) and in the non-supine position (PP: 9.4±8.9; NPP: 48.4±24.8, p=<0.001) were significantly lower and the minimal arterial oxygen saturation in non-REM sleep was significantly higher in the PP group (PP: 80.3±7.6; NPP: 75.1±9.9, p=<0.001). There were no significant differences in all questionnaires including quality of life. The results of the binary logistic regression analysis showed that age, the amount of REM sleep(%) and AHI were significant predictive factors for positional OSA. The significant predictive factors for positional OSA were older age, higher percentage of REM and lower AHI. The questionnaire results were not significantly different between the two groups.

Changesin the Scoring of Obstructive Sleep Breathing Events: According to the AASM in 1999 versus 2007 Recommended Criteria

( Cheon Sik Kim ),( Eun Mi Lee ),( Yong Seok Lee ),( Cheon Ung Cho ),( Sang-ahm Lee ) 대한임상병리사협회 2009 임상생리검사학회 발표자료집 Vol.2009 No.-

Purpose The definition of accurate recording and measuring of sleep related obstructive breathing events are clinically critical as a base for quantifying disease severity and assessment related to diverse morbiditiesin obstructive sleep apnea hypopnea syndrome (OSAHS). The aim of the study is to explore the effect of using different scoring recommendations for apnea and hypopnea in polysomnographic studies: 1) The 1999 AASM Task Force (AASM 1999); 2) The 2007 AASM Task Force (AASM 2007). Method 60 total patients who were diagnosed with OSAHS using the 2007 AASM recommendations (20 patients in each severity grade; mild, moderate and severe 55 males, mean age 47.9±11.7yrs, mean BMI 25.9±3.4kg/m2) at the Asan Medical Center were randomly selected and studied retrospectively. All sleep related scoring was derived from two different criteria AASM 1999 and AASM 2007. We compared the change of apnea index (obstructive; OI, central; CI, mixed; MI), hypopnea index (HI) and AHI using paired-t test (p<0.05). Results Of total patients, higher OI and HI were prominent with AASM 1999 (AASM 1997 vs. 2007; OI; 20.91±20.96/hr vs. 15.23±18.41/hr, p<0.001, HI; 14.30±7.76/hr vs. 12.66±9.26/hr, p<0.001). There were no significant changes in MI and CI between the two criteria. Total AHI with AASM 2007 was lower than AASM 1999 (AASM 1997 vs. 2007; 36.90±24.02/hr vs. 29.57±23.66/hr, p<0.001). In subgroups according to AHI severity grade (5≤<15, 15≤<30, ≥30), apnea and hypopnea index was reduced significantly in all grades, except no change of hypopnea index in severe grade and there was a 50% drop from moderate to mild grade and a 33% drop from severe to moderate grade after AASM 2007 application. Conclusions We investigated the variation of OSAHS according to two different scoring criteria for apnea and hypopnea. The change of AHI criteria influenced to the reduction of AHI score, especially apnea index and resulted in a down grading of severity as approximately more than one third with patients of OSAS. AASM 2007 criteria is more strict to apnea but sensitive to hypopnea detection in mild to moderate severity of OSAS than AASM 1999.

Polysomnographic Results before and after Uvulopalatopharyngoplasty

( Cheon-sik Kim ),( Dae-sik Kim ),( Yong-seok Lee ),( Cheon-ung Cho ),( Sang-ho Pae ),( Won-tae Kim ) 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.2

Uvulopalatopharyngoplasty (UPPP) is one possibility for the treatment of Obstructive Sleep Apnea (OSA). The aim of this study was study the analysis of polysomnography of pre-UPPP and post-UPPP. All patients were evaluated by means of a physical examination, the epworth sleepiness scale (ESS), the beck depression inventory (BDI) and the nocturnal polysomnography (PSG) before surgery, and 6∼12 months after surgery. A total of 15 patients were investigated. All underwent UPPP. The patients were between 26 and 62 years old (mean±SD; 39.7±10.9) with a lean body mass index (BMI) of mean±SD; 26.2±3.0 kg/m2. The comparison of sleep questionnaires showed that after UPPP, the patients had a significantly lower BMI (26.2±3.0 kg/m2 vs 26.0±3.4 kg/m2, p =0.241), ESS (10.0±5.4 vs 6.9±3.2, p =0.022), BDI (9.2±8.2 vs 4.2±4.3, p =0.343) and higher blood pressure (127.5±12.1 vs 123.7±12.0, p =0.272) compared to before UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly lower stage N1 (108.8±53.1 vs 82.2±48.9, p =0.016), lower sleep latency (4.9±4.4 vs 2.0±1.7, p =0.083), a lower total arousal number (210.6±90.3 vs 147.1±87.3, p =0.019), lower oxygen desaturation index (ODI) (30.2±20.9 vs 10.2±15.1, p =0.006), lower apnea-hypopnea index (AHI) (31.6±22.4 vs 10.9±15.4, p =0.005), and a lower respiratory disturbance index (RDI) (37.4±21.3 vs 18.5±16.5, p =0.008) compared to after UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly higher stage N2 (154.0±39.9 vs 180.5±49.5, p =0.017), higher REM (58.5±29.7 vs 72.6±34.0, p =0.249), higher meanSaO2 (94.3±2.0 vs 95.9±0.9, p =0.043), and higher minSaO2 (79.3±8.5 vs 83.1±7.9, p =0.116) than before UPPP. After UPPP, 6 patients were cured, 2 showed marked improvement, and 7 did not improve. After surgery, the success of the treatment was at 53%. The subjective patient satisfaction was higher than before the surgery.

Treatment Outcomes of Mandibular Advancement Devices in Obstructive Sleep Apnea Patients

Kim, Cheon-Sik,Lee, Yong-Seok,Cho, Cheon-Ung,Kim, Dae-Sik 대한임상검사과학회 2011 대한임상검사과학회지(KJCLS) Vol.43 No.2

Mandibular advancement devices (MAD) are therapeutic options for obstructive sleep apnea (OSA). The aim of study was to investigate treatment outcomes of before and after insertion of MAD in OSA patients. We retrospectively selected a total of 13 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea-hypopnea index (AHI), oxygen desaturation index (ODI), wake after sleep onset (WASO), total arousal were measured by before and after MAD. The use of MAD proves to be efficient in reducing snoring, apnea-hypopne index ($17.2{\pm}14.6$ vs $20.9{\pm}14.6$), WASO ($27.4{\pm}28.8$ vs $47.9{\pm}43.6$), oxygen desaturation index ($9.0{\pm}11.6$ vs $16.4{\pm}11.7$), stage N3 ($54.8{\pm}45.2$ vs $36.6{\pm}22.0$), REM sleep times ($73.3{\pm}19.4$ vs $66.0{\pm}31.0$) and increases sleep efficiency ($92.6{\pm}6.6$ vs $87.2{\pm}11.2$). The decreases in apnea index based on a reduction in the overall and supine AHI values after MAD therapy were significantly greater for the positional OSA than nonpositional OSA patients. The use of MAD proves to be efficient in snoring, WASO, sleep efficiency, reduced AHI and associated with good compliance of patients.

Polysomnographic Results before and after Uvulopalatopharyngoplasty

Kim, Cheon-Sik,Kim, Dae-Sik,Lee, Yong-Seok,Cho, Cheon-Ung,Pae, Sang-Ho,Kim, Won-Tae 대한임상검사과학회 2013 대한임상검사과학회지(KJCLS) Vol.45 No.2

Uvulopalatopharyngoplasty (UPPP) is one possibility for the treatment of Obstructive Sleep Apnea (OSA). The aim of this study was study the analysis of polysomnography of pre-UPPP and post-UPPP. All patients were evaluated by means of a physical examination, the epworth sleepiness scale (ESS), the beck depression inventory (BDI) and the nocturnal polysomnography (PSG) before surgery, and 6~12 months after surgery. A total of 15 patients were investigated. All underwent UPPP. The patients were between 26 and 62 years old ($mean{\pm}SD$; $39.7{\pm}10.9$) with a lean body mass index (BMI) of $mean{\pm}SD$; $26.2{\pm}3.0kg/m^2$. The comparison of sleep questionnaires showed that after UPPP, the patients had a significantly lower BMI ($26.2{\pm}3.0kg/m^2$ vs $26.0{\pm}3.4kg/m^2$, p=0.241), ESS ($10.0{\pm}5.4$ vs $6.9{\pm}3.2$, p=0.022), BDI ($9.2{\pm}8.2$ vs $4.2{\pm}4.3$, p=0.343) and higher blood pressure ($127.5{\pm}12.1$ vs $123.7{\pm}12.0$, p=0.272) compared to before UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly lower stage N1 ($108.8{\pm}53.1$ vs $82.2{\pm}48.9$, p=0.016), lower sleep latency ($4.9{\pm}4.4$ vs $2.0{\pm}1.7$, p=0.083), a lower total arousal number ($210.6{\pm}90.3$ vs $147.1{\pm}87.3$, p=0.019), lower oxygen desaturation index (ODI) ($30.2{\pm}20.9$ vs $10.2{\pm}15.1$, p=0.006), lower apnea-hypopnea index (AHI) ($31.6{\pm}22.4$ vs $10.9{\pm}15.4$, p=0.005), and a lower respiratory disturbance index (RDI) ($37.4{\pm}21.3$ vs $18.5{\pm}16.5$, p=0.008) compared to after UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly higher stage N2 ($154.0{\pm}39.9$ vs $180.5{\pm}49.5$, p=0.017), higher REM ($58.5{\pm}29.7$ vs $72.6{\pm}34.0$, p=0.249), higher $meanSaO_2$ ($94.3{\pm}2.0$ vs $95.9{\pm}0.9$, p=0.043), and higher $meanSaO_2$ ($79.3{\pm}8.5$ vs $83.1{\pm}7.9$, p=0.116) than before UPPP. After UPPP, 6 patients were cured, 2 showed marked improvement, and 7 did not improve. After surgery, the success of the treatment was at 53%. The subjective patient satisfaction was higher than before the surgery.

The Prevalence and Characteristics of Positional Obstructive Sleep Apnea

Kim, Cheon-Sik,Lee, Yong-Seok,Cho, Cheon-Ung,Pae, Sang-Ho,Lee, Sang-Ahm 대한임상검사과학회 2012 대한임상검사과학회지(KJCLS) Vol.44 No.2

Patients with obstructive sleep apnea (OSA) often have more aggravated symptoms in the supine position. We tried to investigate the clinical characteristics and the predictive factors for positional OSA. Polysomnographic data were reviewed for OSA patients (apnea hypopnea index, $AHI{\geq}5$) from April, 2008 to April, 2011 at the Asan Medical Center. Clinical data, comorbid medical condition data and questionnaires (SF-36, MFI-20, ESS, BDI, STAI) were assessed. All patients were classified into two groups: positional patients (PP) group and non-positional patients (NPP) group. PP was defined as a patient who had the AHI in the supine position was at least twice as high as that in the lateral position. The body position of patients was confirmed by sleep position sensor and video monitor. All patients had at least 30 minutes of positional and 30 minutes of non-positional sleep. We compared clinical, medical, polysomnographic data, and questionnaire results between two (PP and NPP) groups and investigated predictive factors for the PP group using binary logistic regression analysis. In total, 371 patients were investigated. 265 (71.4%) was categorized as PP group and 106 (28.5%) as NPP group. The mean age ($mean{\pm}SD$) was higher in the PP group ($52.4{\pm}9.8$) than in the NPP group ($49.5{\pm}11.9$) (p<0.05). Comparison of sleep parameters between the PP and the NPP group showed that the PP group had significantly lower BMI (PP: $26.1{\pm}3.2kg/m^2$; NPP: $27.8{\pm}4.3kg/m^2$, p<0.001), neck circumference (PP: $39.7{\pm}2.8cm$; NPP: $41.5{\pm}3.7cm$, p<0.001) and hypertension rate (PP: n=89/265 (33.5%); NPP: n=48/106 (45.2%), p=0.0240). In the PP group, the percentage of deep sleep (PP: $8.7{\pm}8.1%$; NPP: $5.6{\pm}7.0%$, P=0.001) and rapid eye movement (REM) (PP: $17.5{\pm}6.1%$; NPP: $14.0{\pm}6.9%$, p<0.001) were significantly higher whereas the percentage of light sleep (stage N1) was significantly lower than the NPP group (PP: $30.4{\pm}12.3$; NPP: $44.5{\pm}20.8%$, p<0.001). During the sleep, the AHI in the supine position (PP: $48.6{\pm}19.5$; NPP: $60.5{\pm}22.6$, p<0.001) and in the non-supine position (PP: $9.4{\pm}8.9$; NPP: $48.4{\pm}24.8$, p=<0.001) were significantly lower and the minimal arterial oxygen saturation in non-REM sleep was significantly higher in the PP group (PP: $80.3{\pm}7.6$; NPP: $75.1{\pm}9.9$, p=<0.001). There were no significant differences in all questionnaires including quality of life. The results of the binary logistic regression analysis showed that age, the amount of REM sleep(%) and AHI were significant predictive factors for positional OSA. The significant predictive factors for positional OSA were older age, higher percentage of REM and lower AHI. The questionnaire results were not significantly different between the two groups.

드론을 이용한 원거리 가스측정 기술 연구

조남욱(Nam-Wook Cho),심재웅(Jae-ung Sim),김도현(Dohyun Kim),박정우(Jung-Woo Park),이종천(Jong-Cheon Lee) 항공우주시스템공학회 2018 항공우주시스템공학회 학술대회 발표집 Vol.2018 No.4

On the Study of the Novel Type Tensile Specimen for Characterising Trixaiality of Eco-Al

함석우(Seok Woo Ham),조재웅(Jae Ung Cho),전성식(Seong Sik Cheon) Korean Society for Precision Engineering 2019 한국정밀공학회지 Vol.36 No.1

발포 알루미늄으로 된 경사진 이중외팔보 시험편의 접착면에서의 전단 실험 및 시뮬레이션 해석

손홍붕 ( Hong Peng Sun ),전성식 ( Seong S. Cheon ),조재웅 ( Jae Ung Cho ) 한국복합재료학회 2014 Composites research Vol.27 No.6

본 연구에서는 발포 알루미늄으로 구성된 접착 구조물에서의 접합면에 대한 파괴 특성을 조사하기 위하여 각도를 변수로 정하고 TDCB 시험편을 설계하였다. 이 시험편들은 길이는 200 mm이고 시험편에 대한 접착면의 경사 각도는 6°, 8°, 10°와 12°인 네 가지로 모델링을 하였다. 이 시험편들의 실험 및 해석을 분석한 결과, 경사면각도가 6°, 8°, 10°와 12°인 경우에 시험편들의 최대 하중은 각각 약 120 N, 137 N, 154 N과 171 N으로 발생하였다. 해석의 결과 값이 실험치에 가까워져 많은 차이를 보이지 않는 것을 확인할 수 있다. 따라서 이와 같은 연구 방법을응용하여 실험 대신 시뮬레이션을 통하여 접착제로 접착된 알루미늄 폼으로 된 재료의 전단 거동에 관한 물성치를 효율적으로 파악할 수 있다고 사료된다. In this study, tapered double cantilever beam specimens are designed with the variable of angle toinvestigate the fracture property at the bonded surface of adjoint structure. These specimens are made with four kindsof models as the length of 200 mm and the slanted angles of bonded surfaces on specimens of 6°, 8°, 10° and 12°. Byinvestigating experiment and analysis result of these specimens, the maximum loads are happened at 120 N, 137 N,154 N and 171 N respectively in cases of the specimens with slanted angles of 6°, 8°, 10° and 12°. As the analysisresult approach the experimental value, it is confirmed to have no much difference with the values of experiment andanalysis. It is thought that the material property can be investigated effectively on shear behavior of the materialcomposed of aluminum foam bonded with adhesive through simulation instead of experiment by applying this studymethod.