폐쇄성 수면 무호흡증 환자에 있어서 하악 재위치 장치 장착과 체위에 따른 상기도 구조와 근활성도의 변화에 관한 EMG 및 두부방사선학적 연구

박영철,배응권,이정권,이종석,김태관 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.4

폐쇄성 수면 무호흡증(obstructive sleep apnea, 이하 OSA로 표시)은 수면 도중 계속 반복 되어 일어나는 상기도 폐쇄로 인하여 무호흡증을 나타내는 장애(disorder)이다. 근래의 연구에 의하면 상기도 구조의 해부학적 요인뿐 아니라 생리적 요인도 무호흡 발생에 기여한다고 하였으며 또한 이설근이 상기도 유지에 중요한 역할을 한다고 하였다. OSA의 치료를 위해 다양한 술식이 시행되었으며 하악 재위치 장치를 통한 치료 역시 양호한 결과를 나타낸다고 하였다. 그러나 하악 재위치 장치 장착에 따른 구조적 생리적 작용기전에 대한 연구는 미비한 상태이다. 이에 본 저자는 연세대학교 치과대학병원 교정과에 내원한 OSA 환자 26명(남 17명, 여 9명)과 일반 정상 성인 20명(남 10명 여 10명)을 대상으로 앙와위에서 장치 장착 전후의 두부방사선사진을 채득하여 장치에 따른 상기도의 구조 변화를 연구하고 두군 사이의 장치 장착에 따른 효과를 비교하였으며, 또한 OSA 환자 14명(남자 10명 여 4명)을 대상으로 체위 변화와 장치장착에 따른 이설근 근전도 변화를 연구하여 다음과 같은 결론을 얻었다. 1. 상기도 구조에 대한 두부계측학적 측정치 중 연구개의 길이, 연구개 최대 두께와 SPAS, MAS, VAL, H-H1. MP-H에서 정상군과 OSA군 사이의 통계적 유의차를 보였으며, IAS와 EAS는 두 군간에 통계적 유의차를 보이지 않았다. 2. 정상군과 OSA군 모두에서 장치 장착에 따라 후두개가 전방 이동하면서 후두개 수준(epiglottis level)의 기도 폭경은 증가하였고 연구개의 최대 두께가 변하였으며 설골은 전방 이동하였으나 두 군 모두 IAS에서는 다양한 반응을 나타내었다. 장치 장착에 따른 상기도 구조에 대한 효과는 두 군 사이에 서로 차이을 나타내었다. 3. 체위 변화에 따라 앙와위에서 이설근 근전도가 증가하는 경향을 나타내었으나 통계적 유의차는 없었으며, 직립위와 앙와위 모두에서 하악 재위치 장치 장착시에 통계적으로 유의하게 이설근 근전도가 증가하였다. 하악 재위치 장치는 상기도의 해부학적 구조뿐 아니라 상기도 영향을 미치는 것으로 생각되며 장치에 대한 반응은 정상군과 OSA군 사이에 차이를 나타내었고, 두 군은 상기도 생리에 있어서도 서로 다르다고 사료된다. Obstructive sleep apnea (OSA)is a disorder characterized by repetitive episode of upper airway collapse during sleep. Recent studies showed that not only the anatomic factors but the physiologic factors of the upper airway also have effects on the occurrence of apnea and that the genioglossus muscle also plays in important role in the maintenance of the upper airway. A variety of therapies were performed to treat OSA, and among them the use of mandibular repositioning appliances showed reasonable results. But there is still a lack of research on the structural and physiological mechanism upon the use of mandibular repositioning appliances. The author selected 26(male 17, female 9) OSA patients that came to the Yonsei University Dental Hospital, Department of Orthodontics, and 20 normal adults (male 10, female 10) and took cephalometric radiographs of them in a supine position before and after the palcement of the mandibular repositioning appliance to see the structural changes of the upper airway and compare the therapeutic effects between the two groups. We also studied the waking genioglossus muscle activity in OSA patients and investigated the difference in the electromyogram of the genioglosssus muscle upon the change in body posture and the use of mandibular repositioning appliance. Following results were obtained. 1. Among the cephalometric measurements of the upper airway structure, the length of the soft palate, maximum thickness of the soft palate and SPAS, MAS, VAL, H-HI, MP-H showed statistically significant differences between the normal and OSA groups, but the IAS and EAS showed no statistically significant differences between the two groups. 2. In both the normal and OSA groups, as the epiglottis moved forward on wearing the mandibular repositioning appliance, the epiglottis level of the upper airway increased and the maximum thickness of the soft palate changed and the hyoid bone also moved forward, but the IAS in both groups showed various results and the effect of the mandibular repositioning appliance on the structure of the upper airway was different in the two groups. 3. Upon changing the position, the electromyogram of the genioglossus muscle showed a increasing tendency but there was no statistically significant differences, and when the mandibular repositioning appliance were worn there was a statistically significant increase in the electromyogram of the genioglossus muscle in both the upright and supine positions. The mandibular repositioning appliances not only have an effect on the anatomical structure of the upper airway but also on the physiology of the upper airway. There are different responses to the use of mandibular repositioning appliance between the normal and OSA groups therefore it could be considered to have the different physiology of the upper airway between the two groups.

A case of thoracic endometriosis syndrome presenting catamenial hemothorax

( Jae Young Pae ),( Min Jong Song ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

A-16-year-old girl with history of severe dysmenorrhea presented with catamenial chest discomfort since menarche. On her transrectal sonography, there was evidence of Lt.ovary cyst, r/o rupture (4.9x5.9cm sized). Chest x-ray was performed for pre-op evaluation which showed on incidental finding of Rt. hydropneumothorax. She denied a recent history of trauma. Chest CT revealed Pneumothroax, R lung and compressive atelectasis in RML and RLL with Large pleural effusion in R lung. A right-sided chest tube was placed, following which 360mL of haemorrhagic fluid was drained. After the procedure, a chest x-ray image showed expansion of the right lung and decreased R pleural effusion. 2 days later, she had recurrence of pneumothorax, right. She underwent video-assisted thoracoscopic surgery (VATS). In operative field, No visible bullae was seen on Rt. lung surface. But air leak in RML minor fissure margin and visually suspicious endometrial tissue was seen on diaphragm, RML and RLL lung surface. The RML was wedgely resected for air leakage site. The biopsy showed chronic inflammation with mesothelial proliferation in the pleura. On the Co-Operation, under diagnosis of Lt.ovary cyst c endometriosis stage IV c severe pelvic adhesion c perihepatic adhesion, laparoscopic Lt.ovary cystectomy c endometrial spot ablation c adhesiolysis was done. In pathology finding, endometriosis was confirmed in Lt. ovary cyst and subovarian adhesion band. CTD was removed at POD#4. But, Next menstruation started POD#2 was followed by recurrent Rt. hydropneumothorax on the 4th day of her menstrual cycle(MCD4), next day of (removal). Rt. CTD was re-inserted immediately and removed after 6 days. A consecutive CXR over the next 9 days showed significant improvement(Near clearing of Rt. pneumothorax). Inj. GnRH was given from the day of her menstrual cycle for 2 months. 1 more injection of GnRH was scheduled.

The development of practice model for uterus auto-transplantation using domestic pigs

( Jae Young Pae ),( Arvind Manikantan Padma ),( Mats Hellstrom ),( Mihai Oltean ),( Mats Brannstrom ),( Min Jong Song ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: The present study aims to develop a practice model for uterus auto-transplantation using domestic pigs. Methods: Ten domestic pigs were used to develop a practice model. First 3 pigs are used for anatomical investigation to choose proper vessels used for anastomoses. Seven pigs were used to perform the uterus auto-transplantation. Under general anesthesia, the bicornuate uterus was carefully dissected and harvested with its bilateral feeding arteries and draining veins. The feeding arteries were bilateral umbilical arteries and the draining veins were bilateral ovarian arteries. After harvesting the uterus, bilateral arteries were cannulated immediately and the uterus was flushed with cold (+4 C) Custodiol (HTK) solution supplemented with xylocaine (0.4 mg/ml). The uterus was stored at +4 cooling chamber during during flushing. Flushed uterus was placed in its original position and the bilateral umbilical arteries and bilateral ovarian veins were anastomosed end to side to bilateral external iliac arteries and veins respectively. Indocyanine green (ICG) angiography was performed to monitor of reperfusion for 1hour. Results: Mean total operation time was 298 minutes and mean duration of donor surgery was 119 minutes. The mean cold ischemic time was 56 minutes and the mean warm ischemic time was 123 minutes. Estimated mean blood loss was 200 mL. All seven auto-transplanted pigs were considered well isolated and flushed. They also showed satisfactory reperfusion judged by change in gross appearance and ICG angiography. Conclusion: This study showed that a practice model for uterus auto-transplantation using domestic pigs is feasible and demonstrated that a satisfactory reperfusion could be achieved.

Effective recellularization of sheep uterine bio-scaffolds by enzymatic preconditioning

( Jae Young Pae ),( Arvind Manikantan Padma ),( Mats Brannstrom ),( Mats Hellstrom ),( Min Jong Song ) 대한산부인과학회 2021 대한산부인과학회 학술대회 Vol.107 No.-

Bioactive characteristics of an implant surface coated with a pH buffering agent: an in vitro study

Pae, Hyung-Chul,Kim, Su-Kyoung,Park, Jin-Young,Song, Young Woo,Cha, Jae-Kook,Paik, Jeong-Won,Choi, Seong-Ho Korean Academy of Periodontology 2019 Journal of Periodontal & Implant Science Vol.49 No.6

Purpose: The purpose of this study was to evaluate the effectiveness of conventional sandblasted, large-grit, acid-etched (SLA) surface coated with a pH buffering solution based on surface wettability, blood protein adhesion, osteoblast affinity, and platelet adhesion and activation. Methods: Titanium discs and implants with conventional SLA surface (SA), SLA surface in an aqueous calcium chloride solution (CA), and SLA surface with a pH buffering agent (SOI) were prepared. The wetting velocity was measured by the number of threads wetted by blood over an interval of time. Serum albumin adsorption was tested using the bicinchoninic acid assay and by measuring fluorescence intensity. Osteoblast activity assays (osteoblast adhesion, proliferation, differentiation, mineralization, and migration) were also performed, and platelet adhesion and activation assays were conducted. Results: In both the wetting velocity test and the serum albumin adsorption assay, the SOI surface displayed a significantly higher wetting velocity than the SA surface (P=0.000 and P=0.000, respectively). In the osteoblast adhesion, proliferation, differentiation, and mineralization tests, the mean values for SOI were all higher than those for SA and CA. On the osteoblast migration, platelet adhesion, and activation tests, SOI also showed significantly higher values than SA (P=0.040, P=0.000, and P=0.000, respectively). Conclusions: SOI exhibited higher hydrophilicity and affinity for proteins, cells, and platelets than SA. Within the limits of this study, it may be concluded that coating an implant with a pH buffering agent can induce the attachment of platelets, proteins, and cells to the implant surface. Further studies should be conducted to directly compare SOI with other conventional surfaces with regard to its safety and effectiveness in clinical settings.

음성환경에 따른 한국어 폐쇄음의 음향적 특성 : 시간적 특성을 중심으로 focusing on their temporal characteristics

배재연,신지영,고도홍 한국음성과학회 1999 음성과학 Vol.5 No.2

The purposes of this study are two-folds: to find out the acoustic features of Korean stops in various utterance positions and their influence on the neighbouring segments. Korean stops(/p, p', p^h+, t, t', t^h-, k, k', k^h/) are examined from CV, V_1CV_2, V_1NCV_2, V_1LCV_2 sequences. Three speakers (two male and one female speakers of Seoul dialect) served as subjects for the present study. VOT, closure duration of the target stops and duration of the neighbouring segments were measured from acoustic data. The results can be summarized as follows. first, stops show different temportal aspects depending on their place of articulation as well as their voice types. Velar stops tend to have shorter closure duration and longer VOT due to relatively slower movement of the articulator (i.e. tongue body) and higher supraglottal air pressure during the closure, respectively. Second, temporal aspects of the neighbouring segments appear to be influenced by the voice type of stop. The preceding segment tends to be longer when a stop has shorter duration. On the other hand, the following segment tends to be shorter, when a stop has longer VOT. Keywords: stops, closure duration, VOT, contextual influence, temporal characteristics

Treatment Analysis of Patients with Severe Multiple Trauma Due to Suicide Attempts

Yejune Pae,Han-Young Lee,Jae-myeong Lee 대한외과학회 2023 대한외과학회 학술대회 초록집 Vol.2023 No.5

쓰기부진 초등생의 형태소 및 철자지식을 활용한 문장쓰기 중재 효과

이재국(Jae kook Lee),신가영(Ga young Shin),윤효진(Hyo jin Yoon),배소영(So yeong Pae) 학습자중심교과교육학회 2015 학습자중심교과교육연구 Vol.15 No.6

The Korean writing system Hangeul is known for relatively transparent language in reading although there are Korean children who experience reading and writing difficulties. Grammatical morphemes seem to be neglected in traditionally writing intervention in Korea. This study investigated intervention effect on morpheme focused eojeol writing for children with poor orthographic knowledge. Five elementary school children participated in two week intensive program for 10 days. Five children matched for Korean spelling ability with the experimental group participated in assessments. In Korean, syllable final letters/codas in free morpheme or root part of predicates have phonological changes depending on the following grammatical morphemes (e.g. ㅅ s could be pronounced either /s/ or /kk/, 빗으로 (pis(comb:noun)-eolo(with) /piseolo/), 빗고(pis(comb:predicate)-ko(and) /pikko/). Randomized control trial design was used with two tasks tapping orthographic knowledge. Five children in the experimental group significantly improved eojeol writing ability compared to five children in the control group both in the training words (F(1,7)=44.177,p<.01) and in the generalization words(F(1,7)=24.590,p<.01). In conclusion, this study provided a piece of evidence in short term writing intervention focusing on grammatical morphemes for relatively transparent language. Grammatical morphemes which lead phonological changes with free morpheme and root of predicates need to be considered in writing intervention. However further studies are needed to explore the phonology-semantic-grammar interaction in detail for efficient orthographic intervention. 본 연구는 한국어 특성을 고려한 철자중재가 쓰기부진아동의 철자쓰기에 효과적 인지 확인하고자 하였다. 2-5학년 쓰기부진아동 10명을 중재집단과 통제집단으로 무선배치한 후 개별중재를 실시하였다. 총 10회기 중 1회기와 10회기는 평가를 실시 하였고 8회기를 중재하였다. 중재는 문법형태소 활용과 음운규칙을 중심으로 자소 음소 불일치 어절 쓰기를 진행하였다. 낱말보고 베껴 쓰기, 규칙 적용된 부분 쓰기, 그림보고 베껴 쓰기, 조사 ‘-을, -이, -은’ 붙여서 쓰기, 어미 ‘-고, -게, -다’ 붙여서 쓰기, 고쳐 쓰기를 중심으로 진행하였다. 사전 쓰기 정확률을 공변인으로 한 반복측 정분산분석을 실시하였다. 중재과제 및 일반화과제에서 두 집단 간 통계적으로 유의 미한 차이를 보여 중재효과를 밝혔다(훈련과제: F(1,7)=44.177, p<.01 일반화과제: F(1,7)=24.590, p<.01). 2주 뒤에 실시한 중재집단의 유지평가에서는 사후평가와 통 계적으로 유의미한 차이가 없어 중재효과가 유지됨을 확인하였다(훈련과제 p=.125 p>.05, 일반화과제 p=.625 p>.05). 더 많은 수의 아동을 대상으로 한 후속연구를 통 해 한국어 해독 및 철자 습득과정을 좀 더 자세히 살펴볼 필요가 있다.

A concise synthesis of tetrabenazine: an intramolecular aza-Prins-type cyclization via oxidative C-H activation.

Son, Young Wook,Kwon, Tae Hui,Lee, Jae Kyun,Pae, Ae Nim,Lee, Jae Yeol,Cho, Yong Seo,Min, Sun-Joon American Chemical Society 2011 ORGANIC LETTERS Vol.13 No.24

<P>A concise synthesis of tetrabenazine and dihydrotetrabenazine is described. The key feature of this synthesis is the intramolecular aza-Prins-type cyclization of an amino allylsilane via oxidative C-H activation.</P>

β-Lapachone, a substrate of NAD(P)H:quinone oxidoreductase, induces anti-inflammatory heme oxygenase-1 <i>via</i> AMP-activated protein kinase activation in RAW264.7 macrophages

Byun, Seung Jae,Son, Young,Hwan Cho, Baik,Chung, Hun-Taeg,Pae, Hyun-Ock the Society for Free Radical Research Japan 2013 Journal of clinical biochemistry and nutrition Vol.52 No.2

<P>AMP-activated protein kinase (AMPK), a crucial regulator of energy metabolic homeostasis, is suggested to regulate inflammatory responses, but its precise mechanisms are not fully understood. It has been reported that pharmacological activation of AMPK induces heme oxygenase-1 (HO-1) expression. β-Lapachone (BL), a well-known substrate of NAD(P)H:quinone oxidoreductase (NQO1), has been demonstrated to stimulate AMPK activation <I>via</I> NQO1 activation, and to exert anti-inflammatory effects in macrophages. Here we examined whether AMPK activation by BL would be linked to HO-1 expression in RAW264.7 macrophages and whether HO-1 expression could mediate the anti-inflammatory effects of BL. BL treatment induced concentration- and time-dependent AMPK phosphorylation and HO-1 expression. 5-Aminoimidazole-4-carboxamide-1-β-<I>D</I>-ribofuranoside, an AMPK activator, also induced HO-1 expression. In contrast, compound C (CC), an inhibitor of AMPK activation, prevented the increase in BL-induced HO-1 expression. BL pretreatment reduced lipopolysaccharide-induced production of tumor necrosis factor-α, a pro-inflammatory cytokine, and expression of inducible nitric oxide synthase, a pro-inflammatory enzyme. These inhibitory effects BL were almost completely abolished by CC and partly by tin protoporphyrin-IX, a competitive inhibitor of HO-1. Accordingly, the present results indicate that BL induces anti-inflammatory HO-1 expression in macrophages <I>via</I> AMPK activation, providing one of possible mechanisms by which BL can exert anti-inflammatory effects.</P>