• Title/Summary/Keyword: 고혈압환자

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Clinical Study of Extra-anatomic Bypass (해부외 회로 조성술에 관한 임상적 고찰)

  • Kim Jong Won;Chung Sung Woon
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.377-381
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    • 2005
  • Background: Extra-anatomic bypass was performed in the patient who could not use anatomic bypass due to many causes. The purpose of this study is to evaluate the efficacy of extra-anatomic bypass surgery. Material and Method: We reviewed 31 patients who underwent extra-anatomic bypass surgery at Pusan national university hospital. We analysed the combined diseases, etiologic diseases, symptoms, patency rate and the factors affecting patency rate retrospectively. Result: There were 26 cases of femoro-femoral bypass and 5 cases of axillo-bifemoral bypass among 31 patients. The mean age was 70.23 years. Combined disease were hypertension, hyperlipidemia, and ischemic heart disease in order of frequency. The indications for surgery were disabled claudication, tissue necrosis, rest pain, and a cute ischemia. We analysed the ages, smoking history, hypertension, ischemic heart disease, severity of limb ischemia, and hyperlipidemia as factors affecting patency rate. We could not find any statistical differences between these factors. The primary graft patency rates were $73.65\%$ one year, $73.65\%$ two year, and $65.46\%$ three year respectively according to the Kaplan-Meier method. Conclusion: Nevertheless extra-anatomic bypass has a relatively low patency rate, it has good merits that is less dangerous, simple and easy re-do surgery compared to anatomic bypass. We think that extra-anatomic bypass is one of the good treatment modalities for the high risk vascular patients.

Literature Review of Empowerment Intervention Studies for Patients with Chronic Physical Health Conditions in Korea (만성적인 신체질환을 가진 환자에게 적용된 임파워먼트 중재 연구 고찰 - 국내를 중심으로)

  • Kim, Jiyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.455-467
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    • 2020
  • This study was a systematic review examining the effect of empowerment intervention studies among patients with chronic physical health conditions in Korea. The PICOT-SD (Participants, Intervention, Comparison, Outcomes, Timing of outcome measurement, Setting, Study design) strategy was applied. A total of 19 studies published between January 2000 and April 2020 were selected. Study participants were rheumatoid arthritis patients, hemodialysis patients, stroke patients, diabetes mellitus patients, chronic pulmonary disease patients, hypertensive patients, cancer patients, chronic kidney disease patients, and kidney transplantation patients, etc. A total of 17 studies were found to have presented a conceptual framework. Empowerment skills were participation, dialogue, experience, interaction, support, and problem solving, etc. The most frequently used dependent variables were self-care (n=13), empowerment (n=10), self-efficacy (n=7), and depression (n=5). Self-care, empowerment, and self-efficacy showed significant improvement among patients in at least 60% of the included studies. Based upon this review, there is evidence that empowerment intervention studies are an effective method to improve the health of patients with chronic physical health conditions. This study further suggests the development of an empowerment intervention program to verify the effects of the various variables identified in this study.

A Study on Medical Information Platform Based on Big Data Processing and Edge Computing for Supporting Automatic Authentication in Emergency Situations (응급상황에서 자동인증지원을 위한 빅데이터 처리 및 에지컴퓨팅 기반의 의료정보플랫폼 연구)

  • Ham, Gyu-Sung;Kang, Mingoo;Joo, Su-Chong
    • Journal of Internet Computing and Services
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    • v.23 no.3
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    • pp.87-95
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    • 2022
  • Recently, with the development of smart technology, in medical information platform, patient's biometric data is measured in real time and accumulated into database, and it is possible to determine the patient's emergency situations. Medical staff can easily access patient information after simple authentication using a mobile terminal. However, in accessing medical information using the mobile terminal, it is necessary to study authentication in consideration of the patient situations and mobile terminal. In this paper, we studied on medical information platforms based on big data processing and edge computing for supporting automatic authentication in emergency situations. The automatic authentication system that we had studied is an authentication system that simultaneously performs user authentication and mobile terminal authentication in emergency situations, and grants upper-level access rights to certified medical staff and mobile terminal. Big data processing and analysis techniques were applied to the proposed platform in order to determine emergency situations in consideration of patient conditions such as high blood pressure and diabetes. To quickly determine the patient's emergency situations, edge computing was placed in front of the medical information server so that the edge computing determine patient's situations instead of the medical information server. The medical information server derived emergency situation decision values using the input patient's information and accumulated biometric data, and transmit them to the edge computing to determine patient-customized emergency situation. In conclusion, the proposed medical information platform considers the patient's conditions and determine quick emergency situations through big data processing and edge computing, and enables rapid authentication in emergency situations through automatic authentication, and protects patient's information by granting access rights according to the patient situations and the role of the medical staff.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Improvement of medical law regulations for telemedicine services (원격의료서비스를 위한 의료법 관련 규제 개선방향)

  • Choi, Jung-Ah;Jung, Yong Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.1 no.2
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    • pp.85-89
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    • 2015
  • It has been reported that cerebral disease is the most leading to death as a single disease even though next to cancer in the most important cause of death in the country. Even if patients maintain a life without death, it will have to suffer from side effects such as hemiplegia and language disorders. In this paper, the symptoms and treatment of cerebral infarction cases are described through the medical dramas (The Third Hospital, The Brain) and movie (Amur). Even if there is the same stroke each drama or movie, depending on the previous history or current physical condition of the patient knew which treatment the law is different.

A Case of Posterior Reversible Leukoencephalopathy Syndrome Following Poststreptococcal Glomerulonephritis (A군 사슬알균 감염 후 사구체신염 환아에서 발생한 가역적 후두부 뇌병증 증후군 1례)

  • Lee, Eun Kyoung;Kang, Jin Han;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.113-116
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    • 2015
  • Posterior reversible leukoencephalopathy syndrome is a clinical radiographic syndrome of many causative factors. Sudden onset headache, vomiting, altered mental status, blurred vision and seizures are main symptoms shown in posterior reversible leukoencephalopathy syndrome. In addition, it typically shows radiological findings of edema in the white matter of posterior cerebrum, being in commonly bilateral but asymmetric. We report a case of poststreptococcal glomerulonephritis (PSGN) presenting as posterior reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.

베트남의 약침 제조법

  • Hanh, Pham Thuc
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.37-37
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    • 2003
  • 약침은 경혈에 약물을 주입하는 방법이다. 이 방법은 아래의 인자 (즉 약물의 효과와 침의 효과, 주입하는 용액이 침자리에 미치는 효과들) 덕택에 효과를 증강시키는 방법이다. 1970년대와 1980년대 초기에 베트남 전통의들에 의해 적용되어 좋은 효과를 얻었다. 적응증으로는 만성 관절염, 신경성 감각 이상증, 위통, 고혈압, 천식, 좌골신경통, 요통 들이다. 주로 쓰인 침자리는 배수혈과 복모혈, 원혈과 아시혈이다. 약물은 vitamin B1, B6, B12, novocain 2%, 염화나트륨 용액 0.9%에 한 침자리에 0.2 to 2.0ml씩을 주입한다. 때때로 진통제인 voltarene 이나 pervincamine, cerebrolysin을 쓰기도 한다. 치료 기간은 하루에 한 번씩 2주 이하로 하고 적어도 5일은 휴식을 한다. 약침의 위십이지장증의 진통효과에 미치는 영향을 검증하기 위한 예비실험 결과를 요약하면 아래와 같다. 베트남에서 약 전체 인구의 5.63%가 위산과다에 따른 궤양성 통증을 가지고 있는데, 이 예비 연구는 이들에 약침의 진통효과를 검증하고자 한다. 관찰 대상이 된 남자 41명, 여자 15명(나이 20-69세 사이) 이 모두 경증에서 중증도의 위통을 3-15년 동안 앓았는데 이들 모두 엑스 선 촬영과 위내시경으로 확증을 받았다. 관찰기간 동안 부작용은 없었는데 약침군은 26 환자로 Vit B1, B2, B6, novocain 2%, 하루에 한 번씩, 15일 동안 개별적 진단에 따른 침자리에 치료받았고, 대조군은 30 명으로 atropin 농도 0.25 mg/injection 도 근육주사를 하루에 한 번씩 같은 기간동안 받았다. 결과는 약침군에서 Good: 7.7%, Rather good: 88.5%, no response: 3.8%. (편역자 주: 발표 초록에서 대조군에 대한 결과가 빠져 있음). 결론적으로 약침과 아트로핀 주사가 모두 궤양성 통증을 완화시키는데 그 진통정도는 동등하다고 판단하였다. 약침의 진통효과가 오래 지속되었고 환자들은 부작용을 호소하지 않았다.

Nine cases of strongyloidiasis in Korea (분선충의 인체 감염 9례)

  • 이상금;신보문
    • Parasites, Hosts and Diseases
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    • v.32 no.1
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    • pp.49-52
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    • 1994
  • Nine cases of human infection with Strongyloines stercornlis are reported among patients admitted to the Seoul Paik and Sang-Kye Paik Hospitals, Inje University, from April 1990 to Junuary 1992. The Patients, 7 males and 2 females acted between 50 and 70, either had the history of long term use of steroids for management of arthritis, or were complicated with other chronic diseases such as hypertension, liver diseases, psychotic disorders, and gastrointestinal problems. All of the nine patients revealed rhabditoid larvae of S. stercorolis in fecal examination. A 57-year-old woman who complained of arthritis and abdominal discomfort, was treated with albendazole and mebendazole, and on the 4th and 5th treatment day 220 parasitic adult females were collected from the diarrheal stool. The patient had a long history of administration of steroids for treatment of arthritis, and seems to have suffered from hyperinfection syndrome due to autoinfection with S. stercordis. This is the 3rd report on the recovery of parasitic adult females of S. stercoraLis in Korea.

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Factors Influencing Influenza Vaccination Among Korean Adults Diabetic Patients (우리나라 성인 당뇨병 환자에서 인플루엔자 예방접종 관련요인)

  • Park, Ji-Hye
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.447-454
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    • 2018
  • The purpose of this study was to investigate the influenza vaccination rate and vaccination-related factors in adult diabetics in Korea using the Korean Community Health Survey (KCHS). Data on 228,261 adults aged 19 years and over were derived from the KCHS, which was conducted in 2015. Sociodemographic factors, health behavior, comorbid diseases, and subjective health status were analyzed for their relationships with influenza vaccination by the chi-squared test and multiple logistic analysis. As a result, the level of influenza vaccination rate among adult diabetics in Korea was as low as 62.4%. For those with diabetes, Influenza vaccination was related with age, gender, education level, residency, marital status, occupation, smoking, health screening, and comorbid diseases (p<0.05). In conclusion, in order to increase the influenza vaccination rate among diabetic patients, systematic education and publicity are essential to raise awareness of vaccination. At the same time, the government should support them with their policies such as free vaccination expansion.

맥진기 연구에 대한 중의사의 인식에 대한 수요조사

  • Kim, Gyeong-Cheol;Kim, Jung-Han;Sin, Sun-Sik;Kim, Hun;Lee, Hae-Ung;Kim, Jong-Hwan;Du, Seung-Hui;Park, Ju-Yeon;Jo, Yeong-Il
    • Journal of Korean Medical classics
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    • v.22 no.3
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    • pp.299-320
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    • 2009
  • 한중 맥진기 관련 학술 교류와 맥진기 수출을 위한 전략으로 중국의 광주중의약대학 중의사를 대상으로 맥진과 맥진기에 대한 인식을 조사하여 보고하는 바이다. 임상에서 가장 중요하게 생각하고 활용도가 높은 전통적인 병증으로 장부병증과 팔강병증으로 나타났으며, 한방 진단방법 중 가장 중요하게 생각하고 활용하는 방법으로 문진과 맥진으로서, 그 이유는 진단 효율성과 환자와의 상담으로 나타났다. 또한 임상에서 한방 진단기기의 중요한 이유로는 측정기술과 데이터의 신뢰를 들었으며, 중요하지 않다고 생각하는 이유로는 측정기술과 데이터의 신뢰성 부족과 전통적인 진단법을 보조하기엔 적합하지 못함을 들었다. 진단방법 중에서 맥진의 중요도와 활용도는 75%가 가장 높게 나타났고, 맥진법 중에서 가장 잘 활용하는 부위는 촌구맥진법으로 나타났다. 촌구 맥진시 가장 중요하게 생각하는 요소는 환자의 자세와 손목 높이와 촌관척 부위였으며, 단안(單按)과 총안(總按)의 순서는 총안(總按)후 단안(單按)이 단연 우수하였다. 임상의 중요 맥상으로는 부침(浮沈)을 들었으며, 맥상 형성 기전과 표준화 연구에 가장 적합한 연구 방법론은 위수형세론에 입각한 문헌 연구와 병증별 맥상에 대한 임상 데이터 구축으로 나타났다. 그리고 대표적인 노인 특유의 맥상은 미세약맥이었으며, 그 이유는 노화로 인한 체력저하와 기혈부족을 들었다. 그리고 맥진기와 연계하는 만성 생활습관병 병증지표 연구개발에 가장 적합하다고 판단되는 병증 체계는 장부병증이었으며, 질병은 고혈압과 동맥경화증으로 나타났다. 또한 임상에서의 활용도와 유의성이 높은 맥진기로써의 주된 기능으로는 오장육부 상태 진단을 들었으며, 맥진기의 임상적인 활용도를 높일 수 있는 현대적인 임상 분야는 심혈관 질환이 가장 높게 나타났다. 맥진기 개발에 선행되어야 할 기반연구로는 촌관척 부위 찾기의 기준 확립과 임상 변증과의 관계 확립으로 나타났으며, 제공 받고자 하는 맥상 정보구성은 환자의 맥상명과 맥상 정도와 환자의 맥상에 따른 병증명 제시로 나타났으며, 제공되는 병증 서비스로는 장부병증이 가장 높게 나타났다.

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