• Title/Summary/Keyword: 고혈압환자

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사상체질(四象體質)과 비만(肥滿)의 상관성에 관한 임상적 연구

  • Kim, Dal-Rae;Baek, Tae-Hyeon
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.319-335
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    • 1996
  • 연구 목적 : 복지부 발표 '1993년도 대한민국 국민들의 영양상태'보고서를 보면 1인당 섭취열량은 1969보다 257Kcal가 줄어든 것으로 나타났다. 그런데도 불구하고 일부의 사람들은 과도한 열량을 섭취하고 있기 때문에 비만인 사람이 점점 늘어나고 있다. 그렇다보니 신문이나 잡지에서는 거의 매일 살빼는 약이나 신종 다이어트방법에 대한 광고와 기사를 앞다투어 내보내고 있는 실정이다. 비만증은 근래에 발병률이 현저히 증가하면서 중풍, 당뇨병, 고혈압, 암, 간경화증, 당석증 등의 만성질환의 이환율을 증가시키고, 관절에 큰 부담을 주어 골관절염을 보다 빠르게 진전시키며, 사람들의 수명을 단축시키는 등 심각한 건강상의 문제를 일으키고 있다. 또한 비만증은 용모의 손상을 일으켜 정신적인 스트레스의 주요 인자로 등장하고 있기도 하다. 비만인이 증가하는 원인으로는 서구화된 음식습관으로 동물성 지방질과 단백질의 섭취증가, TV 자동차 세탁기 오디오 리모콘 등 생활이기의 사용으로 인한 운동부족, 체질과 질병 등이 재기되고 있다. 이제까지 비만을 치료하기 위한 많은 시도가 있었으나 주된 이론은 섭취음식의 절재와 운동량을 증가시키는 것이었으며, 체질적인 요소를 중심으로 비만증을 해결하려는 시도는 없었다. 이에 저자는 1992년 8월 20일부터 1995년 8월 19일까지 만 3년동안 상지대학교 부속한방병원 체질의학과에서 치료받는 461명의 환자를 대상으로 사상체질과 비만과의 상관성을 임상적으로 연구하고 그 효과를 보고하는 바이다. 연구 결론 : 상지대학교 부속한방병원에 내원치료를 받고 있는 비만증환자들을 대상으로하여 체질과 비만과의 관계를 연구한 결과는 다음과 같다. 1. 비만증 환자의 70.2%가 태음인이었다. 2. 치료결과 4주동안에는 $1.48{\pm}1.64kg$, 5주부터 8주동안에는 $2.05{\pm}2.10kg$, 9주부터 12주동안에는 $2.18{\pm}2.27kg$, 13주부터 16주동안에는 $2.08{\pm}2.88kg$이 감량되었다. 3. 체중감량에 있어 태음인이 가장 많은 감소를 보였다. 연령별로는 10대에서 가장 많은 감소를 보였다. 4. 비만환자의 혈액 가운데 총 콜레스테롤, 저밀도 지방단백이 높온 사람보다 유리지방산과 중성지방이 높은 경우가 대부분을 차지했다. 5. 비만인의 혈청지질에서는 FFA, TG가 높았다. 그 이유는 육식보다는 당질과 지방질의 섭취로 나타난 것이었다.

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Deriving rules for identifying diabetic among individuals with metabolic syndrome (대사증후군 환자 가운데 당뇨환자를 찾기 위한 규칙 도출)

  • Choi, Jinwook;Suh, Yongmoo
    • Journal of Digital Convergence
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    • v.16 no.11
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    • pp.363-372
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    • 2018
  • The objective of this study is to derive specific classification rules that could be used to prevent individuals with Metabolic Syndrome (MS) from developing diabetes. Specifically, we aim to identify rules which classify individuals with MS into those without diabetes (class 0) and those with diabetes (class 1). In this study we collected data from Korean National Health and Nutrition Examination Survey and built a decision tree after data pre-processing. The decision tree brings about five useful rules and their average classification accuracy is quite high (75.8%). In addition, the decision tree showed that high blood pressure and waist circumference are the most influential factors on the classification of the two groups. Our research results will serve as good guidelines for clinicians to provide better treatment for patients with MS, such that they do not develop diabetes.

Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.317-321
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    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

Influence of Lifestyle-Related Diseases on the Oral Health of the Rural Elderly in Korea (일부 농촌지역 60세 이상 노인의 생활습관병이 구강건강에 미치는 영향)

  • Park, Jung-Hye;Lee, Hee-Kyung;Lee, Kyeong-Soo;Jang, Eun-Jin
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.249-259
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    • 2010
  • Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea. Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses. Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased. Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

Minisatellite 5 of SLC6A18 (SLC6A18-MS5): Relationship to Hypertension and Evolutional Level (SLC6A18 유전자의 minisatellites 5 (SLC6A18-MS5)의 고혈압과의 관련성 및 진화적 의미)

  • Heo, Chang-Hwan;Lee, Sang-Yeop;Seol, So-Young;Kwon, Jeong-Ah;Jeong, Yun-Hee;Chung, Chung-Nam;SunWoo, Yang-Il
    • Journal of Life Science
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    • v.18 no.12
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    • pp.1733-1738
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    • 2008
  • SLC6A18, one of the neurotransmitters, was reported the possible relationship to hypertension, and it contained eight blocks of minisatellites. In this study, SLC6A18-MS5 sequence which showed the highest heterozygosity among seven minisatellites was analyzed using the Transfac software, the putative binding sites for the transcription factor Pax4 and HNF4 were discovered as a result. The HNF4 is involved in the diabetes pathway and suggested the relationship to hypertension. Thus, we investigated the putative functional significance of allelic variation in this minisatellites with respect to susceptibility for hypertension. To address this possibility, we analyzed genomic DNA from the blood of 301 hypertension-free controls and 184 cases with hypertension. A statistically significant association was not identified between the allelic distribution of SLC6A18-MS5 and occurrence of hypertension. We then examined the meiotic segregation of SLC6A18-MS5 and it was transmitted following Mendelian inheritance. Therefore, this locus could be useful markers for paternity mapping and DNA fingerprinting. Moreover, we undertook a comprehensive analysis of the genomic sequence to address the evolutionary events of these variable repeats. SLC6A18 minisatellites regions are only conserved in human and primates. This result suggestedthat intronic minisatellites analysis is powerful evolution marker for the non-coding regions in primates and can provide a great insight to the molecular evolution of repeated region in primates.

The Comparison of Clinical Outcomes of Off-pump versus On-pump Coronary Artery Bypass Grafting in Diabetes Patients (당뇨 환자에서 시행한 Off-pump CABG와 On-pump CABG의 비교 연구)

  • 송석원;임상현;홍순창;조수진;장병철;강면식;신혜란;유경종
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.553-558
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    • 2004
  • Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CAB G) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. Material and Method: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. Result: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. Conclusion: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.

Pulmonary Embolectomy for Treatment of Pulmonary Embolism (폐색전증의 수술적 치료)

  • Park, Byung-Joon;Park, Pyo-Won;Shim, Young-Mog;Lee, Young-Tak;Park, Kay-Hyun;Kim, Jhin-Gook;Kim, Wook-Sung;Sung, Ki-Ick
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.492-496
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    • 2009
  • Background: The treatment of acute pulmonary embolism is difficult, and it can be lethal when cardiogenic shock is involved with major pulmonary embolism. In the past, pulmonary embolectomy was considered as the last choice for patients with pulmonary embolism. Accordingly, we analyzed our experience with seven cases of pulmonary embolectomy as an alternative option for the early treatment of pulmonary embolism. Material and Method: A retrospective analysis of medical charts of all patients who underwent pulmonary embolectomy at our hospital over the past eight years was performed. The patients were observed during their hospital stay and followed until their last visit to the outpatient department. Result: Among 7 patients (4 men and 3 women), 4 had massive pulmonary embolism, and 3 had sub massive pulmonary embolism. An extracorporeal membrane oxygenator was inserted in 3 patients before surgery. There was no mortality, and postoperative echocardiography showed no pulmonary hypertension in 6 patients. Conclusion: Pulmonary embolectomy can be performed with minimal mortality. We think that the use of an extracorporeal membrane oxygenator in patients with cardiogenic shock before surgery improves survival.

Relative Association of Overhydration and Muscle Wasting with Mortality in Hemodialysis Patients: Assessment by Bioelectrical Impedance Analysis (혈액투석 환자에서 Bioelectrical Impedance Analysis를 활용하여 측정한 과수분량과 근육량 감소와 사망률의 상관관계)

  • Kim, Eunju;Seo, Sang Oh;Choi, Yu Bum;Lee, Mi Jung;Lee, Jeong Eun;Kim, Hyung Jong
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.548-555
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    • 2018
  • Background/Aims: Assessment of fluid status in hemodialysis patents is very important. Overhydration in hemodialysis is associated with generalized edema, cardiovascular complications, and hypertension. The aim of this study was to determine the factors correlated with mortality of hemodialysis patients, assessing body muscle mass and fluid status using bioelectrical impedance analysis (BIA). Methods: This study enrolled 93 patients who underwent hemodialysis between January 2010 and May 2015 at CHA Bundang Medical Center. Medical records of enrollees up to June 2017 were reviewed retrospectively. These included laboratory results (serum albumin, C-reactive protein [CRP], lipid profile, etc.) and BIA data (extracellular water, intracellular water, total body water, soft lean mass, fat free mass, skeletal muscle mass, etc.). Results: Eleven of 93 patients had expired by May 2017. Among the surviving subjects, mean age was younger, CRP levels were lower, albumin levels were higher, and extracellular water/total body water (ECW/TBW) ratios were lower than in the expired patient group. Kaplan-Meier survival analysis revealed that overhydration (ECW/TBW > 0.4) was associated with higher mortality. Conclusions: In hemodialysis patients, overhydration is an important factor in mortality, and BIA could be a reliable modality in its assessment. We suggest that, for hemodialysis patients, overhydration is more of a risk factor for mortality than is muscle wasting.

A Study on the Pulse Wave Parameter in Hypertension Patients (고혈압 환자의 맥상 연구)

  • Jung, Hyun-Jung
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.18 no.2
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    • pp.51-62
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    • 2014
  • Objectives The purpose of this study was to determine whether a pulse analyzer was useful to characterize the variables of pulse wave of hypertension (HT), compared with those of normal blood pressure group (NP). Methods The subjects were 22,646 who worked at car manufacturing factory. The pulse wave variables and pulse types measured in Guan by DMP 1000. Results In the main and secondary pulse type, there were significant differences between HT and NP. Whereas, in the field of pulse wave variables, no specific differences were between HT and NP. Conclusion Although pulse wave variables were not statistically significant, pulse analyzer might have reliable diagnostic sensitivity between hypertension and non-hypertension population.

$^{131}I-MIBG$ Scintigraphy in Double Focuses Pheochromocytoma (이중병소를 가진 갈색종의 $^{131}I-MIBG$ 신티그라피)

  • Kim, Hak-Hee;Chung, Soo-Kyo;Kim, Sung-Hoon;Park, Young-Ha;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.151-154
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    • 1992
  • 갈색종은 비교적 드문 종양으로 다발성으로 생기는 경우는 더욱 드물다. 갈색종은 수술로 90%이상 완치 가능한 질환이므로 수술전 종양의 위치와 범위를 정확히 확인하는 것 이 매우 중요하다. 저자들은 최근 파동하는 고혈압을 주소로 내원한 33세 남자환자에서 복부전산화 단층촬영술상 우측부신의 종양만을 확인할 수 있었으나, $^{131}I-MIBG$ 신티그라피에서는 우측 부신의 병소외에 골반강 내에 또다른 병소가 발견되어 골반강 전산화 단층촬영술을 추가로 시행하였고 이어 수술로써 확진된 이중병소의 갈색종 1예를 보고하는 바이다.

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