• Title/Summary/Keyword: 고혈압 환자

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"Off-pump" Coronary Artery Bypass Graft in the Chronic Renal Failure Patients -3 Cases Report- (만성 신부전증을 동반한 협심증 환자에서 심폐바이패스를 사용하지 않는 관상동맥우회술 -3예 보고-)

  • 김태헌;김기봉
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.835-839
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    • 1999
  • Since the first report of coronary artery bypass grafting (CABG) in patients with end-stage renal disease in 1974, numerous reports have documented the feasibility of CABG in patients with chronic renal diseases. Patients with chronic renal failure often have comorbid disorders such as hypertension, and diabetes mellitus, each with their own complications and associated impact on both short and long-term survivals. In addition, infection and sepsis have been identified as significant causes of morbidity and mortality in most series of patients with end-stage renal disease undergoing cardiac surgical procedure. As a result of these and other factors such as perioperative volume and electrolyte disturbances, patients with chronic renal failures are at an increased risk of complication and mortality after CABG. We report 3 cases of "Off-pump" CABG in the chronic renal failure patients. patients.

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The Prevalence of Chronic Degenerative Disease and Utilization of Medical Facility in Rural Population (농촌지역(農村地域) 주민(住民)의 만성퇴행성질환(慢性退行性疾患) 유병률(有病率) 및 이용의료기관(利用醫療機關))

  • Ann, Kil-Soo;Chun, Byung-Yeol;Yeh, Min-Hae
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.209-220
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    • 1996
  • This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Oral rehabilitation with magnetic overdentures for an old patient with complex systemic diseases (복합적인 전신질환이 있는 안면마비 환자의 양악 자성 피개의치 수복 증례)

  • Ko, Eunjin;Ahn, Sujin;Lee, Sukwon;Park, Sujung;Lee, Richard Sungbok
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.150-156
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    • 2015
  • As dental implant treatment becomes popular for both partial and complete edentulous patients, old people with complex systemic diseases also tend to prefer implant-assisted-overdenture or implant-supported-fixed prostheses to conventional complete denture. In this case, 77-year-old female who was on medication for hypertension and osteoporosis and paralyzed on right side due to stroke visited for implant-assisted-overdenture on lower jaw. After oral and radiographic examination, root-assisted magnet overdenture on upper jaw and implant-assisted magnet overdenture on lower jaw are planned. Consequently, overdentures using self-adjusting magnetic attachment(SA) system on both jaws resulted in recovering satisfying function and retention, which is enable to insert and remove with only one hand.

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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Serum Total Calcium, Ionized Calcium Ion and Lipid Compositions in Hypertensive Koreans (정상인과 고혈압 환자의 식이 Calcium 섭취빈도와 혈청의 Calcium 수준과 지질조성의 비교)

  • 박광희
    • Journal of Nutrition and Health
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    • v.22 no.6
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    • pp.476-484
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    • 1989
  • An epidemiological survey was made on dietary calcium intake, serum total calcium and ionized calcium ion, and serum lipid compositions. Compared with 120 normotensive controls, 101 hypertensive subjects were significantly higher in the levels of serum cholesterol and triglyceride, but lower in HDL-cholesterol and higher in the ratio of total choesterol/HDL-chol Hypertensive subjects were also significantly lower in the relative amount of fatty acids C18:2 but higher in those of C20:0, C20:2 and total amount of saturated fatty acids(longer than C14:0) than control serum. Patients were significantly lower in serum total calcium and ionized calcium ion concentrations and significantly less calcium ingestion from milk and dairy produces by feeding frequency test.

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의약품 시판 후 조사의 연구방법 개발에 관한 연구 - Angiotensin 전환효소 억제제의 부작용을 중심으로-

  • 김영식;조홍준;송윤미;서홍관;최현림;서학은;김영주;신호철;박은숙
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.94-94
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    • 1993
  • Angiotensin 전환효소 억제제를 재료로하여 다기관 협동을 통한 시판 후 조사방법론을 개발하고, 아울러 Angiotensin 전환효소 억제제 투여시 나타나는 기침의 발생율과 이와 관련된 요인을 밝히고자 시판 후 조사를 시도하였다. 방법: 1992년 2월부터 1992년 10월까지 11개 병원 가정의학과를 방문하여 Angiotensin 전환효소 억제제를 투여한 고혈압 환자 348명을 연구대상으로 하였다. 이중 남자가 147명, 여자가 201명이었으며, 연령별로는 39세이하 38명, 40-54세 156명, 55세 이상이 154명이었다. 최초 약물투여 후 2, 4, 8, 12주에 추적 관찰하였으며, 기침의 발생율은 PC-SAS 6.04를 이용하여 Kaplan-Meier 방법과 Log-Rank 방법으로 분석하였다.

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Obesity and Reproduction

  • Lee, Taek-Hu
    • 대한생식의학회:학술대회논문집
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    • 2006.11a
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    • pp.67-80
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    • 2006
  • 비만 특히 복부비만은 여성의 임신 및 출산에 많은 악영향을 미친다. 비만이 가임력에 영향을 미치는 기전은 명확히 밝혀지지는 않았지만, functional hyperandrogenism과 insulin resistance에 수반된 hyperinsulinemia가 중요한 역할을 하리라 여겨진다. 또한 지방조직은 활발하게 대사 작용이 일어나는 장소로서 steroid hormone을 modification 시키고, 여러 가지 adipokine들을 분비시키는데 이런 지방조직의 분비물들은 생식계에 영향을 미친다. 비만이 생식계에 미치는 영향은 간략히 다음 표와 같이 정리할 수 있다 (Table 3). 특히 PCOS 환자에서 비만은 hyperinsulinemia에 의한 난소의 steroidogenesis 증가와 SHBG의 감소에 연관되어 hyperandrogenism 과 무배란의 원인으로 작용한다. 비만은 약물에 의한 배란유도 및 체외수정의 성공률 또한 떨어뜨리며, 임신이 되더라도 자연 유산, 조산, 임신성 당뇨, 임신성 고혈압 등의 위험은 높인다. 이와 같이 최근 급격히 증가하는 비만은 여성의 건강 특히 생식계에 많은 문제를 야기시킨다. 특히 청소년기의 비만은 성인이 된 뒤 PCOS로 발전하여 불임, 심혈관 질환 등과 같은 많은 합병증을 일으킬 수 있으므로 세심한 주의를 기울여야 하겠다.

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Cognitive-behavioral Approach to Patients with Cardiovascular Diseases (심장혈관계 질환 환자들에 대한 인지행동적 접근)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.185-196
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    • 1995
  • The author reviewed cognitive-behavioral approach to A type behavior pattern and hypertension which are known to be risk factors for coronary heart diseases. Those cognitive distortions frequently found in persons with A type behavior include all-nothing thinking, selective attention, personalization, and attribution of causality. Cognitive-behavioral techniques were also described, which can be applied to management of each characteristic of A type behavior pattern such as time urgency, perfectionism, achievement striving, low self-esteem, excessive work involvement, hostility, and depression. Cognitive-behavioral intervention for hypertension might help the patients to recognize and monitor anger-engendering conflicts, identify characteristic styles of responding, and experiment with alternative ways of managing conflict and anger. Since different features predominate in different individuals, it is necessary to develop treatment plan on the basis of individual characteristics and problems.

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