• Title/Summary/Keyword: 고혈압 환자

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Effects of Professional Oral Care for Long-term Patients in Nursing Facilities on the Streptococcus mutans Population in the Intraoral Region (전문가구강관리가 요양병원 장기입원환자들의 구강 내 Streptococcus mutans 수에 미치는 영향)

  • Choi, Sung-Mi;Kim, Gi-Ug;Sakong, Joon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5062-5069
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    • 2014
  • In this study, professional oral care was provided and 3 times a day twice a week by a dental hygienist for 3 months from July 24 to October 25, 2011, to 43 long-term patients in a single nursing facility located at the city of D, and the number of mutans strepococci colonies within the saliva and the level of salivation were then analyzed after 3 samplings with an interval of 1 month to compare the intraoral conditions among the subjects and examine the effects of professional oral care on the Streptococcus mutans population in the intraoral region of long-term patients in a nursing facility. The level of salivation was elevated from 5.8 ml to 6.4 ml after one month and to 7.5mL after two months. The population of bacteria decreased from $6{\times}10^8CFU/ml$ to $3{\times}105CFU/ml$. In terms of the change in the bacterial population in accordance with systemic diseases, the patients with hypertension and diabetes showed a meaningful decrease in the population. As more dental charge and prosthesis are present, the number of bacteria decreased significantly. On account of the close relationship between a professional oral care and the population of Streptococcus mutans at the intraoral region of long-term patients in nursing facilities, various dental health programs should be researched and developed to consider the characteristics of long-term patients in nursing facilities and manage them continuously but effectively.

Trend of Emergency Department Visits for Elderly Patients with Chronic Diseases : 2014-2019 (만성질환을 동반한 노인 응급환자 추이: 2014-2019)

  • Lee, Myoung-Hwa;Kim, Ji-Yeon;Huh, Young-Jin;Oh, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.11 no.1
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    • pp.183-190
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    • 2021
  • The purpose of this study was to determine the change trend of emergency department visits among elderly patients with chronic diseases. Using the National Emergency Department Information System data, from January 1, 2014 to December 31, 2019, the selected patient data were evaluated for the emergency department discharge main diagnosis codes for eight chronic diseases. The incidence of elderly chronic diseases, emergency department visits, and admission rates were analyzed. Since 2014, there has been a consistent increase in the number of elderly patients visiting the emergency department, especially among those aged over 85 years. The number of emergency department visits among the elderly chronically ill patients also increased, with a significant increase in ischemic heart disease and arthrosis cases. Furthermore, there was a significant difference in the number of chronically ill patients in each year from 2014-2019 (P<0.001). With respect to the trend of admission rates to the emergency department by chronic disease, most diseases showed an increasing trend (P<0.001). however, hyperlipidemia showed a continuous decreasing trend in all age groups since 2014 (P<0.001). Among the elderly chronically ill patients, a greater increase in the admission rate following emergency department visits was noted in those over 85 years of age, with a significant difference in all diseases, except for hyperlipidemia, hypertension, and tuberculosis (P<0.001). As the aging population grows, the emergency department admission rates among the elderly chronically ill patients will rise rapidly. This could create issues with respect to the use and consumption of emergency medical resources. Hence, it is necessary to manage chronic diseases effectively in the elderly.

Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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Relationship of Risk Factors and Incidence to Size, Number and Location of Unruptured Intracranial Aneurysm (비파열 동맥류의 크기, 개수, 위치에 따른 위험요인과 발생빈도의 상관관계)

  • Choi, Pahn Kyu;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.240-247
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    • 2017
  • The increased investigation of the cerebral arteries with magnetic resonance angiography has resulted in an increase in the identification of unruptured intracranial aneurysms (UIAs). Knowledge of the distribution and factors associated with UIAs might be helpful for understanding the pathological mechanism of unruptured aneurysms. This study examined patients who visited a health care center and had a health examination from January 2007 to December 2016. Subjects who underwent magnetic resonance angiography with a health examination at the Health Screening were enrolled in this study. The incidence and risk factors of UIAs (age, sex, hypertension, diabetes mellitus, smoking, alcohol, and coronary artery disease) were investigated by comparing the size (more than 3 mm vs. less than 3 mm) and multiple aneurysm (single vs. multiple aneurysms). The frequency of aneurysm according to the site was also analyzed. Among the 187166 subjects, who received a health examination, 18954 underwent magnetic resonance angiography. Of them, 367 (1.93%) had UIAs. A comparison of the size of more than 3 mm and less than 3 mm showed that the mean age of the more than 3 mm group of patients was significantly higher than the other size groups (more than 3 mm $57.16{\pm}8.47$ vs. less than 3 mm $55.12{\pm}8.19$; p=0.07). High-density lipoprotein was significantly higher in the more than 3 mm group than in the less than 3 mm($55.95{\pm}16.03$ vs. less than 3 mm $50.85{\pm}13.65$; p=0.007). Hypertension was significantly higher in the multiple aneurysm group (single 153 in 399 (38.3%) VS multiple 19 in 35 (54.3%); p=0.065). An aneurysm of less than 3 mm in size was frequent in the distal internal carotid artery (34.3%) and MCA-bifurcation (16.4%) (p=0.003). Aneurysms of more than 3 mm were frequent in the distal internal carotid artery (43.4%) and MCA-bifurcation (13.4%), and anterior communicating artery (13.4%) (p=0.003). The difference in size and single or multiple aneurysm revealed other risk factors. These risk factors suggest that degenerative and hemodynamic disorders may lead to the presence of aneurysms.

Arteriovenous Fistula Formation with Prosthetic Graft Using the Vena Comitantes as a Venous Outflow (동반정맥을 정맥유출로 이용한 인조혈관 동정맥루 조성술)

  • Lee, Gun;Lim, Chang-Young;Lee, Hyeon-Jae
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.41-45
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    • 2009
  • Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.

Clinical Observation for Endotracheal intubation Patients in ICU (중환자실(重患者室)에서 기관내(氣管內) 삽관후(揷管後) 퇴원(退院)한 환자(患者)의 임상통계(臨床統計) 고찰(考察))

  • Nam, Chang-Gyu;Moon, Byung-Soon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.407-432
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    • 1996
  • Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.

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Prognostic Factors in Childhood IgA Nephropathy (소아 IgA 신병증의 예후에 관한 고찰)

  • Park Jae-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo;Choi In-Joon
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.17-23
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    • 1997
  • After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.

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Assessment of Carotid Geometry by Using the Contrast-enhanced MR Angiography (조영증강 MR 혈관 조영술을 이용한 경동맥 기하학의 평가)

  • Lee, Chung-Min;Ryu, Chang-Woo;Kim, Keun-Woo
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.47-55
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    • 2010
  • Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.

Changes of Clinical Findings of Acute Poststreptococcal Glomerulonephritis (소아에서 연쇄상 구균 감염 후 급성 사구체 신염의 임상양상의 변화)

  • Choi, Byung-Ho;Chu, Mi-Ae;Hong, Eun-Hui;Hwang, Hyun-Hee;Cho, Min-Hyun;Ko, Cheol-Woo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.157-163
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    • 2008
  • Purpose : Several studies have reported the recent increase in the incidence of acute poststreptococcal glomerulonephritis(APSGN). The objective of this study is to see changes of clinical findings/manifwstation in children with APSGN. Methods : Medical records of 63 children who were diagnosed with APSGN in the deparment of Pediatrics, Kyungpook National University Hospital, between January 1992 and December 2006 were reviewed retrospectively. We analyzed various clinical characteristics such as age, sex, degrees of proteinuria, degrees of hematuria, and presence or absence of histories of systemic antibiotic use in children with APSGN, and compared the children with APSGN who were diagnosed between 1992 and 2000 to those who were diagnosed between 2001 and 2006. Results : Age of the patients ranged from 2-14 years(median 7.11 years) at the time of disease onset. Study patients consisted of 41 boys and 22 girls. APSGN followed infection of the throat in 87% of cases. Patient developed an acute nephritic syndrome 12 days after an antecedent streptococcal pharyngitis. Forty patients presented with gross hematuria. Fortyone patients had hypertension at the time of diagnosis. Hypertension disappeared within 7.8$\pm$8.2 days, gross hematuria within 11.3$\pm$17.2 days and microscopic hematuria within 3.5$\pm$3.9 months from the disease onset. Patients in 2001-2006 had significantly higher increase of antistreptolysin O(ASO) titer. However, no significant differences in clinical characteristics were observed. Age, sex, severity of proteinuria, gross or microscopic hematuria, antibiotic therapy did not affect the clinical manifestations of glomerulonephritis. In other words, hypertension, duration of hematuria, recovery of serum C3 level are not different between the two time periods. Conclusion : Our data indicates that patients in 2001-2006 had significantly higher level of ASO titer. However, they did not show significant clinical differences. To evaluate the causes of the resurgence of APSGN, a national epidemic is needed.

A Comparative Study on Food Habits and Nutrient Intakes with Body Mass Index of Hypertensive Patients commuting to a Local Health Center (지역사회 고혈압 환자의 비만도에 따른 식습관 , 영양상태 및 고혈압관리 실태)

  • Jo, Gyeong-Ok;Gwon, Sang-Hui
    • Journal of the Korean Dietetic Association
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    • v.8 no.2
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    • pp.185-198
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    • 2002
  • The purpose of this study was to compare food habits and nutrient intakes with body mass index of hypertensive patients commuting to a Local Health Center. A total of 85 patients were divided into two groups according to BMI. The non-obese group comprised 43 subjects with BMI below 25㎏/$m^2$ , while the obese group comprised 42 subjects with BMI above 25㎏/$m^2$ . All Subjects were interviewed for general characteristics, food habits, clinical characteristics, effort for health maintenance and the knowledge of hypertension and nutrition. Anthropometric assessments such as weight, height, waist-hip ratio and biochemical measurement of blood urea nitrogen, creatinine, triglyceride, total cholesterol, HDL-cholesterol and fasting blood glucose(FBG) were obtained from subjects. In general characteristics, smoking, drinking, exercise, and hypertension status were not significantly different between the two groups. Food habits and the means of daily energy and nutrients were not significantly different between the two groups. An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea, 2000) consumed by patients showed that but for ascorbic acid and phosphorus, all nutrients were below the RDA. And intakes of vitamin $B_1$(P<0.001), vitamin $B_2$(P<0.01), niacin(P<0.001) of the obese group were significantly lower than that of the non-obese group. Blood urea nitrogen, creatinine, triglyceride, total cholesterol, HDL-cholesterol and fasting blood glucose were in the normal range and there was not a significant difference in the two groups. Therefore, more effective nutrition education programs about exercise, smoking, caloric intake, vitamins and minerals are required for hypertensive patients commuting to Local Health Center.

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