• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.487-494
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• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• Journal of Biomedical Engineering Research
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• v.21 no.3 s.61
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• pp.261-271
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• 2000

The present study investigated flow dynamics of a two-dimensional abdominal aortic bifurcation model under sinusoidal flow conditions considering wall motion. impedance phase angle(time delay between pressure and flow waveforms), and non-Newtonian fluid using computational fluid dynamics. The wall shear stress showed large variations in the bifurcated region and the wall motion reduced amplitude of wall shear stress significantly. As the impedance phase angle was changed to more negative values, the mean wall shear stress (time-averaged) decreased while the amplitude (oscillatory) of wall shear stress increased. At the curvature site on the outer wall where the mean wall shear stress approached zero. influence of the phase angle was relatively large. The mean wall shear stress decreased by $50\%$ in the $-90^{\circ}$ phase angle (flow wave advanced pressure wave by a quarter period) compared to the $0^{\circ}$ phase angle while the amplitude of wall shear stress increased by $15\%$. Therefore, hypertensive patients who tend to have large negative phase angles become more vulnerable to atherosclerosis according to the low and oscillatory shear stress theory because of the reduced mean and the increased oscillatory wall shear stresses. Non-Newtonian characteristics of fluid substantially increased the mean wall shear stress resulting in a less vulnerable state to atherosclerosis.

• The Journal of Traditional Korean Medicine
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• v.15 no.1
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• pp.128-144
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• 2006

This Study aims at looking into the use of oriental medical services in treating hypertension. The first objective to be explored through this study is the morbidity caused by the disease, classifying them by age, gender, and occupation. The second is to determine the regular use of anti-hypertensive medicine and their efficacy in controlling blood-pressure. The third is to investigate the use-rate and satisfaction of oriental medical service. 838 households across the country, were asked to answer questionnaires for the period of time from Apr. to Jun. 2005. The conclusion from the survey can be summarized as following. The age of which the first medical diagnosis of hypertension were made showed lower in males, those with higher education and income. The study showed females were more active in blood-pressure control, with their frequent monitoring of blood-pressure for the past year. With age, people in under 50 age group proved to be less active. The management of high blood pressure was more effective in group with regular dosage compared to group with irregular use of anti-hypertensive medication, but their difference was minimal. Also, group with no medication showed signs of blood-pressure control. The use of oriental medical service for the past year, were more frequent in groups with lower education, either low or high income, old age, females and occupations in agriculture, forestry and fishing industry. Results were similar in both general population and high blood-pressure patient group. Females, people over 51 years old and with lower education showed more intentions in utilizing oriental medical services in the future. Results were similar in both general population and high blood-pressure patient group. It is necessary to offer a more accurate information on oriental medical treatments. Also, a systematic reform to reduce the patient's share of the treatment cost, as well as, heightening public awareness on the infirmity of present blood-pressure management system is crucial.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.83-91
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• 2012

The obesity is a medical condition in which excess body fat has accumulated to the extent. It may have an adverse effect on health, leading to reduced life expectancy and increased health problems such as lifestyle disease, hypertension, and diabetes. Furthermore, it may cause the mental illness such as depression, bipolar disorder, anorexia, hyperphagia, and so on by shrinking psychologically. So, it is regarded as the serious worldwide social problem. Recently, although there are many general obesity care methods with various approaches, these can't be the radical obesity care because of the side effects such as surgery aftereffect, drug addiction, and so on. For these reasons, a methodical approach with a consideration of individual obesity pattern is strongly demanded. In this study, complex obesity care and management system which is overcome the weakness of non-surgical obesity treatment is proposed. And the individually adapted obesity treatment system with the far-infrared therapy module, oxygen therapy module, color therapy module, and microwave therapy module was developed. The complex obesity treatment system which is proposed in this study, could improve the efficiency of treatment by suggesting the various treatment protocols. And proposed system could be the foundation of the high quality obesity treatment system.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.23-29
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• 2003

Purpose : This study was performed to determine the natural history of histologically confirmed IgA nephropathy in pediatric patients who presented with hematuria and proteinuria. Patients and Methods : We reviewed the clinical course of 57 patients diagnosed with IgA nephropathy at the age of 15 years or younger from 1981 to 2000. All patients presented with hematuria or minimal proteinuria($<40\;mg/m^2/day$) and had normal renal function and blood pressure at the time of renal biopsy. Based on the clinical and pathological findings at the time of diagnosis, we sought for complications of IgA nephropathy such as heavy proteinuria(${\ge}40\;mg/m^2/day$), hypertension, and chronic renal failure. Results : The mean age at presentation was $9.5{\pm}2.8$ years(4 to 15 years) and 42(74%) were male. Isolated gross hematuria was observed in 20 patients(35%), microscopic hematuria in 3(5%), minimal proteinuria in 4(7%), both gross hematuria and minimal proteinuria in 15(26%), and both microscopic hematuria and minimal proteinuria in 15(26%). During a median follow-up of $7.0{\pm}3.5$ years, 38(67%) had complete resolution of hematuria and proteinuria, 12(21%) had persistently abnormal urinalysis without development of adverse events. Only 7(12%) developed adverse events : 4(7%) developed severe proteinuria, 1(2%) became hypertensive, and 2(3%) developed Impaired renal function. By univariate analysis using the chisquare test, the age at presentation(>10 years)(P<0.01) and poor histological classes of the Lee or Haas classification at onset(P<0.05) were significantly correlated with adverse events, whereas sex and clinical signs at onset were less concordant. Conclusion : We can conclude that the prognosis of IgA nephropathy diagnosed in early childhood is better and a good correlation exists between the clinical manifestations of this disease and the histological classes.

• Korea Journal of Hospital Management
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• v.22 no.1
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• pp.1-9
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• 2017

Purpose : Many studies showed that having a usual source of care improved the efficient access of healthcare service. However in Korea there have been few studies on the usual source of care. So this study aims to find whether having a usual source of care affect the medical utilization and expense. Methodology/Approach : We used the Korean Health Panel data in 2012, 2013 to examine the change of utilization and expenses in ambulatory care affected by having a usual source of care. We selected 1,215 hypertension patients without usual source of care in 2012 and performed linear regression analysis to identify the difference between treatment group(with usual source of care in 2013) and control group(without usual source of care in 2013). Then we performed analysis again separated by the age group. Findings : Among study population, 711(58.5%) reported that they have a usual source of care in 2013. Treatment group reported 1.85 less increase in outpatient visits and 69,234 won less increase in expense than control group with weak significance(visit ${\beta}$ -1.85 p-value 0.0807, expense ${\beta}$ -69,234 p-value 0.0541). People under the age of 65 showed significant change in outpatient visits for tertiary hospital (visit ${\beta}$ -0.78 p-value 0.0154, expense ${\beta}$ -91,462 p-value 0.0168). The analysis which focused outpatient for mild disease showed similar trend. Practical Implications : This study supports the positive effect of having usual source of care which decrease inefficient outpatient utilization. Promoting physician-patient relationships is important for efficiency of healthcare service.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.63-74
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• 2016

Objectives : There is a need to develop a data quality management algorithm to improve the quality of healthcare data using a data quality management system. In this study, we developed a data quality control algorithms associated with diseases related to hypertension in patients with diabetes mellitus. Methods : To make a data quality algorithm, we extracted the 2011 and 2012 discharge damage survey data from diabetes mellitus patients. Derived variables were created using the primary diagnosis, diagnostic unit, primary surgery and treatment, minor surgery and treatment items. Results : Significant factors in diabetes mellitus patients with hypertension were sex, age, ischemic heart disease, and diagnostic ultrasound of the heart. Depending on the decision tree results, we found four groups with extreme values for diabetes accompanying hypertension patients. Conclusions : There is a need to check the actual data contained in the Outlier (extreme value) groups to improve the quality of the data.

• Journal of Korean Public Health Nursing
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• v.32 no.2
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• pp.235-248
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• 2018

Purpose: This qualitative study examined the participation in ICT-based management from the perspectives of patients with chronic diseases. This study was conducted as one of several studies evaluating the effectiveness of chronic disease management in the Ministry of Health and Welfare. Methods: Focus group interviews were used as its guiding methodology. Group interviews with 16 patients were carried out using semi-structured interview questions developed from a literature review and discussion with researchers. Content analysis was used to analyze the data. Results: A total of 11 sub-themes were extracted through a comparison of the concepts and semantic analysis, and finally, four themes were derived: "Satisfied with systematic management of health care", "Leading in health care", "Understanding the pattern of blood pressure and blood sugar change" and "Adherence to existing health care habits". Conclusion: This study is meaningful in that it used qualitative analysis through FGI to evaluate the effects of an ICT-based chronic disease management project. Based on this study, a mixed-method design study and an intervention study among patients with metabolic syndrome is proposed.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.723-725
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• 2010

A 14-year-old spayed, mixed breed, female cat was admitted for evaluation of a polyphagia, hyperactivity and chronic weight loss. Physical examination revealed a tachycardia and mild elevated systemic blood pressure. This cat had azotemia and mild increased total thyroxin (TT4) and free thyroxin concentration. However triiodothyronine (T3) level was normal, the T3 suppression test for definite diagnosis were made. No changes of TT4 serum concentration before and after the exogenous T3 administration in this cat showed hyperthyroidism. This cat was diagnosed as mild hyperthyroidism concurrent with chronic kidney disease (CKD) and antithyroid drug, methimazole, was used for medical management. This is first case report describing clinical and laboratory characteristic features of feline hyperthyroidism complicated with CKD and its clinical outcome using medical management in our country.

• Journal of Nutrition and Health
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• v.9 no.4
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• pp.47-53
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• 1976

As the seriousness of hypertension in adults is increasingly recognized, attention is being focussed on its control through continuous health supervisions. Complications arising from high blood pressure exceed those of many other adult health problems and affect the nursing needs of these patients. In order to contribute to effective nursing care planning and improved health supervision, 248 medical records of hypertensive patients admitted to Internal Medicine at Ewha Medical Center from January 1971 to August 1976 were examined. Results were as fellows: 1. The sample group averaged 5.0% of the total number of patients admitted to internal medicine during the period studied. The proportion increased slightly with each successive year. 2. Patients with hypertension averaged 31.4% of all patients with cardiovascular discease. This proportion was stable over the period. 3. Hypertensive patients were primarily in their 40s. The average age was 55.1 years. 4. Women were most frequently affected in their 60s and men in their 40s. 5. The bloo pressure of these in their 30s was not well controlled on discharge. Rates for those in their 30s averaged 151.5/107mmhg, for those in their 40s 161.5/110mphg, and for those in their 60s 169/100mmhg. 6. Complications increased with each age range from the 40s to the 60s for both men and women. 7. Complications related to systolic hypertension occurred most frequently when the rate exceeded 200mmhg. Cerebral vascular accident was the primary complication, presenting implications for nursing intervention. 8. Complications related to diastolic hypertension occurred most frequently when the rate was in the $110{\sim}129mmhg$ range. C.V.A. again was the primary complication needing nursing care planning. 9. Diets ordered for patients were low salt 79.%, salt free 4.19%, diabetic 6.1%, and protein free ('no protein') 2.0%. Caloric, salt end protein levels were not defined. Recommendations based on the findings were directed to diet and other therapies.