• Journal of Chest Surgery
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• v.11 no.3
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• pp.316-320
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• 1978

This report presents a case of patent ductus arteriosus complicated with total left lung atelectasis and mitral regurgitation. Her mother complained growth retardation and exertional dyspnea. The 3 year old girl had large patent ductus arteriosus [Qp/Qs=5.6] which resulted in moderate pulmonary hypertension, left atrial hypertrophy and enlargement, consequently the left main bronchus was compressed between the dilated left atrium and aorta. We would like conclude the cause of mitral regurgitation as the result of annular dilatation secondary to left atrial enlargement rather than congenital associated to patent ductus arteriosus. 3 weeks later from ligation of patent ductus arteriosus, the left atrial dimension was markedly reduced echocardiographically [from 3.9cm to 2.7cm], and the left lung progressively aerated by halves.

• Advances in environmental research
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• v.1 no.1
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• pp.57-68
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• 2012

Recent studies showed that air pollution is a risk factor for hospitalization for chronic obstructive pulmonary disease (COPD). However, there is limited evidence to suggest which subpopulations are at higher risk from air pollution. This study was undertaken to examine the modifying effect of specific secondary diagnosis (including hypertension, diabetes, pneumonia, congestive heart failure) on the relationship between hospital admissions for COPD and ambient air pollutants concentrations. Hospital admissions for COPD and ambient air pollution data for Taipei were obtained for the period from 1999-2009. The relative risk of hospital admissions for COPD was estimated using a case-crossover approach. None of the secondary diagnosis we examined showed much evidence of effect modification.

• The Journal of the Korea Contents Association
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• v.16 no.5
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• pp.399-409
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• 2016

Purpose: The purpose of this study was to examine factors influencing health related quality of life(HRQOL) in patients with hypertension. Methods: This study carried out secondary analysis using the data from the $5^{th}$ Korean National Health and Nutrition Examination Survey. Subject samples who were selected are 1,240 hypertension patients. The data were analyzed by using descriptive statistics, traditional classic regression, and quantile regression. Results: Restriction of activity, depressive mood, and subjective health status had only significant effects on HRQOL(p<.001). After quantile regression, depressive mood and subjective health status had only significant at 20%(p<.001), 40%(p<.001), and 60%(p<.01) of HRQOL. Perceived stress(p<.001) and regular exercise(p<.01) had only significant at 20% of HRQOL. Current drinking status had only significant at 20%(p<.001) and 80%(p<.01) of HRQOL. Conclusions: Quantile regression maybe a better statistical tool in understanding the heterogeneous effect of hypertension patient's HRQOL as health outcome. Therefore interventions are needed for patients with hypertension to manage each of the factors affecting the patient's perceived health status by each quantile.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.81-84
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• 1978

A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.221-225
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• 2009

Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.

• Health Policy and Management
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• v.9 no.2
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• pp.118-138
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• 1999

This study presents the variations on drug utilization for outpatients' URI, gastritis. and hypertension by the type of hospital- tertiary hospital. general hospital. hospital. clinic. It investigated drug expenses. daily drug expenses. days of medication. the highest price of the drugs used. and the number of the different drugs used for each disease and type of hospital. This study also performed analysis to see how much the variations of variables related to drug use affect the variations of drug expenses. The dependent variable was drug expenses and the independent variables were days of medication. the average price of the drugs used. and the number of the different drugs used. Analysis of the drug utilization was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Patients with secondary diseases were excluded. In this study. 379 patients with URI, 386 patients with gastritis. 1.257 patients with hypertension were included. It was founded that there were large variation on drug utilization between the types of hospital for same diseases. Days of medication were longest in tertiary hospitals and shortest in hospitals or clinics. Clinics showed the lowest daily drug expenses in all of the diseases investigated. Daily drug expenses were highest in general hospitals or hospitals. which also tended to use drugs of higher price than other types of hospital. General hospitals and hospitals had larger variations in daily drug expenses and the highest price of drugs. It suggested that drug might be utilized overly in general hospitals and hospitals and some other factors might influence on drug utilization in these hospitals. It was found that the variations of drug expenses were affected by the variations of drug price and days of medication rather than the number of the different drugs. Then the strategy to reduce the variations of drug utilization and to improve the quality of drug utilization should focus on the drug price and days of medication. Further study is needed to assess the quality as well as the variation of drug utilization and to show the factors which affect them.

• Gut and Liver
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• v.12 no.6
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• pp.655-663
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• 2018

Background/Aims: The association between metabolic syndrome and colorectal cancer (CRC) has been suggested as one of causes for the increasing incidence of CRC, particularly in younger age groups. The present study examined whether the current age threshold (50 years) for CRC screening in Korea requires modification when considering increased metabolic syndrome. Methods: We analyzed data from the National Health Insurance Corporation database, which covers ~97% of the population in Korea. CRC risk was evaluated with stratification based on age and the presence/absence of relevant metabolic syndrome components (diabetes, dyslipidemia, and hypertension). Results: A total of 51,612,316 subjects enrolled during 2014 to 2015 were analyzed. Among them, 19.3% had diabetes, hypertension, dyslipidemia, or some combination thereof. This population had a higher incidence of CRC than did those without these conditions, and this was more prominent in subjects <40 years of age. The optimal cutoff age for detecting CRC, based on the highest Youden index, was 45 years among individuals without diabetes, dyslipidemia, and hypertension. Individuals with at least one of these components of metabolic syndrome had the highest Youden index at 62 years old, but the value was only 0.2. Resetting the cutoff age from 50 years to 45 years achieved a 6% increase in sensitivity for CRC detection among the total population. Conclusions: Starting CRC screening earlier, namely, at 45 rather than at 50 years of age, may improve secondary prevention of CRC in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.120-124
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• 2001

Sclerosing cholangitis is a chronic cholestatic disease characterized by inflammation and obliterative fibrosis of the bile ducts, leading to biliary cirrhosis and ultimately to liver failure. In children, sclerosing cholangitis is known to be associated with Langerhans cell histiocytosis, as well as with congenital immunodeficiencies and cystic fibrosis. Secondary sclerosing cholangitis is suspected in Langerhans cell histiocytosis with chronic cholestasis, liver dysfunction and portal hypertension. Unlike primary sclerosing cholangitis, the cholangitis associated Langerhans cell histiocytosis is destructive in nature and progresses more rapidly to biliary cirrhosis, therefore uniformly the prognosis is poor. In this setting, liver transplantation should be considered early in children with sclerosing cholangitis complicating Langerhans cell histiocytosis before end-stage liver failure and variceal bleeding. We experienced a case of secondary sclerosing cholangitis in Langerhans cell histiocytosis in a 2-year-old boy. We report this case with brief review of the related literatures.

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.846-855
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• 1999

Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.198-208
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• 2006

Background : Ginseng has traditionally been used in oriental countries to recover vital energy from Qi deficiency, and has shown various biomedical effects in the scientific literature. Recent reports suggest that ginseng could regulate blood pressure (BP), but much controversy still remains. Therefore, we intended to assess the anti-hypertensive effect of several ginseng types frequently used in clinics. We also investigated the anti-hypertensive effect on Koreans and Chinese, and by the body type according to Sasang Constitution Medicine (SCM). Methods : The study subjects were recruited from mildly hypertensive patients who exhibited pre-hypertension(120/80 to 139/89 mmHg) and stage I hypertension (140/90 to 159/99 mmHg) in Korea and China. After assigning the subjects into a Korean, a Chinese, a red, and an American ginseng group by randomization, we prescribed ginseng at a dose of 4.5 g per day for 4 weeks. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication using a 24-hour ambulatory blood pressure monitor (24 hr ABPM. We also monitored adverse effect and laboratory findings to secure the subjects' safety. In addition, all of the subjects in Korea consulted a specialist of Sasang Constitution Medicine to identify their constitutional type. Results : There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, 33 treated with red ginseng, and 64 treated with American ginseng. Korean, Chinese, and American ginseng all reduced subjects' BP; Korean and Chinese ginseng showed more effect. The secondary analysis on the subjects' nationality revealed that all of the ginseng types showed more significant anti-hypertensive effect in Chinese patients than in Koreans. The third analysis on the constitutional type of SCM showed there was no significant difference in the effectiveness and the safety of ginseng among the constitutional types. Conclusions : We suggest ginseng, especially Panax ginseng without any steaming-drying process, could be useful for mild hypertension. Further, ginseng is safe regardless of subjects' constitutional type or type of ginseng within a dosage of 4.5g per day.