• Title/Summary/Keyword: Secondary hypertension

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Comparison of Demographic Characteristics, Comorbidity, and Health Habits of Older Adults with Mild Cognitive Impairment and Older Adults with Normal Cognitive Function (경도인지장애노인과 정상노인의 인구학적 특성, 동반질환 및 건강습관 비교)

  • Park, Myonghwa;Sung, Mi Ra;Kim, Sun Kyung;Lee, Dong Young
    • Journal of Korean Academy of Nursing
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    • v.44 no.4
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    • pp.351-360
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    • 2014
  • Purpose: This study was done to compare demographic characteristics, comorbidity, and health habits of elders with mild cognitive impairment (MCI) and elders with cognitively normal function (CNF). Methods: Secondary data analysis was conducted using data from the Database of the Seoul Dementia Management Project for 5,773 adults age 60 and above. Results: The MCI group showed an older age distribution, but there was no significant education difference between the two groups. Elders with MCI had more diabetes and stroke than elders with CNF. In subgroups, the same findings were observed in women, but not in men. While more men with MCI had hypertension compared to men with CNF, there was no significant difference in hypertension between the two groups for women. Elders with MCI, men in particular, had a lower prevalence of obesity than men with CNF. MCI individuals did less exercise compared to individuals with CNF. While there were no significant differences in alcohol consumption and smoking between MCI and CNF groups, the over 80's subgroup with MCI reported more alcohol consumption. Conclusion: Findings from this study could be helpful in designing community-based dementia prevention programs and health policies to reduce the prevalence of dementia or related cognitive impairments.

The Effect of Voice Therapy in Unilateral Vocal Fold Paralysis (일측성 성대마비 환자의 음성치료 효과)

  • Lee, Chang-Yoon;An, Soo-Youn;Chang, Hyun;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.45-50
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    • 2016
  • Background and Objectives : This study aims to conduct post-voice therapy to patients with unilateral vocal fold paralysis for vocal improvement, motility recovery and analyze the results. Materials and Methods : Voice therapy was conducted to 13 patients who had shown response to voice therapy amongst 98 patients diagnosed with unilateral vocal fold paralysis. In order to be able compare before and after perceptual, acoustic and aerodynamic evaluations were conducted after voice therapy. Also, by using dysphagia checklist, we have verified whether if the patient had dysphagia prior to voice therapy. The therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic. Results : All 13 patients who underwent voice therapy had shown improvements that are statistically significant from 4 scales excluding the S scale from auditory perception evaluation (p<0.05), with enhanced glottal contact. In acoustic evaluation, Jitter, Shimmer and NHR had shown significant improvement after voice therapy. MPT was also notably improved among aerodynamical evaluation (p<0.001). All 11 patients had with dysphagia prior to voice therapy reported to have improved swallowing functions. Conclusion : Application of adequate voice therapy to patients with unilateral vocal fold paralysis, is an effective method that might be employed in the initial phase. Especially, the voice therapy proposed in this study is expected to be useful for patients in hypertension status due to secondary compensation after initial paralysis, since it focuses on improving vocal symptoms in a calm state with the supraglottis sufficiently relaxed. Also, the therapy is expected to be effective for improving swallowing functions.

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Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension in a Patient with Antiphospholipid Syndrome and Systemic Lupus Erythematosus (항인지질 증후군과 전신성 홍반성 루푸스 환자에게 발생된 만성 폐혈전색전성 폐동맥 고혈압에 대해 시행한 혈전내막제거술)

  • Kang, Pil-Je;Kim, Jeong-Won;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.867-870
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    • 2007
  • Antiphospholipid syndrome (APS) is defined as venous and/or arterial thromboses, recurrent fetal losses, thrombocytopenia in combination with repeatedly positive tests for the lupus anticoagulant (LAC), and anticardiolipin antibodies (aCL). The pulmonary manifestation is APS are relatively rare. We report a rare case of antiphopholipid syndrome with systemic lupus erythematosus in a patient who presented with pulmonary hypertension secondary to a chronic pulmonary thromboembolism. A bilateral thromboendarterectomy was performed satisfactorily and the incision was extended to the left intrapleural pulmonary artery.

Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data

  • Kim, Yeon-Yong;Park, Jong Heon;Kang, Hee-Jin;Lee, Eun Joo;Ha, Seongjun;Shin, Soon-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.5
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    • pp.294-302
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    • 2017
  • Objectives: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of selfreported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

Internal Structure of the Health-Related Quality of Life Instrument with 8-Items in a Nationally Representative Population (한국형 건강 관련 삶의 질 측정도구(Health-Related Quality of Life Instrument with 8-Items)의 심리계량적 내적구조 평가: 국민건강영양조사 8기 1차년도 자료 적용)

  • Lee, Eun-Hyun
    • Journal of Korean Academy of Nursing
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    • v.53 no.3
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    • pp.359-369
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    • 2023
  • Purpose: This study evaluated the internal structure (structural validity, internal consistency, and measurement invariance) of the Health-Related Quality of Life Instrument with Eight Items (HINT-8), developed to measure Korean people's health-related quality of life. Methods: A secondary analysis was conducted using data from the Korea National Health and Nutrition Examination Survey, involving 6,167 adults aged over 18 years. The structural validity of the HINT-8 was assessed using exploratory graph analysis and confirmatory factor analysis. Internal consistency and measurement invariance were analyzed using McDonald's omega (ω) and multigroup confirmatory factor analysis, respectively. Results: The HINT-8 had a single dimension and good internal consistency (ω =.804). The one-dimension HINT-8 exhibited matric invariance but not scalar invariance across sociodemographic groups (sex, age, education, and marital status). Further, it exhibited scalar or partial scalar invariance across medical condition groups (hypertension, diabetes, depressive symptoms, and cancer). Conclusion: The study finds that the HINT-8 demonstrated satisfactory structural validity and internal consistency, indicating its suitability for practice and research. However, the HINT-8 scores cannot be compared across different groups regarding sex, age, education, and marital status, as the interpretation varies within each sociodemographic category. Conversely, interpretation of the HINT-8 is consistent for individuals with and without hypertension, diabetes, depressive symptom, and cancer.

Diabetes Mellitus prevalence and related factors in Korean Adult over 19 years according to time trend: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2011, 2021

  • Ji-Suk Seong
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.8
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    • pp.123-131
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    • 2024
  • The purpose of this study is to identify the prevalence of diabetes and related factors and thereby to provide fundamental data for the prevention and management of diabetes. This study is a secondary analysis based on the raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) for the years 2011 and 2021. Analysis method was frequency analysis, complex samples Chi-square test, complex samples logistic regression analysis. As a result of the study, the factors related to diabetes were sex, age, education level, hypertension, dyslipidemia, and subjective health recognition in 2011(Negelkerke R2=.255), and sex, age, education level, hypertension, dyslipidemia, mother's diabetes, and subjective health recognition in 2021(Negelkerke R2=.327). This study is meaningful in that the factors related to diabetes were identified according to time trend, and the changes in the related factors were confirmed. Development and application of an intervention program to prevent diabetes are necessary.

The Evaluation of Sasang Constitution with Use of Health Examination Data in Workplace (산업장내(産業場內) 건강검진(建康檢診) 자료(資料)를 활용(活用)한 사상체질(四象體質)의 평가(評價))

  • Kwon So-Hui;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.6 no.2
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    • pp.1-18
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    • 2002
  • The subjects were 420 workers who received oriental and western health examination both in the workplaces for 1 month. This study was planned for the reflection of western health examination results through evaluation of Sasang constitution with use of data from western health examination, and for the presentation of basic data applicable to constitutional medicine with preventive medicine. Data that were collected in field research were analyzed into frequencies, One-Way ANOVA, Chi-square testing by the study purposes, and the research results were as follows: 1. The distribution of Sasang constitution in 420 subjects was Taeumin > Soumin > Soyangin, and the general characteristics of subject by Sasang constitution were no significant difference. 2. For the measured values for body by the subject of Sasang constitution, Taeumin had higher value for height, body weight, systolic and diastolic blood pressure than other 2 constitutions. Soumin had the lowest values in average for all items, and on the other hand, Soyangin had high pulse pressure compared to other constitutions. It was significant difference between constitutions. 3. For the hematological average, Taeumin had high average for FBS, Total-C, GPT, and Taeumin ,and Soyangin had high in Hb compared to Soumin. Soyangin had the highest average for ${\gamma}-GPT$, and there were significant differences between FBS, Total-C, Hb, GPT, ${\gamma}-GTP$, excepting for GOT. 4. For the result of health examination by the Sasang constitution of subject, Taeumin showed the highest percentage in the items of obesity, primary care, secondary suspicion, and showed significant difference by the constitution. For the distribution of the past disease history by the health examination result of Sasang constitution, Taeumin and Soumin had high prevalence rate for hypertension, liver disease, and Soyangin had high prevalence rate for liver disease, hypertension. For the requirement of lifestyle improvement to the subject, the highest requirements by the Sasang constitution were physical exercise for Soumin, regulation of body weight for Taeumin, and it showed significant difference. For the requirement of primary care by the constitution, the highest requiremetns were obesity control for Taeumin, blood pressure control for Soumin, Soyangin, and liver suspicion was the highest distribution for each constitution in the case of having decision for secondary suspicion.

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Hunt-Hess and Fisher Grades as Predicting Factors for Chronic Hydrocephalus in Surgically Treated Ruptured Aneurysm (수술적 치료를 받은 파열성 뇌동맥류환자에서의 예후와 뇌실-복강 단락술의 예측인자로써의 Hunt-Hess Grade와 Fisher Grade)

  • Hong, Chang Ki;Park, Chong Oon;Hyun, Dong Keun;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.60-65
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    • 2001
  • Objective : The popular grading systems in use, such as Hunt-Hess grade and Fisher scale score, are based primarily on the patient's clinical conditions or computerized tomography score after aneurysmal subarachnoid hemorrhage(SAH). The author investigated whether the need for ventriculoperitoneal(VP) shunt for chronic hydrocephalus and outcome can be predicted by Hunt-Hess grade and Fisher scale. Methods : A series of 146 patients admitted to our hospital from August 1991 to July 1999, who presented with SAH and underwent craniotomy for aneurysm clipping were studied retrospectively. Chronic hydrocephalus was defined as clinically and radiographically demonstrated hydrocephalus that lasted 2 weeks or longer after initial hemorrhage which required shunting. Patients were evaluated based on following factors : Hunt-Hess grade, Fisher scale, age, sex, hypertension, aneurysm location, and intervals from aneurysm rupture to operation. Results : The overall mortality rate of the study group was 8.2%. Hunt-Hess grade(p=0.001) or Fisher scale (p=0.001) at all pretreatment times was significantly correlated with outcome. In addition, there was an increased risk of poor outcome in older age(65<). However, there were statistically no significant relationship between outcome and sex, location of aneurysm, hypertension, and interval from aneurysmal rupture to operation(p>0.05). Of 134 surviving patients, 16 patients(12%) underwent VP shunt placement secondary to chronic hydrocephalus. Hunt-Hess grade(p=0.001) is more predictive of chronic hydrocephalus than Fisher scale(p=0.146). Aneurysm location was significantly correlated with development of chronic hydrocephalus (p<0.05), without significant correlations in sex, age, hypertension. IVH, and ICH. Conclusion : This study suggests that there is a high clinical correlation between outcome and Hunt-Hess grades and Fisher scales on admission, but Hunt-Hess grade is more predictive for chronic hydrocephalus than Fisher scale. In addition, age(<65 yrs) is the significant factor for prediction of outcome. There was a trend of increasing risk for chronic hydrocephalus according to aneurymal location.

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A retrospective clinical study of isolated patent ductus arteriosus (동맥관 개존증의 임상적 고찰)

  • 곽영태
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma

  • Jo, Soo Yeon;Ryu, Soo Hyung;Kim, Mi Young;Moon, Jeong Seop;Yoon, Won Jae;Kim, Jin Nam
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.155-158
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    • 2016
  • Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.