• 제목/요약/키워드: Systolic pressure

검색결과 1,580건 처리시간 0.038초

응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰 (Clinical Patterns of Penetrating Torso Injury at Emergency Department)

  • 윤순영;전영진;원태희
    • Journal of Trauma and Injury
    • /
    • 제18권1호
    • /
    • pp.47-52
    • /
    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

미숙아 동맥관 개존증의 외과적 교정에 관한 임상적 고찰 (Clinical Considerations of the Surgical Closure of the PDA in the Premature Infants)

  • 김상익;박철현;현성열;김정철;권진형;박국양
    • Journal of Chest Surgery
    • /
    • 제32권8호
    • /
    • pp.702-708
    • /
    • 1999
  • 배경: 미숙아 동맥관 개존증의 약물적 치료로 Indomethacin을 사용하는데 이때 발생하는 합병증, 부적응증, 또는 동맥관이 다시 열릴 경우 외과적으로 교정함으로써 수술에 따른 위험성 및 합병증이 적고 지속적인 동 맥관 폐쇄가 가능하다. 대상 및 방법: 1996년 4월부터 1998년 8월까지 동맥관 개존증을 동반한 미숙아중 수 술 당시의 체중이 1.5 kg 이하인 11명의 환아(남아: 5, 여아: 6)를 대상으로 하였다. 술전 동반질환으로 선천 성 심질환(7), 유리질막증(6), 폐렴(4), 뇌실내 출혈(4), 기흉(3), 고빌리루빈혈증(2), 괴사성 장염(2), 신부전증 (1), 간질(1), 수두증(1) 등이 있었다. 사용된 외과적 술식은 헤모클립을 사용한 경우(8)와 동맥관을 결찰한 경 우(3)가 있었다. 동맥관의 크기는 3~6 mm(5.0$\pm$1.2)였다. 결과: 동맥관을 폐쇄한후 수축기 및 확장기 혈압이 상승하였고 심박동수는 감소하였다. 동맥혈 개스 결과도 호전되었다. 수술과 관련된 합병증은 없었다. 술후 6명의 환아에서 호흡기 증상의 호전과 함께 인공호흡기이탈이 가능했고 모두 외래 추적 관찰중이다(3개월~ 12개월). 술후 5명의 환아가 사망하였는데 사망 원인은 유리질막증(2례), 기관지폐 이형성증과 폐렴(1례), 패 혈증(1례), 심부전증과 특발성 호흡곤란증(1례)이었다. 결론: Indomethacin에 부적응증 혹은 합병증이 있거나, Indomethacin용법에 효과가 없거나 또는 혈역학적으로 의미있는 단락을 동반하는 미숙아 동맥관의 우선 치료 법은 조기 외과적 교정술이다.

  • PDF

비만 소아들에서의 경동맥 내막중막 두께 측정 (Carotid Intima-Media Thickness Measurement in Obese Children)

  • 박경옥;최석주;염희현;정소정;유정진;박영신;이동환
    • Clinical and Experimental Pediatrics
    • /
    • 제48권9호
    • /
    • pp.935-938
    • /
    • 2005
  • 목 적 : 소아 비만은 동맥 경화에 따른 성인 심혈관 질환의 독립적인 위험인자이다. 저자들은 비만 소아들을 대상으로, 동맥경화증의 조기 병변인 경동맥 내막중막 두께가 정상아들에 비해 증가되어 있는지를 확인해 보고자 본 연구를 시행하였다. 방 법 : 총 32명을 대상으로 하였는데, 체질량지수가 연령, 성별 표준치의 85 백분위수 이상인 21명의 비만아/과체중아들을 비만군으로 하였고, 85 백분위수 미만이었던 11명을 정상 대조군으로 하였다. 모든 대상 소아들에서 만성 질환력과 약물 투여력이 없었다. 연령, 성별, 신장, 체중, 수축기/이완기 혈압 등이 조사되었고, 초음파를 통해 경동맥 내막중막 두께가 측정되었다. 19명의 비만아군 환아들에서 혈청 포도당, 간 transaminase 수치, 콜레스테롤 수치 등이 검사되었다. 결 과 : 비만아군의 경동맥 내막중막 두께가 대조군에 비해 증가되어 보였으나 유의한 차이를 보이지는 않았다(0.42 vs. 0.40, P=0.0592). 단순선형회귀분석 결과 체질량지수를 포함하여 경동맥 내막중막 두께의 변화를 통계적으로 의미있게 설명해 주는 변수는 없었으나, 체질량지수가 유의성에 근접하였다(P=0.0585). 결 론 : 소아들을 대상으로 경동맥 내막중막 두께 측정이 연구된 것은 저자들이 조사한 바로는 국내에서 본 연구가 시초의 것으로 생각된다. 통계적 유의성에 근접하였으나 조사 대상수의 부족으로 비만아에서 경동맥 내막중막 두께의 상승이나 체질량지수와의 의미있는 연관성을 증명해 내지는 못하였다. 향후 보다 많은 비만 소아들을 포함한 연구가 후속되어야 할 것으로 판단된다.

자연발증고혈압쥐에서 카제인 가수분해물의 혈압강하효과 (Antihypertensive Effects of Casein Hydrolysate in Spontaneously Hypertensive Rats)

  • 김현수;인영민;정석근;함준상
    • Journal of Animal Science and Technology
    • /
    • 제44권4호
    • /
    • pp.483-490
    • /
    • 2002
  • 본 논문에서는 카제인 가수분해물의 in vivo 상에서 혈압강하 효과를 알아보고, 혈압강하 기능을 갖는 기능성 펩타이드로서의 활용 가능성을 검토하기 위하여 안전성 검사를 실시하였다. 카제인 가수분해물의 소화관 단백질 분해효소 (펩신, 트립신, 카이모트립신) 내성 시험 결과 카제인 가수분해물은 소화관 효소 처리에 의하여 ACE 저해효과에 차이가 없었으며, 자연발증고혈압쥐를 이용한 혈압강하 실험에서 500 mg/kg을 경구 투여한 결과 12.9% (-28.88 mmHg, P<0.05) 저하하였고, 이들 가수분해물을 30% 난황으로 유화할 경우 15.9% (-30.76 mmHg, P<0.01)의 혈압이 감소하여 난황으로 유화에 의해 다소 혈압강화 효과가 증가하였다. 장기 투여에 의한 혈압강하 효과에서 35일 부터 수축기혈압 감소효과가 나타났으며 12.46% (P<0.05) 감소하였다. 가수분해물의 장기투여에 의한 자연발증고혈압쥐의 체중변화는 대조구와 비교하여 차이가 없었다. 혈압강하 효과를 가지는 카제인 가수분해물의 안전성을 조사한 결과 간장장애 지표로서 사용되는 GOT, GPT 활성에 차이가 없었다. 간장 비대 등의 장기 비대 현상도 없었고 조직병리학적 검사에서도 차이가 없었다. ACE 저해활성을 가지는 카제인 가수분해물은 혈압강하제와 비교하였을 때 비교적 낮은 활성을 나타내지만 항상 섭취하는 식품 중에 존재한다는 점에서 그 유용성이 기대되며, 고혈압 예방을 위한 기능성 식품이나 의약품으로서 개발하기 위해서 앞으로 ACE 저해 펩타이드에 대한 체계적인 안전성 검사가 이루어져야 할 것으로 생각된다.

한국인 제2형 당뇨병 여성환자에서 심혈관질환 위험인자와 과일류 및 생선류 섭취와의 관련성: 제4기와 제5기 국민건강영양조사 자료를 이용하여 (Relationship between fruit and fish intakes and cardiovascular disease risk factors in Korean women with type 2 diabetes mellitus: Based on the 4th and 5th Korea National Health and Nutrition Examination Surveys)

  • 오지수;김혜숙;김기남;장남수
    • Journal of Nutrition and Health
    • /
    • 제49권5호
    • /
    • pp.304-312
    • /
    • 2016
  • 본 연구는 2007~2012년 국민건강영양조사 자료를 이용하여 30세 이상 제2형 당뇨병 여성 환자의 과일류 및 생선류 등의 식품섭취량과 심혈관질환 위험인자와의 관련성을 분석하였다. T2DM군이 NFG군에 비해 과일류 및 생선류의 섭취량이 유의적으로 낮았고 이들의 섭취량이 증가할수록 고중성지방혈증의 위험성이 유의적으로 감소하는 것으로 나타났다. 또한, 과일류와 생선류 섭취량은 각각 중앙값 이상으로 많이 섭취한 군 (FF3)이 각각 중앙값 이하로 섭취한 군 (FF1)에의 비해 TG 농도가 높을 위험이 유의적으로 낮았다. 이러한 결과는 과일류에 김치를 제외한 채소류, 버섯류, 해조류의 섭취량을 포함시켜 분석했을 때에도 같은 결과를 나타내었다. 따라서, 한국인 제2형 당뇨병여성 환자의 과일류 및 생선류의 섭취가 심혈관질환에 긍적적인 영향을 미치는 것으로 보이며, 과일류나 생선류 중 어느 한 종류만 많이 섭취하기보다는 두 종류를 모두 적절히 섭취하는 것이 심혈관 질환 위험성을 낮추는데 효과적일 것으로 사료된다.

유산소 운동이 폐경 후 비만여성의 혈청지질, 렙틴, 그렐린 및 인슐린저항성지수에 미치는 영향 (Effects of Aerobic Exercise on Serum Blood Lipids, Leptin, Ghrelin, and HOMA-IR Factors in Postmenopausal Obese Women)

  • 이정아;김지현;김종원;김도연
    • 한국산학기술학회논문지
    • /
    • 제18권2호
    • /
    • pp.549-558
    • /
    • 2017
  • 본 연구는 체지방률이 32% 이상인 폐경 후 비만여성 36명을 대상으로 유산소운동이 혈청지질, 렙틴, 그렐린 및 인슐린저항성지수에 미치는 영향을 구명하기 위하여 운동집단(18명)과 통제집단(18명)으로 나누어 유산소운동인 라인댄스를 16주간 실시한 후 체조성, 혈청지질, 렙틴, 그렐린 및 인슐린저항성지수를 운동전과 후로 측정하여 비교분석하였다. 본 연구의 결과 운동 후에 운동집단에서 체중, 체지방률(%BF), 체질량지수(BMI), 내장지방면적(VFA), 렙틴(Leptin), 인슐린(Insulin), 글루코스(Glucose), 인슐린저항성지수(HOMA-IR), 총콜레스테롤(TC), 중성지방(TG), 아포리포프로틴(Apolipoprotein) B, 저밀도지단백 콜레스테롤(LDL-C) 및 수축기혈압(SBP)이 유의하게 감소하였다. 또한 아포리포프로틴(Apolipoprotein) A-1, 그렐린(Ghrelin) 및 고밀도지단백 콜레스테롤(HDL-C)이 유의하게 증가하였다. 유산소운동집단의 내장지방면적에 영향을 미치는 에너지대사조절인자의 회귀분석결과에서 주요요인으로 그렐린, 인슐린, 글루코스 및 HOMA-IR 나타났다. 따라서 규칙적이고 지속적인 유산소운동이 폐경 후 비만여성의 체조성, 내장지방, 혈청지질, 렙틴, 그렐린 및 HOMA-IR을 개선시키는 데 효과가 있을 것으로 생각된다.

제 2형 당뇨 환자의 저혈당지수 영양교육이 혈당관리에 미치는 영향 (Effects of Low Glycemic Index Nutrition Education on the Blood Glucose Control in Patients with Type 2 Diabetes Mellitus)

  • 김미자;권순자;이선영
    • Journal of Nutrition and Health
    • /
    • 제43권1호
    • /
    • pp.46-56
    • /
    • 2010
  • This study was intended to assess the effects of low glycemic index (LGI) nutrition education on dietary management and glycemic control of patients with type 2 diabetes mellitus. The subjects were 48 sex-matched patients with type 2 diabetes mellitus, aged $66.5\;{\pm}\;6.2$ years, visiting a public health center. They were divided into two groups: the control group (males 10, females 14) and the educated group (males 10, females 14). The educated group was provided with a LGI nutrition education program for 7 weeks. The control group was educated only one time for general diabetic education. Anthropometric indices, knowledge and perception of efficacy of low glycemic index carbohydrates, dietary glycemic index (DGI) and glycemic load (DGL), fasting blood glucose, and HbA1c were assessed. In the educated group body weight, body mass index and systolic blood pressure (from $138.0\;{\pm}\;18.9\;mmHg$ to $130.6\;{\pm}\;15.0\;mmHg$) were significantly reduced after the nutrition education (p < 0.05). The scores of knowledge and perception of efficacy of low glycemic index carbohydrates increased significantly in the educated group. Dietary glycemic index and glycemic load of the educated group decreased significantly from $103.4\;{\pm}\;67.6$ to $45.4\;{\pm}\;27.1$ (p < 0.001), and from $173.3\;{\pm}\;135.9$ to $66.8\;{\pm}\;50.4$ (p < 0.001), respectively. Also fasting blood glucose and HbA1c levels of the educated group significantly decreased from $124.5\;{\pm}\;28.8\;mg/dL$ to $96.7\;{\pm}\;21.6\;mg/dL$ (p < 0.001) and from $7.1\;{\pm}\;1.3%$ to $6.4\;{\pm}\;1.2%$ (p < 0.05), respectively. The score of knowledge and perception of efficacy of low glycemic index significantly correlated with fasting blood glucose and HbA1c levels negatively. DGI, DGL and duration of diabetes significantly correlated with HbA1c level positively. From stepwise multiple linear regression analysis, DGI, DGL and the duration of diabetes were extracted as factors influencing HbA1c level of the subjects. The results of this study suggest that low glycemic index nutrition education programs is an effective intervention measure for the glycemic control in type 2 diabetic patients.

한국산 잡견의 정상 생리학적 기준치 (Normal Physiologic Data of Korean Mongrel Dogs)

  • 김종환
    • Journal of Chest Surgery
    • /
    • 제2권1호
    • /
    • pp.115-132
    • /
    • 1969
  • The normal physiological values of Korean mongrel dogs were studied, comparing them with foreign references, on the basis of control physiological data measured on 110 cases out of the dogs submitted to the experiments in our department. The hemodynamic measurements varied widely between the both limits of reported normal control data, with the mean value of heart rate $140.4{\pm}26.6$/min., and both the systolic and diastolic arterial blood pressures $137.2{\pm}31.7$mmHg and $104.7{\pm}14.4$ mmHg, as well as the venous pressure of $9.11{\pm}2.18$ cm.$H_2O$. Hematologically, the number of red blood cells $4,571,000{\pm}767,000$per cu.mm., the amount of hemoglobin $11.57{\pm}3.74$ gm/dl and the hematocrit $37.3{\pm}7.2$ per cent, were equally the values a little lower than the reported normal means. However, the white blood cells were within the reported normal limits both in number, $10,384{\pm}4,877$ per cu. mm and their differential counts with slightly broader ranges of variation. The platelet count was $149,800{\pm}47,000 $per cu. mm and was also far below the normal, while the coagulation time $9.03{\pm}2.69$min. and the prothrombin time $13.17{\pm}6.52$sec were within normal limits, though a little prolonged. The serum electrolytes, Na $146.6{\pm}10.44$mEq/L.,K $4.46{\pm}0.84$mEq/L., CI $118.3{\pm}7.88$mEq/L. and Ca $11.45{\pm}5.62$mg./dl, and the blood glucose level of $94.9{\pm}31.79$mg./dl were essentially not different from the reported normal values. The serum proteins, total protein $7.15{\pm}1.41$gm/dl., albumin $4.09{\pm}0.77$gm./dl. and globulin $3.18{\pm}0.88$gm/dl. were included near the higher limits of the reported normal levels. The thymol turbidity 0.1-3.04 units were normal in 10 cases, and the cephaline flocculation was within normal range except 2 cases out of 26 dogs, showing two positive in 24 hours. And the nitrogen series, NPN $34.61{\pm}10.29$mg/dl. and BUN $12.77{\pm}6.37$mg./dl. were normal. It may be concluded that from the point of view of hereby measured physiological data compared with the foreign references, the Korean mongrel dogs have a compatible laboratory data with only the special regards to their tendency toward anemia in red blood cell series.

  • PDF

둔상에 의한 흉부대동맥 손상에서 TEVAR에 관한 임상연구 (Clinical Analysis of TEVAR in Blunt Thoracic Aortic Injury)

  • 구관우;최진호;최민석;박상순;설영훈;고승제;예진봉;김중석;김영철;황정주
    • Journal of Trauma and Injury
    • /
    • 제28권4호
    • /
    • pp.232-240
    • /
    • 2015
  • Purpose: Thoracic aortic injury is a life-threatening injury that has been traditionally treated by using surgical management. Recently, thoracic endovascular aortic repair (TEVAR) has been conducted pervasively as a better alternative treatment method. Therefore, this study will focus on analyzing the outcome of TEVAR in patients suffering from a blunt thoracic aortic injury. Methods: Of the blunt thoracic aortic injury patients admitted to Eulji University Hospital, this research focused on the 11 patients who had received TEVAR during the period from January 2008 to April 2014. Results: Seven of the 11 patients were male. At the time of admission, the mean systolic pressure was $105.64{\pm}24.60mm\;Hg$, and the mean heart rate was $103.64{\pm}20.02per$ minute. The median interval from arrival to repair was 7 (4, 47) hours. The mean stay in the ICU was $21.82{\pm}16.37hours$. In three patients, a chimney graft technique was also performed to save the left subclavian artery. In one patient, a debranching of the aortic arch vessels was performed. In two patients, the left subclavian artery was totally covered. In one patient whose proximal aortic neck length was insufficient, the landing zone was extended by using a prophylactic left subclavian artery to left common carotid artery bypass before TEVAR. There were no operative mortalities, but a patient who was covered of left subclavian artery died from ischemic brain injury. Complications such as migration, endovascular leakage, collapse, infection and thrombus did not occur. Conclusion: Our short-term outcomes of TEVAR for blunt thoracic aorta injury was feasible. Left subclavian artery may be sacrificed if the proximal landing zone is short, but several methods to continue the perfusion should be considered.

  • PDF

운동이 스트레스로부터의 심장 반응과 정서 반응에 미치는 영향 (The Effect of Physical Activity on Cardiovascular and Psychoaffective Responses to Stress)

  • 서경현;이재구
    • 보건교육건강증진학회지
    • /
    • 제24권3호
    • /
    • pp.21-34
    • /
    • 2007
  • Objectives: This study aims to examined whether physical activity prevent the negative effect of psychological stress on cardiovascular reactivity by reducing stress induced sympathetic output and preventing norepinephrine depletion negative psych-affective responses. It is assumed that physical activity reduces the magnitude of cardiovascular responses and psychological responses to stress which threaten individuals' physical and mental health. The result of investigating the effect of physical activity on reducing negative physiological and psychological responses would suggest useful information health for practitioners who want to prevent stress-induced diseases, especially coronary heart disease. Methods: participants of this study were 30 students (10 males & 20 females), whose mean age was 21.30 (SD=2.29). Fifteen students (5 males & 10 females) were assigned for in each group, treatment and control groups. They were interviewed and given a survey that included a consent form, demographics sheet and psychological tests, such as State-Trait Anger Expression Inventory and State-Trait Anxiety Inventory. Before the application of psychological stress, participants in treatment group were going through with a course of physical exercise, running on treadmill 15minutes, while participants in control group were not physically active. After exercise, there was 15 minutes resting period before applying cognitive stress. During the experiment, all participants performed challenging cognitive tasks for 20minutes in situations that were designed to experience learned helplessness and measured their cardiovascular reactivity including blood pressure and heart rate every 5 minutes, until 10 minutes after finishing the application of psychological stress(recovering state). In the end of experiment, they were given some psychological test again. Results: Heart rates of exercise group were significantly higher than non-exercise group, especially, five minute after applying cognitive stress and at the end of recovery, in other word 10 minutes after stressful event. Systolic blood pressures of exercise group were lower than those of non-exercise group during the stressful event, but this differences in borderline level of significance. state anger level of exercise group decreased even experiencing stress, while those of non-exercise group increase. And state anxiety level of exercise group decreased in borderline level of significance. Conclusion: This study reiterate health benefits of physical activity and suggest that regular moderate exercise may regulate cardiovascular reactivity and psycho-affective responses from stress by reducing stress induced sympathetic output.