• 제목/요약/키워드: circulatory system diseases

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정상 신기능을 보인 Goodpasture 증후군 1예 (A Case of Goodpasture's Syndrome with Normal Renal Function)

  • 김성경;이진국;주겨레;허성은;김정훈;김영균;이숙영;김승준;김치홍;송소향;박성학;최영진
    • Tuberculosis and Respiratory Diseases
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    • 제59권1호
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    • pp.86-92
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    • 2005
  • Goodpasture's syndrome is a disease that is characterized by hemoptysis, anemia, and glomerulonephritis with renal failure. Goodpasture reported a case of a young man who expired as a result of a pulmonary hemorrhage and glomerulonephritis at the recovery phase after an influenza infection in 1919. In 1958, Stanton et al. described a combined case of these two diseases as Goodpasture's syndrome. Since then, antiglomerular basement membrane antibody(anti-GBM Ab) has been confirmed to play an important role in the mechanism of this syndrome, and it was reported that this syndrome was an autoimmune disease. The triad of alveolar hemorrhage, glomerulonephritis and circulating anti-GBM Ab forms the basis of a diagnosis of Goodpasture's syndrome. When patients are affected by disease, the relief of symptoms can be accomplished by eliminating the anti-GBM Ab from the circulatory system through hemodialysis, plasmapheresis and immunoabsorption. However, the patients usually die from a massive pulmonary hemorrhage when the diagnosis or treatment is delayed. The incidence of Goodpasture's syndrome is common in the western world, but it is extremely rare in Korea with only five cases being reported. In three of these cases, pulmonary hemorrhage and renal failure was the initial manifestation. Therefore, hemodialysis or plasmapheresis were absolutely essential treatments. We report a case of Goodpasture's syndrome in Korea with a normal renal function.

Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • 제53권7호
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

독거노인의 사회안전망에 대한 활성화 방안 - 광양시 무선페이징시스템 대상자 중심으로 - (Activation plan of social safety network of the aged living alone - Focused on the aged using wireless paging system in Gwangyang-si -)

  • 이재민
    • 한국응급구조학회지
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    • 제13권3호
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    • pp.41-58
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    • 2009
  • Objective : The purpose of this study is to identify actual operations and issues of wireless paging system operation for the aged living alone as the end users of wireless paging system primarily in Gwangyang city, and thereby to explore possible advanced and integrated ways to promote social safety network for the aged. Methods : The survey tool used in this study was a structured questionnaire form consisting of question items. The researcher hereof conducted this survey by means of direct visit and interview during two seasons, i.e. from February to August, 2008 and from December 2008 to March 2009, respectively. Results : 1) For general demographic characteristics, it was found that 90.9% of all respondents were women and 61.2% of all respondents were at age 75 to 84. for health conditions, it was found that more than 90% of all respondents often took medicines due to their unhealthy body, and most of respondents suffered from musculoskeletal diseases 79.3% and circulatory diseases 61.6%. for walking capacity, it was found that 45.5% of all respondents used walking aids, and disable respondents (11.5% of all respondents) were represented primarily by those with physical disability (52.6% of disable respondents). for actual use of medical institutions, it was found 47.3% of all respondents relied on local clinics, since they preferred neighborhood hospitals or clinics they can trust for medical care. for social activities and supports, it was found that 43.6% respondents had 'needs for assistance at times' and 33.9% respondents have 'no need for assistance'. And it was found that the major difficulties in living alone at old age were represented primarily by health problems 37.8% and economic difficulties 33.5%. 2) For characteristics related to wireless paging system, it was found that 90.3% respondents used wireless paging system recommended by firemen, and 28.5% respondents used this system. and it was found that 59.6% respondents used this system once, and 85.2% respondents used it because of acute or chronic diseases. more than 90% respondents thought that they knew about wireless paging system and considered themselves safe, but 83.6% respondents didn't attach a remote control on their upper clothes, and even 49.1% respondents turned off the power of wireless paging system due to their concern about electricity bill and noise. 3) It was found that 83.6% respondents felt it necessary to use wireless paging system, and wireless paging users felt more satisfied with using the system than non-users, and 50.7% showed high satisfaction at certain psychological benefits like 'confidence in coping with critical situations' and 'a sense of relief'. In addition, it was found that some respondents who answered that 'they didn't turn off the paging system as they knew how it works' and those who answered that they knew 'how to use it' showed relatively high satisfaction. And some respondents who kept it well and felt it necessary also showed high satisfaction. 4) It was found that the level of satisfaction our respondents felt with using wireless paging system varied significantly availability($x^{2}$ = 12.759, p = .002), psychological advantages($x^{2}$ = 12.174, p = .002), knowledge about how to use system($x^{2}$ = 7.021, p = .016), power on/off($x^{2}$ = 13.221, p = .001), level of knowledge about system($x^{2}$ = 21.002, p = .000), maintenance($x^{2}$ = 9.871, p = .007) and level of necessity($x^{2}$ = 34.939, p = .000) on the statistical basis.

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한양방 병용치료에 대한 문헌고찰 (A Literature Review of the East-West Medical Combined Treatment)

  • 김창석;김상균;김영은;김철;예상준;장현철;송미영
    • 한국한의학연구원논문집
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    • 제18권2호
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    • pp.101-116
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    • 2012
  • Objectives : This study aims to analyze the papers of the east-west medical combined treatment and suggest the research direction. Methods : 183 research papers were collected by using 25 keywords including combination(in korean words, 병용), collaborative practice(in korean words, 협진) in Korean Medical Database(KMbase) and Oriental Medicine Advanced Searching Integrated System(OASIS). We analysed the type of studies, the kind of diseases, the treatment method, the kind of herbs and drugs in frequent use, and the result of research. Results : Among the analysed 183 papers, clinical studies are 89 cases and experimental studies are 94. 5 cases of clinical studies are Randomized Controlled Trial(RCT). The cancer(50 papers) and diseases of the circulatory system(25 papers) occupied mostly in treatment studies. Because Combined treatment was actively progressed in oriental medicine, treatment was mainly applied the combined oriental medical treatment with herbs and western drugs. In herbal medicine, Mahwangyounpae-tang(麻黃潤肺湯) and Eunkyo-San(銀翹散) were frequently used in the papers. In western drugs, Cyclophosphamide, Cisplatin, and Mitomycin C were frequently used in the papers. 154 papers introduced the treatment effect, 14 papers announced the safety, and 4 papers mentioned the side effect. Conclusions : We suggested several future research direction as follows. Clinical studies based on experiment studies must be more activated and many RCT shoud be shown. Experimental group in clinical studies should be clearly separated to confirm the treatment method is effective or isn't effective. Studies about the side effect must be expanded, and every study should be confirmed both the treatment effect and safety.

양성 발작성 자세변환성 현훈(Benign Paroximal Positional Vertigo, BPPV)으로 의심되는 현훈증 환자를 자음건비탕(滋陰健脾湯) 가미방(加味方)과 Dix-hallpike Maneuver로 치료한 치험 1례 (One Case of Dizziness Patients Suggested Benign Paroximal Positional Vertigo treated by Jaeumkunbitang-gamibang and Dix-hallpike maneuver)

  • 신선호;정용준
    • 대한한방내과학회지
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    • 제21권1호
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    • pp.181-184
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    • 2000
  • Dizziness is one of common diseases clinically, it is defined as a hallucination or an illusion of motion that causes sensation disorder of circumstance, and described as circulatory. rotatory leaning. shaking sensation. In particular, benign paroximal positional vertigo(BPPV) is one of peripheral vertigo, it causes dizziness due to debris which has collected within a part of the inner ear. Chemically, debris are small crystals of calcium carbonate. They are derived from structures in the ear called 'otoliths' that have been damaged by head injury, infection, or other disorder of the inner ear, or degenerated because of advanced age. The symptoms of BPPV include dizziness or vertigo, lightheadedness, imbalance, and nausea, Activities which bring on symptoms will vary in each person, but symptom are almost always precipitated by a position change of the head or body. As for treatment of vertigo, it is differentiated as excess in the upper and deficiency in the lower(上實下虛) and treated in oriental medicine and are used to stability. antihistaminics . anticolinergics . vestibule control drug of GABA system in western medicine. Moreover, Dix-hallpike maneuver is applicated in diagnosis and treatment of BPPV patients. A case of dizziness patient suggested benign paroximal positional vertigo who is diagnosed as weakly dizziness(虛暈)showed prominent improvement by Jaeumkunbitang-gamibang(滋陰建脾湯) and Dix-hallpike maneuver.

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한의학문헌의 계량서지학적 분석을 위한 기초연구 - 대한한의학회지를 대상으로 - (Fundamental Study for Bibliometric Analysis of Oriental Medical Literature - Based on The Journal of Korean Oriental Medical Society -)

  • 권영규;변성희;서미령
    • 대한한의학회지
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    • 제20권1호
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    • pp.30-43
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    • 1999
  • This is a fundamental study for bibliometric analysis investigating the general, research, copyright activities and cited literature related to the field of Oriental Medicine, The data used for this study included theses published by the Journal of Korean Oriental Medicine Society over a period of nine years, from 1990 to 1998, We investigated the productivity of national authors, distribution of cited literature and subject analysis about Oriental Medicine and its authors quantitatively, So we were able to reach several conclusions: 1. The rule of Lotka is applied considerably to analyze the productivity of authors in the field of Oriental Medicine, When it comes to the analysis of national authors it was found that most authors in this field of study published 2 to 10 volumes, likewise other studies. And the rate of co-authorships was high, because most surveys are clinical. 2. When it comes to distribution of cited literatures, independent volumes were cited more than journals. This represents that the citing style of Oriental Medicine has a tendency to follow the methodology of historical research. 3. Scholars in the field of Oriental Medicine mainly tend to cite self-subjects among cited literatures. After analysing self-subjects in this field, the result is that the order of frequency used as cited literatures is as follows: Internal Medicine, Herbology and Oriental Prescription, Acupuncture & Moxibustion. Acupuncture point, and subjects with the circulatory system diseases were mainly cited as far as subordinary subjects of Internal Medicine.

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한국인의 사망구조 변화에 대한 고찰 (A Study on Changes of Korean Mortality Pattern, 1930~1980)

  • 유임숙;김초강;공세권
    • 한국인구학
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    • 제9권2호
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    • pp.79-92
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    • 1986
  • Death is one of the population movement phenomena used as an important health index in most society. Especially it is regarded as group phenomenon in a specific group rather than individual one and considered important in public health field because the level and cause of death is related to health of public. The auther examined the changes of the Korean mortality pattern to evaluate the status of the Korean public health by studying mortality indicator using the population census and other materials from 1930 to 1980. The results are as follows: First, the Korean crude death rate was reduced to one third in 1980 compared to that in 1930, but the crude birth rate was constant from 1930 to 1960 causing the increase of population. So the population pattern is changing from the classic pyramic shape to bell shape and the dependency ratio was reduced from 78 in 1930 to 61 in 1980. Second, the infant mortality rate decrease rapidly. In 1980 it was one seventh of that in 1930 which was proved by the change of the age-specific death rate curve from U to J shape. Third, the male mortality reduction after the age of forty was much less than that of female, which explained the specific death pattern of high mortality in Korean middle and oldaged males. Fourth, the main cause of death was changed from infectious, parasitic, respiratory and digestive system disease to circulatory of tumorous diseases. Considering the above results, Korean health problem is now changing from the infant infection to geriatric chronic regressive disease. That naturally the direction of health service should be turned from the infant stage maternal and child health to the health problems of old people.

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고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB (Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study)

  • 조현주;정혜진;임사비나
    • 대한한의학회지
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    • 제40권3호
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

일개 농촌 면단위지역 주민의 보건지소 의료 이용 추이 (Utilization Trends of Health Subcenter for Primary Medical Care in a Korean Rural Area)

  • 조희숙;위자형
    • 농촌의학ㆍ지역보건
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    • 제21권2호
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    • pp.151-157
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    • 1996
  • This study was analyze through the reports which published on the subject matter of Su Dong-Myun from year of 1972-1993, and analysis of data in 1994 was performed with medical records on the health subcenter by PC-SAS program. The result are as follows: The number of population in Su-Dong Myun(study area) was 5,707 in 1995, 4,641 in 1985 and 5,424 in 1975. In the composition rate of population "0-14" of age group only showed markedly decreasing tendancy from 42.8% in 1975 to 19.1% in 1995. However, "65 and over" showed markedly increasing tendancy from 5.7% in 1975 to 9.8% in 1995. Annual utilization rate showed rapidly increasing tendency from year of 1972 to 1978, such as 314 per showed rapidly decreasing tendency, such as 708 in 1981, 485 in 1984, 272 in 1987, 309 in 190 and in 1993. In the annual age-specific utilization rate, the age group of "0-14" showed the highest rate of 621 per thousand population in 1975, 1159 in 1980, 1021 in 1985 and 538 in 1990. However the age group of "65 and over" showed the highest rate of 481 in 1994. Age specific annual utilization rate showed markedly decreasing tendency in the age group of "0-14" and "15-44", however showed slightly decreasing tendency or same level in the group of "45-64" and "65 and over" from year of 1980 to 1994. In the age specific utilization rate, the lower down the age was, the higher tendency the rate showed, such as 621 per 1,000 population in "0-14" of the age group, 543 in "15-44", 406 in "45-64" and 294 in "65 and over" in 1975. However, the higher up the age was, the higher tendency the rate showed in 1980, 1985 and 1994, except "0-14" of age group. The 5 major diseases were disease of Respiratory system, Gastrointestinal system, Skin and Subcutaneous tissue, Accidents, Poisoning and Violence and Nervous system and Sense organ, in 1975, 1980 and 1985. However, in 1990 and 1994, the 5 major disease were disease of Respiratory system, Gastrointestinal system. Skin and Subcutaneous tissue, Musculoskeletal system and, Connective tissue and Circulatory system. In Composition rate of patient in Su Dong-Myun Health Subcenter by Charged Medical Fee, medical insurance showed almost all the highest rate of 93.9% in year of 1994 and C.H.D.A. of 100% in 1975. Proportion of insurance showed increasing tendency such as 6.6% in 1980, 21.3% in 1985, 69.0% in 1990 and relatively C.H.D.A. showed decreasing tendency.

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시스템다이내믹스를 활용한 미세먼지 저감 정책이 미세먼지 농도와 건강에 미치는 영향 분석 (An Analysis of the Effects of Fine Dust Reduction Policies on PM10 Concentration and Health Using System Dynamics)

  • 이세호;강정은;이지윤;박민영;최지윤
    • 환경영향평가
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    • 제32권5호
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    • pp.318-337
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    • 2023
  • 본 연구는 시스템다이내믹스를 활용하여 미세먼지 저감 정책이 미세먼지 농도와 건강에 미치는 영향을 살펴보았다. 시스템다이내믹스는 미세먼지 발생원, 저감 정책, 미세먼지 농도, 건강영향 간의 동태적이며 순환적인 관계의 모델링을 구축할 수 있는 장점이 있다. 연구에서는 국내의 대표적 미세먼지 저감 정책인 산업부문 미세먼지 배출규제, 디젤차 규제, 전기차 확대, 공원·녹지면적 확대를 대상으로 정책 시나리오를 작성하여 현재 추세가 유지될 때와의 2030년 기준 결과를 비교하였다. 분석 결과, 전기차 지원정책은 0.21㎍/m3의 PM10 농도 저감과 494명의 순환기계 질환자 수 감소 효과가 있었으며 전국적으로 고르게 효과가 나타났다. 산업 배출량 규제 시나리오에서는 0.22㎍/m3의 가장 높은 PM10 농도가 감소하였으나 전기차 지원보다 적은 질환자 수 감소 효과(358명)가 나타났는데 이는 해당 정책이 충북 단양군, 부산 사하구 등 일부 공업지역을 중심으로 높은 미세먼지 저감 효과를 보였기 때문이다. 이러한 결과는 지역의 배출원 특성에 맞는 정책 선정의 필요성을 제시하였다.