• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5849-5859
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• 2012

The aim of this study was to find out the impact of age and hypertensive status on postprandial hypotension(PPH). Twenty-six hypertensive elderly ($77.7{\pm}7.2$ years old), twenty-five normotensive elderly ($80.2{\pm}6.8$ years old) and twenty-six young adults ($20.0{\pm}1.5$ years old) took part in the study. The blood pressure (BP) and heart rates (HR) were measured every 15 minutes, from 30 minutes before a meal to 90 minute after a meal in sitting position, using an ambulatory blood pressure monitor. In the hypertensive group, postprandial reduction in systolic BP continued from 30minutes to 90minutes. The reductuion rate of systolic BP of hypertensive elderly group was significantly greater than other groups (p<.05). However, there were no significant differences in trend of HR change between the groups (p=.082). The incidence of PPH was significantly higher in the hypertensives than other groups (73.1% vs 24% vs 0%, respectively, p=.001). In conclusion, age and hypertensive status had a significant impact on PPH. Elderly persons require more intensive BP monitoring and nursing intervention.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.1
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• pp.68-80
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• 1996

Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.

• Biomedical Science Letters
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• v.4 no.2
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• pp.153-164
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• 1998

A study on factors related to stroke patients in three oriental medical hospitals in Taegu area was conducted from October 1997 through December 31, 1997. One hundred and sixty three hospitalized and ambulatory patients were interviewed by traind interviewers according to the questionnaires prepared in advance. The results are summarized as follows； male and female ratio of the subjects was 1 to 1.36, and of the subjects 36.8% were 60's of the age and 25.2% were 50's and 19.6％ were 70's. 74.7％ of the patients were married and 41.5％ of them had only six year education. 20％ of the subjects became stroke victims while they were engaged in physical activities, 16.2% while in sleep, 15.5％ because of psycological shock, and 7.2％ while drinking. Of 157 precisely diagnosed cases, cerebral infarction was the most frequent cause (47.7%), cerebral hemorrhage was the second (38.2%), and subarachnoid hemorrhage (5.1％) respectly, Of 161 cases, 64％ were normal in body weight, 26.7％ were obese and 9.3% were light. Of 163 cases, 65.6% of them did not drink alcohol. Of 162 cases, 63％ did not smoke cigarettes.

• The Journal of Korean Physical Therapy
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• v.11 no.1
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• pp.23-43
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• 1999

A study on severity of cerebro-vascular accident patients in Korea was conduced in order to determine the risk factors affecting the severity of stroke patients. This study was performed by interviewing a total of 477 hospitalized and ambulatory patient of CVA in Seoul, Taejon, and Taegu and Pusan areas from April 1, 1998 through June 30, 1998. The results are as follows; 1. Two hundred and sixty seven $(56\%)$ at Four hundred and seventy seven subjects were manes, md two hundred and ten $(44\%)$ were females. $28.3\%$ of the subjects' ages were 50's and $27.3\%$ were 60's and $18.5\%$ were 70's. $22.6\%$ of the subjects' occupations were home makers, $17.8\%$ were farming. $66.4\%$ of the subjects spent their childhood in urban areas and $33.1\%$in rural areas. $41.7\%$ of the subjects became violin of CVA in Spring, $35.0\%$ in Winter. 2. On physical and mental conditions of the subjects at the occurrence of CVA, $28.7\%$ of the subjects were engaged in physical activities. $22.6\%$ were in a rest stale $19.5\%$ were in sleeping and $18.9\%$ were mentally shocked. $79.4\%$ of the male subjects and $14.8\%$ of female subjects smoked cigarettes. $82\%$ of male subjects drank coffee. $81.1\%$ of the subjects did not exercise regularly. $45.9\%$ of the subjects had the systolic blood pressures in the range of 160 to 199 mmHg and $5.6\%$ of the subjects had hypertension before the occurrence of stroke and $11.7\%$ had diabetes. 3. Of the types of strokes, cerebral hemorrhage was the highest $(49.1\%)$. cerebral infarction was the second $(41.1\%)$. Severe strokes were found in cerebral hemorrhage cases $(52.0\%)$ and cerebral infarction cases $(40.1\%).\;50.9\%$. of the male subjects were moderate cases, $50.9\%$ were severe cases. In females, moderate cases were $72.4\%$, severe cases $15.2\%$. $37.5\%$ of the subjects who had preceding diseases were severe cases, and $15.6\%$ of the subjects without preceding diseases were severe cases. $50.7\%$ of the subjects whose family members had strokes had severe strokes. $34\%$ of the subjects sleeping less than 6 hours a day, $42.4\%$ of the subjects with irregular eating habits, $33.3\%$ of the subjects who liked meat, and $42.3\%$ of the subjects who liked salty foods had severe strokes. $35.9\%$ of the subjects with hot temper, $27.6\%$ of the subjects with moderate temper and $14.5\%$ of subjects with mild temper were severe cases. 4. The correlation coefficient between obesity and blood pressure was 0.094.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.302-308
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• 1999

Background: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern of the pathologic reflux in peptic ulcer patients. Materials and Methods: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. Results: The prevalance of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54,5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7% Conclusion: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.26-32
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• 2014

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.

• Advances in Traditional Medicine
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• v.7 no.5
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• pp.494-500
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• 2008

Ginseng has been traditionally used to recover vital energy from Qi deficiency in oriental countries. Recent reports suggested that ginseng could regulate blood pressure (BP), but much controversy still remain. Therefore, we intended to assess the anti-hypertensive effect of some ginseng species on Koreans and Chinese. This is a randomized, double blinded controlled clinical trial. The study subjects were recruited from the mild hypertensive patients who belonged prehypertension(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, and an American ginseng group by randomization, we prescribed ginseng with the dose of 4.5 g per a day for 4 w. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication by 24 h Ambulatory Blood Pressure Monitor (24 h ABPM). We also monitored adverse effect and laboratory findings to secure the subjects' safety. There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, and 64 treated with American ginseng. All of the ginseng species reduced subjects' BP. Especially, Korean and Chinese ginseng showed more excellent effects. The secondary analysis on the subjects' nationality revealed that all of the ginseng species showed more significant anti-hypertensive effect in Chinese than in Koreans. We suggest ginseng could be useful for mild hypertension regardless of its species. And it would be safe within the dosage of 4.5 g per a day.

• Journal of the Korean Institute of Intelligent Systems
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• v.21 no.4
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• pp.456-462
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• 2011

As the ARRA enacted recently in the United States, the interest in EHR systems have been increased in the field of medical industry. The passage of the ARRA presents a program that provides incentives to office-based physicians and hospitals adapting the EHR systems to guarantee interoperability with various medical standards. Thanks to the incentive program, a great number of EHR systems have been developed and lots of office-based physicians and hospitals have adapted the EHR systems certified by CCHIT. Keeping pace with the rapid changes in the market of healthcare, some enterprises try to push in to the United States healthcare market based on the experience acquired by developing EHR systems for hospitals in Korea. However, the developed system must be customized because of the different medical environment between Korea and the United States. In this paper, therefore, we design and develop an integrated EHR platform to guarantee the interoperability between different medical information systems based on medical standard technologies. In the developed platform, an integrated system has been composed by integrating various basic techniques such as data transmission standards and its methods, medical standard terminologies and its usage, and knowledge management for medical decision-making support. Moreover, medical data can be processed electronically by adapting an HL7 interface engine and the terminologies for exchanging medical information and the standardization of medical information. We develop SeniCare, an EHR system for supporting ambulatory care of the office-based physicians, based on the platform, and we verify the usability of the platform by confirming whether SeniCare satisfies the criteria of "meaningful use" issued by CMS or not.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.822-826
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• 2006

Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system, especiallythe sympathetic system. This study was designed to investigate the autonomic nerve system in patients with essential hyperhidrosis and healthy controls by the frequency domain analysis of heart rate variability (HRV). Methods : 17 head-hyperhidrosis patients in the ambulatory care were investigated. All were inspected at the first medical examination. using the PSA of HRV. HRV was measured for minutes after 5 minutes bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then we compared the values of patients with means of normal Korean subjects. Results : The values of natural logarithmic measure of HRV (LnTP, LnHF, LnLF, LnVLF) of patients With head-hyperhidrosis we examined were $6.85{\pm}1.61$, $4.93{\pm}$2.00, $5.40{\pm}1.83$, and $6.13{\pm}1.37$, respectively. None of these values were higher than means of normal subjects. Conclusions : This study suggests that the function of the autonomic nervous system does not increase in patients with head-hyperhidrosis.