• 농촌의학ㆍ지역보건
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• 제36권3호
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• pp.157-166
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• 2011

이번 연구는 일개 사업장 근로자를 대상으로 24시간 활동혈압에 따른 고혈압군과 정상군의 불안과 우울정도를 비교하고 불안증상과 우울증상에 따른 혈압 양상을 비교 분석하고자 하였다. 일개 사업장 근로자 107명을 대상으로 2009년 12월 10일부터 2010년 3월 20일까지 사업장을 방문하여 BAI와 BDI로 불안과 우울정도를 조사하였고 임상혈압과 24시간 AMBP로 활동혈압을 측정하였다. 임상혈압과 24시간 AMBP에서 고혈압군과 정상군의 BAI와 BDI 점수는 모두 유의한 차이가 없었지만, 우울증상군에서 정상군보다 야간 이완기혈압 비강하 발생위험도가 6.85배 (CI 1.50-30.01)높았다. 고혈압 치료를 시작하거나 치료 중인 환자에서 치료순응율을 향상시키고 심혈관계 질환 예방을 위해서는 심리적인 중재도 필요하다고 판단되어진다.

• Clinical and Experimental Pediatrics
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• 제51권6호
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• pp.604-609
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• 2008

목 적 : 비만은 고혈압의 위험 인자로서 소아 청소년기의 비만이 성인기의 비만으로 발전하기 때문에 결국 소아 청소년기의 비만으로 심혈관계 등 여러 문제가 유발된다고 볼 수 있다. 따라서 소아 청소년기 비만증에서 정확한 혈압의 측정은 매우 중요하겠다. 본 연구에서는 소아 청소년 비만 환자들을 대상으로 수시 혈압 측정으로 선별 검사한 후 이들의 24시간 혈압을 측정함으로 ABPM의 유용성과 의미에 대해 고찰해보고자 하였다. 방 법 : 2006년 2월 1일부터 2007년 12월 1일까지 한동대학교 선린병원의 소아 청소년과를 방문하여 ABPM을 시행한 모든 환자들을 대상으로 하였다. 자료의 분석은 수축기, 이완기 혈압측정을 수면 혈압과 이를 제외한 각성 혈압으로 나누어 분석하였고 야간 혈압 강하(night dip)를 평가하였다. 환자는 정상군(1군)과 체질량계수만 95 백분위수가 넘는 비만군(2군) 그리고 비만이면서 외래혈압이 120/80 mmHg이상인 비만 위험혈압군(3군)으로 구분하였다. 결 과 : ABPM을 시행한 환자는 모두 49명이었고 비만군이 18명이었고 비만 위험혈압군이 12명이었다. 정상군은 19명이었다. 각 군의 수축기 평균혈압을 비교하였을 때 모든 군에서 통계학적으로 의미 있는 차이를 나타내었고(1군, $105.1{\pm}4.7$; 2군, $111.0{\pm}7.1$; 3군, $117.8{\pm}6.6mmHg$), 이완기 평균 혈압의 경우 1군과 3군에서만 통계학적으로 의미 있는 차이를 나타내었다($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$). 각성 혈압을 비교한 결과도 1군과 3군간에만 통계적으로 유의한 차이가 있었다. 수면혈압인 경우 수축기 혈압은 3군이 1, 2군에 비해 통계적으로 유의하게 높았으나, 이완기 혈압은 다른 경우와 마찬가지로 1군과 3군간에만 유의한 차이가 있었다. 본 연구에서 각 군간에 야간 혈압 강하를 조사해보니 통계적으로 의미 있는 차이를 보이지 않았다. 결 론 : 본 연구에서 ABPM을 시행한 결과 비만 위험혈압군에서 통계적으로 유의하게 혈압이 높았다. 소아 청소년에서, 특히 향후 심혈관 질환 및 여러 질환의 위험인자로 알려진 비만아에서 ABPM의 적극적인 활용이 필요로 하겠다.

• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.403-409
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• 2014

Purpose: Although high morning blood pressure (BP) is known to be associated with the onset of cardiovascular events in adults, data on its effects in children with hypertension are limited. Our retrospective study aimed to define the clinical characteristics of children with morning hypertension (MH) and to determine its associated factors. Methods: We reviewed 31 consecutive patients with hypertension, confirmed by the ambulatory blood pressure monitoring (ABPM). We divided these patients into 2 groups: the MH group (n=21, 67.7%), morning BP above the 95th percentile for age and height (2 hours on average after waking up) and the normal morning BP group (n=10, 32.3%). We compared the clinical manifestations, laboratory results, and echocardiographic findings including left ventricular hypertrophy (LVH) between the groups. Results: The early/atrial (E/A) mitral flow velocity ratio in the MH group was significantly lower than that in the normal morning BP group. In addition, LV mass was higher in the MH group than in the normal morning BP group, although the difference was not statistically significant. The age at the time of hypertension diagnosis was significantly higher in the MH group than in the normal morning BP group (P =0.003). The incidence of hyperuricemia was significantly higher in the MH group than in the normal morning BP group. Conclusion: Older patients and those with hyperuricemia are at higher risk for MH. The rise in BP in the morning is an important factor influencing the development of abnormal relaxation, as assessed by echocardiography. Clinical trials with longer follow-up periods and larger sample sizes are needed to clarify the clinical significance of MH.

• Clinical and Experimental Pediatrics
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• 제52권7호
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• pp.752-755
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• 2009

It is well known that hemodynamic load is one of the most important determinants of cardiac structure and function. Circadian variations in blood pressure (BP) are usually accompanied by consensual changes in peripheral resistance and/or cardiac output. In recent years, reduction in circadian variations in BP and, in particular, loss of nocturnal decline of BP were observed in hypertensive patients with left ventricular hypertrophy (LVH). The patients with only a slight or no loss of nocturnal decline of BP were considered "non-dippers". Regression of LVH was observed after prolonged antihypertensive therapy. Restoration of the circadian rhythm of BP was also observed. However, the classification of patients into "dippers" and "non-dippers" is arbitrary and poorly standardized and repeatable, and in the recent studies, most hypertensive patients with LVH were "dippers". Therefore, we should be particularly cautious about the conclusions drawn using this index. On the other hand, reduced activity of low-pressure cardiopulmonary baroreceptors and impaired day-to-night modulation of autonomic nervous system activity were observed in patients with only LVH. Therefore, alterations in cardiac structure may impair BP modulation. On the other hand, the reverse can also be trueprimary alterations in BP modulation, through a persistently elevated afterload, can increase cardiac mass. Thus, the interrelationship between cardiac structure and BP modulation is complex. Hence, new and more specific methods of evaluating circadian changes in BP are needed to better clarify the abovementioned reciprocal influences.

• 한국직업건강간호학회지
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• 제18권1호
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• pp.14-21
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• 2009

Purpose: This study was performed to investigate the effect of shift work on diurnal blood pressure (BP) pattern in nurses. Method: We studied 20 healthy nurses engaged in 3 shift work. 24-hour ambulatory BP monitoring was performed to each nurse two times during the day and night shift. Five nurses were excluded because of inadequate BP measurement. Results: All subjects were female. The mean age was 27.4 years (range: 23-33 years) and mean body mass index was 19.7 Kg/$m^2$ (range: 18.0-21.2 Kg/$m^2$). The changes of systolic BP ($17.8{\pm}9.1$ vs. $13.2{\pm}4.7%$, p=0.031), diastolic BP ($22.3{\pm}8.7$ vs. $17.3{\pm}9.0%$, p=0.061), and heart rate ($25.2{\pm}5.2$ vs. $12.5{\pm}8.7%$, p=0.001) during the sleeping period were decreased after a night shift compared with day shift. The non-dipper group significantly increased from 20% to 40% after a night shift (p=0.018). Conclusion: Working night shift is significantly associated with non-dipper status in nurses.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2005년도 ICCAS
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• pp.834-837
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• 2005

In this paper, we describe the method of non-invasive blood pressure measurement using pulse wave transit time(PWTT). PWTT is a new parameter involved with a vascular that can indicate the change of BP. PWTT is measured by continuous monitoring of ECG and pulse wave. No additional sensors or modules are required. In many cases, the change of PWTT correlates with the change of BP. We measure pulse wave using the photo plethysmograph(PPG) sensor in an earlobe and we measure ECG using the ECG monitoring device our made in the chest. The measurement device for detecting pulse wave consists of infrared LED for transmitted light illumination, pin photodiode as light detector, amplifier and filter. We composed 0.5Hz high pass, 60Hz notch and 10Hz low pass filter. ECG measurement device consists of multiplexer, amplifier, filter, micro-controller and RF module. After amplification and filtering, ECG signal and pulse wave is fed through micro-controller. We performed the initial work towards the development of ambulatory BP monitoring system using PWTT. An earlobe is suitable place to measure PPG signal without the restraint in daily work. From the results, we can know that the dependence of PWTT on BP is almost linear and it is possible to monitoring an individual BP continuously after the individual calibration.

• 전기학회논문지
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• 제56권6호
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• pp.1170-1176
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• 2007

The conventional urodynamic monitoring is fulfilled by artificially filling a bladder with saline. Generally. it is difficult to evaluate the physiological functions of the storage and voiding of a bladder. With this aim, we constructed an ambulatory urodynamic monitoring (AUM) system and proposed a novel method estimating abdominal pressure by measuring bio-impedance variations. Our system was clinically evaluated for 10 patients. It turned out to be that as the intensity of the abdomen contraction increased, the amplitude of bio-impedance signal and the RMS value of EMG increased more as compared to those who observed during the rest mode. Also, we determined the optimum electrode pair for estimating the abdominal pressure using bio-impedance method and consequently compared with the conventional methods. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified in terms of impedance change, correlation coefficient and SNR Our results showed the optimum electrode pair (1,9) which could detect impedance changes due to the increase of the intensity in the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2+0.0620x+0.6958$, respectively. Thus, our system demonstrated that the abdominal pressure could be measured noninvasively and conveniently by simply estimating bio-impedance values. We propose that this optimum electrode configuration would be useful for the future studies involving the handy measurements of abdominal pressure with our suggested ambulatory urodynamics monitoring system.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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• pp.46-48
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• 2007

In this study, we determined the optimum electrode pair for measuring the abdominal pressure using bio-impedance method. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified using values of impedance change, correlation coefficient and SNR. Our results showed the optimum electrode pair (1, 9) which could detect impedance changes due to an increase of the intensity of the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2$+0.0620x+0.6958, respectively. It demonstrated that the abdominal pressure could be measured non-invasively and simply using bio-impedance method. We propose that this optimum electrode configuration would be useful for future studies involving the convenient measurement of abdominal pressure by ambulatory urodynamics monitoring study.

• 대한한방내과학회지
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• 제20권1호
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• pp.222-231
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• 1999

Uwhangchungsimwon(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arteriosclerosis, autonomic imbalance, mental instablity, etc in Korean traditional hospitals, In particular it is often initialy chosen for emergency care of acute stroke. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics. Using transcranial Doppler ultrasound, we studied changes of mean flow velocity and pulsatility index(PI) of middle cerebral arteries (MCAs) from 11 health young volunteers who were administrated with 1 pill UC and 11 health controls who were not. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with breath-holding index(BHI). Systolic blood pressure, diastolic blood pressure, and heart rate were measured using ambulatory blood pressure monitoring(ABPM). In UC administration group, the evaluation was performed during basal condition. and repeated at 20, 40, and 60 min after administration. In controls, the evaluation was performed at corresponding time intervals. Mean flow velocity in middle cerebral artery, systolic blood pressure, diastolic blood pressure, and heart rate did not change during the observation period and were not different between these two groups. However, administration of UC was associated with decreases in PI by $3.6{\sim}12.4%$ in BHI by $17.9{\sim}24.8%$ compared with pre-administration period. Decreases in PI and BHI with UC were significantly different compared with control group (p<0.05). These results indicate that UC decreases PI and BHI in cerebral artery, which is due to a dilation of cerebral resistance vessels.

• 전기학회논문지
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• 제56권7호
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• pp.1339-1342
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• 2007

In this study, we determined the optimum electrode pair for measuring the abdominal pressure using bio-impedance method and compared with conventional methods. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified using values of impedance change, correlation coefficient and SNR. Our results showed the optimum electrode pair (1, 9) which could detect impedance changes due to an increase of the intensity of the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2+0.0620x+0.6958$, respectively. It demonstrated that the abdominal pressure could be measured noninvasively and simply using bio-impedance method. We propose that this optimum electrode configuration would be useful for future studies involving the convenient measurement of abdominal pressure by ambulatory urodynamics monitoring study.