• Title/Summary/Keyword: Angina

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A Study on the Educational Needs of the Coronary Heart Disease Patients in a Municipal General Hospital (관상동맥질환자의 교육 요구 -일개 종합병원 내원환자를 중심으로-)

  • 고경희;이성은
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.143-161
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    • 1998
  • The purpose of this study is to find out the educational needs for the coronary heart disease patients of a general hospital in a municipal general hospital. The study subjects were 90 outpatients who had been diagnosed as myocardial infection or angina at the hospital from January 3, 1998 to January 31, 1998. The questionaire was consisted of risk factors and educational needs for coronary heart disease patients. The qusetions on the education needs of the coronary heart disease were consist of 34 questions in 6 fields. In analyzing the data, the number and the percentage were calculated in patients general characteristics, the average and the standard-deviation were calculated to understand the educational needs, t-test and ANOVA were used to find out inter group difference on educational needs. In ANOVA, the advanced analysis was done by Scheffe-test. The results of this study were as follows: 1. 52(57.8%) of the patients (90%) live in Kangnung-city and 95% of the patients live in the middle-east part of Korea. At the age distribution 39 to 80, 41.1% of the patients were in their sixties and average age was 62.4 years old. 40% of the patients left school in mid-course or graduated from middle school or high school 2. As a result of the study on the risk factors of the coronary heart disease, the patients who have hypertension and diabetes were 41.1% and 20% respectively. In smoking and drinking, smokers were 30% and drinkers were 40% and average of smoking and drinking duration over 30 years old. 47.8% were over 140mgHg systolic - BP and 45.8% were over 90mmHg diastolic - BP 3. The patients' educational needs average 94.88 (maximum 134), and item average 2.79(maximum 4.0), the highest needs field was the characteristic of disease 33.22(maximum 44). Item average 3.02 (maximum 4.0) and the lowest education needs field was the physical activity and exercise 10.21(maximum 16). Item average 2.55(maximum 4.0) 4. General characteristics which were different from the general characteristic educational needs were statistically different by group of educational level, occupation, age and sex. 5. The risk factors which were different from the coronary heart disease patients' risk factors educational needs were statistically different by groups of the heart disease patients in family and the patients who take regular exercise. with a result the nurses need to improve the educational programs while considering the high educational needs field and the characteristics which showed significant concerns statistically.

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The Usefulness of Myocardial SPECT for the Preoperative Cardiac Risk Evaluation in Noncardiac Surgery (비심장 수술 환자에서 수술 전후 심장사건의 위험도 평가를 위한 심근관류 SPECT의 유용성)

  • Lim, Seok-Tae;Lee, Dong-Soo;Kang, Won-Jun;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.273-281
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    • 1999
  • Purpose: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. Materials and Methods: 118 patients (M: F=66: 52, $62.7{\pm}10.5$ years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-20l/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods ($14.6{\pm}5.6$ days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Results: Perioperative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease, Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. Conclusion : We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.

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An Analytical Study on Student's Physical Examination of Elementing and Seconding School in Korea (우리나라 초(初)·중(中)·고(高) 학생(學生) 신체검사결과(身體檢査結果)에 대한 분석연구(分析硏究))

  • Youn, Chong Duk
    • Journal of the Korean Society of School Health
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    • v.1 no.1
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    • pp.114-132
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    • 1988
  • Aiming to appraise student's health status and recommend improvement and strengthening of the school health services, statistical analysis of the results of health examination were done with summarized data which were collected nation-wide through the Ministry of Education. After analysis of data obtained, the results of the study summarized as follows; 1) Requested Adequate care Requested Adequate care showed from 5 % to 3% in 1962 and 1984 respectively. In sexes, Requested Adequate in girls (2.8%) more apparent than in boys (2.5%) 2) Eyes i) Weak vision, abnormal refraction of eyes (myopia, hypermetropia and astigmatism), eye diseases (trachoma, others) were found as shown in the Table 2, Figure 3. Weak vision and abnormal refraction of eyes showed from 2 % (Elementary), 5 % ( Secondary) to 4 % (Elementary), 14 % (Secondary) in 1962 and 1984 respectively. In both sexes, the older the age of students the more weak vision and abnormal refraction of eyes had rapidly increased especially in over 15-year old. ii) Eye diseases (trachoma, others) showed from 2% to age of students the more diseases had students. 3) Ear, nose and pharynx Hearing disturbance, ear diseases (otitis mediae, others), nose (empyema, hypertrophy) and pharynx diseases were found as following 1) Hearing disturbance was found from 0.3%(Elementary), 1 %(Secondary) to 0.05 % (Elementary), 0.4 % (Secondary) in 1962 and 1984 respectively, however, recently the older the age of students the more had students. ii) Ear diseases showed from 1.7 % (Elementary) 1.0 % (Secondary) to 0.3 %(Elementary), 0.5%(Secondary) in 1962 and 1984 respectively. iii) In diseases of the nose and pharynx, tonsilitis showed from 2.5% (Elementary), 3.5 % (Secondary) to 1.8 % ( Elementary). 2.5% (Secondary) in 1962 and 1984 respectively. 4) Skin Infectious skin diseases and other skin diseases were found from 1.5% to 0.6% in 1962 am 1984 respectively. 5) Teeth Dental caries (in milk and permanent teeth) and otner oral diseases are shown from 12 % (Elementary), 8%(Secondary) to 75%( Elementary), 25% (Secondary) in 1962 and 1984 respectively. 6) Other defects and diseases A relatively higher morbidity was shown in the tubercular diseases, in anemia, and in heart diseases among the tuberculous diseases, nodular diseases, Pleurisy, heart diseases, anemia, beriberi, hernia, neurasthenia, speech difficulty, mental disorders, bone dysformity, motion difficulty of extremities. In both sexes, tuberculous diseases were found almost equally in both sexes and anemia in girls was more apparent than in boys. Trying to provide more effective health services in schools : i) A better and more effective physical examination should be carried out in each school and prior to the physical examination, the qualified daily observation of children by teacher should be keenly practiced. ii) According to the results of the required annual physical examination the leading cause of morbidity were dental caries, myopia, angina and otitis mediae and fore these diseases follow up should be carried out. iii) For prevention and treatment of diseases and defects health education for students in the classroom as well as to parents is urgently requested.

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Dual Grafting of Left Internal Thoracic Artery and Saphenous Vein to Left Anterior Descending Artery (좌내흉동맥편과 복재정맥편을 좌전하행지에 동시에 문합한 관상동맥 우회로술의 임상적 결과)

  • 최종범;양현웅;한재오;최순호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.709-714
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    • 1999
  • Background: When internal thoracic artery (ITA) and saphenous vein graft are anastomosed to the same coronary artery, the patency rate of the internal thoracic artery graft with relatively narrow diameter may be decreased owing to competition of pressure and flow rate. We evaluate the clinical outcome and the patency of the ITA graft in patients undergoing dual grafting to the same coronary artery. Material and Method: In 14 patients with the ITA graft having relatively low flow, the ITA and saphenous vein graft were anastomosed to the same coronary artery. During the mean follow-up period of 33.5 months, coronary angiography was performed in 6 patients who complained of recurrent angina, needed confirmation of graft flow, or showed postoperative Q wave. Result: In all 6 patients, the ITA and saphenous vein grafts were patent without stenosis or obstruction. Two patients showed good flow in both grafts, 2 showed competitive flow in the ITA graft, and the remaining 2 showed poor flow in the ITA graft. Conclusion: Early operative closure When saphenous vein grafting was added to the same coronary artery that the internal thoracic artery was anastomosed to, the perfusion to the coronary artery was satisfied and the dual grafting did not affect the short-term and mid-term patency rate of the ITA.

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The Comparison of Anger between Patients with Coronary Artery Disease and Healthy Individuals (관상동맥질환 환자들과 정상인 간 분노의 비교)

  • Koh, Kyung-Bong;Lee, Sang-Hyuk;Kim, Jang-Woo;Roh, Kyu-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.23-29
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    • 2004
  • The objective of this study was to make a comparison on anger level between patients with coronary artery diseases and healthy individuals. 233 patients with coronary artery diseases and 215 normal controls were enrolled in this study. The Anger Expression Scale, the anger and aggression subscales of the Stress Response Inventory(SRI) and the hostility subscale of the Symptom Checklist-90-revised(SCL-90-R) were used to assess the level of anger. The patients with coronary artery diseases scored significantly higher on the anger-out and anger total subscales of the anger expression scale, the anger and aggression subscales of the SRI than the normal controls. The patients with angina pectoris had significantly higher scores in the anger-out and anger-total subscale than those with myocardial infarction. Male subjects scored significantly higher on the anger-in subscale than females, whereas female subjects scored significantly higher on the anger-out subscale than male subjects. These results suggest that patients with coronary artery diseases are likely to have a higher level of anger or anger expression than normal controls and that there may be difference in anger expression between male and female patients. It is emphasized that anger management is needed to prevent the coronary artery disease patients from aggravating the illness.

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The Stress Perception, Depressive Symptoms and Medical Comorbidity in Healthcare Center (대학병원 건강검진센터 내원자의 스트레스 지각 정도, 우울 증상 및 신체질환 이환율)

  • Shim, In-Bo;Joe, Sook-Haeng;Ham, Byung-Joo;Han, Changsu;Jeong, Hyun-Ghang;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.27-43
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    • 2013
  • Objectives : We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. Methods : 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. Results : 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. Conclusions : In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.

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Anti-proliferation Effects of Isorhamnetin on Lung Cancer Cells in Vitro and in Vivo

  • Li, Qiong;Ren, Fu-Qiang;Yang, Chun-Lei;Zhou, Li-Ming;Liu, Yan-You;Xiao, Jing;Zhu, Ling;Wang, Zhen-Grong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.3035-3042
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    • 2015
  • Background: Isorhamnetin (Iso), a novel and essential monomer derived from total flavones of Hippophae rhamnoides that has long been used as a traditional Chinese medicine for angina pectoris and acute myocardial infarction, has also shown a spectrum of antitumor activity. However, little is known about the mechanisms of action Iso on cancer cells. Objectives: To investigate the effects of Iso on A549 lung cancer cells and underlying mechanisms. Materials and Methods: A549 cells were treated with $10{\sim}320{\mu}g/ml$ Iso. Their morphological and cellular characteristics were assessed by light and electronic microscopy. Growth inhibition was analyzed by MTT, clonogenic and growth curve assays. Apoptotic characteristics of cells were determined by flow cytometry (FCM), DNA fragmentation, single cell gel electrophoresis (comet) assay, immunocytochemistry and terminal deoxynucleotidyl transferase nick end labeling (TUNEL). Tumor models were setup by transplanting Lewis lung carcinoma cells into C57BL/6 mice, and the weights and sizes of tumors were measured. Results: Iso markedly inhibited the growth of A549 cells with induction of apoptotic changes. Iso at $20{\mu}g/ml$, could induce A549 cell apoptosis, up-regulate the expression of apoptosis genes Bax, Caspase-3 and P53, and down-regulate the expression of Bcl-2, cyclinD1 and PCNA protein. The tumors in tumor-bearing mice treated with Iso were significantly smaller than in the control group. The results of apoptosis-related genes, PCNA, cyclinD1 and other protein expression levels of transplanted Lewis cells were the same as those of A549 cells in vitro. Conclusions: Iso, a natural single compound isolated from total flavones, has antiproliferative activity against lung cancer in vitro and in vivo. Its mechanisms of action may involve apoptosis of cells induced by down-regulation of oncogenes and up-regulation of apoptotic genes.

Prescribing Patterns of Antihypertensive Drugs by Outpatients with Hypertension in 2007 (고혈압 환자의 혈압강하제 처방양상 - 외래 처방전을 중심으로 -)

  • Sung, Ye-Na;Jang, Sun-Mee;Lim, Do-Hee;Shin, Suk-Youn;Song, Hyun-Jong;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.2
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    • pp.167-179
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    • 2009
  • Hypertension is one of the most common chronic diseases and it causes cardiovascular and cerebrovascular disease. While antihypertensive drug use increased, it took 15% of national health insurance drug expenditure. This study aimed to examine the pattern of antihypertensive drug prescription using National Health Insurance claims database and compare it with recommendations of Korea Hypertension Treatment Guidelines. Among the antihypertensive drugs, calcium channel blocker(64.4%) was most commonly prescribed class, and diuretics(44.6%), angiotensin II receptor blocker(33.3%), angiotensin converting enzyme inhibitor(11.7%) was followed. Approximately 81% of antihypertensives prescription were without cardiovascular or cerebrovascular disease, and among the comorbid conditions, diabetes(10.7%) was most common. calcium channel blocker(62.3%) was mostly prescribed class for hypertension with angina pectoris, angiotensin receptor blocker(45.3%) with myocardial infarction, diuretics(70.2%) and calcium channel blocker(49.5%) with congestive heart failure. For Hypertension with cerebrovascular disease, calcium channel blocker(68.0%) and angiotensin receptor blocker(43.3%) were prescribed mainly. When it comes to diabetes, calcium channel blocker(57.2%) was still mostly prescribed and angiotensin receptor blocker(45.9%) followed. But in hospitals and tertiary hospitals, angiotensin receptor blocker(65.7, 66.1%) was mostly prescribed for the patients with diabetes. For Hypertension with chronic renal disease, angiotensin receptor blocker(59.5%), calcium channel blocker(56.5%), diuretics(54.6%) were mainly used. Average number of classes per prescribing was $1.89{\pm}0.89$ class, average days per prescribing was $33{\pm}19$ day. Among the hypertension without comorbidity, 40.5% of prescription was monotherapy and 58.8% of polytherapy included diuretics. Among the outpatient prescriptions, calcium channel blocker was the most commonly used class, and the prescription pattern in clinic did not closely followed recommendations of Hypertension Treatment Guidelines.

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Beta Blockers or Calcium Channel Blockers as Primary Antianginal Drug after Percutaneous Coronary Intervention: Prescription Pattern and its association with Clinical Outcome (관상동맥중재술 전후 주요 항협심증 약제로서의 베타차단제와 칼슘채널차단제: 처방패턴 및 임상결과에 미치는 영향)

  • Noh, Sun Young;Jo, Yun Hee;Cho, Yoon Sook;Hahn, Hyeon Joo;Lee, Hae-Young;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.213-219
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    • 2016
  • Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.

The Immediate and Long Term Result of Surgical Angioplasty of Left Main and Proximal Left Anterior Decending Coronary Artery (좌주관상동맥 및 좌전하행지기시부의 수술적 혈관 성형술의 중장기 성적)

  • 안현성;김응중;신윤철;지현근;이원용
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.692-697
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    • 2001
  • Background: The left main coronary artery surgical angioplasty has become the choice of surgical procedure in isolated LM disease. We have performed 22 cases of LMCA surgical angioplasy since 1996. We report the immediate and long term result of the surgical angioplasty with their postoperative angiography. Material and Method: Between July 1994 and October 2000, 22 patients(11 men and 11 women) were subjected to surgical patch angioplasty of the LMCA, 1 patient had an additional angioplasty performed on the proximal right coronary artery. The LMCA was approached anteriorly with or without transection of the main pulmonary artery(21 cases), and in a patient who had undergone an aortic valve replacement, LMCA was approached superiorly with transection of the ascending aorta. Additional grafting was required in 5 cases. The on-lay patch was used with autologous pericardium in 6 cases and bovine pericardium in 16 cases. Result: There was no operative mortality. There was 30~50% stenosis of the anastomosis site in 3 cases at the postop. coronary angiography. Coronary angiography was reperformed in 5 cases between 5th months and 15th months postoperatively. There was 40~60% stenosis of the anastomosis site in 2 cases. There was one death at 42nd months postoperatively but the cause was unknown. No patient complained of angina with a mean follow up of 48.$\pm$22.5 months. Conclusion: There were only several coronary angiographic results in long term follow-up but we had relatively good clinical results for LMCA surgical angioplasty in the immediate and long term. The excellence of LMCA surgical angioplasty needs the result of the long term follow-up.

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