• Title/Summary/Keyword: Blood Pressure

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Impact of Hemodialysis on Left Ventricular Performance: A Doppler Echocardiographic Study (혈액투석 유지요법 환자에서 투석 전후의 좌심실 Doppler 심초음파를 이용한 기능지표의 변화)

  • Kang, Dong-Oh;Lee, Du-Ha;Kim, Hyun-Seo;Kim, Hyun-Su;Kim, Sung-Rok;Park, Jong-Seon
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.309-317
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    • 1999
  • Background: Left ventricular diastolic filling is an important determinant for maintenance of cardiac output during hemodialysis. Few investigators have studied the influence of hemodialysis on diastolic function. To evaluate the change of left ventricular systolic and diastolic function. we performed M-mode and Doppler echocardiographic studies before and after hemodialysis. Methods: The study population consisted of 30 patients(15 patients were male, mean age $45{\pm}10$ years) with CRF on maintenance hemodialysis. They have normal left ventricular systolic function(Fractional shortening>30%) and no evidence of valvular heart disease or regional wall motion abnormalities. The ejection fraction (EF) was measured using M-mode echocardiography and Doppler indices such as peak E velocity, peak A velocity, isovolumetric relaxation time(IVRT), deceleration time(DT). and left ventricular ejection time(LVET) obtained from Doppler echocardiography. The index of myocardial performance (IMP) was calculated from each of the Doppler velocity indices. Results: The weight reduction after hemodialysis was $2.1{\pm}1.0kg$(p<0.0001), After hemodialysis, there was some decrease in blood pressure(p<0.05), but no significant change in heart rate, EF and fractional shortening, mean VCF, peak A velocity, and DT. And significant reduction in peak E velocity, E/A ratio(p<0.0001. p<0.001), and significant increase in IVRT and IMP(p<0.05, p<0.0001) were noted. Conclusion: In conclusion, preload reduction is the main mechanism that accounts for changes in Doppler diastolic indices after hemodialysis. And an increased IMP suggests that diastolic function may be aggravated after hemodialysis, and that implies impaired left ventricular filling and disturbed left ventricular compliance.

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A Study on Therapeutic Compliance of Hypertensive Patients in a Rural Health Subcenter (일개 농촌지역 보건지소 고혈압 환자의 치료지속성)

  • Song, Min-Keun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.155-164
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    • 2002
  • Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

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Prevalence of Lower Urinary Tract Symptoms and Association of Hypertension with I-PSS (국제 전립선 증상 점수(I-PSS)를 이용한 하부요로증상의 유병률 및 고혈압과의 관계)

  • Ha, Jee-Young;Cho, Dong-Young;Yang, Sang-Kuk;Chang, Soung-Hoon;Lee, Kun-Sei;Lee, Won-Jin;Yu, Byung-Yeon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.265-273
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    • 2000
  • Benign prostatic hyperplasia (BPH) is a highly prevalent, age-related disorder in men which place a considerable burden on health care resources worldwide. While BPH and hypertension are apparently diverse disease processes, they have some features in common(e.g. underlying etiology of the sympathetic nervous system). The purpose of this study is to estimate the prevalence of lower urinary tract symptoms using I-PSS(international prostate symptom score) and to investigate the association of hypertension with I-PSS. This study was carried out to 390 men(40~86 year old) at 3 Myun in Chungju City from July to August, 1997. Subjects answered on questionnaire for I-PSS and were checked age, education, marital status, annual income, blood pressure. The mean age of subjects was 59.8 year old. The mean of I-PSS were increased by age decades(40~49, 50~59, 60~69, 70~86) and it's scores were 4.4, 7.0, 8.2, 12.3 respectively. Strong correlations were observed between the I-PSS and the QUL(quality of life)(P=0.0001). I-PSS(mean-value) were 7.85 in hypertensive group and 8.39 in normotensive group but there was no statistically significance between the two groups(P>0.05). The proportion of mean scoring greater than 8 was 42.5%. There have been reports of association between lower urinary tract symptoms and hypertension, but there was no consistent suggestion that such an association could be casual. The need for high-quality epidemiological information and consequent increased prospects for prevention is obvious.

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The Family History of Chronic Diseases, Food Group Intakes, and Physical Activity Practices among School Children in Seoul, Korea (서울지역 일부 초등학생의 생활 습관병 가족력, 식품군 섭취 형태 및 활동량 평가)

  • Lee, Young-Nam;Ha, Ae-Wha
    • Journal of the East Asian Society of Dietary Life
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    • v.17 no.5
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    • pp.644-652
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    • 2007
  • In this study, we examined family history of chronic diseases, food group intake and physical activity in $5^{th}\;and\; 6^{th}$ grade elementary school children. Food group intake was compared with the KDRI food guides for children. The measurements of daily physical activity, television viewing, computer use, and daily servings of five food groups, including grains, meats, dairy products, fruits, and vegetables, were based on child and parent self-reports. As indices of obesity, the obesity index(%) and BMI(Body Mass Index) were used. The results were as follows. In boys, 83.2% were normal weight with 7.4% slightly obese, 7.4% moderately obese, and 2.0 were highly obese while the percentages of normal and slightly obese in girls were 89.9% and 6.2% respectively (p<0.05). The boys had more hours of daily physical activity(p<0.05) and more hours of computer usage(Internet searching or games)(p<0.05) than the girls. Slightly over 50% of the subjects met the daily recommended servings of grains, dairy products, fruits, and vegetables according to the KDRI food guides. However, only 26% of boys and 27% of girls met the recommended daily servings of protein foods such as meats, beans, and eggs. Thirty two percent(32%) of girls consumed high fat snacks everyday while 32% consumed high sugar snacks every day. The girls consumed more vegetables(p<0.05) and more high sugar snacks(p<0.05) than the boys. The children with family histories of obesity showed greater obesity rates(p<0.05) and sedentary lifestyles(p< 0.05) than those children without a family history of obesity. Children with family histories of high blood pressure consumed more sewings of vegetables and high fat snacks than the controls(p<0.05). The children with family histories of obesity consumed more high sugar or high fat snacks than the controls(p<0.05).

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Predictability of Impending Events for Death within 48 Hours in Terminal Cancer Patients (말기암환자에서 임박사건 간 48시간 임종예측도 비교)

  • Hwang, In-Cheol;Choi, Chung-Hyun;Kim, Kyoung-Kon;Lee, Kyoung-Shik;Suh, Heuy-Sun;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.28-33
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    • 2011
  • Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

Analysis of Experimental Researches in Korea on the Effects of Aromatherapy to Relieve Pain (아로마테라피의 통증 감소 효과에 관한 국내 실험논문 분석)

  • Park, Jeong-Sook;Park, Jeong-Eon;Yang, Jang-Soon;Kwak, Hye-Weon;Han, Jung-An
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.8-19
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    • 2011
  • Purpose: This study identifies research trends and provides fundamental data related to curative power of aromatherapy to relieve pain in Korea. Methods: The study analyzed 44 experimental studies on humans that were published in Korea before the end of December, 2009. The key words used for searching were: aroma, aromatherapy, hyang-yobeob, hyanggi-yobeob, hyanggichilyo, aromatherapy and pain, headache, scapulodynia, omodynia, feeling uncomfortable in the perineal region, sense of pain, labor pains, arm pain, menstrual pain, aches, and dysmenorrheal. Those words were found on websites, including those for Korea Education & Research Information Service, the National Assembly Library, KISS, KoreaMed, and NDSL. Collected data were analyzed using descriptive statistics. Results: The results showed that most of essential oils to relieve pain is composed of three to four kinds of oils, including Lavender, Roman chamomile, Rosemary, and Clarysage. Aromatherapy is applied usually by means of massage (50%), inhalation (13.6%), or a combination of the above two (13.6%). Measuring instruments as a dependent variable include VAS, questionnaire, GRS, blood pressure, pulse, and Algometer. Aromatherapy plays an important role in soothing headaches and arthralgia. However, when it comes to labor and menstrual pain, it doesn't seem to be effective. Conclusion: The study found that different kinds of oil, frequencies, and periods of time are used for the same symptoms. Further research should employ standardized oil blending, application, duration, and measuring instruments, and more systematically analyze the effects of aromatherapy to establish the effects on relieving pain.

Effects of Repeated Immobilization Stress on the Renal Peripheral Benzodiazepine Receptor in Rats (반복적 부동화 스트레스가 흰쥐 신장의 말초성 benzodiazepine 수용체에 미치는 영향)

  • Park Yong Hoon;Moon Han Ku;Shin Son Moon;Lee Eun Ju;Lee Eun Sil;Ha Jeoung-Hee
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.20-26
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    • 1999
  • Purpose : Several modulatory factors for renal peripheral benzodiazepine receptor (PBR) has been reported, but their physiological significance remains elusive. Tissue-specific, stress-induced down-regulation of renal PBR coupled with the pharmacological stimulation of these effects by angiotensin II suggested that physiological significance of renal PBR may be related to the pathophysiology of stress-induced hypertension. The boderline hypertensive rat (BHR) has been used extensively to study the interaction of environmental factors, such as stress and blood pressure. The BHR is the first-generation progeny of a cross between the spontaneously hypertensive rat and the control Wistar-Kyoto rat. The pathogenesis of stress induced hypertension in this model is not demonstrated well. Methods In this study, BHR (male, 150-200 g) and Sprague-Dawley (SD, male, 150-200 g) rats were treated by repeated immobilization to induce anxiety. We used plus-maze performance to observe the level of anxiety by measuring percent open crosses and percent time in open. Results : Percent open crosses and percent time in open in BHR were lower than in SD rats (P<0.05). Receptor densities of renal PBR in BHRs were significantly lower than those of SDs (P<0.05). We also observed that the renal PBR was upregulated in the repeatedly stressed (immobilization, 2 hours daily, for 2 weeks) rats, both in the BHR and SD. However, the density of renal PBR in the stressed BHR was still lower than that of stressed SD. Renal PBR has been suggested to be an important organs which Is responsible for the production of cholesterol-derived products during stress. Conrlusion : From these results, it can be summarized that the lowed density of renal PBR may be involved in the pathogeneis of stress-induced hypertension.

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Renal Effects of a Low Protein Diet and Antihypertensive Drugs on the Progression of Early Chronic Renal Failure in 5/6 Nephrectomized Rats (저단백 식이 및 항고혈압제의 투여가 만성신부전증의 진행에 미치는 영향에 관한 실험적 연구)

  • Kim, Kyo-Sun;Kim, Kee-Hyuk;Kim, Sang-Yun;Kang, Yong-Joo;Maeng, Won-Jae
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.125-132
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    • 1998
  • Purpose : To study whether a low protein diet increase the efficacy of antihypertensive therapy on the progression of renal failure, we conducted an experimental study using 5/6 nephrectomized rats(n=63). Methods : At 7 days after surgery, rats were randomly assigned to three groups according to receiving antihypertensive drug: no antihypertensive drug (U), enalapril (E), and nicardipine (N), respectively and fed a low protein diet (6$\%$ protein). Proteinuria, mesangial matrix expansion score and glomerular volume were assessed at 4, 12 and 16 weeks after renal ablation. Results : Group U rats on a low protein diet developed progressive hypertension ($140{\pm}8,\;162{\pm}5,\;171{\pm}5\;and\;184{\pm}11\;mmHg$ at 4, 8, 12 and 16 weeks) which were controlled by E and N. Group U rats on a low protein diet developed proteinuria ($74{\pm}15\;mg/day$ at 16 weeks) which were decreased by E ($42{\pm}12 mg/day$) or N ($48{\pm}8 mg/day$) (p<0.05). Mesangial matrix expansion score and glomerular volume were not different between groups U, E and N on a low protein diet regardless of the antihypertensive drugs administered. Conclusion : A low protein diet did not affect blood pressure. Enalapril and nicardipine-treated rats on a low protein diet did not have different mesangial matrix expansion and glomerular volumes from rats on a low protein diet at 12 weeks and 16 weeks, in spite of the better controlling of systemic hypertension and lessening of proteinuria. Thus, combined treatment with a low protein diet and antihypertensive drugs didn't appear to show any addition,11 effects to attenuate glomerular injury.

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Studies on the Effect of Cation on the Activity at the 5th Instar Larvae of Bombyx mori (5령유충의 배맥관운동에 대한 양이온의 영향에 관한 연구)

  • 윤종관;사기언
    • Journal of Sericultural and Entomological Science
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    • v.18 no.2
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    • pp.89-93
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    • 1976
  • The physiological saline solution for animals is known as Ringer's solution which is used for keeping the function of cold blooded vertebrate animals. Primaily the saline solution is used for the purpose of perfusion experiment in frogs. Later the saline solution is applied in several kinds of animals including human being with satisfactory results. However, this saline solution was introduced to silkworm and it was found that the result was not as successful as in the case of other animals and human being. Normally, in the case of silkworm, the physiological saline solution is prepared in order to maintain the normal function of separated organs and tissues. To this end, the saline solution is adjusted to contain the certain amount and strength of ions, osmosis pressure and hydrogen concentration. The most of cases, the physiological saline solution should be prepared so that the constituent of the solution be the same with the blood selium and body fluid. The hydrogen concentration in the ion element of the saline solution is adjustable by adding Na$\^$+/, K$\^$+/, Ca$\^$++/, Mg$\^$++/ which are followed by adding of buffer solution such as NaHCO$_3$and NaH$_2$PO$_4$. Determination of optimum concentration of cation in the physiological saline solution, and the optimum mixing rate of more than two kinds of cations are based on the movement of dorsal vessel in the silkworm larvae. The optimum concentration of cations in the solution is prepared by adding NaCl solution which is under zero point. However, this solution was further added with the different concentration of KCl and CaCl$_2$. By dropping the prepared solution on the 5th larvae, the effects of solution was measured. The measurement was done by observation of movement' of dorsal vessel and its time length, and the number of pulses. According to the experiment, it was found that when only NaCl solution was applied, the number of pulses is increased for a moment, and the pulse stopped after one hour or so. When KCl solution was added the time of pulse was prolonged and in the contrast, the number of pulses was slow down. If KCl and CaCl$_2$solutions are added the time of pulse was further prolonged. Even though the adding of KCl and CaCl$_2$are found to be effectible, the correlation between the concentration of solution and the movement of dorsal vessel was not observed. However, it was same in the case of adding Ca$\^$++/ or K$\^$+/. It was found that when Mg$\^$++/ was added to dorsal vessel the number of the pulses was not decreased although the prolonged time pulse was observed.

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Bilateral Sequential Lung Transplantation in Dogs (황견에서 동종 순차적 양측 폐이식 수술에 관한 연구)

  • 이두연;김해균;문동석;윤용한;홍윤주;이성수
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.108-112
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    • 1998
  • Experimental trials of unilateral lung transplantation in dogs have been attempted and satisfactory results were obtained without any noticeable difficulty in surgical techniques. Fourteen dogs with the body weight of around 25 kg were anesthesized by 20~30 mg/kg of intravenous Entobar,; one was sacrificed to make available blood for use during transplantation for the recipient dog. A mid-sternotomy incision was performed and 20 mg/kg of Prostaglandin E1 was infused through the pulmonary artery and Euro-Collin's(E-C) preservation solution, cooled down to 4$^{\circ}C$, was perfused at the rate of 70cc/kg by a pressure of 30 cmH2O. The heart-lung block was then resected out and promptly immersed in the prepared preservation solution at 4$^{\circ}C$. One lung preserved in the EC solution at 4$^{\circ}C$ was anastomosed to the recipient dog in the order of the pulmonary vein, bronchus then pulmomary artery and the thoracotomy incision was closed after the bleeding control and tube thoracostomy. Then the pneumonectomy in the opposite side was perfomed in the same manner and the tailored lung was transplanted in the order of the pulmonary vein, bronchus, then pulmonary artery. We conclude that in the bilateral sequential lung transplantation, the right lung transplantation should precede to better expose the operative field and to prevent reperfusion injury; also, the cardiopulmonary bypass should be consider for certain appropriate cases.

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