• Title/Summary/Keyword: Essential Hypertension

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Surfer's Myelopathy : Case Series and Literature Review

  • Choi, June Ho;Ha, Jung-Ki;Kim, Chung Hwan;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.767-773
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    • 2018
  • Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

Diagnosis of Primary Aldosteronism and Usefulness of Aldosterone/Renin Ratio in Secondary Hypertension (이차성 고혈압 환자에서 알도스테론/혈장 레닌활성도 비율을 이용한 원발성 알도스테론증의 진단 및 임상적 유용성 평가)

  • Kim, Hye-Sook;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.241-246
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    • 2008
  • Purpose: To study of difference among primary aldosteronism patients and normal groups and essential hypertension patients and to confirm aldosterone/plasma renin activity ratio increase in secondary hypertension group which was diagnosed as primary aldosteronism. Materials and method: 1. Period: from April 2006 to March 2008. 2.Targets: 901 patients who visited seoul national university bundang hospital. 3. Groups: we divided by three groups. (normal group (n=147), essential hypertension (n=709), primary aldosteronism (n=45)) 4. Then calculated aldosterone/plasma renin activity ratio. 5. We used ROC curve to measure sensitivity and specificity. Results: 1. normal groups aldosterone/plasma renin activity ratio: $52.8{\pm}52.46$ essential hypertension patients aldosterone/plasma renin activity ratio: $171.04{\pm}291.56$ primary aldosteronism patients aldosterone/plasma renin activity ratio: $2325{\pm}2200$. 2. Aldosterone/renin ratio was significant in comparing each groups (p<0.001). 3. The sensitivity was 91.1% and the specificity was 92.4% when cut off of aldosterone/renin ratio was 485. Conclusion: It was confirmed that aldosterone/plasma renin activity ratio in primary aldosteronism was higher than normal group. According to this result, we can tell that aldosterone/ plasma renin activity ratio is very useful in diagnosis of primary aldosteronism.

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A Study on the Factors Affecting Self-Regulation Program for Hypertensives (본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구)

  • Park, Young-Im
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.234-249
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    • 1995
  • Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

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Association Analysis of Comorbidity of Cerebral Infarction Using Data Mining (데이터 마이닝을 활용한 뇌경색증과 동반되는 질환의 연관성 분석)

  • Lee, In-Hee;Shin, A-Mi;Son, Chang-Sik;Park, Hee-Joon;Kim, Joong-Hwi;Park, Sang-Young;Choi, Jin-Ho;Kim, Yoon-Nyun
    • The Journal of Korean Physical Therapy
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    • v.22 no.1
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    • pp.75-81
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    • 2010
  • Purpose: The purpose of this study was to apply association rule mining to explore the labyrinthine network of cerebral infarction comorbidity and basic data supply to develop cutting-edge physical therapy protocols for cerebral infarction with comorbidity Methods: From clinic records of enrollees of A Hospital in D city, patients over 18 years of age with cerebral infarction and cerebral infarction comorbidity were recruited as a case group. All diagnoses of that hospital were categorized according to the "International Classification of Disease (ICD)" diagnosis system. We extracted code I63 from the "Korea Classification of Disease (KCD)-4". Associated rule mining was done with a priori modeling and Web nodes to examine the strengths of associations among those diagnoses. The support and confidence values of associated rule mining results were examined. Results: The subjects of this study were 2,267 cerebral infarction patients. E11 (Non-insulin-dependent diabetes mellitus), E78 (Disorders of lipoprotein metabolism and other lipidaemias), G81 (Hemiplegia), I10 (Essential hypertension), and K29 (Gastritis and duodenitis) were high frequency diagnoses, being found in 10% or more of total diagnoses of cerebral infarction from frequency analysis results. The highest frequency diagnosis was 1,042 (46.0%) for I10. The second most frequent diagnosis was for E11(21.5%) while the third most frequent diagnosis was E78 (20.2%). Results from a priori modeling and Web nodes indicated that cerebral infarction has a strong association withessential hypertension, non-insulin-dependent diabetes mellitus, disorders of lipoprotein metabolism and other lipidaemias. Conclusion: Cerebral infarction is associated with hypertension, diabetes mellitus, and disorders of lipoprotein metabolism and other lipidaemias. The result of this study will be helpful to clinicians treating patients with cerebral infarction.

A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

A Study on Factors Affecting Hypertension in Young and Middle-aged Groups: Using Data from the 2021 Community Health Survey (청·중년층의 고혈압에 영향을 미치는 요인에 관한 연구: 2021년 지역사회건강조사 자료 활용)

  • Young-Hee Nam
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.1
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    • pp.1-15
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    • 2024
  • Objectives: This study aims to examine the general characteristics and physical activity characteristics of young and middle-aged individuals with hypertension, with the goal of identifying key influencing factors and providing public health policy recommendations. Methods: Participants in this study used data from the 2021 Community Health Survey. The study participants include 5,511 individuals diagnosed with hypertension in the young and middle-aged group (aged 19 to 49). The collected data were analyzed using SPSS 26.0. Results: Model 1 is the influencing factors of young and middle-aged hypertensive patients according to general characteristics. The explanatory power is R2= .065. The influencing factors are as follows. Economic activity (𝛽= -.219, p<.001), breakfast per week (𝛽= .117, p<.001), gender (𝛽= .090, p<.001), subjective health status (𝛽= .073, p<.001), and education level (𝛽= .069, p<.001). Model 2 is the influencing factors of young and middle-aged hypertensive patients, including physical activity characteristics. The explanatory power is R2= .076. The influencing factors are as follows. Strength exercises (𝛽= -4.791, p<.001), the walking activity (𝛽= -2.694, p<.01), and the high-intensity physical activity (𝛽= -2.629, p<.01). Conclusion: The active management of young and middle-aged hypertension is essential to prevent progression to serious disease. To prevent hypertension in young and middle-aged people, health education is needed to develop and utilize health promotion programs that take into account general characteristics and physical activity characteristics.

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review

  • Yoojin Lindsey Chung
    • Journal of Yeungnam Medical Science
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    • v.41 no.3
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    • pp.158-165
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    • 2024
  • Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

A Study on Self-care Behavior Types of Hypertensives : Q-methodological Approach (고혈압환자의 자가간호행위 유형에 관한 연구 : Q 방법론 적용)

  • Park Young-Im
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.39-57
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    • 1999
  • Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.

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A Study about Self-care for Hypertensives in Rural area (일부 농촌지역 고혈압 환자의 자가간호 수행요인 연구)

  • Park, Young-Im
    • Research in Community and Public Health Nursing
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    • v.8 no.1
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    • pp.45-60
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    • 1997
  • Essential hypertension is a typical chronic disease requiring adequate and continuous management. Many studies supported that self-care was the essential factor to promote the wellbeing of hypertensives and self-efficacy increased healthy, behavior. The comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care performance for hypertensives in company. And this self-regulation program was recommended to apply for hypertensives in rural area. The purpose of this study is to identify the general characteristics affecting self-care and interrelationship among the factors including self-care, self-efficacy, HLOC, perceived benefits, barriers and family support. 40 subjects were interviewed from Dec. 1996 to Jan. 1997 and the data was analyzed by the SPSS PC+ program with t-test and multiple correlation to determine the variables affecting the self-care behavior. The results were as follows: 1) Level of self-care was significant difference according to sex(t= -2.27, p=.0l9). religion (t=1.57, p=.055) and smoking habit (t=4.42, P=.000). Perceived self-efficacy was more significantly high among the non-smoking group (t=3.25, P=.000) and female group (t=-2.534, p=.0l3). 2) There were significant positive correlation among the variables: self-care and self-efficacy (r=.5460, p=.000), external-LOC and self-care(r=.2548, p=.056), external-LOC and self-efficacy(r =. 2901, p=.035), self-efficacy and perceived benefits (r=3307, p=.019). And there were significant negative correlation between self-care and barriers (r=-.5438, p=. 000), self-efficacy and barriers (r= - .4153, p=.004). From the above results, it can be concluded that the self-care is more required in male hypertensives and self-efficacy is one of the important factors to increase healthy behavior in cluding self-care. Thus self-regulation program can be recommended in the management of the hypertensives in community settings.

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