• 한국간호교육학회지
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• 제5권1호
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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.

• Journal of Chest Surgery
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• 제23권1호
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• pp.32-40
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• 1990

Surgical correction of congenital cardiac defects in infants and children with an elevated pulmonary arterial pressure or pulmonary vascular resistance carries a significant early postoperative mortality. And accurate assessments of cardiac output is critically important in these patients. From April 1988 through September 1989, serial measurements of cardiac index, ratio of pulmonary-systemic systolic pressure, ratio of pulmonary-systemic resistance, central venous pressure, left atrial pressure, and urine output during the first 48 hours after the cardiac operation were made in 30 congenital cardiac defects associated with pulmonary hypertension. Cardiac index showed significant increase only after 24 hour postoperatively and this low cardiac performance in the early postoperative period should be considered when postoperative management is being planned in the risky patients. There were no variables which showed any significant correlation with cardiac index. In 12 cases[40%], pulmonary hypertensive crisis developed during the 48 hours postoperatively, and they were treated with full sedation, hyperventilation with 100 % 0y and pulmonary vasodilator infusion. In all patient with preoperative pulmonary hypertension, surgical placement of a pulmonary artery catheter is desirable to allow prompt diagnosis of pulmonary hypertensive crisis and to monitor subsequent therapy.

• 기본간호학회지
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• 제19권4호
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• pp.474-482
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• 2012

Purpose: The purposes of this study were to identify knowledge, health belief and compliance in patients with hypertension and to identify the most important predictors for compliance of hypertensive patient. Method: The participants in this study were 117 patients who were receiving treatment for hypertension at E. university hospital or one of three local clinics in D-city. Data were collected using a knowledge measurement instrument, health belief scale, and an instrument on compliance. Collected data were analyzed using $X^2$ test, ANOVA, multiple linear regression with PASW statistics 18.0 program. Results: There were statistically significantly positive correlations between knowledge of hypertension and health belief, health belief and compliance. But there was no correlation between knowledge of hypertension and compliance. In the multiple regression analysis, perceived barriers, perceived severity, perceived benefits were significant predictors to explain compliance and accounted for 54.1% of the variance in compliance. Conclusion: The results of the study indicate that health belief and compliance are significantly strongly correlated. Thus it is suggested that nursing interventions to improve compliance should include nursing care plans to increase health belief, perceived severity, perceived benefit and to decrease perceived barrier.

• Journal of Yeungnam Medical Science
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• 제41권4호
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• pp.300-305
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• 2024

Cytomegalovirus (CMV) retinitis is a rare disease, and overlapping manifestations involving the anterior segment are extremely uncommon. We report a patient who initially presented with persistent corneal edema and was later diagnosed with CMV retinitis. A 72-year-old man with uncontrolled intraocular pressure (IOP) in his right eye visited a tertiary hospital. At initial presentation, the IOP was 36 mmHg and the fundus was not clear due to corneal edema. Spectral domain optical coherence tomography revealed paracentral acute middle maculopathy (PAMM). Panretinal obstructive vasculopathy was observed on ultra-widefield fluorescein angiography. Three weeks later, trabeculectomy was performed to resolve the persistently high IOP. Once corneal edema improved, a white patch-like peripheral lesion and silver wire-like retinal vasculature were observed. Polymerase chain reaction of the aqueous humor was positive for CMV. Oral valganciclovir and intravitreal ganciclovir were administered as antiviral therapies. Despite treatment for 4 months, the final visual acuity was no light perception, with persistent corneal edema and neovascularization of the iris. We describe a rare case of the simultaneous occurrence of hypertensive uveitis and CMV retinitis. The presence of PAMM could be an initial identifiable sign of CMV retinitis, even in the presence of media opacity.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권2호
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• pp.143-149
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• 2023

Objective: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions: The risk rate of IS increased in patient with pyogenic spondylitis.

• 대한간호학회지
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• 제16권3호
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• pp.38-66
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• 1986

Based on the statistical data of FKMIS during five years from 1981 to 1985, the major findings of studying on the treatments of employee's modical insurance covered people were made as follows. 1. During five years, the total number of trratment case was increased 25.14% annually, and so doubled. The consultation rate was increased from 2.086 to 2.856, showng annual increase of 8.17% and total increase of 36.91%. In the cafe, of in-patient, the rate was from 0.056 to 0.602, . showing annual increase of 2.58%. And in out-patient, the rate was from, 2.030 to 2.794, showing annual increase of 8.31%. The male: female ratio of treatment case was changed from 1 : 1.1 to 1 : 1.2. 2. Case of chronic disease was on the increase .every year. The ratio of medical expenditure of that disease to the total medical expenditure was increased from 22.99% in 1984 to 25.0% in 1985. 3. As a whole, the consultation rate of circulatory disease was increased from 26.10 in 1981 to 46.53 in 1985, showing an nual increase of 15.55 %. The rate of in-patient was increased from 2.06 to 2.94, showing annual increase of 9.30%. The rate of out-patient wag from. 24.04 to 43.59, showing annual increase of 16.04%. 4. The duration (days) of circulatory disease in 1985 by types is as follows. In the case of in-patient, rheumatic fever rheumatic heart disease, (22. 67), ischaemic disease (17.39), cerebrovascular disease (17.18), disease of pulmonary circulation and other from of heart disease (15.82), hypertensive disease (13.18), other disease of circulatory disease(11.55). In the case of out-patient, visiting day (11.57 day) and medical expenditure per case (7,853 won) is lower than that of other diseases (4.39 day, 4,361 won). 5. Cases of circulatory chronic disease were two times as many as those of non-chronic disease. Incidence of the out-patient was shown higher than that of in-patient. In the case of duration per case, the chronic disease(12.92 days) was longer that of non-chronic disease (9.8 day). 6. The male: female ratio of chronic rheumatic heart disease is 34.56 : 65.44 (in-patient) and 34. 67 : 65.33 (out-patient). The consultation rate(case per 1,000 persons) was increased from 1.11 in 1983 to 1.30 in 1985, showing annual increase of 8.22 %. The duration, visiting day, was decreased slightly, but medication day wasincreased from 13.93 in 1983 to 16.72 in 1985, showing annual increase of 9.56%. 7. The male: female ratio of hypertensive disease (case) was 39.36 : 60.64(in-patient) and 40.67 : 59.33 (out-patient). The consultation rate was increased from 19.59 in 1983 to 25.36 in 1985, showing annual increase of 13.78%. Duration, visting day was decreased slightly, but medication day was increased from 11.82 in 1983 to 12.77 in 1985, showing annual increase of 3.94%. 8. The male： female ratio of chronic pulmonary-ischaemic heart disease (case) was 48.90 : 51.10 (in-patient) and 43.66 : 56.34 (out-patient). The consultation rate of chronic pulmonary-ischaemic heart disease was increase from 0.69 in 1983 to 1. 12 in 1985, showing annual increase of 27.40％. Duration, visiting day, was decreased from 2.67 in 1983 to 2.36 in 1985, and medication day was decreased from 0.69 in 1983 to 1.12 in 1985, showing annual decrease of 2.09%. 9. The male: female ratio of cerebrovascular disease (case) was 47.90 : 52.10 (in-patient) and 52.28 : 47.72 (out: patient). The consulatation rate was increased from 2.12 in 1983 to 2.89 in 1985, showing annual increase of 16.76%, Duration, visiting day, was decreased slightly, but medication day was increased from 12. 67 in 1983 to 13.85 in 1985, showing annual increase of 4.55%. 10. In case of artery and capillary disease, the male: female ratio of case was 61.80 : 38.20 (in-patient) and 51.77 : 48.23 (out-patient). But durntion, visiting day, was increased from 3.45 in 1983 to 3.60 in 1985, showing annual increase of 2.15 % and the medication day was increased from 10. 06 to 10.18, showing annual increase of 0.59%.

• Journal of Chest Surgery
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• 제24권2호
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• pp.143-152
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• 1991

From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from 1 month to 9 years [mean 2.1 years]. Six patients had truncus type I, 3 patients had truncus type II, and one patients had truncus type IIIc. Right ventricular pulmonary artery continuity was established with a porcine valved conduit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventricular /left ventricular pressure ratio ranged from 0.4 to 0.71 [mean 0.51${\pm}$0.14]. The lung histology revealed grade II pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital [50%], and they were less than 2 year of age. One patient, who had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with postoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months [range 1 to 78 months]. Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation. Although results in infants less than 2 years old have not been good, current improvement of intra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.155-164
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• 2002

본 연구는 일개 보건지소에 등록된 고혈압 환자의 치료율 및 관리율을 구하고 치료지속성과 관련성이 있는 변수를 파악하고 치료중단 이유를 조사하기 위하여 2000년 11월 이전에 군남면 보건지소에 등록되어 치료받고 있는 고혈압 환자 295명을 대상으로 하여, 의무기록조사와 전화설문조사를 병행하여 실시되었다. 그 결과는 다음과 같다. 1. 대상자 295명중 남자가 108명(36.6%), 여자가 187명 (62.7%)이었으며 평균연령은 남자 64.6세, 여자 66.3 세로 여성에서 더 높았다(p<0.05). 2. 대상자의 54.9%가 지속적인 치료를 받는 것으로 조사되었고, 간헐적 치료군이 19.3%, 치료중단군이 25.8%였다. 3. 성, 연령, 의료보장, 거주지 등 연구대상자의 특성중 거주지로부터 보건지소까지 이동시 소요되는 시간만이 치료지속성과 통계적으로 유의한 관련성이 있었다(p<0.01). 3. 치료중단의 이유로는 증상 또는 몸의 불편함이 없어서가 23.9%를 차지하였고 그 다음으로 타의료기관 이용(18.4%), 교통의 불편(17.9%), 약국 이용(14.9%), 거동 불가능(7.5%), 경제적인 이유(6.0%), 보건지소 서비스에 불만족(4.4%) 순이었다. 4. 전체 대상자 295명의 평균 치료혈압은 $144.9{\pm}12.9/86.9{\pm}8.6mmHg$이었고, 이들 중 평균 치료혈압 이 140/90mmHg 미만으로 적절히 조절되는 환자는 32.5%였다. 이러한 연구결과를 종합해 볼 때, 보건지소 고혈압 환자들의 낮은 치료율, 관리율을 개선하기 위해서는, 적극적인 추후관리와 고혈압에 대한 환자의 잘못된 인식을 교정해주는 효과적인 보건교육을 포함하는 보다 체계적인 고혈압 관리 사업이 요구된다고 하겠다.

• 동의생리병리학회지
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• 제21권1호
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• pp.303-307
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• 2007

This clinical experience reports the effect of wood and fire acupoints therapy on a hypertensive patient. Wood acupoint indicates Jing point in yin channel or Shu point in yang channel. Fire acupoint is Jing in yin channel or Jing in yang channel among the five acupoints of Jing, Xing, Shu, Jing and He. The patient was treated with indicated acupoints of 7 channels: lung, large intestine, spleen, pericardium, triple warmer, heart and liver, for 5 weeks. In case of necessity, another acupoints were added with wood and fire acupoints. After 5 weeks treatment, the blood pressure improved by 125/80 which is in normal level. This result suggests that wood and fire acupoints therapy is effective in the treatment of hypertension.

• 대한간호학회지
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• 제31권6호
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• pp.998-1011
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• 2001

In order to improve self-management of elderly hypertensives in this study, the researcher examined the effect of blood pressure regulation by an abdominal relaxed breathing training which regulates physical response to stress and lessens the activity of the sympathetic nerve. Method: A quasi-experimental pre-test and post-test design was used. Thirty elderly hypertensive patient ; Sixteen in the abdominal breathing group and fourteen in the control group participated in this study. The abdominal relaxed breathing training consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Result: 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of total stress response, physical stress response, behavioral-cognitive stress response between the experimental group and control group over three different times, and interaction by groups and over time. Conclusion: Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.