• Title/Summary/Keyword: Hypertensive patient

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Primary Aldosteronism by Adenoma 1 Case (부신선종으로 인한 원발성 알도스테론증 환자 1례)

  • Lee, Kyung-Jin;Koo, Bon-Soo;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.20 no.1
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    • pp.280-285
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    • 1999
  • We report 1 patient with Primary aldosteronism caused by malfunction of adrenal gland. which occupies 1-2% of the whole Hypertensive disease. The patient was 35 year-old female with the history of hypertension. She was hospitalized at Department of Circulatory Internal Medicine. College of Oriental Medicine, Kyung Hee University, Seoul, because of low limb weakness, chest discomport, palpitation and dry mouth. The value of serum potassium level was o.6 and at last adenoma was diagnosed on the basis of abdomen CT scan. The Primary aldosteronism manifests myasthenia, headache, dry mouth, palpitation. In laboratory findings, it especially shows specific U -wave in EKG due to low serum potassium level resulted from excessive flow-out through urine. It could be regarded as ‘Flaccid paralysis of Limbs(?症)‘, the Oriental medical term which indicates a condition of general weakness. We report on this case with a review of literature.

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A Qualitative Study on Management Behaviors about Blood Pressure of Participants in Moxibustion Clinical Trial for Hypertension (고혈압-뜸 임상시험 참여자들의 혈압 관리행동에 대한 질적연구)

  • Moon, A-Ji;Kim, Tae-Jung;Lee, Seoung-Geun;Kim, Nam-Kwen;Lee, Key-Sang
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.543-557
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    • 2012
  • Objectives : The purpose of this study which adopted a qualitative method was to evaluate blood pressure management behaviors of pre- and stage 1 hypertension patients and to provide fundamental data for developing a strategy about proper oriental medical treatment through analyzing factors related to a moxibustion clinical trial. Methods : Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 10 hypertensive patients. The interviews lasted for approximately 50 minutes. Results : Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural and they may have side effects. On future management plan of patients, most of them will continue to keep moxibustion and healthy behavior in the well-controlled blood pressure group. However in the uncontrolled blood pressure group, there was an increasing tendency to begin medication. Conclusions : For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

The Effect of Right Stellate Ganglion Block on Hemodynamics following Endotracheal Intubation (우측 성상 신경절 차단이 기관내 삽관에 따른 심혈관계 반응에 미치는 영향)

  • Oh, Soo-Won;Koo, Gill-Hoi
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.58-63
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    • 1997
  • Background : Endotracheal intubation is one of the methods most securely establishing airway. But accompanying hemodynamic responses are harmful to coronary or cerebral vascular disease patients. These hemodynamic responses are regarded as the results of sympathetic stimulation due to pharyngolaryngeal stimulation, and sympathetic blocking method-stellate ganglion block- may be obtundate these hemodynamic responses. Methods : 75 patients of ASA physical status I-II were selected. There were 40 patients normotensive (Group I), 35 patients hypertensive (Group II) Group I, steliate ganglion block was performed on 20 patients (Group I-S) the remainder had no procedure (Group I-O). Group II, 18 patients received SG3 (Group II-S), 17 patients had no procedure (Group II-O). SGB was performed with 1% lidocaine 8 ml on right stellate genglion after patient's consent. Blood pressure (IIP) and pulse rate(PR) were first measured in the pre-anesthesia room. Follow up BP and PR are checked immediately following SGB and every 5 minutes for subsequent 20 minutes, then after arrival at operatig room, then immediately after intubation and at 3, 5, 10, 15 and 20 minutes after incubation. Results : All group experienced significantly increased blood pressure and pulse rate upon arrival at the pre-anesthesetic and opeating rooms, as compared to when patients rates in the ward. After intubation and for subsequent 5 minutes, significant changes were measured. Patients then recovered to preblock value. In Group I, no statistical significance was recorded between subgroup I-S and I-O. However in Group II, there were significant differences between sub-group II-S and II-O. In evaluating pulse rate changes, there were no significant differences between Group I-S and I-O; nor II-S and II-O. Conclusion : The proper diagnosis of Stellate Ganglion Block had some measure of protective effect on hemodynamics following endotracheal intubation, especially in hypertensive patients.

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The Effect of Individual Education for Hypertensives at Home on Knowledge of Hypertension, Attitude about Chronic Disease, Self-care Management And Blood Pressue. (개별접촉 교육이 고혈압 환자의 지식$\cdot$태도와 자기건강관리 이행 및 혈압 변화에 미치는 영향)

  • Kim Myung Soon;Yang Young Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.52-68
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    • 1995
  • This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

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The depressive effect of S'NC nerve control treatment in hypertension patients (고혈압 환자에서 뇌신경조절의학 S'NC의 혈압강하 효과)

  • Han, Chang-Hyun;Han, Sang-Yeob;Shin, Mi-Suk;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.13 no.3
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    • pp.87-95
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    • 2007
  • Objectives : The aim of this study was to investigate the antihypertensive effect of S'NC nerve control treatment in hypertensive patients. Methods: We measured the blood pressure of 5 patients who were admitted in the Oriental Medical Clinic of S'NC Medicine Research Institute from 19th April 2007 to 29th June 2007. Eligible participants had systolic blood pressure ${\ge}$140mmHg or diastolic blood pressure ${\ge}$90mmHg. Blood pressure measurements were after the patient had been in bed rest for at least 10 min. Ten sessions of S'NC nerve control treatment over 2 weeks were performed in the patients. Blood pressure were measured twice before and after each treatment. Results : After 2 weeks, blood pressure reduction was observed in the treatment patients, with an average decline of systolic blood pressure up to 21mmHg and diastolic blood pressure up to 20mmHg. But, there were not statiscally significant The effects of S'NC nerve control treatment by measuring time on blood pressure were as follows: In a systolic blood pressure(p=0.087) and diastolic blood pressure(p=0.609) was gradually deceased not significantly from 1st to 10th. Conclusion: These results suggest that S'NC nerve control treatment may be efficacious in decreasing arterial blood pressure in hypertensive patients. Controlled trials investigating the efficacy of S'NC nerve control treatment for lowering blood pressure are warranted.

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A Blood Pressure Lowering Effect Only through Complex Korean Medical Treatment, without Antihypertensive Drugs, for Patients with Stress Induced Hypertension - A Case Report (스트레스성 고혈압 환자에서 고혈압 약물 복용 없는 복합한의치료만의 강압 효과 - 증례보고)

  • Lee, Ji-hyun;Roh, Min-yeong;Yoon, Seok-yeong;Jun, Hyung-sun;Han, Yang-hee;Leem, Jung-tae
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.808-819
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    • 2021
  • Objectives: This study considered the effectiveness of integrative Korean medical treatment for stress-induced hypertensive patients without the use of conventional medication. Methods: A 62-year-old female with stress-induced hypertension (HTN) was hospitalized for 33 days. Her pattern identification was ascendant hyperactivity of liver yang (Ganyangsanghang)-type HTN. Herbal medicine and acupuncture were used for the treatment: Cheonggansoyo-san for 33 days and Chunwangbosim-dan for 15 days, together with acupuncture for 20 minutes twice a day. Blood pressure was checked daily during hospitalization with a digital sphygmomanometer in the brachial artery. Results: After 33 days of treatment, blood pressure decreased. The Handicap Inventory (DHI) scale and Pittsburg Sleep Quality Index (PSQI) scores both decreased. The patient also reported fewer complaints. A five-month follow-up after discharge, with no further treatment, confirmed stable blood pressure. Symptom improvements continued with no significant side effects. Conclusions: This study indicates that Korean medical treatment is effective for stress-induced hypertensive patients.

Functional Mediastinal Pheochromocytoma

  • Lee, Jang Hoon;Lee, Seok Soo;Lee, Jung Cheul;Kim, Myeong Su;Choi, Joon Hyuk
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.88-91
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    • 2013
  • A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with ${\alpha}$ and ${\beta}$ blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.

A Successful Prosthetic Correction of Long Narrow Segment Coarctation of the Aorta: Report of A Case (대동맥축착에 대한 Teflon 인조혈관 이식술 치험예)

  • 김근호
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.90-97
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    • 1977
  • This is a report of a. case in which a long narrow segment coarctation of the aorta was successfully corrected with Teflon graft. The patient was 30 year old man with hypertensive symptoms that occurred 7 years prior to operation. Blood pressure measured 230/110 mmHg in the arms and 110/80 mmHg in the legs. Pulses were strongly tensive in radial artery, but very weak in femoral artery and even absent in dorsal pedis artery. Final preoperative diagnosis was made by aortography which showed a long narrow segment between aortic arch and descending thoracic aorta and highly developed collateral circulations. A long hypoplastic narrow segment was located proximal to the ligament arteriosus, and diaphragmatic stenosis of the aorta was located just distal to the ligamentum arteriosus. After prosthetic correction of the coarctation of the aorta, blood pressure were measured 130/ 80 mmHg in the arms and 150/100 mmHg in the legs. Peripheral pulses were palpated normally, and the postoperative course was uneventful.

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Cerebral Aneurysm and Aortic Coarctation in a 46, XY Female. Is it Causal or Coincidental?

  • Ju, Sun-Min;Yi, Hyeong-Joong;Ko, Yong;Kim, Kwang-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.137-140
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    • 2005
  • Most vascular disorders tend to affect both the brain and heart, and among them, a clinical syndrome constituting cerebral aneurysm and aortic coarctation(AC) has been well recognized. Persistent hypertensive impact to the cerebral vasculature with developmental anomaly of the neural crest, precursor of ectomenchymal, would be closely associated with development of the cerebral aneurysm in AC. Gonadal steroid hormone, a guardian of the cardiovascular system, has been known for its protective effects on the vascular wall. Gonadal steroid hormone (androgen) insensitivity such as 46,XY female syndrome may increase the risk of hypertention and subsequent vascular anomalies. The authors report on a 46-year-old 46,XY female patient with AC who underwent surgical clipping of the ruptured cerebral aneurysm. Clinical implications and proposed pathogenetic mechanisms of aneurysm in this intersex syndrome are presented and discussed.

Comparision of medical care utilization between newly detected hypertensive patients and known hypertensive patients (정기건강진단으로 밝혀진 고혈압환자의 의료이용에 관한 연구)

  • Cheon, Byung-Yool
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.47-60
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    • 1988
  • The monthly ambulatory treatment days in newly detected hypertension group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling,959 patients were selected : among them, 544 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of these patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparision to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant variable responsible for ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables reponsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical rare utilization, additional variables should be considered.

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