• Title/Summary/Keyword: Hypertensive patients

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Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

  • Gimm, Geunwu;Chang, Young;Kim, Hyo-Cheol;Shin, Aesun;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Yoon, Jung-Hwan;Kim, Yoon Jun
    • Gut and Liver
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    • v.12 no.6
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    • pp.704-713
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    • 2018
  • Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Analysis of Factors Affecting Medication Adherence to Improve Life Care in Patients with Hypertension (고혈압 환자의 라이프케어 증진을 위한 약물 순응도 영향요인 분석)

  • Gil, Eun-Ha
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.2
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    • pp.213-224
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    • 2020
  • Purpose: This study is a descriptive and secondary analytical study that uses panel data to identify the factors of medication adherence to improve life care of hypertensive patients. Methods: The subjects of this study were 2,484 patients who were taking medication after hypertension using Korea Medical Panel 2015 data (β-version 1.0). Data analysis was performed using Chi-Square, Scheffe's test, and logistic regression using SPSS/win 22.0. Results: The level of medication adherence in patients with hypertension was 94.2%. The factors of medication adherence were gender and age in Model I of demographic factors, and the presence of disability, smoking, and drinking in Model II. Model III, which added drug use factors, was identified as drinking, drug duration, side effects, drug satisfaction, and payment of drug costs. Conclusion: In order to improve life care for hypertension patients, education and interventions on the importance of take medication and side effects of medications and how to take them will be needed in the early stages of diagnosis.

The Condition of Controlling Blood-pressure and the Use of Oriental Medical Services in Hypertensive Patients (고혈압(高血壓) 환자(患者)의 혈압관리실태(血壓管理實態)와 한방이용(韓方利用) 현황(現況))

  • Shin, Taek-Su;Yoo, Seong-Gi;Chong, Myong-Soo;Lee, Ki-Nam
    • The Journal of Traditional Korean Medicine
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    • v.15 no.1
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    • pp.128-144
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    • 2006
  • This Study aims at looking into the use of oriental medical services in treating hypertension. The first objective to be explored through this study is the morbidity caused by the disease, classifying them by age, gender, and occupation. The second is to determine the regular use of anti-hypertensive medicine and their efficacy in controlling blood-pressure. The third is to investigate the use-rate and satisfaction of oriental medical service. 838 households across the country, were asked to answer questionnaires for the period of time from Apr. to Jun. 2005. The conclusion from the survey can be summarized as following. The age of which the first medical diagnosis of hypertension were made showed lower in males, those with higher education and income. The study showed females were more active in blood-pressure control, with their frequent monitoring of blood-pressure for the past year. With age, people in under 50 age group proved to be less active. The management of high blood pressure was more effective in group with regular dosage compared to group with irregular use of anti-hypertensive medication, but their difference was minimal. Also, group with no medication showed signs of blood-pressure control. The use of oriental medical service for the past year, were more frequent in groups with lower education, either low or high income, old age, females and occupations in agriculture, forestry and fishing industry. Results were similar in both general population and high blood-pressure patient group. Females, people over 51 years old and with lower education showed more intentions in utilizing oriental medical services in the future. Results were similar in both general population and high blood-pressure patient group. It is necessary to offer a more accurate information on oriental medical treatments. Also, a systematic reform to reduce the patient's share of the treatment cost, as well as, heightening public awareness on the infirmity of present blood-pressure management system is crucial.

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Automatic Blood Pressure Control Using PI Controller with $H_{\infty}$ Loop-Shaping

  • Han, Jeong-Yup;Lee, Sang-Kyung;Park, Hong-Bae
    • 제어로봇시스템학회:학술대회논문집
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    • 2004.08a
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    • pp.326-329
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    • 2004
  • In this paper, we show a new form of blood pressure controller combined PI control with $H_{\infty}$ loop-shaping. Hypertensive patients or post-operative patients need to maintain normally blood pressure. Exact regulation of blood pressure is needed for maintaining variable blood pressure of preventing complications. The regulation of blood pressure is achieved by injecting drugs, and usually sodium nitroprusside is used as those kinds of drugs. It is necessary to control the infusion rate sodium-nitroprusside carefully to achieve the desired blood pressure. It has been known that regulation of blood pressure by automatic controller is more effective than regulation of blood pressure by human operators. The control of blood pressure has many constraints and uncertainties. Most of biological system has the time-varying variables and the side effects such as increased risk of sepsis and organ failure. To solve such a problem, we design a new robust PI controller using $H_{\infty}$ loop-shaping to decrease noise effects that come out from human body and errors for time delay. The system with designed controller shows more stable control of mean blood pressure and more robust performance for uncertainties. Validation methods for the control performance are confirmed to computer simulations.

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The Case-Control Studies Between The Single Nucleotide Polymorphisms of the Human SA and MTHFR Gene and Hypertension in Korean Population

  • Kang, Byung-Yong;Bae, Joon-Seol;Kim, Ki-Tae;Lee, Kang-Oh;Kang, Chin-Yang;Chung, Ki-Wa;Oh, Sang-Duk
    • Environmental Mutagens and Carcinogens
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    • v.22 no.3
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    • pp.157-163
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    • 2002
  • The role of the kidney in initiating hypertension has been much debated. The SA gene is expressed in the kidney and is association with hypertension in man and in experimental animal models. Also, increased plasma concentrations of homocysteine have been found in patients with coronary artery disease (CAD) and hypertension. The genetic variation of methlene tetrahydrofolate reductase (MTHFR) gene is related to its enzyme activity and to the plasma homocysteine concentration. In view of the effect of SA and MTHFR as risk factor for cardiovascular diseases, we investigated the Pst I RFLP of the SA gene and C667T mutation of the MTHFR gene in the Korean patients with hypertension. There were no significant differences in the allele and genotype frequencies of these polymorphisms between normotensive and hypertensive subjects. Therefore, our results do not support a possible role of these genes on hypertension in Korean population.

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The Clinical Study of 12 Cases of Paralyric Ileus Patients Treated with Bo-Ryu Enema (보류관장을 시행한 마비성 장폐색환자 12례에 대한 임상적 고찰)

  • Lim, Joon-Seek;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.20 no.1
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    • pp.210-221
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    • 1999
  • A clinial observation was done on 12 cases of paralytic ileus patients, treated by Bo-Ryu Enema(保留灌腸), who were hospitalized from May 1, 1995 to October 31, 1996 at the Department of Oriented Internal Medicine II, Oriental Medicine Hospital. Taejon University. The results were as follows; 1. The ratio between male and female was 1 : 1.4. The distribution of age. 70' years or over, 60', 50' years generation were revealed in turn. 2. In classiffication of human coporeal constitution, Soeumin(少陰人) were 9 cases(75.0%), Taeumin(太陰人) 2 cases (16.7%), Soyangin(少陽人) 1 case (8.3%). 3. In distribution of disease on admission, Stroke sequela was the most number with 7 cases(58.3%), Stroke 3 cases(25.3%). Hypertensive encephalopathy and Brain tumor were 1 case, each other. 4. The effect of treated by Bo-Ryu Enema was as follows: Each of Excellent(良好) and Good(好戰) were 6 cases(50%) but. Fair(別無好戰) and Poor(惡化) were no case.

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Pharmacokinetic Changes of Acebutolol after Orall Administration in Rabbits with Diabetes Mellitus Induced by Alloxan

  • Choi, Dong-Hyun;Bae, Hak-Yeon;Choi, Jun-Shik
    • Archives of Pharmacal Research
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    • v.26 no.6
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    • pp.499-503
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    • 2003
  • Because physiological changes that potentially alter pharmacokinetics occurs in diabetes mellitus patients, pharamacokinetics of drugs used in the treatment of hypertension was studied using acebutolol as a model anti-hypertensive drug. Thus, the pharmacokinetics of acebutolol was investigated after oral administration of acebutolol (15 mg/kg) to control rabbits and rabbits with acute or chronic diabetes mellitus induced by alloxan. Kidney and liver functions were documented for acute and chronic diabetes mellitus groups based on plasma chemistry data. After oral administration of acebutolol to acute and chronic groups, the plasma concentrations appeared higher; As a result, area under the plasma concentration-time curve from time zero to time infinity10575 and 8668 $\mu g\cdot$ h/mL for acute and chronic group, respectively. In comparison, the area was apparently smaller in the control group (i.e., 7132 $\mu g\cdot$ h/mL). The half-life in acute groups was significantly prolonged 8.45 h compared with the half-life in the control group (i.e., 6.30 h). Alteration in acebutolol pharmacokinetics was more pronounced in the acute group as evidenced by the significantly higher values the area under the plasma concentration time curve, absorption rate constant and maximum plasma concentration compared with chronic or control group. Therefore, these observations indicate that acebutolol pharmacokinetics may be affected in patients with diabetes mellitus, especially in the early stage of the disease.

Analysis of Pulsating Flow in Elastic Parallel Plates and an Elastic Pipe Model Using Moving Boundary Algorithm (이동경계 수치해법을 이용한 탄성평판 및 탄성관 모델내의 맥동유동 해석)

  • Park Hyung Gyu;Kim Charn-Jung;Lee Chong-Sun
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.29 no.4 s.235
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    • pp.425-434
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    • 2005
  • In order to analyze pulsating flows in elastic blood vessels, a method based on the ALE concept and finite volume method was reformed and modulated to include wall motion of elastic vessels and impedance phase angle(phase difference between wall motion and blood flow). Our study indicated wall shear rates(WSR) were significantly influenced by the wall motion and the impedance phase angle. For larger wall motion more than $5{\%},$ the computed WSR started to deviate from the results of the perturbation theory that assumed smaller wall motion. The study showed that oscillatory shear index increased as the impedance phase angle became more negative like $-70{\circ}\;or\;-80{\circ}$ due to reduced mean WSR and increased amplitude of WSR. This result indicated that hypertensive patients are more vulnerable to atherosclerosis than normal persons because of the role of more negative impedance phase angles usually observed in these patients.

Successful use of a mesocaval shunt to treat refractory ascites in a chronic pancreatitis induced portal vein thrombosis

  • Souradeep Dutta;Bishal Pal;Duvuru Ram;Sreevathsa Kadaba Shyamprasad;Vishnu Prasad Nelamangala Ramakrishnaiah
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.204-209
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    • 2022
  • The state of intense peripancreatic inflammation in chronic pancreatitis can give rise to various vascular complications such as venous thrombosis and arterial pseudoaneurysms. Due to its intimate location with the pancreas, spleno-mesenteric-portal axis suffers the greatest blunt of thrombotic complications. Treatment modalities for such cases of chronic portal vein thrombosis have always been controversial and challenging. Medical management with anticoagulants is both risky and unsatisfactory due to presence of varices, hypersplenism, and persistence of the inflammatory pathology. Although endovascular techniques have been tried in various case reports, there are definite anatomical challenges in cases of long segment porto-mesenteric thrombosis with massive ascites. Surgical shunts have been historically described for cirrhotic and non-cirrhotic portal hypertensive patients. However, its use in patients with refractory ascites due to chronic pancreatitis induced portal vein thrombosis has not been reported in the medical literature. Here, we present a case of an extensive portal vein thrombosis with massive refractory ascites in a patient with alcohol-induced chronic pancreatitis successfully treated with a surgical mesocaval shunt using an interposition small diameter graft.

Association between Genetic Variation in the Human Factor Ⅶ Gene and Essential Hypertension in Korean Population

  • Shin, Jung-Hee;Kang, Byung-Yong;Lee, Kyung-Ho;Lee, Chung-Choo;Kim, Ki-Tae
    • Environmental Mutagens and Carcinogens
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    • v.21 no.2
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    • pp.106-112
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    • 2001
  • In view of the effect of factor Ⅶ as a risk factor for essential hypertension, we investigated the length (I/D) polymorphism at position 323 promoter region and exon 8-Msp I RFLP of the human factor Ⅶ gene in the Korean patients with essential hypertension and normal controls. There were no significant differences in the allele, genotype and haplotype frequencies of these polymorphisms between normotensive and essential hypertensive subjects. The significant linkage disequilibrium was however, detected between two polymorphic sites. The Msp I RFLP and I/D polymorphism were also significantly associated with plasma triglyceride (TG) levels. Therefore, our results suggest that the significant association between two genetic variations in the human factor Ⅶ gene and plasma TG level may reflect the potential role of human factor Ⅶ gene as one of the genetic components for cardiovascular risk.

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