• Title/Summary/Keyword: Hypertensive patients

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Wall Shear Stress Between Compliant Plates Under Oscillatory Flow Conditions: Influence of Wall Motion, Impedance Phase Angle and Non-Newtonian Fluid (맥동유동하에 있는 유연성 있는 평판 사이의 벽면전단응력: 벽면운동과 임피던스 페이즈 앵글과 비뉴턴유체의 영향)

  • Choe, Ju-Hwan;Lee, Jong-Seon;Kim, Chan-Jung
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.25 no.1
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    • pp.18-28
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    • 2001
  • The present study investigates flow dynamics between two dimensional compliant plates under sinusoidal flow conditions in order to understand influence of wall motion, impedance phase angle (time delay between pressure and flow waveforms), and non-Newtonian fluid on wall shear stress using computational fluid dynamics. The results showed that wall motion induced additional terms in the streamwise velocity profile and the pressure gradient. These additional terms due to wall motion reduced the amplitude of wall shear stress and also changed the mean wall shear stress. The trend of the changes was very different depending on the impedance phase angle. As the impedance phase angle was changed to more negative values, the mean wall shear stress decreased while the amplitude of wall shear stress increased. As the phase angle was reduced from 0°to -90°under $\pm$4% wall motion, the mean wall shear stress decreased by 12% and the amplitude of wall shear stress increased by 9%. Therefore, for hypertensive patients who have large negative phase angles, the ratio of amplitude and mean of the wall shear stress is raised resulting in a more vulnerable state to atherosclerosis according to the low and oscillatory shear stress theory. We also found that non-Newtonian characteristics of the blood protect atherosclerosis by decreasing the oscillatory shear index.

A Survey of Hypertension Treatment in Korean Medicine (고혈압 한의 진료 실태조사)

  • Kang, Ja-yeon;Kang, Ki-wan;Jeong, Min-jeong;Kim, Hong-jun;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.1022-1029
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    • 2016
  • Objectives: This study surveyed doctors of Korean medicine on how they treat hypertension in their Korean clinical practices. Methods: An invitation to take an Internet-based questionnaire was sent to doctors who were registered in the Association of Korean Medicine in September 2016. Participants were first asked general profile questions, which included age, gender, work experience as a practitioner, and specialties. Second, they were asked whether they had experience with hypertension treatment and additional questions related to hypertension. Results: A total of 991 replies were received to the questionnaire. Most of the Korean medical doctors (95%) had blood pressure units and had monitored blood pressure. A majority of the Korean medicine doctors (55%) had provided hypertension treatment. Acupuncture and herbal medicine were commonly used for the treatment of hypertensive patients. In addition, bloodletting, moxibustion, pharmacopuncture, cupping, Chuna, Qigong exercise, meditation, and Tai Chi were used. Many doctors also recommended lifestyle modification. The respondents said that Korean medicine improves general health conditions (42.6%) and has low adverse effects (29.9%). One of the most common opinions about the revitalization measures of Korean medicine was expanding health insurance benefits (20.8%). Conclusions: Through this survey, we found out information about the present situation of hypertension treatment in Korean medicine. In the future, it is possible that hypertension treatment using Korean medicine will be demanded and used by practitioners if it is covered by public health insurance.

Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods (유동식 및 고형식을 이용한 동위원소 식도통과검사의 임상적 의의에 대한 연구)

  • Choe, Jae-Gol;Lee, Min-Jae;Song, Chi-Wook;Hyun, Jin-Hai;Suh, Won-Hyuck
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.61-72
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    • 1995
  • The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2 % and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm (DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

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A Clinical Case Report On The Patient With Pheochromocytoma (갈색세포종 환자 1례의 임상증례(臨床證例) 보고)

  • Kim, Guk-Bum;Han, Jong-Hyun;Han, In-Sun;Kim, Eun-Gon;Lee, Jung-Hi;Kang, Beung-Chul;Seung, Kyung-Wha;Choi, Young-Kuy;Shim, Yun-Seub
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.281-289
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    • 2005
  • Objective : Pheochromocytoma may arise within the adrenal medulla, or in other locations, where symptheic ganglia or chromaffin tissues are known to exist. Approximately 0.1 % of hypertensive patients have Pheochromocytoma, This study is to report the clinical effects of ShiHo-GuiZhiTang on pateints who have suffered from such symptoms of Pheochromocytoma as sweating, hypertention, Indigestion, anxiety neurosis, nausea, headache, and epigastric discomfort. Method : ShiHo-GuiZhiTang was used for a patient who had suffered from symptoms of Pheochromocytoma which was diagnosed as Banpeubanri-jueng of soyang disease in Sanghan-Ron. Result : In treating the patient with symptoms of Pheochromocytoma with ShiHo-GuiZhiTang, results were good. Conclusion : The results of this study suggest that ShiHo-GuiZhiTang is effective for such symptoms of Pheochromocytoma as sweating, hypertention, Indigestion, anxiety neurosis, nausea, headache, and epigastric discomfort.

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The Effect of LR3 Acupuncture on Blood Pressure and C-fos Expression in Hypertensive Rats Induced by 2K1C (침자(鍼刺)가 혈압(血壓) 및 신경계(神經系) 혈압중추(血壓中樞) c-fos 발현에 미치는 영향(影響))

  • Kang Dong-Hwan;Yun Yeo-Chung;Kim Jeong-Sang;Kim Won-Jae;Na Chang-Su
    • Korean Journal of Acupuncture
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    • v.19 no.1
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    • pp.47-56
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    • 2002
  • The frequency of the hypertension is increasing as the life level is improved and an average span of the life is extended since we approached modern stage. The hypertension is also dangerous disease which raises fatal complication for example with the bleeding aproplexy and the ischemic attack. The medicinal treatment about the hypertension is required patients to take continually. The acupuncture have been introduced because a medicine-chemical treatment hasn't good influence on the human body. It recently has been processed that studies acupuncture effect for blood pressure and have been found out that blood pressure go down. The object of this study observe the effect of LR3 acupuncture on hypertension in Renal Hypertension RAT induced by 2K1C. The 2K1C model was based on renin-angiotensin system. We put the silver clip in renal artery to induce renal hypertension. We try to observe that LR3 acupuncture influence on the blood pressure and c-fos expression in CVLM, NTS, RVLM. In results, the blood pressure was decreased during acupuncture than before acupuncture, after acupuncture. The heart rate was also decreased during acupuncture than before acupuncture, after acupuncture. The LR3 acupuncture significantly effects on blood pressure and heart rate (P<0.05). The increased expression of c-fos was shown in CVLM, NTS, but not in RVLM. In conclusion, LR3 was relived the action of control upon the hypertension and related with medulla, particularly CVLM, NTS. It needs to be closely examined pharmacological mechanism and studied combination with other acupoints.

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Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors (공중보건의의 고혈압 진단 및 치료과정 평가)

  • Song, Yun-Mi;Kim, Yoon;Cho, Hong-Jun;Jeong, Hoi-Suk;Kim, Yong-Ik
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.126-143
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    • 1996
  • Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

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Review of Analysis of the Effect of Tai Chi Exercise on Blood Pressure and Cardiopulmonary Function (타이치 운동이 혈압과 심폐기능에 미치는 영향에 대한 논문 분석)

  • Eun, Young;Lee, Hea-Young;Choi, Jung-Hyun;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.12 no.2
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    • pp.132-142
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    • 2005
  • Purpose: The purpose of this study is to analyze the effect of Tai Chi exercise on Cardiorespiratory function and to identify directions for future research. Method: 19 articles from Medline search of english journals(1981-2004) and 2 from Korean nursing journals were surveyed. The contents analysis were focused on outcome measures and relative factors regarding cardiopulmonary function. Results: There are 21 articles including 8 articles with quasi experimental design, 7 articles with randomized controlled design and 6 articles with comparative non experimental research design. The major subjects of research were older adults, but hypertensive patients, cardiac rehabilitative patient, and osteoarthritic patient also included. The major style of Tai Chi was Yang style with 108-form. The duration of Tai Chi exercise was from 12weeks to 13.2 years in comparative non experimental studies, but 6 weeks to 16weeks in randomized controlled experimental studies. The most effective duration for cardiopulmonary function was over 16weeks. The variables for cardiopulmonary function were blood pressure, heart rate and cardiopulmonary function via $VO_2$ max(ml/kg/min). To reduce the blood pressure in the result was found in 2 articles, to reduce the heart beat was found in 1 article, to improve the cardiopulmonary function via $VO_2$ max in results were found in 7 articles(73%) among 11 articles. Conclusion: The Tai Chi exercise over 16weeks improves the cardiopulmonary function. It is suggested that to verify the effect of Tai Chi on cardiopulmonary function, the difference of gender, age, health status will be identified through repeated experiments.

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Postanesthetic Cerebral Infarction Following Neck Dissection -A case report - (경부청소술 마취 후 발생한 뇌경색 -증례 보고-)

  • Park, Chang-Joe;Lee, Jong-Ho;Kim, Myung-Jin;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.1 s.4
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    • pp.34-37
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    • 2003
  • Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

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Study on methodology about clinical effect of single point acupuncture in patients with hypertension (단일경혈을 이용한 침의 임상효과에 관한 방법론 연구 - 고혈압 환자를 중심으로 -)

  • Son, Yang-Sun;Yeo, Soo-Jung;Kim, Yoon-Ju;Park, You-Sun;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.29 no.1
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    • pp.23-36
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    • 2012
  • Objectives : This study was conducted to investigate effective treatment point selection method using oppressive pain in acupoints as elementary attempt for standard methodology of clinical acupuncture studies. Methods : Twenty seven subjects with hypertension or within prehypertension category - systolic and diastolic blood pressure (BP) over 120/80mmHg - were divided into two groups, oppressive pain point treatment group and oppressive painless point treatment group. In oppressive pain point treatment group, single point acupuncture (SPA) was conducted for 16 sessions during 8 weeks on most oppressive painful point among 6 selected acupuncture points used in previous trials and clinic. As a SPA intervention, 15 minutes with deqi sensation- elevating manipulation was conducted on the treatment acupoint. Same process was conducted in oppressive painless point treatment group on most oppressive painless point with subject blinding. Results : Significant reduction was observed in both systolic and diastolic BP after short time intervention (15.5/8.8 mmHg, 10.7/7.1 mmHg, P<0.05, respectively at 1 week) and maintained for 8 weeks intervention period in all groups (12.8/8.0 mmHg, 19.4/12.6 mmHg, P<0.05, respectively). No significant difference of BP change between oppressive pain point treatment group (N=10) and oppressive painless point treatment group (N=9) was observed during 8 weeks study period. Conclusions : SPA treatment as used in this pilot study was effective for lowering BP in mild hypertensive population, but oppressive pain in acupoint had no effect on treatment. This present result suggests the possibility of SPA for hypertension treatment regardless of oppressive pain.

The Association between cardiovascular disease and Periodontal Disease on Convergence Study in Adults over Age 40. (40세이상 성인의 심혈관질환과 치주질환 관련성에 관한 융합적 연구)

  • Lee, Yeon-Kyoung;Kim, Min-A
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.65-71
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    • 2019
  • The purpose of this study was to investigate the relationship between cardiovascular disease and periodontal disease. The subjects were 3,149 adults over 40 years of age using the third year National Health and Nutrition Examination Survey (2015). Data were analyzed using the SPSS 22.0 program. As a result, the relationship between cardiovascular disease and periodontal disease was 1.27 times higher in obesity group compared to normal group, when adjusted for disturbance variables (age, smoking status, drinking status, income) In hypertensive patients, the hypertension group had a 1.32-fold higher risk of periodontal disease when the disturbance variables (age, smoking status, drinking status, income) were adjusted compared to those without hypertension. Therefore, cardiovascular disease is associated with periodontal disease, and it can be used as a good basis for educational and preventive measures to reduce or prevent the incidence of cardiovascular disease and periodontal disease in the future.