• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.923-928
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• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.

• 대한치과마취과학회지
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• 제10권2호
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• pp.183-189
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• 2010

Medical emergencies are not rare in dental practice but when an emergency does occur it can be life-threatening. Medical emergency such as hypertensive crisis can be encountered in dental practice and the dentist should be competent in emergency management by taking life support courses. This report shows 3 cases of hypertensive crisis during dental treatment and we discuss proper management of the patients. The medical and dental management for the hypertensive crisis included a correct diagnosis, pharmacological usages for pain control and stress relieving environment making.

• 대한핵의학회지
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• 제8권1_2호
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• pp.1-11
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• 1974

The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto es during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1. Plasma volume was increased in the patients during the oliguric-and hypertensive diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2. Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3. Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4. Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5. Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance in these cases. Relatively increased circulating blood volume due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6. Cardiac hemodynamic alteration returned to normal during late stage of the diuretic phase, while renal hemodynamic changes were normalized at six months after the onset.

• 한국임상약학회지
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• 제21권4호
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• pp.364-375
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• 2011

Given that single blockade with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) can achieve only partial and undurable suppression of the Renin Angiotensin System (RAS), it has been hypothesized that dual blockage would be more beneficial in the management of blood pressure (BP) reduction and prevention of progressive chronic kidney disease (CKD) than either agent alone. Thus, it has been suggested that the combination of an ACEI and an ARB might provide renal benefits to hypertensive patients over and above BP reduction. However, this might also expose patients to additive or synergistic side effects. We attempted to conduct a systematic review to evaluate the benefits and harms of combination therapy in hypertensive patients with or without kidney diseases. MEDLINE and KoreaMed were searched for relevant randomized clinical trials in adult hypertensive patients with or without diabetes (restricted to 1997, limited to trials published in English). Results were summarized using the random-effects model, and between-studies heterogeneity was estimated with $I^2$. A final analysis of ten trials (23,928 patients) revealed that the combination of an ACEI and an ARB reduced blood pressure (SBP/DBP) by 3.95/2.02 mmHg (95% confidence interval [CI], -4.38 to -3.53/-2.33 to -1.71) compared with ACEI monotherapy, and 2.83/2.64 mmHg (95% CI, -3.25 to -2.41/-4.95 to -0.33) compared with ARB monotherapy. Eight trials (391 patients) demonstrated a significant reduction in 24h-proteinuria (weighted mean difference, 0.16 g/day, 95% CI, -0.26-0.05), but they did not translate into an improvement in GFR. Tests for heterogeneity showed no difference in effect among the studies. The combination therapy reduced proteinuria by 30% (95% CI, 23% to 37%) and 39% (95% CI, 31% to 48%) compared with ACEI monotherapy and ARB monotherapy, respectively. However, in patients who had proteinuria more than 0.5 g/day, the combination therapy failed to show significant reduction in urinary protein excretion. The current cumulative evidence suggests that diabetic patients with proteinuria on dual RAS blockade have an increase risk of adverse events such as hyperkalemia, hypotension, and so on, compared with ACEI or ARB alone. It is, therefore, proposed that the combination therapy should not be routinely used for the treatment of hypertension with or without compelling indications.

• 보건행정학회지
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• 제3권2호
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• pp.25-56
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• 1993

Hypertension has already become a serious health problem in many countries. Treatment is effective, however, and the detection and long-term management of those at risk pose sustained challenges. Community programs can be an important strategy for primary prevention of hypertention and for monitoring the progress and promoting compliance of hypertensive patients. Hwachon Health Demonstrain Project has designed community hypertention control program, especially emphasizing role of public health sector, and operate that model from 1990 at Hwachon county, Kwangwon province. This paper appraise the effectiveness of curent activities. Many paper appraise the effectiveness of curent activities. Many hypertensive persons who have not recognized his disease were identified and began hypertension treatment. However about two thirds of patients have not complied continuously with medical advice. Consequently, the project team redirects its efforts. Less emphasis is being placed screening and identification of patients, while more emphasis is being placed on increasing compliance with treatment recommendations. Some approches to improve hypertension control program are also discussed in the context of the field experience and literature on this suvjest.

• 대한지역사회영양학회:학술대회논문집
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• 대한지역사회영양학회 2000년도 추계학술대회:통일한국을 대비한 영양감시체계 개발
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• pp.106-106
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• 2000

• 대한간호
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• 제7권1호통권33호
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• pp.30-35
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• 1968

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 1999년도 제4차 추계학술대회 초록집
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• pp.40-40
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• 1999

• 가정의학회지
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• 제39권6호
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• pp.323-324
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• 2018

• 융합정보논문지
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• 제10권7호
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• pp.58-66
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• 2020

본 연구의 목적은 고혈압환자의 생애주기별 건강행태와 삶의 질과의 관계를 파악하는 것이다. 본 연구는 2017년 지역사회건강조사의 자료를 가지고 2차 자료를 분석하여 실시하였다. 연구대상은 고혈압을 진단받은 총 62,056명을 대상으로 삼았다. 자료분석은 SPSS WIN 20.0을 이용하여 분석하였다. 연구결과 첫째, 고혈압치료 및 약물순응도는 성인기에서 중장년기, 노년기보다 훨씬 낮게 나타났다. 둘째, 생애주기별 삶의 질 점수는 성인기가 가장 높았고 연령이 증가할수록 낮아지는 것으로 확인되었다. 셋째, 건강행태에 따른 삶의 질은 생애주기 전반에서 음주, 운동, 저염식이에 따라 차이를 보였다. 본 연구에서 제시된 결과를 고려하여 고혈압환자의 평생 건강관리를 위한 생애주기별 보건교육이 필수적임을 시사하며, 특히 성인기의 고혈압환자의 약물순응도를 높일 수 있는 방안을 개발하고, 삶의 질을 향상을 위한 건전한 건강행태를 가질 수 있도록 교육 및 의학적 접근 등 융복합적 접근이 필요할 것으로 판단된다.