• 제목/요약/키워드: Ischaemic heart disease

검색결과 10건 처리시간 0.022초

직장의료보험 수진분석을 통한 만성 순환기계질환의 실태연구 (A Study on the Aspects of Chronic Circulatory Disease Through Treatment Analysis of Employee s Medical Insurance)

  • 이길숙;정연강
    • 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%.

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Obestatin is present in saliva: alterations in obestatin and ghrelin levels of saliva and serum in ischemic heart disease

  • Ozbay, Yilmaz;Aydin, Suleyman;Dagli, A. Ferda;Akbulut, Mehmet;Dagli, Necati;Kilic, Nermin;Rahman, Ali;Sahin, Ibrahim;Polat, Veli;Ozercan, H. Ibrahim;Arslan, Nadi;Sensoy, Dogan
    • BMB Reports
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    • 제41권1호
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    • pp.55-61
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    • 2008
  • Ghrelin and obestatin are a single gene products and are a multiple functional peptides that regulates energy homeostasis, and food intake. In the present work, we studied the secretion of ghrelin and its co-secreted peptide obestatin in 44 patients with ischemic heart disease with that of 27 healthy matched controls. Here we first conducted using an immunohistochemistry assay to screen whether human salivary glands have any obestatin immunoreactivity. Then, serum and saliva obestatin and acylated ghrelin levels were determined by using Radioimmunoassay. Our immunohistochemical analysis demonstrated that obestatin was localized in the striated and excretory duct of human salivary gland. We also report for the first time that obestatin, like ghrelin, is present in human salivary gland and saliva. No evidence of the role of obestatin or ghrelin saliva levels in the context of ischemic heart disease was found. Salivary ghrelin and obestatin levels are correlated in controls with the blood levels. Determination of salivary values could represent a non-invasive alternative to serum ones that can be useful in clinical practice.

고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB (Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study)

  • 조현주;정혜진;임사비나
    • 대한한의학회지
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    • 제40권3호
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

Effect of Fibrinogen Genotype and Other Characteristics on Plasma Fibrinogen Levels

  • Mi-Hwa Lee
    • 대한의생명과학회지
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    • 제8권4호
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    • pp.275-282
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    • 2002
  • This study was carried out to investigate the effect of fibrinogen genotype and other characteristics on the plasma fibrinogen levels. Many studies have conformed that high plasma fibrinogen levels are associated with the increased risk of ischaemic heart disease, stroke and arterial disease. And fibrinogen levels are related with age, obesity, cholesterol and alcohol consumption, genotypes. For this study the blood samples were collected from 93 healthy Koreans (66 males and 27 females). The blood samples were individually analyzed by smoking status, cholesterol levels, genotype, age, and gender. The plasma fibrinogen was assayed by clotting method (modified Clauss assay) and cholesterol was assayed by cholesterol oxidase method. Subjects were classified by current smokers, ex-smokers (<6 month), or nonsmokers. The $\beta$-fibrinogen genotype was detected by PCR of relevant region and digestion with HaeIII, with the H$_1$H$_1$ allele allowing cleavage by this restriction enzyme and H$_2$H$_2$ allele being refractory. In conclusion, the study shows that the factor of the increasement in the fibrinogen level was closely related with the cholesterol level, smoking status and genotype (H$_1$H$_2$); but there was no significant difference by gender, Especially, among the people over 50 years of age, fibrinogen level was higher with the increasement of cholesterol level (<200 mg/dl), current smoker, and genotype H$_1$H$_2$.

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Mortality Attributable to Second Hand Smoking in Morocco: 2012 Results of a National Prevalence Based Study

  • Tachfouti, Nabil;Najdi, Adil;Lyoussi, Badiaa;Nejjari, Chakib
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2827-2832
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    • 2016
  • Purpose: To estimate the number of deaths attributable to second hand smoking (SHS) in Morocco in 2012. Materials and Methods: prevalence based study focusing on mortality from ischaemic heart disease (IHD) and lung cancer among non-smokers aged 35 and over. Prevalence of SHS among never smokers was gathered from a national cross sectional survey on tobacco and population attributable risk (PAR) was calculated by applying PARs to mortality. The analyses were stratified by sex, age and area of exposure. Results: Rates for exposure to SHS among men aged 35-64 years ranged from 20.0% at home to 57.4% at work. Among non-smoking Moroccans aged 35 and over, 233 (IC: 147 - 246) deaths were attributable to exposure to SHS; 156 (IC: 100 - 221) in women and 77 (IC: 44 -125) in men. A total of 173 (122 - 222) deaths were estimated to have been caused by exposure only at home, 34 (9 - 76) by exposure only at the work place and 26 (15 - 58) by exposure both at home and work places. Exposure to SHS could be responsible for 182 (128 - 237) deaths from IHD and 51 (19 - 109) from lung cancer. Conclusions: These data confirm that SHS needs urgent attention in Morocco.

의료의 질 평가 우선순위 설정 (Priority Areas for National Health Care Quality Evaluation in Korea)

  • 신숙연;박춘선;김선민;김남순;이상일
    • 보건행정학회지
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    • 제19권3호
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    • pp.1-26
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    • 2009
  • Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

Is aggressive intravenous fluid prescription the answer to reduce mortality in severe pancreatitis? The FLIP study: Fluid resuscitation in pancreatitis

  • Julia McGovern;Samuel J Tingle;Northern Surgical Trainees Research Association (NOSTRA);Stuart Robinson;John Moir
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.394-402
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    • 2023
  • Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

사망원인과 특정사인생명표에 관한 연구 (A Study on The Life Tablefor Specific Causes of Death in Korea)

  • 한동준
    • 한국인구학
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    • 제6권1호
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    • pp.43-69
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    • 1983
  • This study was conducted to make the life tables from specific causes of death in Korea. Both "Life tables of Korea in l978-79" and "the statistics on causes of death statistics in 1980" issued by Economic Planning Board were used as source of data for this study. Among the 58, 187 death certificates reported to the concerned authorities, 39, 801 causes were drawn for the purpose of this study. As a result, it is revealed that two thirds of men in Korea died from these 10 major causes of death. The summarized results are as follows: 1. According to recent statistics, 10 major causes of death in 1980 were shown in the order of 1) malignant neoplasms, 2) cerebrovascular disease, 3) accidents and adverse effects, 4)hypertensive disease, 5) ischaemic heart disease and heart attack, 6) chronic liver disease and cirrhosis, 7) tuberculosis, 8) pneumonia, bronchitis, emphysema and asthma, 9) suicide, 10) diabetes mellitis. 2. The major causes of death in Korea were very similar to those of developed countries such as West Germany, Denmark and Japan. This means that our pattern of death causes is almost approaching to that of developed countries. 3. Our crude death rate in 1980 was on the line of 6.6 per 1, 000 people. This is very low level, compared with 12.1 in West Germany and 10.0 in Denmark, however, our age sepcific death rate was on the verge of doubled level in each age category as to that of West Germany, Denmark and Japan. The fact tells us that our death rate is very high yet, especially in young and prime adult age, and the proportion of the aged is quite low. 4. Average ages of people died from malignant neoplasms, cerebro vascular diseases and hypertensive diseases were 63.1, 66.6, 67.3 respectively, however, that of accidents and adverse effect was only 42.5. This shows that accidents occur indifferently from age. 5. In the curve of eventual death probability, the curve of malignant neoplasms was the highest of all curves before 60 in age. However, the probability curve of eventually dying from accidents and adverse effects tends to decline with age. 6. In this study five life tables from major causes of death (four leading causes of death and of tuberculosis) were constructed for 1979. These life tables are reflecting accurately the effects of age distribution on the specific cause of death. In the surviving curje of these tables we can see that the curve of accidents is adversely related to age. While curves of neoplasms, hypertension and tuberculosis are not diminishing before 40 in age, they are going sharply downward after 50 in age.ard after 50 in age.

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Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

  • Roswall, Nina;Weiderpass, Elisabete
    • Journal of Preventive Medicine and Public Health
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    • 제48권1호
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    • pp.1-9
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    • 2015
  • The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

파브리병 환자의 진단과 선별검사의 최신지견 (A Recent Insight into the Diagnosis and Screening of Patients with Fabry Disease)

  • 윤혜란;조지훈
    • 대한유전성대사질환학회지
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    • 제24권1호
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    • pp.17-25
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    • 2024
  • 파브리병은 X염색체-연관 리소좀 축적 장애이다. 이는 α-갈락토시다제 A(α-Gal A)의 활성이 없거나 결핍되어있는 α-갈락토시다제 A 유전자의 돌연변이로 인해 발생한다. 이러한 효소활성의 저하로 인해 대사되지 못한 지질인 globotiaosylceramide (Gb3)가 다양한 인체 조직에 점진적으로 축적된다. 파브리병의 조기진단 시기를 놓치는 경우 신장 및 심장 기능의 점진적인 손상이 심각하게 발생한다. 환자는 말초 근육 통증, 위장 장애, 일과성 허혈 발작 및 뇌졸중을 경험하기도 한다. 피부, 눈, 귀, 폐 및 뼈 등에서 이 병의 진행으로 인한 추가 증상이 종종 나타난다. 치료과정 없이 병이 진행되면 심장이나 신장의 개입으로 인해 기대 수명이 단축되는 치명적인 결과를 초래한다. 따라서 파브리병을 조기에 발견하는 것이 발병율과 사망율을 감소시키는 데 매우 중요하다. 비정형성 파브리병의 변이를 식별하기 위한 globotriaosysphingosine(lyso-Gb3)과 심장 침범을 식별할 수 있는 고감도로 탐지할 수 있는 트로포닌 T(hsTNT)는 모두 중요한 진단 마커이다. 효소 대체 치료(enzyme replacement therapy) 또는 샤페론 치료(chaperone therapy)는 파브리병 치료의 주요 두 가지 방법이다. 질환이 드물기도 하지만 진단이 제대로 잘 되지 않는 놓치기 쉬운 질환이기도 하다. 따라서 이종설의 목적은 파브리병의 조기 진단과 진단에 대한 최근의 업데이트된 현황 보고와 진단을 위한 기본 자료를 제공하는 데 있다. 또한 효소 대체 치료 및 일반적인 진단 알고리즘과 그에 연관된 필요한 정보를 제공한다.

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