• Title/Summary/Keyword: essential hypertension.

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Diagnosis-Specific Analysis of Small Area Variations in Hospital Services (일부 다빈도 진단명들의 지역간 의료이용 변이)

  • 이선희;조우현;남정모;김석일
    • Health Policy and Management
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    • v.4 no.1
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    • pp.49-76
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    • 1994
  • Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

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Occipital Intradiploic Epidermoid Cyst with Intracranial Hypertension

  • Park, Byung-Hyun;Lee, Hyun-Sung;Lee, Jong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.377-380
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    • 2006
  • Intradiploic epidermoid cysts of the cranium are rare, benign and slow growing lesion. However, these cysts may cause neurologic deficits due to mass effect. Intradiploic epidermoid cysts are thought to be derived from persistent ectodermal remnants present in the cranial bones during embryogenic development. Here, we report a case of an occipital intradiploic epidermoid cyst with posterior fossa extension. The patient developed intracranial hypertension associated with hydrocephalus due to aqueductal stenosis, and venous congestion secondary to compression of the torcular and the transverse sinus. The imaging studies included a computerized tomography[CT] venogram, which is essential for determining the pathophysiological mechanism of the clinical spectrum and for surgical planning. Near total removal was accomplished and the postoperative course was uneventful. Postoperative imaging studies demonstrated a reversal of the neural structures, but no patency of the sinus, which was presumably indicative of prolonged sinus stenosis. The patient gradually improved and was discharged free of symptoms.

Hypertensive Encephalopathy with Reversible Brainstem Edema

  • Lee, Sungjoon;Cho, Byung-Kyu;Kim, Hoon
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.139-141
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    • 2013
  • Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury.

Patterns in the Outbreaks of Senile Diseases of Industrial Workers in Kwang-ju and Ghon-nam Area (일부 산업체 근로자의 성인병 발생양상)

  • 정희곤
    • The Korean Journal of Food And Nutrition
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    • v.5 no.2
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    • pp.99-103
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    • 1992
  • Patterns in the outbreaks of senile diseases were investigated on 1, 264 workers by special examination among the 43, 210 industrial workers by the screening test performed in Kwang-ju and Chon-nam Branch of Korean Industrial Health Association from January 4 to December 31 in 1991. The results are summarized as follows : 1) Prevalence rate of senile diseases of industrial workers was 2.9%. And prevalence rate according to the kinds of senile diseases was observed in the order of hepatitis (0.9%), hypertension(0.7%), diabetes mellitus(0.5%), anemia(0.4%). 2) Prevalence rate of complicated senile diseases of industrial workers was 0.5%. And prevalence rate according to kinds of complicated senile diseases was observed in the order of others hypertension and arteriosclerosis (0.1%), HBV and others chronic hepatitis(0.1%), essential hypertension and arteriosclerosis(0.03%), iron deficiency anemia and leukopenia(0.03%).

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ACE inhibitory activity of Peptide from krill(Euphausia superba) Hydrolysate

  • Kim, Dong-Soo;Kim, Young-Myoung;Park, Douck-Choun;Do, Jeong-Ryong
    • Proceedings of the Korean Society of Fisheries Technology Conference
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    • 2001.10a
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    • pp.183-184
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    • 2001
  • Angiotensin I converting enzyme (ACE) in renin-angiotensin system is a cause of essential hypertension, which covers most hypertension, one of the major adult diseases. Thus, the inhibition of ACE would be indispensable for the prevention and cure of hypertension. Therefore, a lot of studies on the ACE inhibitor have been conducted. Peptides from the protein hydrolysate have been reported as an remarkable inhibitor. Especially, various ACE inhibitory peptides were isolated and identified from marine products for their utilization as value added products. (omitted)

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A novel blood pressure modulator C1q/TNF-α-related protein 1 (CTRP1)

  • Han, Sora;Yang, Young
    • BMB Reports
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    • v.51 no.12
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    • pp.611-612
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    • 2018
  • $C1q/TNF-{\alpha}-Related$ Protein 1 (CTRP1) has recently been shown to act as a blood pressure regulator, as it induces vasoconstriction. In the aorta, CTRP1 facilitates recruitment of angiotensin II receptor 1 (AT1R) to plasma membrane, through activation of the AKT/AS160 signaling pathway. This leads to activation of the Ras homolog gene family (Rho)/Rho kinase (ROCK) signaling pathway, resulting in vasoconstriction. Accordingly, mice overexpressing Ctrp1 have hypertensive phenotype. Patients with hypertension also display higher circulating CTRP1 levels, compared to healthy individuals, indicating that excessive CTRP1 may affect development of hypertension. Conversely, CTRP1 is regarded as an 'innate blood pressure modulator' because CTRP1 increases blood pressure under dehydration to prevent hypotension. Mice lacking Ctrp1 fail to maintain normotension under dehydration conditions, resulting in hypotension, suggesting that CTRP1 is an essential protein for maintaining blood pressure homeostasis. In conclusion, CTRP1 is a novel, anti-hypotensive vasoconstrictor that increases blood pressure during dehydration-induced hypotension.

Automatic Extraction of Blood Flow Area in Brachial Artery for Suspicious Hypertension Patients from Color Doppler Sonography with Fuzzy C-Means Clustering

  • Kim, Kwang Baek;Song, Doo Heon;Yun, Sang-Seok
    • Journal of information and communication convergence engineering
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    • v.16 no.4
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    • pp.258-263
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    • 2018
  • Color Doppler sonography is a useful tool for examining blood flow and related indices. However, it should be done by well-trained operator, that is, operator subjectivity exists. In this paper, we propose an automatic blood flow area extraction method from brachial artery that would be an essential building block of computer aided color Doppler analyzer. Specifically, our concern is to examine hypertension suspicious (prehypertension) patients who might develop their symptoms to established hypertension in the future. The proposed method uses fuzzy C-means clustering as quantization engine with careful seeding of the number of clusters from histogram analysis. The experiment verifies that the proposed method is feasible in that the successful extraction rates are 96% (successful in 48 out of 50 test cases) and demonstrated better performance than K-means based method in specificity and sensitivity analysis but the proposed method should be further refined as the retrospective analysis pointed out.

Patient Compliance and Associated Factors in the Community-based Hypertension Control Program (지역단위 고혈압사업에 있어서 환자의 치료순응도와 결정요인)

  • Kim, Jee;Min, Kyung-Bok;Kwon, Soon-Ho;Han, Dal-Sun;Bae, Sang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.215-227
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    • 1999
  • Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.

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Effect of the Auriculoelectrostimulator on Blood Pressure In Hypertensive Rat Models (고혈압모델에서 귀혈위자극기의 혈압강하 효과)

  • Kim Hee-Young;Kim Sung-Ok;Hwang Hye-Jeong;Hahm Dae-Hyun;Lee Kwon-Soon;Kim Soon-Taek;Shim Insop;Lee Hye-Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.724-728
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    • 2004
  • Several studies have shown that a low frequency stimulation can depress blood pressure in hypertension. We had developed a new auriculoelectrostimulator as an electronic blood pressure regulator for simple and easy stimulation. The new auriculoelectrostimulator was employed in hypertensive rat model induced by immobilization stress, diabetic and essential hypertensive rat models. Rats were stimulated by auriculoelectrostimulator at ear acupoint (Ear point for hypertension) bilaterally. Ear stimulation by auriculoelectrostimulator significantly decreased blood pressure in all hypertensive rat models and inhibited the increase of heart rates in stressed and spontaneous hypertensive rats. The results showed that auriculoelectrostimulator had depressive effects on hypertension in rat hypertensive models, suggesting that it is useful in treatment of hypertension.

Association between Angiotensin I-Converting Enzyme Gene Polymorphism and Hypertension in Selected Individuals of the Bangladeshi Population

  • Morshed, Mahboob;Khan, Haseena;Akhteruzzaman, Sharif
    • BMB Reports
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    • v.35 no.3
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    • pp.251-254
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    • 2002
  • The genetic factors that contribute to the development of coronary artery disease (CAD) are poorly understood. It is likely that multiple genes that act independently or synergistically contribute to the development of CAD and the outcome. Recently, an insertion/deletion (I/D) polymorphism of the human angiotensin I-converting enzyme (ACE) gene, a major component of the renin-angiotensin system (RAS), was identified. The association of the ACE gene D allele with essential hypertension and CAD has been reported in the African-American, Chinese, and Japanese populations. However, other studies have failed to detect such an association. It has been suggested that these inconsistencies may be due to the difference in backgrounds of the population characteristics. In the present study, we investigated the I/D polymorphism of the ACE gene in 103 subjects of both sexes, consisting of 59 normal controls and 44 patients with hypertension. The allele and genotype frequency were significantly different between the hypertensive and control groups (p < 0.01). Among the three ACE I/D variants, the DD genotype was associated with the highest value of the mean systolic blood pressure [SBP] and mean diastolic blood pressure [DBP] (p = < 0.05) in men, but not in women. In the overall population, the mean SBP and DBP was highest in DD subjects, intermediate in I/D subjects, and the least in II subjects.