• Title/Summary/Keyword: hypertension and diabetes

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Long-Term Results of Arteriovenous Fistula for Hemodialysis in Chronic Renal Failure (혈액투석을 위한 동정맥루의 장기관찰 성적)

  • 김인광
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.764-769
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    • 1994
  • From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

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Novel Impedance Method for Analyzing Truncal Obesity (중심성 비만 분석을 위한 새로운 임피던스 해석법)

  • Lim, Taek-Gyun;Seo, Kwang-Seok;Jeong, In-Cheol;Jun, Suk-Hwan;Noh, Yeon-Sik;Kim, Eung-Seok;Yoon, Hyung-Ro
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.58 no.4
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    • pp.849-856
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    • 2009
  • Truncal obesity associated with insulin resistance and metabolic syndrome increase the likelihood of hypertension, various cardiovascular diseases, hyperlipidemia and coronary heart diseases. International Diabetes Federation (IDF) experts recognized that it is necessary to develop the simple diagnostic tool which is applicable to diagnose truncal obesity worldwide, and proposed the method using a waist circumference but there is a limit to estimate subcutaneous fat distribution. However, waist line is also influenced by total fat capacity less than the intra abdominal fat. The more having severe obesity, the more correlation coefficient between waist line and intra abdominal fat is low. Therefore, this thesis defines a new abdominal impedance measurement position and impedance-index to analysis central obesity. This proposes the new model to estimate abdominal obesity using the abdominal impedance-index and CT images acquired fro 160 Korean subjects. The proposed model shows that the abdominal fat distribution has a higher correlation than waist line. (Adj R2=0.809, 0.667 and 0.687 with abdominal fat area, visceral fat area and subcutaneous fat area respectively).

A Survey on Clinical Characteristics of patients Visiting Pain Clinics (통증클리닉 내원환자의 임상적 특성에 관한 분석)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myoung Hee
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.146-150
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    • 2005
  • Background: Recently, the number of patients visiting pain clinics has been increasing with the augmented concerns of those patients about the management of their pain. We conducted this study in order to elucidate the characteristics of patients visiting pain clinics and to determine a method to further raise their awareness about pain treatment. Methods: We reviewed 1,424 new patients who visited our pain clinic from March 2003 to December 2004. We analyzed these patients according to their age and sex, treatment method before visiting the pain clinic, coexisting disease, chief complaint and pain location, resident district, route of visiting pain clinic, and degree of impairment due to pain by use of questionnaire. Results: In age distribution, the largest proportion (23.5%) was in their 50's. Most patients (64.0%) had received treatment in an oriental medicine clinic before visiting the pain clinic. The most common coexisting disease was hypertension (20.3%) and low back pain was the most common chief complaint (68.3%). Most of the patients lived in Gyeonggido (87%) and most visited our pain clinic on the recommendation of other patients who had visited our pain clinic before. Conclusions: We need to guide pain patients to undergo proper treatment much earlier using patient education or a referral system. Moreover, we should be more careful in patients with diabetes mellitus, and should have greater concern in the treatment of low back pain.

Recognition towards oral health care and plaque removal in the elderly people (노인인구의 구강건강 및 치석제거 인식도 조사)

  • Kwak, Jung-Suk;Woo, Seung-Hee;Lee, Jae-Ra
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.4
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    • pp.727-733
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    • 2015
  • Objectives: The purpose of the study is to investigate the awareness toward oral health and plaque removal in the elderly people in Korea. Methods: An interview method was carried out to 308 elderly people from a senior welfare facility in Mokpo, Jeonnam from May 1 to December 30, 2011 after receiving informed consents. Except 4 incomplete answers, data were analyzed using SPSS 18.0 program. The questionnaire consisted of demographical characteristics of the subjects, experience of plaque removal, recognition towards plaque removal, and correlation to systemic diseases. Results: Most of the elderly people experiences plaque removal(63.4%) and 55.9% had revisit intention. Those having plaque removal accounted for 47.8% and they had good subjective oral health recognition. Those not having plaque removal accounted for 61.8% and 61.8% having average systemic health condition and 53.3% having poor oral health recognition. The plaque removal was closely related to subjective oral health recognition. Conclusions: It is necessary to develop the preventive oral health program for the elderly people. The plaque removal in the elderly people is the most important services to prevent the systemic diseases including hypertension, arthritis, diabetes, nervous disease, and gastrointestinal diseases.

Yearly Report on CVA Patients(VI) (뇌졸중환자에 대한 연례보고(VI))

  • 이청정;홍의실;백은기;최유경;고승희;박세기;김동우;한양희;전찬용
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.81-91
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    • 2001
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 177 patients who were admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University with a diagnosis of stroke from Jan. I, 1999 to Dec. 31, 1999. Results : Ischemic stroke (74.0%) was more common than hemorrhagic stroke (19.8%). The proportion of males was 53.7%, of females was 46.3%, and the most prevalent age group is those in their sixties. Cerebral infarction was most frequently noticed in MCA territory, hemorrhage in putamen. Hypertension was the most common preceding disease, followed by diabetes mellitus. The rate of recurrence was high in cerebral infarction. The onset mode of cerebral infarction was sleeping and rising and of cerebral hemorrhage was acting. Most patients visited the hospital within 24 hours. The most common symptoms at admission were motor weakness and speech disorder. The most common complication was urinary tract infection. Admission period was 29.5 days. Physical treatment from onset in cerebral infarction and in cerebral hemorrhage was 17.4 and 22.0 days, respectively. Conclusions : Our study of CVA patients was similar to previous studies from 1994 to 1998. In most cases, western and oriental treatment and medicine were given synthetically. Prescription of sasang constitutional medicine had wide application.

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Extra-anatomic Bypass in Lower Limb Ischemia (하지동맥 폐쇄환자에서 실시한 Extra-anatomic bypass술의 임상적 고찰)

  • Kim, Gyu-Man;Kim, Jong-Won
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.920-925
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    • 1993
  • Extra-anatomic bypass was proposed by Freeman in 1952 and has been used for patient with lower extremity arterial occlusion who had very high operative risk, especially elderly or severly illed patient.We had performed 14 cases of extra-anatomic bypasses from Jan. 1991 till July 1993 and having been following up them. Their results were summarized as follow. Among total 14 patients, 13 was male. Their mean age was 64.8 years old, ranged from 48 to 80. The most common complaint was pain on lower limb and they visited hospital 6.1 months in average after onset of symptom. Frequently, they were associated with systemic diseases such as generalized atherosclersis, hypertension, diabetes mellius, etc. Axillary artery was used as donor artery in 8 cases and crossover femoro-femoral or femoro-popliteal bypass was performed in 6 cases. Postoperative complications were notedd in 8 cases so their morbidity rate was 42.8%. Except for two contraindicated cases, one or more anticoagulants were used routinely . Among them, combined use of aspirin and persantine was most commonly applied.After bypass graft, nine cases were occluded beteween 10 and 53 months. So their average duration of freedom from reocclusion was 35.7 months and 3-year patency rate was 63%.

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Nutrition Education for the Elderly in the US

  • Reicks, Marla
    • Journal of Community Nutrition
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    • v.4 no.1
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    • pp.51-58
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    • 2002
  • Eating behavior change as a result of nutrition education interventions as secondary prevention strategies can contribute to an increase in life expectancy and better health for older adults in the United States (U.S.). Many of the chronic conditions prevalent in older adults are modifiable by dietary changes, including heart disease, diabetes mellitus, hypertension, obesity and osteoporosis. Important demographic observations in the U.S. including the projected large increase in number of older adults by 2030 have implications for nutrition education focus and services. A comprehensive review of nutrition education interventions for older adults in the U.S. published in 1995 identified elements from adult education theories that contribute to the effectiveness of nutrition education. These elements have been the focus of more recent studies with older adults providing additional evidence for relationships between concepts from commonly used behavior change theories and dietary patterns or change. In the U.S, an important program contributing to nutritional adequacy of the diet for older adults is the Elderly Nutrition Program which provides resources for congregate dining and includes a mandatory nutrition education component. Nutrition education is also provided through clinic based programs, and print and broadcast media. Application of the Transtheoretical Model has shown that the level of interest or motivation to comply with dietary guidance may be greater for some older adults due to an increasing burden of chronic disease and poorer quality of life, while others may not feel a need to change lifestyle habits.

Development of a Cardiovascular Index That Estimates Cardiovascular Health Degree by Survey and Noninvasive Examination (설문과 비침습적 검사를 통하여 심혈관계 건강 정도를 알려주는 심혈관지수의 개발)

  • Lee, Chong Sun;Chung, In Wook
    • Journal of the Korean Society for Precision Engineering
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    • v.31 no.5
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    • pp.459-466
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    • 2014
  • An index was developed that estimates cardiovascular health degree with easily available physiological information such as survey and noninvasive measurement. The survey score was calculated by utilizing questions related to personal disease history, self-feeling, and management state. The measurement score was calculated using physiological parameters such as blood pressure, accelerated plethysmograph(APG), and heart rate variability(HRV), and augmentation index(AI). In order to evaluate effectiveness of the cardiovascular index and modify weighting factors used in each item, a clinical trial was done in a general hospital. The cardiovascular index showed a clear correlation of 0.685 with the doctor's score on the cardiovascular health degree. The correlation between the self-estimated score and doctor's score was as low as 0.217. The large gap between these two scores demonstrated necessity of more objective tools like the cardiovascular index. The cardiovascular score showed a significant difference between normal persons and patients suffering hypertension or diabetes. (p=0.000).

Analysis of patients transported in ambulances by season and daily temperatures (계절 및 기온에 따른 119 구급대 환자 이송 건수 및 병력의 차이)

  • Lee, Kyoung-Youl;Lee, Jeong-Hyeok
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.3
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    • pp.123-134
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    • 2019
  • Purpose: This study aimed to analyze the number of patients with and without medical history transported to the emergency department due to changes in daily temperature and season. Methods: Data on emergency activity sheet and daily weather were collected from March 2016 to February 2017 in the city of Gyeonggi-do. In total, 13,531 patients were transferred to the emergency department in 119 ambulance. Data were analyzed using the Statistical Package for the Social Sciences (version 21). Results: The daily average number of patients transferred was the highest in August and September, i.e., the summer season. The higher the daily highest and lowest temperatures, higher the daily average number of patients transferred. In contrast, patients with medical history of hypertension, diabetes, heart disease, cerebrovascular disease, and pulmonary disease had a higher incidence of transfers in the winter season and on days with lower temperature. Conclusion: The results indicate that as people become more active during the summer when temperatures are high, the chances of daily emergencies increases, whereas patients with medical history are more likely to experience emergencies when the temperatures were lower. Hence, 119 ambulances will have to be prepared in advance to deal with this trend.

Enhancement for competencies of health education specialists to prevent chronic diseases in public health organizations (공공부문 보건의료조직의 만성질환 예방사업에서 요구하는 필요능력과 보건교육사의 직무 강화 방안)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.31 no.5
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    • pp.135-146
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    • 2014
  • Objectives: This study performed to enhance the competency of health education specialist on population-based program to prevent chronic disease in public health organizations. In addition, it will provide the basic data to enhance specialized competency for health education specialist. Method: The current operating strategy and demanded competency related to chronic disease programs were analyzed by reviewing the Korean Health Plan 2020, the guideline of integrated health promotion programs, and the job description of health education specialist. Results: Preventive programs for chronic disease provide with healthy lifestyle programs in integrated health promotion service. First, health education specialist should learn to professional knowledge on health risk factor and chronic disease. Second, they should cultivate the integrated competency to manage operations on obesity, hypertension, diabetes, cardiovascular disease, and cancer prevention programs. Third, they get strengthened the-job training to implement health education, public relations, campaigns, media advocacy, and utilization of multi-media. Conclusion: It should implement the preventive programs for chronic disease in various health promotion services through coordination with multiple sectors. To identify of the job in preventive program for that, it would be required empowerment of health education specialists on disease prevention science and practical life skill.