• Title/Summary/Keyword: hypertension and diabetes

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Evaluation of Prescription Data for Development of Warfarin Nomogram in Korean Patients with Cerebral Infarction (뇌졸중 환자군의 Warfarin Nomogram 설정을 위한 실제 처방전 평가)

  • Jang, Ju-Young;Ko, Kyung-Mi;Yoon, Ji-Yeon;Han, Ok-Yeon;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.53 no.2
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    • pp.83-88
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    • 2009
  • Warfarin is the most widely used oral anticoagulant in the world but maintenance of proper therapeutic range and prevention of adverse drug events always need to be careful. Especially, in Korea, warfarin dosing for patients with cerebral infarction is currently based on the nomogram which is done by foreign clinical trials not for the Korean. Therefore we evaluate warfarin dose of patients in the neurology and eventually get the base data of warfarin nomogram for Korean with stroke. We performed this study retrospectively on reviewing the medical charts to evaluate the prescribed loading dose (LD) and maintenance dose (MD) of warfarin and each responding International Normalized Ratio (INR) with any bleeding adverse drug reaction including of patient's characteristics for total 75 patients with stroke in the department of neurology of Kangnam ST. Mary's Hospital from January 2005 to June 2008. All evaluated patients should not be treated with warfarin in the past at all and should be initiated warfarin therapy first.ly at this time. All evaluated patients were divided as two classes by wafarin LD which is; 1) HDG - a high loading dosing group prescribed over 5mg, and 2) LDG - a low loading dosing group prescribed 5mg or below. As a result, average LD was $9.34{\pm}0.22$ mg (p=0.000) in HDG and $4.25{\pm}0.39$ mg (p=0.000) in LDG. Average baseline INR was $0.91{\pm}0.05$ (p=0.161) in HDG and $1.26{\pm}0.14$ (p=0.002) in LDG. On the first and second week, daily MD was $4.21{\pm}0.14$ mg (p=0.000) and $2.96{\pm}0.19$ mg (p=0.696) in HDG and also in LDG, $2.95{\pm}0.29$ mg (p=0.000) and $3.14{\pm}0.36$ mg (p=0.696). Also average reacting daily INR was respectively $2.53{\pm}0.12$ (p=0.141) and $2.51{\pm}0.16$ (p=0.678) in HDG, and in LDG, $2.11{\pm}0.17$ (p=0.141) and $2.42{\pm}0.14$ (p=0.678). After the second week, INR was not measured in regularly. Also most of underlying diseases were hypertension (n=38), diabetes mellitus (n=14), dyslipidemia (n=8) in order. Four ADRs with simple hemorrhage were occurred and those were due to drug interaction by comedication. In the conclusion, proper starting LD for Korean with stroke is 10 mg if baseline INR is around 1.0 or 5 mg if over 1.3. Proper MD need to be more evaluated in the future for setting up warfarin nomogram to make prospective study.

An Analysis of Clinical Prognosis Factors of Peripheral Facial Palsy and the Effects of Electrodiagnostic Test (말초성 안면신경마비 경과에 대한 임상적 예후인자 및 신경생리검사의 유용성 분석)

  • Ahn, Chang-Beohm;Yoon, Hyun-Min;Jang, Kyung-Jun;Kim, Cheol-Hong;Jung, Kyoung-Keun;Min, Young-Kwang;Kim, Soo-Min;Kim, Jeong-Eun;Cho, Beohm-Gyu
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.209-223
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    • 2007
  • Objectives : Facial Nerve Paralysis is one kind of common diseases and it can be treated by natural therapy and the efficiency of treatment is relatively high. In clinical trial, it is not difficult to find patients who were not completely recovered from Facial Nerve Paralysis, so the symptoms are fixed permanently. This leads many doctors and patients to have interests in the progress and prognosis of the disease, so this study was to analyze clinical prognosis factors and verify the effects of Electrodiagnostic Test. Methods : The 378 subjects were chosen from 987 patients who were suffering from Peripheral Facial Palsy, diagnosed with Bell's palsy and Ramsay Hunt Syndrome and had admission treatment. They got Oriental-Western Medicine Treatment within two weeks after outbreaks of the disease and treated at least over 3 weeks using Oriental-Western Medicine Treatment. Results : 1. There was a significant difference in the results of treatment according to gender, age, types of Facial Palsy, existence of Post Auricular Pain, existence of Labyrinth Symptom, HBGS, and existence of onsets of recovery as clinical prognosis factors of Peripheral Facial Palsy, However, a statistically significant difference was not shown in the results of treatment according to the position of Facial Palsy(left or right), existence of a relapse, and diabetes, hypertension. 2. As a result of overall treatment, 77.2% of patients were recovered almost entirely and 22.8% were not, and the quelae of incomplete recovery were Synkinesis, facial contracture, facial spasm, crocodile tears and scheroma in order of frequency. 3. The results of electrodiagnostic test represented useful correlation to predict the final effects of treatment. Conclusion : Based on the above results, the prognosis factors, the degree of recovery, and the sequelae of incomplete recovery were analysed and the effects of electrodiagnostic test was verified.

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A Panel Study on Determinants of Catastrophic Health Expenditure of the Middle- and Old-Aged Households (중·고령 가구의 과부담 의료비 발생의 결정요인에 관한 패널연구)

  • Park, Jin Yeung;Jung, Kee Taig;Kim, Yong Min
    • Health Policy and Management
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    • v.24 no.1
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    • pp.56-70
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    • 2014
  • Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

A Study on the Treatment of SD rat Menopausal Obesity Utilizing Fermentation Techniques (발효기법을 이용한 SD rat의 갱년기 비만 치료효과에 관한 연구)

  • Lee, Joung-Woon;Lee, Young-Chul;Kim, Dong-Hyun;Na, Hye-Sook;Ma, Jin-Yeul
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.118-126
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    • 2005
  • In our study, osteoporosis was induced by ovariectomized in female Sprague-Daweley (SD) rats, and the prevention and treatment efficacy of the climacteric disease the ostmenopausal type I pattern was examined by using the experimental substance soybeans and arowroot. No clinical signs and mortality after continuous oral administration of experimental substances for 14 weeks were not observed, however, the weight of experimental animals underwent ovariectomized was increased significantly in comparison with control group (p<0.01). The atrophy of the uterus due to T3 group was 23.64% after 7 weeks, 24.44% after 14 weeks (in comparison with N.C. group), and it was statistically significantly increased. In regard to the change of blood cells, it was observed that platelets were statistically significantly reduced in the ovariectomized group, and administered orally experimental substances continuously for 7 weeks, in all groups administered experimental substances, it was found that platelets had the tendency to be increased more than N. C. group. In regard to He change of blood biochemistry, removed the ovary, the concentration of ALP showed the tendency to be increased than control group, and particularly in T3 group, it was increased significantly. In regard to the concentration of cholesterol, in comparison with negative control group, it was reduced 68% at 7 weeks and 35% at 14 weeks. After ovariectomized, the amount of estrogen was found to be reduced by 21.37% in comparison with control group, it showed the tendency to be increased by 4.49% in T1 group and 7.62% in T2 group, the concentration of estrogen in each group showed the tendency to be increased than negative control group, and in T3 group, it was increased to 100.46% and 117.65% in T4 group, and it was increased more than control group. Based on the above experimental results, in the experimental animals female rats, because of the hormonal imbalance induced by ovariectomized, a large mount of fat is accumulated in the body and due to it osteoporosis, obesity, hypertension, hyperlipidemia, fat of the liver, arteriosclerosis, diabetes, and other metabolic diseases were developed. Hence, when the experimental substance Extraction of ferment arrowroot was orally administered continuously for 14 weeks, it was thought that a certain proportion of the hormonal balance was maintained that functioned as a substance interfering the accumulation of fat, and it was considered to be of help in the treatment of not only osteoporosis Type I, but also for the prevention and treatment of various endocrinal diseases.

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'Clinical Observation on the 290 cases of Cerebrovascular Accident' (뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III))

  • Kang, Kwan-Ho;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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Health related practices and morbidity among adult in rural area (농촌지역 주민의 건강관련 행위와 질병이환과의 관계)

  • Song, Jue-Bok;Rhee, Boo-Ouk;Shin, Hai-Rim;Jung, Kap-Yeol;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.342-355
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    • 1997
  • This research was carried out to determine the performance rate of health related practices, to measure the agreement between morbidity by doctor's diagnosis and morbidity by subject' self-reported and the degree of association between health related practices and morbidity rate by doctor's diagnosis, to identify their effects on morbidity among rural area populations. The data were gathered by volunteer residents (over the age of 20) of Haman Myeon, Haman Gun, Kyeongsangnam Do in Korea, from June 10, 1993 to June 12, 1993 (369 male and 516 female). Face to face interview, lab, chest P-A, EKG and physical examination were completed. Descriptive statistics, agreement analysis and multiple logistic regression procedures were employed for analyses. The results of the study were summarized as follows : 1) Age adjusted morbidity rates by doctor's diagnosis and self-reported were 38.5% (male:37.3%, female:36.5%), 26.4% (male:33.3%, female:27.5%), respectively. Kappa coefficient between morbidity by doctor's diagnosis and morbidity by self-reported was 0.21 (male:0.21, female:0.22). 2) The frequency of disease by doctor's diagnosis was as follows: hypertension(15.3%), gastritis (9.6%), diabetes mellitus (8.5%), live. disease (8.1%), and degenerative arthritis (6.2%) in the study population. 3) Order of health practice performance rate was as follows: Males-normal body weight (62.1%), non-heavy alcohol consumption (57.5%), 7-8 hours of sleeping (50.1%), non-smoking (21.7%), and exercise (19.8%). Females- non-heavy alcohol consumption (97.3%), non-smoking (84.7%), normal body weight (57.8%), 7-8 hours of sleeping (45.0%), and exercise (9.9%). 4) There was no significant relationship between health related practice and morbidity except exercise among health related practices. 5) Health related practice index which was recategorized by high, medium, and low had effects on the probability of developing morbidity.

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The Study on Risk Factor of Metabolic Diseases in Pancreatic Steatosis (췌장지방증에서 대사성질환의 위험 요인에 관한 연구)

  • Cho, Jin-Young;Ye, Soo-Young;Kim, Dong-Hyun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.81-88
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    • 2016
  • The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

Characteristics of Patients' Self-Perceived Health in Traditional Korean Medical Facilities - Based on the Ministry of Health and Welfares Report on Usage and Consumption of Korean Medicine in 2011 - (주관적 건강인식수준에 따른 한방의료기관 이용환자의 특성 비교 - 2011년 한방의료이용 및 한약소비실태조사(보건복지부)를 중심으로 -)

  • Sung, Angela Dongmin;Choi, Sungyong;Park, Haemo;Kim, Hyundo;Lee, Sungdong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.29-43
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    • 2015
  • Objective : The purpose of this study was to identify characteristics of patients' self-perceived health in traditional Korean medical facilities. Method : This research was conducted based on the survey on patients whom have visited traditional Korean medical facilities in 2011 by the Ministry of Health and Welfares and Korean Institute for Health and Social Affairs. Using a sample of 3,931 (1,180 male and 2,751 female) outpatients' self-perceived health based on the data from usage and consumption of Korean Medicine. 'Healthy', 'Fair', and 'Poor Health' were used to measure patients' self-perceived health status. The data was analyzed by frequency, t-test, cross correlation analysis and multiple logistics regression analysis using the SPSS program package. Results : Sex(P<0.001), age(P<0.001), marital status(P<0.001), education(P<0.001), employment status(P<0.001), occupation(P<0.001), health insurance(P<0.001) and income level(P<0.0001) showed statistical significance. Main Treatment Facilities(P<0.001), experience of taking Korean medicine(P=0.032), experience of receiving acupuncture treatment(P<0.001), number of visits(P<0.001), medical expense (P=0.005), and subjective health status after the treatments showed statistical significance for Korean herbal medicine(P=0.038), acupuncture (P=0.001), cupping therapy(P=0.006), oriental physiotherapy(P=0.003), and treatment satisfaction(P<0.001). For subjective health status based on suffering disorders in the past three months, the response of poor health was higher in the group suffering recent illnesses. Statistical significance was seen in hypertension (P=0.002), arthritis(P<0.001), lumbar pain(P<0.001), diabetes mellitus(P=0.001), stroke(P<0.001), hwa-byung (P=0.001), gastric disorders(P=0.021), common cold(P<0.001), ankle sprain(P<0.001), muscular injury(P<0.001), lumbar sprain(p=0.009) and fracture(P=0.03). Also the number of diseases during the past three months showed statistical significance(P<0.001). Statistical significance was also seen in Level of knowledge(P<0.001), route of information(P<0.001), reliability of Korean medicine(P=0.003), insurance coverage(P=0.005), medical costs(P<0.001), and future willingness to use Korean medicine(P<0.001). As a result of the multiple logistics regression analysis, risks of subjective poor health statistically increased in female population, elderlies, medicaid beneficiaries, less educated, higher medical expense, and more disorders during the past three months. Conclusion : Patients' self-perceived health status has significant differences with each variables such as sex, age, marital status, education, health insurance, medical expense, number of diseases.

Correlations of Plasma Taurine, Homocysteine and Serum Lipid Levels of Elderly Women (노년기 여성들의 혈장 타우린의 농도와 혈장 호모시스테인 및 혈청 지질농도와의 상관관계)

  • Ahn, Chang-Soon;Lee, Yeon-Joo
    • The Korean Journal of Food And Nutrition
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    • v.23 no.4
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    • pp.501-510
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    • 2010
  • This study was conducted to assess blood components caused by metabolic syndrome increasing in postmenopausal elderly women. The blood samples of these subjects were analyzed to investigate the correlation of plasma taurine levels and plasma homocysteine levels, and serum lipid profiles. The subjects were 33 elderly women($72.8{\pm}4.4$ years). Their mean height, weight and BMI were $150.5{\pm}5.7\;cm$, $57.5{\pm}6.3\;kg$ and $25.4{\pm}2.5\;kg/m^2$. 16 women of this study subjects have been chronic diseases such as hypertension or diabetes. Their fasting blood glucose was $98.2{\pm}24.0\;mg/d{\ell}$, and their plasma total cholesterol (TC), HDL-C, LDL-C, triglyceride(TG) were $216.5{\pm}29.9$, $52.1{\pm}10.7$, $145.7{\pm}27.9$ and $141.2{\pm}59.6\;mg/d{\ell}$, respectively. Their blood lipid profiles were higher than the standard levels of metabolic syndrome, thus these levels of lipid profiles may play a role as risk factors on the elderly person. Plasma taurine level of the subjects was $278.5{\pm}48.1\;{\mu}mol/{\ell}$, and their plasma homocysteine level was $12.8{\pm}2.9\;{\mu}mol/{\ell}$. The concentration of plasma vitamin $B_{12}$ was significantly decreased by aging(p<0.05). The correlation of plasma homocysteine and plasma folate showed significantly negative(p<0.05). Thus, the decreased levels of plasma vitamin $B_{12}$ and folate by aging might affect on the plasma homocyteine concentration acting as a risk factor of cardiovascular diseases for elderly person. The correlation of plasma taurine and hemoglobin, and their platelet showed significantly positive(p<0.05). In conclusion, the diet on the elderly person is one of the important factors to prevent their health from chronic diseases. This study recommends that well balanced diets are needed for elderly person to keep their health and prevent from metabolic syndrome.

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City (평택시 군용비행장 주변지역 주민건강조사)

  • Kim, Hyun-Joo;Roh, Sang-Chul;Kwon, Ho-Jang;Paik, Ki-Chung;Rhee, Moo-Yong;Jeong, Jae-Yun;Lim, Myung-Ho;Koo, Mi-Jin;Kim, Chang-Hoon;Kim, Hae-Young;Lim, Jeong-Hun;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.307-314
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    • 2008
  • Objectives : We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. Methods : The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. Results : The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% Cl) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% Cl 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% Cl 2.14-11.64) for those highly exposed to fighter noise. Conclusions : The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.