• Journal of Chest Surgery
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• v.29 no.3
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• pp.263-270
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• 1996

Twenty two patients underwent total anatomic correction of complete atrioventricular septal defect associated with other cardiac anomalies between July 1986 and December 1994. Age ranged from 6 months to 11 years(mean 49.6 $\pm$ 35.8 months), and they were composed of 7 males and 15 females. Combined major cardiac anomalies were tetralogy of Fallot(TOF) in 11 cases, double outlet of right ventricle (DORV) in 6 ca es, and transposition of great arteries (TGA) in 5 cases. Down's syndrome was associated in 5 patients with TOF and 1 patient with DORV. They were classified as Rastelli type A in 3 patients, B in 2 patients, and C in 17 patients. Modified Blalock-Taussig shunt was performed.in 5 patients and Waterston shunt in 1 patient as a palliative procedure. There were 7 perioperative deaths(31.8%) and the causes were pump weaning failure, low cardiac output, acute renal failure, persistant pulmonary hypertension and hypertensive crisis, and sepsis. Reoperations were performed in 4 cases to repair atrioventricular valvular regurgitation or to relieve the right ventricular outflow tract (RVOT) or pulmonary arterial stenosis. One late death was due to aspiration pneumonia. Second reoperation was necessary for progressive worsening of left atrioventricular regurgitation and RVOT stenosis in one patient. Fourteen survived patients were followed up for a mean of 66.0 $\pm$ 26.7months and all of them w re NYHA functional class I or II.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.15-27
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• 2003

Objectives: This study was conducted to compare the medical care patterns of hypertensive patients between rural and urban areas. Methods: We selected one rural county(Region A where there were 19 public health centers; one health center, 8 health sub-centers and 10 community health posts) and two urban districts(Region B and C where there was no health sub-center and community health post) in Daegu city. Region B had similar socioeconomic characteristics with rural county A while region C had different characteristics. The medical insurance records of 14,422 incident patients (2,501 in region A, 4,873 in region B and 7,048 in region C) with diagnostic code of hypertension from September 1998 to August 1999 were reviewed. Incident patient was defined as a patient who had no record of medical fee claim for hypertension to the national health insurance corporation in past 6 months and visited a medical facility for hypertension for the first time. The data for annual visit days, annual prescription days and annual total medical expenses were abstracted. The medical care pattern was categorized by the number of annual visit days and prescription days. The most proper care group was defined as the patient who visited 6-15 days with 240 prescription days or more in a year. Results: The type of medical facilities for the most visit was clinics, 373.% and it was followed by general hospitals, 28.2%; public health centers, 24.7%; and hospitals, 9.8% in region A(p<0.05). In region B, it was clinics, 63.1% and followed by general hospitals, 27.6%; health center, 5.2%; and hospitals, 4.1%(p<0.05). In region C, it was clinics, 53.8% and followed by general hospitals, 35.0%; health center, 6.3%; and hospitals, 4.9%(p<0.05). Annual mean total medical expenses per patient was highest in region C(won195,993) and followed by region A(won191,683) and region B(won178,713). The proportion of the most proper care group was 7.7% in region A, 5.2% in region B and 6.7% in region C(p<0.05). According to the type of medical facilities for the first visit, the proportion of the most proper care group was highest(14.7%) in the patients of public health centers, and it was followed by general hospitals, 8.8%; clinics, 3.6%; and hospitals, 2.0% in region A(p<0.05). In region B, it was highest in general hospitals, 9.7% and followed by hospitals, 4.0%; health center, 3.6%; and clinics, 3.4%(p<0.05). In region C, it was highest in general hospitals, 10.1% and followed by clinics, 5.2%; hospitals, 4.1%; and health center, 3.1%(p<0.05). Conclusions: The proportion of proper care for hypertension was higher in rural area and it was attributed to the care of health center, sub-centers and community health posts which appeared to follow patients better than hospitals and clinics.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.10
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• pp.1287-1292
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• 2007

The purpose of this study was to compare knowledge on hypertension and blood parameters through blood pressure control of hypertensive patients commuting to a public health center. Hypertensive subjects were classified according to their blood pressures into a well-controlled group (SBP<140 mmHg and DBP<90 mmHg, n=44) and an uncontrolled group ($SBP\geq140mmHg\;or\;DBP\geq90mmHg$, n=41). All subjects were interviewed for clinical characteristics, effort for health maintenance and knowledge on hypertension and nutrition. Biochemical measurement of blood urea nitrogen, creatinine, triglyceride, total cholesterol, HDL-cholesterol and fasting blood glucose (FBG) were obtained from subjects. The knowledge about hypertension and effort for health maintenance were not significantly different between the groups. However, the nutrition knowledge score of the well-controlled group was significantly higher (p<0.05) than that of the uncontrolled group. On the test of nutrition knowledge, 97.7% of the well-controlled group answered correctly to the item, 'Medication is an easy way to control blood pressure'. This result was significantly higher (p<0.05) than that of the uncontrolled group of whom 82.9% answered correctly. Participants in both groups had only a little understanding about the importance of a balanced diet. Blood parameters were in the normal range and there was not a significant difference between the groups. However total cholesterol, triglyceride and fasting blood glucose levels of the uncontrolled group were higher than those of the well-controlled group. Therefore, education programs about the continuous control of hypertension through careful monitoring, medication, and exercise are required. The uncontrolled group was especially in need of strengthening education. Also more effective nutrition education programs about low salt, high fiber, low cholesterol, and balanced diets are required for hypertensive patients commuting to public health center.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.551-560
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• 2006

Purpose: This study was to develop and prove the effects of aself management compliance promotion program for primary hypertension patients who reside in rural communities. Method: The content of the self management compliance promotion program developed by this study was as follows: A leader trains patients as a group or individually, in walking, education and green tea therapy from the first to twelfth week. From the thirteenth to twenty fourth week, the patients should perform walking and green tea therapy by themselves. One hundred twenty subjects volunteered to participate in the study, who were among those registered as hypertension patients in the 14 community health clinics located in Chungcheongbuk-do. Result: Systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglyceride, step width, and degree of obesity decreased significantly. High-density lipoprotein cholesterol, step length, knowledge of hypertension, and self management compliance significantly increased, Conclusion: A self management compliance promotion program for primary hypertensive patients enhances biophysical index and knowledge on hypertension, thus ultimately suggesting a nursing intervention for promoting self management compliance.

• Research in Community and Public Health Nursing
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• v.26 no.4
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• pp.390-397
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• 2015

Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

• Nutritional Sciences
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• v.2 no.2
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• pp.76-81
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• 1999

Sodium restricted diets are known to lower blood pressure in salt sensitive, hypertensive patients. Thare is increasing evidence that potassium plays an important role as a protective factor in the regulation of blood pressure. The objective of the current study was to measure parameters of sodium, potassium, and chloride utilization as affected by feeding of substantial quantities of bread made from whole ground white torn meal, whole ground yellow corn meal, and whole ground wheat flour. The breads provided 40 percent of a caloric content of the constant, measured laboratory diet. The 28-day study was divided into an introductory period of 7-days and three experimental periods of 7-days each. Order of assignment to specific treatments for 12 healthy subjects were according to a complete randomized block design. Yellow corn bread diets resulted in the highest potassium retention (243 mg/day) and the lowest urinary sodium and potassium ratio (1.53 $\pm$ 0.26) numerically in comparison to the other test breads. The excretions of sodium and chloride were higher during controlled feeding periods than during the self-selected diet period(p < 0.05). This indicates a response to the higher intake of these electrolytes from the experimental diets than from self-selected diets. There was no significant difference in the effect of white corn bread, yellow corn bread, or whole wheat bread diet on electrolyte status in humans. However, the yellow corn bread diet resulted in a somewhat more favorable urina교 sodium to potassium ratio than that from white corn bread or whole wheat bread diet.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.17 no.1
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• pp.28-35
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• 2010

Purpose: The study compared the hypertension care efficacy of a case management intervention program for registered clients. Methods: The nonequivalent control group pretest-posttest design involved 53 registered hypertensive patients of a customized visiting health care service in S-city(n=28 experimental group, n=25 control group). Data collection and case management intervention were carried out from April to July, 2009. The experimental group had six home visits and two phone calls, and the control group had two home visits during the 8-week period. Outcome variables for test hypotheses were changes in physiologic index (blood pressure and total cholesterol) and degree of self-management performance and confidence. Results: Repeated measure ANOVA and t-test of means revealed significant differences before and after program for systolic and diastolic blood pressure and self-management performance and confidence, but no significant difference concerning total cholesterol. Conclusion: A case management program can have positive effects on blood pressure control and self management. However, research is needed to create a more effective case management for vulnerable patient populations.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.48-60
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• 2016

Purpose: The purpose of this study was to identify the attributes of the concept, of psychological resistance to antihypertensive medication. Methods: The study was conducted in accordance with Walker and Avant's conceptual analysis process. We reviewed 47 related studies selected from 4 international and Korean databases including Medline, CINAHL, NDSL, and RISS to perform the analytical processes from January 1980 to September 2015. Results: The attributes of psychological resistance to antihypertensive medication include 1) reservation, 2) opposition, 3) denial, 4) refusal, and 5) seeking alternative therapy. The antecedents of the concept can be classified into patient factors such as reactance trait and knowledge deficit, provider factors, interpersonal factors, and environmental factors. The consequences of psychological resistance to antihypertensive medication are non-compliance, deterioration of the disease, developing complications, increased anxiety, and changes in life. Conclusions: The concept of psycho logical resistance to antihypertensive medication can provide guidance for the development of an intervention program that promotes the compliance to medication regimen of hypertensive patients. Further research needs to be done to develop a measurement tool for psychological resistance to antihypertensive medication.

• 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.

• Biomedical Science Letters
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• v.18 no.4
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• pp.406-412
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• 2012

The polymorphism (insertion, I or deletion, D) of angiotensin converting enzyme (ACE) gene is designated as the presence of a 287 bp Alu repeat. The D/D homozygote carrier is associated with high ACE activity, and this high activity has been implicated with hypertension, coronary artery disease, or diabetic nephropathy. We studied the clinical candidate marker in ACE gene polymorphism using chemical and hematological analysis. The subjects are divided into normotensive and hypertensive groups and ACE genotype in the group was confirmed by PCR method. Chemical analysis was preceded with Hitachi7060, and hematological analysis was performed using Mythic 22. In 116 targeted people, 17 (38.64%) of 44 I/I genotype group are hypertension, 15 (34.09%) in 44 with D/I, but, D/D type in the 28 cases is 15 patients (53.57%) in hypertension. In hypertension group, biochemical analysis (triglyceride, and alkaline phosphatase) and hematological analysis (white blood cell, platelet) are showed high value in D/D genotype of ACE gene. The relationship between hypertension and ACE genotype is the same results as previously reported and we thought that the high laboratory value of white blood cell, platelet, triglycerides, and alkaline phosphatase are also indicator of hypertension in D/D type of ACE.