• Title/Summary/Keyword: hypertensive patients

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Chunghyul-dan for the Prevention of Stroke Progression in Silent Brain Infarction (무증후성 뇌경색 환자에 대한 청혈단(淸血丹)의 중풍예방효과)

  • Cho Ki-Ho;Ji Nam-Gue;Jung Woo-Sang;Park Seong-Uk;Moon Sang-Kwan;Ko Chang-Nam;Kim Young-Suk;Bae Hyung-Sup
    • The Journal of Korean Medicine
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    • v.26 no.2 s.62
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    • pp.77-84
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    • 2005
  • Objectives: Chunghyul-dan is a combinatorial herbal medicine, and previous studies reported it had therapeutic effects for microangiopathy, which is a major part. in the progression of stroke, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities, Therefore, we examined the inhibitory effect of Chunghyul-dan on stroke occurrence in patients with silent brain infarction. Methods: We prescribed Chunghyul-dan at 600 mg a day to patients with silent brain infarction confirmed by brain MRI, and monitored stroke occurrence, drug compliances, and adverse effects for 1 year, We then performed follow-up brain MRI to detect new vascular lesions after 1 year of Chunghyul-dan medication. As for the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results: There were twenty-one subjects who were treated with Chunghyul-dan for more than 1 year, None of them experienced new clinical syndromes characterized by rapidly developing clinical symptoms and signs of focal and at times global loss of brain function, which could be accompanied with evidence of stroke occurrence, or any adverse effects during the Chunghyul-dan medication period. These results might be explained by various biochemical effects of Chunghyul-dan on microangiopathy, which is closely related with cell cycle progression, hypertension, hyperlipidemia, vascular inflammation, and oxidative damage. Of the 10 subjects lost to follow-up, six were reached; two of them had stroke occurrence. Conclusions: We suggest Chunghyul-dan could be useful for prevention of stroke occurrence in patients with silent brain infarction by preventing the progression of microangiopathy. Further study with a randomized controlled trial is needed to confirm this suggestion.

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Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies (소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술)

  • Kwak, Ju Yuong;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.137-142
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    • 2005
  • Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

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The Effect of Re-building of Public Health Facilities on the Hypertension Control in the Rural Area (농촌 보건기관의 신축이 고혈압 환자 혈압 조절에 미치는 영향)

  • Chun, Sung-A;Na, Baeg-Ju;Kim, Chul-Woung;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.33 no.1
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    • pp.37-45
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    • 2008
  • Objectivesthe hypertension control in the rural area.Method: 6 health centers and 59 health subcenters in some Chung-chung province was surveyed. And 29,503 patients were finally selected who had records of prescription about hypertension at list once in those medical doctor was a medical specialist or not, and whether the facilities were recently rebuilded or not was measured.Results: The Overall control rate was 53.9%. Women had higher hypertension control rate than men. And 60s and 70s years old are had higher hypertension control rate than 40s and 80s years old. Patients who patient who treated in rebuilded public health facilities had higher hypertension control rate.Conclusions: Rebuilding of public health facilities were related to increasing control rate of hypertensive patients.

A Preliminary Study on the Inhibitory Effect of Chunghyul-dan on Stroke Recurrence on Patients with Small Vessel Disease

  • Cho, Ki-Ho;Jee, Nam-gue;Jung, Woo-Sang;Park, Seong-Uk;Moon, Sang-Kwan;Ko, Chang-Nam;Kim, Young-Suk;Jung, Woo-Sang
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.224-236
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    • 2007
  • Background : Chunghyul-dan is a combinatorial herbal medicine; previous studies reported it had therapeutic effects for microangiopathy, a major part in the progression of small vessel disease, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities. Therefor, we examined the inhibitory effect of Chunghyul-dan on stroke recurrence in patients with small vessel disease. Methods : We prescribed Chunghyul-dan at 600 mg a day to patients with small vessel disease, and monitored stroke recurrence, drug compliances, and adverse effect for 1 year. We then performed follow-up brain MRI to find new vascular lesions after 1 year of Chunghyul-dan medication. For the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results : There were 73 subjects treated with Chunghyul-dan for 1 year; new vascular events were found in 3. Of the 85 subjects lost to follow-up, fifty four could be contacted, and eight of them had stroke recurrence. One year of Chunghyul-dan medication reduced the odds ratio of stroke recurrence by 75% compared to the subjects lost to follow-up and the rate increased to 88%, when adjusted for other relevant risk factors for stroke recurrence. These reductions were much higher than those of aspirin and other kinds of conventional anti-platelets. There was no adverse effect in any of the study subjects. Conclusions : We suggest Chunghyul-dan could be useful for inhibition of stroke recurrence. Further study with a randomized controlled trial is needed to confirm this suggestion.

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A study of the development of macrovascular complications and factors related to these complications in young adults with childhood/adolescence-onset type 1 diabetes mellitus (소아청소년기에 1형 당뇨병으로 진단된 젊은 성인에서 대혈관 합병증의 발생과 이에 연관된 인자에 대한 연구)

  • Kang, Min Jae;Kim, Joo Hwa;Chung, Hye Rim;Lee, Young Ah;Shin, Choong Ho;Yang, Sei Won;Kim, You Yeh;Jin, Seon Mi;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.220-226
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    • 2009
  • Purpose : Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence. Methods : Seventy-two patients ($23.9{\pm}2.4$ years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed. Results : Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects ($0.43{\pm}0.06$ mm vs $0.39{\pm}0.06$ mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01). Conclusion : Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.

Implementation of Service Model to Exchange of Biosignal Information based on HL7 Fast Health Interoperability Resources for the hypertensive management (고혈압 관리를 위한 헬스레벨 7 FHIR 기반 생체정보 교환 서비스 모델 구현)

  • Cho, Hune;Won, Ju Ok;Hong, Hae Sook;Kim, Hwa Sun
    • Journal of Internet Computing and Services
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    • v.15 no.3
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    • pp.21-30
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    • 2014
  • Hypertension is one of the major causes of death in the world as it is related with cardiovascular or cerebrovascular disease, so it is needed to provide continuos management for blood pressure. This study selected Health Level 7 Fast Health Interoperability Resources (HL7 FHIR) as a bio-signal data exchange service model that can provide constant blood pressure management in the rapidly growing mobile health care environment. The HL7 FHIR framework developed communicates with the IEEE 11073-10407 Personal Health Device (PHD) protocol through the bluetooth Health Device Profile (HDP) between the manager (smart phone) and the agent (hemomanometer) and acquires information about blood pressure. According to the test results, it performed its tasks successfully including hypertension patients' blood pressure monitoring, management on measured records, generation of document, or transmission of measured information. Because in the actual, clinical environment, it is possible to transmit measured information through the TCP/IP protocol, it will be needed to conduct constant research on it and vitalize it in the field of mobile health care afterwards.

Korean Herbal Medicine on Hypertension : A Systematic Review in Korean Internal Medicine's Studies (한약 복용이 고혈압에 미치는 영향: 내과학회 학회지 논문에 대한 고찰)

  • Baek, Hye-Ki;An, Jung-Jo;Jo, Hyun-Kyung;Yoo, Ho-Ryong;Kim, Yoon-Sik;Seol, In-Chan
    • Journal of Haehwa Medicine
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    • v.18 no.2
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    • pp.81-88
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    • 2009
  • Background : Almost people know hypertension's treatment is taking western medicine. But korean herbal medicine(KHM) also have an effect of turning down blood pressure. Objectives : This study aims to review the influence of KHM on hypertension in korean internal medicine's studies systematically. Additionally, we tried to estimate the change of data of hypertension and let people know a possibility of herbal treatment on hypertension. Methods : Systematic studies searches were performed on one database of korean internal medicine to November 2009. Screening and selection of the studies and extraction of data were performed by one author. Results : Twelve studies were included. All studies were performed retrospectively. Almost studies's object were hypertensive rats. Two studies's object were rabbits and only one study's object was hopitalized patients. Blood pressure and pulse was changed significantly after taking KHM in almost studies, and rest of items, aldosterone, catecholamine, electro, angiotensin converting enzyme inhibitory effect, renin activity were changed significantly after taking KHM. Conclusions : KHM might have an effect of lowering blood pressure, but almost studies's object were animals, so it is necessary to investigate an effect of KHM for people.

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Clinical Outcomes according to Radiological Classification of Brainstem Hemorrhages (방사선학적 출혈양상에 근거한 뇌간출혈의 분류에 따른 임상결과)

  • Cho, Won Jung;Moon, Seong Ho;Lee, Seung Min;Yang, Jae Young;Choi, Chun Sik;Ju, Mun Bae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.217-221
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    • 2000
  • Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n=7) and diffuse tegmentobasilar hemorrhage(group II, n=30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

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Development of a Salt Taste Sensor for Improvement on Meal HabitDirection Method (식습관 개선을 위한 음식 짠맛센서 개발)

  • Yang, Gil-Mo;Seo, In-Ho;Kim, Gi-Young;Lee, Kang-Jin;Son, Jae-Yong;Mo, Chang-Yeon;Kim, Yong-Hoon;Park, Saet-Byoul
    • Journal of Biosystems Engineering
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    • v.35 no.5
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    • pp.310-315
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    • 2010
  • The amount of salt intake of Korean people is 11.4 grams per a day, which is 2.3 times of the recommended daily salt intake by WHO - 5 grams of salt a day. The relationship between high salt consumption and increased risk of high blood pressure, observed not only in hypertensive but also in normotensive patients. High salt intake is also associated with an increased risk of heart attack, cerebral ischemia and osteoporosis. Therefore, this research is for developing a salt taste sensor to reduce sodium consumption and improve meal habits for the perception of a more bland taste of most foods. When the sensor was put into food sample, current intensity achieved with distribution cables. Current intensity was correlate with a simple equivalent of salt taste stimulus intensity. The salt taste sensor consists of salinity & temperature measuring probe, signal processing circuit and LCD display & LED warning light. When salinity is going over a set point, LCD displayer indicate salt taste on LCD panel by percent value (%), and at the same time, blue LED light change to red LED light. So we could know the grade of salt taste in soup before meals conveniently and objectively. The results show that operating range of 10 to $80^{\circ}C$ and accuracy of ${\pm}0.1%$ were achieved with an analysis time of about 2 or 3 sec. Moderate reductions in salt intake can help to avert adult diseases and lead a healthy life.

Risk Assessment of Smoking for Ischemic Stroke in Koreans

  • Jung, Woo-Sang;Choi, Byung-Ok;Park, Jung-Mi;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.19-24
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    • 2003
  • Background and Purposes : Smoking is a well-known risk factor for ischemic stroke. It may contribute to s1Toke by inducing the aggregation of platelets and formation of atheroma, reducing cerebral blood flow, and increasing fibrinogen. However, the relative risk varies according to different ethnicity and area. Therefore, we performed this study to assess the risk of smoking for ischemic s1Toke in Korea. Methods : Cigarette smoking habit was studied in 308 patients with ischemic s1Toke and in 348 age- and sex-matched control subjects who had no history of stroke using case control methods. In multiple logistic regression analysis, smoking had a significant value of odds ratio adjusted for hypertension, diabetes mellitus, and hyperlipidemia. Results : The adjusted odds ratio (AOR) and 95% confidence interval (CI) was significant in the medium smokers (AOR, 1.92; 95% CI, 1.11 to 3.33: p< 0.05) and heavy smokers (AOR, 2.80; 95% CI, 1.64 to 4.78: p< 0.05). Furthermore, the OR was higher in hypertensive subjects than in normotensive subjects compared to non-smokers (AOR, 1.98; 95% CI, 1.01 to 3.85: p< 0.05). Conclusions : Our findings suggest that smoking is an independent risk factor for ischemic stroke in Korea.

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