BACKGROUND: Hypertension is one of the frequent problems for which family physicians are well encountered to manage. Nonpharmacologic measures which include stress relaxation, low salt diet, weight reduction, moderation of alcohol intake, physical activity, tobacco avoidance are used as definitive or adjuvant therapy for hypertension. Family physicians should vigorously encourage their patients to adopt these life style modifications. This study was conducted to know how many nonpharmacologic treat,ment modalities are adopted by hypertensives and to find predicting factors. METHODS: A total of 100 of the hypertensive patients who are followed up via the department of family medicine, Hanyang University Hospital, from September 1995 through November 1995 are included in this study. A trained nurse interviewed patients according to the previously designed structured questionnaire. The overall response rate was 90% and the fill-up rate of the questionnaire was 100%. RESULTS: Sixty three patients were women. The mean age was 57.4 years(range, 20 to 84). Sixty one percent accompanied one or more other diseases, of which diabetes mellitus was the most common disorder. The mean systolic pressure was 143.9 mmHg and the mean diastolic blood pressure was 89.3mmHg. Ninty-three percent of patients received antihypertensives with compliance of 81 to 100%. Twenty four percent of patients adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent no smoking. Of those six non-pharmacological treatments, 3.6 behaviors were adhered. Male patients were more attended with the low salt diet. Eleven patients of 2S alcoholics(44.0%) reduced their amount of alcohol intake and 8 of 17 smokers quitted smoking (47.1%) after they were diagnosed as hypertension. The mean BEPSI score was 1.5. Fifty one percent of patients had stress within the last three months, 32 percent had cumulative fatigue. The occupational stress was the most common one. All exercise which patients reported were isotonic. Seventeen percent of the patients took certain herb medicine or folk medicine. CONCLUSIONS: Of those 100 hypertensives who were treated at the department of family medicine, Hanyang University hospital, 24% adhered to regular exercise, 36 per cent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent quit smoking in order. Of those six non-pharmacological treatments, 3.6 behaviors were adhered on the average. Nonpharmacologic treatment should be promoted by family physician as an important strategy for treatment of hypertension.
Antihypertensive Agents ; Blood Pressure ; Compliance ; Diabetes Mellitus ; Diet ; Diet, Reducing ; Drinking ; Fatigue ; Female ; Humans ; Hypertension ; Life Style ; Male ; Medicine, Traditional ; Motor Activity ; Physicians, Family ; Relaxation ; Smoke ; Smoking ; Tobacco ; Weight Loss ; Surveys and Questionnaires

BACKGROUND: Blood pressures rneasured by a nurse at reception room as a part of routine physical examination are oft,en used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors. METHODS: Two hundred ninety one patients who visited to one university hospital farnily practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting t,ime, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer. RESULTS: Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6+/-11.9mmHg (P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(SBP) in more than 5mmHg is more likely to be hypertensive than the group with SBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5rnmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa, 0.747, P<0.01). CONCLUSIONS: Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patients factors which may influence blood pressure level.
Blood Pressure* ; Coffee ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Mass Screening ; Outpatients* ; Physical Examination ; Smoke ; Smoking ; Sphygmomanometers

This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

PURPOSE: The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. METHODS: The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. RESULTS: The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. CONCLUSION: IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.
Anemia ; Anorexia ; Blood Cells ; Body Mass Index ; Child ; Colitis ; Colitis, Ulcerative ; Erythrocyte Indices ; Humans ; Inflammatory Bowel Diseases ; Medical Records ; Rectal Prolapse ; Serum Albumin ; Weight Loss

No abstract available.
Sinusitis*

No abstract available.
Dust* ; Mastoid*

No abstract available.
Acne Vulgaris* ; Hair Removal* ; Pigmentation Disorders*

The human chromosome analysis is widely used to diagnose genetic disease and various congenital anomalies. Many researches on automated chromosome karyotype analysis has been carried out, some of which produced commercial systems. However, there still remains much room for improving the accuracy of chromosome classification. In this paper, We propose an optimal pattern classifier by neural network to improve the accuracy of chromosome classification. The proposed pattern classifier was built up of multi-step multi-layer neural network(MMANN). We reconstructed chromosome image to improve the chromosome classification accuracy and extracted three morphological features parameters such as centromeric index(C.1.), relative length ratio(R.L.), and relative area ratio(R.A.). This Parameters employed as input in neural network by preprocessing twenty human chromosome images. The experiment results show that the chromosome classification error is reduced much more than that of the other classification methods.
Chromosomes, Human ; Classification* ; Humans ; Karyotype*

BACKGROUND: Anemia is a most common complication of chronic renal failure and erythropoietin has proven to be a effective treatment for anemia in dialysis patient. However, in patients with pre-dialysis chronic renal failure, Use of erythropoietin is usually limited because of its high cost and frequent administration. The purpose of this study was to evaluate the efficacy of low dose erythropoietin treatment in patient with pre-dialysis chronic renal failure. METHODS: We administered erythropoietin 2000U weekly to 25 patients with pre-dialysis chronic renal failure untill hemoglobin and hematocrit reached to 11g/dl, 33% respectively. After then we administered erythropoietin 1000U weekly as a maintenance dose. We measured the level of hemoglobin, hematocrit, reticulocyte count, serum creatinine, BUN, serum iron, ferritin, total iron binding capacity every two weeks for 12 months. RESULTS: 1) In 25 patients treated for 16 weeks, hemoglobin and hematocrit level increased from 8.2g/dl,24.2% to 8.8g/dl,28.2%(p< 0.05) respectively. After 28 weeks treatment, 23 patients(92%) reached target hemoglobin and hematocrit value(11g/dl,33%). 2) Serum iron level increased from 180.2ug/dl to 165.1ug/dl(p< 0.05) after 16 weeks treatment. But there were no significant changes in serum ferritin and total iron binding capacitiy. 3) There was no significant change in reciprocal serum creatinine value before and after erythropoietin treatment. 5) There was no significant side effect except mild exacerabation of hypertension(2 cases) during erythropoietin treatment. CONCLUSION: This result show that relatively low dose erythropoietin treatment in patient with pre-dialysis chronic renal failure can be used as a effective treatment for anemia despite of slow and gradual response.
Anemia ; Creatinine ; Dialysis ; Erythropoietin* ; Ferritins ; Hematocrit ; Humans* ; Iron ; Kidney Failure, Chronic* ; Reticulocyte Count

OBJECTIVE: To evaluate the usefulness of cutaneous silent period(CSP) in assessing the pain sensory function mediated by the Adelta fiber in diabetic polyneuropathy and to define the proper CSP parameter and method. METHOD: We studied 18 diabetic polyneuropathy patients and 20 age-matched healthy subjects. CSPs were recorded in the abductor pollicis brevis muscle and soleus muscle with the surface electrodes and a painful electrical stimulation was given to the mixed nerves(median and tibial nerve) and cutaneous nerve(ulnar and superficial peroneal nerve). Onset latency, end point and duration of CSP were compared between two groups. CSP parameters correlated with the motor and sensory nerve conduction parameters in diabetic polyneuropathy patients. RESULTS: CSP onset latency and end point were significantly delayed in diabetic polyneuropathy patients for both mixed nerve and cutaneous nerve stimulations. There was no difference in CSP duration between two groups. CSP onset latency was shortend and duration was prolonged in mixed nerve stimulation due to an antidromic collision, which showed a cutaneous nerve stimulation as the propor method. There was no correlation between the CSP parameters and motor and sensory nerve conduction parameters. In 3 cases, the CSPs were unable to the evoked despite the sensory nerve action potential was normally evoked. This suggests that the CSP would give an information about the Adelta fiber function than the large myelinated fiber. CONCLUSION: This study indicates that the CSP is a useful supportive electrophysiologic study to assess the Adelta fiber function in diabetic polyneuropathy. The CSP onset latency and cutaneous nerve stimulation are the useful parameter and method for the CSP.
Action Potentials ; Diabetic Neuropathies* ; Electric Stimulation ; Electrodes ; Humans ; Muscle, Skeletal ; Myelin Sheath ; Neural Conduction ; Sensation