The Effects of the Metabolic Syndrome on the Total Medical Charge / 보건행정학회지

BACKGROUND: This study purposed to analyze the effects of metabolic syndrome on the total medical charge of patients. METHODS: 2013 National Health Insurance Service sample research database (eligibility database, medical database, and health examination database) was used for this study. Gamma regression was applied to analyze the effects of metabolic syndrome on the total medical charge and logistic regression was used to determine the probability of medical charge which was higher than the third quartile. Sociodemographic characteristics (age and household income), health behavior factors (smoking, drinking, exercise, and body mass index), and disease related factors (family history and metabolic syndrome) were included as the independent variables. RESULTS: people who had metabolic syndrome spent more medical expenses than those without metabolic syndrome both in man and woman group. The standard regression coefficient was 0.09 (p<0.001) in man with metabolic syndrome and 0.16 (p<0.001) in woman. In addition, woman with metabolic syndrome spent more than the third quartile of medical charge. The odds ratios was 1.04 (p=0.16) for man with metabolic syndrome and 1.18 (p=0.013) for woman. CONCLUSION: people with metabolic syndrome spent more medical charge, so it will need to consider policy interventions for preventing the incidence and management of metabolic syndrome in Korean people.

Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease

PURPOSE: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. METHODS: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. RESULTS: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. CONCLUSION: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

Effects of Amrinone on the Systemic and Pulmonary Hemodynamics in Patients with Pulmonary Hypertension / 대한마취과학회지

BACKGROUND: Amrinone is a noncatecholamine, nonglycoside agent with both inotropic and vasodilatory properties and therefore seems suitable for therapy of right ventricular(RV) dysfunction. The effects of amrinone on systemic and pulmonary hemodynamics in patients with secondary pulmonary hypertension were evaluated. METHODS: With IRB(Institutional Review Board) approval, 21 patients with pulmonary hypertension whose mean pulmonary arterial pressure(mPAP) was greater than 30 mmHg consented to participate in this prospective study. After the sternotomy under the steady state of anesthesia with fentanyl and low concentration of isoflurane, hemodynamic variables including heart rate, systemic arterial pressure(SAP), PAP, cardiac output were measured as control values. Patients recieved an initial bolus dose(1.0 mg/kg) of amrinone followed by a continuous infusion(7.5 mcq/kg/min) for 30 minutes. Hemodynamic variables were measured at 10 minutes and 30 minutes after the start of the continuous infusion. RESULTS: Amrinone reduced SAP and PAP and vascular resistance without tarchycardia. There was no significant change of cardiac output. Ratio of mPAP to mean SAP was decreased after the administration of amrinone. CONCLUSIONS: In cases of chronic RV failure with pulmonary hypertension, amrinone is especially useful because it improve cardiac performance without tarchycardia and reduce RV afterload. Indeed in this study, the fact that amrinone decreased SAP and systemic vascular resistance but reduced PAP and pulmonary vascular resistsnce more significantly(p<0.01) was revealed.

Effects of Amrinone on the Systemic and Pulmonary Hemodynamics in Patients with Pulmonary Hypertension / 대한마취과학회지

BACKGROUND: Amrinone is a noncatecholamine, nonglycoside agent with both inotropic and vasodilatory properties and therefore seems suitable for therapy of right ventricular(RV) dysfunction. The effects of amrinone on systemic and pulmonary hemodynamics in patients with secondary pulmonary hypertension were evaluated. METHODS: With IRB(Institutional Review Board) approval, 21 patients with pulmonary hypertension whose mean pulmonary arterial pressure(mPAP) was greater than 30 mmHg consented to participate in this prospective study. After the sternotomy under the steady state of anesthesia with fentanyl and low concentration of isoflurane, hemodynamic variables including heart rate, systemic arterial pressure(SAP), PAP, cardiac output were measured as control values. Patients recieved an initial bolus dose(1.0 mg/kg) of amrinone followed by a continuous infusion(7.5 mcq/kg/min) for 30 minutes. Hemodynamic variables were measured at 10 minutes and 30 minutes after the start of the continuous infusion. RESULTS: Amrinone reduced SAP and PAP and vascular resistance without tarchycardia. There was no significant change of cardiac output. Ratio of mPAP to mean SAP was decreased after the administration of amrinone. CONCLUSIONS: In cases of chronic RV failure with pulmonary hypertension, amrinone is especially useful because it improve cardiac performance without tarchycardia and reduce RV afterload. Indeed in this study, the fact that amrinone decreased SAP and systemic vascular resistance but reduced PAP and pulmonary vascular resistsnce more significantly(p<0.01) was revealed.