Background: According to previous epidemiologic studies, the metabolic syndrome, dietary and lifestyle factors were associated with colon polyps. The aim of this cross-sectional study was to assess the relationship between the risk of the colorectal adenoma incidence and the individual components of the metabolic syndrome with lifestyle factors such as drinking, cigarette smoking and physical activity.Methods: Sigmoidoscopic examination for colon cancer screening was performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital in Ulsan, Korea. A total of 1,565 subjects underwent satisfactory sigmoidoscopy. The subjects with a history of colon cancer or polyps or inflammatory bowel disease were excluded from the study. Alcohol consumption, cigarette smoking and other confounding factors were included as covariates in the models.Results: After adjusting for age, physical activity, smoking and alcohol intake, the subjects of metabolic syndrome (>= 3 vs. 0 components) combined with cigarette smoking had a positive association with colorectal adenoma incidence (OR 3.63, 95% CI 1.49 similar to 8.89). Physical activity was negatively associated the risk of the colorectal adenoma incidence (OR 0.60 95% CI 0.44 similar to 0.81).Conclusion: These results suggest that clustering of components of the metabolic syndrome combined with cigarette smoking significantly increased the colorectal adenoma risk, but physical activity reduced the risk of colorectal adenoma incidence in Korean adult males after multivariate adjustment.
Background: Physicians rarely take patients' sexual history during routine medical visit, although it would give very helpful information to reach accurate diagnosis and proper management. This survey was conducted to assess the primary physicians' perspectives towards sexual history taking and their actual behaviors on it.Methods: The survey questionnaire was made through the literature review, in-depth interview and pilot survey. We mailed this questionnaire to 400 primary care physicians who were randomly selected from the lists of internists and family physicians in Seoul and Gyunggi province and 73 of them responded.Results: The mean age of the respondents was 44.3 years. Most of them responded that sexual history is necessary only when the patients' chief complaints are directly related to sexual issues. Among the total, 94% of them answered that he or she took sexual history in less than 25% of the patients who visited his/her own clinic during last one month. The most prevalent barriers to initiate sexual history taking were fear of patients' misunderstanding about sexual harassment or intrusion into patients' personal life (60.3%) and uncertainty to conducting sexual history taking (53.4%). They thought that they were not well educated enough to take sexual history with confidence and more structured education is needed in medical schools and postgraduate residency training.Conclusion: Sexual history seemed not to be taken by primary care physicians as a routine medical practice and physicians showed rather passive attitude. Beneficial effects of sexual history taking on patients' management and related communication skills should be emphasized and systematically educated.
Background: A curriculum in medical school should help doctors achieve professional attitude, ethics and values by socialization process. However, existing knowledge-based curriculum has lots of shortcomings to reach these ideal goals. This study was operated to investigate the effect of a 'service-learning program' for premedical students in medical college of Korea University.Methods: The survey was conducted from July 3 2006 to 5 at Chungbuk Eumsung Kkottongnae. A total of 99 students completed surveys; before and after the intervention. The questionnaire was consisting of necessity and goal of the program and it also include assessment of students' attitude and contents of the program. Each item was assessed by using 5-Likert scale. For comparing the items, we practiced paired t-test.Results: 97 (response rate 97.9%) students completed survey. 53 students (54.6%) agreed 'the program is really needed.' About the questions: 'self-development from program', 'the program will be helpful for medical activity in the future.' students gave positive answers. The participants' attitude, interest was significantly increased. Also 'the motivation', 'appropriation of the program and time allocation', 'general satisfaction' were all increased.Conclusion: 54.6% of participants thought a servicelearning program was necessary for a medical curriculum and this program would be helpful to get self-development and professionalism. Active attending for a service-learning program increased interest and motivation. It will be needed further study about the long-term effect of a service-learning program.
Background: Depression increases the risk of cardiovascular risk factors in adults. However, the association between depression and cardiovascular risk factors was not well evaluated in South Korea. Our study was done to evaluate the association between depression and cardiovascular risk factors in workers.Methods: The study population was selected among adults working in several industries that had more than 50 employees. They had received their medical examinations at the Health Promotion Center of Hallym University Sacred Heart Hospital between March and November 2005. We estimated the odds ratio to determine whether depression (Korean Center for Epidemiologic Studies Depression Scale score >= 21) was associated with each cardiovascular risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity).Results: The prevalence of depression was 15.5%. Depression was significantly associated with hypertension (P<0.001), obesity (P=0.03) and hypercholesterolemia (P=0.004). The adjusted odds ratio for hypertension and hypercholesterolemia were 1.41 (95% CI 1.04 +/- 1.91) and 1.59 (95% CI 1.05 +/- 2.40), respectively. The association between depression and obesity was eliminated after adjustment (1.25, 95% CI: 0.97 +/- 1.61).Conclusion: Depression was significantly associated with hypertension and hypercholesterolemia in workers. Further long-term study on the association of depression with cardiovascular risk factors is necessary.
Background: Menstruation is often regarded as a privilege for women allowing reproductive activity. However, abrupt hormonal fluctuations in menstrual cycle may cause distressing physical and psychological symptoms such as premenstrual syndrome (PMS). PMS is known to have a great impact on daily life activities and social functions, and might result in significantly decreased quality of life (QOL). In this study, we aimed to evaluate a relation between PMS and QOL in young adult Korean women.Methods: Self-administered questionnaires were distributed to a total of 514 women who were aged 16 similar to 35 years and who were employed in an industrial complex located in Gyeonggi-do, Korea. PMS was assessed using diagnostic criteria recommended by the American Psychiatric Association. QOL was assessed using Korean health related Quality of Life Scale. The association between PMS and QOL was examined in 440 women using the two-sample t-test after excluding 74 women who were missing for variables essential for the assessment of PMS and QOL.Results: The prevalence of PMS was 7.3% (32 out of 440 women). Women with PMS had the worse QOL score in almost all domains of QOL except for spiritual health (physical function, psychological health, social function, pain, vitality, role limitation, health status perception, and health status change).Conclusion: There was a significant relation between PMS and QOL. The finding of significantly lower QOL in women with PMS suggests that PMS should be evaluated and treated actively in primary care.
Background: In spite of its high prevalence and social impact, pain in the elderly has not been managed appropriately. Understanding the multidimensional aspect of pain is crucial in its effective management. Patients with chronic pain are known to be more profoundly affected by psychological and social factors. We, therefore, classified chronic pain patients and especially focused on the relationship between pain and stress.Methods: The subjects were 149 persons older than 60 years attending a certain geriatric college. A survey was peformed employing the Korean version of Geriatric Pain Measure (GPM-K), the Korean Version of Brief Pain Inventory (BPI-K), the Elderly Life Stress Inventory (ELSI), the Perceived Stress Scale (PSS), the Geriatric Depression Scale Short Form-Korea Version (GDSSF-K), and the Revised Chalder's Fatigue Scale (Fatigue).Results: A total of 103 people, who completed both the questionnaires on pain and stress were enrolled. There was a significant correlation between GPM-K and ELSI (ELSI: r=.38, P< 0.01). In chronic pain patients, not only ELSI, but also PSS was correlated with GPM-K (ELSI: r=. 37, P< 0.01, PSS: r=. 25, P=0.04).Conclusion: There was a significant correlation between GPM-K and ELSI in the elderly. In chronic pain patients, it was more closely associated with GPM-K. We, therefore, believe that stress management can be useful in the management of pain, especially in the management of chronic pain patients.
Background: The objective of the current study was to evaluate the association between fatty liver and osteoporosis in Korean postmenopausal women.Methods: We examined postmenopausal women who participated in a health screening test from April 2004 to November 2007. Data about lifestyle and current medical diseases and medications were collected from medical records and medical interviews. Body weight, height, waist circumference and blood pressure were measured. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry and body composition analyzer and abdominal ultrasonography were conducted for each participant.Results: One thousand two hundred forty-five postmenopausal women were selected for this study. In postmenopausal women, the spine BMD levels (g/cm(2)) were significantly different in each subjects with normal (0.819 +/- 0.004), mild (0.846 +/- 0.007), moderate (0.844 +/- 0.009) and severe (0.779 +/- 0.031) fatty liver adjusted for age (P < 0.01). The proportion of osteoporosis were significantly different in each subjects with normal (39.1%), mild (30.3%), moderate (31.6%) and severe (56.3%) fatty liver. A multiple logistic regression analysis was performed to determine the association between fatty liver and oste-oporosis after age, body mass index, smoking, alcohol drinking and regular exercise. In severe fatty liver compared to the normal subjects of fatty liver, adjusted odds ratio was 3.6 (95% CI 1.2 +/- 10.9).Conclusion: In severe fatty liver disease, the proportion of osteoporosis was increased and the bone mineral density was lower than the normal subjects of fatty liver.
Background: Childhood obesity is becoming more prevalent, associated with a variety of adverse consequences which leads to adulthood obesity. Although diagnosis is usually made by body mass index, there is neither a cutoff point for the percentage body fat nor abdominal circumference. The aim of this study was to identify each cutoff point for both measures.Methods: The measurement of height, weight, abdominal circumference and percentage body fat was performed through manual assessment and bioelectrical impedance analysis for 4,242 subjects aged 11 in Gunpo City, South Korea. The cutoff point for body fat percentage and abdominal circumference is set to maximize the sum of sensitivity and specificity for detecting obesity and overweight using the Receiver Operating Characteristics (ROC) curve.Results: The mean percentage body fat was 13.6 +/- 6.9% for boys and 19.4 +/- 5.3% for girls. The mean abdominal circumference of boys was 68.0 +/- 9.1 cm, and that of girls was 64.3 +/- 7.7 cm. The cutoff point of percentage body fat for obesity was 21.8% in boys and 24.5% in girls. The prevalence of obesity was 15.2%, 16.7% for males and females, respectively. The abdominal circumference cutoff for obesity was 76.9 cm in boys and 70.7cm in girls. Based on that, the prevalence of obesity was 19.7% for boys and 20.0% for girls, which was higher than what was identified by body mass index, as in the case of body fat percentage.Conclusion: The cutoffs of body fat percentage and abdominal circumference in one city of Gyeonggi Province were lower than those suggested in the previous studies.
Background: Atherosclerosis of the coronary artery is related to the obstructive coronary artery disease. The coronary artery calcium score test is a non-invasive and useful indicator of atherosclerosis. The Framingham risk scoring system is a traditional indicator of the cardiovascular risk. This cross-sectional study was performed to evaluate the relation of the coronary artery calcium scores with Framingham risk scores.Methods: We evaluated 135 patients who visited the Department of Family Medicine in Severance Hospital and had a test of the coronary artery calcium scores from January 5th, 2005, to August 12th, 2006. The Framingham risk scores were calculated. We analyzed the correlation between the coronary artery calcium scores and the Framingham risk scores and tested the difference between the groups divided by categorization of the calcium scores.Results: The coronary artery calcium scores were significantly correlated with the Framingham risk scores (r=0.282, P<0.01). There was a significant correlation in case of women (r=0.349, P<0.01), but not in case of men. There was a significant difference between the group whose calcium score was 0 and the group whose calcium scores were above 0 (P<0.001).Conclusion: There was a positive correlation between the coronary artery calcium scores and the Framingham risk scores. The coronary artery calcium score seems to be a significant factor to assess the cardiovascular risk.
Background: Body image, a personal perception of the body shape, is known to influence motive to control body weight. This study aimed to evaluate perception of body image according to the weight status in children.Methods: The study participants were 442 Korean boys and girls enrolled in 2nd or 6th grade of a primary school. Heights and weights were measured by standardized method. Each child was asked to fill in a questionnaire asking about the factors which might be probably related to body image and to select a figure reflecting their current and ideal images among 7 drawings grading the extent of fatness. Weight status was classified using the age-and gender-specific cut-off points of the International Obesity Task Force based on the body mass index calculated. Chi-square test and multiple linear logistic regression test were performed.Results: Among the subjects, 17% of the children were overweight, and 4.3% were obese. Among the overweight or obesity group, the children who chose figures corresponding to fatty body image were 4% and 32%, respectively, and the children who wanted to be thinner were 27% and 47%, respectively. Only the previous trial for weight reduction was independently associated with body image distortion defined as being satisfied with current body image in overweight or obese children.Conclusion: Safe and systematic efforts providing children with adequate body image perception would be needed to prevent and manage the obesity problem, especially for overweight or obese children who think their body images as normal or who were satisfied with their current body images.
Background: It is well recognized that thyroid hormone stimulates bone turnover, increasing bone resorption, thus affecting bone mineral density, but few data are available on untreated subclinical hypothyroidism. The aim of this study was to examine whether bone mineral density is increased in postmenopausal subclinical hypothyroidism patients compared with postmenopausal normal thyroid function women, and to evaluate the relationship between thyroid hormones (TSH, FT4) and bone mineral density or various biochemical markers of bone metabolism.Methods: This was a cross sectional study of 132 postmenopausal women aged from 51 to 70 who undertook health screening program in Pundang CHA general hospital from 1996 to 2001. They were divided into two groups; subclinical hypothyroidism group (n=52) and normal thyroid function group (n=80) matched by age.Results: The total bone mineral density was significantly increased in the subclinical hypothyroid group than in the normal group (P<0.05). The serum osteocalcin was lower in the subclinical hypothyroidism group (P<0.05), but neither the alkaline phosphatase nor the deoxypyridinoline showed any significance. For all participants in this study, TSH, but not FT4, exhibited significant correlation with the total bone mineral density (r=0.188, P<0.05), and with the osteocalcin (r=-0.191, P<0.05). Multiple regression analysis identified the TSH as an independent predictor of the total bone mineral density (beta=0.0410; P<0.05).Conclusion: This study indicated that subclinical hypothyroidism is one of the factors which can elevate bone mineral density in postmenopausal women.
Background: Elevated plasma homocysteine is an independent risk factor for cardiovascular diseases caused by atherosclerosis. Previous studies have shown that plasma homocysteine is associated with components of the metabolic syndrome such as hypertension, insulin resistance, and dyslipidemia. In this study, we investigated the association between the plasma homocysteine levels and the metabolic syndrome on Korean adults.Methods: The study group with the metabolic syndrome and the control group without the metabolic syndrome were selected from the examinees of equivalent age and gender in the Health Promotion Center. Among the subjects, 107 adults with the metabolic syndrome and 123 adults without the metabolic syndrome were categorized into the study and the control groups, respectively. Medical history, medication, and life style were recorded through a questionnaire and physical examination was performed on all subjects. We measured fasting glucose, total cholesterol, triglycerides, high-density lipoprotein, hs-CRP, homocysteine levels and others by blood sampling. The metabolic syndrome was defined by the criteria for clinical diagnosis of the metabolic syndrome by AHA/NHLBI.Results: The mean ages in the study group and the control group were 54.6 +/- 9.3 and 54.6 +/- 8.7 years, respectively, and the numbers of males 29 (27.1%) and 39 (31.7%), respectively. The plasma homocysteine was observed to be positively correlated with age, waist circumference, diastolic blood pressure, apolipoprotein A-1, fasting glucose, fasting insulin, HOMA-IR, and hs-CRP. Among the components of the metabolic syndrome, hypertension showed a strong correlation with the levels of the plasma homocysteine (10.62 +/- 3.92 mu mol/L vs. 9.09 +/- 2.63 mu mol/L, P=0.001), whereas hyperglycemia, abdominal obesity, and dyslipidemia did not correlate with the levels of plasma homocysteine. Adjusted homocysteine levels to age, gender, alcohol drinking history, and smoking history was still higher in the study group compared to those in the control group (10.320 +/- 0.290 mu mol/L vs. 10.320 +/- 0.290 mu mol/L, P=0.017).Conclusion: The results indicate that the metabolic syndrome leads to a higher level of homocysteine in adults after adjustment to age, gender, alcohol drinking history, and smoking history.
Background: There have been many studies on osteoporosis, which is one of the most important cause of fracture in adults. However, whether moderate physical activity during youth confers lasting benefits for bone is unclear. Thus, we are here concerned with the relation of teenage physical activity and bone mineral density in Korean premenopausal women.Methods: From March to June 2007, 75 clients who visited a general hospital for medical check-up were enrolled in this study. The subjects reported physical activity for four age periods (12 similar to 18, 19 similar to 34, 35 similar to 49, current) using self reporting questionnaire. And they completed two 3-day food records, had measurements of height and weight, and aBMD assessed using dual-energy X-ray absorptiometry at the lumbar spine (L2-4) and femoral neck.Results: There was a significant relation of teenage physical activity (especially weight bearing physical activity) and aBMD in both sites (lumbar spine r=0.42, P<0.01; femoral neck r=0.33, P<0.01). But the activity during other age periods was not associated with the current aBMD at both sites.Conclusion: Our results suggest that moderate physical activity during the teen years appears to have lasting benefits for lumbar spine and femoral neck aBMD in Korean premenopausal women.
Background: The purpose of this study was to examine the association between the change of parental weight status and the change of their child's weight status over 2 years.Methods: A total of 379 children ages 11-13 years were measured their height and weight in 2001 and 2003. Their parents completed a questionnaire including self-reported parental weight and height during the same period. Parental weight status was classified as overweight (BMI >= 25 kg/m(2)) and non-overweight (BMI<25 kg/m2). Children's weight status was classified as overweight and non-overweight using the age and gender-specific BMI established by the Korean Academy of Pediatrics. The weight status over 2 years was categorized as a group of persistent overweight, persistent non-overweight, shifting overweight to non-overweight, and shifting non-overweight to overweight.Results: After adjusting for the child's gender and the father's weight status, the odds ratio for being persistently overweight over 2 years in a child having a mother with persistent overweight was 2.8 (95% CI: 0.9-8.5) compared to a child having a mother with persistent non-overweight. Likewise, the odds ratio for being persistently overweight over 2 years in a child having a father with persistent overweight was 2.9 (95% CI: 1.4-6.1) compared to the child having a father with persistent non-overweight.Conclusion: Parental weight status over 2 years was associated with the 2-year weight status in children. The parents-and family-based intervention are needed to prevent and manage childhood obesity.
