The correlation between simple anthropometric indices and abdominal visceral fat accumulation by computed tomography

BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.

Medical advice for overseas travelers by primary care physicians

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A study on the bacteriuria in the elderly who reside in a nursing home

BACKGROUND: Urinary tract infection(UTI) is one of the most common diseases dealt with by primary physicians. UTI is common in the elderly and has a great influence on the quality of the elderly's life. Thus, we conducted a study in one nursing home to find out the prevalence of bacteriuria and epidemiologic characteristics of the elderly. METHODS: The study was performed twice on April 12 and on May 4, 1999 among 108 subjects residing in a nursing home of Hanam City. The authors inquired the subjects pertaining to the history of UTI symptoms, collected urine samples by midstream clean-catch technique and catheterization and performed routine and microscopic urine analysis and urine culture. RESULTS: The overall prevalence of bacteriuria in subjects was 23.1%(25/108) ; 20% (3/15) in males and 23.7%(22/93) in females. The prevalence of the bedrriden subjects was 40.9%(9/22). Among the urine samples of 25 cases which were positive in the urine culture, E. Coli was found in 15 cases(60%). The sensitivity, specificity, positive and negative predictive value of pyuria for bacteriuria were 44.0%(11/25), 87.9%(73/83), 52.3%(11/21) and 83.9%(73/87), respectively, while those of nitrite test for bacteriuria were 64.0%(16/25), 97.5%(81/83), 88.8%(16/18) and 90.0%(81/90), respectively. The prevalence of bacteriuria increased by 16.23% as age increased by ten years using the Cochran-Armitage's linear trend test. CONCLUSIONS: The prevalence of bacteriuria in the elderly residing in a nursing home was higher than that of the elderly residing in a community. In the elderly over 60 years old, the prevalence of bacteriuria increased as the age increased. Immobility is considered as a risk factor of bacteriuria. Bacteriuria may be treated by antibiotics focused on E. Coli. Thus, we can expect improvement in the quality of life as well as extension of life span.

Usefulness of Thermography in Diabetic Neuropathy

Background : diabetic neuropathy is one of the serious complication of diabetes mellitus and it can cause serious foot problems. These foot problems could be preventable if early detection method of diabetic neuropathy is established. Therefore, essential diagnostic tool is needed. The changes on electrophysiologic studies(EPS) may to be necessarily correlated with clinical neuropathy. Theater has attempted to confirm the thermography as an useful tool for detecting diabetic peripheral neuropathy. Methods : Author has studied 20 patients with diabetes visiting to department of family medicine of Korea University Hospital between December 1, 1998 and June, 30, 1999. All cases were evaluated on clinical criteria. Furthermore, the EPS and thermography have been taken. The author investigated the results of thermograpy and the relation of the clinical diagnosis and EPS. Results : among 20 cases, 12(60.0%) cases have shown abnormality on EPS and 6(30.0%) cases of them was also abnormal on clinical criteria, the other 8(40.0%) cases were normal on EPS. Results of EPS were moderately related to clinical diagnosis. 10(50.0%) cases have shown abnormality on thermography and 6(30.0%) cases of them were also abnormal on clinical criteria, the other 10(50.0%) cases were normal on thermography. Results of thermography were related to clinical diagnosis. Among 12(60.0%) cases were abnormal on EPS, 9(45%) cases also have shown abnormality on thermography. Among 8(40.0%) cases were normal on EPS, 7(35.0%) cases were also normal on thermography. Results of thermography were highly related to EPS. Conclusion : Thermography is a useful diagnostic tool in diabetic peripheral neuropathy.