The Role of Alcoholics' Insight in Abstinence from Alcohol in Male Korean Alcohol Dependents

This study was performed to examine the relationship between the abstinence results of alcohol dependents after discharge and the level of insight at the time of discharge. 117 male Korean alcohol dependents discharged from a community-based alcohol treatment center were followed up to determine the initial months of abstinence on a successive basis (IMA), total months of abstinence during 12-month period (TMA), and complete abstinence for one full year after discharge. Analyses of abstinence results with adjustment for the differences in baseline characteristics were performed for subjects' insight levels (poor, fair and good). The mean IMA of patients with good insight was significantly (p<0.01) longer than that of patients with poor insight and TMA of patients with good insight was significantly (p<0.001) longer than that of others. Using patients with good insight as the reference, patients with poor insight showed an adjusted odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.01-0.75, p<0.05) for complete abstinence for one full year after discharge and patients with fair insight, adjusted OR of 0.17 (95% CI=0.03-0.81, p<0.05). These results suggest that alcohol dependents' insight could be regarded as a factor related with abstinence.

The Relationship between the Upright Serum aldosterone Level and the Left Ventricular Geometry in Essentioal Hypertension

BACKGROUND: Aldosterone acts as a non-hemodynamic factors on the hypertensive heart regarding sodium retension or myocardial fibrosis. To elucidate whether aldosterone is associated with the specific left ventricular geometry or not, we investigated the relationship between the upright serum aldosterone levels and the echocardiographicleft ventricular structure in the essential hypertension patients never treated. METHODS: Echocardiographic indices included M-mode measured left ventricular mass index (LVMI), relative wall thickness (RWT). Aldosterone is measured by Radioimmunoassay for the serum withdrawn from the subjects at least 3 hours upright position. 63 patients and 20 normal control subjects were evaluated. RESULTS: 1) 84.1% (63/53) of cases showed left ventricular hypertrophy. 7 patients showed normal LVMI, 3 patients showed concentric remodeling geometry. 19 patients had concentric left ventricular hypertrophy (LVH). 34 patients had eccentric LVH. 2) The serum aldosterone level has negative correlation with the RWT (r=-0.27, p=0.03) but not with LVMI (r=0.08, p=NS). There was difference among groups (ANOVA, F=0.009). Serum aldosterone is higher in eccentric LVH group than in concentric LVH group (10.5+/-1.2 ng/dL vs 5.2+/-0.6 ng/dL, p=0.0001) and than in control group (10.5+/-1.2 ng/dL vs 6.6+/-0.8 ng/dL, p=0.01). CONCLUSION: In this study, we observed that the serum aldosterone level was not correlated with the LVMI but with RWT negatively so that eccentric LVH group showed higher serum aldosterone levels than control group and concentric LVH group.

Application of acidic primer for orthodontic adhesive system / 대한치과교정학회지

Acidic primer is the bonding agent which combines the conditioning and priming agent into the single solution and was originally developed for the dentin bonding system. It is less harmful to the tooth structure and more convenient to manipulate than the traditional etching procedure. The purpose of this study is to evaluate the shear bond strength of various bonding materials when the enamel is treated with acidic primer for the bracket bonding procedure. Fifty recently extracted human premolars were randomly separated into five groups : Group I using Clearfil Liner Bond 2 adhesive system to the enamel treated with acidic primer, Group II using Transbond XT adhesive system to the enamel treated with acidic primer, Group III using panavia 21 adhesive system to the enamel treated with acidic primer, Group IV using Fuji-Ortho LC adhesive system to the enamel treated with acidic primer, Group V using Transbond XT adhesive system to the enamel treated with 37% phosphoric acid. The shear bond strength was measured with Instron universal testing machine after storing in 37oC water bath for 48 hours. After debonding, the teeth and brackets were examined under scanning electron microscope (SEM) and assessed with the adhesive remnant index (ARI). The results were as follows : 1. There were no significant differences in shear bond strength between group III (8.69 +/- 2.72 MPa), group IV (9.7 +/- 3.16 MPa), and group V (10.48 +/- 2.60 Mpa) (p>0.05). 2. The shear bond strength of group III and group IV was significantly higher than that of group I (1.09 +/- 0.53 Mpa), and Group II (2.70 +/- 1.46Mpa) (p0.05). This result suggests that the combination of acidic primer and some bonding adhesive can provide sufficient shear bond strength for clinical orthodontics.

Changes of markers of bone turnover and spinal BMD after 1 year treatment according to treatment strategies & predictability of changes of BMD by changes of bone markers in Korean postmenopausal women with osteoporosis

BACKGROUND: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1 year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3 4 months. Some data showed that changes of bone markers after 3 months could predict the changes of the BMD after 1 year. METHODS: 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups, HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made. RESULTS: Our results showed those findings 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8% 4.7%). CONCLUSION: These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1 year treatment. But, HRT with antiresorptive agents may be effective in treating postmenopausal osteoporotic Korean women.

Influence of alcoholic's insight on their abstinent outcomes for one year after discharge

BACKGROUND: This study was intended to present the importance of insight status concerning the abstinence of alcoholics. METHODS: The 214 subjects, who participated in insight improving programs during hospitalization in an alcohol treatment center, were followed up for their abstinent status during the 12 month period after discharge. The relation between their abstinence results and insight status was investigated. To find out the influence of other factors upon abstinence, stepwise multiple regression was performed over variables including disease severity, sociodemographic, therapeutic and familial features. RESULTS: The 73 individuals (34.1%) had 'no remission', 110 (51.4%) 'early full remission', and 31 (14.5%) 'sustained full remission'. The insight degree was significantly correlated with both 'initial consecutive months of sobriety'(IMS) after discharge and 'total months of sobriety'(TMS) during the follow up. The 153 subjects (71.5%) relapsed within four months after discharge, and the rate of continuous abstinence at each month differed significantly among three insight groups. On the inter group shifts during hospitalization, the abstinent months were greater in the group whose insight changed from 'poor ' to 'good insight' than the one from 'fair ' to 'good insight'. By stepwise multiple regression analysis, the higher insight scores, older age and shorter hospital days, in a decreasing order of association, the longer IMS and TMS, while absence of religion and lower MAST scores was associated only with IMS, with their overall R2 value of 18.5% and 20.8%, respectively. CONCLUSION: The insight degree was related to the length of abstinence and thus it is necessary to develop insight improving programs which can be of help to recovering patients.

Structural Modeling of Stress, Life Style and Health Status in Industrial Employees / 대한산업의학회지

OBJECTIVES: The purpose of this study was to examine stress affecting the life style(such as alcohol consumption, smoking, exercise, sleep disturbance, obesity), and to determine the relationships among the stress, life style and health status of in industrial employees. METHODS: This study utilized the data from health survey and laboratory test(such as liver enzymes and lipid profiles) in 463 Industrial Employees. Psychosocial wellbeing index was used in stress scales. The data were analyzed using SAS version 6. 11, LISREL version 8. 12i and PRELIS 2, 12i. The analytic methods for study were chi-square analysis, anova and covariance structural analysis. RESULTS: There was no significant relationship between socio-demographic characteristics and stress. The older person, married, higher education level, higher economic status and researcher group included the good life style. The higher streas groups included the more alcohol consumption, more smoking, less exercise and more sleep disturbance. There was no significant relationship between stress and health status(liver enzymes and lipid profiles) Alcohol consumption, less exercise and obesity had a significant relationship with abnormal liver enzymes. Alcohol consumption, smoking, less exercise, sleep disturbance and obesity had a significant relationship with abnormal lipid profiles. Based on the findings, the structural model of stress, life style and health status was established and then consider to socio-demographic characteristics the covariance structural analysis was used. The higher stress scores included the bad life style. The bad life style included the lower health status. Regardless stress, obesity was significant relationship with health status. CONCLUSIONS: Control of stress was initiative clues in health-promotive behaviors. Less alcohol consumption, no smoking, regular exercise, no sleep disturbance and not obese were health-promotive behaviors. Stress influenced the life style, and then life style influenced the health status.

Interdisciplinary treatment for ectodermal dysplasia / 대한치과교정학회지

Ectodermal dysplasia is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures. Characteristic manifestations include scanty hair and eyebrows, pigmented and hyperkeratinized skin around the eyes and mouth, frontal bossing with prominent supraorbital ridges, nasal bridge depression and dental anomalies. Hyperthermia or unexplained high fever as a result of the deficiency of sweat glands is common medical history. Findings of intraoral structures are anodontia or oligodontia with conical crowns. Consequently, generalized spacing and loss of vertical dimension of occlusion. Interdisciplinary approach has been performed to treat a 10-year old boy with ectodermal dysplasia. Orthodontists and a prosthodontist worked together on this case, and the result was satisfactory.

The analysis of the present status of the medical internet sites in Korea

BACKGROUND: After the World-Wide-Web(www) appeared, history has abruptly fallen in the new era of the Internet. In Korea, after the first medical internet site appeared, there was a major development in the WWW. But the quality and quantity of the web-page remains in infancy. Therefore, through the analysis of the Korean medical internet sites on present status, directions for development of Korean medical internet sites can be made. METHODS: From April 1st, 1999 to June 30th, 1999 in the Korean web sites, we visited 1044 sites. They included "Medmark Korea" representing medical search engine, "Eulji medical library" in the Eulji Medical College Hospital, and the medical sites of the "Yahoo Korea", "naver.com", and "simmani.com". Through this internet search, the information about locations, first publication year, classification by characteristics of homepage, speciality, web service form was obtained. Among these sites, acquireing from insufficient source further, questions were sent to the webmasters of 143 websites by e-mail. The questions included 7 items on the characteristic of webmasters, 8 items on the general characteristics of internet sites, 8 items on the contents, and their own comments. RESULTS: The occupation of webmasters was as follows: were physicians 94.4%, were male. According to age distribution, those in their thirties was 48.2%, and forties, 33.3%. Amone the 521 websites confirmed, there were 44 sites in 199 151 in 1996, 237 in 1997, and 79 in 1999. According to the distribution of location, metropolitan areas including Seoul, Inchon, Kyonggi occupied 68.9% among total. The main portion of the intentional visitors was ordinary people comprising 39.2%, members 9.8%, and physicians 7.7%. Concerning the purposes of publication, 38.7% of websites intended for health education to citizens, 31.0% for publicity of hospital or organizations, and 15.5% for exchange of information between members. For the most significant contents, 26.6% focused on the common-sense health issues, 35.7% on exchange of special medical information, 8.4% on education data for medical students, and 13.3% on publicity of hospitals. For the update interval, 22.0% renewed their sites within 1 week, 22.7% in 1 month, 23.4% in 3 months, and 20.6% in 6 months. For the effectiveness of homepage, the rate of `good' and `very good' response was 52.8%. CONCLUSION: Our investigation, showed that medical internet sites are lead by those in their thirties and forties. Web sites was concentrated to metropolitan areas where informational infrastructure was well developed. It is emphasized that efforts to informationalization by are needed by, governmental medical database systems should be established, and that the guidelines which enables validity of medical information should be set forth.

The relationship between health habit and stress amount in life events

BACKGROUND: Chronic stress is associated with physical illness such as coronary artery disease and hypertension. Daily life habits being able to affect physical health and are associated with mental stress. We studied the relationship between physical illness and stress amount so far. However, the investigation about the stress and the health habits to affect disease directly was not studied enough. Eventually we tested this investigation to know the relationship between stress amount and health habits. METHODS: We measured stress amount and health habits for a month(from May 1 to May 31, 1997) through the people who had already received health screening and were working as researchers. We used 147 results out of 212. Health habits were investigated about 6 articles out of "Breslow's 7 Health habits" and stress amount was measured by evaluation scale made by Lee, Pyoung-sook. RESULTS: There were no differences in amounts of stress of subjects according to age, years in work, hours of sleeping, having breakfast or not, the frequency of exercise and body mass index(BMI). But there were significant differences in amounts of stress of subjects according to drinking amount, smoking or not, and health habit index(P<0.01). CONCLUSIONS: Drinking and smoking appeared to be health habits related to the amounts of stress. Prospective studies are needed ? find a causal relationship between health habits and stress amount.

The Effect of Hormone Replacement Therapy on Bone Mineral Density of The Lumbar Spine and Hip in Postmenopausal Women

BACKGROUND: The improvement in social economic standard of living and aging bring high attention to osteoporosis in women. Many studies have been released so far about how effectively Hormone Replacement Therapy(HRT) in postmenopausal women works for the increase in Bone Mineral Density(BMD) in hip and vertebrae with the different rate of bone formation. In addition, it has been believed that HRT could increase BMD of hip and lumbar vertebrae reduce fractures caused by osteoporosis. In this study, we will find the effect of HRT on the increase in BMD of lumbar vertebrae and hip in postmenopausal women, by measuring and comparing BMD of lumbar vertebrae with high rate of trabecular bone to that of hip with high rate of cortical bone one year after HRT in postmenopausal women. METHODS: Subjects were 48 out of 325 postmenopausal women patients who visited osteoporosis clinic, Sun Hospital, Taejeon, from January, 1995 to December, 1995 and had the osteoporosis test and the vertebrae osteoporosis test one year after. We compared and analyzed the change of BMD in each part by retesting BMD of lumbar vertebrae and hip one year after the continuous HRT in women. SPSS/PC was used for statistical procedure. RESULTS: Subjects have mean age of 54.8+/-4.5 years, mean menopausal age of 48.4+/-3.5 years, mean postmenopause period of 6.5 +/- 5.9 years, mean body mass index 23.4+/-3.1kg/m2, mean weight of 56.7 +/- 7.8kg and mean height of 154715.4cm. No correlation was observed of their age, menopausal age, the number of years since menopause and body mass index to the changing rate of BMD in lumbar vertebrae and femur one year after HRT in women. The BMD prior to treatment was, respectively, as follows , L2-L4(0.8983710.llg/cm2), Hip(neck, 0.7597+/-0.10g/cm2 ; trochanter, 0.6259+/-0.08g/cm2 ; Ward's triangle,0.5186+/-0.90g/cm2), and that one year after treatment ; L2-L4(0.9277+/-0.llg/cm2), Hip(neck,0.7592710.llg/cm2 ; trochanter, 0.63227:0.08g/cm" ; Ward's triangle,0.5340+/-0.09g/cm2). There was significant increase in BMD of lumbar vertebrae and femur Ward's triangle(P<0.01) among BMD of each part one year after HRT, but BMD of femur neck and that of trochanter region has no significant incense. CONCLUSIONS: It was found that one year treatment with HRT in postmenopausal women resulted in significant increase in BMD of not only lumbar vertebrae with lots of trabecular bone but also Ward's triangle regions of femur, regardless of age and postmenopausal period of postmenopausal women at the beginning of treatment. It is considered that HRT may be effective in preventing osteoporotic fractures of lumbar vertebrae and hip on postmenopausal women, and that postmenopausal period would not be an important factor in the beginning of HRT treatment.

The relationship between Stress and life Styles in Business

BACKGROUND: Stress is found to have influence on physical and mental disorders, and also to daily life styles related to physical health and mental stress. There are many studies that concern the stress and coping response and the relation ships physical, mental disorders and stress. But relationship between stress and life styles have seldom been investigated. Therefore, we investigated the relationship between stress and life styles. METHODS: From June 2, 1997 to June 30, 1997, we selected 463 businessmen we who had undergone regular health screening SUN hospital as subjects of the investigation in the survey on life styles included diet habit, salt ingestion, meat ingestion, alcohol drinking, smoking habit, physical exercise, sleep disturbance, and stress perception was measured by Psychosocial Well-being Index(PWI). RESULTS: 'There was significant difference in diet habit according to ages, marital status education level, monthly income(P<0.01), and job tenure(P<0.01), salt ingestion according to monthly income and body mass index(P<0.05), alcohol drinking according to religion or none, smoking according to age, marital status, monthly income, body mass index(P<0.05), and religion(P<0.01), exercise according to age, education level(P<0.01), monthly income(P<0.01), job department, and job tenure(P<0.05), and sleep disturbance according to age, education level, body mass index(P<0.05), and monthly income(P<0.01). There was no difference in the average scores of PWI according to general characteristics. The average scores of PWI concerning about life styles showed significant difference in diet habit, arcohol drinking, smoking habit, exercise, and sleep disturbance. CONCLUSIONS: The correlation of health habit and motility rate has already proved. This investigation has showed that there is a correlation between life styles and stress. So, we concluded that it is the best way to keep the good health habit by stress control for health promotion and disease prevention.

Evaluation of family function in the inpatient of rehabilitation medicine department witn impairment of activity of daily living

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.

A Study On The Factors Of Absenteeism Among The Manufacturing Workers / 예방의학회지

This study was to examine the actual conditions and contributing factors of absenteeism in manufacturing workers. Subjects were 1,184 workers employed in Taejon city and the observation period for absenteeism was 3 months (June to August), 1992. We obtained the following results. 1. Percentage of the absentees among the studied subjects were 21.1% in gross absence and 6.9% in sickness absence. Gross absence rate of subjects was 1.2% and sickness absence rate was 0.5%. 2. In the group of absentees, mean days of absence was 2.8 days and those of sickness was 4.4 days. Mean days of sickness absence due to injury was higher than that of illness, but the total days of sickness absence was high in extremity injuries, trunk injury, general fatigue, head injury, musculoskeletal problem in that order. 3. Variables contributing to the absence were job classification, education level, working hours per day, exposure of noxious factor, worker classification. 4. In the group of absentees, variables influencing the gross absence rate were working atmosphere, body mass index, working environment, working hours per day but those of the sickness absence were working hours per day, education level and working atmosphere.

Health status and medical care utilization patterns of rural aged / 예방의학회지

To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows; 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benefits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (P<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6%; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs; the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in the health centers of subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (P<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.