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.

Practicality of thermography in evaluation of osteoarthritis of knee joint

BACKGROUND: About 80 percent of the Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteoarthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis. METHODS: Twenty patients who had visited the department of family medicine, Korea University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed. RESULTS: Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i.e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05). CONCLUSIONS: Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.

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.

Usefullness of Thermography in Migraine Diagnosis

Background : The reports from researchers present new imaging diagnosis, which makes it possible to observe the vascular change(temperature change) of face in migraine. However, we do not have enough study for thermography to find out migraine in Korea. thus, this study was performed in order to apply thermography to migraine patients. Methods : From November in 1989 to July in 1999, patients with headache who visited to Korea University Hospital Family Medicine were undertaken. Among them, 6 patients who were appropriated for the International Headache Society criteria for migraine were performed facial thermography. Results : Six patients who were appropriate for IHS criteria for migraine were undertaken in this study. When they had headache attack, we tested thermography. Asymmetry of heat loss on supraorbital and frontotemporal areas was not significantly different in three of them. The others showed the difference of heat loss more than 0.5 degrees C in supraorbital and frontotemporal areas. It was in headache side that heat loss was showed. Two of patients who showed heat loss were enable to follow up and one of them showed the disappearance of asymmetrical heat loss. Conclusions : As a result, facial thermograms demonstrated the significant differences in heat loss from the temple and orbits in migraine patients. We concluded thermography in migraine patients is suitable for clinical use