ABSTRACT
BACKGROUND: Bupropion SR (sustained-release) is the first non-nicotine-based therapy that is effective for achieving abstinence from smoking. We conducted this clinical trial of bupropion SR for smoking cessation with a seven week follow-up. METHODS: The study subjects involved fifty smokers who had visited the Family Medicine Department at Asan Medical Center from May 2003 to January 2004. Treatment consisted of seven weeks of bupropion 150 mg twice daily. The target day for quitting smoking was day 7. RESULTS: Among 50 subjects who had received bupropion SR, 28 subjects completed the clinical trial and were analyzed. Nineteen subjects were lost to follow up after their first visit. Three subjects discontinued the medication on their own and were lost to follow up after their second visit. According to a telephone interview, 17 subjects out of 22 subjects who were lost failed to feel the need of a revisit for smoking cessation. The rate of abstinence was 26.77% at week 7. The major causes of relapse in smoking were stressful events and anxiety. Only one subject discontinued the treatment attributed to adverse event (nausea). The most common adverse events were insomnia, anxiety, arthralgia, and nausea. We studied to see if the amount of smoking, other smokers in the household, previous attempts to quit, Beck Depression Inventory, and Fagerstrom Tolerance Questionnaire were associated with smoking cessation. However, they failed to show any significant correlation. CONCLUSION: This trial showed that the abstinence rate at the end of 7th week was 25.7% without any serious adverse events.
Subject(s)
Humans , Anxiety , Arthralgia , Bupropion , Depression , Family Characteristics , Follow-Up Studies , Interviews as Topic , Life Change Events , Lost to Follow-Up , Nausea , Recurrence , Sleep Initiation and Maintenance Disorders , Smoke , Smoking , Smoking Cessation , Surveys and QuestionnairesABSTRACT
BACKGROUND: Our study was done to identify the risk factors of hypertension in order to implement primary prevention strategy in Korean healthy adults. METHODS: The subjects, who had received medical examination at the Health Promotion Center of Asan Medical Center from June 1990 to February 1991, were included in the Asan Cohort Study. A total of 1,329 men and 886 women were followed up to June 2000. The subjects who initially had hypertension or coronary heart disease or were diagnosed with hypertension within 1 year after study enrollment were excluded. Incident cases were ascertained through the chart review, telephone contacts, and follow up examination. During the follow-up period, 140 male and 76 female hypertension incident cases occurred. For each case one normotensive control was selected, matched on sex, age, and follow-up period. We used conditional logistic regression for matched pairs to estimate odds ratio. RESULTS: For men, daily alcohol intake, family history of hypertension and body mass index (BMI) were the risk factors of hypertension. Compared with non-drinkers, men who drank alcohol 20~29.9 g/day and over 30 g/day had adjusted relative risk for hypertension of 4.05 (95% confidence interval (CI) 1.09~15.08) and 1.37 (0.61~3.11), respectively. Family history of hypertension increased OR 5.35 times. Compared with men having BMI of less than 23 kg/ m2, the adjusted OR for men with BMI of 23~24.9 kg/m2 and over 25 kg/m2 were 2.39 (1.15~4.97) and 2.05 (0.96~4.39), respectively. For women, BMI was a risk factor of hypertension. Compared with women having BMI of less than 23 kg/m2, OR for women with BMI of 23~24.9 kg/m2 and over 25 kg/m2 were 3.51 (1.13~10.89) and 2.93 (1.28~6.72), respectively. CONCLUSION: Our study proved that obesity (men and women), alcohol intake (men), and family history of hypertension (men) were risk factors of hypertension in Korean adults.
Subject(s)
Adult , Female , Humans , Male , Body Mass Index , Cohort Studies , Coronary Disease , Follow-Up Studies , Health Promotion , Hypertension , Logistic Models , Obesity , Odds Ratio , Primary Prevention , Risk Factors , TelephoneABSTRACT
OBJECT: Spontaneous pontine hemorrhage can be diagnosed by CT or MRI, but the clinical course is variable according to the location of the hemorrhage. MATERIALS AND METHODS: Author attempted to analyse 39 cases of spontaneous pontine hemorrhage, considering factors to influence their prognosis, admitted in Inje University Busan Paik Hospital from 1998 to 2002. RESULT: Pontine hemorrhage was classified according to the finding of CT scan;4 cases of Type I (hematoma, localized in the tegmentum), 18 cases of Type II (those in the tegmentolaterally), 16 in Type III (those in the basis pontis mainly with tegmentum and midbrain). Male to female ratio was 31:8, mean age was 48.2 years (9-76 years). Initial Glascow Coma scale was 7.6 (3-14), and mean follow-up period was 5.1 months (0.1-52 months). Associated diseases were as follows;hypertension;20, pulmonary tuberculosis;2, hypertension with D.M;1. Treatment modality was consisted of 36 conservative treatment, 1 stereotactic hematoma aspiration, 2 Gamma-Knife radiosurgery for associated cavernous malformations. Prognosis was good at following order of the tegmentotectal, tegmentolateral type. CONCLUSION: The prognosis of tegmentotectal, tegmentolateral type hemorrhage was better than basis pontis. The little volume of the hematoma, the better prognosis.
Subject(s)
Female , Humans , Male , Coma , Follow-Up Studies , Hematoma , Hemorrhage , Hypertension , Magnetic Resonance Imaging , Prognosis , RadiosurgeryABSTRACT
BACKGROUND: Even though tuberculosis (TB) is still a major public concern in Korea, there are few data on the management of TB patients and its outcome in the private sector in contrast with those of the public sector. METHODS: The nine-hundred-twelve TB patients who were registered in a private university hospital from 2001 to 2002 were enrolled. The patients were divided into pulmonary (TB(P)), extrapulmonary (TB(E)), and combined (TB(P+E)) groups, and were also divided into initial and retreatment groups. The clinical characteristics, diagnostic methods, treatment regimens, and outcomes were analyzed and compared between the groups. RESULTS: The mean age of 912 patients was 49.2 years and the male-to-female ratio was 56%:44%. The number of patients of the initial and retreatment groups of TB(P), and those of (TB(E)+TB(P)+E) were 449, 169, 237, 57, respectively. The bacteriological study was performed in 97.9%, and positive culture was confirmed in 54.5% and 29.6% of patients with TB(P) and (TB(E)+TB(P)+E), respectively (P<0.05). The AFB smear was positive in 40.8% of TB(P) patients. The PCR was done in 63.6% of (TB(E)+TB(P)+E) group. The MDR was detected in 7.6% of isolates. Overall, treatment completion rate was 74.6%, default rate 13.7%, and death rate 0.5%. CONCLUSION: Even though the management of TB patients in a private hospital was satisfactory in terms of national guidelines, the high default rate was still a problem. Efforts to decrease the default rate is needed independently or in cooperation with the public sector.
Subject(s)
Humans , Diagnosis , Hospitals, Private , Korea , Mortality , Polymerase Chain Reaction , Private Sector , Public Sector , Retreatment , Treatment Outcome , TuberculosisABSTRACT
Programs that promote health through schools (school health programs), when delivered through schools that are themselves organized to promote health (health-promoting schools), are one of the essential means through which the twin goals of "Health for All by the Year 2000" and "Education for All" can be achieved. There are numerous evidences that school health programs are cost-effective and highly beneficial for adolescents themselves and communities they are belonged to. These days, the world's trend for school health programs has two directions. One is that to achieve best goals for school health, well-organized efforts are needed from governments, communities, schools, parents, and doctors. So, a new concept of 'comprehensive school health programs' is emerging. The other is that physicians should play an active roles not only for the school health promotion and school health education but also for the other steps including marking polices, and advising community members who are concerned with school health services. Now, it is also time for Korean doctors to be an advocate for comprehensive school programmes and to participate actively in those programs.
Subject(s)
Adolescent , Humans , Education , Parents , Physician's Role , School Health ServicesABSTRACT
Ganglioneuromas commonly arise from sympathetic ganglia. These neoplasm may be located wherever ganglion cells are normally found from skull base to pelvis including adrenal gland. Ganglioneuromas in spinal cord are very rare. We report a case of dumbbell-shaped extradural spinal ganglioneuroma. A 7-year-old boy was admitted to our hospital with a 20 day-history of both leg pain and a 10 day-history of progressive paraparesis. On magnetic resonance image, there was a dumbbell-shaped extradural spinal cord tumor in T11-L4 level. Two stage operation(First : Laminoplastic laminotomy of T11-L4 to remove the extradural portion of the tumor in the spinal canal, Second : Right retroperitoneal approach for the removal of paraspinal tumor located in L2-3 level) was performed. Pathologic diagnosis was a ganglioneuroma and paraparesis improved postoperatively.
Subject(s)
Child , Humans , Male , Adrenal Glands , Diagnosis , Ganglia, Sympathetic , Ganglion Cysts , Ganglioneuroma , Laminectomy , Leg , Paraparesis , Pelvis , Skull Base , Spinal Canal , Spinal Cord , Spinal Cord NeoplasmsABSTRACT
BACKGROUND: The number of the elderly living in a home for the aged is increasing as the socio-culture changes, but health management for the institutionalized elderly has been discontinuos, centered on the single treatment of the disease. The aim of this study is to collect baseline data which is for development of the health maintenance program for the elderly living in a house for the aged. METHODS: We reviewed the journals related to the health maintenance program for the elderly. We selected the contents about health management program for the elderly. 3 domain of the contens were done. The 3 domain were physical health (interview for health habit, physical exam, clinical test), mental health (Korean version of geriatric depression scale, Korean version of mini mental status examination), assessment of functional status (katz activities of daily living, lawtons instrumental activities of living).. 158 elderly people living in a home for the aged in Seoul have been researched since August 1996. RESULT: Total subjects were 158 (men 73, women 85). The average age was 78.1(+/-7.2). The rate of smoking, alcohol drinking, exercise were 32%, 20.4%, 34.4%, each. The rate of assitive device use was 28.3%. The prevalence of sleep distur-bance, urinary incontinence were 69.7%, 17.3%. The prevalence of gait disturbance was 38.4%. The occurrence rate of falling for last 1 year was 29.6%. The prevalence of fear of falling was 57.2%. The positive rate of VDRL was 12.3%, the prevalence of anemia was 48.7%. The prevalence of degenerative arthritis, hypertension were 44.2%, 31.3%, each. The prevalence of depression, dementia were 71.3%, 56.7%, each. The rate of elderly person dependent on one and more ADL was 8.1%. CONCLUSION: We found the health status of the elderly living in a home for the aged. On the basis of the results of the study, it is needed that continuous application of the program for management of the elderly in a home for the aged, keeping searching proper contents of examination and methods of measurement.
Subject(s)
Aged , Female , Humans , Activities of Daily Living , Alcohol Drinking , Anemia , Dementia , Depression , Gait , Hypertension , Mental Health , Osteoarthritis , Prevalence , Seoul , Smoke , Smoking , Urinary IncontinenceABSTRACT
BACKGROUND: Because of many physical, psychological, and social stresses, adolescence is a vulnerable period to psychiatric disorders. But in Korea, there is actually not enough time for primary care physicians to screen such patients during ordinary medical interviews. Therefore this research was done to develop and validate a brief screening questionnaire for the detection of adolescent patients with psychiatric problems. METHODS: Three family physicians in charge of their own adolescent clinics developed a five-item questionnaire for screening adolescents with psychiatric problems by reviewing related literature with consultation by a psychiatrist. After performing a pretest and gathering second opinions from other psychiatrists and nurse-teachers, final questionnaire was redeveloped. Verification of its reliability by using test-retest method and internal consistency by calculating Cronbach's alpha coefficient was done. Also inspection of its validity by comparing the scores of psychiatric patient group to normal group was done. And finally the discrimination point was obtained. RESULTS: For reliability Kappa value of new questionnaires ranged from 0.33 to 0.63. One item was dropped because of its negative influence to the internal consistency and the discrimination power. With the four final items, we estimated the validity for distinguishing psychiatric patients from the normal group by calculating the sensitivity and specificity of each cutting point of scores. For the each cutting point 1, 2, and 3, sensitivity was 85%, 75%, 40%, respectively, and specificity was 27%, 62%, 84%, respectively. We considered score 1 as the best cutting point because the purpose of the questionnaire was screening rather than diagnosis. CONCLUSION: A brief four-item screening questionnaire(SAPPO. Screening method of Adolescent Psychiatric Problems in Outpatient clinic) was developed and its reliability and validity was estimated.
Subject(s)
Adolescent , Humans , Diagnosis , Discrimination, Psychological , Korea , Mass Screening , Outpatients , Physicians, Family , Physicians, Primary Care , Primary Health Care , Psychiatry , Referral and Consultation , Reproducibility of Results , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
BACKGROUND: Korean health related Quality of Life Scale(KQOLS) was developed to measure the quality of life reflecting Korean's own language expression and culture. In order to confide in the results of KQOLS, it is necessary to establish verification of the psychometric properties(reliability, validity, responsiveness). METHODS: KQOLS's final 46 items and item option responses were established by expert panels. Reliability was tested by 2 weeks test-retest method and internal consistency method. Validity was tested by factor analysis and clinical validity. Sensitivity and specificity for detecting treatment-related changes were also tested. RESULTS: A high degree of internal consistency was observed for each of domains(Cronbach's alpha value of 0.77 or higher). Two weeks test-retest reliability correlation coefficients scores were highly significant except health perception domain. A principal components analysis identified 9 factors with eight values greater than 1.0 which were approximately the same as intended domains. Normal control group had statistically significant higher scores than patients group except in spiritual health and social function domains. Improved group of patients had statistically significant higher scores than non-improved group of patients after treatment except in spiritual health and health status perception domains. CONCLUSION: Korean health related Quality of Life Scale(KQOLS) is both a valid and a reliable instrument, but fine refinements such as items revision and item response options modification will be needed.