Smoking Status and Augmentation Index in Korean Male Subjects

BACKGROUND: Smoking is a major risk factor of cardiovascular morbidity and mortality. Arterial stiffness has been identified as an important determinant of cardiovascular risk. Augmentation index is an indicator of arterial stiffness, which can be quantified noninvasively. The goal of this study was to assess the effect of current smoking status on augmentation index (AIx) in Korean male subjects. METHODS: A total of 70 males without clinical cardiovascular diseases were studied in this cross sectional study. AIx was measured in 35 current smokers and 35 nonsmokers by recording pressure waveforms using radial applanation tonometry in a SphygmoCor device. RESULTS: Augmentation index was significantly higher in the current smokers (19.4+/-12.9% vs. 9.7+/-12.8%; P<0.05). A multiple regression model confirmed that smoking status was independently associated with arterial stiffness (beta=0.350, P<0.001). CONCLUSION: Current smoking is associated with increased augmentation index, which is a marker of cardiovascular disease. Further studies are required to investigate clinical applications of arterial stiffness.

The Association of Nonalcoholic Fatty Liver Disease with Metabolic Syndrome

BACKGROUND: Recently, the diagnosis of non-alcoholic fatty liver disease (NAFLD) has been made more frequently, as the use of ultrasonography on health screening has been on the rise. The aim of this study was to elucidate the relationship between NAFLD and the metabolic syndrome defined by NCEP-ATP III criteria. METHODS: A total of 1,675 subjects, who attended for routine physical check?ups, were screened. Among those, 401 subjects were selected after excluding the subjects with either significant alcohol consumption, evidence of viral or toxic hepatitis, significant liver or renal dysfunction, or overt thyroid disease. NAFLD was diagnosed if the subjects had a "bright liver" on ultrasonographic examination. The diagnosis of metabolic syndrome was made according to the criteria of NCEP-ATP III established in 2001. RESULTS: The prevalence of NAFLD was 27.2%. Blood pressure, body weight, body mass index, waist circumference, and serum levels of total cholesterol, triglyceride, fasting glucose and liver enzymes were higher among the subjects with NAFLD than the control. The prevalence of obesity, IFG/DM, dyslipidemia and hypertension was higher in the NAFLD group. The prevalence of the metabolic syndrome was 19.2%, which was higher in the NAFLD group than the control group. The odds ratio of NAFLD for the metabolic syndrome was 6.458 (95% C.I. 3.178~13.124). CONCLUSION: NAFLD was closely associated with the metabolic syndrome regardless of the presence of obesity.

Family Physician's Knowledge, Attitude, Experience and Training on Breastfeeding

BACKGROUND: Breastfeeding is not common in Korea despite its known benefits. The role of family physicians is important in promoting breast-feeding since they can provide prenatal and postnatal care on lifelong basis. This paper analyzed a survey of family physicians on their knowledge, attitude, experience, and training concerning breastfeeding. METHODS: The survey was carried out by e-mail enquiry to the residents and board-certified physicians registered in the Korean Academy of Family Medicine. The enquiry was developed by Gary L. Freed composed of 18 questions about knowledge, attitudes, experience, and training. The answers to the questions were analyzed to give frequency and the associations between the variables. RESULTS: Among the total, 64% of the residents and 76% of the physicians answered yes to whether breastfeeding was the best means of feeding an infant under 6 months of age. Also, 83% of the residents and 85% of physicians answered it was right to quit breastfeeding completely when breast abscess developed. The breastfeeding promotion was done more frequently by those who had personal experience. They had higher rate of educating patients than those who did not (28% vs. 9%, P<0.0001). Despite its importance, 86.5% of the residents and 77.6% of the physicians answered that they did not have enough opportunity to learn about breastfeeding during their training years. CONCLUSION: Although family physicians are required to play a role in promoting breastfeeding, they are insufficiently trained under the current system. Therefore, it is necessary to develop a traning program to educate the residents on breastfeeding.

Weight Loss Reduce hsCRP Levels in Korean Premenopausal Obese Women

BACKGROUND: Obesity has been proposed as a risk factor for cardiovascular diseases. CRP has been proposed as an independent risk factor for cardiovascular diseases, and has been associated with body weight and body fatness. It has been known that weight reduction reduces CRP. We examined the hypothesis that weight loss can reduce plasma CRP levels in Korean, obese premenopausal women. METHODS: In a sample of 36 Korean obese (BMI 25.00~47.02 kg/m2), premenopausal (22~48 years) women, we measured hsCRP, plasma lipid profiles, blood glucose, body weight, body mass indexes, body fatness and intra abdominal body fat area. A 12-week weight reduction program was conducted in 36 obese women. When the program was finished, fat distribution, hsCRP and lipid profile test was repeated. The effects of weight loss on CRP levels were tested by means of paired t-test and nonparametric Wilcoxon signed rank test. RESULTS: We found that plasma CRP level was positively associated with body weight, body mass index, body fatness, CT-measured abdominal visceral and subcutaneous fat area. After a 12-week weight loss protocol, the average weight loss was 7.97+/-3.46 kg (P<0.0001) with loss of fat mass 5.29+/-0.59 kg, and 1.98+/-1.20 kg lean body mass. Plasma CRP levels were both positively associated with plasma CRP level reductions (P=0.0437). CONCLUSION: Obesity and adiposity influenced significantly on plasma CRP in Korean premenopausal women on cross sectional basis. Moreover, 12-week caloric restriction induced weight loss decreased plasma CRP levels. Weight loss represents an intervention to reduce plasma CRP and can mediate to reduce cardiovascular disease risk in Korean obese premenopausal women.

Development of a Fatigue Symptom Checklist for Commercial Drivers: An Experimental Trial / 대한산업의학회지

OBJECTIVES: Fatigue is a primary human factor for decreased job performance in the workplace. It is well documented that drowsiness is a typical symptom of fatigue and is closely associated with commercial drivers'safety and well-being. However, few studies have been conducted to develop or validate fatigue symptom instruments for a working population. The main purpose of this study was to develop a general fatigue checklist and a driving fatigue checklist for Korean commercial drivers. METHODS: A total of 287 bus drivers in a commercial transportation company participated in a self-administered survey that was designated Study 1. Based on the statistical results of Study 1, a focus meeting with 16 professional consultants was conducted to revise the fatigue symptom instrument for Study 2. In Study 2, 288 commercial drivers (156 bus drivers and 132 truck drivers) participated in the revised questionnaire survey. All collected responses were entered into a SPSS worksheet and the data analysis was conducted using SPSS software 11.1. The exploratory factor analysis used in this study followed the principle component factoring rule and the varimax rotation method for factor extraction. The criteria for item selection were an Eigen value of 1.0 or greater, a communality score of .50 or greater, and no 'fence rider'property over the extracted factors. RESULTS: Through Study 1, the consultant meeting, and Study 2, a general fatigue checklist was developed with a total of 3 factors and 11 items, and a driving fatigue checklist was developed with 2 factors and 10 items. The 3 factors of the general fatigue checklist were physical fatigue, psychological fatigue, and chronic tiredness. The two factors of the driving fatigue checklist were physical fatigue and perceptive and functional fatigue. CONCLUSIONS: The primary contents of general fatigue were different from those of driving fatigue according to the two fatigue instrument factors developed in this study. The primary fatigue symptoms of the commercial driving population were identified as physical fatigue and perceptive and functional fatigue.

Relationship between Manufacturing Workers'Job Conditions and Stress / 대한산업의학회지

OBJECTIVES: In this study we performed an analysis of the stress associated with the working conditions of 6,764 workers based on 'A survey of healthy condition of workers on 1999'by the Korean Occupational Safety and Health Agency. The Purpose of this study was to provide basic data for health education and management for industrial workers'health promotion. METHODS: Collected data were analyzed using the t-test, ANOVA and multiple regression analysis, using the SPSS 10.0 program. RESULTS: When the degrees of stress were analyzed according to demographic characteristics, females were found to have higher levels of stress than males (p<0.001). Furthermore, as age was lowered and as the work space became larger, the degrees of a stress were also found to be higher (p<0.001 and p<0.01, respectively). When the degrees of stress were analyzed according to working conditions, longer working hours (p<0.001) and reduced break times (p<0.05), gave rise to higher degrees of stress. Also, as the work space was reduced in size and as the work intensity was augmented, the degrees of a stress were made higher (p<0.01). In terms of physical working conditions, humidity and a lack of sense of security resulted in higher degrees of stress (p<0.01). When the workers sense that their environment is noisy or dusty has poor lighting or ventilation or that the rest room and cafeteria facilities are inadequate, the degrees of stress are found to be higher. As regards the social environment, when the workers sensed that the degree of job demand or job control was higher or that the degree of social support was lower, the degrees of stress were increased (p<0.001). Among those factors which influenced physical stress in the stepwise multiple regression analysis, the primary factor was found to be the safety of the working place (5.1 %). Other factors which influenced physical stress were degree of job demand, age, work intensity, humidity, sexual discrimination, length of working hours, size of work space and the existence or not of a regular break time in this order. Total R2 due to these factors was 12%. Among those factors which influenced mental stress in the stepwise multiple regression analysis, the primary factor was the degree of job demand (4.8 %). Other factors which influenced mental stress were humidity, age, sexual discrimination, the degree of a job control, safety of the working place, degree of social support, a working site, size of the work space, quality of lighting, the existence or not of a regular break time and length of working hours in this order. Total R2 due to these factors was 13.1 %. CONCLUSIONS: The above results shows that working conditions are strongly related to stress. Furthermore, when both physical and social working conditions are continuously managed and improved, workers may not only reduce their levels of stress but also maximize their working efficiency.