Changes in Blood Pressure, Blood Glucose, and Lipid Profile Caused by Changes of Weight, Percent Body Fat, and Waist Circumference in Adult Men with Normal Weight and Waist Circumference / 가정의학회지

BACKGROUND: Metabolic indexes (blood pressure, blood glucose, and lipid) differ depending on lower or upper normal value of obesity indexes (weight, percent-body-fat, and waist circumference) despite normal value. Therefore, we examined metabolic indexes changes across obesity indexes changes. METHODS: We analyzed 344 adult men who received routine-checkups with normal weight and waist circumference before and after follow-up. We used multiple-linear-regression to examine associations between changes of obesity indexes and metabolic indexes before and after follow-up. We examined differences of metabolic indexes by t-test and odds ratios of normal or abnormal metabolic indexes by multiple-logistic-regression in groups where obesity indexes were increased and decreased. RESULTS: The mean follow-up was 1.38 +/- 0.32 years and there were associations between weight change rate and changes in systolic-blood-pressure (SBP), diastolic-blood-pressure (DBP), triglyceride (TG), and high-density-lipoprotein (HDL) (P = 0.001, 0.03, 0.001, 0.01), associations between percent-body-fat change and changes in SBP, DBP, fasting-blood-glucose (FBG) and TG (P = 0.02, 0.002, or = 100 of 2.98 (95% confidential interval [CI], 1.18 to 7.51) with a significance on only FBG of initially normal metabolic components and conversely percent-body-fat decrease group had odds ratio of FBG < 100 of 3.22 (95% CI, 1.21 to 8.60) with a significance on only FBG of initially abnormal metabolic components. CONCLUSION: Increased obesity indexes even within normal range, could change metabolic indexes.

Evidence Based Acupuncture / 한양의대학술지

Acupuncture is an important portion of Complimentary and Alternative Medicine and has been applied widely, but understanding of acupuncture is not complete, a steady progress has been made in recent years with modernized techniques. The controversies of acupuncture should be defined through scientific evidence. There are a lot of problems for application of acupuncture in practice and research, such as, in the diagnosis, therapy and evaluation of acupuncture. We need standardized tools and scientific methods for diagnosis and treatment. It is an essential key to refine the effect of acupuncture and to prove the mechanisms. We should have basic concepts of acupuncture and apply it objectively for promotion of health and prevention of illness and treatment of disease as mentioned in Medical Acupuncture. Korean Hand Acupuncture Therapy (KHT) has many advantages for this purpose. It was found and developed in 1971 and since has been widely used in the world. KHT is easy to learn and to practice without side effect. The important concept of health in KHT is defined as the harmonized state of cerebral circulation which consists of anterior and posterior circulation. Disease and dysfunction result from imbalance of the anterior and posterior circulation. We present the basic concept of KHT and some studies to prove the mechanism of acupuncture using thermograph, transcranial Doppler and fMRI. We need a standard research protocol of acupuncture. KHT can be a good candidate for this purpose. KHT fulfills the requirements such as role, theory, diagnosis, treatment and evaluation and study.

The Effect of Lifestyle Modification Program for Medical Students' Personal Health Practices / 가정의학회지

BACKGROUND: Lifestyle is an important risk factor for many diseases. We need to educate medical students for advocating health promoting behaviors to their patients. Teaching knowledge, however, was not enough for medical students to change their health-related lifestyle. In this study, we investigated health promoting behaviors of medical students, and the improvement of their health behaviors after competitive lifestyle modification program. METHODS: All sophomores of medical college in Seoul National University were included in this study. We performed lifestyle modification program consisting of lecture, group competition, and feedback. We focused on reforming health behaviors like smoking, drinking, exercise, stress management and eating habits. And we also checked common symptoms of functional diseases, medication frequency for relieving these symptoms and general life satisfaction. RESULTS: After 2 months of lifestyle modification program, the obese (P = 0.0455) and the average value of BMI (P < 0.001) were decreased and two of smokers quitted smoking. Numbers of medical students with health related habits such as regular exerciser (P = 0.027), frequent user of symptom-relief medication (P < 0.001), breakfast skipper (P = 0.005) were signifi cantly changed in positive way, and the average value of general life satisfaction score (P = 0.003) was improved. CONCLUSION: Lifestyle modification program improved medical students' health habits and enhanced general life satisfaction.

Clinical Features and Treatment Outcomes of Upper Gastrointestinal Bleeding in Patients with Cirrhosis

With recent progress in treatment modalities, mortality from upper gastrointestinal (UGI) bleeding has decreased appreciably. The aim of this study was to establish how UGI bleeds are managed in Korean patients with cirrhosis and to evaluate treatment outcomes. A total of 479 episodes of acute UGI bleeding in 464 patients with cirrhosis were included during a six-month period at nine tertiary medical centers. Treatment outcomes were assessed by failure to control bleeding, rebleeding and mortality. The source of bleeding was esophagogastric varices in 77.7% of patients, nonvariceal lesions in 15.9%, and undefined in 6.5%. For control of bleeding, endoscopic and pharmacologic treatments were used in 74.7% and 81.9% of patients, respectively. Variceal ligation was a major technique for endoscopic treatment (90%), and terlipressin and somatostatin were the main pharmacologic agents used (96.4%). Initial hemostasis was achieved in 86.8% of cases, but rebleeding occurred in 3.8% and 16.8% of cases within five days and six weeks of hemorrhage, respectively. Five-day and six-week mortality were 11.3% and 25.9%, respectively. Survival of patients with variceal bleeding seems to be remarkably improved than previous reports, which may suggest the advances in hemostatic methods for control of variceal hemorrhage..

The Survey for the Actual Condition of Drug Medication and Development of Health Care Cost Associated with Toxic Liver Injury in Korean; A Multicenter Study for the Detection and the Development of Nationwide Reporting System of Toxic Liver Injury / 대한간학회지

BACKGROUNDS/AIMS: In Korea, interests in health and health care costs have been increased along with the increase of mean survival rate and income level. The aim of this study is to investigate the actual condition of drug medication and burden of health care cost. METHODS: A total of 1,434 subjects in four tertiary medical centers were enrolled in this study. The questionnaires were obtained between March 2005 and September 2005. Based on this information, the actual condition of drug medication and health care cost were analyzed. RESULTS: The mean age of the subjects was 55.0+/-11.4 years (16-87 years). The male and female ratio was 1.74:1. The subjects with drug medication except for doctor's prescription are presently 26.6% and were 40.9% in the past. Traditional medicine (39.6%) and health food (29.9%) are more frequently used than herbal medicine (5.8%) and medical supplies (4.2%) now. In the past, herbal medicine (14.6%) was more frequently used compared with the present. The side effects of drug medication were developed in 90 subjects (7.5%). The total mean health care costs were 895,000 won/year, the herbal medicine, 834,000 won/year, the health food, 950,000 won/year, and the traditional medicine, 324,000 won/year. CONCLUSIONS: In this study, the subjects with other drug medications without doctor's prescription were as high as ever. The frequency of the use of the herbal medicine was decreased. However, the frequency for the use of the health food and traditional medicine have relatively increased. The side effects and additional large amounts of health care costs were occurred.

Microsatellite instability in mongolian gerbils induced by Helicobacter pylori / 대한내과학회지

BACKGROUND: During Helicobacter pylori (HP) gastritis, the organisms cause an impairment of DNA repair that results in accumulation of mutations in the genome of epithelial cells and an increased risk of gastric carcinoma. The aim of this study was to determine whether microsatellite instability (MSI) could be induced by chronic HP infection in the Mongolian gerbil model. METHODS: Seven-weeks old, specific pathogen-free male Mongolian gerbils were infected with the HP strain CA20. They were sacrificed at the each time points (1, 2, 3, 6, 9, 12 months). Areas of gastritis were carefully microdissected. DNA from tissues was analyzed for the presence of MSI by genomic DNA amplification with five gerbil microsatellite markers per sample. Gerbil markers labelled with Fam or Hex were obtained to perform MSI analysis using the 310 Genetic Analyzer. RESULTS: MSI was more frequent in the area of gastritis than in that of normal (p<0.05). Six showed MSI-low and one showed MSI-high within the area of gastritis (p<0.05). CONCLUSIONS: This study shows that chronic HP infection in the Mongolian gerbil induces MSI. This finding indicates that HP infection causes a decrease in DNA MMR proteins in epithelial cells of the stomach that may reach critically low levels, allowing for the accumulation of mutations such as those seen in microsatellite regions.

Change of serum ghrelin concentration according to severity of hepatosteatosis / 대한내과학회지

BACKGROUND: Recently, ghrelin has been reported to be associated with insulin resistance. Nonalcoholic fatty liver disease (NAFLD) is a condition in which insulin resistance relatively plays a pivotal role. The aim of this study was to evaluate the change of serum ghrelin concentration according to severity of hepatosteatosis. METHODS: Sixty five apparently normal male adults who underwent health screen examinations were classified into three groups, Group I: normal (27 subjects), Group II: mild (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic findings of liver. We analyzed the association between serum ghrelin concentration and severity of hepatosteatosis by ANOVA test. And the independent correlation between serum ghrelin concentration and insulin resistance related factors, HOMA (homeostatic model assessment), BMI (body mass index), WC (waist circumference), HC (hip circumference), WHR (waist to hip circumference ratio) were analyzed by multiple linear regression analysis. RESULTS: Serum ghrelin concentration tended to decrease according to severity of hepatosteatosis (Group I: 230.9+/-94.3, Group II: 195.2+/-97.2, Group III: 164.3+/-71.4 pmol/L). But this was statistically insignificant (p=0.081). The independent correlation between serum ghrelin concentration and insulin resistance related factors were not observed. CONCLUSIONS: Our study did not prove the correlation between insulin resistance related factors and serum ghrelin concentration in NAFLD according to severity of hepatosteatosis. However, we found a tendency to decrease serum ghrelin concentration according to severity of hepatosteatosis. So, further studies are required for certification these correlations.

Is Gastric Cancer a New Indication for Surveillance Colonoscopy? Colon Cancer is Increased in Gastric Cancer Patients / 대한소화기학회지

BACKGROUND/AIMS: It has been reported that the risk of gastric polyp is increased in various colonic polyposis syndromes or in series of patients with sporadic colonic polyps. However, there are only a few large case controlled studies of colon cancer incidence in gastric cancer patients who underwent colonoscopy. The aims of this study were to determine the incidence of colorectal neoplasm and to evaluate the necessity of colonoscopic surveillance in patients with gastric cancer. METHODS: We performed colonoscopy in 105 patients with gastric cancer who agreed to undergo colonoscopy before or after 6 months from gastric resection between January 2002 and December 2004 in Kangbuk Samsung hospital. As a control group, 269 consecutive, age and sex matched patients without gastric neoplasm on gastroscopy who underwent colonoscopy within 6 months for the evaluation of various gastrointestinal symptoms during the year 2004 were included. Endoscopic reports and pathological results were reviewed retrospectively. RESULTS: In the patient group, adenomatous polyps were diagnosed in 24/105 patients (22.9%) and colorectal adenocarcinoma in 10/105 patients (9.5%). In the control group, adenomatous polyps were diagnosed in 78/269 patients (29.0%) and colorectal adenocarcinoma in 2/269 patients (0.7%). The incidence of colorectal adenocarcinoma between the patient group and control group showed significant differences (odds ratio 11.04, p=0.003). CONCLUSIONS: The risk of colorectal adenocarcinoma increases significantly in patients with gastric cancer. We suggest that the patients with gastric cancer might carry a high risk for colorectal cancer whom require surveillance colonoscopy.

Esophageal Duplication Cyst / 대한소화기학회지

No abstract available.

Factors affecting serum levels of adipokines in Korean male patients with nonalcoholic fatty liver disease / 대한내과학회지

BACKGROUND: Adipokines are associated with various metabolic disorders including insulin resistance, obesity and dyslipidemia. Metabolic disorders have also been reported to be associated with nonalcoholic fatty liver disease (NAFLD). We aimed to estimate changes in serum adipokines levels according to the degrees of steatosis and to determine independent factors influencing serum adipokines levels in Korean male patients with NAFLD. METHODS: 65 Korean male patients were subjected. The degrees of steatosis were stratified into the three groups, Group I: normal liver (27 subjects), Group II: mild fatty liver (24 subjects) and Group III: moderate to severe fatty liver (14 subjects), according to ultrasonographic liver findings. The anthropometric parameters, fasting serum adipokine levels including leptin, adiponectin and resistin were measured in all subjects. The level of insulin resistance was estimated using the HOMA-IR. RESULTS: Serum leptin levels were significantly different among the three groups (mean+/-SD: Group I (2.052+/-1.071), Group II (2.879+/-1.016), Group III (4.457+/-1.965 ng/mL), p<0.001). Serum adiponectin and resistin levels were not significantly different among the three groups (p=0.184, p=0.649, respectively). BMI and HOMA-IR were independent factors of changes in serum leptin levels (p=0.026, p=0.001, respectively), but independent factors of changes in serum adiponectin and resistin levels were not observed. CONCLUSIONS: Our study support a indirect role to induce metabolic disorder for leptin in the pathogenesis of NAFLD, but do not support roles for adiponectin and resistin in the pathogenesis of NAFLD. BMI and HOMA-IR were only independent factors of changes in serum leptin levels.

Levofloxacin-Azithromycin Combined Triple Therapy for Helicobacter pylori Eradication / 대한소화기학회지

BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. This study evaluated the eradication rate, tolerability, and compliance of levofloxacin- azithromycin combined triple therapy for H. pylori eradication. METHODS: 1) First-line eradication: A total of 78 H. pylori-positive patients were enrolled. Seventeen military men in Armed Forces Capital Hospital were treated with 7 days of levofloxacin-azithromycin combined triple therapy (omeprazole 20 mg bid, levofloxacin 500 mg od, and azithromycin 500 mg od), and 61 patients in Kangbuk Samsung Hospital were treated with standard PPI-based triple therapy (omeprazole 20 mg bid, amoxicillin 1.0 g bid, and clarithromycin 500 mg bid) for 7 days. 2) Second-line eradication: A consecutive series of 59 patients who failed H. pylori eradication with standard PPI-based triple therapy in Kangbuk Samsung Hospital were randomized to two groups. Thirty patients were retreated with 7 days of bismuth-based quadruple therapy (omeprazole 20 mg bid, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid), and remaining 29 patients were retreated with levofloxacin-azithromycin combined triple therapy. Patient's compliance and tolerability were evaluated at the end of treatment. The status of H. pylori infection was assessed 8 weeks later then. The successful eradication of H. pylori was defined as negative results from histology and CLO test, or 13C-urea breath test. RESULTS: First-line eradication rate of levofloxacin-azithromycin triple therapy was lower than that of standard PPI-based triple therapy, but there was no statistically significant difference (70.6% vs. 80.3%, p=0.390). Second-line eradication rate of levofloxacin-azithromycin combined triple therapy was significantly lower than that of bismuth-based quadruple therapy (ITT/PP 65.5%/73.1% vs. 90%/90%, p<0.0001). The compliances of all patients were more than 85%. Two of patients with levofloxacin-azithromycin combined triple therapy complained self-limiting side effects (mild dizziness; mild insomnia with general weakness). CONCLUSIONS: Levofloxacin-azithromycin combined triple therapy should not be recommended as the first-line or second-line H. pylori eradication regimen in Korea.

Relationships between serum osteoprotegerin levels and insulin resistance, cardiovascular risk factors and bone metabolism in type 2 diabetic patients / 대한내과학회지

BACKGROUND: Osteoprotegerin (OPG) is a soluble glycoprotein which inhibits osteoclastogenesis through binding to receptor activator of nuclear factor-kappaB ligand (RANKL). OPG-knockout mice develop early-onset osteoporosis and arterial calcification. Recent studies report that serum OPG levels are elevated in diabetic patients with cardiovascular disease and are associated with the presence and severity of coronary artery disease. We examined the relationships between serum OPG levels and insulin resistance, bone metabolism and cardiovascular risk factors in diabetic patients. METHODS: In 84 diabetic patients (33 men, 51 women, mean age 56.7 years old) were studied. Blood pressure, body mass index (BMI), fasting blood glucose, postprandial 2-hour blood glucose, fasting insulin and lipid profiles were measured. Serum OPG levels were measured with sandwich ELISA method. Bone mineral density (BMD)s were checked and serum osteocalcin and urine deoxypyridinoline levels were checked as bone turnover markers. 24-hour urine microalbumin were checked and left ventricular mass index (LVMI) were evaluated with echocardiography. From simple chest X-ray, the presence of aortic calcification were confirmed by a trained radiologist. Homeostatic model assessment (HOMA)-insulin resistance (IR), quantitative insulin sensitivity check index (QUICKI) were calculated as insulin resistance indices. RESULTS: Serum OPG levels were positively correlated with age, LVMI, HOMA and negatively correlated with lumbar spine BMD and QUICKI. After adjustment for age, only LVMI showed persistent correlation with serum OPG levels and when multiple regression analysis was performed with LVMI as the dependent variable, BMI and OPG were the significant predictors of LVMI (R2=0.054, p=0.012). Dividing the subjects into 3 groups according to 24-hour urine microalbumin levels, mean values for serum OPG levels increased as 24-hours urine microalbumin levels increased, but without statistical significance. Mean serum OPG levels were higher in patients with aortic calcification, without statistical significance. CONCLUSION: Serum OPG levels were positively correlated with insulin resistance indices and negatively correlated with lumbar spine BMD in diabetic patients, suggesting a compensatory mechanism to counteract bone loss progression. Serum OPG levels were independent predictor for LVMI in diabetic patients, warranting further research on OPG as the marker for future cardiovascular mortality in diabetic patients.

Comparison of insulin resistance and serum hsCRP levels according to the fasting blood glucose and blood pressure in nondiabetic and normotensive range / 대한내과학회지

BACKGROUND: Insulin resistance is a strong contributor to cardiovascular diseases. The increasing prevalence of diabetes and the subsequent complications confers a great importance to the early detection and intervention of diabetes. However, the exact roles of blood glucose and blood pressure in nondiabetic and normotensive range to vascular complications are not precisely defined. High-sensitivity C-reactive protein (hsCRP) levels have consistently been associated with various cardiovascular endpoints in a number of studies. The aim of this study was to find out whether the insulin resistance and hsCRP, a non-traditional cardiovascular risk factor, increase according to the fasting glucose and blood pressure levels in nondiabetic and normotensive individuals. METHODS: In 7,979 participants (4,847 males, 3,132 females, mean age 46 yrs) undergoing medical checkup program in Kangbuk Samsung Hospital, blood pressures, body mass index (BMI), fasting blood glucose, fasting insulin, lipid batteries and hsCRP levels were checked. All participants were subdivided into 5 groups according to fasting glucose level and into 4 groups according to the blood pressures. Homeostatic model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS: HOMA-IR and QUICKI increased according to the increment in fasting glucose and blood pressure in nondiabetic and normotensive range (p<0.01). Log (hsCRP) level significantly increased in proportion to the increment in fasting glucose and blood pressure in nondiabetic and normotensive range (p<0.01). CONCLUSION: Insulin resistance correlated with increment in the fasting glucose and blood pressure even in nondiabetic and normotensive range. Cardiovascular risk might be increased in proportion to the increment of fasting glucose and blood pressure even in the normal range. There may not be the glycemic and hypertensive threshold for the cardiovascular risk.

Development of Korean Standard Brain Templates

We developed age, gender and ethnic specific brain templates based on MR and Positron-Emission Tomography (PET) images of Korean normal volunteers. Seventy-eight normal right-handed volunteers (M/F=49/29) underwent 3D T1-weighted SPGR MR and F-18-FDG PET scans. For the generation of standard templates, an optimal target brain that has the average global hemispheric shape was selected for each gender. MR images were then spatially normalized by linear transformation to the target brains, and normalization parameters were reapplied to PET images. Subjects were subdivided into 2 groups for each gender: the young/midlife (<55 yr) and the elderly groups. Young and elderly MRI/PET templates were composed by averaging the spatially normalized images. Korean templates showed different shapes and sizes (mean length, width, and height of the brains were 16.5, 14.3 and 12.1 cm for man, and 15.6, 13.5 and 11.4 cm for woman) from the template based on Caucasian (18.3, 14.2, and 13.3 cm). MRI and PET templates developed in this study will provide the framework for more accurate stereotactic standardization and anatomical localization.

Relationship between Peripheral Leukocyte Count and the Severity of Stable Angina Determined by Coronary Angiography

BACKGROUND: Inflammation has been demonstrated to be an important risk factor for the development of cardiovascular disease (CVD). The relationship of the peripheral leukocyte count to the severity of stable angina remains to be clarified. The present study analyzed the relationship of the peripheral leukocyte count to the severity of stable angina determined by coronary angiography. METHODS: The data from 108 patients with stable angina, and 92 subjects with normal coronary angiograms were reviewed, and the role of the peripheral leukocyte count as a risk factor for stable angina evaluated. In addition, the correlation of the peripheral leukocyte count and the severity of stable angina, as assessed by the Gensini's score in the stable angina group, were analyzed. RESULTS: Age, the prevalence of hypertension and diabetes, and the fasting blood sugar were significantly higher, and the HDL was lower in the stable angina than the control group. A multivariate analysis showed that a peripheral leukocyte count over 6, 800/mm3 was an independent variable, but with no statistical significance (p=0.067), and diabetes (OR=3.02, 95% CI: 1.29~7.02) and old age (OR=3.62, 95% CI: 1.33~9.87) were independent risk factors for stable angina. A positive correlation between peripheral leukocyte count and Gensini's score was noted in the stable angina group even after adjusting for age, fasting blood sugar, blood pressure and lipid profiles (R2=0.198, p=0.015). CONCLUSION: An increased peripheral leukocyte count is considered not so much an indicator of the pathogenesis of stable angina, but as a predictor for disease progression. Furthermore, it is considered that the above correlation will be helpful in screening high-risk groups that require relatively active interventional therapy.

Association between serum osteoprotegerin levels and disease severity and cardiovascular risk factors in patients with coronary artery diseases / 대한내과학회지

BACKGROUND: Osteoprotegerin (OPG) is a glycoprotein that acts as a decoy receptor to receptor-activated RANKL (receptor-activated NF-kappa B ligand) and inhibits the differentiation of osteoclasts. OPG knock-out mice showed severe osteoporosis and aortic calcification and high serum OPG levels have been shown to predict future cardiovascular mortality in old Caucasian females. We measured serum OPG levels in coronary artery disease patients, compared serum OPG levels among different groups according to the number of stenotic vessels and observed the correlation with aortic calcification and cardiovascular risk factors. METHODS: One hundred subjects were enrolled in which coronary angiograms were performed due to chest pain in Kangbuk Samsung Hospital from April to August, 2003 (59 males, 41 females, mean age 56.9 +/- 11.9 yrs). Blood pressure, body mass index, fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol levels were measured in every subject. Cardiac echocardiograms were checked in 82 subjects and left ventricular mass indices (LV mass index) were calculated. Serum OPG levels were measured with enzyme-linked immunosorbent assay (ELISA) method. The presence of calcifications in aortic knob was checked in simple chest X-ray. RESULTS: Subjects were divided in 4 groups according to the number of stenotic vessels (significant stenosis>or=50%); 45 subjects in normal group, 30 in 1-vessel disease group, 15 in 2-vessel disease group and 10 in 3-vessel disease group. Mean value for age was significantly different among groups (p<0.01). Mean serum HDL-cholesterol level of normal group was higher than that of 1-vessel disease or 2-vessel disease group (p<0.05). Serum OPG levels increased significantly as the number of stenotic vessels increased and in post-hoc analysis, mean serum OPG levels were higher in 3-vessel disease group than normal or 1-vessel disease groups (p<0.05). Age, LV mass index and number of stenotic vessels showed significantly positive correlation with serum OPG levels, although only number of stenotic vessels showed persistently significant correlation after adjustment for age. There were no differences of serum OPG levels according to the presence of fasting hyperglycemia or aortic calcifications. CONCLUSION: Serum OPG levels increased as the number of stenotic coronary arteries increased and showed positive relationships with age, LV mass index. OPG seems to be elevated as a compensatory mechanism to the progression of atherosclerosis in humans.

The Relationship of the Hypertension, Insulin Resistance, and Metabolic Syndrome in the Serum Uric Acid Level

BACKGROUND AND OBJECTIVE: The relationship between serum uric acid and metabolic syndrome variables has not been reported in Korea. Therefore, whether the circulating levels of serum uric acid are independently related to hypertension, insulin resistance and the variables of metabolic syndrome were assessed. SUCJECTS AND METHODS: A total of 53,477 health screen examinees were enrolled and divided into four groups (Quartile 1:6.29 mg/dL) according to their serum uric acid level. The blood pressure, lipid profiles, fasting plasma glucose, waist circumference, HOMA, high sensitivity CRP and apolipoprotein were compared between the four groups. RESULTS: There was a positive association between blood pressure and the serum uric acid level (p<0.001). After adjustment for covariates the prevalence of hypertension due to uric acid was 1.192 (95% CI, 1.038-1.368 p=0.013), and 1.408 (95% CI, 1.221-1.623 p<0.001) times higher in subjects in the third and fourth uric acid level quartiles, respectively, compared to the subjects in the first quartile. Insulin resistance and metabolic syndrome variables were positively correlated with the serum uric acid level. The number of metabolic syndrome variables was also increased with an elevated serum uric acid level. CONCLUSION: Our study suggests that serum uric acid levels were independently associated with hypertension, insulin resistance and the variables of metabolic syndrome in the Korean population. Although the serum uric acid level was normal value, the risk of metabolic syndrome was increased with an elevated serum uric acid level. However, because of the cross-sectional nature of our study, these findings should be confirmed in prospective cohort studies.

Quantification of Brain Images Using Korean Standard Templates and Structural and Cytoarchitectonic Probabilistic Maps / 대한핵의학회잡지

PURPOSE: Population based structural and functional maps of the brain provide effective tools for the analysis and interpretation of complex and individually variable brain data. Brain MRI and PET standard templates and statistical probabilistic maps based on image data of Korean normal volunteers have been developed and probabilistic maps based on cytoarchitectonic data have been introduced. A quantification method using these data was developed for the objective assessment of regional intensity in the brain images. Materials and METHODS: Age, gender and ethnic specific anatomical and functional brain templates based on MR and PET images of Korean normal volunteers were developed. Korean structural probabilistic maps for 89 brain regions and cytoarchitectonic probabilistic maps for 13 Brodmann areas were transformed onto the standard templates. Brain FDG PET and SPGR MR images of normal volunteers were spatially normalized onto the template of each modality and gender. Regional uptake of radiotracers in PET and gray matter concentration in MR images were then quantified by averaging (or summing) regional intensities weighted using the probabilistic maps of brain regions. Regionally specific effects of aging on glucose metabolism in cingulate cortex were also examined. RESULTS: Quantification program could generate quantification results for single spatially normalized images per 20 seconds. Glucose metabolism change in cingulate gyrus was regionally specific: ratios of glucose metabolism in the rostral anterior cingulate vs. posterior cingulate and the caudal anterior cingulate vs. posterior cingulate were significantly decreased as the age increased. 'Rostral anterior'/ 'posterior' was decreased by 3.1% per decade of age (P< 10 (-11), r=0.81) and 'caudal anterior'/ 'posterior' was decreased by 1.7% (P< 10 (-8), r=0.72). CONCLUSION: Ethnic specific standard templates and probabilistic maps and quantification program developed in this study will be useful for the analysis of brain image of Korean people since the difference in shape of the hemispheres and the sulcal pattern of brain relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques.

Nationwide Telephone Survey on Leisure Time Physical Activity among Koreans / 한국역학회지

Epidemiologic research has demonstrated that varying grade of physical activity has protective effects on several chronic diseases, including coronary heart disease, hypertension, diabetes mellitus, osteporosis, anxiety and depression. Despite the importance of physical activity as an health promotion factor, there have been only a few research data available in Korea. This telephone interview survey on randomly sampled 1,060 adultsaged 15-69 years was carried out to find out the prevalence of self-reported leisure-time physical activity among Korean adults in terms of health promotion practice. The nationwide telephone interview survey was conducted from April through May 1997. Multistage stratified random sampling method was used for sample selection, the respondent was randomly selected from an entire group of adults who lived at the residence connected with the telephone number. A total of 1,060 adults were interviewed and the interviewees' leisure-time physical activity was categorized into four patterns: 'physically inactive', 'irregularly active', 'regularly active, not intensive', and 'regularly active, intensive'. About 53% of the respondents were physically inactive, 15% irregularly active, 14% regularly active, and only 18% were regularly active, intensive. Women were less active than men anc persons of lower socioeconomic status(SES) were less active than higher SES. Physical activity was not significantly associated with smoking status, drinking pattern and overweight, but negatively associated with daily smoking amount and total duration of smoking in smokers. Individuals with higher lever of physical activity were more likely to check blood pressure regularly and have had screening examination for stomach cancer. Conclusively, the proportion of Korean people who perform appropriate level of physical activity in terms of health promotion is still very low, thus an enforced intervention program becomes indispensable to achieve the national health goal by the year 2000.

A survey of family medicine residency training programs in Korea

No abstract available.