Association of Smoking Status and Dietary Pattern -A Data of Male Screeners at a Health Promotion Center-

BACKGROUND: Smoking greatly increases the risk of cancer, cardiovascular diseases and osteoporosis. Besides direct harm from smoking, some dietary pattern of smokers have been reported to increase such risk. This study aimed to analyze various nutrients by smoking status, and to find out whether smokers maintain harmful dietary patterns. METHODS: One thousand and six hundred fourteen men were selected who visited the health promotion center of an university hospital in Seoul. The inclusion criteria was the completion of dietary survey. Dietary analysis was done by calculation of amounts of each nutrients from 24-hour recall method. We compared total intake of each nutrients and total calories by smoking status with analysis of variance (ANOVA). Then we adjusted the results for exercise and education level by ANCOVA (analysis of covariance). RESULTS: The study subjects were 840 current smokers (52.0%), 479 ex-smokers (29.7%) and 295 non-smokers (18.3%). The consumption of total fat and cholesterol was significantly high in smokers than non-smokers (P=0.012, P=0.005). The alcohol intake was higher in smokers and ex-smokers than non-smokers (P <0.001, P=0.007). The smokers and ex-smokers had less calcium than non- smokers (P=0.001, P=0.044). Furthermore, the smokers exercised less than ex-smokers and non-smokers (P <0.001). CONCLUSIONS: The smokers consumed more total fat and cholesterol which increases the risk of cardiovascular diseases. They also had less calcium and drank more alcohol. Comprehensive approach which includes intervention for dietary intakes in addition to smoking cessation is desirable to decrease health risk for smokers.

Tele-Primary Care and Patient Satisfaction in Korea / 대한의료정보학회지

Korea has a unique feature for telemedicine, including geographical mal-distribution of medical resources, immature health care delivery and heavy traffic in metropolitan areas. As one solution for these issues, we developed a tele-primary care system and tested its feasibility and user satisfaction. The tele-primary care system is based on PC's with videoconferencing hardware. The patient PC equipped with diagnostic peripherals such as blood pressure, stethoscope, magnifying camera, and so on. There are two remote clinics and 4 homes which are connected to the telecare center through leased lines or fast internet. Three hundred ninety eight patients were seen during the period of one year and each made about 2 visits on an average. The health problems seen through tele-primary care were not different from ones in primary care clinics. Drugs were prescribed over the half of the visits and labs were used only infrequently. Most users were satisfied and felt comfortable with this new type of medicine. We found tele-primary care system would be one solution for health delivery issues in Korea.

Type of Alcoholic Beverage and High Risk Drinking for Acute Harm / 예방의학회지

OBJECTIVE: Studies have suggested that beer is associated with a high risk of mortality and morbidity. The purpose of this study was to investigate how types of alcoholic beverage are related to high risk acute harm. METHODS: Data from the 1997 Korea's Behavioral Risk Factor Surveillance System Survey, collected through telephone questionings, were analyzed based on multi-stage stratified random sampling (N=1, 045). Among those who had drunk at least one type of alcoholic beverage in the last month, one episode where the drinker had consumed the highest level of ethanol was selected, and the alcohol consumption per drinking day categorized into four risk levels of short-term, 'acute' harm, according to the WHO guidelines. Employing ordered logistic regression analyses, as the explanatory variables, types of alcoholic beverage, with and without socioeconomic characteristics, were considered. RESULTS: Spirits and soju were more than ten and three times, respectively, more likely than beer, while makkolli and wine were almost as likely as beer, to involve high risk drinking, irrespective of controlling for the socioeconomic characteristics. CONCLUSIONS: Unlike most Western countries, in Korea, beer, rather than spirits or soju, is generally less likely to be associated with high risk drinking for acute harm. The influence of beverage types on high risk drinking for acute harm appears to vary between countries.

Identification of Related Factors of Female Sexual Function in Family Medicine Outpatients

BACKGROUND: Female sexual function is influenced by much more factors than that of male and has a close relationship with psychosocial factors. A satisfying sex life has a high correlation to a happy married life. A questionnaire provides easy access to private matters and in a multidimensional manner. The objective of this study was to identify the factors related to female sexual function to help sexual adjustment in marriage. METHODS: A hundred married women living with their spouses, who visited an outpatient clinic of family medicine department of a university hospital in Seoul were studied. After filling out the self-administered questionnaire, a face-to-face interview was done on all study subjects. For multivariate analysis of the related factors, the outcome variables were a binary response of the normal female sexual cycle ?drive, lubrication, orgasm, and satisfaction. RESULTS: The multivariate analysis showed that the household income was a significant factor related to Drive (Odds Ratio: OR=0.6, 95% Confidence Interval: CI 0.4~0.9). Age was a significant factor related to Insufficient Lubrication (OR=1.1, 95% CI 1.0~1.3). Insufficient foreplay was a risk factor for Insufficient Lubrication (OR= 2.4, P=0.052). In multivariate analysis of the Orgasm related factors, the perceived health status showed an OR of 7.1 (95% CI 1.5~32.6) and both marital satisfaction and open communication showed an OR of 6.0 (95% CI 1.3~26.8) and an OR of 5.8 (95% CI 1.2~28.2), respectively. The significant related factors to Satisfaction were in order of importance of sex life, education, and open communication, with an OR of 3.6 (95% CI 1.7~7.6), 2.5 (95% CI 1.1~5.9), and 2.0 (95% CI 1.0~3.8), respectively. CONCLUSION: The positively related factors to female sexual function were good perceived health status, high marital satisfaction, placing importance in sex life, and open communication regarding sexual matters. Increasing age and household income were found to be factors adverse to female sexual function.

Association between Type and Amount of Exercise with Bone Mineral Density in Adult Women

BACKGROUND: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD. METHODS: This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA. RESULTS: The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise. CONCLUSION: The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.

The Impact of the Change of Leisure Time Physical Activities on Body Weight

BACKGROUND: The risk of overweight and obesity to health is well known. Physical activity is important in the treatment of obesity in terms of healthy body composition and maintenance of body function. This study is a follow-up study to identify the impact of changes of leisure time physical activities on body weight. METHODS: The study subjects were people who visited a health examination center in Seoul at least twice between 1995 and 2000. Seven hundred people who completed physical activity questionnaires each time they visited were included. Three hundred eighty two of them were men, and 318 were women. The questionnaire was Baecke physical activity questionnaire, consisted of items for work activities, sports activities, and non-sports leisure activities. Each index of activities was calculated. RESULTS: Ninety seven people (13.9%) reduced their weights more than 5% of initial body weights. Twenty eight people (4.0%) gained their weights more than 5% of initial body weights. In five hundred and seventy five people (82.1%) their body weights were changed within 5% of initial body weights. Non-sports leisure time indices increased greatly and were significantly more than sports indices in reduced weight group. Non-sports leisure time indices were not changed significantly in gained weight group. The dose-response relationship existed between changed body weight (kg) and difference of leisure time indices. The multivariate analysis showed that female was a significant factor related to reducing weight (odds ratio=4.5, 95% confidence interval 2.7-7.5). Increase of non-sports leisure indices showed borderline significance (odds ratio=1.4, 95% confidence interval 0.9-2.0). CONCLUSION: To increase non-sports leisure activities for the purpose of reducing body weight is actively recommendable. Such activities performed on a daily basis may have impact on reducing weight through repeatability and ease of access.

Factors Affecting Pulmonary Function in the Elderly Ex-Smokers

BACKGROUND: The elderly ex-smokers are not free from the effect of previously exposed smoking, and have a tendency to participate in health promoting behavior eagerly. This study was designed to evaluate factors that affect pulmonary function in the elderly ex-smokers. METHODS: The ex-smokers with normal chest radiological findings who visited Seoul National University Hospital Health Promotion Center were analyzed. The effect of various factors including age, height, smoking amount, and duration of smoking cessation on pulmonary function indices were analyzed with bivariate correlation analysis. Multiple regression analysis was performed using factors indentified significant in bivariate correlation tests. RESULTS: Multiple regression analyses were done for the all age group and the elderly group. Factors significantly affecting Forced vital capacity(FVC) were height,age and duration of smoking cessation for both grroups. Smoking amount was not significant. Forced expiratory volume in 1 second(FEV1) was significantly influenced by height, age, duration of smoking cessation, and smoking amount for both group. In the all age group, peak expiratory flow(PEF) was siginificantly influenced by age, regular exercise, and duration of smoking cessation. In the elderly group, PEF was significantly affected by height, age, regular exercise, and duration of smoking cessation. The factors significantly affectiong FEV1/FVC were age, smoking amount in the all age group, and regular exercise, smoking amount in the elderly group. CONCLUSION: Smoking amount was a significant factor decreasing FEV1 in the elderly ex-smoker. Duration of smoking cessation was significant in normalization of pulmonary function indices in both the all age group and the elderly group. It is inferred that smoking cessation is beneficial in reversing the adver sely affected pulmonary function indices even in the elderly.

Vitamin D and estrogen receptor gene polymorphism and their interaction associated with bone mineral density in Korean postmenopausal women / 대한내과학회지

BACKGROUND: Strong genetic components to the determination of bone mineral density (BMD) have been suggested by family and twin studies. However, association between gene polymorphism and BMD was not consistent in Korean as well as other ethnic groups. The goal of present study is to evaluate the relationship between vitamin D receptor (VDR) and/or estrogen receptor (ER) gene polymorphism and BMD after adjusting for suggested confounding factors and the possibility of VDR gene by ER gene interaction which could impact the bone mass of Korean postmenopausal women. METHODS: We determined the VDR and ER genotypes using a polymerase chain reaction based Bsm I restriction length fragment polymorphism (RFLP) and Pvu II and Xba I RFLP respectively, in a population based DNA sample of 132 Korean postmenopausal women aged 45 to 71. And then related the VDR and ER genotypes to BMD, bone related hormones, biochemical bone markers, and clinical characteristics in these women. Multiple regression analysis was used to predict variables contributing to BMD. Age, height, weight, years since menopause, VDR B genotype, and ER P and X genotypes were used as independent variables. RESULTS: There was no significant relationship of VDR or ER genotypes to lumbar or femoral neck BMD, hormones, and bone turnover markers. However, after controlling for potential confounding factors, a statistically significant ER X genotype effect on femoral neck BMD (p=0.038), but not on lumbar BMD was observed. Moreover, there was more significant effect on femoral neck BMD by an interaction of VDR B * ER X genotype (p=0.013) in multiple regression analysis. CONCLUSION: The ER X genotype was associated with femoral neck BMD in Korean postmenopausal women. This association was more significant with the VDR B genotype interaction.

Standardization of The Two-question Case-finding Instrument As A Screening Instrument for The Adolescent's Depression

BACKGROUND: The current various case-finding instruments for detecting depression in Korea are too cucumbersome and time-consuming for routine use in primary care or student and soldier groups because of too many questions. We carried out this study in order to investigate the validity of the two-question case-finding instrument for detecting depression easily in the primary care or the mentioned groups. METHODS: We selected one boy high school in Seoul and 155 sophomer students answered the questionnaire by self-report. The questionnaire included two questions about depressed mood and anhedonia: (1) "During the past month, have you often been bothered by feeling down, depressed or hopeless?" (2) "During the past month, have you often been bothered by little interest or pleasure in doing things(e.g., studying, playing or talking with friends) ?". And then a resident of family medicine interviewed them and made a diagnosis for depression using the diagnostic criteria of DSM-IV. Simultaneously we compared the test characteristics of a two-question case-finding instrument with those of a previously validated Beck Depression Inventory as a currently world-wide used screening instrument for depression. RESULTS: The prevalence of major depression as determined by the interview was 6.6%(10 of 151). The two-question case finding instrument had a Cronbach's alpha of 0.663-internal consistency, a sensitivity of 100%, a specificity of 54.6%, a positive likelihood ratio of 2.20 and a negative predictive value of 1.00.(A "yes" answer to either of the two questions was considered a positive test.) And the BDI had a sensitivity of 90%, a specificity of 68.1%, a positive likelihood ratio of 3.63 and a negative predictive value of 0.99(cut-off point=15). Area under the ROC curves of the two-question case-finding instrument was 0.882, greater than that of the BDI, 0.834. CONCLUSIONS: The test characteristics of a two-question case-finding instrument were higher compared to those of BDI for major depression. Therefore, the two-question case-finding instrument is a useful measure for detecting depression and less time-consuming in primary care and certain groups.

Spouse concordance of coronary risk factors and the effect of marriage duration

BACKGROUND: Familial aggregation of coronary risk factors is well known, which are hypertension, hyperlipidemia, diabetes mellitus, and obesity. However inter-spouse relation of the risk factors has remained controversial. As spouses are not blood-related, any risk factor relation that exist probably may not reflect genetic factors, but the environmental factors to which the couple is exposed. Moreover, the effect of assortative marriage should be considered. This study is designed to identify inter-spouse relation of coronary risk factors and to document the effects of marriage duration to spouse concordance. METHODS: From May 1995 to March. 1999, we enrolled 1,859 couples who had visited the Health Promotion Center at Seoul National University Hospital. We analysed inter-spouse correlation of body mass index, blood pressure, glucose, serum lipid factors, uric acid, smoking, alcohol drinking, and stress known as coronary risk factors. The correlation coefficients were compared according to marriage duration. RESULTS: There was statistically significant spouse concordance for all risk factors with the exception of smoking. The correlation coefficients of blood pressure, total cholesterol, and triglyceride increased with marriage duration but troughed at 30-39 years of marriage. Those of body mass index and glucose peaked at early and late marriage duration. Those of HDL-cholesterol and uric acid was relatively fixed throughout marriage. CONCLUSION: The presence of significant inter-spouse correlation for most of the coronary risk factors reflect the influence of assortative marriage and environmental factors on spouse concordance. If a spouse has many cardiovascular risk factors, partner should be evaluated for risk factors.

The Clinical study for Efficacy and Safety of Amezinium methylsulfate

BACKGROUND: Amezinium methylsulfate(Risumic) is the useful drug in the treatment of essential hypotension. This drug elevate blood pressure by stimulating sympathetic nervous system and improve symptoms related hypotension. This study was designed to evaluate efficacy and safety of Risumic for patients with essential hypotension. METHODS: This study was performed in patients with systolic blood pressure less than 100mmHg from June, 1999 to December, 1999. Risumic blood pressure response, improvement of symptom and side effect were examined in a double-blind, placebo-controlled, crossover trial. RESULTS: Total of 54 patients participated in this study and only 55.6% of them were finished and the rest of them(44.4%) was stopped. 6 patients of this patients were stopped because of side effects. But there was no difference in side effects in Risumic and placebo periods. In diastolic BP, Risumic group is 5mmHg higher than placebo group. And then there was significant difference in statistics. CONCLUSIONS: In essential hypotensive patients, Risumic is elevater DBP than SBP, side effects frequency was no significance difference in Risumic and placebo group.

Factors related with amount of stress in the elderly

BACKGROUND: Functional status is important in the elderly and stress is highly related with functional status. This study was designed to evaluate the factors related with stress amount of the elderly. METHODS: The questionnaires for stress amount and health related factors were asked to the elderly who visited Health promotion center of Seoul national university hospital before health examination. Chi square-test, analysis of covariance were constructed to explore the factors related to stress amount. RESULTS: Mean age is 65.2+/-4.0 years and the proportion of the male is 54.9%. The frequency of severe stress is 10.4%, frequency of moderate is 26.5% and frequency of mild is 63.1%. The variables related to the stress are sex, marriage status, education status, average income, exercise, smoking, alcohol, subjective health cognition, satisfaction on life, disaster and personal loss and disease (anemia, hyperthyroidism). CONCLUSION: We conclude that sociodemographic characters, family factors, health behaviors, psychologic factors and biomedical factors are all related to the stress amount.

The Factors Associated with Serum Triglyceride Level in Healthy Adults

BACKGROUND: Previously, a large epidemiological study has found that an increase in the serum triglyceride level is an independent risk factor of coronary artery disease and by treating it, the mortality due to coronary artery disease could be decreased. Our study is designed to analyze the serum triglyceride level in healthy adultg and to study various factors influencing the serum triglyceride level. METHODS: Study involved all patients who visited Seoul National University Hospital Health Promotion Center from May 1995 to Feb 1997. After a complete history and a physical examination, each participant answered a questionnaire involving sociodemographics, tobacco, alcohol, exercise, menstrual cycle and daily dietary contents. A blood chemistry was also drawn after 12 hours of fasting. We used analysis of covariance and multiple regression analysis to correlate triglyceride level with forementioned variables. RESULTS: Healthy 3,332 men and 2,986 women were statistically analyzed. The average triglyceride levels were 110.7mg/dl(geometric mean). Men at ,50's had the highest level of triglyceride. As women aged, their triglyceride increased. The proportion of participants in their 40's in men and 70's and over in women with triglyceride >200mg/d1, a value of clinical importance, was 19.0% and 18.4% respectively. The triglyceride level changed significantly according to BMI, exercise, physical fitness, alcohol, tobacco, blood pressure, uric acid and glucose. However, no statistically significant difference was found among diet thyroid function, income and region. For men, a multiple regression analysis revealed that the factors influencing triglyceride level, in decreasing order, were BMI, uric acid, tobacco, diastolic blood pressure, ALT and maximal oxygen uptake. However, for women, a similar analysis showed that BMI, systolic blood pressure, exericise, tobacco and age played a significant role(p<0.001). CONCLUSIONS: Serum triglyceride level was associated with correctable behavioral factors such as obesity, smoking, alcohol, exercise, and physical fitness. Among these factors obesity was the most related factor with triglyceride level.

A study for the development of Korean version of the Duke-UNC functional social support questionnaire

BACKGROUND: Social support is defined as interpersonal transaction ; the giving of symbolic or material aid to another. It has been shown to have both buffering effects and direct beneficial effects on diverse health related outcomes. But there has been the dearth of well-validated measurement instruments. This article describes the development of Korean version of the Duke-UNC functional social support questionnaire(DUFSS), focusing on the aspect of social support. METHODS: The 13-item, self-administered questionnaire was translated to Korean language. It was evaluated on 177 patients attending the family medicine clinic of Seoul National University Hospital during one month(November, 1996.) Comparisons to the family APGAR, COOP/ WONCA functional status chart are made to assess validity. Factor analyses are performed. Correlation of the questionnire score with the sum of family APGAR and each items of COOP/ WONCA functional chart are measured Internal consistency are evaluated. RESULTS: The questionnaire score are correlated with significantly correlated with social activity item. The total Cronbachs alpha is calculated as 0.89. The four content areas developed by factor analyses are donfidant support(items 8, 9, 10), af fective support(items 4, 5, 6, 7), instrumental support(items 3, 12) and quantity of support(item 1). These shows similarity to American study results. CONCLUSIONS: The Korean version of the Duke-UNC functional social support questionnaire has been documented as having high reliability and moderate validity. It covers two dimensions well(confidant support, affective support) with a small enough number of questions. Instrumental support may need further study.

A study on the predictors of the positive urine culture in the community hospital patients with presumptive UIT's

No abstract available.

The reliability of health risk appraisals questionnaire: in SNUH lifetime health-monitoring program

No abstract available.

A comparison of reminder models for increasing compliance forcervical cancer screening in a family practice setting

No abstract available.

Factors related to serum total cholesterol

No abstract available.

Baseline factors associated with smoking cessation

No abstract available.